Medical Articles by Dr. Ray - Collection of health news, health articles and useful medical information you can use in everyday life.

Jun

2020

Chronic Inflammation Can Cause Many Diseases

By Ray Schilling | Alzheimer’s disease, Asthma, Cardiovascular disease, Diabetes, fish oil, heart attack, Inflammation, kidney disease, Obesity, omega-3 fatty acids, osteoarthritis, Pain, polyunsaturated oil, Vitamins and supplements

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

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

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

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

Specialized pro-resolving mediators (SPM)

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

Three vital tasks of pro-resolving mediators

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

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

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

Newer studies about SPMs

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

Chronic Inflammation Can Cause Many Diseases

Conclusion

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

Jun

2020

Mediterranean Diet Reduces Heart Attacks and Strokes in Diabetes

By Ray Schilling | Cardiovascular disease, cholesterol, Diabetes, food, heart attack, Heart Disease, High Blood Pressure, Mortality, Nutrition, olive oil, omega-3 fatty acids, Processed food, Stroke

A recent publication came to the conclusion that a Mediterranean diet reduces heart attacks and strokes in diabetes. This Canadian and Spanish study compared prospective cohort studies and randomized trials (RCT). 41 reports (3 RCTs and 38 cohorts) formed the basis for this analysis.

Details of the study

Metaanalysis showed that a Mediterranean diet reduced the cardiovascular disease incidence by 38%. It also reduced myocardial infarctions (heart attacks) by 35%. Next the authors compared the highest to the lowest adherents to the Mediterranean diet (Med diet). The highest Med diet adherents showed the following reductions:

Cardiovascular disease mortality: 21%

Coronary heart disease incidence: 27%

Coronary heart disease mortality: 17%

Stroke incidence: 20%

Stroke mortality: 13%

The conclusion was that the Mediterranean diet is beneficial to prevent heart disease and strokes in people with diabetes.

Other studies

In a study from the United Kingdom dated March 2019 several clinical trials were analyzed regarding non-diabetic populations. Again, the question came up, what the effect of a Mediterranean diet was on cardiovascular disease incidence and mortality. The authors reviewed 30 RCTs (49 papers) with12,461 randomized participants and seven ongoing trials. In one study the observation time was 46 months. A Mediterranean diet reduced the cardiovascular disease mortality by 65%!

Another study from Spain published in 2019 examined 7356 older adults (average 67 years) and followed them for 6.8 years. The investigators kept track of the physical activity and put everybody except the controls on a Mediterranean diet. The group on the lightest leisure-time physical activity consuming a Mediterranean diet had the lowest mortality. The all-cause mortality of this group was 73% lower than the control group.

What is so healthy about the Mediterranean diet?

Despite a wide variation between all the 15 countries bordering the Mediterranean Sea, there are common characteristics: an abundance of vegetables and fruit, along with nuts and legumes. Cereal products are largely whole grain. Olive oil is the principal fat source, and people eat fish, seafoods and poultry in moderation. They consume red meat rarely. Cheese and yogurt can be part of the diet, depending on the region.

The first clinical evidence supporting the health benefits of the Mediterranean diet came from the Lyon Heart Study. The researchers placed patients who had a heart attack either on the diet designed by the American Heart Association or a Mediterranean style diet. After a follow-up of 27 months, the group eating the Mediterranean diet had a reduction of heart attacks by 73% and a decreased mortality by 70% compared to the other group.

More detail on the ingredients of the Mediterranean diet

An analysis of the various foods of the Mediterranean diet shows the reasons for the health benefits clearly. The fats that people on a Mediterranean diet eat are heart-healthy monounsaturated fats like olive oil or fats that contain omega-3 fatty acids. They come from fish (tuna, salmon, trout, sardines) or from plant sources (walnuts, other tree nuts and flax seed).

As there is an emphasis on natural foods, the diet is extremely low in trans fatty acids (hydrogenated fats), which increase the risk for cardiovascular disease. As people consume more than 300g of vegetables per capita daily, the contents of antioxidants and other beneficial plant chemicals is much higher in comparison to Western diets. There are many individual components of the Mediterranean diet that contribute to the reduction of disease. This is particularly true for heart disease. It also is apparent, that it is not one single food or nutrient that is responsible for the health benefits. What matters are the interactive effects of all the nutrients that lead to the health benefits.

No processed food means healthier living

The practical application does not mean deprivation and starvation, but a move away from processed fats (margarine), baked goods (donuts, muffins, pastries), and high saturated fat snacks and trans fats (chips, crackers, cookies, pies). Food choices move towards those of fresh fruits and vegetables, nuts, fish, and olive oil. Portions or servings have to be adequate to maintain a healthy weight.

Mediterranean food is not the heaping plate of pasta with an afterthought of vegetables. It also is not the super-size fast food pizza with pepperoni and cheese. Mediterranean food incorporates fresh food rather than the fast food. It entails a shift from large portions of red meat to smaller portions of fish, a transition from highly processed foods to ample helpings of dark green vegetables with a dose of olive oil. Low amounts of alcohol, especially red wine can make a meal enjoyable, which means one drink per day for women, and two drinks per day for men. And after dinner go for a walk!

Olive oil is one of the reasons why the Mediterranean diet is so healthy

In the past it was thought that the monounsaturated fatty acids in olive oil would be the reason why it is protective of the heart. However, newer studies have shown that it is the polyphenols and among these in particular hydroxytyrosol that lower blood pressure and protect you from hardening of the arteries.

In a 2012 study from Spain it was found that mortality from heart attacks was 44% lower than that of a control group who did not incorporate olive oil in their diet.

How polyphenols in olive oil work for you

Only two tablespoons of extra virgin olive oil per day protect you from heart disease. It does so by reducing the total cholesterol level in the blood as well as the LDL cholesterol level. When there is more polyphenol in olive oil (such as in extra virgin olive oil), the body produces more HDL, which is essential to extract oxidized LDL from arterial plaque. On top of that polyphenol rich olive oil will increase the size of the HDL particles (these larger particles are called HDL2), which are more efficient in extracting oxidized LDL from arterial plaques. A Sept. 2014 study in humans showed that higher polyphenol olive oil as found in extra virgin olive oil caused an increase in the more effective HDL2 particles, which cleans out plaques from arteries more efficiently than the regular, cheaper olive oil.

Endothelial function

The endothelium is the lining of the arteries. Normal endothelial functioning involves widening of the arteries and maintaining its flexibility. The body achieves this through production of a signal molecule, called nitric oxide; the endothelial cells that line our arteries from inside produce it. Exercise increases the production of nitric oxide as well (Ref.1).

In a group of patients with poor endothelial function 2 tablespoons of olive oil (polyphenol rich) per day given over 4 months (the time of the study) showed a significant improvement of endothelial function.

The authors suggested that an enzyme in the endothelial cells, called nitric oxide synthase is being stimulated by components of polyphenol-rich olive oil. This leads to protracted release of nitric oxide, which in turn keeps blood vessels flexible and wide open. Other investigators found that olive oil can influence even a hereditary gene variant of endothelial nitric oxide synthase found in people with a history of premature heart attacks. This high-risk group of people should take extra virgin olive oil regularly to prevent premature heart attacks and strokes.

Endothelial dysfunction occurs when the arteries no longer can deliver adequate amounts of blood to vital organs like the heart or the brain. Endothelial dysfunction is also present in patients with type 2 diabetes, obesity, high blood pressure and metabolic syndrome. Introducing extra virgin olive oil in the diet of these patients will help restore their endothelial function.

Lowering blood pressure

In a study on 23 hypertensive patients it was shown as far back as in 2000 that extra virgin olive oil over 6 months allowed physicians to reduce high blood pressure medications by 48%. When the study was crossed over, the reverse was the case for the control group on sunflower oil. The polyphenols of olive oil released nitric oxide, which is known to lower blood pressure. This is an important finding. High blood pressure is a risk factor for the development of hardening of the coronary arteries. This leads to heart attacks, congestive heart failure, but also stroke. Regular intake of 2 tablespoons of extra virgin olive oil often will reverse high blood pressure and restore normal endothelial function.

