Oct
10
2020

Medical Myths about Aging

Medical myths about aging are easy to debunk. Many people believe that it is inevitable that they become disabled as they age, their lives become unbearable, without passion, boring and full of pain. Some aspects of your health may decline with age, none of the myths discussed below is inevitably happening in everyone. Studies showed that a positive outlook on aging and life in general will help you to live longer and stay healthier.  Here I discuss 7 common myths about aging.

Myth 1: Everyone will experience physical deterioration

It is common for people to experience reduced muscle strength, increased blood pressure, excessive fat accumulation and osteoporosis. A study with 148 older patients showed that an expectation of reduced fitness in older age actually resulted in less physical activity when older age arrived.

But you can maintain good cardiovascular function and good muscle strength with a regular exercise program.  This study showed that men and women can reduce mortality by exercising regularly, even in older age.

Myth 2: Older adults cannot exercise

There are several reasons why older people stop exercising or are afraid to start exercising. People use the excuse of their arthritis getting worse from exercise. But studies showed the opposite: joint function improves and joint pains are getting better with exercise. Your muscles get stronger and you are less likely to fall. Your heart and lungs are improving their functions and your mentation improves. Exercise increases the HDL cholesterol, which reduces the risk for heart attacks and strokes.

Myth 3: As we age, we need less sleep

For many years there was the notion that older people need less sleep. What was not known then was that people above the age of 60 have no appreciable secretion of melatonin from the pineal gland. But when they replace their melatonin deficiency by taking a nighttime dose of 3 mg at bedtime, they will sleep better and longer. They may need a second dose of melatonin in the middle of the night. We need 7 to 8 hours of sleep at night for our diurnal hormone rhythm.

This will also slow down our aging clock.

Myth 4: Your brain slows as you age

Dementia is common when you get older. 13.9% have it at age 71 and older. 37.4% have dementia over the age of 90. But the majority, namely 86.1% in the 71+ age group and 62.6% above the age of 90 do not have dementia. A Mayo Clinic study showed that when the person engaged in artistic activities in midlife or later in life the risk for mild cognitive impairment (MCI) development was reduced by 73%, involvement in crafts reduced it by 45% and engagement in social activities by 55%. In a surprise finding the use of a computer late in life was associated with a 53% reduction in MCI development. These are very significant observations.

Physical activity reduces risk for dementia

Apart from stimulating your brain, physical activities also significantly reduce the risk for dementia. A synopsis of 11 such studies showed that dementia is reduced by 30% when physical activity is started in midlife and the person is aging compared to non-exercisers.

Myth 5: Osteoporosis occurs only in women

There is a serious misunderstanding about osteoporosis. Several factors work together that can cause osteoporosis. Women in menopause are more likely to develop it due to the missing ovarian hormones estrogen and progesterone. These hormones work together and stimulate vitamin D induced calcium deposition into bone as well as decreasing bone resorption.

Vitamin K2 also deposits calcium into the bone. In postmenopausal women who take bioidentical hormone replacement, vitamin D and K2 the bone density remains strong. Unfortunately, the opposite is true in postmenopausal women who take synthetic hormones. Synthetic hormones have side chains that do not fit the natural hormone receptors of a woman. This is why osteoporosis persist. And, yes, men get osteoporosis, but typically 10 years later. Typically, they get into andropause where testosterone production declines 10 years later.

Myth 6: People stop sex as they age

With age men can develop erectile dysfunction (ED) and women vaginal dryness, both of which can interfere with having sex. A large study showed that only 0.4% of men in the age group 18-29 had ED. In the age group of 60-69 there were 11.5% who suffered from ED. What this means though is that 88.5% of men age 60-69 did not suffer from ED. Fortunately for those who have ED drugs like Cialis and Viagra can correct their problem and they can have regular sex. What a change from 25 years ago when none of these drugs were available (approval of Viagra by FDA in 1998 and of Cialis in 2003).

Bioidentical hormone replacement beyond menopause and andropause preserves your normal sex drive as well. There are additional benefits of bioidentical hormones. They have positive effects on the heart, brain, bones and the muscle mass.

Myth 7: It is too late to stop smoking now

One of the myths that many older smokers like to say is that it would be too late to stop smoking. They think the damage to heart and lungs is permanent and quitting now is too late. Fact is that quitting smoking immediately improves your blood circulation and gives you more oxygen. In just 1 year the risk of getting a heart attack is cut into half. In 10 years, the risk of a heart attack or stroke is the same as that of non-smokers. There is a reduction of getting lung cancer by half.

Medical Myths About Aging

Medical Myths about Aging

Conclusion

There are all kinds of medical myths about aging. We may think that physical deterioration is inevitable. Or we believe that older people cannot exercise. And we cannot help it, but our brain slows down as we get older. And there is the question whether we need less sleep as we age. Osteoporosis is a disease of women, is it not? These older couples, they don’t have sex any more, do they? And is it too late to stop smoking now that I am 65 years old? All of these myths exist, but there is a need to debunk them.

The truth behind the medical myths about aging

I explained in detail what the medical truths are behind these questions. Many of these myths have developed in the past. But with regular exercise, balanced nutrition (Mediterranean diet) and a positive attitude much of these old myths can be overcome. Bioidentical hormone replacement when hormones are missing is another powerful tool. Yes, we all age. But we are still living and can enjoy life as long as it lasts.

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Jun
20
2020

Chronic Inflammation Can Cause Many Diseases

We knew since the mid 1990’s that chronic inflammation can cause many diseases. Among these are cancer, hardening of the arteries (atherosclerosis), arthritis, dementia (Alzheimer’s disease), frailty and other degenerative disorders. LifeExtension reviewed this topic in 2019.

Older people often accumulate chronic inflammation, which associates with the aging process. Persistent pain is one of the symptoms that chronic inflammation can cause.

Doctors use tests like the C-reactive protein, hemoglobin A1C, homocysteine and the erythrocyte sedimentation rate to measure chronic inflammation.

When the doctor diagnoses chronic inflammation, it is important to find ways to inhibit it and finally resolve it. Curcumin, ginger and non-steroidal anti-inflammatories are examples of measures that help inhibit inflammation. But it is only lately that scientists have found specialized pro-resolving mediators (SPM) that help to resolve chronic inflammation. They are polyunsaturated fatty acids, which health food stores offer as supplements.

Specialized pro-resolving mediators (SPM)

Researchers isolated several pro-resolving mediators that are metabolites of omega-3 fatty acids. This link discusses an experiment where researchers obtained synovial fluid from arthritis patients who took omega-3 fatty acids. They compared this to synovial fluid from volunteers who also took omega-3 fatty acid supplements. Within 4 weeks there was a big difference for the arthritis patients with higher levels of E- and D-series SPMs in synovial fluid and plasma. Dr. Silverman reviewed the action of SPMs here. He points out that they can be taken as supplements and that they are safe, because they do not have any side effects. Conditions such as asthma, irritable bowel syndrome and various musculoskeletal conditions with chronic inflammation respond very well to SPM supplements. Omega-3 fatty acid supplements (EPA) metabolize into the E-series resolvins.  On the other hand, Krill oil with Docosahexaenoic acid (DHA) metabolizes into protectins, maresins and the D-series resolvins.

Three vital tasks of pro-resolving mediators

SPMs fulfill three vital tasks, called remove, restore and renew.  First, they activate macrophages, which remove dead cells and cellular debris as a result of chronic inflammation. Second, they restore the healthy balance of inflammatory compounds and anti-inflammatory substances. Third, SPMs help renew tissues that were damaged by chronic inflammation.

