Feb
17
2024

Ashwagandha’s Benefits

Medical news today had an article in October 2023 that reviewed ashwagandha’s benefits. I thought it would be useful to discuss this topic in an abridged version. Often things get distorted on the Internet and a reality check helps to separate facts from fiction. Ashwagandha (botanical name: Withania somnifera) is a small shrub that grows in Southeast Asia, Africa and some areas of India. An alternative name is Indian ginseng.  Ashwagandha has been part of Ayurvedic medicine for more than 3000 years.

About ashwagandha’s effectiveness

Ashwagandha is part of natural medicines that go under the name of adaptogens. The effective substances of ashwagandha were isolated. Researchers named them withanolides. They are alkaloids and consist of polyoxygenated steroidal lactones with 28-carbon ergostane skeletons.

People are taking ashwagandha supplements to counter stress and fatigue. But it also increases testosterone, which increases muscle mass. In addition, there is an increase of libido in men as well as in women.

People with insomnia benefit from the relaxing and sleep-inducing effect of ashwagandha supplements. Ashwagandha stimulates the immune system. It also significantly counters the stress response, as it lowers cortisol levels.

The active chemical components of ashwagandha

Various researchers pinpointed the diverse actions of ashwagandha extracts to withanolides, which are the pharmacologically active ingredients. There are at least 25 different chemical structures of withanolides, which are depicted in this reference: This explains the diverse effects of ashwagandha extracts on the immune system, the stress hormone axis, the libido brain centers and testosterone production. One human study showed that within 96 hours of ashwagandha extract administration the immune system was activated; T cells and natural killer cells were measured and were significantly elevated in number in comparison to controls:

Specific clinical trials showing effects of ashwagandha

Effects on the brain

In a small clinical study oral intake of ashwagandha improved performance on cognitive tasks, executive function, attention, and reaction time.

Dr. Amala Soumyanath is a professor of neurology in the School of Medicine at Oregon Health & Science University. She stated: “These laboratory studies show that ashwagandha extracts can act on neurotransmitter pathways including those involving serotonin and Gamma-aminobutyric acid (GABA), and also affect systems like the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic-adrenal-medullary (SAM) axis.”

What does this mean? It means that ashwagandha contains a mix of withanolides that calm down the brain, particularly when it is stressed. At the same time, it increases serotonin and GABA, which has antidepressant and calming effects. Clinical trials have measured cortisol levels in volunteers and found that cortisol is lowered within a few weeks. This is the strongest evidence that ashwagandha in fact counteracts stress.

Libido and muscle strength

A small human study found that muscle strength was higher after exposure to oral ashwagandha in comparison to controls.

Ashwagandha showed a significant increase of maximum oxygen consumption (VO2max) in healthy adults and athletes, which is a direct measurement of exercise fitness. A clinical trial with 50 overweight males aged 40-70 years, showed that 16 weeks of oral ashwagandha increased their testosterone level by 14.7%. In addition, there were improvements in fatigue, vigor, and sexual and psychological well-being. There was also an increase of 18% of DHEA-S a precursor of testosterone. The authors felt that a larger study with a longer observation time would be beneficial to confirm this study. Overall, the objective effects of ashwagandha are in the mild to moderate category. The mild increase in testosterone affects libido only marginally. Some articles in social media are vastly exaggerating the objective findings.

Health risk of ashwagandha

There are downsides as well. Ashwagandha stimulates the immune system and in doing so may exacerbate autoimmune diseases. It also can increase thyroid hormones, which is important to know for people with hyperthyroidism or hypothyroidism. Men who have hormone sensitive prostate cancer should avoid ashwagandha, because it elevates testosterone.

Researchers pointed out that gastrointestinal upsets, such as diarrhea, nausea, and vomiting due to ashwagandha are common side effects. The higher the dosage and the longer the exposure is, the more likely it is that the patient experiences side effects. Researchers reported a few cases of reversible liver toxicity cases due to ashwagandha. At this point the effects of concomitant medications taken at the same time as ashwagandha is not known.

Ashwagandha’s Benefits

Ashwagandha’s Benefits

Conclusion

Lately social media is full of ashwagandha’s benefits. Rosy reports of increased libido, extra energy and boosts of confidence circulate on the Internet. Men are told that in order to build up muscle bulk with exercise they must take ashwagandha. This review checked the facts. There is a 14.7% rise in testosterone from taking ashwagandha and this may contribute to an increase of muscle mass with exercise, but this is not a huge effect. Also, the mild increase of libido due to the increase of testosterone is not as significant as reported in the social media. The active ingredients of ashwagandha are the withanolides, which researchers isolated. They do help to deal with stress-related problems like lack of energy and insomnia. In addition, they stimulate the immune system to give a stronger response.

Side effects of ashwagandha

But ashwagandha also has some side effects. It can make auto immune reactions worse. It can interfere with both hyperthyroidism and hypothyroidism. Men who have hormone sensitive prostate cancer must avoid ashwagandha because of the testosterone increase. Gastrointestinal upsets, such as diarrhea, nausea, and vomiting from ashwagandha supplementation are common side effects. So far scientific evidence is based on relatively small clinical trials. Scientists must conduct much bigger trials that are going on for several years to provide more in-depth information on the effects of ashwagandha.

Mar
11
2023

Hormone Imbalance can Impact Health

Dr. Erika Schwartz spoke at the 30th Anti-Aging Conference in Las Vegas about “hormone imbalance can impact health”.  The talk was scheduled early in the morning on Dec. 10, 2022. She pointed out that when hormones are in balance people have energy, they sleep well, they have normal sexual functioning and they are fertile. But in contrast, when hormones are not in balance, their weight goes up, they suffer from fatigue, depression, and anxiety. In addition, they often have skin and hair changes, changes in menstrual regularity, acne, infertility and decrease in libido. Finally, they may have problems in building muscle mass, women develop vaginal dryness and men erectile dysfunction. However, people also can develop autoimmune conditions and various cancers.

Symptoms of hormone imbalance at various ages

Teens

Most importantly, acne is an embarrassing, but common symptom. Depression, PMS, mood swings and headaches are also very common. By the same token, weight gain occurs frequently from faulty diets (fast food, lack of vegetables and fruit and sugary soda drinks).

The twenties and thirties

The birth control pill interferes with the normal function of LH and FSH resulting in lack of ovulation and infertility. Other symptoms are bloating, constipation, weight changes, libido changes and postpartum depression.

The forties and fifties

Mood changes and irritability, weight problems, menstrual changes, and changes in sexual desire are typical for this age group.

The sixties and over

Hot flashes are common in this age group, but they can start in women from the age of 50 onwards. Other symptoms are night sweats, insomnia, skin and muscle changes. Many diseases of the aging occur like diabetes, arthritis, cardiovascular disease, dementia, degenerative and autoimmune diseases.

Diagnosis of hormone imbalance

The doctor takes a detailed history about exposure to environmental pollutants, the birth control pill in women and medications. In addition, the doctor wants to know whether the patient consumed meat from animals that were treated with antibiotics. Next the physician inquires about physical changes, symptoms of hirsutism, menstrual

irregularities and infertility. There are three steps to diagnosing hormone imbalances:

  1. Listen to the patient and inquire about the subjects just mentioned.
  2. Order extensive laboratory tests including hormone levels.
  3. Review all of the medications and supplements the patient is taking.