Preventing heart attacks and strokes

In April of 2013 The New England Journal of Medicine published a Spanish diet study that showed that a participants on a Mediterranean diet with olive oil or nuts had 30% less heart attacks over 5 years than people on a low fat control diet. Other studies have also shown that olive oil and omega-3 fatty acids play a big role in preventing heart attacks and strokes. We also know that regular exercise reduces the risk further; so does keeping your body mass index below 25.0. Extra virgin olive oil is part of the protection from heart attacks and strokes. The study did not show any protection against cancer.

Mediterranean Diet Reduces Heart Attacks and Strokes in Diabetes

Conclusion

A Mediterranean diet reduced heart attacks and strokes in diabetic patients, but also in patients without diabetes. Here I attempted to show what the ingredients of a Mediterranean diet are that lead to such astounding positive effects. There is an emphasis on vegetables and fresh ingredients of food. In addition, olive oil and a lack of processed food are also important. With these wholesome ingredients the lining of the arteries works best. The body reduces cholesterol and lowers blood pressure. The end result is that there are less heart attacks and strokes, and people live longer.

Note: Part of this was previously published here and also here.

Jun

2020

Adequate Vitamin D Level Strengthens the Immune System

By Ray Schilling | immune system, Infectious Disease, Inflammation, kidney disease, Lung Disease, Mortality, Prevention, Vitamins and supplements

The Covid-19 coronavirus crisis is teaching us that an adequate vitamin D level strengthens the immune system.

When we age, our resistance to infections weakens, but this may be because our immune system needs more vitamin D3. I have reviewed the super powers of vitamin D3 before in 2014. In the past the thought was that the human body would need only 400 IU of vitamin D3 every day to cure rickets. And these were the daily vitamin D3 recommendations from medical authorities for several decades. Gradually it became known that for cancer prevention, infection prevention, cardiovascular illness prevention and for diabetes prevention much higher doses of vitamin D3 were necessary. As pointed out in the previous link, almost 50% of the world population is deficient in vitamin D. This is due to a lack of exposure to sunlight and due to inadequate supplementation with vitamin D3.

History of vitamin D

Dr. Adolf Windaus received the Nobel prize for chemistry in 1928. It was to acknowledge “… his studies on the constitution of the sterols and their connection with vitamins”. His work involved the metabolism of vitamin D and the precursors of vitamin D.

Rickets

As the above link shows, rachitic children were treated since the mid 1800’s with cod liver oil and since the early 1900’s also with ultraviolet light. But we know now that 400 IU of vitamin D3 per day is just enough to cure rachitic children, but it is not enough to strengthen the immune system to fight influenza viruses or the Covid-19 coronavirus. I will discuss further below what vitamin D blood levels are important to achieve a healthy state of the immune system.

Adequate vitamin D level strengthens the immune system

The immune system is very complicated and consists of many cell types that interact with each other and the rest of the body. It is important to recognize that the innate immune system immediately inactivates intruding viruses. But the vitamin D blood concentration has to be high enough. The acquired immunity consists of antibodies that are produced by B cells. The antibodies were produced during prior infections that you have survived and you are now immune to. However, other antibodies that circulate in your blood may have originated from vaccines you received in the past (whooping cough, measles, tetanus, diphtheria etc.). With the Covid-19 coronavirus it is the innate immunity that plays the biggest role until a vaccine will be found in the future.

Vitamin D is a hormone

This 2013 paper explains that vitamin D is a hormone that stimulates its own vitamin D receptor. This is a nuclear receptor that has close relations to the cell DNA and can stimulate more than 900 polypeptides. They are messenger molecules that are involved in a variety of physiological functions. One of the key functions is the immune system. This link explains that T cells that have vitamin D receptors can develop into cytotoxic T cells (also known as “killer T cells”). They are important in fighting cancer, but also parasites.

The key is that the hormone vitamin D can release more than 100 polypeptides that have the power to fight virus attacks including the Covid-19 coronavirus.

Three mechanisms how vitamin D works against the virus

The researchers outlined 3 mechanisms of how vitamin D works:

Maintaining tight epithelial junctions making it more difficult for the Covid-19 coronavirus to penetrate.
“Killing enveloped viruses through induction of cathelicidin and defensins.” These powerful antiviral polypeptides can kill viruses that have invaded the blood stream within 1 to 2 days.
“…And reducing production of proinflammatory cytokines by the innate immune system, thereby reducing the risk of a cytokine storm leading to pneumonia.” It is people who get the viral pneumonia that are at a high risk of death. By bringing the blood level up to the higher range of normal, between 50 and 80 ng/mL, patients that have encountered Covid-19 coronavirus are more likely to survive.

Two polypeptides, cathelicidin and defensins

Again, I like to emphasize that it is not vitamin D that has a direct effect on the virus. It is two polypeptides, cathelicidin and defensins, which are powerful antiviral polypeptides, that are released by vitamin D.

They can kill viruses that have invaded the blood stream and can eliminate the cytokine storm. This all happens very fast, within only 1 to 2 days. But you have to have an adequate vitamin blood level for this to occur (about 50-80 ng/mL).

Sources of vitamin D

First of all, vitamin D is readily absorbed from food. But there are not many foods that contain enough vitamin D for the immune system. The ones that contain vitamin D are as follows:

“Fatty fish, like tuna, mackerel, and salmon.
Foods fortified with vitamin D, like some dairy products, orange juice, soy milk, and cereals.
Beef liver.
Cheese
Egg yolks. “

Sun induced amount of vitamin D

Secondly, vitamin D can be synthesized in the skin from exposure to sunlight. But for this to happen all the necessary enzymes need to be present. This link explains that many older people above the age of 65 have low vitamin D blood levels because of a lack of sun exposure and a lack of cutaneous synthesis because of enzyme issues.

Vitamin D supplements

The most reliable source of vitamin D are vitamin D3 supplements. When people supplement with the same dose of vitamin D3 there will be people who get higher vitamin D blood levels than others, as absorption in the gut is different for different people. The ones who have relatively low vitamin D blood levels are often called “slow vitamin D absorbers”. But when the vitamin D3 dosage is increased even those people will reach the recommended high normal range (50-80 ng/mL).

Vitamin D blood level

The vitamin D blood test has the scientific name “25-hydroxy vitamin D level”. This is now the recognized gold standard for determining who is deficient or has normal levels with respect to vitamin D. The following 2013 publication has studied the vitamin D level of 1,470 healthy Swiss men and women, 60 years or older. Vitamin D levels were classified as severely deficient when the level was below 10 ng/mL. The vitamin D level was deficient between 10 and 20 ng/mL. The level was insufficient when between 21 and 29 ng/mL. A level above 30 ng/mL is normal.

8 % of the subjects were severely insufficient and 66% had insufficient vitamin D levels. Only 26.1% of the subjects had normal levels. Over 50% of healthy older Swiss (above the age of 70) had insufficient vitamin D levels.

Which vitamin D level is safe and which is not?

A peer-reviewed publication of the effects of vitamin D in health and disease contains 269 references.

What vitamin D level is optimal? This question was reviewed in this paper.

Below 15 ng/mL the immune system is paralyzed
With a level above 30 ng/mL the immune system is working
A level of 50-80 ng/mL has the immune system working optimally
Above 150 ng/mL toxic vitamin D levels start
With 300 ng/mL severe toxicity begins

Vitamin D toxicity

It is only with high levels of vitamin D (more than 150 ng/mL) that you have to worry about high calcium levels in the blood or kidney stones (toxic levels). But the key is to not exceed 80 ng/mL regarding the vitamin D blood level. This gives you a lot of flexibility before you reach toxic levels (above 150 ng/mL). For those who want more information, here is a thorough, peer reviewed publication about vitamin D toxicity with 59 references.

