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

Jan

2020

Preserving Youthful Power

By Ray Schilling | exercise, fasting mimicking diet, Fitness, Health

Dr. Christopher W. Shade (PH.D.) presented a lecture in Las Vegas on Dec.13, 2019 talking about preserving youthful power. The presentation was at the 27^th Annual World Congress on Anti-Aging Medicine and his title was “Building Youthful NAD+ Power with Precursors, Sirtuin-Activating Compounds, and Methylation support”.

In the first place, nicotinamide adenine dinucleotide (NAD⁺) is a signalling molecule between the DNA of the nucleus of cells and the energy producing mitochondria that reside in the cells. The exact nature of the interaction is described in this review article. It describes how stress leads to a depletion of NAD+ and sirtuins, and causes accelerated aging. On the other hand, calorie restriction and exercise lead to increased production of NAD+, activation of sirtuins and longevity.

Details about low NAD+ activity

It is important to realize that when NAD+ is below a critical level the following disease states can develop. First, in the brain it is Alzheimer’s disease and neurodegenerative disease. Second, in the eyes macular degeneration and keratoconjunctivitis sicca can develop. Third, severe plaque-type psoriasis can occur in the skin. Fourth, the pancreas develops hyperinsulinemia and metabolic syndrome. Fifth, type 2 diabetes can make your muscles weak. Sixth, sarcopenia with loss of muscle mass and cardiovascular disease in the heart can also develop. Seventh, the liver reacts to the metabolic syndrome by causing hepatic steatosis. Metabolic syndrome causes inflammatory cytokines in the fatty tissue. Eighth, the lungs react by developing chronic obstructive pulmonary disease. Ninth, your blood can get endotoxin-induced inflammation and sepsis from bacteria. A lack of NAD+ causes all of these negative changes simultaneously in the body.

In fact, when a person exercises regularly, uses intermittent fasting as a tool of calorie restriction and takes supplements of NAD+ all of these negative processes stop and sirtuins are activated restoring the body to a more youthful condition.

Summary about the effects of NAD+

In other words, NAD+ is important for cardiometabolic health, energy balance, liver health, immune health and cognitive health. NAD+ is also involved in maintaining the membrane polarity of cell walls. The blood /brain barrier and the gut/blood barrier are also kept intact by NAD+. In addition, NAD+ is involved in detoxification and control of the action of free radicals. It also is important to control Inflammation. For these reasons, it is not a surprise that people with normal NAD+ function will be healthier than those who have a problem with this.

Sugar reduces NAD+ to NADH

It is important to note that scientists could show in animal models and in humans that sugar overconsumption leads to the reduction of NAD+ to NADH. All of the negative effects described above for low NAD+ are then coming true. NADH is a reduced and disabled form of the oxidized NAD+. In essence, this substance has no biological action.

Energy metabolism

Biochemists have determined with regard to the energy metabolism of mitochondria that there are three occasions where enzymes are dependent on NAD+. Without NAD+ the energy-providing oxidative metabolism in mitochondria would not take place. As NAD+ is lower in older age, this explains why an aging population has less energy. In addition, as we age, the number of mitochondria per cell is decreasing. That is to say that an aging population has less energy than youthful people.

Other factors that are important in preserving youthful power

The AMPK signalling pathway

AMPK stands for 5′ AMP-activated protein kinase. This is an enzyme that consists of three protein portions. In humans it is expressed in liver, brain and muscle tissue. It provides energy in the liver by fatty acid oxidation. In muscles it stimulates glucose uptake and fatty acid oxidation. AMPK also inhibits cholesterol synthesis, lipogenesis and triglyceride synthesis. Fasting and exercise can stimulate AMPK production, which in turn will stimulate SIR1 genes and NAD+ production. This is especially happening in muscle tissue. To put it another way, there are a close-linked metabolic reactions between NAD+, AMPK and sirtuins.

Balance between AMPK, NAD+ and methylation

Given the right circumstances this can lead to detoxification, longevity and energy. This is what intermittent fasting and exercise can do for you. AMPK needs high NAD+ levels to give you all of the benefits. But NAD+ must be balanced with methylation. This is a somewhat difficult subject to explain, but the link explains it in somewhat technical terms. In other words, with a balance of the body’s biochemistry the person is healthy. When there is a disbalance, you get sick.

Practical application how to supplement for preserving youthful power

Dr. Shade asked the rhetorical question: how can we achieve a balance between NAD+ and methylation?

His answer is to supplement with the following supplements.

Trimethylglycine (Betaine) 2‐5g/day
Vitamin B2: 10‐30mg/day
SAMe or methylcobalamin 1000‐3000mcg/day
Measure Homocysteine as marker of methylation; if it is low, the methylation pathway is normal and there is balance.

Next: how to we raise NAD+? The answer is by cardio-metabolic blending.

Berberine and quercetin (they are respiratory chain modulators)
Resveratrol, silymarin and lipoic acid (they are liver kinase B1 activators)
Resveratrol or pterostilbene and quercetin (they are sirtuin activators)
Nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) 200- 400 mg per day
Trimethylglycine (Betaine) 2-5 grams per day and methylcobalamin, B2, and others (methylation support)

Preserving Youthful Power

Conclusion

It is difficult to describe energy flow in biochemical terms. Dr. Christopher W. Shade did exactly that in a lecture he gave at the 27^th Annual World Congress on Anti-Aging Medicine in Las Vegas on Dec.13, 2019. The key for preserving youthful power is to balance the metabolism that occurs in the nucleus of the body cells with the metabolism taking place in the mitochondria. The mitochondria are the energy producers, but the steering of this occurs through the metabolic products from the cell nucleus. NAD+ plays a key role in our energy metabolism. But there is an interplay with AMPK, which stands for 5′ AMP-activated protein kinase. Sirtuin genes interact with these messenger molecules as well and this is where longevity comes in.

Longevity through sirtuin stimulation

Sirtuins are longevity genes that help us get more energy for a longer period of time. Regular exercise stimulates this complex biochemistry giving us extra NAD+ for energy. Intermittent fasting also stimulates sirtuins, which adds to the extra energy and gives us longevity. This is not a bad deal when you look at it from a distance. We can achieve a lot preserving our energy through an active life style. Supplements can be an auxiliary measure, but they are not effective enough without positive lifestyle choices.

Dec

2019

Non-Alcoholic Fatty Liver Disease

By Ray Schilling | Allergies, autoimmune disease, blood test, Diabetes, exercise, fiber, Inflammation, Nutrition, Obesity

Non-alcoholic fatty liver disease (NAFLD) has been increasing in the general population. About 25% of all Americans suffer from this condition. It is more common among obese, overweight and diabetic patients. But it is also very common in people whose gut bacteria are abnormal. Antibiotic residues in red meat and in poultry can cause these gut bacteria changes according to scientists. Metabolic products of these abnormal gut bacteria are absorbed in the gut and end up in the portal vein. This is a large vein collecting all the nutrients and leaked toxins and transports them to the liver. The liver detoxifies toxins and digests nutrients. In the process the liver can get inflamed and turn into a fatty liver.

Fatty liver is still reversible

When liver damage continues, fibrotic changes can develop and liver cirrhosis is the next stage of this disease. Fatty liver is still reversible, but liver cirrhosis is not.

The January 2020 edition of LifeExtension magazine contains a review of non-alcoholic fatty liver disease (NAFLD). It also tells you what you can do to normalize the condition. In the following I am reviewing this article.

