Oct
12
2013

Music More Powerful Than Anti-Anxiety Drugs

When was the last time you saw your physicians for anxiety and you were given a prescription that said: “for anxiety listen to your favorite music!” instead of receiving a prescription for an anti-anxiety drug (anxiolytic). This is exactly what a recent study suggests that showed prior to surgery you can control your anxiety either with anti-anxiety drugs or by listening to your favorite music. Listening to your favorite music will do you no harm, while many drugs do have harmful side effects.

How singing can change the brain chemistry

Other studies have investigated how singing can change your brain functioning in terms of brain chemistry. The researchers found that singing will release dopamine in your brain, which is responsible for feeling pleasure; it will stimulate your immune system by elevating immunoglobulin A and decreasing cortisol (the stress hormone). This in turn will preserve your immune cells (lymphocytes). Oxytocin levels of your brain are increased, which promotes social affiliation. It also calms down the autonomic nervous system resulting in a better airway opening, calming of your heart rate and soothing the wave-like muscle contractions in your gut, medically called peristalsis. You would refer to that as “butterflies in your stomach”. Music therapy reduces pain and anxiety by 50% and is important for children and adults alike.

Pain and anxiety reduced

A study in Germany showed that pain and anxiety were significantly reduced with music therapy. A Taiwanese study of women in labor found that music therapy significantly reduced pain and anxiety of women during labor. Ref. 1 explains that music therapy is useful as an adjunct to treating cancer pain, and reducing anxiety associated with colposcopy procedures. It also can help when treating patients who had heart attacks in the setting of a cardiac care unit.

Music More Powerful Than Anti-Anxiety Drugs

Music More Powerful Than Anti-Anxiety Drugs

Hypnosis and guided imagery

Music has been successfully combined with clinical hypnosis and guided imagery where words are carefully chosen to help the patient experience pleasant feelings, which counteract the experience of pain, anxiety or fear of dying. A simple relaxation CD or tape with soothing background music will facilitate this type of therapy. This is useful for patients in a palliative care unit where they prepare themselves to accepting the inevitable death from an incurable disease. But chemotherapy patients undergoing these procedures for cancer treatments also have benefitted from a significant reduction in nausea, vomiting (side effects of chemotherapy) and pain.

Autism and music therapy

A Cochrane study showed that autistic children did better in terms of communication skills when music therapy was incorporated into the treatment protocol. One of the core deficits in autistic children is in the area of communication and social skills. This is where music therapy was most effective. Behavioral problems (stereotypic behavior) in autistic children did not respond to music therapy. A comprehensive treatment program for autistic children should therefore incorporate music therapy. Here is a blog that describes what difference music therapy can make in the lives of autistic children written by a member of the American Music Therapy Association.

Substance abuse and music therapy

An area where you may not expect music therapy to have a role is in the area of drug and substance abuse rehabilitation , which is discussed in more detail in this site. The beauty about music therapy is that it is not a drug, yet the natural endorphins that are released by the brain help the affected person getting through withdrawal easier. Music therapy helps building up self-esteem, participating in group activities, promoting self awareness and expressing feelings.

Mood disorders in adolescents

One important area where music therapy has been employed is with anxiety and depression in adolescents. Adolescents spend an average of 4 hours per day listening to music. So they are already programmed to listen to music. With the help of a music therapist they can be directed to listening to the type of music that will help them get motivated, relax more, make them feel accepted and be part of their peer groups. In this study the authors suggested to combine music therapy with dance and art therapy. In this way the whole person gets involved in the treatment and this can be integrated with conventional antidepressant treatments at reduced doses (with less side-effects) or with cognitive therapy.

General objectives of music therapy

Music therapy is best incorporated into a treatment protocol as an adjunct. It can help reduce the use of drugs for psychiatric patients, for people with anxiety and for patients with pain conditions. The Cleveland clinic has a useful summary about music therapy, which describes the uses of it for reducing anxiety, for helping with coping skills, mood improvement and distraction from pain. There are registered music therapists you can ask for help. The website of the American Music Therapy Association may have other useful links for you.

Conclusion

Music therapy is a treatment modality with no side effects, but providing effective treatment for quite an impressive range of clinical conditions as discussed. Music therapists are widely available in the US and many other countries. This treatment can be integrated with conventional or complementary treatments. It helps people to heal the body as a whole unit (mind and body).

More information on anxiety disorders: http://nethealthbook.com/mental-illness-mental-disorders/anxiety-disorders-panic-disorders-phobias-ocd-ptsd-anxiety-others/

References

1. Rakel: Integrative Medicine, 3rd ed.© 2012 Saunders. Chapter on Integrative Therapy; subchapter of Mind-Body Therapy.

Last edited Nov. 7, 2014

Sep
28
2013

Sleepless Nights

Sleeping problems (insomnia) are very common. About 10% of the population suffers from chronic insomnia; 30% of the population suffers from occasional sleep problems. In a large outpatient population of a clinic consisting of 3500 patients who had at least one major clinical condition, 50% complained of insomnia, 16% had severe symptoms, 34% had mild symptoms (Ref.1). Insomnia is more common among women, and older people as well as in people with medical or psychiatric illnesses. Long-term studies have shown that the same insomnia problems persist throughout many years. It is not possible to offer a simple remedy for insomnia, because insomnia is a complex problem. Here I will discuss some of the causes of insomnia and also discuss some of the treatment options.