Vitamin D supplement compliance

The question is why not more people take adequate vitamin D3 supplements. We know that vitamin D can prevent so many chronic diseases including serious viral infections. The answer is complex, but it includes a fear of the population of vitamin toxicity (kidney stone and high calcium levels). However, as pointed out before, this occurs only above a vitamin D level of 150 ng/mL. With proper vitamin D blood level monitoring you never reach toxic levels of vitamin D.

Denial

Denial likely is another major factor. People feel that if they have a balanced diet, they would be protected from vitamin D insufficiency. As pointed out before this is a grave error to think as our food does not contain sufficient vitamin D to strengthen our immune system.

False security with low doses of vitamin D

Finally, there are people who think that low doses of vitamin D, like 1000 IU of vitamin D daily, would be enough. But it is not enough. This is why testing vitamin D blood levels is so important. It is a reality check. The blood level must be in the high normal range (50-80 ng/mL). At this level the immune system functions optimally.

Compliance issues

In this context there was an interesting study done by LifeExtension, a company that publishes monthly health magazines. In this study the company examined the vitamin D blood levels of LifeExtension members. They are the ones who should be knowledgeable in how important it is to have good, preventative vitamin D blood levels. The study showed that 38% of the vitamin D test results were less than 30 ng/mL. In addition, 69% of the vitamin D tests were less than 40 ng/mL. Finally, 85% of the vitamin D test results were less than 50 ng/mL. What this means is that LifeExtension members were non-compliant when it came to taking regular adequate vitamin D3 doses. This resulted in levels that were too low for the majority to protect them from the Covid-19 coronavirus.

Covid-19 coronavirus infections and vitamin D blood level

There is a tight relationship between vitamin D blood levels and the strength of the immune system. Essentially, coronavirus mortality measures who is vitamin D deficient. Without enough vitamin D on board the virus penetrates into the blood stream and penetrates the lining of the respiratory tract. Next the cytokine storm develops, which leads to viral pneumonia. Higher doses of vitamin D3 will mitigate the course of Covid-19 coronavirus.

Adequate Vitamin D Level Strengthens the Immune System

Conclusion

The Covid-19 coronavirus pandemic has taught us how important an intact immune system is to survive the virus when you get it. We do know for some time how closely related a good vitamin D level is with the functioning of the immune system. I have reviewed here what a desirable vitamin D level is and how we can achieve this with oral vitamin D3 supplements. The goal is to achieve a vitamin D level in the upper range of normal (50-80 ng/mL). With a level like this the virus cannot penetrate the mucous membranes of the respiratory tract and even if it did, it cannot produce a cytokine storm in the blood that would lead to the deadly viral pneumonia or to blood clots. When the virus invades the bloodstream, vitamin D releases powerful antiviral polypeptides that can kill viruses within 1 to 2 days.

Literature

Here are some peer-reviewed publications on vitamin D:

https://www.mdpi.com/2072-6643/12/4/988/htm157 references (April 2, 2020 publication)
The role of Vitamin D in the prevention of Coronavirus Disease 2019 infection and mortality
Startling Findings About Vitamin D

May

2020

New Multi Cancer Blood Screening Test

By Ray Schilling | breast cancer, Cancer, cervical cancer, leukemia, lung cancer, prostate cancer

A recent publication describes how a new multi cancer blood screening test can diagnose various cancers early. Many years back the same research group at the Johns Hopkins Medical School did lung cancer screening studies. The researchers then were analyzing saliva samples between 1974 and 1982. They identified 15 patients who later developed adenocarcinoma of the lung. The researchers were able to diagnose the lung cancer 1 year prior to what ordinary screening tests could do. This ensured an early diagnosis and early treatment with a better long-term prognosis.

Liquid biopsy promises early cancer detection

The new publication from the Johns Hopkins University in Baltimore, Maryland, is based on the following fact: Cancer cells consist of mutated cells. They shed DNA with mutations typical for this cancer into the bloodstream. By taking blood samples and analyzing the circulating mutated DNA researchers can first establish that the DNA belongs to a certain cancer mutation. But at the same time, they can locate the cancer, if they find mutated DNA. The pathologist can say that the patient has a cancer in a breast, the colon, lungs or ovaries, wherever it is located.

Oncoblot test was a precursor to the multi cancer blood screening test

Around 2014 a cancer screening test came out of the human genome project. It was called the Oncoblot test. It screened for 25 of the most common cancers. And it was screening for ENOX2 proteins from cancer cells. Apparently, this is a fetal protein normally expressed only during fetal life, bit in adults only expressed when a cell turns cancerous. It was a 1000 USD test in the US that health plans did not cover. But it screened for more than 25 different common cancers 6 to 8 years before they become clinically manifest: Suddenly around 2017 the Oncoblot test was no longer available. I could not find out the reason for this. Was the test producing too many false positives or false negatives? This would have made this cancer screening test unreliable. Apparently researchers of the Oncoblot test company are attempting to refine the test further.

My own case of prostate cancer

Strangely enough in 2016 I had an Oncoblot test done and it accurately diagnosed that I had prostate cancer. My cancer specialist from Ft. Lauderdale used Doppler ultrasound to visualize it and performed a 3-dimensional prostate biopsy to verify the histology. Subsequently he removed it with ablation cryotherapy, because a study of his involving 70 prostate cancer patients and spanning over 10 years had shown the best survival data. My 3-monthly PSA values since have been negative for recurrent prostate cancer.

New multi cancer blood screening test from Johns Hopkins Medical School

A review in Science magazine explains the details of the new multi cancer blood screening test. It is called CancerSEEK and is based on 16 common genetic markers that show changes in cancer cells. In addition, the researchers also test for cancer-related proteins, which change when cancer cells are present. The test also indicates the location of the early cancer. CancerSEEK can detect about 60% of liver cancers and 100% of ovarian cancer. The researchers tested 812 healthy controls. Only 7 (1%) tested positive for cancer. CancerSEEK also tested 1005 patients who had early cancer.

More details of the CancerSEEK test

The test detected between 33% and 98% of cases, which depended on the tumor type. The sensitivity was 69% or higher for stomach, pancreatic, and esophageal cancers; ovarian and liver cancer had a sensitivity of 98%. In 80% of the cases physicians could narrow the positive cancer test to two possible sites. The researchers think that the cost of one CancerSEEK test will be less than 500.00 USD. There is another study described where 9,911 participants were enrolled. 25 cancers were found. The diagnosis involved 2 lymphomas, 2 colorectal cancers, one appendix cancer, 2 uterine cancers, one thyroid cancer, one kidney cancer, 9 lung cancers, one breast cancer and 6 ovarian cancers. This study will continue to go on for another 5 years.

Possible problems with the new multi cancer blood screening test

Researchers dubbed the cancer screening test as “liquid biopsies” with the purpose to detect hidden cancers. The smaller the cancer is, the less the cancer cells excrete DNA and cancer proteins into the bloodstream. This means that in some of the early cancer cases the sensitivity of the test could be very small. Because many cancers will be detected much earlier there could be definite cures, if the cancer is in an early stage. On the other hand, Dr. Nickolas Papadopoulos from the Johns Hopkins University in Baltimore, Maryland, said: “The issue is not overdiagnosis, but overtreatment.” Some of the small tumors may never turn into larger tumors and it is justified to observe for a period of time.

A large 5-year clinical study involving up to 50,000 women is the next project to test the CancerSEEK test further. A private philanthropic group, The Marcus Foundation, is funding this project.

New Multi Cancer Blood Screening Test

Conclusion

A new multi cancer blood screening test, the CancerSEEK test, is in development. It is based on a combination of various cancer markers. Researchers measure cancer DNA mutations and also cancer proteins. They also determine the tissue location of the cancer. Researchers did much work already in terms of sensitivity and specificity of the test. Physicians integrate the test further with conventional medical tests to confirm the location of the cancer. With breast cancer mammograms are the additional tests, with colorectal cancer colonoscopies. A large 5-year clinical study involving up to 50,000 women is the next project to test the CancerSEEK test further. In future the CancerSEEK test will become a routine screening test for cancer. The cost for one CancerSEEK test will be less than 500.00 USD. The hope is that cancer cures will improve due to earlier detection.