Probiotics can help to reverse non-alcoholic fatty liver disease

Two studies that I will describe in more detail later showed that probiotics can reduce inflammation in the blood significantly and can reverse fatty liver disease. Abnormal bacteria in the gut can also lead to leaky membranes of the gut wall. This can become permanent and the condition has the name “leaky gut syndrome”. Researchers have linked this condition to the development of autoimmune diseases. People with obesity and with high blood sugars (people with diabetes) have the highest risk of developing non-alcoholic fatty liver disease (NAFLD). The condition (NAFLD) does not produce any symptoms. But a combination of blood tests and scans can diagnose the condition.

Good and bad gut bacteria

If you allow the bad gut bacteria to stay, inflammation of the gut wall with leaky gut syndrome develops. This allows bacteria, toxins and other substances that should stay out of the blood to enter the body. Researchers have found that good bacteria can control the gut inflammation by taking probiotics, that will allow the leaky gut wall to heal. They found the following bacteria to be beneficial:

Lactobacillus casei
Lactobacillus rhamnosus
Streptococcus thermophilus
Bifidobacterium breve
Lactobacillus acidophilus
Bifidobacterium longum
Lactobacillus bulgaricus

Probiotics usually contain most or all of these good bacteria. This allows the inflamed gut wall to heal and restore the gut barrier.

Two human trials

A randomized, double-blind, placebo-controlled clinical trial was published in 2014. 52 patients with NAFLD who were overweight or obese were taking probiotics twice a day versus a placebo control group. After 28 weeks the experimental group showed normalized liver enzymes and a significantly reduced C-reactive protein. The C-reactive protein was reduced by 54% in comparison to the placebo group.

The other clinical trial consisted of 50 patients with NAFLD, but a normal or low body mass index. Half of the patients were taking probiotics, the other half placebo pills. The researchers noted that after 28 weeks the inflammatory markers were much lower in the experimental group than in the placebo group. Also, the liver values were now normal.

Discussion

Patients with non-alcoholic fatty liver disease are in danger of progressing to liver cirrhosis and liver failure. At this point only a liver transplant could rescue them from death. However, as the clinical trials have shown, the use of probiotics to normalize the gut bacteria can normalize the inflammation of the gut and reverse fatty liver disease. Regular exercise and weight loss through the use of a lower calorie diet will also help in normalizing the liver function. When prebiotics are added to probiotics the healing effect is amplified even further. Prebiotics contain fiber that cannot be digested, but which is useful for bacteria from the probiotics to multiply on.

Non-Alcoholic Fatty Liver Disease

Conclusion

We need to pay more attention to the food we are consuming. For instance, regular beef in the US contains antibiotic residues that permanently change the gut flora. This leads to an inflammatory reaction of the gut wall and leaky gut syndrome. Gut bacteria and toxic substances can now enter into the portal vein and reach the liver. The liver attempts to detoxify this, but in the process, it also develops non-alcoholic fatty liver disease (NAFLD). About 25% of Americans have this condition, which is asymptomatic. The only way to diagnose it is through blood tests and scans. Two clinical trials have documented that NAFLD can reverse back to normal with the consumption of probiotics. Regular exercise and weight loss (calorie-reduced diet) also help to reverse NAFLD back to normal liver tissue. It is obvious that a timely intervention is necessary to avoid the progression to liver cirrhosis!

Dec

2019

When Natural Substances Turn Into Poison

By Ray Schilling | addiction, alcohol, marijuana, Substance abuse, toxins

Although people increased the use of brain stimulating substances in the last 17 years, nobody paid attention to the situation, when natural substances turn into poison. The Center for Injury Research and Policy and the Ohio State University College of Medicine, both in Columbus, OH conducted a study. The researchers looked at the use of natural substances from 2000 to 2017. They noted that during this time marijuana had increased by 150% and there was a 64% increase of nutmeg use. Nutmeg contains the hallucinogenic substance myristicin, a potent mind-altering substance. There was a 4949% increase of kratom use, which comes from the leaves of a South American tree which have powerful mind-altering substances. The original study of the researchers was published here.

More hallucinogenic substances

Other natural substances came from Jimson weed, where the leaves and seeds contain natural substances that cause hallucinations and euphoria. It contains the chemicals atropine, hyoscyamine, and scopolamine. These interfere with the normal messenger molecule acetylcholine in the brain and in nerves. 21% of all toxic reactions between 2000 and 2107 were due to Jimson weed. Besides those, 16% of all toxic reactions came from magic mushrooms. There are other natural substances which are similar. They come from a shrub that grows in East Africa and southern Arabia. Khat contains the alkaloid cathinone, which is a stimulant. It causes excitement, loss of appetite, and euphoria.

More details about the different natural substances and their actions

Marijuana

Marijuana includes dried leaves, the stem, seeds and flowers of the Cannabis sativa or Cannabis indica plant. The mind-altering THC compounds are what people are seeking out. When a person smokes marijuana, the THC enters the blood through the lungs. The THC reaches the brain and causes a “high”. This can be associated with seeing brighter colors, get an altered sense of time, have hallucinations, delusions and in severe cases a psychosis. Marijuana peaks at different times depending on whether it is smoked or taken in as an edible. When smoked, the effect of marijuana is felt by the user within a few minutes. Ingested as edibles will take 30 minutes to one hour to show an effect, but it lasts a lot longer (3 to 4 hours). This is important to know, particularly if other agents including alcohol are combined with marijuana.

Nutmeg

Nutmeg is used in small amounts as a spice, typically ¼ to ½ teaspoon in a family dinner. However, when a person consumes 2 teaspoons or more of nutmeg, such as more than 10 mg, toxic symptoms occur. Symptoms from myristicin, the active substance in nutmeg, can be hallucinations, dizziness, confusion and seizures.

Kratom

Kratom is a tropical tree (Mitragyna speciosa), which is native in Southeast Asia. The leaves contain mind-altering compounds. At this time kratom is freely available on the Internet. There is no restriction in the US. But there are health concerns. Kratom has both opioid and stimulant effects on the brain. It produces sensations of pleasure, sedation and decreased pain. In small amounts people experience increased energy, sociability and alertness. There are a number of side effects: nausea, sweating, itchiness, dry mouth, increased urination, constipation, loss of appetite, hallucination and seizures. Kratom caused 8 of the 42 deaths reported by the Ohio State University College of Medicine, Columbus, OH study.

Jimson weed

The leaves and the seeds of Jimson weed are used by drug-seeking individuals. It causes hallucinations and euphoria, a heightened sense of well-being. It contains the chemicals atropine, hyoscyamine, and scopolamine. These interfere with acetylcholine, one of the major hormones in the brain and nerves. 15-100 grams of leaf and 15-25 grams of the seeds can be lethal. Children are more sensitive, so the lethal dose is much smaller for them. Jimson weed slows down the stomach emptying and also the activities of the large intestine leading to severe constipation. It can cause glaucoma and also rapid heartbeat. Urinary retention is also common.

Khat

Khat is a drug found in the wild East African shrub called Catha edulis. It contains a central nervous system stimulant, called cathinone. People living on the Arabian Peninsula are chewing the leaves of this plant. It is illegal in Canada and the US. In Ethiopia 30% of adolescent girls and 70% of the adolescent boys chew khat. The effect of khat is similar to the effect of a strong coffee. It has a stimulant effect like the coca plant that is used to make cocaine. It increases respirations, elevates blood pressure and leads to gum disease. This results in tooth decay. Ulcers and constipation occur more often. People on khat become more talkative, elated and euphoric. Some say that they have more imagination and are able to associate things better. From a medical point of view Khat causes constipation, hemorrhoids and impotence. Other symptoms are blurred vision, headaches and dizziness.

Kava kava

Piper methysticum, a plant native to the western Pacific Islands is from which kava kava is made. Kava kava relaxes you, but it has caused liver damage and is even responsible for a few deaths. It has been banned from many European countries and Canada. It is still available in the US. Some people take kava kava for sleeping problems, anxiety and restlessness. There are many more claims that kava kava is effective for other diseases, but research could not confirm those claims. Kava kava is detoxified in the liver, but in doing so there are profound interactions with other drugs that get detoxified in the liver. This liver toxicity has led to irreversible liver damage requiring a liver transplant. Several people have died because of liver failure.