Symptoms of insomnia

The person who suffers from insomnia will usually state that they have problems falling asleep. Worries of the day suddenly circulate through their thoughts and they toss and turn nervously looking at the clock from time to time and getting more and more anxious that they cannot sleep. Others fall asleep OK, but in the middle of the night they wake up perhaps to visit the restroom, but then they cannot go back to sleep. Others wake up 2 hours before their normal alarm clock time and they feel their stomach rumbling making it impossible to fall back to sleep. Older people with chronic diseases and general poor health suffer more from insomnia. In this setting insomnia may be more related to the underlying disease rather than old age. Psychiatric disorders also are associated with more insomnia. Treat the underlying psychiatric illness, and the insomnia disappears.

Although insomnia is a sleep disturbance during the nighttime, people who are affected with this complain of daytime fatigue, of overstimulation, yet they catch themselves making frequent mistakes, and their inability to pay attention gets them involved in accidents and falls. Longitudinal studies have shown (Ref. 1) that people with chronic insomnia are more likely to develop psychiatric disease, such as major depression,  anxiety disorder and alcohol and substance abuse. Unfortunately these disorders can by themselves again cause insomnia, which reinforces chronic insomnia. Insomnia leads to poorer social and physical functioning, affects emotions, leads to a lack of vitality and physical endurance, contributes to worsening of pain and can affect general and mental health.

Research about insomnia

Much has been learnt from sleep studies using polysomnography monitoring during a full night’s sleep. These studies have been used mainly as a research tool. In such studies eye movements, brain wave activity, muscle activity, chest movements, airflow, heart beats, oxygen saturation and snoring (with a microphone) are all simultaneously recorded. This way restless leg syndrome, sleep apnea, snoring, seizure disorders, deep depression etc. that can all lead to insomnia can be diagnosed and separated from insomnia. The stages of sleep (wakefulness, stage 1 to 3 sleep and the REM sleep stage) can also be readily measured using polysomnography (Ref.2). According to this reference the majority of insomnia cases do not need this complex procedure done.

Sleepless Nights

Sleepless Nights

Causes of insomnia

Traditionally insomnia cases are classified into primary insomnia and secondary insomnia. Secondary insomnia is caused by all of the factors discussed below. When they are dealt with, we are left with cases of primary insomnia.

The following medical conditions can cause insomnia: heart disease, pulmonary diseases like asthma and chronic obstructive pulmonary disease (COPD); gastrointestinal disease like liver cirrhosis, pancreatitis, irritable bowel syndrome, ulcers, colitis, Crohn’s disease; chronic kidney disease; musculoskeletal disease like arthritis, fractures, osteoporosis; neurodegenerative disease like MS, Parkinson’s disease, Alzheimer’s disease; endocrine disease like diabetes, hyper- or hypothyroidism, adrenal gland fatigue and insufficiency; and chronic pain conditions. Also, psychiatric conditions like major depression, schizophrenia and anxiety disorders can cause insomnia.

This list in not complete, but it gives you an idea of how complex the topic of insomnia is.
The physician who is seeing a patient with insomnia needs to rule out any of these other causes of insomnia to be certain that the only condition that is left to treat in the patient is insomnia itself. The other diagnoses have to be dealt with separately or else treatment of insomnia will fail.

Ref. 1 points to a useful model of how to think about causation of insomnia: there are three points to consider, namely predisposing, precipitating, and perpetuating factors. Let’s briefly discuss some of these.

Predisposing factors

We are all different in our personal make-up. If you are well grounded, chances are you are not susceptible to insomnia. Anxious persons or persons who have been through a lot of negative experiences in life will have personality traits that make them more prone to insomnia. Lifestyle choices such as late nights out, drinking with the buddies in a bar (extreme circadian phase tendencies) will have an impact on whether or not you develop insomnia.

Precipitating factors

A situational crisis like a job change or the death of a loved one can initiate insomnia.  However, there could be a medical illness such as a heart attack, a stroke or the new diagnosis of a psychiatric illness that has become a precipitating factor. Sleep apnea and restless leg syndrome belong into this group as well as would the stimulating effect of coffee and caffeine containing drinks. Jet lag and nighttime shift work can also be precipitating factors.

Perpetuating factors

Daytime napping to make up for lost sleep the night before can undermine sleep initiation the following night, which can lead to a vicious cycle. Similarly, the use of bedtime alcoholic drinks leads to sleep disruption later that night and can become a perpetuating factor, if this habit is maintained. Even the psychological conditioning of being anxious about whether or not you will fall asleep easily or not the next night can become a perpetuating factor.

I will return to this classification and the factor model of causation of insomnia when we address treatment options.