May

2020

Unusual Presentations of the Covid-19 Coronavirus

By Ray Schilling | Uncategorized

Unusual presentations of the Covid-19 coronavirus were unknown when it first emerged in Wuhan, China at the end of 2019. Initially the virus presented with a high fever, cough, tiredness, sore throat and aches and pains. Subsequently cases of diarrhea, conjunctivitis, headaches and loss of smell were often accompanying the illness. Patients with a weak immune system in old age or from chronic diseases are particularly vulnerable. They can come down with viral pneumonia, which often results in intubating the patient. 50% of these cases may recover, the other 50% die.

Descriptions of unusual presentations of the Covid-19 coronavirus

In the last few months doctors have seen unusual presentations of the Covid-19 coronavirus. There were cases that seemed to be fine in the first 10 days. But then sudden severe illness struck. In one case a 38-old man was diagnosed with Covid-19 coronavirus in an urgent care clinic. He was told to go home and isolate. He felt not too bad, but had a bit of a cough. The following day he woke up with his legs feeling cold and numb. His leg muscles were so weak, he could not walk. An ambulance took him to the Westchester Medical Center in New York.

Blood clot secondary to Codid-19 coronavirus

Tests showed that he had a large blood clot in his aorta right at the bifurcation of the iliac arteries. When no blood goes through the iliac arteries, no blood can reach the femoral arteries. This explained his leg symptoms. Emergency surgery removed the blood clot and saved this man’s legs and life.

Pediatric multisystem inflammatory syndrome

This syndrome can affect children less than 5 years of age, although in the beginning it was assumed that children would be less likely to have Covid-19 coronavirus infections. Pediatric multisystem inflammatory syndrome is the second phase of a coronavirus infection. Symptoms include abdominal pain, gastrointestinal symptoms and inflammation of the heart. Symptoms are persistent fever, inflammation and poor function in one or more organs. Some children present with shock. These children need admission and treatment in a pediatric ICU ward right away. Some doctors think that the cytokine storm initiated by the Covid-19 coronavirus is responsible for this syndrome. It may be an overreaction of the immune system that can be the cause.

Delirium in patient testing positive for Covid-19 coronavirus

A patient in Saudi Arabia who has been traveling abroad presented with confusion from a delirium. He had a spiking fever and mild respiratory symptoms. A swab test for SARS-CoV-2 was positive. He recovered very quickly and spontaneously and had no residual problems.

Unusual presentations of the Covid-19 coronavirus in elderly patients

In a study from French Switzerland coronavirus patients who were older than 70 years of age were analyzed. Half of the patients who died were over 83 years old. Symptoms can be as vague as “altered general condition”, unusual fatigue or delirium. Even a fracture can be an indication that a hidden coronavirus infection caused dizziness, loss of balance and a fall.

Gastrointestinal symptoms common in adults

In adults symptoms of fatigue, diarrhea, nausea and vomiting are common for Covid-19 coronavirus. This is in contrast to the usual presentation of upper respiratory symptoms followed by a fever and coughing.

Unusual presentations of the Covid-19 coronavirus in pregnant women

A publication from Wuhan, China reported about pregnant women shortly before and after their deliveries.

Their gestational age was between 38th weeks to 41st weeks. Prior to their delivery they had no fever or symptoms of coronavirus. Following the delivery many had a mild fever of 37.5℃-38.5℃. Kidney and liver functions were normal. Two women had mild elevation of heart enzymes. The newborn babies were all healthy. Women before the delivery tend to not have any fever. After the delivery low-grade postpartum fever or mild respiratory symptoms were the only symptoms present in those with positive tests for Covdi-19 coronavirus.

Unusual Presentations of the Covid-19 Coronavirus

Conclusion

There are unusual presentations of the Covid-19 coronavirus. Older people may present with an “altered general condition”, unusual fatigue or delirium. In very young children the pediatric multisystem inflammatory syndrome may present as abdominal pain, gastrointestinal symptoms and inflammation of the heart. On the other hand, in more severe cases acute shock may be present. In late pregnancy shortly before delivery the pregnant women had hardly any symptom and no fever. But post-delivery women with positive Covid-19 test presented with a mild fever and cold also show mild respiratory symptoms. In middle aged adults sudden blood clots stemming from inflammation of the lining of blood vessels can shut off the blood supply to multiple organs. This causes a dangerous condition of multiple organ failure. The liver, heart and kidneys are often affected.

This is still a new virus, and researchers do not know enough. Much more research is necessary to clarify the differences of presentation in patients with Covid-19 coronavirus.

May

2020

Cutting Out Bad Lifestyle Habits Increases Life Expectancy

By Ray Schilling | addiction, alcohol, breast cancer, Cancer, Cardiovascular disease, cholesterol, Diabetes, diet, exercise, Fitness, food, heart attack, Inflammation, lifestyle, lung cancer, Mortality, Nutrition, Obesity, Prevention, Stroke

A Jan. 8, 2020 study stated that cutting out bad lifestyle habits increases life expectancy. It was a publication in the British Medical Journal by the Harvard T.H. Chan School of Public Health. The senior author of the study was Frank Hu, chair of the Department of Nutrition at Harvard Chan School. The researchers looked at data collected from a large group of males and females that had been accumulated for 34 years. They found that a 50-year-old male or female who did not change their lifestyle habits had another 25.5 years to live for males and another 29 years to live for females.

Five bad lifestyles and life expectancy

The 5 bad lifestyle habits were smoking, a body mass index above 25.0, excessive alcohol intake, less than 30 minutes of exercise per day and an unhealthy diet.

When people cut out all of those risky lifestyles, 50-year-old men and women had a life expectancy of 37.6 years for men and 43.1 years for women. This was an addition of 12 years of healthy life for men compared to controls who did not change their lifestyles. With regard to women there was an addition of 14 years of life compared to controls.

Diseases that kill prematurely

The research team wanted to know what diseases caused the most reduction in life expectancy when people did not change their bad lifestyle habits. Men and women who cut out all negative lifestyle habits were 82% less likely to die from cardiovascular disease. They also were 65% less likely to die from cancer. Bad lifestyles caused the two major diseases, cardiovascular disease (heart attack and strokes) and cancer, which increased overall mortality. The overall study time was about 30 years. The third major disease that can cost lives is diabetes. In addition, the research team identified chronic diseases as being another potential cause of people dying prematurely.

Additional life expectancy

When life expectancies were broken down according to diseases, the following was noticed.

For men:

When cancer free When free of heart issues Without diabetes

6 more years 9 more years 10 more years

For women:

When cancer free When free of heart issues Without diabetes

8 more years 10 more years 12 more years

Dr. Frank Hu, who chairs the department of nutrition at Harvard T.H. Chan School of Public Health said: ”We found that following a healthy lifestyle can substantially extend the years a person lives disease-free”. Those who do not shed their bad lifestyle habits will come down with one or more of the mentioned diseases and die prematurely. Others who cut out all their bad lifestyle choices live substantially longer.

Diseases caused by poor lifestyle habits

It is important to review the diseases that shorten life expectancy due to having poor lifestyle habits.

Cardiovascular disease

Smoking, lack of regular exercise and poor eating habits result in being overweight or developing obesity. All of these are risks with LDL cholesterol elevation and HDL cholesterol lowering that leads to heart attacks and strokes. Here is a study that shows how life is shortened after a heart attack.

It is clear from this how important it is to give up all of the poor lifestyle habits to avoid this from happening.

Cancer

90% of lung cancers are the result of cigarette smoking.

Heavy drinking can contribute and also lead to cancer of the liver, esophageal cancer, cancer of mouth and throat and cancer of the breasts in women. In addition, cancer of the colon and rectum are also caused by consuming too much alcohol in both sexes.