How do hormone imbalances affect our bodies? They affect our mental health, our sleep, brain function, libido, energy, weight, digestion (leaky gut), joints and the immune system.

Two clinical examples about hormone imbalances

Dr. Schwartz gave two clinical examples showing how correction of hormone imbalances led to normalization of the hormone imbalance.

Example 1

A 17-year-old female complained about acne in her face, had no periods, was fatigued and had migraine headaches. She was in senior high school and wanted to look and feel better before graduation. Her periods started at age 12, but were irregular. Her physician started her on the birth control pill at age 14. Within one year she stopped having any periods and also started getting hyperpigmentation in her face. Dr. Schwartz noted that she had no allergies and that she did not take any supplements. She took Estarylla (ethinyl estradiol/ norgestimate), a BCP formulation and Excedrin for migraines. Her ferritin level was 12 (11 to 307 micrograms per liter is normal for women). TSH was 5.16 (normal now 0.5-2.5). This meant she was borderline iron deficient and also mildly hypothyroid.

Diagnosis and treatment plan

Dr. Schwartz diagnosed a hormone imbalance. The treatment schedule consisted of stopping the BCP, start a low dose 30 mg NP thyroid in the morning. In addition, the doctor prescribed adrenal support pills and low-dose iron pills with vitamin C. The doctor also addressed lifestyle and self-awareness issues with the patient. 4 months later she was seen again and had regular periods, no more migraines and she felt more energy. The face pigmentation was gone and she felt great.

Example 2

A 42-year-old woman presented to Dr. Schwartz with psoriatic arthritis, weight gain, problems sleeping, brain fog and irregular periods. Her last menstrual period was 6 months ago. Her doctor had recently placed her on a statin drug and put her on the BCP Mirena. This is a progestagen releasing IUD placed in the uterine cavity, which was given to her in an attempt to regulate her periods. She was divorced and a mother of 3 children. At work she was a business partner in a high stress law firm. Personally, she was trying to date, but has been unsuccessful so far. She would like to lose weight and gain more energy. What she was hoping for was that her doctor address her overall health.

Medication and blood tests

She did not have any allergies. Her medications consisted of Rosuvastatin 10 mg daily and Mirena for the last year. As supplements she took Turmeric. Blood tests showed that her hemoglobin A1C was 5.7, the vitamin D blood level was 17 ng/mL (very low). The TSH level measured 1.29 (in the normal range). Estradiol blood level was in the lower range, progesterone level the same. Finally, her testosterone level was low as well. The other blood tests were all normal.

Diagnosis for this patient and treatment plan

Dr. Schwartz diagnosed hormone imbalance due to natural and environmental factors.

She ordered Mirena to be removed and to stop Rosuvastatin. Instead, she started the patient on vitamin ADK ( a mix of vitamin A, vitamin D and vitamin K)– 5000 IU daily. She also started her on Omega3 1000mg daily. In addition, she discussed a well-balanced diet, regular exercise and sleep issues (7-8 hours every night) with her.

Hormone replacements

As blood tests showed a low estradiol level, she started her on Estrogel, a form of estrogen. She also started her on progesterone tablets (Prometrium) 100 mg at bedtime as well. This keeps progesterone and estrogens balanced. As her testosterone was on the low side, she started her on Testosterone cypionate 100 mg/ml (0.4 cc per injection) intramuscularly once a month. Dr. Schwartz also started adrenal support, 2 capsules in the morning. Further she was told to start 3 capsules of NMN (Nicotinamide Mononucleotide Supplements) daily and 5 units of Semaglutide subcutaneously weekly. The latter medication helps the pancreas to release the right amount of insulin when blood sugar levels are high.

Follow-up at 6 months

The doctor reassessed he patient after 6 months. She had developed increased self-awareness. She lost 30 pounds and she slept for 7.5 hours most nights. Her energy level has increased and she improved her dietary choices. She had started regular work-outs. Overall she was now happier at work and at home with her children. She feels now more like an age of 25, and she has been starting to date.

General remarks about hormone imbalance

When hormones are in balance, we are healthy. Hormones can get out of balance at any age; the examples above involved 17 and 42 year old patients. Keep in mind that it is impossible to have optimal health without balanced hormones. Dr. Schwartz said that the more pieces of the puzzle you address, the more likely you are going to truly help improve quality and quantity of life. Lifestyle factors that must be addressed are:

  • Diet
  • Exercise
  • Stress Management
  • Sleep
  • Breathing
  • Mitochondrial and cellular integrity
Hormone Imbalance can Impact Health

Hormone Imbalance can Impact Health

Conclusion

Hormone imbalances occur frequently when our lifestyle factors are slipping. Often untoward side effects of medication are also contributing to the hormone imbalance. The holistic doctor takes a thorough history, examines and takes blood tests including key hormone tests. When imbalances of hormones are detected, this has to be addressed with supplements and hormone replacements. At the end the hormones balance each other and the patients’ abnormal symptoms disappear. It only takes a few weeks before the patient will feel normal again.

Oct
25
2022

Overcoming Grief after a Loss

This article is about overcoming grief after a loss. During the Covid epidemic many people died, which caused a lot of grief among their loved ones. Unresolved grief can cause anxiety and depression. Whenever you have lost a loved one, counseling can help you to continue the grieving process.

Claire Bidwell Smith is an author of several books and has a master’s degree of clinical psychology from Antioch University in Los Angeles. She published the book “Anxiety-the missing stage of grief” (Hachette Books, 2018). In it she explores the stages of grief and notices that anxiety is very much part of the grieving process. However, this point is often overlooked by mainstream psychologists. Claire Bidwell Smith offers strategies to deal with the loss of a loved one and overcome the anxieties that people often feel as well. Here is a write-up from CNN where Claire Bidwell Smith was interviewed.

Anxiety is a powerful emotion

Anxiety can be very powerful, but it is often mistaken for a physical problem. As a result, people present at the emergency room of a hospital for various symptoms of pain and a myriad of other complaints. After expensive tests the doctor finds no physical abnormality and the diagnosis is anxiety or panic attack. Smith said that 70% of her referrals went to the hospital first and were diagnosed as panic attacks. Patients have a hard time to understand that their anxiety is a direct result of their grieving process.

Relationship between grief and anxiety

CNN asked Smith how grief and anxiety are related. She answered that a sudden death from an infection like Covid makes you realize that we are not safe and are not in control. Everything in your life changes and emotional upheaval is much bigger than ever imagined. Grief, which consists of emotions that accompany a loss of life can force you to kneel down emotionally speaking. This process feeds anxiety. People who grieve the loss of a loved one get anxious about their own health and about the safety of other loved ones. They may not even realize that what they are experiencing is anxiety or that this is related to the grieving process.

Anxiety

Anxiety is a condition that presents with fears and worries. This can present with many different body symptoms. The patient may experience chest pains and think it is a heart attack. But tests are normal and the physician calls it anxiety. Similarly, anxiety can present as stomach aches, headaches or insomnia.

What coping strategies are available?