Magic mushroom

Wild mushrooms, namely magic mushrooms that contain psilocybin are a popular way to get a high. Psilocybin is psychoactive and hallucinogenic. Psilocybin is classified as a Schedule I drug in the US, meaning that it is highly addictive, but has no currently accepted medical use for treating any medical condition. Magic mushrooms cause nausea, yawning, drowsiness, nervousness, panic, paranoia, hallucinations and psychosis.

Toxic side effects of natural substances reported to Poison Control

There were 67,369 calls to poison control centers in the United States between January 1, 2000 and December 31, 2017 regarding natural substances. This is when natural substances turn into poison. There were 41.4% from calls regarding older than 19-year-old individuals. 34.8% of calls to the poison control center was regarding the age group between 13- and 19-year olds. 46.9% of cases were due to marijuana, 21.1% of the calls to the poison control centers were due to anticholinergic plants, 15.6% were due to hallucinogenic mushrooms. In the age group of 3-19 years 47.8% called because of marihuana overdoses. Above the age of 19 it was 53.0% who overdosed on marijuana. In children less than 6 years of age 44.4% of toxic overdoses came from anticholinergic plants.

Deaths reported in the study

The study reported 42 deaths from 2000 to 2017. 8 deaths were due to kratom. 7 deaths among the 42 deaths occurred in people under the age of 18. 5 of the 42 deaths occurred in teenagers aged 13 to 19. Two of the deaths occurred in children under the age of 12. These were due to marijuana.

Discussion

When reviewing the research of natural substances with the potential to cause addiction, it is important to see things in the right perspective.

Natural substances can be poisonous for you

Many people think that a natural substance, like a leaf from nature, should be trustworthy. But it is the chemicals that people swallow, inhale or chew that matter. Opium also comes from a “harmless” poppy seed. But opium is a powerful and addictive substance. All of the natural substances reviewed above contain potent mind-altering agents. This means that the natural substances are not safe.

Using SPECT scan to measure brain activity

None of the above-mentioned natural substances are harmless. They all attack the brain and interfere with the action of the natural brain hormones in the brain. This may be reversible for a few weeks, but eventually it leads to a chemical burn with permanent damage to the brain. This is when natural substances turn into poison. Dr. Daniel Amen, a psychiatrist has developed a scan that will depict changes in the brain in addicted persons. It is called the Single Photon Emission Computed Tomography or SPECT scan. This nuclear medicine scan measures blood circulation of the brain and brain activity. With prolonged use all of the natural substances show a decreased brain activity pattern on the SPECT scan.

Missing toxicity studies about natural substances

Armed with the SPECT scan as a tool and the knowledge that all of the reviewed “natural” substances have toxic effects on the brain makes one wonder how US citizens could willingly consume these substances for the past 17 years. It was probably a mix of curiosity, peer pressure and the fact that these natural substances were readily available, which made many people try them. There is very little research about toxicity in this field. This is only starting now. To my way of thinking this is another warning sign that people should stop their love-affair with mind-altering natural substances.

When Natural Substances Turn Into Poison

Conclusion

I have reviewed the thorny issue of natural substances and how they can turn into poisons. All of the substances reviewed affect brain function. This is why people experience hallucinations, elations and euphoria. But this is not real. It is due to the toxic effect of chemicals on the brain.Advertisements promote kava kava as a relaxing substance. But it can damage the liver and as a result several people have died. It is unknown to a large extent how these natural substances interact with other illicit drugs or with alcohol.

It is best to avoid consuming any of these natural substances. Anybody who consumes them is knowingly consuming a poison, and it means that the user will get into health problems…naturally!

Dec

2019

The Use Of Oncolytic Viruses For Cancer Treatment

By Ray Schilling | Cancer, cervical cancer, immune system, prostate cancer, vaccinations

In the first place, preliminary experiments indicate that the use of oncolytic viruses for cancer treatment may become a reality. There are several lines of research that point to the fact that oncolytic viruses can make a difference in treating incurable cancer patients.

Notably, Canadian researchers had reported in 2011 that oncolytic viruses created by genetically modifying smallpox vaccine viruses would enter tumor cells of patients, but not damage normal cells. Specifically, a high percentage of the end stage patients responded with tumor regression.

Shortly after Mayo Clinic physicians were desperate when two patients with end stage multiple myeloma, a vicious bone tumor, did not respond to chemotherapy. Significantly, they tried something unconventional: high doses of the measles vaccine in an attempt to stimulate the immune system. Here is an overview from 2014 that shows that many different cancers respond to various immunological approaches.

Study from Holland regarding end stage melanoma patients

Here is a small human study involving end-stage melanoma patients treated with the oncolytic virus T-VEC combined with pembrolizumab (Keytruda). It is important to realize that Keytruda helps to reactivate a T-cell response to the cancer cells. In this case the cancer cells absorb the oncolytic virus (T-VEC), but it leaves normal cells alone. Inside the cancer cells the oncolytic virus multiplies and destroys the cancer cells. In this 2017 study 21 patients with terminal, nonresectable melanoma received treatment with T-VEC and Keytruda. Specifically, 62% of the patients showed an objective response to the treatment. Moreover, 33% fulfilled the criteria of an immune-related response. In the past terminal patients like these had a 0% response to radiotherapy or chemotherapy.

History of research about oncolytic viruses

To begin with, in 1912 rabies virus treatment against cervical carcinoma was a first attempt to treat cancer. Researchers conducted many experiments between 1950 and 1970 with wild type or naturally attenuated viruses. This included, for example, hepatitis A and B viruses. In 1991 cancer researchers developed the concept of genetically engineered oncolytic viruses. Today cancer researchers know that the protection mechanisms in most cancer cells have deficiencies. This involves the interferon‐beta signal pathway. Having said this, there is an opportunity to let oncolytic viruses destroy cancer cells, while normal cells stay unaffected. An oncolytic virus that cancer experts use in human cancers is the genetically engineered herpes simplex virus type I (HSV‐1). Others that cancer researchers developed have strange names like T‐Vec, G47∆, JX594, CG0070 and Reolysin.

Various cancers that researchers treated with oncolytic viruses

Here are a few examples of cancers where researchers used oncolytic viruses to exert a significant therapeutic effect.

Glioblastoma

Glioblastoma is a deadly form of a brain tumor, which has a high rate of mortality. Researchers have investigated new avenues to treat this cancer. Researchers tested the genetically engineered dendritic vaccine. Initial clinical trials showed significant effectiveness compared to non-treated controls. In a large phase 3 clinical trial 331 patients with newly diagnosed glioblastoma received treatment at the time of neurosurgery with dendritic cell vaccine. 30.2% of the patients were still alive and doing well after 3 1/3 years. Without the added vaccination procedure all of these patients would have died in the past because of the aggressiveness of the glioblastoma.

Multiple myeloma

Researchers could cure multiple myeloma and other cancers by using the measles vaccine. Here is a report by the popular press about two women who had multiple myeloma. One woman got cured by high doses of a measles vaccine. The other women experienced some relief, but did not survive.

This publication explains that oncolytic viral therapy of cancer is a lot more complicated than originally thought.

Prostate cancer

Researchers found that vaccines against prostate cancer were effective with the combination of oncolytic virus therapy with regular anti-cancer treatments. But oncolytic virus therapy alone has a poorer prognosis than a combination of chemotherapy or radiotherapy with oncolytic virus therapy.