Diabetes

There are a variety of risk factors causing diabetes. Obesity, a lack of exercise, a bad diet with too much carbohydrates and the aging process are what contributes to the development of type 2 diabetes.

We see again that it is largely lifestyle issues that drive the onset of this disease. People who have developed diabetes need to control their blood sugar very closely to avoid complications of diabetes. This includes making healthier choices.

Otherwise complications of diabetes are diabetic nephropathy, blindness from macular degeneration of the cornea, heart attacks, stroke and diabetic neuropathy. In addition, vascular complications also include artery occlusions in the lower extremities with frequent foot or below knee amputations.

Chronic diseases

Often chronic diseases develop when there is generalized development of inflammation. COPD, chronic kidney disease and arthritis are examples of such conditions. In addition, Alzheimer’s disease, arthritis, asthma, Crohn’s disease, cystic fibrosis and diabetes belong into this category. All of these chronic diseases have in common that cytokines produce inflammation in the body. This keeps the chronic disease going and makes it more difficult to cure. When the person with a chronic disease makes poor lifestyle choices, the inflammation just becomes more chronic.

Smoking is one of the factors that makes chronic inflammation more chronic. Having a body mass index above 25.0 (being overweight) and above 30.0 (obesity) also creates more inflammation in the body. Excessive alcohol intake damages body cells and releases free radicals. These in turn cause inflammation and make the chronic disease more difficult to treat. An unhealthy diet tends to raise the bad LDL cholesterol, introduces pesticides and other chemicals into the system and adds to the chronic inflammation. Finally, a lack of exercise is not contributing to a healthy circulation and lowers the protective HDL cholesterol, paving the way for heart attacks and strokes.

Cutting Out Bad Lifestyle Habits Increases Life Expectancy

Conclusion

Bad lifestyle habits are what causes us to get illnesses and die prematurely. Functional medicine and anti-aging medicine are at the frontier of modern medicine. These specialties are teaching us how to stay well and age gracefully. For decades conventional medicine has treated only symptoms, but not the causes of diseases. But this has not changed the mortality rates of heart attacks and cancer. Smoking, a body mass index above 25.0, excessive alcohol intake, exercising less than 30 minutes of exercise per day and an unhealthy diet are causes that make us sick. These bad lifestyle factors cause chronic inflammation in our system. They are the real cause of heart attacks, strokes, cancer and diabetes, the major killer diseases that prevent healthy aging.

Facing bad lifestyle habits

Bad lifestyle habits cause chronic inflammation. T he C-reactive protein blood test can measure the degree of inflammation that is present. A fasting insulin level can detect whether a person is in danger of developing diabetes and improved lifestyle habits can prevent this from happening. Men can add 12 years and women 14 years of healthy life by eliminating bad lifestyle habits. By eliminating chronic inflammation our new life expectancy, which is 79 to 80 years, now can reach 92 to 94 years. It is up to you how healthy you stay and whether or not you age gracefully.

May

2020

Vitamin D Is the Definitive Link

By Ray Schilling | Alzheimer’s disease, Arthritis, Asthma, autoimmune disease, breast cancer, Diabetes, heart attack, Infectious Disease, Osteoporosis, Stroke, Vitamins and supplements

Vitamin D deficiency caused rickets in the past, but now we know that vitamin D is the definitive link for other health problems. The lack of it is the reason for numerous illnesses. A search in my website gives you more than 170 blogs where I am discussing the effect of vitamin D. These describe how vitamin D is the definitive link in a lot of different diseases. In a 2015 study from Brazil the authors noted that a critical vitamin D blood level was 12 ng/mL. All these critically ill patients received treatment in an ICU setting. In vitamin D blood levels of 12 ng/mL the mortality rate was 32.2%. A control group of ICU patients with more than 12 ng/mL had a mortality rate of only 13.2%. The authors concluded that a low vitamin D level on ICU admission was an independent risk factor for mortality in this critically ill patient group.

A few diseases where low vitamin D is the definitive link for a poor outcome

In patients, who have arthritis, cardiovascular disease, breast cancer, diabetes, osteoporosis, influenza and others, the laboratory tests that shows their 25-hydroxy vitamin D level, are usually below 15 ng/mL. This link has 269 peer reviewed references.

A 2015 Italian study showed that microvascular complications in diabetes patients were high, if the vitamin D3 blood levels were low. If patients had high levels of vitamin D, there were no complications such as retinopathy or nephropathy. But if levels were below 20 ng/mL, damages were significant in the capillaries of the eyes and kidneys.

Multiple sclerosis

It has been known for some time that in the northern hemisphere MS is more common because of the lack of sunshine, which in turn leads to less vitamin D3 production in the skin. Multiple sclerosis (MS) is an autoimmune disease where immune cells attack the lining of nerves. Both nerve cells and immune cells have vitamin D receptors. It appears that vitamin D calms down immune cells and remission of an MS relapse is more likely.

Dr. Fitzgerald and colleagues published a study in JAMA Neurology in 2015. Results of this study showed marked differences between MS patients with high and low vitamin D levels.

Multiple sclerosis rates with high and low vitamin D levels

Patients with the highest vitamin D blood levels (more than 40 ng/mL) had the lowest rates of new MS lesions. Previous studies found that a low blood level of vitamin D (less than 25 ng/mL) had an association with a higher risk of developing MS. Dr. Fitzgerald’s study showed that a 20 ng/mL (50.0-nmol/L) increase in serum vitamin D levels associated with a 31% lower rate of new MS lesions. Patients with the highest vitamin D level of more than 40 ng/mL (100 nmol/L) had the lowest amount of new MRI lesions (47% less than the patients with the lowest vitamin D levels).

Dementia and Alzheimer’s disease

A 2014 study showed that patients with a low vitamin D level had a connection with a high risk of dementia and Alzheimer’s disease.

Specifically, the researchers found the following observations.

Vitamin D level of less than 10 ng/mL: 122% increased risk of Alzheimer’s
A vitamin D level of 10 to 20 ng/mL: 51% increased risk of Alzheimer’s

Vitamin D is the definitive link for the immune system

In a publication of 2006 Dr. John Cannell and co-workers have reviewed why influenza has seasonal outbreaks. They found that the innate immune system was very dependent on vitamin D. Those who did not get enough sunlight in the northern hemisphere during January, February, March and April have an average 25-hydroxy vitamin D level of only 15 to 17 ng/mL. In contrast, from July to September the same volunteers had vitamin D levels of 24 to 29 ng/mL. The authors stressed that this was the reason why spring flus in the late winter/early spring season are common, but disappear in summer.

Vitamin D requirements for immune system is 2000 IU or more per day

Vitamin D is essential for the functioning of the innate and adaptive immune system. They also are the reason why children are not as affected by influenza viruses as adults are. Dr. Cannell said: “The innate immunity of the aged declined over the last 20 years due to medical and governmental warnings to avoid the sun. While the young usually ignore such advice, the elderly often follow it”. Had the older patients taken higher doses of vitamin D3 every day, their immunity would have been as strong as the children’s immunity. The publication cites another paper that found that 2000 IU per day or more will strengthen the immune system. Note that this is a higher dose than treating rickets. Treatment of rickets responds to only 400 IU of vitamin D3 per day.

Mechanism of action of vitamin D in infectious diseases like influenza or Covid-19 coronavirus

Here is evidence from US researchers that states that higher doses of vitamin D3 will mitigate the course of influenza and of Covid-19 coronavirus. The researchers outlined that vitamin D has 3 effects:

Maintaining tight epithelial junctions making it more difficult for the Covid-19 coronavirus to penetrate them.
“Killing enveloped viruses through induction of cathelicidin and defensins.” These powerful antiviral polypeptides can kill viruses that have invaded the bloodstream within 1 to 2 days.
“…And reducing production of proinflammatory cytokines by the innate immune system, thereby reducing the risk of a cytokine storm leading to pneumonia.” People who get viral pneumonia are at a high risk of death. By bringing the vitamin D blood level up to the higher range of normal, between 50 and 80 ng/mL, patients that have encountered Covid-19 coronavirus are more likely to survive.