Drugs that can cause insomnia

One major possible cause for insomnia  can be side effects from medications that patients are on (would belong to the ‘perpetuating factors’ among causes). Physicians call this “iatrogenic insomnia”. The antidepressants, called selective serotonin reuptake inhibitors (SSRI’s) like Prozac are particularly troublesome with regard to causing insomnia as a side effect. Other antidepressants like trazodone (Desyrel) are used in small doses to help patients with insomnia to fall asleep. Some asthmatics and people with autoimmune diseases may be on prednisone, a corticosteroid drug. This can cause insomnia, particularly in higher doses; so can decongestants you may use for allergies; beta-blockers used for heart disease and hypertension treatment; theophylline, an asthma medication and diuretics. Central nervous stimulants like caffeine or illicit drugs can also cause insomnia. Hormone disbalance in general and hyperthyroidism specifically as well as Cushing’s disease, where cortisol levels are high will cause insomnia.

Treatment of insomnia

So, how should the physician approach a patient with insomnia? First it has to be established whether there is secondary insomnia present due to one of the predisposing, precipitating or perpetuating factors. In other words, is there secondary insomnia due to other underlying illnesses? If so, these are being addressed first. Lifestyle choices (staying up late every night) would have to be changed; alcohol and drug abuse and overindulging in coffee or caffeine containing drinks needs to be dealt with. Cognitive therapy may be beneficial when mild depression or anxiety is a contributing factor to insomnia.

The remaining insomnia (also medically termed “primary insomnia”) is now being treated.

The following general points are useful to get into the sleeping mode (modified from Ref. 3):

  1. Ensure your bedroom is dark, soundproof, and comfortable with the room temperature being not too warm, and you develop a “sleep hygiene”. This means you get to sleep around the same time each night, have some down time 1 hour or so before going to bed and get up after your average fill of sleep (for most people between 7 to 9 hours). Do not sleep in, but use an alarm clock to help you get into your sleep routine.
  2. Avoid caffeine drinks, alcohol, nicotine and recreational drugs. If you must smoke, don’t smoke later than 7PM.
  3. Get into a regular exercise program, either at home or at a gym.
  4. Avoid a heavy meal late at night. A light snack including some warm milk would be OK.
  5. Do not use your bedroom as an office, reading place or media center. This would condition you to be awake.  Reserve your bedroom use only for intimacy and sleeping.
  6. If you wake up at night and you are wide awake, leave the bedroom and sit in the living room doing something until you feel tired and then return to bed.
  7. A self-hypnosis recording is a useful adjunct to a sleep routine. Listen to it when you go to bed to give you something to focus on (low volume) and you will find it easier to stop thinking.

Drugs and supplements for insomnia

1. In the past benzodiazepines, such as diazepam (Valium), lorazepam (Ativan), fluorazepam (Dalmane), temazepam (Restoril), triazolam (Halcion) and others were and still are used as sleeping pills. However, it was noted that there are significant side effects with this group of drugs. Notably, there is amnesia (memory loss), which can be quite distressing to people such as not remembering that someone phoned while under the influence of the drug, you promised certain things, but you cannot remember the following morning what it was. Another problem is the development of addiction to the drugs with worse insomnia when the drugs are discontinued. Many physicians have stopped prescribing benzodiazepines.

2. There are non-benzodiazepines drugs that are used as sleeping pills (hypnotics), such as Zaleplon (Sonata), Zolpidem (Ambien) and Eszopiclone (Lunesta).  They seem to be better tolerated.

3. Ramelteon, a melatonin agonist, is available by prescription in the US. It probably is the best-tolerated mild sleeping pill and works similar to melatonin, but is more expensive. Chances are that your physician likely would prescribe one of the non-benzodiazepines drugs or Ramelteon for you as they do not seem to be addicting.

4. However, there is an alternative: Many patients with insomnia tolerate a low dose of trazodone (Desyrel), which is an antidepressant with sleep restoring properties. A low dose of 25 to 50 mg at bedtime is usually enough for insomnia. This allows the patient to fall asleep within about 30 minutes of taking it, and sleep lasts through most of the night without a hangover in the morning. Many specialists who run sleep laboratories recommend trazodone when primary insomnia is diagnosed. However, this is still a drug with potential side effects as mentioned in the trazodone link, but 50 mg is only ¼ of the full dose, so the side effects will also be less or negligible.

5. I prefer the use of melatonin, which is the natural brain hormone designed to put us to sleep. Between 1 mg and 6 mg are sufficient for most people. We know from other literature that up to 20 mg of melatonin has been used in humans as an immune stimulant in patients with metastatic melanoma with no untoward side effects other than nightmares and some tiredness in the morning. A review from the Vanderbilt University, Holland found melatonin to be very safe as a sleeping aid. There are several melatonin receptors in the body of vertebrates (including humans), which are stimulated by melatonin.