Cervical cancer

The high-risk HPV16 strain most often causes cervical cancer. The HPV (human papilloma virus) vaccine targets patients with previous exposure to HPV16. However, researchers have noticed that in some cases a phenomenon called the “HPV immune escape” has allowed in some vaccinated women to still develop cervical cancer. Now a group of researchers are investigating how the vaccine could be improved by finding out how the immune system is being tricked in these cases by the HPV virus to bypass the antibodies of the vaccine.

Pancreatic cancer

This cancer is very difficult to detect in the early stages, and as a result the outlook for chemotherapy or radiotherapy is extremely poor. Researchers have used several approaches as an alternative to conventional therapy. Immunotherapy is an option. Mayo clinic researchers have already announced that the measles vaccine approach will likely be applicable to pancreatic cancer treatment as well in the near future. However, other clinical trials are on the way to use alternative vaccination procedures.

Neuroblastoma, glioma and melanoma

This link shows that the FDA has accepted engineered oncolytic herpes virus (engineered to secrete GM-CSF) as a treatment against melanoma. Other approaches with engineered bacteria can affect neuroblastoma and glioma.

Survival data using oncolytic viruses for cancer treatment

Cancer researchers have completed a number of smaller clinical trials at this point. One of them describes end stage melanoma (stage III and IV) where the only treatment was with the oncolytic virus T‐Vec. The overall response rate compared to the control, which was only 5.7%, the experimental group with T-Vec was 26.4%. This is considered a good response rate given that we are dealing with end stage melanoma patients.

Mechanism of how oncolytic viruses stimulate the immune system to overcome various cancers

As mentioned above oncolytic viruses multiply in the cancer, once they have been incorporated. This leads to cancer cell death. It exposes the dead cancer tissue to the immune system. What helps in the process is that inhibitory proteins from the cancer cells that used to inhibit the immune system are no longer provided by the dead cancer cells. The end result is that the immune system mounts a formidable response against the cancer cells through killer T cells. This immune response also affects remote metastases of the same histological cancer type. This review article summarizes how oncolytic viruses work for cancer cell destruction and how this method can be combined with other treatment modalities.

The Use Of Oncolytic Viruses For Cancer Treatment

Conclusion

Currently various cancer centers are involved with clinical trials in humans to test the power of oncolytic viruses. What cancer researchers have learnt is that oncolytic viruses are a useful tool to kill cancer cells. But the immune system of cancer patients is in a suppressed state. Pembrolizumab (Keytruda) is a medication that will stimulate the immune system by stimulating killer T cells to destroy cancer cells. The combined effect of killing cancer cells with oncolytic viruses and stimulating the immune system is the big news. This has been the breakthrough that cancer researchers have been waiting for. Now several clinical trials are on the way where survival rates for cancer patients given the new combination therapy are assessed.

Oncolytic virus therapy here to stay

It is a treatment which is no longer a thought model with animal experiments. Well known medical centers are using it in patients, and as the results become more obvious, it will very likely become a new treatment modality for cancer.

Nov

2019

Ketogenic Diet With Ketone Supplementation

By Ray Schilling | Alzheimer’s disease, Anti-aging medicine, diet, Nutrition, Weight loss

There is a newer way to shed some pounds using a ketogenic diet with ketone supplementation. Ketosis with a ketogenic diet is difficult to achieve because it requires a lot of fat consumption and at the same time extremely low carb intake to trigger the ketogenic response. The October 2019 issue of LifeExtension magazine contained an article about a ketogenic diet with ketone supplementation. There are dip sticks with which you can test your urine for ketone bodies to verify that your metabolism has switched to ketosis. But you can also take some ketone supplements including beta-hydroxybutyrate. By adding this supplement it is easier to achieve ketosis.

Why do people think of starting a ketogenic diet?

Calorie restriction can mimic the effects of fasting. It leads to ketone production and improved energy metabolism. Your blood sugar goes down, you lose weight and diabetes becomes easier to manage. In an animal experiment with worms with the pretty name “C. elegans” researchers fed beta-hydroxybutyrate to these roundworms. They extended their lifespan by 20%.

Many who are motivated to go on a ketogenic diet hope to lose weight and others may hope to live longer. One large US study from the Brigham and Women’s Hospital, Boston, MA showed that mortality over a period of 25 years was lowest when carbohydrates were in the 50 to 55% range. In the same study when carbohydrates were replaced in ketogenic diets with animal-derived protein and fat sources, mortality increased by 18%. Meat and fat were from sources such as lamb, beef, pork, and chicken.

Problems with ketogenic diets

Physicians have had the concern that their patients on ketogenic diets tend to eat cheap fats and meats that contain trans fats. These unhealthy fats lead to premature death from accelerated hardening of the arteries resulting in heart attacks and strokes.

The alternative: a ketogenic diet with ketone supplementation

A new approach to anti-aging is taking ketone bodies like beta-hydroxybutyrate as a supplement. A publication from 2017 stated that oral ketone bodies could mimic the life extending properties of caloric restriction. The authors stated: “An exogenous ketone ester provides a new tool for mimicking the effects of caloric restriction that can be used in future research. The ability to power mitochondria in aged individuals that have limited ability to oxidize glucose metabolites due to pyruvate dehydrogenase inhibition suggests new lines of research for preventative measures and treatments for aging and aging-related disorders.”

Another publication from 2017 describes how ketones can be used as alternatives to glucose for energy. Brain cells and muscle cells in particular are very capable to utilize ketone bodies for energy. Two principal ketones are significant: acetoacetate and beta-hydroxybutyrate. The liver is involved when fatty acids are broken down and ketones are manufactured.

Ketone metabolism

Ketones provide energy without raising blood sugar levels or stimulating insulin secretion. The body requires less processing of ketones to release energy. This means that less NAD+ is used to metabolize ketones. The end result is that more NAD+ circulates in the body, which is used to repair damaged DNA and helps slow down the aging process. Ketones mimic many of the effects of caloric restriction and intermittent fasting dieting. Ketone metabolism reduces risk factors for diabetes and heart disease.

Human experiments

A 2018 study took 20 individuals aged between 18 and 35 years and tested them with an oral glucose tolerance test. Half of the subjects received a ketogenic hydroxybutyrate monoester, the other half just water (placebo group). The ketogenic group had 16% lower blood glucose levels. Their insulin sensitivity was 11% lower. The authors concluded: “These results suggest that ketone monoester supplements could have therapeutic potential in the management and prevention of metabolic diseases.”

Longevity in humans

There has been a lot of research in the last few years indicating that sirtuins (SIR1 and SIR3) are important anti-aging genes. NAD+ needs to activate sirtuins first to make them effective. Unfortunately with the aging process less NAD+ is available, which leaves the sirtuins genes inactivated.

In rat experiments feeding of a ketogenic diet resulted in increased levels of NAD+. The researchers measured an oxidative DNA damage marker in the hippocampus of the brain. This showed much less DNA damage in rats fed a ketogenic diet when compared to controls on a regular diet.

Study of humans with Alzheimer’s disease

Another human study examined the blood of Alzheimer patients, patients with mild cognitive impairment and normal controls. Alzheimer patients had low ketone levels in the blood as well as low 2-hydroxybutyric acid. Overall this showed that there is a change in metabolism in Alzheimer’s patients that leads to low ketone bodies in the blood on one hand and beta amyloid deposits on the other hand leading to memory loss.

A further experiment with Alzheimer’s patients showed that cognitive function improved after elevation of ketone blood levels following ingestion of beta-hydroxybutyrate.