Some examples where SPM’s were helpful resolving inflammation in health conditions

  • Alzheimer’s disease patients had reduced SPMs in cerebrospinal fluid of living patients and in the hippocampus of corpses who had Alzheimer’s disease.
  • A research group showed that defective SPM resolution can be responsible for missing resolution of atheromatous plaques in arteries. This leads to more and more hardening of arteries until a heart attack or stroke occurs.
  • With obesity or metabolic syndrome insulin resistance develops. Researchers found that certain SPM’s are missing in obesity, which causes chronic inflammation. However, they also found that precursors of SPMs such as 17-hydroxydocosahexaenoic acid (17-HDHA) can serve as a novel treatment agent to treat obesity-related complications.

Newer studies about SPMs

  • 62 patients with knee osteoarthritis had the precursor of resolvins, 17-HDHA tested in the blood. Compared to controls with no arthritis the 17-HDHA level in the arthritis patients was low. When levels of 17-HDHA were high, there was no pain in osteoarthritis patients.
  • Chronic periodontitis is a chronic inflammatory condition in the mouth. In a rabbit model this condition was cured with resolvin E1 derived from omega-3 fatty acids.
  • Delayed wound healing is typical for type 2 diabetes. In a mouse model with diabetic mice researchers inflicted skin wounds on mice. Subsequently they showed that with resolvins mice wounds healed much faster than in control mice.
  • Chronic kidney failure, liver impairment, diabetes, obesity and coronary heart disease showed abnormalities in the SPM system in humans. Potentially they will be healed with the help of resolvins or their precursors, which includes the omega-3 fatty acids EPA and DHA.
Chronic Inflammation Can Cause Many Diseases

Chronic Inflammation Can Cause Many Diseases

Conclusion

New compounds have been detected that derive from the omega-3 fatty acids EPA and DHA. They have the name specialized pro-resolving mediators (SPM). Included are the resolvins D1 and D2, the resolvins E1, E2 and E3 as well as the precursors 18-hydroxyeicosapentaenoic acid (18-HEPE) and 17-hydroxydocosahexaenoic acid (17-HDHA). The function of these compounds is to stimulate macrophages to clean up areas of chronic inflammation and remove cell debris and injured cells that cannot survive. While anti-inflammatories like ginger and curcumin only tone down the inflammation, SPMs help to resolve chronic inflammation. Various chronic clinical conditions were identified as being due to chronic inflammation. Chronic kidney failure, liver impairment, diabetes, obesity and coronary heart disease showed abnormalities in the SPM system. We may soon see alternative approaches treating these conditions with specialized pro-resolving mediators.

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Feb
01
2020

About the Opioid Epidemic

Dr. Anna Lembke gave a talk about the opioid epidemic on Dec. 13, 2019. This was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019. The full title of her presentation was “From Freud to Fentanyl: Update on the Opioid Epidemic.” Dr. Lembke is an associate professor at the Stanford University School of Medicine. From 1999 to 2010 opioid sales went up 6-fold. Opioid treatment admissions and opioid deaths have risen 5-fold in the same time period. Physicians prescribe too many opioid pills. One slide summarized how patients got opioid pills. 53% had pain pills given by friends for free or bought opioids from them. 37.5% received pain pills from a doctor by prescription. 6% bought pain pills from a drug dealer or a stranger. In about 3.4% it was not traceable how the persons using drugs obtained them.

Compassionate doctor and drug-seeking patient

The doctor went through medical school wanting to care about patients. Compassion to help is a powerful motivating force. On the other hand, most patients are glad that the physician wants to help and they do their part to contribute to healing. Except, there is a small percentage of patients who take advantage of a soft-hearted physician. They will demand prescriptions, even if they are not in pain. They may do this to sell the drugs to get some extra income. Others take more pills than what the doctor  prescribed, because they want to get high on the drugs. Patients who have an addiction to pain pills, have a process in their brain, called neuroadaptation. Whenever the dosage in the blood goes down, they are now adapted to taking more pills.

About the opioid epidemic and the role of Big Pharma

Pharmaceutical marketing spent more than 26 billion USD in 2012. This consisted of drug representatives visiting doctor’s offices and giving hand-outs of free samples to physicians. There were promotional mailings, advertisements, direct-to-consumer advertising and educational and promotional meetings. In addition, pharmaceutical marketing included sponsoring clinical trials. In 1980 there was still an opinion that pain drugs would be harmless and in the majority of cases would not be the cause for abuse.

Purdue Pharma, the producer of the pain pill OxyContin, was caught in secretly pushing the sales of OxyContin in order to sell more of their drug suboxone, which helps with drug withdrawal.

A law suit against Purdue Pharma brought the  “project Tango” to light.

Three myths about drug addiction

Myth #1: Opioids work for chronic pain

The pain pill producers have been pushing for the concept that pain pills would work for chronic pain. However, clinical studies showed that pain pills will only work for acute pain and when it becomes chronic pain, pills against pain become less reliable. People who take pain pills for chronic pain enter into a vicious cycle. They need to take more pain pills to experience relief from pain. But they often do not realize that the drug withdrawal pain is what gets them into seeking more drugs.

Purdue stated this:“We now know that many patients with chronic, non-malignant pain respond very well to opioids. The barriers to vastly improved treatment for hundreds of thousands of people in pain, are simply the misinformation and prejudice of doctors, pharmacists and regulatory bodies.” Purdue Physicians’ Pain Management Speaker Training Program, April 1997

Myth #2: When it comes to opioids, no dose is too high and no duration is too long

This reflects what Purdue says to increase its pain medication sales.“Opioids are effective, easily titrated, and have a favorable benefit-to-risk ratio. Large doses of opioids may be necessary to control pain if it is severe, and extended courses may be necessary if the pain is chronic.” Purdue Physicians’ Pain Management Speaker Training Program, April 1997

Evidence from unbiased researchers show that opioids taken in high doses and taken over long periods of time harm patients.

Patients develop cardiac arrhythmias, depression and may commit suicide. Other symptoms are  constipation, addiction, cognitive impairment, hormonal imbalances and  death. In addition, opioids can cause an annoying skin hypersensitivity.

Research further showed that gradual opioid withdrawal improves chronic pain (2017 study by Frank et al.)

Myth # 3: Less than 1% will get addicted to pain pills

Purdue stated:
“Contrary to our teaching, addiction is very rare and possibly nonexistent as a result of treating such patients with opioids.” Purdue Physicians’ Pain Management Speaker Training Program, April 1997

Here is the truth: A meta-analysis of 38 studies showed that people abused pain pills on average between 21 and 29%. Addiction rates were between 8% and 12%. These figures likely are under estimates. The authors said that the real figure of opioid abuse is likely about 40%.

Poor people treated differently

Poor people on Medicaid in the US receive twice the rate of opioids as do non-Medicaid patients. But Medicaid patients die at 6-times the rate from prescription overdoses. Often patients receive a prescription for pain pills and also a prescription for benzodiazepines. The doctor prescribes benzodiazepines for sleep problems or anxiety. Drug interactions of two potentially addicting drugs likely are more detrimental on the long-term.

Examples of a doctor’s visit (YouTube display)

Dr. Lembke played a YouTube video where she was role-playing her previous behavior as a supportive physician who prescribed opioids to patients (drug-seeking patient and supportive physician).

However, she said that she learnt from experience. In the meantime, when she finds out from a computer program that a patient is deceiving her, she behaves differently (doctor non-supportive towards a doctor-shopping drug addict).