Criticism of high dose vitamin D treatment

A common criticism of treatment with higher doses of vitamin D is that people would develop high blood calcium levels and would get kidney stones. Three recent studies have demystified this. A 2012 study looked at patients who were in the higher range of calcium levels, but deficient in vitamin D. They were treated with vitamin D3 und closely supervised. The calcium levels did not change after 1 year of high doses of vitamin D.

This 2018 study observed that there is a small amount of kidney stone formers who will form kidney stone with or without vitamin D3 treatment. However, the large majority of patients do not form kidney stones with vitamin D treatment and their blood calcium levels stay the same before and after vitamin D treatment.

Toxic vitamin D blood levels

Toxic levels of vitamin D blood levels are above150 ng/mL, or 375 nmol/L. The therapeutic levels discussed here are well below these toxic levels.

Placebo controlled New Zealand study fails to show kidney stones

A placebo-controlled study from New Zealand went on for 3.3 years. 100,000 IU of vitamin D3 monthly (3333 IU per day on average) in the experimental group were compared to a placebo group. There were no vitamin D induced kidney stones and also no changes in calcium levels.

In past studies regarding vitamin D toxicity were done. But with these investigations there were many confounding factors that led to false results. The investigators at those times mistakenly thought that they were side-effects of vitamin D. Up to this day conventional medicine often warns of hypercalcemia and kidney stones with vitamin D treatment. While the patient is on higher vitamin D levels, the physician can do blood and urine tests to see whether or not there is any concern.

Polypeptides released by vitamin D

There are more than 100 polypeptide hormones that are controlled by vitamin D. The most important ones for control of bacterial and viral infections are the defensin family and the cathelicidin family of polypeptides. They are instrumental in preventing the cytokine storm with a Covid-19 coronavirus infection treated with high vitamin D doses.

Decades after the original description of vitamin D researchers found out that vitamin D actually is a hormone.

There are vitamin D hormone receptors on almost every cell of the body. Vitamin D integrates the body cells and they respond as one unit. It is only recently that researchers found out about the release of polypeptides, particularly defensin and cathelicidin. They are vital in the defence against the Covid-19 Coronavirus and the various flu types.

Vitamin D Is the Definitive Link

Conclusion

The detection of vitamin D originally occurred when rickets was examined. But later researchers found that vitamin D has hormone qualities.

You can prevent several diseases, like arthritis, cardiovascular disease, breast cancer, diabetes, osteoporosis and influenza. But you must take adequate amounts of vitamin D to bring the vitamin D blood level up. 25-hydroxy vitamin D blood levels are now recognized as the standard test to measure whether you have enough vitamin D on board. When it comes to fighting infections the vitamin D blood level has to be above 30 ng/mL (above 75 nmol/L). At this level the immune system will release defensin and cathelicidin polypeptides. These are powerful antiviral and antibacterial substances that can even fight Covid-19 coronavirus.

High vitamin D therapy is safe

With careful monitoring of blood vitamin D levels side effects of high vitamin D dosages were not found. Conventional medicine keeps on repeating old studies with confounding errors. This scares people, and as a result they don’t want to take enough vitamin D for prevention. Hypercalcemia and kidney stones were NOT found in randomized newer studies. As long as the vitamin D level does not exceed 50-80 ng/mL (or 125-200 nmol/L) vitamin D therapy is perfectly safe.

May

2020

The Quality of Food is Important

By Ray Schilling | diet, fish oil, food, Health, heart attack, Nutrition, Obesity, omega-3 fatty acids, organic food, osteoarthritis, polyunsaturated oil, Prevention, Processed food, sugar

Many authors wrote books about food; the quality of food is important. Recently I came across a book review regarding the book “The Way We Eat Now” by Bee Wilson. In the March 2020 edition of the health magazine “LifeExtension” Laurie Mathena interviewed Bee Wilson about her book.

Bee Wilson explained that there is a distinct history about the production of food throughout the centuries. She described 5 phases.

During the hunter/gatherer time people were eating a low-fat diet with berries, wild greens and wild animals.
Stage two began around 20,000 BC. It was the agricultural age with a switch to cereals. At that time the population experienced rapid growth.

More stages

Only a couple of centuries ago, agriculture made progress with crop rotation and by adding fertilizers. This led to a more varied diet. People ate more vegetables, less starchy food and animal protein.
After the Second World War there was a major food transition. Processed food was introduced. People started eating more fat, meat, sugar and a lot less fiber. We are now experiencing a phenomenon that we are simultaneously overfed, but undernourished. We get too many calories, but our diet is poor in nutrients. This type of diet causes obesity and degenerative type illnesses.
Stage 5 involves people abandoning junk food and eating more vegetables and fruit again. The more knowledgeable people are about the link between a good diet and health, the healthier people eat. This stage requires governments and other organizations to do their part in assisting people to make that food transition.

Food labeling changes in Chile

Here is one example of how governments can make a difference. This happened in Chile. Chile used to have the highest consumption of sugary beverages in the world. Prior to 2016 the average consumer in Chile bought more than 50% of the food as ultra-processed. This resulted in Chile having the second highest obesity rate after Mexico. The government of Chile decided in 2014 to introduce very simple labels for every food item. The government of Chile demanded that all the foods with too much sugar, high saturated fat, food high in salt and high in calories had proper labels. These labels are simple, hexagonal warning labels.

Warning labels

For instance, if a food product had too much salt in it, it would say in the hexagonal label: “Warning: high in salt”. As the labels had the effect of lowering sales, the food companies reformulated their products very quickly to stay under the threshold triggering the food warning. In 2016 Chile also decided to tax unhealthy foods higher. The government taxed sugar-sweetened colas with an 18% extra tax. Schools had to abandon junk foods sales.

Quality of food

When you start cutting out junk food and other processed foods, the quality of your food intake is improving. Eat more vegetables, and fruit. Eat wild salmon, which provides omega-3 fatty acids. Do not consume vegetable oils like soybean oil, canola oil, safflower oil, corn oil and grape-seed oil. They all contain omega-6 fatty acids. Omega-6 fatty acids are essential fatty acids and they convert mainly into energy. But the problem is that our western diet contains too many omega-6 fatty acids. Omega-6 fatty acids can convert into arachidonic acid, which causes inflammation. This in turn can cause heart attacks and strokes on the one hand and arthritis on the other hand.

The omega-6 to omega-3 ratio is important

In the past a healthy ratio between omega-6 and omega-3 was 4:1 or less. The average American now eats food with 16-times the amount of omega-6 fatty acids than omega-3’s. This is an omega-6 to omega-3 ratio of 16:1. No wonder people get sick with degenerative diseases.

Brain health maintained by eating enough omega-3 fatty acids

Here is a study that looked at brain structure using MRI scans. 3660 participants aged 65 received MRI brain scans. The researchers recorded their food intake with questionnaires. They rescanned 2313 of these individuals 5 years later. The group highest in omega-3 consumption was compared to the group with the lowest omega-3 consumption. Blood tests were also done both initially and 5 years later to verify the omega-3 intake. The researchers found that the higher omega-3 group had less subclinical infarcts and the white matter of the brain was of a better grade. They concluded that fish consumption, the major source of omega-3 fatty acids, had a beneficial effect on brain health later in life, preventing Alzheimer’s disease.

Cook your own food, do not eat out frequently

When you cook your own food, you can choose the right foods as you shop. Stay away from the “dirty dozen”, which is poisoned with insecticides, herbicides or pesticides. Instead you can buy organic foods that have not been sprayed with toxic substances. When you eat out, you have no choice about what you eat. Food in restaurants also contains food preservatives that are not labeled in North America, but that would be labeled in restaurant menus in Europe. In addition, food in restaurants often contains too much salt, too much sugar and the wrong oils. Omega-6 fatty acids are much cheaper than olive oil, and as a result this is what the chef uses.