A healthy way to raise ketones

Investigators in this human study determined whether various ketone-drinks were elevating blood ketone bodies reliably. 15 volunteers received ketone esters or ketone salts as a drink. There was a reduction of blood pH by 0.1 units using ketone esters. The ketone salts elevated the urinary pH from 5.7 to 8.5. An experiment with 16 volunteers measured the effect of having a meal before taking ketone esters. The ketone blood level showed a reduction of 33% after the volunteers consumed a meal and they took the ketone supplement afterwards. Ketone supplements lowered blood glucose, lowered free fatty acid and also lowered triglyceride concentrations. On the other hand, there was no change of the electrolyte levels. The authors said: “We conclude that exogenous ketone drinks are a practical, efficacious way to achieve ketosis.”

Ketogenic Diet With Ketone Supplementation

Conclusion

The liver produces ketones when a person is fasting or is on a ketogenic diet. However the high fat content of a ketogenic diet can lead to atherosclerotic plaques in the arteries with the subsequent developments of strokes and heart attacks. A much safer way of raising ketone bodies in the blood is by taking ketogenic supplements by mouth. Animal experiments and clinical trials have shown that oral ingestion of ketogenic substances appear in the blood stream within 30 minutes and remain there for 3 to 4 hours. The body tolerates ketogenic supplements well with no side effects.

Prevention of Alzheimer’s disease, achieving weight loss and longevity

They likely will play a larger role in the prevention of Alzheimer’s disease in the future. Ketogenic supplements may be an adjunct to weight loss diets. In addition, fatty acids metabolize into ketones, which turn into energy in brain cells and muscles. Oral ketones stimulate the formation of NAD+, which activate longevity genes (sirtuins). Older people have a hard time to metabolize glucose because of certain enzyme deficiencies. But the brain and the muscle tissue can metabolize ketones rapidly, even in older age. Unfortunately the price of such supplementation is forbidding at the present time.

Nov

2019

Omega-6 Fatty Acids Compromise Your Health

By Ray Schilling | Alzheimer’s disease, Arthritis, Cardiovascular disease, heart attack, Heart Disease, Inflammation, Nutrition, omega-3 fatty acids, Stroke

In an editorial of the October 2019 edition of LifeExtension William Faloon explained that omega-6 fatty acids compromise your health. He focused particularly on memory loss and the development of Alzheimer’s disease.

After a review of the medical literature he noted that Americans are eating too many foods that are laden with omega-6 fatty acids. Part of it is due to food processing with the wrong oils ). But the other problem is that processed foods also are full of omega-6 fatty acids. The merchants like omega-6 fatty acids, because they prolong the shelf life of products. But recent evidence shows that a high ratio of omega-6 to omega-3 ratio in our food can interfere with our memory and may even lead to dementia.

Evidence that omega-6 fatty acids are interfering with brain function

A recent publication analyzed 116 non-demented subjects aged 69 on average.

Blood tests were taken where 32 nutrients related to a Mediterranean diet were analyzed. In addition the researchers from the University of Illinois did functional MRI scans to assess higher brain function. The researchers also did cognitive tests to assess mental functioning.

The results of these experiments showed that higher lycopene levels had an association with better memory and higher executive function.
Subjects with higher carotenoids and trans lutein showed higher intelligence on testing.
B-vitamins that reduce homocysteine (vitamin B2, folate and vit. B12) and vitamin D showed an association with better executive functioning.
Two parts of memory testing showed that a proper balance of omega 6 to omega 3 ratio resulted in a better memory.
Higher omega-3 levels in the blood associated with higher overall intelligence and better executive function.

Impact of omega-6 on brain function

Researchers have proven that omega-3 fatty acids can help controlling inflammation in the body. This can prevent cardiovascular disease and neurodegenerative disorders like Alzheimer’s disease. However, our western food contains a surplus of omega-6 fatty acids, which causes inflammation in the body. It depends on our food choices, but it also depends on the preparation of the food. One chicken leg with skin contains about 1800 mg of omega-6 fatty acids. The process of deep-frying the same chicken leg increases the content to 4322mg of omega-6.

One deep fried KFC chicken breast with skin has 12,663 mg omega-6 fatty acids The reason is that a lot of the deep-frying oil is full of omega-6 fatty acids.

Cooking oils

Here is a run down of cooking oils. All of the cooking oils have a different mix of omega-3 and omega-6 fatty acid composition. Many also contain oleic acid, which is an omega-9 fatty acid.

Researchers have proven that omega-3 fatty acids can help control inflammation in the body. This can prevent cardiovascular disease and neurodegenerative disorders like Alzheimer’s disease.

As it is obvious from the table in the second last link olive oil contains 71.27% oleic acid, 9.76% omega-6 and 0.76% omega-3. It is the content of the majority of oleic acid (omega-9), which makes olive oil such healthy oil. Only two table spoons of olive oil per day will prevent heart attacks and strokes because oleic acid lowers the bad LDL cholesterol and increases the good HDL cholesterol. Olive oil removes beta-amyloid plaques inside the brain, which means it prevents Alzheimer’s disease.

Recommendation of best cooking oil

Considering that olive oil has such powerful healing properties, I recommend that you cook and bake with olive oil. Also use olive oil as part of your salad dressing. On the other hand avoid these oils: corn oil, sunflower oil, soybean oil, cottonseed oil and safflower oil. They contain too much inflammatory omega-6 fatty acids.

Our western food contains a surplus of omega-6 fatty acids, which causes inflammation in the body. It depends on our food choices what is in the food. But it also depends on the preparation of the food. One chicken leg contains about 1800 mg of omega-6 fatty acids. When it is deep fried with skin it contains 4322mg of omega-6.

One deep fried KFC chicken breast with skin: 12,663 mg Omega-6 fatty acids. One of the reasons is that a lot of the deep-frying oil is full of omega-6 fatty acids.

Math to calculate retained omega-6 from deep-frying

You notice that many cooking oils are high in omega-6. Soybean oil has 50.42% omega-6 in it. If you cook French fries or chicken in it and the food retains only 1 teaspoon of oil in it, that’s 5000 mg times 50.42%, which is 2521 mg of omega-6 added just from deep-frying your food.

Balancing omega-6 and omega-3 fatty acids

Omega-6 fatty acids are essential fatty acids that are mainly used for energy. But the problem is that in our western diet too many omega-6 fatty acids are in our food. Omega-6 fatty acids can be converted 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. 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.

KFC chicken breast example

In the example of a KFC chicken breast with skin 12,663 mg omega-6 fatty acids are consumed. To balance this with omega-3 fatty acids the person would have to consume 3166 mg omega-3 fatty acids. One serving of wild salmon provides 2000 mg of omega-3. I take 3600 mg of molecularly distilled fish oil every day as a supplement (2 capsules in the morning and 2 at night). Together with the wild salmon this is 5600 mg of omega-3. This would result in an omega-6 to omega-3 ratio of 2.26:1, which is considered to be well balanced. But generally people do not consume so much seafood and fish oil supplements to balance the omega-6 fatty acids with omega-3. It comes down to be selective with your food choices.

Prevention of Alzheimer’s disease (dementia)

Since the mid 1980’s dementia cases have reduced by an average of 25%.

This is because people have become more conscious of healthier eating habits and supplements. More people take lycopene, a carotenoid supplement that helps prevent heart disease. Whatever helps the heart also helps the brain. Omega-3 supplements and consumption of seafood, especially wild salmon, is also useful. If people will reduce their omega-6 to omega-3 ratio to 4:1 or less, which too can help prevent Alzheimer’s disease.

Study to show that omega-3 fatty acids preserve the brain in older age

The following study 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.