About the Opioid Epidemic

About the Opioid Epidemic

Conclusion about the opioid epidemic 

The topic of opioid addiction is multifaceted. I summarized a lecture presented at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019 by Dr. Lembke. She talked about the opioid epidemic and the difficulties keeping the science of opioids separated from the marketing by Big Pharma. Three myths of Big Pharma were analyzed and on every occasion the truth was the opposite of the myth. Chronic pain does not respond to opioids, yet many physicians keep on prescribing these drugs. Medicaid does not help poor patients. They get twice the opioid prescriptions as non-Medicaid patients get. But Medicaid patients die at 6-times the rate from prescription overdoses. There are many unanswered questions regarding opioids. Hopefully, more judicious prescribing by physicians and alternative ways of treating pain by chiropractors, physiotherapist and acupuncturists will gradually improve the situation.

Oct
26
2019

Steroid Injections Are Doing Harm, But Stem Cells Help

When a person has osteoarthritis, steroid injections are doing harm, but stem cells help. A new study published in the journal “Radiology” came to the conclusion that steroid injections are doing harm.

The article was published on October 15, 2019. 459 patients with osteoarthritis of knees or hips received injections with intraarticular corticosteroids or placebo to conduct this study. As a matter of fact steroid injections are a standard treatment for moderate to severe osteoarthritis. The injections consisted of triamcinolone 40 mg mixed with a local anesthetic. 36 of these patients (8%) had adverse events in their joints.

Here is the break down of these negative events following intraarticular corticosteroid injections.

  • Accelerated osteoarthritis progression (6%)
  • Subchondral insufficiency fracture (0.9%)
  • Osteonecrosis (0.7%)
  • Rapid joint destruction with bone loss (0.7%)

Critical analysis of effects of intraarticular corticosteroid injections

The authors reviewed the literature and came across an evidence-based review by the Cochrane Musculoskeletal Group involving 1767 participants. The review showed an overall low evidence for all outcomes. Intraarticular corticosteroid injections were inconsistent and variations between trials were high. Certainly, there was a moderate improvement of joint pain, and physical joint function improved as well.

But then again more severe osteoarthritis in knee or hip joints showed a lack of improvement and in many cases even joint deterioration. With this in mind, these cases often ended up with total hip or total knee replacements. Overall the Cochrane review showed a lack of objective evidence of symptom improvement after intraarticular corticosteroid injections in people with osteoarthritis.

Mesenchymal stem cell injections for osteoarthritis

A fairly recent alternative approach to treating osteoarthritis is by mesenchymal stem cell injection with platelet-rich plasma activation. Researchers conducted a meta-analysis of 35 studies regarding knee osteoarthritis and mesenchymal stem cell injections in 2018. There were minor adverse events like knee pain and swelling. No serious side effects of the stem cell treatments were noted. The outcome of the treatment was classified as “very low” to “low”. The reason for this were poor study designs, large heterogeneity among the studies and wide variation among the 95% confidence intervals regarding study outcomes.

Australian study of mesenchymal stem cell injections into symptomatic knees

A short-term study from Australia examined 30 patients with mesenchymal stem cell therapy for knee osteoarthritis. There were two treatment groups. One group received 100 million adipose tissue derived mesenchymal stem cells into symptomatic osteoarthritis knee joints. Another treatment group received 100 million mesenchymal stem cells twice, namely at baseline and at 6 months after the first injection. The third group served as a control with continued conservative management. All of the groups had baseline MRI scans (magnetic resonance imaging) to assess the knee conditions. Both treatment groups had pain and inflammation at baseline. After 1 year following the initial treatment the patients had repeat MRI scans. They showed modification of the disease process in the treatment arm, while the controls had deteriorating osteoarthritis. The researchers concluded that adipose derived mesenchymal stem cell treatment of knee osteoarthritis has the potential of preventing disease progression.

Why stem cells help with osteoarthritis of the knees and the hips

Here is a research project between researchers from Palm Harbor, Florida and researchers from Serbia. The Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences University of Kragujevac, Serbia reviewed the literature on treatment of osteoarthritis.

The researchers explain that the physician can easily harvest mesenchymal stem cells by doing a liposuction of fat cells. These stem cells maintain their differentiation potential and there is only minor immunological rejection because of low histocompatibility antigen expression. As a result mesenchymal stem cells stay in the joint where they are injected.

Two processes that occur with injected stem cells

Two main advantages of mesenchymal stem cells stand out. Mesenchymal stem cells are capable of building up hyaline cartilage and in addition they have immunosuppressive characteristics. In comparison with controls patients who receive intraarticular injections of mesenteric stem cells have less pain and less swelling.

This review paper cites all the major animal and human studies regarding mesenchymal stem cell therapy for osteoarthritis. It concludes that stem cell therapy is most effective in mild to moderate osteoarthritis cases. It stresses the point that stem cells can regenerate joint tissues and that the inflammatory process of osteoarthritis is interrupted by the stem cells. This stabilized the osteoarthritic condition.

Steroid Injections Are Doing Harm, But Stem Cells Help

Steroid Injections Are Doing Harm, But Stem Cells Help

Conclusion

Mesenchymal stem cells derived from fatty tissue will repair tissue defects in joints afflicted by osteoarthritis. The stem cells also take care of the inflammation, which takes care of pain and swelling. Range of motion of the joint increases following stem cell treatment. Other studies have shown that intraarticular steroid injections do not interrupt the degenerative process. MRI scan studies have shown deterioration of the joint tissues following steroid injections. All in all, stem cell treatments of joints with osteoarthritis are superior to a treatment with steroid injections.

Aug
10
2019

Fasting Mimicking Diet For 5 Days Every Month

In December 2017 I heard Dr. Longo speak at a medical conference in Las Vegas. He suggested the use of the fasting mimicking diet for 5 days every month. I am getting into the age group where a little help from nature would not harm (I am 74 years old). I started immediately in December 2017 to do a fasting mimicking diet (FMD) for 5 days.

Effects of fasting mimicking diet

In the beginning you just notice that you are not as hungry as you thought you would be, because you do take in three mini meals of about 200 calories each, which curbs your appetite. It is also important to consume enough liquids. Please note: liquids! Not liquor! Wine, beer or any alcoholic drinks are not part of the diet. You can drink water, but, this may get boring, and you can take water with lemon, herbal teas, black tea and coffee, as long as you stay away from sugar-laced drinks.

How the FMD works

Your total calorie intake will amount to no more than 600 calories per day for the 5 days where you do the fasting mimicking diet. Your body mass index (BMI) decreases between 0.1 and 0.4 per day to a total of 0.5 to 0.9 for the 5 days. This does not seem much, but if it is accumulating every month, a person who is obese now could have a normal weight within one year. The first day of this fast may present some challenges. I found that in the afternoon I felt hungry. What helped was a hot drink( tea, coffee, clear broth). Day two was better, and from day three it has become a routine. There are  no ferocious hunger pangs, no headaches or feelings of weakness or tiredness. I am always surprised that my energy level is improving when I do the fasting mimicking diet for 5 days every month.Dr. Longo suggests not to exercise during the fast. It is obvious that this time is not suitable for half- marathons or taxing hikes, but I found that thirty minutes of aerobics and thirty minutes of weight training felt good. Listen to your body! If you feel lightheaded at any time, stop! The emphasis is on “moderate”.