6. Other natural methods are the use of L-Tryptophan at a dose of 500 mg at bedtime, which can be combined with melatonin. It is the amino acid contained in turkey meat, which makes you tired after a Thanksgiving meal. GABA is another supplement, which is the relaxing hormone of your brain, but with this supplement tolerance develops after about 4 to 5 days, so it is only suitable for very short term use. Herbal sleep aids are hops, valerian extract and passionflower extract. They are available in health food stores.

Conclusion

A lack of sleep (insomnia) is almost a given in our fast paced lives.

When it comes to treatment, all of the other causes of secondary insomnia need to be treated or else treatment attempts would fail. What is left is primary insomnia. This is treated as follows:

We need to review our sleeping habits, lifestyles and substance abuse. Remove what is detrimental to your sleep. Start with the least invasive treatment modalities such as self-hypnosis tapes, melatonin, L-Tryptophan or herbal extracts. Should this not quite do the trick, asks your doctor for advice. The non-benzodiazepines drugs or Ramelteon would be the next level up. It may be that an alternative such as low dose trazodone would be of help. Only, if all this fails would I recommend to go to the more potent sleeping pills (keep in mind the potential for addiction to them).

References

1. David N. Neubauer, MD (John Hopkins University, Baltimore, MD): Insomnia. Primary Care: Clinics in Office Practice – Volume 32, Issue 2 (June 2005)  © 2005, W. B. Saunders Company

2: Behrouz Jafari, MD and Vahid Mohsenin, MD (Yale Center for Sleep Medicine, Yale University School of Medicine, New Haven, CT, USA): Polysomnography. Clinics in Chest Medicine – Volume 31, Issue 2 (June 2010), © 2010 W. B. Saunders Company

3. Jean Gray, editor: “Therapeutic choices”, 5th edition, Chapter 8 by Jonathan A.E. Fleming, MB, FRCPC: Insomnia, © 2008, Canadian Pharmacists Association.

Last edited Sept. 28, 2014

Jun
15
2013

Electro-Acupuncture Is Twice As Effective As Conventional Acupuncture

I am discussing here that electro-acupuncture is twice as effective as conventional acupuncture. Imagine that you had lower back pain and your doctor said that physically everything was OK. Would you consider traditional Chinese acupuncture? 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). The much simpler, but more effective electro-acupuncture using electrical skin pads instead of needles replaced traditional Chinese acupuncture.

The science of electro-acupuncture

In 1958 news came from China that they were doing major surgeries with patients staying awake and pain free only with the use of electro-acupuncture. In other words no chemical anesthesia was necessary to make patients comfortable. Professor Ji-Sheng Han from the Beijing Medical University observed that only electrical stimulation was powerful enough to produce the pain relief that was necessary to allow general surgery. Dr. Han conducted systematic experiments to study the phenomenon of electro-acupuncture and published this in Ref. 2. One of the experiments consisted of two rabbits. Electro-acupuncture anesthetized the donor rabbit. The vet removed spinal fluid from the first rabbit and transferred it into the second rabbit (the recipient rabbit) that did not receive further treatments.

The second rabbit was pain free and the vet performed surgery 

The injection of spinal fluid made the second rabbit pain free to the point where the vet could performed surgery on it without pain. Other researchers such as Dr. Pomeranz found that the brain released endorphins in response to electro-acupuncture, powerful morphine-like substances. It was the endorphins that were responsible for making the recipient rabbit of Dr. Han’s experiment pain free. Other experiments of Dr. Pomeranz showed that naloxone, a morphine and endorphin blocker also blocked the analgesic effect previously found by transferring spinal fluid. These lines of experiments also explain why some patients did not respond to electro-acupuncture, as they have a deficiency in the pain control system of their brain lacking endorphin release. Dr. Han did 30 years of experimentation and also observed patients very closely.

Placebo effect investigated by Dr. Han

Dr. Han also investigated the placebo effect and found that this can explain about 30% of healing. However, the remainder of the 70 to 75% response to electro-acupuncture in his opinion was due to the procedure. He was able to explain that traditional Chinese acupuncture points were merely spots on the body where electric currents penetrate the skin easier. When internal nerves pick up the electrical signals the also transmit to the spinal cord and to the brain. The electrical impulses then switch over in the brain and spinal cord to nerves that go to other areas of the body. This explains how electrical impulses can travel from conducting polymer pads applied over acupuncture points, release neuropeptides in the brain and help the body to heal. Functional MRI studies confirmed that certain frequencies stimulate the brain through electro-acupuncture or traditional Chinese acupuncture to give pain relief.

Electro-Acupuncture Twice As Effective As Conventional Acupuncture

Electro-Acupuncture Twice As Effective As Conventional Acupuncture

Electro-acupuncture produces stronger signals in the brain

These types of studies have also shown that electro-acupuncture produces stronger signals in the brain than traditional Chinese acupuncture.

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. The health professional can use this method 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. However, this may also be useful as an adjunct to treating high blood pressure and cardiovascular disease.

One area where clinical hypnosis and electro-acupuncture have a closely relationship is called “conditioned healing” (Ref.1). For instance, with posttraumatic stress disorder (PTSD) in soldiers who returned from battle or in rape victims researchers showed that hypnotherapy treatment while using electro-acupuncture for 30 minutes at the same time can be useful in alleviating the symptoms these patients experience.