Omega-6 Fatty Acids Compromise Your Health

Conclusion

Omega-6 fatty acids are abundantly present in junk food, deep fries, processed foods and polyunsaturated oils like corn oil, sunflower oil, soybean oil, cottonseed oil and safflower oil. Because food processors like the long shelf life of processed food made with these oils, people’s intake of omega-6 fatty acids has been climbing. Now the omega-6 to omega-3 ratio regarding the average American food consumption is about 16:1. It should be 4:1 or less. It is important that you learn what contains omega-6 fatty acids and that you start cutting down. You do need a certain amount of omega-6 fatty acids for cell energy, but most people do not get enough marine based omega-3 fatty acids. Wild salmon and other seafood provides omega-3 fatty acids.

Balancing omega-6 with omega-3

I have shown using an example how you can balance omega-6 and omega-3. Having the right ratio of omega-6 to omega-3 will also help you prevent dementia down the road. Consuming more olive oil can prevent heart disease and dementia as well. This contains oleic acid (an omega-9 fatty acid), which lowers LDL cholesterol and raises HDL cholesterol.

Nov

2019

Trans Fat Causes Alzheimer’s Disease

By Ray Schilling | Alzheimer’s disease, Dementia, heart attack

The FDA is aware for some time that trans fat causes Alzheimer’s disease. This is why the FDA has outlawed trans fats in 2015. But the industry was given 3 years to phase out trans fats. The FDA also gave special extensions to many companies, which allows these companies to continue adding trans fats into your food until January 2020. CNN reported about a Japanese study that examined the correlation between trans fat levels in the blood and the risk of coming down with Alzheimer’s disease.

Japanese trans fat study

This Japanese study followed 1,628 Japanese community residents (men and women) for about 10 years. Researchers used the typical trans fatty acid, elaidic acid to monitor the accumulation of trans fats in patients. This is possible with a simple blood test, which serves as a marker for industrial trans fats. 377 participants developed dementia (247 Alzheimer’s disease and 102 vascular dementia). Based on the blood elaidic acid levels earlier in the study individuals with higher trans fat levels were more likely to develop Alzheimer’s disease as the study progressed. Patients whose trans fat blood levels were in the higher range were 50% to 75% more likely to develop Alzheimer’s disease or dementia.

Comment by an Alzheimer’s researcher

Dr. Richard Isaacson, director of the Alzheimer’s Prevention Clinic at Weill Cornell Medicine in New York was not involved in the study. But he commented on the importance of it. He said: “The study used blood marker levels of trans fats, rather than more traditionally used dietary questionnaires, which increases the scientific validity of the results.” He continued: “This study is important as it builds upon prior evidence that dietary intake of trans fats can increase risk of Alzheimer’s dementia.”

Other studies that indicate that trans fats cause Alzheimer’s disease

On June 10, 2019 researchers published a paper that stated that three simple steps would prevent strokes and heart attacks. Heart disease is the leading cause of death for both men and women. In the US about 610,000 people die of heart disease every year, which is about one in every 4 deaths. Here are a few facts. First, there is the simple observation that patients do not control their high blood pressure enough to avoid a heart attack or stroke. Secondly, patients with high blood pressure need to restrict their salt intake, or they will develop heart attacks or strokes. Finally, patients need to avoid exposure to artificial trans fatty acids as this leads to direct damage of the lining of the arteries.

Why avoiding artificial hydrogenated fats is important

Given enough time, this will cause heart attacks and strokes. If patients survive to a ripe old age, they will develop Alzheimer’s disease as well. Apart from controlling blood pressure and restricting salt intake the third factor was to avoid artificial hydrogenated fats.

Hydrogenated fatty acids or trans fats

Hydrogenated fatty acids or trans fats still make their way into the grocery-shopping basket. They are present in baked goods, snacks like chips, creamer and margarines. Think of cakes and cookies, crackers, piecrust, potato chips, corn chips and microwave pop corn. Deep fried food is also full of trans fats (french fries, doughnuts, fried chicken). Trans fats can make their way into frozen pizza crusts, non-dairy coffee cream, canned biscuits and cinnamon rolls. Above all do not buy any form of margarine. Hydrogenated fatty acids affect the arteries directly by increasing the harmful LDL cholesterol and decreasing the protective HDL cholesterol. This accelerates hardening of the arteries, which in turn causes heart attacks, strokes and on the long run Alzheimer’s disease.

Eliminate trans fats

We need to eliminate trans fats as they are causing heart attacks and Alzheimer’s disease. There is an important difference between ruminant trans fats and artificial trans fats. Ruminant trans fats have been part of the human diet for millennia like milk fat and fat from cows, goats or sheep that are on pasture. Milk products for instance contain fat with 2-5% natural trans fats. 3-9 % of the fat in beef and lamb consists of natural trans fats. Studies have shown that the body is able to handle these natural trans fats, and heart attacks are not more frequent in people eating moderate amounts of these products including butter from cows that graze on pasture.

Artificial trans fats

Quite the opposite is true for artificial trans fats in margarine that comes from vegetable oil. Avoid bakery items like sweet pieces or muffins and other products that contain hydrogenated oils. Read labels! Use olive oil or coconut oil, but avoid vegetable oils like corn oil, safflower oil or grape seed oil to get away from trans fats and unstable oils that turn rancid. Rancid oils contain free radicals that oxidize LDL cholesterol and attack the lining of your arteries through small dense LDL cholesterol. Remember that merchants add artificial trans fats to prolong the shelf life of processed food. Your best defense against trans fats is to not buy processed foods. This is what I do.

Poor diet habits can cause Alzheimer’s

A new study from the Brock University in St. Catharine’s, Ont. showed that poor diet habits can cause Alzheimer’s. A significant risk for Alzheimer’s was a combination of high saturated fats in the diet in combination with too much sugar. Another triggering factor was the normal aging process that also contributed to the development of Alzheimer’s.

Study showing that poor diet habits can cause Alzheimer’s

Master student Bradley Baranowski and PhD student Kirsten Bott conducted the experiments under the supervision of Assistant Professor of Health Sciences Rebecca MacPherson. The experimental group consisted of middle-aged mice that were observed for 13 weeks. They received a high-fat/high-sugar diet. The control group received a normal diet.

The experimental group with the high fat/high sugar diet was aging prematurely. They also showed elevated inflammatory markers, elevated insulin levels and cellular stress. Dr. MacPherson mentioned that the middle-aged mice would be comparable to humans aged 40 to 60. “We’re trying to see what the initiating signals are that can lead to progression of Alzheimer’s disease,” MacPherson said.

Lifestyle choices matter

“People often view Alzheimer’s disease as a genetic disease when in fact, genetic mutations leading to Alzheimer’s accounts for less than five per cent of cases,” Baranowski said in the press release. “This study highlights that our lifestyle choices matter and can potentially put us at risk of developing or progressing neurodegenerative diseases such as Alzheimer’s.”

Over the years many other researchers have analyzed what factors contribute to developing Alzheimer’s. It probably is a combination of several factors.

Trans Fat Causes Alzheimer’s Disease

Conclusion

Researchers are aware of trans fats causing Alzheimer’s disease, heart attacks and strokes for a long time. They increase the bad LDL cholesterol, decrease the good HDL cholesterol. Rancid oils contain free radicals that oxidize LDL cholesterol and attack the lining of your arteries through small dense LDL cholesterol. The FDA has started to initiate steps in 2015 to make the use of trans fats in the food industry illegal. Completion of this in the US occurs in early 2020. Many countries are more lax in their laws. It is up to the consumer to read food labels and decide not to buy certain products known to contain trans fats like frozen pizza crusts, non-dairy coffee cream, canned biscuits and cinnamon rolls, just to mention a few. Eliminate artificial trans fats from your food and avoid the risk of Alzheimer’s disease.

Nov

2019

Non-Drug Treatment For Migraines In Women

By Ray Schilling | Drugs, headache, Hormones

In the following I am discussing the non-drug treatment for migraines in women. There are a number of different types of headaches: common headaches, tension type headaches, cluster headaches and migraine headaches. Here I am only zeroing in on migraine headaches.