There are many support groups to help people with anxiety; in addition, grief therapists can help with individual counseling. It may be difficult to motivate the patient to make use of these services. Since Covid you can have access to virtual anxiety support services. It is important that people seek counseling support, as otherwise they get stuck in their anger or guilt. Unfortunately, many people give up and end up in substance abuse. They develop relationship problems and get into trouble at work or in school. So, not seeking support only backfires. Get yourself on a waiting list for a counselor! Work through your grief and you will feel better.

What is your advice to people who resist a formal mental health treatment?

Smith mentioned that there are a lot of self-guided online courses. Also, reading books and articles about grieving are useful, because you get on with your grieving process. Social media is another source for information about the grieving process. It helps you to understand what other people with the same problem experienced and how they overcame it. Having said this, people can develop a full-blown anxiety disorder or clinical depression. In this case they require an assessment by a psychiatrist.

What is the role of meditation and mindfulness in healing anxiety?

Smith pointed out that when we grieve and when we are anxious, we spend time in the past or we worry about the future. Meditation and mindfulness bring our awareness to the present moment. Meditation helps us to focus on our own thoughts. It helps us also to detach from negative thoughts or irrational fears.

Imagination as another powerful tool

Smith explained as an example that she was not there when her mother died in the hospital. When she is overcome by negative emotions regarding this memory, she envisions herself crawling into the hospital bed with her dying mother, holding her and saying good bye to her. Smith admitted that it took her about 5 years before she was ready to do these imagination experiments. By using this imagining tool your present focus is on the now away from negative emotions of the past or fears what the future may hold.

Stories help to reduce grief

How we handled a painful story from the past determines how it influences our daily thinking. Often people do not know how to handle such a story and they tend to suppress it. But psychologists found that it is much healthier to deal with these stories and reframe them. When people find a way how to explore their story, they can reframe it and remove the negative feelings that had an association with it in the past. Healing comes from therapy, from counseling, online grief forums and support groups. There are also grief writing classes where you can rewrite your story experiencing how the past memories become less powerful and the future is brighter.

Stay connected with your lost loved one

It used to be taught that the best therapy would be to “letting go and moving on”. But now psychologists think it is better to move forward with the person you have lost. Specifically, what this means is that it is OK to have an inner talk with the person you lost. Smith added: “For example, pondering: What advice would my dad give me about this job offer? What would my mom think of my new boyfriend?”

The crux of grief work is making meaning out of loss

CNN asked Claire Bidwell Smith whether she quoted Hope Edelman who authored the book “The After Grief”. Hope Edelman said in this book that the “crux of grief work is making meaning out of loss”. Smith’s reply was that this stage develops naturally. But she cautioned that guilt, regret and anger are standing in the way of our ability to make meaning. They have to be dealt with first. This is why counseling, grief work and overcoming guilt and anger are so important.

Overcoming Grief after a Loss

Overcoming Grief after a Loss

Conclusion

When we lose a loved one or lose our job, we experience a grief reaction. There are powerful negative feelings like anger, guilt and other feelings that make it difficult to overcome our grief. Claire Bidwell Smith is an author of several books and has a master’s degree of clinical psychology from Antioch University in Los Angeles. She was interviewed by CNN regarding her work and her latest book “Anxiety-the missing stage of grief” (Hachette Books, 2018).

Anxiety is an important aspect of grieving

In the interview she explained that anxiety is an important aspect of grieving. But many people go to the emergency room of a hospital, because they think the symptoms, they feel are physical. It is the emergency physician who tells them after several tests that they have anxiety and they need to seek a counselor. After a few months of counseling grieving persons usually feel a lot better. They are now accepting what happened in the past and hope for a better future.

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Sep
19
2021

World Suicide Prevention Day is on September 10

A CNN article points out that world suicide prevention day is on September 10.

Some statistics regarding suicides

According to the WHO more than 700,000 People die from suicide every year.

In the US suicide rates have risen between 1999 and 2018. President Joe Biden stated: “In 2019, suicide was the 10th leading cause of death in the United States, and the second leading cause of death for young people between the ages of 10 and 34.”

This was further underlined by a study from the CDC. It pointed out the emergency room visits started to climb in May 2020 for attempted suicide in youth. The CDC stated: “The mean weekly number of these visits was 26.2% higher during summer 2020 and 50.6% higher during winter 2021 compared with the corresponding periods in 2019”.

Triggering factors that make people commit suicide

Suicidal thoughts start when a vulnerable person encounters stressful events. The life situation can become so painful that in their way of thinking suicide is the only way to stop the pain. There are huge differences of opinions: what may be meaningless to one person, may feel devastating to another.

Common triggering factors are as follows.

  • Illness and physical discomfort
  • Conflicts with family or friends
  • Illness of family members
  • Death of family member or friend
  • Loneliness

In a study 50% expressed two of these 5 triggers, 37.5% expressed one of the 5 triggers. 12.5% expressed three of the 5 triggers.

With the Covid-19 epidemic there are new pressures on people. They cannot freely move around or travel. He/she may have lost a friend or relative to Covid. And people may be anxious about their own survival. I described this here before.

Biochemical changes in the brain with depression

In the past low serotonin levels in the brain were thought to be the main cause of depression. But researchers realized later those medications that increased serotonin levels did not always help depression. They found that dopamine and norepinephrine are also important brain transmitters that play a role in depression. When dopamine levels are low, depression occurs. Similarly, when norepinephrine is low, the patient can develop depression. On the other hand, in bipolar disorder the brain produces too much norepinephrine, which causes manic episodes. https://www.verywellmind.com/the-chemistry-of-depression-1065137 The physician needs to take a thorough history and note from that which brain transmitter system would be mainly affected. This helps the physician later to decide which antidepressant to choose from to rebalance the brain transmitters.

How to detect stress signals

There are a number of risk factors, which the CDC has outlined, for which the health professional or a family member wants to look in order to assess the suicide risk.

Does the patient have a history?

People with a mood or anxiety disorder, or with an alcohol or substance abuse disorder are at a higher risk of developing depression and suicide.

Did the person experience a loss?

A loss can be a death in the family, a loss of a job or the loss of an important person in a relationship. This is particularly bad when there is social isolation and a lack of support. With Covid-19 millions of people have suffered the loss of a job, social isolation and having to quarantine.

Is it easy for the distressed person to get a gun?

Firearms are a common means for people to kill themselves. When there is easy access to a gun, there is a high probability that the person uses it in times of distress.

History of previous suicide attempt

When a person attempted to commit suicide, but failed, there is a higher risk for them to repeat a suicide attempt and succeed. Also, there is a copycat phenomenon when the news comes out that a famous personality committed suicide. For instance, when the comedian Robin Williams committed suicide in 2014 there was a 10% rise in suicides in the following months all over the US.

Belief system that honours personal sacrifice

Some religious or cultural groups consider suicide a noble solution to a personal dilemma.

A person from this background is at a much higher risk to commit suicide.

Warning signs of pending suicide attempt

There are a number warning signs that point to a higher risk of possibly planning suicide.