Transition from stage 4 to stage 5

When you want to transition from stage 4 to stage 5 regarding your food composition you are swimming against the stream of establishment. At this point you are more or less alone when you want to abandon French fries, processed food bars, hamburgers and sugary soft drinks. But the more you eat at home, the more you take out your lunch box with food prepared at home, the more you are winning the war against convenience foods. It is what you put into your mouth, which is the fuel for your body. Don’t compromise regarding the quality of your food!

The Quality of Food is Important

Conclusion

The quality of food is important. We have been inundated by ads from the food industry that we should eat fast foods (hamburgers, French fries), processed foods like power bars and drink sugary drinks. We have met the entire lineup on television! But it is best to buy basic foods and prepare all your food from scratch. Be careful that you avoid the “dirty dozen” foods. If you want to eat these, buy the organic food versions. This way you avoid pesticides and other poisons. Stick to extra virgin olive oil as a fat source and avoid vegetable oils. Soybean oil, canola oil, safflower oil, corn oil and grape-seed oil contain a lot of omega-6 fatty oils.

Inflammation caused by vegetable oils

These cause inflammation in your blood vessels and joints. The end result are heart attacks, strokes and arthritis. I also eat a lot of wild salmon and other seafoods, a great source of omega-3 fatty acids. In addition, I take two capsules of molecularly distilled fish oil in the morning and at night. Eat more vegetables and fruit. You are now paying attention to the fact that the quality of food is important.

Here is a link to the book by Bee Wilson; “The Way We Eat Now”.

Apr

2020

Exosomes can Regenerate Your Stem Cells

By Ray Schilling | Anti-aging medicine, Arthritis, blood brain barrier, Diabetes, exercise, fasting mimicking diet, Fitness, Heart Disease, immune system, Inflammation, kidney disease, lifestyle, mitochondria

Dr. Douglas J. Spiel gave a talk on how exosomes can regenerate your stem cells. In essence, this was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019. His original topic was: “Placental MSC Exosomes for Longevity and Chronic Disease”. Notably, MSC stands for “mesenchymal stem cells”. Dr. Spiel recommended this website to look at applications of exosome therapy.

Essentially, what scientist found is that certain factors from stem cells can activate your own stem cells to regenerate tissues that grow old. These factors are messenger RNA (mRNA) and micro RNA (miRNA), which come as tiny particles of 40‐100 nm.

Advantages of administering exosomes

To emphasize, exosomes can be given systemically as infusion, and they can regenerate your stem cells, if they are in need of treatment. They cross the blood brain barrier, so it is possible to treat brain diseases. That is to say, there is no first-pass removal in the lungs as it is with mesenchymal stem cells (MSC). The potency is related to the age of the donor and his/her stem cells. Notably, exosomes are easy to store, freeze and administer.

Exosomes influence the growth of target cells and promote regeneration. In addition, exosomes stimulate immunomodulation and have anti-inflammatory and anti-fibrotic properties. To clarify, the only limitations are that the strength of the exosomes is related to the age of the blood donor. The exosome fraction comes from mesenchymal stem cells. That is to say, it circulates in the plasma portion of the blood, which is obtained by spinning blood cells down in a centrifuge. To emphasize, exosomes can regenerate your stem cells.

Applications of exosomes for various clinical conditions

Joint inflammation

Mesenchymal stem cells are useful to treat arthritis. But it is important to realize that exosomes from mesenchymal stem cells are doing the same by stimulating the body’s own stem cells situated in the joints. In fact, several target cells have been identified that are stimulated by exosomes. These are chondrocytes, chondrocyte progenitor cells, cartilage-derived stem cells and synovium‐resident multipotent progenitor cells. In addition, other target cells are osteoblasts and osteoclasts in resident MSC within the subchondral bone and chondrogenic cells in the knee joint.

Disc degeneration

Degenerative intervertebral discs respond to exosome treatments. The IL1 beta cytokine is involved in intervertebral disc degeneration. Exosomes inactivate these cytokines and have antioxidant and anti-inflammatory effects. Exosomes are not all the same. Different sub-fractions were isolated that have anti-inflammatory, immune-stimulating, antioxidant and other effects on the body.

Aging research

Researchers were able to pinpoint aging to various factors that contribute to premature aging. To clarify, when there is a decrease of catabolic processes and an increase of anabolic processes, an older person can combat premature senescence. Another key point, aging is also linked to redox homeostasis. Simply put, oxygenation processes in the body need to be balanced by reduction processes. This keeps the body in a healthy state. ADP/NADH production can be stimulated by exosomes.

Longevity comes from good lifestyles

With the use of exosomes, the aging process slows down, as oxidative stress is neutralized, damaged mitochondria are removed and cellular debris as well. That is to say, this improves inflammation and premature aging.

As has been noted, in the past 200 years life expectancy has doubled in most countries. 4 areas where longevity is particularly common are: Okinawa, Japan; Sardinia, Italy; Nicoya, Costa Rica and Loma Linda, USA. Only 7% of longevity stems from genetic factors, the rest is from lifestyles we adopt. In the final analysis, people who die prematurely followed a very poor lifestyle causing them to develop diseases, which ultimately killed them.

Clinical diseases from aging

Ultimately, advanced aging puts you at risk of getting cardiovascular disease (heart attacks and strokes), cancer and neurodegenerative diseases (Alzheimer’s disease, Parkinson’s disease). From the third decade onwards, there is the risk of bone loss, which causes osteoporosis. As has been noted, loss of cartilage causes osteoarthritis. Loss of muscle strength and muscle mass is called sarcopenia. With aging there is often an accumulation of abdominal fat. Hormones are disbalanced. Blood pressure is often elevated and blood lipids as well. Insulin resistance can develop and the blood vessels become stiffer. This causes heart attacks and strokes.

The details of the aging process are much more complicated than originally thought of. There is a combination of aging of the DNA, mitochondrial aging, stem cell exhaustion and a change of intercellular communication due to dysregulated endocrine signalling. In addition, there is a decline of the immune system and epigenetic factors that can turn off longevity genes.

Oxidative stress as a cause of premature aging

Dr. Spiel pointed out that reactive oxidative species (also known as free radicals) cause damage to mitochondria and mitochondrial DNA. But we need the energy from the mitochondria for a comfortable life. In essence, antioxidants can neutralize free radicals. Age-related conditions due to oxidative stress are: cardiovascular disease, chronic kidney disease and type 2 diabetes, chronic obstructive pulmonary disease, cancer, neurodegenerative disease, frailty and sarcopenia. Surely, both reactive oxygen and reactive nitrogen are free radicals. They have one or more unpaired electrons and all aerobic body cells produce them. Reactive oxygen and nitrogen species (RONS) cause oxidative damage to our cells and contribute to the development the diseases just mentioned.

Antioxidants help to prevent diseases

But antioxidants can contain these free radicals in various ways. The body has five built-in enzymatic ways to protect itself and five non-enzymatic ways (bilirubin, vitamin E, beta-carotene, albumin and uric acid). In addition, there are antioxidants that a person can take as supplements to inactivate RONS. These are: vitamin C and E; phenolic antioxidants like resveratrol, phenolic acids, flavonoids, oil lecithin, selenium, zinc and drugs like acetylcysteine.

Without control of the oxidative stress RONS can lead to cellular senescence and chronic inflammation. This leads to a vicious cycle where chronic oxidative stress and inflammation feed on each other leading to premature diseases.

Causation of several diseases

As we age, the body reduces the inborn antioxidant enzymes (superoxide dismutase and glutathione peroxidase). Before we can understand how to live longer, we need to be aware what happens in various health scenarios as follows.