A few case studies using electro-acupuncture

Here are a few case studies that illustrate the use of electro-acupuncture with regard to patients (modified Ref.1). A treatment consists of a 30-minute session where the patient is either sitting or resting comfortably on an examining table. Treatments initially are often given twice per week until the pain is only about 50% of the original pain (severity of pain is scored on a 0 to 10 scale in the beginning). From that point on the visits are reduced to weekly sessions. Most clinical problems require three to 12 sessions. If the pain goes away, but returns after a few weeks, repeat sessions can be scheduled, which often lead to pain relief in a shorter time interval than was the case with the original problem. Chronic problems can be treated on an ongoing basis once per month, if there was a clinical response, but the pain reoccurs.

A 53-year-old painter with left shoulder pain

A 53-year-old painter with left shoulder pain, which radiated into the left chest, had problems with painting above his head. His physician did heart studies, but everything was OK. He was told that this was due to a muscle spasm in the shoulder muscles. One electrode was placed over the hoku point (also called LI-4  acupuncture point), which is located over the first interosseous muscle between the thumb and index finger, the other electrode over the area of pain in the left shoulder. Only seven treatments, twice per week for 2 weeks were given, then treatments with weekly intervals were administered. This approach cured his shoulder problems, and he could return to paining.

A 39-year-old woman with lower back pain

A 39-year-old woman came to the office complaining of lower back pain, which radiated into her right leg to the knee area. After tests she was told that she had spinal stenosis with sciatica (irritation of the sciatic nerve). No surgery could be done for this. She was given twelve electro-acupuncture treatments with one electrode placed below her right knee (ST-36 acupuncture point) and another electrode placed over her right lower back over one of the BL acupuncture points. She was almost pain free for about two weeks, but the pain came back after the last treatment. Since then she has been getting ongoing monthly electro-acupuncture visits with about 80% pain relief. Keep in mind that spinal stenosis is a condition for which regular medicine has nothing to offer other than symptomatic pain medication, which she did not want.

A 30-year-old schoolteacher with anxiety attacks 

A 30-year-old schoolteacher suffered from anxiety attacks and agoraphobia (fear of open spaces) for several years. The therapist used conditioning with electro acupuncture to treat this woman. She received a series of treatments with electro-acupuncture over both interosseous muscles (hoku acupuncture point or LI-4) for 30 minutes during which time she was also listening to a relaxation tape with music in the background and suggestions for self-hypnosis. The physician taught her how to do self-imagery at home. Subsequently she did this for 10 minutes two or three times per day. Several weeks later she was able to control her anxiety attacks and overcome her fear of open spaces. In the beginning she rated her symptoms as 8 to 10 in severity on a scale from 0 to 10. At the end of the sessions, she only had occasional symptoms with a 1 to 2 rating on this scale.

A 50-year-old man with cluster headaches 

A 50-year-old man with cluster headaches who had been investigated extensively by a neurologist without any other underlying cause was treated with electro-acupuncture. The electrodes were placed on acupuncture points of the head. Within only 4 sessions most of the headaches were gone. After 8 sessions he had no more headaches. However, a few weeks later his cluster headaches returned, but with ongoing monthly treatments he is able to prevent them from recurring. He did not like the side effects of all the pain medications, so he rather goes for his monthly booster electro-acupuncture treatments.

Take-home message regarding electro-acupuncture

Many people never considered traditional Chinese acupuncture for fear of needles. However, extensive research by Dr. Han and Dr. Ulett showed that electro-acupuncture with electrically conducting polymer pads or with EKG pads will replace the acupuncture needles. Not only is this method needle free, but also the weak electrical impulses that are used with electro-acupuncture treatment double the effectiveness of the older acupuncture method.

Many acupuncturists use both methods of acupuncture, but Dr. Ulett who used traditional acupuncture in the past has completely abandoned it and uses electro-acupuncture with the HANS machine instead. It is a complementary medical treatment, which has been authorized by the FDA.

More on pain conditions: http://nethealthbook.com/neurology-neurological-disease/pain/

References

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

2. J.S. Han: “The Neurochemical Basis of Pain Relief by Acupuncture”. Vol. 2. Hu Bei Science and Technology Press, Beijing, 1998 (784 pages).

Feb
19
2013

Forget The Glass Of Red Wine For Good Health

We have been hearing for over 10 years that 1 glass of red wine per day for women and 2 glasses of red wine per day for men would be recommended in order to prevent a heart attack or a stroke. Now we are confronted with new research from Boston showing that even small amounts of alcohol are bad for you as alcohol is a carcinogen (=cancer producing substance). Misinformation like this occurs when science concentrates only on one angle of health, such as cardiovascular disease prevention and the other part of the equation, the cancer producing (carcinogenic) effect of alcohol, is disregarded.