  • A person may talk about wanting to die or kill themselves.
  • Searching online for ways to kill oneself or buying a gun.
  • Feeling trapped or feeling unbearable pain.
  • Talking about feeling hopeless and having no reason to live.
  • Stating that they feel they are a burden to others.
  • Drinking more alcohol and using more drugs.
  • Acting agitated or anxious. Reckless behavior.
  • A person withdrawing or isolating themselves.
  • A person sleeping too much or too little.
  • Extreme mood swings.
  • Talking about seeking revenge or showing rage.

These are all red flags that should alarm you to ask for help. Not all of these alarm signs are present all the time with people who are considering to attempt suicide. When you have suicidal thoughts in the US, call the National Suicide Prevention Lifeline at 800-273-8255. For Spanish crisis support call: 888-628-9454.

World Suicide Prevention Day is on September 10

World Suicide Prevention Day is on September 10

Conclusion

World suicide prevention day is on September 10. This reminds us every year that suicide is a colossal problem of society. Stress, loss of health, losing a loved one, a broken marriage and financial loss can all contribute to depression. If patients with mental distress do not receive timely intervention and treatment, the life situation can become so painful that in the patient’s way of thinking suicide is the only way to stop the pain. The key is for the loved ones in the circle of friends to pay attention to the warning signs and bring the suicidal person to the attention of the psychiatric health professionals. Sometimes an in-patient admission to a psychiatric facility may be required to interrupt the negative thinking pattern. Ignoring the warning signs can have devastating consequences. Prevention is the only way to avoid suicide.

Nov
28
2020

Mental Illness and Covid-19

A topic less discussed is mental illness and Covid-19. Covid-19 has been noticeably around us since March of 2020. With the various social distancing and quarantining methods people become more or less isolated emotionally. Social gatherings are outlawed depending on where you live. This helps to interrupt the spread of the virus, but it makes people feel more stressed as their relationships get interrupted.

Symptoms of stress

The CDC sums up that stress during a pandemic can cause the following:

  • Fear of your own health and the health of your loved ones
  • Loss of your job or financial support
  • Changes in eating habits
  • Changes in sleep pattern with lack in concentration
  • Increase in use of tobacco, alcohol or other substance consumption
  • Chronic health problems may deteriorate
  • Worsening of Mental health conditions

The more isolated we are, the more stress we feel. This undermines our stress coping mechanisms, makes us more anxious and more depressed.

Develop coping skills

Taking care of your family and friends may relieve your stress, but it needs to be balanced by taking care of yourself. Although you are physically isolated from others when you are in quarantine, you can stay in contact with others by phone or video chats. This makes you less lonely and isolated.

Take care of yourself. This includes eating well balanced meals, exercising regularly and getting enough sleep. Avoid the consumption of alcohol, tobacco and drugs. Share with a family member or friend how you feel. Maintain friendships through the phone, emails, social media and computer chats. This builds a strong support system for you.

Avoid too much exposure to news stories. Seeing negative stories about Covid-19 over and over again can be undermining, so take a break from the news media. Go for a walk. Take a nap.

Suicide

Sometimes depression can get out of control to the point of driving a person to the brink of suicide. In the US major depression is the leading cause of disability for ages 15-44.  At any given year 16.1 million American adults (about 6.7% of the U.S. population age 18 and older) suffer from major depression. 10.3% of Americans have thought about suicide. If you feel that way, do not act on this impulse. Call 1-800-799-4889. That is the National Suicide Prevention Lifeline & Chat.

Medical literature about the psychological impact of Covid-19

In a July 2020 publication the authors pointed out that Covid-19 infection is a significant psychological stressor. There is the fear of getting the virus and uncertainty about the future. Pre-existing anxiety and depression disorders get accelerated from the stress. In addition, mental disorders like schizophrenia with psychosis may worsen. This may require more antipsychotic medication to control it.

A Kaiser Family Foundation poll found in March 2020 that the Covid-19 pandemic has caused a major impact on US citizens. 45% of respondents said that the pandemic has affected their mental wellbeing significantly. If you are scared, depressed or anxious, you are tense and you have problems falling asleep, you are not alone. You can seek and receive help!

Prevention of mental disease from Covid-19

Here is some practical advice from the World Health Organization.

  • Stay informed.
  • Have a daily routine. Get up and go to sleep at regular times. Eat healthy balanced meals. Exercise regularly. Have your work routine and also find time to rest. Do things that you enjoy.
  • Watch the news only to be informed, but limit news watching to a minimum. This will keep anxiety and depression in check.
  • Stay in contact with close friends by phone and computer technology.
  • Keep your alcohol consumption low. If you did not drink before at all, don’t start drinking in an attempt to deal with boredom, fear, anxiety or social isolation.
  • Take breaks from screen time. This reduces tension.
  • Video games: doing this may relax you for a short time. But longer video game activities can make you tense; you should balance this with the rest of your daily activities.
  • Social media. Use this for honest communication. Keep it brief. If you see misinformation, point out the truth.
  • Helping others: if you can, help others in the community with shopping or other chores.

Treatment for Mental disease from Covid-19

When you notice anxiety, depression or a flare-up of psychotic symptoms from schizophrenia, it is important to see your health professional right away. You may need some counselling. Others may need an antidepressant (for depression) or an adjustment to your antipsychotic medication. Some patients with milder depression or anxiety may benefit from cognitive/behavioral therapy. Most importantly, know that help is available! More info about cognitive therapy for suicide prevention.

Mental Illness and Covid-19

Mental Illness and Covid-19

Conclusion

Mental illness and Covid-19 is a huge topic. People definitely have experienced more anxiety and depression since the Covid-19 epidemic. This is because our lifestyle is suddenly restricted. We may have to go through a 14-day quarantine. But we also cannot participate in large gatherings with more than 50 people. Often, we have to wear masks in stores. In areas with high cases of Covid-19 there is also a severe restriction regarding with whom you can visit, leading to feelings of isolation. All of this can lead to mental illness. Essentially there are two ways of coping with this. First, we need to get a routine that makes us more resistant to mental illness. Secondly, if this fails, seek the advice of a health professional right away.

Seek mental illness treatment right away

When you catch mental illness early, it is much easier to treat. Milder cases of depression or anxiety may benefit from cognitive/behavioral therapy. More severe cases often require medication. In this outline I have discussed mental illness during the Covid-19 epidemic. I have not discussed the cases where people came down with Covid-19 coronavirus and got affected in their brain function from the virus. These cases need treatment by a neurologist and psychiatrist, and they are much more complicated.

Jul
18
2020

Key Factors for Centenarians

A study from Washington State University (WSU) showed some of the key factors for centenarians to survive. The publication of the study goes back to June 17, 2020. In general, it was common knowledge that genetics plays a role in 25% to 35% of centenarians for their survival. That is to say, the remainder is the result of lifestyle factors. It is important to realize that the environmental factors play a significant role in the survival of centenarians, said Rajan Bhardwaj, a second-year WSU medical student. He and his research team determined what allowed centenarians to reach an age of 100 or above. Briefly, they identified the following factors that were necessary.