Introduction

A migraine headache is the second most common headache and occurs with an average frequency of about 12% in the general population. Women outnumber men in the U.S. by a factor of 3 to 1 with migraines. There is a genetic factor as migraine sufferers’ family members are getting migraines about 3-fold more often than the general public. Newer insights into hormonal connections point to the fact that often migraine sufferers are in an estrogen dominant state (Ref. 4). With estrogen dominance there is a disbalance between estrogen production and progesterone production. For instance, many women who develop fibroids miss their ovulation and as a result can have fertility problems (no corpus luteum developed in the ovaries). The reason for infertility, fibroid development and the development of migraines in some migraine sufferers is the lack of progesterone in the second half of the cycle.

Xenoestrogens

Xenoestrogens (pesticides, artificial hormones like Provera, the birth control pill etc.) can also function as a contributor to the estrogen load as a woman’s estrogen receptors will have a partial fit with them. The resulting hormone disbalance can trigger migraines in migraine sufferers. The trigger is the relative lack of natural progesterone. This may also be the reason why migraines are much more common in woman than men. On the other hand Dr. S.A. Dugan has done hormone studies on both male and female patients with migraine. He found that both sexes are often also suffering from fibromyalgia, chronic fatigue syndrome, and lipid disorders including high cholesterol, sleep disorders, gastrointestinal problems and depression. When these patients had hormone tests were done on these patients the majority had what Dr. Dzugan called “steroidopenia” (low levels of estrogen, progesterone, testosterone and DHEA). This is discussed in more detail under Ref. 3.

Symptoms

Migraines present in 85% without an aura (formerly called “common migraines”) and in 15% with an aura (formerly called “classic migraines”). An aura consists of changed behaviors such as pacing, yawning, craving of certain foods, lethargy, depression or mild euphoria. These symptoms are separate from the migraine aura, which consists of neurological symptoms such as visual symptoms arise 1 or 2 hours before the migraine headache starts and disappear about 1 hour after the start of the migraine.

Types of migraine aura symptoms

These migraine aura symptoms are quite varied and can include numbness of the skin in a hand or a foot on the side where the migraine is and around the mouth area. Spotty eye field defects can also occur immediately prior to the onset of the headache and there may be deficits in language expression and pronunciation. Other such migraine aura symptoms can consist of double vision, ringing in the ears, balance problems, a gait abnormality and decreased levels of consciousness.

Typically a migraine is confined to one side of the head

The actual migraine headache is on one side of the head, can last 4 hours to 3 days, is throbbing in nature, moderately to severe in intensity and is made worse by physical activity, light or noise. The patient is complaining of nausea and might be vomiting with a severe migraine. In a small percentage of patients a more severe form of complicated migraine (or “migraine with prolonged aura”) can develop where the patient has prolonged symptoms of a migraine aura for more than 1 hour, but usually less than 1 week. These patients should be investigated thoroughly by a neurologist as a small percentage of these patients can develop persistent neurological symptoms including a “migraine stroke ” (=a stroke like clinical picture) (Ref. 1, p. 2067).

Conventional treatment of migraines

Medication that is used is quite different between attacks as compared to during an attack. During a migraine attack non-steroidal anti-inflammatory drugs (=NSAIDs) and dihydroergotamine or Sumatriptan, which stimulate serotonin receptors, are common medications. Drug dependency issues on narcotics have to be discussed frankly with the patient because of the danger of rebound migraines that are triggered by the continued use of narcotics. Sumatriptan can be given intranasally, but it is important for the physician to monitor overuse and dependency on this medication. In males there is a higher risk for heart attacks as a side effect of the medication. The patient can also receive Prochlorperazine (brand name: Stemetil or Compro) intravenously as a drip in an Emergency room setting. This can abort a migraine.

Preventatives of migraine attacks

Between migraine attacks there are a number of preventatives that are effective. They consist of beta-blockers such as propranolol, metoprolol, Timolol and others; NSAIDs such as ASA, naproxen or ketoprofen; calcium channel blockers such as Verapamil or Flunarizine, also antidepressants such as amitriptyline.

Gabapentin is the latest medication that research found to be useful in several smaller studies. Gabapentin (brand name: Neurontin) releases GABA in some parts of the brain and inhibits the NMDA pain receptors. Dr. Stephen Clarke, Clinical Assistant Professor in the Div. of Neurology of the University of BC/Vancouver/Canada, reviewed the use of gabapentin at a conference in Vancouver/BC in November 2004 (Ref. 2).

Other medication for headache prevention are the anticonvulsant gabapentin; the MAO inhibitor phenelzine and the serotonin stimulating drugs methysergide and cyproheptadine. Unfortunately many of these medications do not work 100% and there is a lack of good randomized studies to prove effectiveness.

Non-conventional, but effective treatment of migraines

Bioidentical progesterone treatment

In light of what I explained above with regard to a hormone disbalance in women migraine sufferers, it is logical that Dr. Lee suggested (Ref. 5) using 20 mg of a bioidentical progesterone cream applied to the skin during the second half of the cycle (day 12 to 26 of the cycle). After three months there is usually a significant improvement of the migraines. With only a partial response to this low dose of progesterone cream, the doctor can increase the progesterone dosage temporarily to 40 or 50 mg per day from day 12 to 26 of the cycle for several months. If there is a response, the doctor continues treatments with bioidentical progesterone cream until menopause. An alternative to bio-identical progesterone cream is Prometrium (micronized progesterone) by mouth, 100mg or 200mg at bedtime. Discuss this with your doctor. You will need a prescription from him/her for Prometrium.

Avoid migraine triggering factors

It is important to include in the regimen of anti-migraine measures non drug regimens such as avoidance of triggering factors like certain foods (chocolate, red wine, certain cheeses and strong smells) or bright lights and noises. It is important to pay attention to consistent sleeping patterns and meal times. When emotional factors play a role, counseling, relaxation techniques like yoga, self-hypnosis and biofeedback methods are all helpful as well. The doctor refers more complex migraine cases to a neurologist or a multidisciplinary headache clinic.

Dr. Dzugan’s “correction of steroidopenia” approach

Since Dr. Dzugan published the results of treating migraine sufferers with the Dzugan method, it is important to look at all of the hormones including steroid hormones as mentioned above. Any hormone deficiency is rectified using bio-identical hormones; then the doctor repeats hormone levels to verify hormone balance. Dr. Dzugan found that following “correction of steroidopenia” after 9 to 12 months at the latest almost all of his patients were migraine free and lost all of the other accompanying symptoms.

Non-Drug Treatment For Migraines In Women

Conclusion

Many women suffer needlessly from migraines because of estrogen dominance. Estrogen dominance occurs when they miss an ovulation (because of a lack of the corpus luteum that manufactures progesterone in the second part of the menstrual cycle). But taking the birth control pill or taking HRT with synthetic hormones in menopause can also cause estrogen dominance. This is when bioidentical progesterone replacement can help to rebalance progesterone and estrogen. Migraines often disappear in the process of this approach. If you have migraines, you should discuss the bioidentical progesterone approach with your doctor.

References

Goldman: Cecil Textbook of Medicine, 21st ed.,2000, W. B. Saunders Company
The 50th Annual St. Paul’s Hospital Continuing Medical Education Conference for Primary Physicians, Nov. 16 – 19, 2004, Vancouver,BC, Canada
http://www.ncbi.nlm.nih.gov/pubm…: Dzugan SA, Rozakis GW, Dzugan KS, Emhof L, Dzugan SS, Xydas C, Michaelides C, Chene J, Medvedovsky M.: “Correction of steroidopenia as a new method of hypercholesterolemia treatment.” Neuro Endocrinol Lett. 2011;32(1):77-81.
Dr. John R. Lee, David Zava and Virginia Hopkins: “What your doctor may not tell you about breast cancer – How hormone balance can help save your life”, Wellness Central, Hachette Book Group USA, 2005. On page 256 and 257 Dr. Lee describes how he uses progesterone as a cream to treat PMS.
Dr. John R. Lee: “Natural Progesterone- The remarkable roles of a remarkable hormone”, Jon Carpenter Publishing, 2nd edition, 1999, Bristol, England.