Dr. Longo noticed the following findings in a mouse model as well as on humans. I summarized this before in a previous blog:

Specific results when on the fasting mimicking diet for 5 days every month

  • Obesity diminishes, because of the weight loss effect due to missing calories.
  • Diabetes: insulin resistance becomes lower and blood sugar levels drop.
  • High blood pressure reduced: many patients were able to reduce their medications or discontinue them
  • Pain conditions improve as all kinds of pain disappears, an effect for which there is no explanation at this point
  • Autoimmune diseases like MS and rheumatoid arthritis improve, likely because of the effect of increased stem cell circulation
  • Prevention of heart attacks and strokes because of reduction of LDL, triglycerides and CRP
  • Cancer cure rates improve by protecting normal cells, the bone marrow and stimulating the immune cells
  • Longevity improved in mice with a 3-fold increase of their life span. Telomere length in humans was increased. Increased stem cells will find defective areas that need repair. This effect leads to less disease in older age.

Meal samples of fasting mimicking diet

Dr. Longo developed a kit containing all pre-packaged foods for 5 days under the name “ProLon Fasting Mimicking Diet”. The package is not larger than a shoebox, and the diet is plant-based, has some nutrition bars, drinks as well as freeze-dried soups. You can argue about the nutritional value, as it has an average rating of 3.5 out of 5. It also comes in at a hefty price of 300.00 USD. In reality it is a matter of calorie-math to consume very little food. There are plenty of tables available on the Internet that tell you the nutritional value of foods, and it does not take much effort to compose your own menu.

Here is a fairly typical list of foods

Breakfast: A typical breakfast consists of 2 slices of rye crisp bread (Wasa or Ryvita) with a bit of almond butter on it, a cup of coffee and either black or with stevia and milk.

Lunch: 8 oz. of tomato soup and coffee or tea.

Dinner: A tossed salad with organic bell peppers, ½ tomato, and two thin slices of avocado, vinegar and 1 tablespoon of olive oil.

Here is an alternative meal sample:

Breakfast: Eat a nutrition bar that is based on nuts. It should not be more than 250 calories. Alternatively make your own! Have tea or coffee.

Lunch: 8 oz. of homemade vegetable soup without the addition of pasta or beans.

Dinner: Miso soup and 4 rice crackers, alternatively a small tossed salad with olive oil and vinegar.

Results of fasting mimicking diet for 5 days every month

Here are typical results that I found over several months. I am using body composition scales every day to measure my weight, body fat percentage, visceral fat percentage, muscle percentage, calories burnt and the BMI.

One month the BMI went from 21.9 to 21.1 during a 5-day FMD. Another month the BMI experienced a reduction from 21.7 to 21. 2. Here is a list of the some of the 5-day losses of my BMI on a couple of occasions: 0.8, 0.4, 0.9, 0.7, 0.6, 0.5, 0.7 and so on.

It is important that you are not going on an eating binge after those five days. The FMD conditioned your body to be content with very small amounts of food. Enjoy your food, but stick to moderate portions.

Discussion of fasting mimicking diet for 5 days every month

An intermittent fasting mimicking diet was shown to have a diversified positive health effect in both animal models and humans. For instance, inflammatory bowel disease improves on FMD by improving the bowel microbiota and by promoting the intestinal regeneration.

Intermittent fasting, as this article shows, can prevent age-associated diseases.

This article suggests that T-killer cells that attack cancers are promoted by the intermittent fasting mimicking diet.

A FMD in type 1 diabetic patients has been shown to restore insulin generation in islets of the pancreas of these patients. The result was an improvement of their type 1 diabetes.

More research data on fasting mimicking diet

A clinical trial with 100 subjects was undertaken by Dr. Longo and his research team. He measured markers after 3 cycles of a fasting mimicking diet for 5 days every month. They found that the FMD reduced aging markers, improved diabetes and reduced susceptibility for cancer and cardiovascular disease. In another publication Dr. Longo and co-authors describe how autoimmune diseases can be improved by the use the fasting mimicking diet for 5 days every month.

Another publication by Dr. Longo describes that “age-related disorders including diabetes, cardiovascular disease, cancers and neurological disorders such as Alzheimer’s disease, Parkinson’s disease and stroke” can be prevented by fasting mimicking diet for 5 days every month.

Even cancer prevention and cancer treatment can be helped by the fasting mimicking diet.  The FMD makes chemotherapy more tolerable.

Fasting Mimicking Diet For 5 Days Every Month

Fasting Mimicking Diet For 5 Days Every Month

Conclusion

I have shown that with the fasting mimicking diet (FMD) done for 5 days in every month you can lower your body mass index (BMI) by 0.4 to 0.9 units. On the long-term this helps you to keep your BMI stable and in the 21.0 to 22.0 range. Dr. Longo has researched the effect of the FMD in both mice and humans. He found that you age better with less age-related diseases. In addition, inflammatory bowel disease, autoimmune diseases like MS, rheumatoid arthritis and type-1 diabetes improve. Cancer patients who need chemotherapy tolerate it better. Their immune system also produces more killer T cells that destroy cancer cells. The FMD prevents heart attacks, strokes and cancer. Dr. Longo also has shown that there is stimulation of stem cell production and telomeres are increasing in length. Telomeres are important for longevity, which allows you to age healthier with less disease.

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Feb
18
2018

Causes Of Back Pain And Their Treatment

There are many possible causes of back pain and their treatment is described in this blog. I have listed the 10 most common causes of back pain below. I also added brief therapeutic suggestions.

Facet joint disease (lower back strain)

When there is a misalignment of the facet joints, the joint capsules of these small joints are pulled, which can cause severe back pain. Chiropractic or physiotherapy treatments initially followed by active exercises will help (facet joint pain).

Degenerative disc and facet joint disease

Degenerative changes of the disc material between vertebral bodies and osteoarthritis of the facet joints can cause back pain. This is due to irritation of the nerve roots. Anti-inflammatory medication and physiotherapy treatments often help; swimming will be beneficial as well. End stage intractable disease, if confined to one or two levels, may respond to fusion surgery by a spinal surgeon. While you research the surgical option, I suggest you investigate about the possibility of stem cell therapy with PRP (platelet rich plasma). This is less invasive and will likely heal better than conventional surgery.

Spondyloarthropathies

This is a family of chronic inflammatory joint diseases of the spine . The physician treats the underlying disease and uses anti-inflammatories to control inflammation. Most of all, a person with this condition needs a referral to a rheumatologist for more specific therapy.

Osteoporosis

Osteoporosis is a bone condition that can lead to compression fractures of the spine. These in turn can irritate one of the nerve roots to lea to radiating pain into one or both legs. The physician will treat the underlying hormone disbalance, if present. Regular walking and swimming are used to remobilize. Avoid alcohol, caffeine and stop smoking. Supplements like calcium, bisphosphonates, vitamin D in higher doses and vitamin K2 can help re-calcify the bone.

Scoliosis

Scoliosis is often congenital. This spinal curvature leads to back pain and hurts more the more the spine is curved. Treatment: bracing during growth spurts; good posture; strengthening exercises; in severe cases corrective surgery by a spinal surgeon through the use of Harrington rods.

Spinal stenosis

Spinal stenosis is often the end condition of severe degenerative arthritis of the spine. It is more common in the older generation. As this link explains, there is a narrowing of the channel through which the spinal cord travels. In the past decompression surgery for severe cases was the only means to free spinal cord and nerve roots. In the last few years stem cell therapy is a new addition as an alternative to orthopedic surgery. The advantage of stem cell therapy is that there is no scarring following the procedure and the stem cells function like a biological knife from inside.