Three factors identified by the Washington State University study

  • walkability of the neighbourhood, which encourages regular exercising
  • belonging to the higher socioeconomic class
  • a high percentage of working population in the neighborhood (a mixed population) was also important

In the discussion the authors of the WSU study said that “blue zones” of centenarians had been mentioned before in the literature. To clarify, these are areas in the world where more than the average of centenarians live. Dan Buettner used the term “blue zones” in a National Geographic article about where centenarians were located.

The blue zones

He wrote a book about the location of the 5 blue zones. Notably, they are located in Sardinia (Italy), the islands of Okinawa and a group of Seven Day Adventists in Loma Linda. California. In addition, the Nicoya Peninsula of Costa Rica, and the island of Icaria, Greece complete the 5 blue zones. Specifically, Dan Buettner described the following characteristics of the lifestyle of centenarians.

  • They engage in regular physical activity
  • Mostly eating a plant-based diet including legumes
  • Calorie intake is moderate
  • Moderate intake of alcohol, mostly wine
  • Having a purpose in life
  • Engaged in family life
  • Having an active spiritual life
  • Reducing stress
  • Engaged in social life

Other attributes of centenarians

Dr. Thierry Hertoghe gave a presentation in Las Vegas on Dec. 14, 2019 where he stated that centenarians are positive thinkers. This was at the 27th Annual World Congress on Anti-Aging Medicine. In particular, the topic of his talk was “Positive Psychological Attitudes of Centenarians “. Dr. Hertoghe is an endocrinologist in Belgium. He took an interest in people above the age of 100. These people, he felt, are special people with a very optimistic outlook on life. Dr. Hertoghe went on to say that centenarians have a will to live. Indeed, they adapt to changes; they have a sense of purpose, and they stay active.

More positive attributes of centenarians

Other psychological features, by the same token, show that they have a positive mood and they avoid stress and anxiety. Another key point is that they have self-determination. It must be remembered also that they are very sociable, have close family ties, love their relationships and often have a strong religious faith. In addition, there is a connection between their basic values, beliefs and spirituality. Truly, centenarians insist on their freedom and they have a feeling of youth. For one thing, centenarians have their own centenarian spirit where they can feel young or old.

In the following I am reviewing some of the details that Dr. Hertoghe gave.

The will to live

For one thing, it takes courage to grow old, and all centenarians have this. They say “Life is worth living”. Essentially, they have a certain resiliency in a world that has an obsession about youth. Despite negative experiences they had to overcome they do not give up and they enjoy life as much as they can. A Finnish study examined 400 individuals aged 75-90 and followed them for 10 years. Group 1 who wished to live less than 5 years had a mortality rate of 68%. Group 2 wished to live for 5-10 years. They had a mortality of 45.6%. The last group, group 3 wanted to live more than 10 years. Surprisingly, their mortality was only 33.3%. Be careful what you wish for!

Adaptability

In other words, this describes the capacity to overcome adversity and your ability to adjust. In a study of 7400 Chinese centenarians’ resilience to changes was measured with psychometric psychological tests. The majority of subjects did not qualify for being resilient. However, 9% of male centenarians and 6% of female centenarians had the resiliency where they qualified for high adaptability. This high resilience group had a 2%-4% lower mortality risk. They had a 36%-55% higher probability of not developing cognitive impairment. That is to say, they rated themselves to be in good health and having a “good life” satisfaction. These resilient centenarians had a 7%-12% higher probability of not developing a physical disability. In essence, these high resilient centenarians had no short-term health decline.

Remaining active

If a centenarian remains active and moves about several hours per day, the body functions are preserved. Anna Mary Robertson Moses who was known by her nickname “Grandma Moses” took up painting at age 78. She died at age 101 in 1961.

Positive emotions

One study of 54 Ashkenazi Jewish older adults (aged 98-107) compared those with positive emotions to those with negative emotions. The researchers noted that a positive attitude about life allowed centenarians to live longer.

A study involving 2282 Mexican Americans aged 65 to 99 showed that positive affect scores were a predictor for the following. Subjects with a high positive affect had a 52% lower probability of becoming physically disabled. They were 36% less likely than the negative controls to lose their walking speed. In addition, they were 47% less likely to die during the two-year observation period than their negative controls.

Nurses’ Health Study and Veterans Affairs Normative Aging Study

Two studies, the Nurses’ Health Study (NHS) and men from the Veterans Affairs Normative Aging Study measured optimism. The researchers found that those with the highest optimism scores had a 1.5-fold higher probability in women and 1.7-fold in men to survive to age 85. This was compared to a control with the lowest optimism scores. Dr. Hertoghe provided 19 more studies that showed the effects of positive emotions regarding long term survival. For brevity reasons I will not dwell on them here.

What is the centenarian spirit?

When people are older than 100 years, they often have a mix of humor and eccentricity; they express emotions openly and they are happy people. They accept the death of spouses, siblings and significant others.

By the way, humor has a strong predictive survivor value. In a study that researchers conducted over 15 years, there was a clear positive effect of humor regarding mortality. A sense of humor reduced the all-cause mortality by 48% in males. In women humor lowered mortality regarding cardiovascular disease by 73%. Humor reduced death due to infections in women by 83%. Men had a non-significant reduction of all‐cause mortality by 12% and a significant lower mortality due to infections by 74%. Dr. Hertoghe cited three more publications that showed the power of humor in reducing disease and disability.

The fasting mimicking diet helps you to reach a longer life

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.

Key Factors for Centenarians

Key Factors for Centenarians

Conclusion

As we reviewed the factors that lead to longevity, we learnt that engaging in regular moderate exercise is one of the key factors. But belonging to the higher socioeconomic class and living in a mixed neighborhood with people from all walks of life is also important. We also reviewed the blue zones according to Dan Buettner. Mostly eating a plant-based diet including legumes with moderate calorie restriction prolongs your life. Add to this moderate intake of alcohol, mostly wine, and having a purpose in life. Augment this further with being engaged in family life, having an active spiritual life and reducing your stress level.

Living longer is a matter of fulfilling these longevity factors

With all of this you are on your way to become a centenarian. A review by Dr. Hertoghe in a lecture given at an Anti-Aging Conference in Las Vegas in 2019 added more criteria centenarians have. He provided references regarding the will to live, being adaptable, remaining active and harboring positive emotions. The more of these factors you can adopt, the longer you will live. At the same time, you will avoid getting diseases like heart attacks, strokes or cancer, which leads to a longer and healthier life.

The above text contains parts of this blog. The part about the fasting mimicking diet was published here before.

Apr
18
2020

Changes of Metabolism by Inflammation

Dr. James LaValle gave a presentation about changes of metabolism by inflammation in Las Vegas. I listened to this lecture on Dec. 15, 2020. The 27th Annual World Congress on Anti-Aging Medicine in Las Vegas took place from Dec. 13 to 15th, 2019. His original title was: “Innovations in Metabolism and Metaflammation”. This talk was complex and as a result it may not be easy reading. But it shows how various factors can affect our metabolism and our life expectancy.

In the first place he understands “metabolism” as all of the chemical reactions together that make you feel the way you feel today. In the same way metabolism is the chemistry that drives you toward future health. It is equally important to note that disregulation of your metabolism occurs from global metabolic inflammatory signalling. As has been noted he called this “metaflammation” (inflammation affecting your metabolism).