In 1996 this Australian study followed 1236 men and 1569 women 60 years and over for more than 5 years and studied their mortality rates as a function of alcoholic drink intake. The authors found that there was a short-term protective effect with regard to cardiovascular/stroke mortality. But due to the fact that mortality was the end point for both cardiovascular disease and for cancer, the study was mostly taken as evidence that alcoholic beverages would protect to a certain degree from strokes and heart attacks. The authors were aware that alcohol was cancer causing as they stated, “Those taking any alcohol exhibited an increased proportion of deaths due to cancer at the expense of a reduced proportion of CHD and stroke deaths”. But this part was not mentioned in the popular press or in future alcohol/cardio-protective recommendations. The authors also were aware that the observation time of 5 years was on the short side. We know from other studies that alcohol toxicity requires a longer observation time such as 15 to 20 years or longer to show significance in a multitude of cancers.

Forget The Glass Of Red Wine For Good Health

Forget The Glass Of Red Wine For Good Health

As already mentioned above, recently a new survey of alcohol-caused cancer was published and went through the popular press. Dr. Timothy S. Naimi from Boston University Medical Center was the main investigator of an international team of scientists. The study found that every year 18,200 to 21,300 cancer deaths in the US (that is 3.2% to 3.7% of all US cancer deaths) are directly caused from alcohol consumption. The authors of the study determined that every person who dies from alcohol related causes lost on average approximately 18 years of his/her life (scientists call this “years of potential life lost”).  51% of women developed breast cancer from alcohol exposure, 62% of men came down with upper airway and esophageal cancers. Less than 1.5 drinks per day caused between 26% and 35% of alcohol-related cancer deaths. There was no safe lower margin. The authors concluded, “Reducing alcohol consumption is an important and underemphasized cancer prevention strategy”.

Interestingly, in 2006 other research looked at alcohol caused cancer cases in the world based on WHO data and came to the conclusion that with the increased worldwide consumption, particularly in East Asia, preventative steps by eliminating or replacing alcoholic drinks would be wise.

A recent study in 2012 where cancer rates in the US were compared between Hispanics and Caucasians showed that Hispanics had higher rates of stomach cancer, liver cancer, uterine/cervix cancer and gallbladder cancer. The authors concluded that Hispanics need more screening done such as Pap tests and that effective vaccines (like Gardasil) should be used. In addition effective interventions should be applied to reduce obesity, curtail alcohol consumption and reduce tobacco use.

Studies have shown that there is no safe level of alcohol consumption, not even the famous 1 drink for women and 2 drinks for men (with regard to heart attack prevention), because cancer incidence increases with increasing alcohol consumption in a linear relationship.

What does alcohol do in the body that it is so dangerous to your cells? Many cancer researchers have researched this question in detail. Essentially, alcohol is by itself a toxin for your cells (the targets being sub particles in your cells called microsomes and mitochondria). Your liver metabolizes alcohol into acetaldehyde, your kidneys excrete it and your lungs exhale it (this is how a breathalyzer can detect how much you have been drinking). All of these chemical changes in your cells release free radicals, which in turn attack other cells. This sets up a chronic inflammatory process, which breaks down your immune system, leads to cell mutations and finally to cancer.

What protects you from cancer?  It is the antioxidants that stabilize the above-mentioned processes: vitamin C, glutathione, vitamin D 3, curcumin, multiple vitamins, magnesium, flavonoid foods, cruciferous foods (like broccoli), exercise and soluble fiber.

So, if you were serious about cancer prevention, you may want to stop any alcohol intake and take the above supplements instead. The heart attack and stroke protection will be achieved by flavonoid foods (perhaps specifically adding resveratrol 250 mg per day as well) and exercise.

If you were less conscientious about cancer prevention, at least reduce your alcohol consumption perhaps to the occasional glass of wine or beer, but avoid high percentage spirits and remember, the less the better! You may be toasting to ill health with that glass of wine. Say no to false advertising of the wine industry! Your body will thank you for it.

More information on alcoholism: http://nethealthbook.com/drug-addiction/alcoholism/

Here is another reference where you can read about the recent Boston study:

http://www.physbiztech.com/news/ceasing-alcohol-consumption-leading-way-prevent-cancer-death-study-finds

Last updated Nov. 6, 2014

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Oct
01
2008

Overuse Of Tanning Can Point to Addiction

The use of indoor tanning facilities and tanning beds has become popular over the years. Many individuals use tanning in preparation for a vacation in sunny climates, but an overwhelming number flocks to tanning booths in order to preserve this summer tan. Despite all cautioning from dermatologists, tanning salons have their steady clientele. While the occasional use may be no reason for alarm, steady usage sheds a different light on the”artifical sun”.
Tanning dependence has been found to be common in young adults, as a survey of 400 college student revealed. The behavior can be predicted by certain demographic and behavioral variables. Initially the motivation for tanning is the enhancement of appearance, but often those who use tanning facilities frequently report that it contributes to enhance their mood and help with relaxation and socializing. There was also a disregard for warnings about health risks of the practice. Dr. Carolyn Heckman, PhD of Fox Chase Cancer Center in Cheltenham,Pa. and her colleagues reported that these behaviors are commonly reported by individuals with other types of dependencies. In this respect excessive use of tanning has similarities to other behavioral disorders such as obsessive compulsive behavior and eating disorders, which has given it the nickname “tanorexia”.