 Posttraumatic fibromyalgia

Some people develop lower back pain following traumatic injuries. Instead of resolving their muscle sprain, they end up with chronic pain. Often low dose antidepressants and cognitive therapy will help. Mild physical exercises may help to rehabilitate the patient and return to normal muscle mobility. Unconventional therapy like prolotherapy, dry-needling and low-dose laser therapy (Dr. Weber) may be useful.

Disc herniation with or without sciatica

With disc herniation the back pain is intense, which often prompts the orthopedic surgeon to do an early discectomy (back surgery). But long term studies have shown that only in 3% of all acute back pain cases surgery is necessary; many cases heal on their own. In this case the new regenerative medicine approach of stem cell therapy with PRP will give superb clinical results. Stem cells will rebuild the disc and also take care of any arthritis in the small joint along the spine.

Spondylolisthesis and other congenital malformations

There are 4 grades of slipped vertebral body diseases (spondylolisthesis), where grade IV is the most severe case. Grade I to IIIA do not need surgery, stage IIIB and IV need fusion with instrumentation by a spinal surgeon.

Bone metastases

In stage 4 of many cancers metastases travel through the whole body including the skeleton. The underlying cancer needs treatment, often chemotherapy is required. Unfortunately cancers with bone metastases have a very poor prognosis. Here is a link how to manage symptoms of bone metastases.

Causes Of Back Pain And Their Treatment

Causes Of Back Pain And Their Treatment

Conclusion

I have listed the ten most common ones of back pain. For muscle spasms, simple physiotherapy or chiropractic treatment are often very helpful. Early degenerative changes in joints and discs will often respond to anti-inflammatory medication. But anti inflammatory drugs can be hard on your liver and your kidneys. If your back pain is getting more chronic, your doctor may want to arrange for an MRI scan of the area that causes pain. If this shows degenerative change in the discs and facet joints it is time to contact a regenerative medicine clinic. They specialize in stem cell and platelet rich plasma (PRP) treatments. This may be what you need to restore your back to normal. Conventional surgical methods are often the choice, but they are not always successful. Surgery can leave scarring behind, which by itself can give you chronic back pain.

Feb
03
2018

Drugs Are Not An Escape

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

Pain receptors

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

Pain receptor resistance

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

Insulin resistance

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

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

Therapeutic index

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

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

The danger of Fentanyl

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

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

What drugs do to your brain

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

Big Pharma and opioid drugs

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

Penalty for misrepresentation of OxyContin

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

Alternative treatment of pain

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

Other applications for electroacupuncture

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

Prolotherapy

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

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

Stem cell therapy with PRP and low-dose laser therapy

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

Low dose laser activation of stem cells and PRP

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

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

Curative treatment versus symptomatic treatment

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

Drugs Are Not An Escape

Drugs Are Not An Escape

Conclusion

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

Stem cell therapy

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

Reference 1: George A. Ulett, M.D., Ph.D. and SongPing Han, B.M., Ph.D.: “The Biology of Acupuncture”, copyright 2002, Warren H. Green Inc., Saint Louis, Missouri, 63132 USA

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

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

Dec
09
2017

Stem Cells Cure Back Pain

A person with chronic back pain has several treatment options, but only stem cells cure back pain. Stem cell treatment has been available in the US and Canada and many other countries for approximately 10 years.

I come from a family with a strong history of back pain (mother, maternal grandmother and maternal grandfather). They all got their back pain in their mid to late 40’s. From my growing up years I remember that they complained about chronic back pain on and off. Sometimes they had to cancel events they wanted to attend because they could not tolerate sitting. In those times there were no CAT scans or MRI scans. If you had back pain, you just had to put up with it.

My personal experience

Given my family history of back pain I was surprised that my back pain was only a more persistent problem in the last 1.5 years, but not earlier. Normally a monthly chiropractic adjustment would keep my back symptoms under control. But in the last 1.5 years I needed to see a chiropractor more often than that. I took omega-3 fatty acid supplements for the past several years (two capsules twice per day) thinking that this should halt the development of degenerative arthritis in the lower back joints. When I turned 71, it was clear to me that I was now at the point where my immediate relatives were when they were in their late 40’s. Therefore, diet, exercise, weight loss, good nutrition and supplements can only do that much for you. If there is a familiar disposition, it will eventually catch up with you.

Conventional medicine’s approach to lower back pain

I have practiced as a general practitioner for 16 years in the past. In addition I joined Workers’ Compensation for another 16 years as a medical advisor. From this clinical activity I knew of hundreds of cases first hand what the steps were in the treatment of chronic back pain. First of all, physiotherapy treatments or chiropractic treatments were the treatment protocol. In minor back pain cases this would often help the pain symptoms. Furthermore, if residual pain persisted, the patients received anti-inflammatory medication (non-steroidal anti-inflammatory drugs or NSAID’s). Finally, if symptoms continued to persist, a CT scan or MRI scan was necessary for assessment. If it showed moderate changes like my findings, the patient received intermittent physical therapy, chiropractic therapy or acupuncture therapy. 

Surgical procedures for chronic lower back pain

If there were more severe degenerative changes or spinal stenosis with severe degenerative changes, a referral to an orthopedic surgeon or neurosurgeon would be necessary. But this was often the point of no return. If the surgeon felt that the condition was severe enough to do back surgery, various procedures could follow. For disc herniations irritating one of the nerve roots, laparoscopic discectomy was the treatment of choice. For severe spinal stenosis or intractable pain from end stage facet joint disease instrumentation was an option.

Fusion surgery

Under a general anesthetic the surgeon makes an incision in the patient’s back over the lumbar spine. The surgeon identifies the diseased disc level and places stabilizing stainless steel plates over the affected facet joints or the narrowed disc space. Many people think that fusion surgery would be the end of their trouble. In many cases this can actually be the beginning of chronic back trouble. The problem is that the body is designed to move. If the surgeon takes movement away in one area of the spine, the levels above and below have to work harder. It often takes only a few months or a couple of years, and the patient is back with excruciating pain from degenerative changes in the levels above and below the previous surgery. What does the surgeon usually do? He does more fusion surgery above and/or below the previous area of surgery.

Alternatives to back surgeries

New treatment options have opened up new possibilities. On the one hand there is prolotherapy treatment that I have described under this link. On the other hand stem cell therapy is another popular regenerative technique. Prolotherapy strengthens tissues, relieves pain and increases the range of motion in joints. There is 80 to 85% full pain relief and more than 80% improvement in range of motion. Prolotherapy promotes the healing of torn ligaments and tendons. There are many suitable conditions that lend themselves to the treatment with prolotherapy like the hip, knee, shoulder, ankle, neck, lower back and elbow. With prolotherapy the physician uses hyperosmolar dextrose injections into the affected area. Current thinking is that this irritates the tissues, which mobilizes local stem cells to heal the area.

In my case I had two prolotherapy treatments of my lower back, but it did not change my lower back pain.

MRI scans of my lumbar spine

We needed to find out what was happening in my lower back. My general practitioner ordered MRI scans of my lower back in summer of 2017. There are 5 levels of the lumbar spine from L1 to S1. In my case one level of 5 was normal. The other levels showed bulging of the discs. The scans also showed signs of arthritis in the small joints adjacent to the spine. Lucky for me, there was no sign of spinal stenosis. It was not good news: overall 4 levels of my lumbar spine showed signs of  degenerative disc changes. At the same levels I also had arthritic changes in the facet joints. This was enough to consider some intervention, or I would be headed for trouble in the future.