Dr. LaValle said that understanding disruptors of your metabolism can lead to renew your health on a cellular level. The key to achieve this is to remove inflammatory signals.

Factors that accelerate aging and damage your metabolism

It is important to realize that several factors interfere with the normal aging process. Oxidative stress and inflammation are major factors. But hormone disbalance and increased blood sugar values and insulin resistance can also contribute to accelerated aging and damage your metabolism. Certainly, with a disturbance of the immune balance, autoimmune reactions can take place, which also does not help. In addition, pollutants from the environment derange the metabolism due to heavy metals that block important enzymatic reactions. In the minority there are also genetic factors that can interfere with a normal metabolism.

Many of the metabolic changes can lead to chronic inflammation. One source of inflammation can be lipopolysaccharides that stimulate the immune system to start an inflammatory process.

Many conditions are associated with inflammation such as diabetes, obesity, stress, the SAD diet (standard American diet), and liver or kidney damage.

How Metaflammation is developing

Metaflammation can start in the gut with microbiota alterations. The wrong types of bacteria can release lipopolysaccharides, and low grade endotoxemia develops. With obesity inflammatory kinins start circulating in the body. Stress can activate inflammatory substances in the brain and the rest of the body. Major contributors to inflammation in the body come from faulty diets. The Western diet contains too much sugar and refined carbs; it is too high in trans fats and saturated fats. It contains too many artificial additives, preservatives, salt, sweeteners and dyes. And it is too low in nutrients, complex carbs and fiber.

More problems with metaflammation

Kidney and liver illness can contribute to metaflammation. Several diseases come from chronic inflammation, like cardiovascular disease, type 2 diabetes, chronic kidney disease, depression, cancer, dementia, osteoporosis and anemia. Metaflammation alters the methylation patterns, which can slow down your metabolism. Increased blood lipids and chronic inflammation of the blood vessels lead to cardiovascular problems. The liver and kidneys are the major detoxification organs, and their disease leads to more metaflammation. Metaflammation also leads to hormone disbalances, sleep disorders and dysfunction of the immune system. The brain reacts to metaflammation with cognitive dysfunction and mood disorders. Muscle loss (sarcopenia) is another issue, so is osteoporosis. Finally, chronic metaflammation can cause cancer.

Major causes of metaflammation

The three major causes of metaflammation are changes of the gut microbiome, obesity and chronic stress. When the gut bacteria change because of a Western diet, the wrong bacteria release lipopolysaccharides that are absorbed into the blood. The gut barrier is breaking down and a low grade endotoxemia develops. With obesity adipokines, which are inflammatory substances secreted by the fatty tissue, circulate in the blood. Chronic stress activates inflammation in the brain and in the body.

Two major conditions are common with metaflammation: hyperlipidemia (high fat levels in the blood) and hyperglycemia. Both of these conditions change the metabolism and lead to cardiovascular disease (hyperlipidemia) or to type 2 diabetes (hyperglycemia). Both of these metabolic changes lead to one or more of the conditions mentioned above, accelerate the aging process and lead to premature deaths.

Interaction of various organ systems can cause metaflammation

Dr. LaValle stated that it is vital that your hormones stay balanced. With chronic stress cortisol production is high. This causes increased insulin production, reduced thyroid hormone and lowered serotonin and melatonin production in the brain. It also leads to autoimmune antibodies from the immune system and decreased DHEA production in the adrenal glands. In addition, growth hormone production and gonadotropin hormones are slowing down. We already heard that cortisol levels are up. The end result of these hormone changes is that the blood pressure is up and abdominal visceral obesity develops. The brain shows cognitive decline, with memory loss as a result. The bones show osteopenia, osteoporosis and fractures. The muscles shrink due to sarcopenia, frailty is very common. Heart attacks and strokes will develop after many years. The immune system is weak and infections may flare up rapidly. There are also higher death rates with flus.

Other mechanism for pathological changes with hormone disbalances

When Insulin is elevated, inflammatory markers are found in the bloodstream. This elevates the C-reactive protein and leads to damage of the lining of the blood vessels in the body. A combination of insulin resistance and enhanced atherosclerosis increases the danger for heart attacks or strokes significantly.

There is a triangle interaction between the thyroid, the pancreas and the adrenals. Normally the following occurs with normal function. The thyroid increases the metabolism, protein synthesis and the activity of the central nervous system. The pancreas through insulin converts glucose to glycogen in the liver. It also facilitates glucose uptake by body cells. The adrenal hormones are anti-inflammatory, regulate protein, carbohydrate and lipid metabolism and contribute to energy production.

Change of thyroid/pancreas/adrenals triangle when cortisol is elevated

When cortisol is elevated the balance of the thyroid/pancreas/adrenals’ triangle is severely disturbed. Cortisol is high, the T4 to T3 conversion is limited and, in the brain, there is hippocampus atrophy with memory loss and brain fog. The immune system will change with production of inflammatory kinins (IL-6 and TNF alpha). Insulin sensitivity is down, sugar craving up and weight gain develops (central obesity).

Change of thyroid/pancreas/adrenals triangle when the thyroid is depressed

The thyroid activity can be lower because of autoimmune antibodies (Hashimoto’s disease) or because of hypothyroidism developing in older age. This leads to decreased pregnenolone synthesis from cholesterol. As pregnenolone is the precursor for all the steroid hormones, the metabolism slows down profoundly. Mentally there is depressed cognition, memory and mood. The cardiovascular system shows reduced function. In the gut there is reduced gastric motility. The mitochondria, which are tiny energy packages in each cell, are reduced in number, which causes a loss of energy. There is increased oxidative stress, increased lactic acid production and decreased insulin sensitivity.

Cardiovascular disease not just a matter of high cholesterol

Dr. LaValle stressed that a heart attack or stroke is not just a matter of elevated cholesterol. Instead we are looking at a complicated interaction between hypothyroidism, diabetic constellation and inflammatory gut condition. The inflammatory leaky gut syndrome causes autoimmune macrophages and Hashimoto’s disease. The end result is hypothyroidism. The inflammatory kinins (TNF-alpha, IL-6) affect the lining of the blood vessels, which facilitates the development of strokes and heart attacks. You see from this that cardiovascular disease development is a multifactorial process.

Microbiome disruption from drugs

Drugs affecting the intestinal flora are antibiotics, corticosteroids, opioids, antipsychotics, statins, acid suppressing drugs like protein pump inhibitors (PPI’s) and H2-blockers. Other factors are: high sugar intake, pesticides in food, bactericidal chemicals in drinking water, metformin, heavy metals and alcohol overconsumption. Chronic stomach infection with H. pylori, stress and allergies can also interfere with the gut microbiome.

The microbiome disruption affects all facets of metabolism. This means that there can be inhibition of nutrient absorption and this may affect the gut/immune/brain axis. There are negative effects on blood glucose levels and insulin resistance. A disturbance of the sleep pattern may be present. A significant effect on the hormonal balance can occur (thyroid hormones, sex hormones and appetite related hormones). When liver and kidney functions slow down, there is interference of body detoxification.

Dr. LaValle talked more about details regarding the gut-brain-immune pathology. I will not comment on this any further.