Overuse Of Tanning Can Point to Addiction

Overuse Of Tanning Can Point to Addiction

The population profile showed that most of the tanning dependent individuals were female, and the highest group was white with a medium skin type, as opposed to fair and darker skinned individuals. Those who were doing the most sunbathing in summer and had the highest rates of sunburn also were the most tanning dependent. They were also the ones who used the least amount of sun protection. Smokers had the highest level of tanning dependence, whereas obese individuals had the lowest one. The highest proportion showed up in the female population. Males did not seem to be that interested in tanning.
The research is relevant for health professionals when it comes to teaching patients about skin cancer prevention and education about sun protection. It also points to possible relationships to other addictive disorders.

More information about skin cancer: http://nethealthbook.com/cancer-overview/skin-cancer/

References: 1. http://www.skincancer.org/content/view/317/78/ 2. Am. J. Health Behav. 2008;32:451-64

Last edited November 5, 2014

Jul
01
2008

Buprenorphine Prevents Relapses For Heroin Addicts

It is a great challenge for persons who are suffering of drug addiction to quit. There is the difficult period of detoxification. Even though there is a lot of support, there will be intense withdrawal symptoms, and every drug free day is a hard won victory. It is a major milestone on the road to recovery to be discharged from a detox program, but the task to remain drug free and abstinent is anything but easy. For this reason it is of utmost importance that support to prevent a relapse is available in the form of counseling, support groups and a maintenance program which involves medication is accessible to the patient.

A standard treatment drug has been naltrexone which helped the recovering addict to remain abstinent. It has been largely used in patients who were recovering from heroin addiction. Dr. Richard Schottenfield from Yale University School of Medicine, New Haven, Ct. and colleagues led a randomized trial to compare the efficacy of the standard drug regimen of naltrexone with the medication Buprenorphine in patients who were in the process of receiving detoxification and drug counseling. A group of patients received placebo (sugar pills that contain no medication.) From the 126 detoxified heroin dependent patients 43 received the standard treatment of naltrexone, 44 received Buprenorphine and 39 took placebo pills.

Buprenorphine Prevents Relapses For Heroin Addicts

Buprenorphine Prevents Relapses For Heroin Addicts

The researchers found that patients who received Buprenorphine lasted nearly twice as long till they experienced a relapse than those who were on naltrexone and more than twice as long as compared to those who took placebo pills.HIV risk reduction behaviors were significantly reduced in all three groups. Maintenance treatment with Buprenorphine is a significant public health approach to reduce problems that are connected with heroin dependence and can make a difference to the recovering heroin addict on the path of abstinence from the drug.

More information about opium and heroin addiction: http://nethealthbook.com/drug-addiction/opium-heroin/

Reference: Lancet (2008) vol.371, pages 2192-2200 and 2150-2151

Last edited November 4, 2014

Mar
01
2008

The Culprits For Periodontal Disease

When people think of hazards to dental health, the first thought will be about tooth decay, lack of brushing and flossing and eating candies and other sugar-laden foods. Periodontal disease is often neglected, and yet it is just as threatening to teeth and gums. Destructive periodontal disease will lead to loss of the supporting tissues of the teeth and as a result, there will be loose or shifting teeth and ultimately tooth loss. Generally these findings were seen in older population groups. It was thought that the disease would rarely occur in patients younger than 35 years of age and the theory was that dental plaque was the likely cause. Lifestyle choices were not thought to play a large role. Recent findings told a different story. A cohort study consisting of 903 participants examined self-reported tobacco and marijuana smoking and dental examinations were also done. The authors of the study found that tobacco smoking as well as cannabis (marijuana) smoking was linked with a higher incidence of destructive periodontal disease before the age of 32 years.

The Culprits For Periodontal Disease

The Culprits For Periodontal Disease

In comparison to this dental plaque was not contributing to a higher incidence of periodontal disease in this younger age group. Another risk for destructive periodontal disease in the youngest age group (as young as 12 to 18 years of age) was impaired glucose intolerance (a condition leading to diabetes). Due to those findings it is obvious that brushing and flossing are not the only weapons against periodontal disease. Healthy eating habits and cessation of smoking are equally important for dental health. This is particularly important as heart disease, which is also an inflammatory condition is closely linked to inflammatory disease of the gums and you likely have heard that heart attacks can be prevented by brushing and flossing teeth.