Stem cell treatment for chronic back pain

Following the failed prolotherapy for my lower back pain I needed to figure out what to do next. The MRI scans had shown degenerative changes in the discs of the lower 4 levels of the lumbar spine. There also was arthritis in eight facet joints (two on each side of each of the four L2 to S1 levels). Conventional medicine would have offered corticosteroid injections into the facet joint areas. My experience with many patients who had this procedure was that the effect of the corticosteroid injections wore off after 3 to 6 months. If a patient had more than 3  injections, there usually was a point of no return, and fusion surgery would be next.

Best therapy for my own chronic lower back condition

For me there was no question that stem cell therapy would be the best fit for treating my back condition. In addition platelet -rich plasma and low-level laser therapy could activate the stem cells. This would be the ideal non-invasive treatment option to treat my chronic lower back pain. I had met Dr. H. Michael Weber before. He is a well-known laser expert from Germany who has a double certification as an engineer and as an internist treating various clinical conditions with laser and stem cell therapy. In addition he is an expert of regenerative medicine methods. Also, he invented and designed the laser machines himself. I set up an appointment in the fall of 2017 at his clinic in Lauenförde, Germany.

First day of stem cell treatment

On the first day fat tissue was removed under a local anesthetic from my lower left buttock area. Next a cell separator divides the tissue into connective tissue, fat cells and mesenchymal stem cells. Two blood samples were also taken from me for processing platelet rich plasma (PRP). PRP is a natural stem cell activator. Growth factors and anti-inflammatory cytokines were also part of the mix together with the stem cells.

The very same afternoon I received the stem cell mix by injection. Eight needles, four on each side, were necessary to administer the stem cell combination. I also had a treatment on a light therapy bed with red light to activate stem cells in general. The stem cell injection was a pain free procedure, as I received a shot of a  local anesthetic in the area before. After that the physician inserted laser applicators through the interstitial needles.

Laser activation of injected stem cells

The next step was to use laser treatments with 5 different colors (infrared, blue, red, yellow and green) for 10 minutes for each of the 8 interstitial needles. The laser activation and the PRP mixed with the mesenchymal stem cells were the two main stem cell activators. They are crucial for activating the stem cells. But growth factors and anti-inflammatory cytokines also aided stem cell activation.

Second day of stem cell treatment

On the second day I received an infrared light treatment over my back for 20 minutes. Following that I received light therapy bed treatment for 20 minutes. The physician told me  that all of this was to activate the stem cells further. The next step was a bone marrow low-dose laser therapy.

Bone marrow stem cell activation by low-dose laser therapy

Often stem cell therapists mix mesenchymal stem cells from fat tissue with bone marrow stem cells which they harvest before from pelvic bone marrow. Dr. Weber told me that he would do a direct bone marrow laser activation of the pelvic bone marrow instead. He anesthetized the tissue above the pelvic bone. Following this he made a small hole into the pelvic bone through which he inserted a laser applicator into the bone marrow cavity. 5 different colored lasers were again applied for 10 minutes each to activate the bone marrow stem cells. Studies have shown, as Dr. Weber stated, that low-dose laser activates bone marrow stem cells. They can be found in the blood circulation within 1 hour. This is similar to mixing stem cells in a Petri dish and then injecting it as a mix, except it is a less invasive approach.

Further activation of stem cells

Following these procedures Dr. Weber felt that another light bed therapy was necessary for 20 minutes. He also gave me a Weber medical laser watch called “Regenerate+”. This device fits on the wrist. It is programmed to generate a number of different lasers to shine against the underside of the wrist. This is the area where the ulnar and radial arteries run close to the surface. This device will shine the laser lights for 30 minutes, and the laser light reaches the arterial blood. The circulating stem cells from the stem cell therapy are receiving a further boost this way. Dr. Weber told me to use this device twice a day on an ongoing basis. The Weber medical laser watch stimulates the immune system.  Jet lag also responds to, and it can stimulate stem cells as they circulate in the blood.

Stem Cells Cure Back Pain

Stem Cells Cure Back Pain

Conclusion

Medical tourism is flourishing. I have become a medical tourist myself because I did not want to get crippled by conventional medicine regarding my lower back pain. Two days after my stem cell treatment my back pain was significantly improved. There was mild pain in the area of the fat liposuction site. Four days after the treatment the lumbar spine pain was gone. Innumerable chiropractic treatments and two prolotherapy treatments had not given me relief. Now stem cell therapy in Germany has taken my chronic back pain away in only a few days. I realize that the healing process will take 3 to 6 months to complete, but as a patient what counts most is pain relief.

What, if someone criticizes me for choosing stem cell treatment?

It is difficult to argue with success. Whether somebody criticizes me for having followed a non-conventional treatment protocol does not matter to me. My question back would be: what do you do when conventional methods fail? Are you willing to suffer chronic pain and swallow pain pills that could either get you addicted or have serious side effects? I would try stem cell therapy again, if I had a problem that does not respond to conventional therapy.

Jul
08
2017

Stem Cells For Osteoarthritis

Many clinicians have used stem cells for osteoarthritis of the knee or other joints for some time. However, objective publications about the effectiveness of stem cells are only coming out now. Both stem cell types, derived from fat or stem cells from the bone marrow, are effective. Most doctors are using stem cells from fat (mesenchymal stem cells), because they are so much easier to harvest.

CNN reported about a man, Bill Marlette who had lost one of his arms in the past. He ended up overusing the other arm and as a result developed end-stage osteoarthritis in his wrist. He could not find relief with conventional methods of anti-inflammatories and pain pills. Next he went to a stem cell expert in Munich, Germany who treated him with mesenchymal stem cells from his fatty tissue. Only one treatment took away his chronic pain and helped him regain his wrist mobility.

Approval of stem cell therapy in Germany

Prof. Dr. Eckhard Alt, an expert in regenerative medicine has previously treated patients with end stage osteoarthritis and had good clinical outcomes with it. As a result the German regulatory agency has approved his treatment protocol.

Dr. David Pearce, executive vice president for research at Sanford Health in South Dakota said that Prof. Dr. Eckhard Alt was the first one to use fat cells as a source of mesenchymal stem cells to treat osteoarthritis. He went on to say: ”Those stem cells don’t have to be programmed in any way, but if you put them in the right environment, they will naturally turn into what the cell type around them is.” The physician harvests the stem cells through liposuction. An enzyme mixture is necessary to separate the stem cells from fat cells, oil and connective tissue. A cell separator can also help separating the stem cells from the rest of the cells and tissue.

A case of wrist osteoarthritis

As I mentioned before only one injection was necessary to relieve the chronic pain of Bill Marlette’s wrist. Since his return the doctors in the US have followed Bill closely. They took MRI scans and noted that the bony cysts associated with the severe arthritis have disappeared. His wrist and hand strength have returned to normal. The pain almost disappeared. There were no side effects whatsoever. Because the stem cells are of the same tissue type as all his other cells of his body, one would not expect any tissue rejection by the immune system. Bill Marlette did not need any pain pills following the procedure in August 2016. And he says: “I have more range of motion with my wrist, shaking hands didn’t hurt anymore,” he said. “My wrist seems to continue to improve, and there’s less and less pain all the time.”

Past experiences treating osteoarthritis with mesenchymal stem cells

A 2014 clinical trial from Korea involved 18 patients with osteoarthritis of the knee where adipose mesenchymal stem cells were injected. The high dose group did best. After 6 months there was significant improvement, also confirmed by arthroscopy. The previous cartilage defect in the femoral and tibial condyles had decreased in size. Range of motion in the knee joints and pain had also improved. There were no adverse effects from the treatment.