Changes of Metabolism by Inflammation

Changes of Metabolism by Inflammation

Conclusion

Dr. LaValle gave an overview in a lecture regarding changes of metabolism by inflammation. This took place at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019.

This article is complex and contains a lot of detail, but there is one simple truth: oxidative stress and inflammation are major factors that influence our health on many parameters and lead to a list of illnesses. They lead to hormone disbalance and increased blood sugars and insulin resistance, which can also contribute to accelerated aging and damage of your metabolism. Dr. LaValle explained how high cortisol from chronic stress can lead to low thyroid hormones and in the brain, there is hippocampus atrophy with memory loss and brain fog. With alterations of the immune system there is production of inflammatory kinins (IL-6 and TNF alpha). Insulin sensitivity is down, sugar craving up and weight gain develops (central obesity). It does not stop there! We put our hope in medications, but the sad truth is that there are

Drugs that change the gut biome

Many drugs that are common also change the gut biome with resulting increased permeability of the gut wall (leaky gut syndrome). This overstimulates the immune system and leads to autoimmune diseases like Crohn’s disease and rheumatoid arthritis. Whenever there is an injury to the gut barrier, the blood brain barrier is following suit. This is how brain disease can develop as a result of a change in the gut biome. Impaired cognition, memory and mood can result from this. Alzheimer’s disease is one of the worst conditions that may be related to a combination of gut inflammation, chronic stress and inflammatory kinins.

Jan
11
2020

Centenarians Are Positive Thinkers

Dr. Thierry Hertoghe gave a presentation in Las Vegas on Dec. 14, 2019 where he stated that centenarians are positive thinkers. This was at the 27th Annual World Congress on Anti-Aging Medicine. The topic of his talk was “Positive Psychological Attitudes of Centenarians “.

Dr. Hertoghe is an endocrinologist in Belgium. Dr. Hertoghe took an interest in people above the age of 100. He felt that these people are special people with a very optimistic outlook on life. He went on to study the literature about this topic in detail and this is what this talk was about.

The oldest man, Gustav Gerneth died at 114 years 7 days in Germany (Oct. 22, 2019). The oldest female is Japan’s Kane Tanaka at 117 years (birthday Jan. 2,1903).

So, what is their secret to age that well? Here is what Dr. Hertoghe found out about centenarians.

Attributes of centenarians

Centenarians have a will to live. They adapt to changes; they have a sense of purpose, and they stay active. Other psychological features show that they have is a positive mood and they avoid stress and anxiety. Another important attribute is self-determination. They are very sociable, have close family ties, love their relationships and often have a strong religious faith. There is a connection between their basic values and beliefs and their spirituality. Centenarians insist on their freedom and they have a feeling of youth. Centenarians have their own centenarian spirit where they can feel young or old.

In the following I am reviewing the details that Dr. Hertoghe gave. He covered 13 subtopics regarding causes of longevity in centenarians.

The will to live

It takes courage to grow old and all centenarians have this. They say “Life is worth living”. They have a certain resiliency in a world that has an obsession about youth. Despite negative experiences they had to overcome they do not give up and they enjoy life as much as they can. A Finnish study examined 400 individuals aged 75-90 and followed them for 10 years. Group 1 who wished to live less than 5 years had a mortality rate of 68%. Group 2 wished to live for 5-10 years. They had a mortality of 45.6%. The last group, group 3 wanted to live more than 10 years. Their mortality was only 33.3%. Be careful what you wish for!

Adaptability

This describes the capacity to overcome adversity and your ability to adjust. In a study of 7400 Chinese centenarians’ resilience to changes was measured with psychometric psychological tests. The majority of subjects did not qualify for being resilient. Only 9% of male centenarians and 6% of female centenarians had the resiliency where they qualified for high adaptability. This high resilience group was associated with 2%-4% lower mortality risk. They had a 36%-55% higher odds of not developing cognitive impairment and they rated themselves as being in good health and having a “good life” satisfaction. These resilient centenarians had a 7%-12% higher probability of not developing a physical disability. Short-term health decline was not associated with these high resilient centenarians.

A sense of purpose

Centenarians can still contribute to society. Tao Porchon-Lynch turned 100 in 2014. She opened the Westchester Institute of Yoga in 1982 and is still practicing yoga. There are many ways how centenarians express a sense of purpose. Males often work in their old job, but only part-time. They may help with babysitting the great-grandchildren. Others do volunteer service. Still others may enrol in a university and study what they always wanted to do.

In a 2016 publication people older than 65 were followed between February 2011 and November 2014. Those who had neither hobbies or a purpose in life did not fare well. They had a risk of mortality of 2.08-fold compared to those with a sense of purpose. Dr. Hertoghe provided 9 more references regarding studies that showed the same finding.

Remaining active

If a centenarian remains active and moves about several hours per day, the body functions are preserved. Anna Mary Robertson Moses who was known by her nickname “Grandma Moses” took up painting at age 78. She died at age 101 in 1961.

Positive emotions

One study of 54 Ashkenazi Jewish older adults (aged 98-107) compared those with positive emotions to those with negative emotions. The researchers noted that a positive attitude about life allowed centenarians to live longer.

A study involving 2282 Mexican Americans aged 65 to 99 showed that positive affect scores were a predictor for the following. Subjects with a high positive affect had a 52% lower probability of becoming physically disabled. They were 36% less likely than the negative controls to lose their walking speed. In addition, they were 47% less likely to die during the two-year observation period than their negative controls.

Nurses’ Health Study and Veterans Affairs Normative Aging Study

Two studies, the Nurses’ Health Study (NHS) and men from the Veterans Affairs Normative Aging Study measured optimism. The researchers found that those with the highest optimism scores had a 1.5-fold higher probability in women and 1.7-fold in men to survive to age 85. This was compared to a control with the lowest optimism scores. Dr. Hertoghe provided 19 more studies that showed the effects of positive emotions regarding long term survival. For brevity reasons I will not dwell on them here.

Better stress management

Centenarians avoid excessive stress and attempt to relax instead.  It has been known since the ground-breaking work by Dr. Hans Selye that stress undermines longevity. By using relaxation methods intermittently one can reduce the stress response, which normalizes the excessive ACTH production in the pituitary gland and the concomitant cortisol production in the adrenal glands.

Self-determination

Long-living people have a strong willpower and are determined to succeed with what they want. They have a sense of self-worth and self-esteem. Centenarians have concerns for others, but they also have a healthy regard for themselves. Dr. Hertoghe provided 4 references to illustrate this, but for brevity reasons I will omit them here.

Social involvement

Centenarians have an active social life. They are involved with their family, with the community including often church communities. Sociability has a 2.3-fold higher probability of survival (mortality reduced by 57% due to sociability). Other studies confirmed this.

Practicing religion

Those who are centenarians were often raised in religious families. They developed a strong faith in God. A common theme among centenarians is that they trust in God and believe it is His will that they lived a long life. They also believe that eventually God will call them “home” when He is ready for them. Centenarians who practice religion have a strong belief in an afterlife, which sustains them to live and they accept death when it comes. In a 2017 study 18,370 participants aged 50 and older were interviewed in 2004 and followed for all-cause mortality to 2014. Regular church attendants had a mortality that was 40% less than those who did not attend. Dr. Hertoghe provided 20 more references that showed similar findings.