The lack of inborn antioxidant enzymes leads to vascular endothelial dysfunction, high blood pressure and premature hardening of the arteries. This can become a precursor to heart attacks and strokes.
Elevated blood sugar in the case of type 2 diabetes leads to increased sugar concentration of body cells and formation of free radicals.
Oxidants from cigarette smoke activate macrophages and epithelial cells to produce inflammatory cytokines. Continued smoking releases proteases in the process that break down connective tissue and cause emphysema and COPD.

There are more diseases

Chronic kidney disease comes from oxidative stress affecting the filter units of the kidney, called glomeruli. With a lack of blood supply to the kidneys secondary high blood pressure develops and endothelial dysfunction. It also leads to chronic inflammation.
In the brain oxidative stress leads to cognitive impairment and dementia.
Oxidative stress and chronic inflammation are important ingredients for the development of cancer. RONS and cytokines release NF-kB, which activates cancer genes. RONS can also directly attack the DNA of cells and cause cancer through carcinogenesis.
Sarcopenia and frailty come from the action of RONS on the skeletal muscles. In old age there are less inborn antioxidants available. This leads to decreased muscle quantity or sarcopenia. Eventually frailty results with the risk of falls and fractures.

Preventative measures for slowing the aging process

There is a number of steps that in combination help to slow the aging process.

A Mediterranean diet combined with a fasting mimicking diet or other calorie restricted diet
Regular physical activity
Cognitive training
Vitamin D3 supplementation
Reducing your risk to develop vascular disease
Certain drugs turn on the longevity gene (metformin, rifampin)
Spiel warned that due to limited compliance and variable response these steps alone may not be enough to prevent age-related problems

How to live longer

It is important to recognize the importance of antioxidants to counteract the development of these diseases. As already mentioned, the following counter the effect of free radicals: vitamin C and E; phenolic antioxidants like resveratrol, phenolic acids, flavonoids, oil lecithin, selenium, zinc and drugs like acetylcysteine. Mesenchymal stem cells can also stop the action of free radicals. In addition, exosomes, which are products of mesenchymal stem cells can do the same. Mitochondria, the power houses within the cells, create energy, but also release free radicals. In his clinic Dr. Spiel administers intravenous exosomes to counter the oxidative stress. Numerous studies linked mitochondrial dysfunction to various age-related diseases. There are markers in blood tests that the physician can order to analyze malfunctions in the body. Dr. Spiel showed 4 slides that contained a lot of medical information that is too technical. I omitted it for this review.

Intravenous infusions of exosomes

The important thing to remember is that epigenetics can be changed by exosome infusion and lifestyle changes mentioned above. Dr. Spiel said that generally he uses 15 ml of exosomes by intravenous infusion every 12 weeks for longevity and performance enhancement. This treats conditions like infertility, osteoporosis, osteopenia, heart, liver and kidney weaknesses. Here is the dosing for intravenous exosomes by weight:

20-50 lb: 5 ml; 50-90 lb: 10ml; more than 90 lb: 15 ml; more than 220 lb: 20 ml. Unfortunately, one exosome treatment costs between 500.00 and 922.00 USD, an amount that most people cannot afford.

Contraindication to the use of stem cells or exosome therapy

It is important to realize that a person who has cancer should not receive either mesenchymal stem cells or exosomes. Indeed, exosomes do not differentiate between cancer cells and healthy cells, but stimulate cell division. For the same reason people with myeloproliferative disease (sickle cell anemia, bone marrow dysplasia) should also not receive exosomes. To clarify, other conditions where the physician will not order exosomes are primary pulmonary hypertension, acute bacterial infection or an immune-compromised state. In addition, macular degeneration with neovascularization is also a condition where the health professional does not administer exosomes.

Exosomes can Regenerate Your Stem Cells

Conclusion

Dr. Douglas J. Spiel gave a talk on how exosomes can regenerate your stem cells. Specifically, this was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019. Dr. Spiel explained how disease processes age our organs. Reactive oxygen and nitrogen species (RONS) cause oxidative damage to our cells and contribute to the development of diseases. This involves the mitochondria in the cells as well. The good news is that a healthy lifestyle can counter these damaging processes to a certain extent. But it takes another step to re-establish the balance of our cells, exosome infusions. Exosomes are tiny particles that are shed by stem cells and that circulate in the blood. They can reenergize stem cells that are ailing to become functional again.

Expensive exosome infusions

He recommended an infusion with exosomes every 12 weeks for maintenance of good health and as a “fountain of youth”. Obviously, there are some limitations. As mentioned, it is not suitable for all patients, like cancer patients, patients with sickle cell anemia, acute bacterial infections or pulmonary hypertension. In addition, it is also not a treatment which many patients will seek out as the cost is prohibitive. One exosome treatment cost between 500.00 and 922.00 USD, an amount that most people cannot afford.

Apr

2020

Changes of Metabolism by Inflammation

By Ray Schilling | alcohol, Allergies, Alzheimer’s disease, antibiotics, autoimmune disease, blood brain barrier, Cancer, Cardiovascular disease, cholesterol, diet, Drugs, fractures, heart attack, Hormones, immune system, Inflammation, kidney disease, mitochondria, Mortality, Osteoporosis, schizophrenia, stress, thyroid disease

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.

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

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.

Specialized pro-resolving mediators (SPM)

Three vital tasks of pro-resolving mediators

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

Newer studies about SPMs

Conclusion

Details of the study

Other studies

What is so healthy about the Mediterranean diet?

More detail on the ingredients of the Mediterranean diet

No processed food means healthier living

Olive oil is one of the reasons why the Mediterranean diet is so healthy

How polyphenols in olive oil work for you

Endothelial function

Lowering blood pressure

Preventing heart attacks and strokes

Conclusion

History of vitamin D

Rickets

Adequate vitamin D level strengthens the immune system

Vitamin D is a hormone

Three mechanisms how vitamin D works against the virus

Two polypeptides, cathelicidin and defensins

Sources of vitamin D

Sun induced amount of vitamin D

Vitamin D supplements

Vitamin D blood level

Which vitamin D level is safe and which is not?

Vitamin D toxicity

Vitamin D supplement compliance

Denial

False security with low doses of vitamin D

Compliance issues

Covid-19 coronavirus infections and vitamin D blood level

Conclusion

Literature

Liquid biopsy promises early cancer detection

Oncoblot test was a precursor to the multi cancer blood screening test

My own case of prostate cancer

New multi cancer blood screening test from Johns Hopkins Medical School

More details of the CancerSEEK test

Possible problems with the new multi cancer blood screening test

Conclusion

Descriptions of unusual presentations of the Covid-19 coronavirus

Blood clot secondary to Codid-19 coronavirus

Other unusual presentations of the Covid-19 coronavirus

Pediatric multisystem inflammatory syndrome

Delirium in patient testing positive for Covid-19 coronavirus

Unusual presentations of the Covid-19 coronavirus in elderly patients

Gastrointestinal symptoms common in adults

Unusual presentations of the Covid-19 coronavirus in pregnant women

Conclusion

Five bad lifestyles and life expectancy

Diseases that kill prematurely

Additional life expectancy

Diseases caused by poor lifestyle habits

Cardiovascular disease

Cancer

Diabetes

Chronic diseases

Conclusion

Facing bad lifestyle habits

A few diseases where low vitamin D is the definitive link for a poor outcome

Multiple sclerosis

Multiple sclerosis rates with high and low vitamin D levels

Dementia and Alzheimer’s disease

Vitamin D is the definitive link for the immune system

Vitamin D requirements for immune system is 2000 IU or more per day

Mechanism of action of vitamin D in infectious diseases like influenza or Covid-19 coronavirus

Criticism of high dose vitamin D treatment

Toxic vitamin D blood levels

Placebo controlled New Zealand study fails to show kidney stones

Polypeptides released by vitamin D

Conclusion

High vitamin D therapy is safe

More stages

Food labeling changes in Chile

Warning labels

Quality of food

The omega-6 to omega-3 ratio is important

Brain health maintained by eating enough omega-3 fatty acids