Chinese study

Mesenchymal progenitor cells have the propensity to develop into cartilage. At the Shanghai Medical College, Fudan University Shanghai, China the following experiment took place in 2015. The researchers grew human adipose mesenchymal cells in vitro. Later they injected these mesenchymal progenitor cells into the knees of rabbits with experimentally produced osteoarthritis. Despite doing xenotransplants (human cartilage to rabbits) with known HLA differences the cartilage grew and cured the osteoarthritis of the rabbits. The new cartilage had human HLA markers while the rabbit cartilage underneath had rabbit HLA markers. At 16 weeks the researchers examined the tissues under the microscope and another exam involved the HLA marker testing.

Tehran study

A study from Tehran, Iran was carried out on 18 patients with ankle, knee and hip osteoarthritis in 2015. Physicians injected stem cells from the bone marrow into the osteoarthritic joint. The doctors followed the patients and ordered occasional MRI scans for 30 months. All of the patients had improved significantly with regard to their joint function and pain. The MRI scans also showed thickening of the joint surfaces from new cartilage production.

French/German study

In a 2016 joint French/German study 18 patients with end stage knee osteoarthritis were treated with stem cells. The stem cells came from adipose tissue that went through a cell separator. Physicians injected the mesenchymal stem cell fraction into the osteoarthritic knees. This was a phase I study to rule out any adverse reactions, but none were evident. It also established that there were significant positive improvements in pain and mobility with regard to the affected knees.

General remarks about how stem cells heal osteoarthritis

The example above with end stage osteoarthritis of the wrist was just one example of where osteoarthritis can strike. Perhaps the more common other locations are hips, knees and the facet joints of the lower lumbar spine (causing chronic lower back pain).

The same treatment procedure, which Bill Marlette’s wrist benefitted from is useful for all these other locations. The common factor in osteoarthritis is that the cartilage is getting thinner and thinner until bone rubs on bone causing excruciating pain. It is here where mesenchymal cells can come to the rescue. The stem cells will assess what requires a repair after injection into an affected joint. They recognize that there is a lack of cartilage. Then they transform themselves into chondrocytes, which are cartilage-forming cells. How can stem cells do that? They come with a program to replace missing cells, particularly cartilage and bone cells. But if they are within fatty tissue, they cannot act within a joint that has osteoarthritis. The doctor has to transport the mesenchymal cells into the joint where they can then begin their healing function.

Other methods to treat osteoarthritis

Stem cells are only one of several regenerative treatment modalities for osteoarthritis. Another method are platelet-rich plasma (PRP) injections. Platelets have a lot of anti-inflammatory substances in them and also growth factors that can stimulate stem cells contained in the synovial membrane, the lining of any joint. To get PRP plasma, it is necessary to spin down blood and harvest the PRP fraction with a syringe. After three PRP injections were given into the knees of 90 patients with end stage osteoarthritis these patients were followed for two years.

In the beginning before treatment 100% of the patients had symptoms. After one year following the treatment with PRP their knee functions were normal in 67% of them. After two years only 59% had normal knee function. The investigators pointed out that this treatment modality initially helped to a certain point, but then the effects were slowly fading away.

Stem cell treatment of osteoarthritis of the knee

The literature on either bone stem cells or fat stem cell use for osteoarthritis of the knee in man is still sparse. Nobody has done larger clinical trials. Part of the reasons could be that total knee and total hip replacement in orthopedics is very lucrative. We are still in a symptomatic treatment mode. Physicians treat osteoarthritis conservatively with anti-inflammatories and pain pills. When bone rubs on bone, there can be excruciating pain. The physician refers the patient to an orthopedic surgeon who likely will do invasive surgical procedures. My own impression in general practice in the past is that these procedures do not always turn out the way they are supposed to work. Following total hip or knee replacement joint swelling often remains; pain issues are still there. There can be unequal height issues, balancing problems and so on.

Here is a review of mesenchymal stem cell therapy for osteoarthritis.  This publication is very conventional medicine. An attitude change by conventional medicine would be useful to catch up with what is happening in real life. Some patients will travel abroad to Munich as Bill Marlette did. But others may travel to other places like India, Mexico or wherever medical tourism takes you. Regenerative medicine is there to stay.

Stem Cells For Osteoarthritis

Stem Cells For Osteoarthritis

Conclusion

We have learnt about a case of severe osteoarthritis of the wrist that has been cured in Germany with one injection of mesenchymal stem cells. More common than wrist osteoarthritis is osteoarthritis of the hips, knees and the facet joints of the lower lumbar spine. The same stem cell therapy can be given for osteoarthritis in these locations. I find it very strange that progress in stem cell treatments is so slow in the US. The FDA has decided to be open to clinical trials with stem cell treatments, but progress seems to be much slower than in other countries. Why? We may never know. In the meantime, patients may seek treatments in other countries where such treatments are offered. In real estate sales there is a saying: “Buyer beware”.

Be cautious, if you get treated abroad

The same goes for stem cell treatments in another country. Should you contemplate doing this, do your homework; ask about the qualification of the treating physician, about safety records and whether the local authorities have approved this procedure. In the case of Bill Marlette’s osteoarthritis of the wrist the procedure in Munich, Germany had been accepted by the European equivalent of the FDA, the European Medicines Agency. Safety is top priority, effectiveness is next.

May
05
2017

New Treatments For Premenstrual Syndrome

Dr. Pamela W. Smith gave a talk about new treatments for premenstrual syndrome (PMS). She presented this talk on Dec. 11 at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The original title was “New Treatment Modalities for PMS”.

Signs and symptoms of PMS

Dr. Smith discussed signs and symptoms of PMS first. She showed 9 slides where she listed all of the symptoms of PMS that commonly occur.

Symptoms are varied; they can mimic various psychological problems like anxiety, depression, panic attacks and more. But physical symptoms like abdominal bloating, acne, back aches, and asthmatic attacks are also common. There are a myriad of more symptoms of PMS: constipation, cramps, clumsiness, dizziness, drowsiness, decreased sex drive, facial swelling, forgetfulness, fatigue, headaches, a herpes-like outbreak, hot flashes, sensitivity to light and noise, insomnia, joint pains, mood swings, palpitations, restlessness, poor memory, sore throat, tearfulness, vomiting and weight gain.

What do we know about PMS?

PMS is due to a hormone dysfunction

There is no definitive test that would help in the diagnosis of PMS. But we do know that there is a hormone dysfunction that leads to a monthly recurrence of symptoms during the two weeks prior to the woman’s menstruation. When her period begins or shortly after all of these symptoms disappear.

PMS due to estrogen dominance

PMS is very common; 70to 90% of women have a certain degree of PMS. In 20 to 40% of women symptoms are severe. Many researchers have shown that there is a problem in the feedback loop between the pituitary gland and the ovaries. This leads to a decrease of progesterone production in the ovaries. The result is an overabundance of estrogen, which many hormone experts call estrogen dominance.

Several hormones need checking with PMS

But things can get complicated when other hormone changes occur. A woman may also turn hypothyroid. When she gets closer to menopause estrogen deficiency may also develop. Electrolyte disturbances can occur from high estrogen levels causing excessive aldosterone levels. This would lead to high sodium and low potassium blood levels. The end result may be an activation of the renin-angiotensin system, which could cause high blood pressure.

Neurotransmitters of the brain can be involved in PMS

Neurotransmitters are often disbalanced. When serotonin is low in the brain, depression can develop. Noradrenalin deficiency leads to a lack of focus, energy and memory.