Spiritual involvement

Attributes of spiritual involvement are high ethical principles, resilience and hope that everything will turn out OK. Dr. Hertoghe cited from 7 different references that the average effect of spirituality leads to a 2- to 4-fold greater survival over 17 years.

A feeling of freedom

This makes centenarians less concerned what other people think of them. Dr. Helen Langner, a psychiatrist, still does a part-time psychiatric practice at age 100. She says about a feeling of freedom: “In old age, there’s often a sense of personal freedom because there is less pressure of a career or the responsibilities of work or raising a

family. It can and should be a time for people to do the things that are important to them and a time to enjoy. “

A feeling of youth

Many centenarians are young at heart. Even though they may look physically old, they don’t feel old in their heart.

What is the centenarian spirit?

When people are older than 100 years, they often have a mix of humor and eccentricity; they express emotions openly and they are happy people. They accept the death of spouses, siblings and significant others.

By the way, humor has a strong predictive survivor value. In a study that researchers conducted over 15 years, there was a clear positive effect of humor regarding mortality. A sense of humor reduced the all-cause mortality by 48%. In women humor lowered mortality regarding cardiovascular disease by 73%. Humor reduced death due to infections in women by 83%. Men had a non-significant reduction of all‐cause mortality by 12% and a significant lower mortality due to infections by 74%.

Dr. Hertoghe cited three more publications that showed the power of humor in reducing disease and disability.

Jeanne Louise Calment 

As an illustration for humor Dr. Hertoghe introduced Jeanne Louise Calment to the audience. She was a French woman who broke the record for being the oldest centenarian in the world.  Jeanne Calment died on August 4, 1997 at the age of 122 years and 164 days. She was asked by someone: “Why do you live so long?” She replied: “Because God has forgotten me…” Next question: “How do you consider your future life?” “Very, very short”. Last question:” What do you think of your wrinkles?” “The only wrinkle I have is the one I am sitting on”.

Centenarians Are Positive Thinkers

Centenarians Are Positive Thinkers

Conclusion

Centenarians have certain attributes that make them more resilient than others who die earlier. They have a will to live, an ability to adjust, a sense of purpose and they stay active. Their psychological make-up is such that they have a positive mood and they tend to avoid stress and anxiety. They have a sense of self-determination. They are very sociable, have close family ties, love relationships with people around them, and often have a strong religious faith. Their spirituality has a connection to their basic values and beliefs. Centenarians insist on their freedom and they have a feeling of youth. They have their own centenarian spirit where they can feel young or old. But they also have humor as documented above with the oldest woman that lived. She was 122 years and 164 days old when she died in 1997.

Dec
22
2018

Biological Age Is Different From The Chronological Age

Biological age is different from the chronological age said professor Morgan Levine from Yale Medical School. She is working in the department of pathology. She has found in her research that people of the same chronological age have very different biological ages. From a biological standpoint they may be much younger or older than their chronological age. When people are younger than their chronological age, they have less disease and less mortality. This article has reviewed the facts.

Measuring biological age

Dr. Levine also has developed tools how to determine the biological age. And when the biological age is higher than the chronological age, she recommends lifestyle changes that will set back the biological clock. We age differently according to what we eat, how our genetic make-up is, which we cannot change, whether we are physically active and what environmental toxins we are exposed to. So, the biological age determines our health status and what our final life expectancy will be.

Biomarkers for biological age

A simple blood test that your family doctor can order consists of the following. A fasting blood sugar, kidney and liver tests, immune tests and inflammatory tests. In addition the doctor will want to know whether you are smoking or not, how much alcohol you consume and how much red meat and processed meat you eat. A computer program processes these results, which determines your biological age.

Lifestyle improvements can lower biological age

Biological age testing has a strength built in. By changing your lifestyle you can lower it. When you exercise more regularly and switch to eating a Mediterranean diet you can lower your biological age. Other studies have shown that the Mediterranean diet is anti-inflammatory. A telomere test, which also determines the biological age, is fixed. It is not easily changed by dietary measures and increasing your exercise.

Dr. Levine said: “I think the most exciting thing about this research is that these things aren’t set in stone.”

Putting the biological age to the test

Dr. Levine was curious what her own biological age was. She entered her blood test data and lifestyle facts into the computer. She was surprised that her biological age was not as good as her first assumption. Now she is trying to get more sleep, has increased her exercise level and improved her diet.

Her research team is working on getting the algorithm online so that everyone will be able to put one’s blood tests and other data into the computer program and calculate the biological age. The program will also recommend what steps are likely most helpful to increase one’s health and decrease the biological age.

Lower your biological age

No one wants to live a long life, if they are in pain and have various illnesses like arthritis or Alzheimer’s. But things are different, if they can change lifestyle factors and maintain a low biological age for a long time. Now they can stay active, have no pains and are able to contribute to society.

“By delaying the onset of diseases and cognitive and physical functioning problems people can still be engaged in society,” Dr. Levine said. “I think that is the ideal we should be striving for.”

Other literature about biological age

Inflammation increases the biological age

In this publication the authors stressed that inflammation is the common denominator for developing disease and premature aging. The authors stress further that it is mandatory to change one’s lifestyle to lower the biological age and live longer.

Diastolic blood pressure predicts mortality

In an older study the diastolic blood pressure was related to mortality. The higher the diastolic blood pressure was, the higher the mortality.  The authors also noted that it was the persons with the higher biological age who were at the highest risk of dying.

Scientific study about the predictors for the biological age

Here is a scientific study that examines predictors for the biological age.  This is not easy reading, but I placed it here for completeness sake.

Link to a site that can calculate your biological age

Here is a link to a site that calculates your biological age. It is probably not as good as Dr. Levine’s computer analysis will be when it is available. However, it is a good approximation to what it will be like.

Biological Age Is Different From The Chronological Age

Biological Age Is Different From The Chronological Age

Conclusion

The dream of staying younger for longer is not new. Research has shown that we actually can do something about it. If we look after our lifestyle, don’t smoke, don’t drink excessively, eat a sensible Mediterranean-type diet and exercise regularly, our biological age will be less than our chronological age. It is the biological age that determines how old we get and whether or not we will suffer from age-related illnesses. Researchers also found out that when your biological age is younger than your actual age mortality will occur later. The math is simple. Let’s assume that your biological age is 15 to 20 years younger than your chronological age. As the average life expectancy presently is 80 years, your life expectancy can increase to 95 or 100 years.

Nov
03
2018

When you are sleepless

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

Previous review of the topic of insomnia

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

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

Hormone factors of insomnia

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

Stress and insomnia

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

What to do when you are sleepless

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

Melatonin for when you are sleepless

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

Phosphorylated serine (Seriphos)

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

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

Valerian root capsules

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

Other considerations when you are sleepless

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

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

Sleep lab for when you are sleepless

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

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

Treatment for insomnia when over-the-counter remedies fail

Short acting benzodiazepams

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

Longer acting benzodiazepams combined with antidepressant Trazodone

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

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

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

Clonazepam side effects

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

When you are sleepless

When you are sleepless

Conclusion

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

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

Other possibilities to treat insomnia

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

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