Oct

2019

Steroid Injections Are Doing Harm, But Stem Cells Help

By Ray Schilling | Arthritis, osteoarthritis, Pain

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

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

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

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

Critical analysis of effects of intraarticular corticosteroid injections

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

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

Mesenchymal stem cell injections for osteoarthritis

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

Australian study of mesenchymal stem cell injections into symptomatic knees

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

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

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

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

Two processes that occur with injected stem cells

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

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

Steroid Injections Are Doing Harm, But Stem Cells Help

Conclusion

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

Oct

2019

How Marijuana Affects Your Reproductive Health

By Ray Schilling | Infertility, marijuana

The latest edition of the British Columbia Medical Journal contains an article on how marijuana affects your reproductive health.

Dr. Dunne is an assistant professor in the Department of Obstetrics and Gynecology at the University of British Columbia. She is the author of the linked review above.

Products of the Cannabis sativa plant like marijuana and hashish are most popular in North America. Since October 2018 smoking recreational marijuana is legal in Canada.

The medical community has some concerns, as we do not fully know the long-term effects of smoking marijuana. In the following I will summarize the effects on the male and female reproduction based on Dr. Caitlin Dunne’s report.

Consumption of marijuana

Marijuana contains over 500 compounds, of which 100 are cannabinoids. The ingredient that produces the high a user gets is due to tetrahydrocannabinol (THC). Cannabis is available in different forms. It can be smoked (raw leaves or extract), but it can also be converted into edibles. Ingestion of cannabis creates a longer-lasting experience. The reason for this is that the liver metabolizes cannabis into more psychoactive forms by the liver enzyme, cytochrome P-450. Smoking marijuana can irritate the airways; oral consumption of cannabis products can lead to vomiting, nausea and disorientation.

Contaminants in cannabis such as pesticides, microbial toxins and metals can also be harmful to recreational marijuana users.

Endocannabinoid system

Researchers found endogenous cannabinoids in the brain that function as messenger molecules. They need to activate their targets, the cannabinoid receptors, called CB1 and CB2. CB1 receptors are found mainly in the central nervous system. CB2 receptors are located mainly in the immune system. Reproductive organs have their own cannabinoid receptors. The lining of the uterus contains only CB1 receptors. Ovaries and testicles both use CB1 and CB2 receptors. THC from smoking or ingesting marijuana can stimulate these cannabinoid receptors also. But compared to the body’s own cannabinoids THC is much stronger. This leads to more pronounced effects that concern many physicians.

How marijuana affects your reproductive health: female fertility

The normal functioning of the body requires that the hypothalamus send gonadotropin-releasing hormone (GnRH) to the pituitary to release follicle stimulating hormone (FSH) and luteinizing hormone (LH). The FSH release happens mainly in the first two weeks of the menstrual cycle. LH is released in the 3^rd and 4^th week of the menstrual cycle. Only when the female hormone rhythm works can a follicle in the ovary mature and ovulate normally. After ovulation the corpus luteum needs further LH stimulation to start prednisone production, which helps with embryo implantation and with sustaining the pregnancy.

THC from cannabis consumption interferes at all the levels of these hormone actions. Cannabinoids suppress GnRH, FSH and LH release.

This is the reason why moderate to heavy users of marijuana have infertility problems. If a woman is a moderate to heavy consumer of marijuana she cannot ovulate normally, and hence she has difficulties getting pregnant.

How marijuana affects your reproductive health: pregnancy

THC from cannabis use can cross the placental barrier. Levels in cord blood are three to six times lower than the mother’ blood level, as the placenta attempts to detoxify THC.

Prenatal exposure to cannabis can interfere with fetal growth and alter neurodevelopment. These children can have permanent effects regarding academic achievement and intellectual capacity. Other risks are hyperactivity, attention-deficit disorder, and impulsivity, but also future substance abuse.

CB1 receptors seem to regulate mitochondria, the energy packages of cells and cellular adenyl cyclase.

The end results are mitochondrial dysfunction and oxidative stress.

Clinical studies regarding cannabis use in pregnancy

Recently a BC study followed 243,140 pregnant women. Over an 8-year period cannabis use rose from 2.2% to 3.3%. Closer analysis of the pregnant cannabis group showed an increased risk of poor perinatal outcomes. 47% had smaller babies than expected (“small for gestational age” is the medical term). 27% were born prematurely, there was a risk of 2.4-fold that the baby died in the womb (“intrapartum stillbirth”). Women who used cannabis often used other illicit drugs as well. They also often had a history of mental illness. The authors relied on self-reporting, which means the cannabis use likely was underreported.

An American study

An American study from 2016 identified 7,851 pregnant patients who used cannabis. Like the BC study they showed a low-birth weight and preterm deliveries. But when the authors controlled for confounding factors, namely mainly tobacco use, statistical significance disappeared.

Often marijuana users are also tobacco users. Tobacco has long been proven to lead to prematurely born babies and babies that are too small for their age. The BC study had controlled for tobacco use and thee results were only due to smoking or consuming marijuana.

How marijuana affects your reproductive health: male fertility

Males on cannabis also contribute to infertility of the couple. The hypothalamic/pituitary/testicle hormone axis needs to also be intact for proper sperm cell maturation to take place. In medical language sperm cells are spermatozoa. The hypothalamus generated gonadotropin-releasing hormone (GnRH), which stimulates the pituitary to release FSH and LH. LH stimulates testosterone production in the Leydig cells of the testicles. FSH stimulates spermatogenesis (production of sperm cells) from the so-called Sertoli cells. Testosterone, along with FSH provides a stimulatory effect on spermatogenesis. Whenever a system is that complicated, much can go wrong. Sperm cells contain both CB1 and CB2 receptors. When the man uses marijuana regularly, THC exposure can significantly interfere with CB1 and CB2 receptors.

Effects of THC on sperm motility, sperm concentrations and DNA

This leads to sperm cell mobility reduction. In an experiment where THC was added to sperm from 78 men in vitro (Petri dishes) researchers simulated high marijuana users and moderate marijuana users.

They found that lower THC concentrations caused 28% sperm motility reduction, high TCH caused 56% sperm motility reduction. Many other publications exist that documented similar results and correlated these findings with infertility of couples.

Studies on sperm cell motility and marijuana use are inconsistent. In 2019 a study came out from the Chan Scholl of Public Health where researchers analyzed 1143 semen samples and 317 blood samples.

They found no difference in terms of findings among men who smoked marijuana versus men who never smoked Marijuana. They looked at sperm concentrations, DNA aberrations of sperm cells.

This leaves many questions open regarding marijuana toxicity.

How Marijuana Affects Your Reproductive Health

Conclusion

Marijuana affects the reproductive organs, but it is easier to document in women than in men. In women marijuana has an effect on fertility and on pregnancy, which is measurable. However, in men the results of investigations have been conflicting. Here is a statement of the Society of Obstetricians and Gynecologists of Canada. They believe “there is sufficient evidence of harm to advise women to avoid cannabis when pregnant”. Use of marijuana is also not advisable for women who are breastfeeding. At this point a similar clear suggestion regarding reproductive health cannot be made to men, but the in vitro study with TCH suggests that it is wise to refrain from marijuana when a man tries to father a child. Further studies will likely clarify these outlines.