Women with PMS often have hypoglycemia

Hypoglycemia is also common among women with PMS. This may be due to cravings for sweets and consumption of starchy foods. Women who crave sweets may also consume caffeine excessively. But caffeine increases prostaglandin production in the body. This leads to breast tenderness, abdominal cramping, arthritis and back pains.

PMS after partial hysterectomy

A partial hysterectomy can cause PMS in a woman who never before had symptoms of PMS. The current school of thought is that blood supply to the ovaries after a hysterectomy has decreased, and this could be the reason for the onset of PMS.

Birth control pill can cause PMS

The birth control pill can bring on PMS due to the progestin component in it.

Tubal ligation may cause PMS

Tubal ligations can also be a cause: 37% of women who had tubal ligations develop PMS. The reason is a change in hormone production. In these women estrogen is produced to a higher degree than progesterone is.

Lab tests for women with PMS

Although there is no single test that would be able to diagnoses PMS, a variety of abnormal tests are often abnormal in association with PMS. Frequently there is deficiency for vitamin A, B6, E, magnesium, potassium, zinc and trace minerals. Calcium can be too high or too low, but blood tests will reveal that.

Four PMS types

Dr. Smith said that PMS has been divided into 4 subcategories depending on the main symptoms.

  • Anxiety: PMS A
  • Carbohydrate craving: PMS C
  • Depression: PMS D
  • Hyperhydration: PMS H

PMS A is associated with estrogen excess and progesterone deficiency. There is a diminished stress response in the hypothalamus/pituitary/adrenals axis. Symptoms are mainly anxiety, irritability, insomnia and emotional lability.

PMS C is associated with sugar craving, hypoglycemia, headaches, heart palpitations and spontaneous sweating.

PMS D is leading to increased neurotransmitter degradation. Symptoms consist of depression, crying, despair, feeling hopeless, fatigue, low libido, apathy and insomnia.

PMS H is caused by increased aldosterone activity triggered by estrogen surplus in the late luteal phase. Symptoms are weight gain, swelling of hands and feet, a feeling of bloating, breast tenderness or engorged breasts. Women will find that their clothes simply fit tighter.

Migraine headaches in PMS

Some women with PMS are plagued by migraine headaches. It may have started in puberty or after taking birth control pills for contraception. Sometimes the onset is after a pregnancy, miscarriage or abortion. When PMS develops and a woman has migraines, they usually occur around the same time in her menstrual cycle. With pregnancy the migraines disappear in the last trimester when progesterone hormone production from the placenta is the highest.

Hormonally related headaches can occur for 4 main reasons.

  1. Estrogen and progesterone are on the rise around the time of ovulation
  2. When a woman has hypoglycemia (due to hyperinsulinemia)
  3. Estrogen levels are changing
  4. When there is estrogen dominance

Treatment for PMS

Dr. Smith explained in detail the various treatment modalities for PMS. Treatment has to be personalized according to what type of PMS the doctor thinks that the patient is suffering of.

Dietary factors

In the beginning it is important to pay attention to the diet. Studies have shown that PMS patients tend to eat too many carbs and too much refined sugar compared to patients without PMS. PMS patients also eat too many dairy products and too much sodium. In addition PMS patients are deficient in iron, manganese and zinc. A good start is a Mediterranean diet, which is at the same time anti-inflammatory.

The recommendations is to eat 6 small meals a day. Avoid caffeine and alcohol. They are antagonists to the B complex vitamins. By avoiding sugar, you also avoid fluid accumulation and magnesium deficiency. A low fat, high-complex carb diet helps reduce breast tenderness. Reducing fat and increasing fiber in the diet decreases estrogen levels in the blood. These steps help PMS symptoms.

Nutritional supplements

Magnesium, vitamin B6, A, D3, E, L-tryptophan, calcium, zinc, fish oil (EPA/DHA) and evening primrose oil are the main supplements recommended for PMS patients. Your healthcare provider can advise you what you should take and what dosage.

Exercise

Regular exercise has very beneficial effects on reducing many symptoms of PMS. Even as little as 8 weeks of exercise -as was done in this study- had a significant effect. Exercise elevates endorphin levels, improves blood sugar stability, decreases norepinephrine and epinephrine in the brain and helps to decrease estrogen levels. This will control blood sugar levels, reduce anxiety, reduce estrogen-related symptoms and increase satisfaction.

Thyroid medication

Many women with PMS have borderline hypothyroidism or are overtly hypothyroid. In these cases the patient should receive small amounts of thyroid hormones.

Progesterone

Most PMS patients persistently lack one hormone,  progesterone. The best test for this is a saliva hormone test, because this reflects the tissue levels. Blood levels test too low and are useless. Bioidentical progesterone cream is applied transdermally (through the skin) from day 14 to 25 of each menstrual cycle. Micronized progesterone pills are also bioidentical and can take the place of progesterone cream.

Botanicals

There are a number of home remedies, which are heavily promoted on the Internet. They may, however, not be as effective as advertised.

Estrogen balancing Black Cohosh

Black Cohosh is said to balance estrogen and is anti-spasmodic.

Progesterone raising Chasteberry

Chasteberry decreases LH and prolactin. It raises progesterone, acts as a diuretic and binds opiate receptors. This reduces PMS related aches and pains.

Herbal supplement St. John’s Wort

St. John’s Wort helps these symptoms: anxiety, depression, mood swings, feeling out of control and pain.

Anti-inflammatory Ginkgo biloba

Ginkgo biloba is a mild blood thinner. Women who are on blood thinners should not use it! It improves depressive symptoms and mood, has anti-inflammatory effects and helps with anxiety control.

Nutrient-rich saffron

Saffron: In a clinical trial the Saffron group did significantly better in PMS symptom control than the placebo group.  Saffron is rich in magnesium, vitamin B6, iron and other nutrients that are missing in PMS patients, which explains the effectiveness of this botanical.

Lavender, Motherwort, and Dandelion

Other botanicals: Other botanicals are Lavender, Motherwort, and Dandelion.

Candidiasis

Due to prolonged exposure to high sugar and refined carb intake many women with PMS suffer from candidiasis (chronic yeast infection). Anti-Candida programs help to eradicate Candida overgrowth, which often improves several PMS symptoms.

Mind/body therapy

Cognitive-behavioral therapy helps for depression and anxiety. Hypnotherapy, yoga and biofeedback therapy are also useful methods.

New Treatments For Premenstrual Syndrome

New Treatments For Premenstrual Syndrome

Conclusion

At the present time there is a better understanding of PMS than in the past. Progesterone deficiency and other hormone weaknesses seem to be at the center of this condition. But vitamin and mineral deficiencies also play a role. The healthcare provider should order some baseline blood tests and hormone tests for the patient, including a saliva progesterone level.

Treatment consists of a combination of steps taken simultaneously. The dietary approach comes first: a Mediterranean diet will be beneficial. Next add nutritional supplements. Regular exercise is essential. Finally bio-identical hormone replacement of the missing hormones is necessary.

If there is an underlying chronic candidiasis infection, it needs treatment. The choice of drug would be nystatin. Some botanicals may be helpful, as discussed. When anxiety and depression are important parts of the PMS symptoms, mind/body therapy (such as cognitive therapy etc.) may also be helpful.

The key with PMS treatment is to not give up, but to re-evaluate the condition, if the initial attempt does not bring full relief. By not giving up and using all modalities of treatment the patient will be able to get rid of the condition, eliminate the symptoms of PMS and achieve well being.

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