More information about periodontal disease: http://nethealthbook.com/dentistry/periodontitis/

Reference: Journal of American Medical Association 2008; 299(5): pages 574-575

Last edited November 3, 2014

Aug
01
2007

Alcohol Can Be Culprit in Irregular Heart Beat

Dr. Gregory M. Marcus, an electrophysiologist at the University of California, San Francisco gave a presentation at the Annual Meeting of the Heart Rhythm Society about the effect of alcohol on the heart in younger people.   This convention took place at the Colorado Convention Center at Denver/Co. where from May 9 to 12, 2007 about 11,000 physicians and scientists gathered to discuss the newest in irregular heartbeats (arrhythmias) and new treatments. Dr. Marcus found that in persons younger than 60 years of age one alcoholic drink per day could lead to atrial fibrillation (=atrial fib) or to atrial flutter. He found in persons older than 60 years he was not able to show a statistically significant risk effect of alcohol, but he pointed out that in this older population there were other risks like older age by itself and hypertension, both of which were independent risk factors for atrial fib/atrial flutter.

This was a case study where 195 consecutive patients with atrial fib/atrial flutter were studied. 2/3 of them were 60 or younger. There were also 185 controls with 75% who had supraventricular arrhythmias and 25% with healthy hearts.  There was a linear dose-response curve between number of alcoholic drinks consumed per day and atrial flutter. With atrial fibrillation there was a tendency in this way, but it had not reached quite statistical significance.  This study is the first one to show that in the younger age group there is sensitivity, at least in those who came down with atrial fib or atrial flutter, of the conductive nerve fibers in the atrial wall tissue to the effects of alcohol. Alcohol seems to reduce the effective refractory period of atrial tissue. Dr. Marcus called this the arrhythmogenic effect of alcohol.

Alcohol Can Be Culprit in Irregular Heart Beat

One drink a day can cause atrial fibrillation

It is not clear at the present time how to balance the cardioprotective effect of moderate alcohol intake against this newly found arrhythmogenic effect.  Also, why would the younger age group be more vulnerable to this effect than the older generation? Is there perhaps a subpopulation of more sensitive patients? These are unanswered questions, but at any rate it is important that those who had atrial fibrillation or atrial flutter refrain from alcohol, as they have shown to be especially sensitive to this arrhythmogenic effect.

More information about irregular heart beats: http://nethealthbook.com/cardiovascular-disease/heart-disease/irregular-heart-beats/

Reference: Dr. Gregory M. Marcus at the Annual Meeting of the Heart Rhythm Society

Last edited November 3, 2014

Aug
01
2007

Nicotine Addiction Found More Often in Impulsive Behavior

Why do major depression and nicotine addiction often occur together in middle aged people? This is what Dr. Qiang John Fu, assistant professor of community health in biostatistics at Saint Louis University School of Public Health, asked himself and he conducted a study involving 3,360 pairs of middle-aged, predominantly Caucasian twins to find out. Twin studies are a powerful tool to sort out environmental factors from genetic factors. In this particular study the twins had served in the Vietnam war and 45% were fraternal, the rest were identical twins. With identical twins 100% of the genes are identical while the fraternal twins share about half of the genes.

The researchers found that a group of twins who were addicted to nicotine also had a behavioral disorder, called conduct disorder. This can be well defined with psychological tests and is characterized by behaviors such a stealing, fighting, vandalizing, running away from home and drug addiction (including addiction to nicotine). They were also the ones who were much more vulnerable to develop major depression.  As published in the June issue of Twin Research and Human Genetics Dr. Fu, MD, PhD, the lead researcher explained that he found a set of genes that are responsible for the development of major depression and for addiction to nicotine.

Nicotine Addiction Found More Often in Impulsive Behavior

Major depression and nicotine addiction are linked through a gene

These individuals attempt to self-treat depression with cigarette smoking. Linked with this can also be the conduct disorder mentioned above.  These findings may lead to newer approaches in terms of treatment.

Reference: June issue 2007 of Twin Research and Human Genetics

Last edited December 5, 2012

Nov
01
2005

Hard Liquor And Beer Hike Colon Cancer Risk

The old adage of “everything in moderation” has become something like an excuse-me note for those who do not wish to change their lifestyle. And the little bit that supposedly does not harm is another variation in the theme of excuses. Yet the truth remains, that this does not apply to various lifestyle habits. It still matters, what you ingest in your food or drink, as Dr. Joseph Anderson found out in a study of 2,291 patients.

All of these individuals presented for screening colonoscopy. It turned out that those who had a history of consuming more than 8 drinks of spirits or beer per week for at least ten years were more than twice as likely as abstainers to have significant cancer of the colon. The group that drank beer and hard liquor (and hard liquor also applies to the category of mixed drinks) faced at least a one in five chance to have significant colorectal neoplasia (meaning cancer of the colon or rectum). This came as no surprise to the researchers, as beer and hard liquor seem equally pernicious.
Even though wine does not seem to carry the same risk, Dr. Anderson is in no position to condone counseling patients to drink wine instead.

Hard Liquor And Beer Hike Colon Cancer Risk

Hard Liquor And Beer Hike Colon Cancer Risk

His advice to other doctors is to ” counsel the patients on what they are drinking and counsel them to temper their drinking.”

More information about causes of colorectal cancer: http://nethealthbook.com/cancer-overview/colon-cancer/food-risk-factors-colon-cancer-rectal-cancer/

Reference: The Medical Post, October 11, 2005, page 46

Last edited October 29, 2014