Medical Articles by Dr. Ray

Oct

2016

Commuting Affects Your Health

By Ray Schilling | Fitness, Health, Nutrition, Obesity

A research report from Great Britain was recently reviewed by CNN; it revealed that commuting affects your health.

The longer we commute to work and back the more downtime we have where we do not move our muscles. But we also are exposed to more unhealthy snacks and sugary drinks that make us deposit more fat. The original research report was published here. What were the elements of this study?

Commuting affects your health, study design

Three consecutive annual waves of the British Household Panel Survey were utilized. These are longitudinal surveys of nationally representative households in Great Britain. The sample years were 2004/2005, 2005/2006 and 2006/2007. There were 15,791 participants in the study; of these 4,056 entered the study. The main mode of travel to work was determined at each time point. The self-reported height and weight was taken to calculate the body mass index (BMI) at baseline and at 2 years. Attention was paid to switches of transportation mode (that is from active to sedentary and vice versa).

Commuting affects your health, results of study

Switching from car commute privately to active travel (walking, bicycling) or public transport resulted in a significant loss in BMI. There were even larger reductions of BMI’s in those who enrolled in the first year in active transportation, because of the longer exposure. Those with the longest journeys who used active transportation had significant weight losses.
A group of 787 people switched from active travel or public transport to the use of their private cars as transportation. This resulted in a significant BMI increase.
The study concluded that any interventions that would allow private car commuters to switch to an active mode of transportation could contribute to the population’s BMI being reduced significantly.

Commuting affects your health, Cambridge experiment

In a 2016 study from Cambridge (Great Britain) a similar experiment was done. They studied traffic patterns in the county of Cambridgeshire. The city compared 1143 adults working in the city with 1710 people who used the Cambridgeshire Guided Busway. The public had access to a new bus network that has connections with pedestrian pathways and cyclists since 2011. Longer commuting journeys incorporated walking and cycling, for which otherwise people used a private car and public commute. When officials explained the benefit of active travel to people, there was a 1.8-fold increase of active travel. There was also a 2-fold decrease of commuting solely by car. The weekly cycling commuting time had increased to 1.34-fold compared to the previous level.

Active commute most beneficial

People who at baseline were the vast majority in being inactive in their commute, were the ones who appreciated an active commute most. There was an association of active commuting, greater overall physical activity with an improvement of health and weight loss.

Commuting affects your health, US study

A multi-city study involved the largest 3,914 municipal jurisdictions, which were located in 473 of the most populous U.S. counties. This involved 48 states and the District of Columbia. In order to encourage more active commuting (walking, cycling) many municipalities developed pedestrian zones or pedestrian-friendly zones with adjacent bus transportation. A new concept of transit-oriented developments or districts (TODs) was adopted. TODs are higher density areas that are compact. They are mixed use areas, which you find around transit stops. This encourages walking. The study was completed in 2016. It showed that the TOD zones had higher occupancy rates. Many house owners had no car as they commuted using public transportation only.

Summary about transit-oriented developments or districts (TODs)

TOD zones were more populous, people in it had higher income, and they were more racially diverse and younger. The occupants of TOD zones had a 2.1-fold higher rate of using public transportation and they also had a 2.48-fold higher rate of using active transportation to work.

Commuting affects your health, general comments

The majority of commuters in England and Wales spent 56 minutes in their cars going to and from work in 2013. In London this daily commuting time is 79 minutes. The US data are similar.

With a well-developed public transportation system the authorities developed various programs designed to replace at least some part of the commute by active commuting. This is good for your metabolism, it is good for your cardiovascular status and it gets you away from snacking junk foods driving in your car.

Commuting leads to stress

A survey from London, England polled more than 1500 commuters. 55% reported increased stress levels, 33% reported increased snacking, 29% admitted to fast food consumption, 36% complained about sleeping problems, 41% said that they reduced physical activity and 44% reported that they had less quality time with their friends and family. 58% felt that flexible work hours would improve their health and wellbeing. Remember that how you are commuting affects your health.

My own experience watching commuting in various cities

Over the years I have traveled extensively in Germany, Austria and the US. In Europe it is interesting how many years ago the pedestrian zones in the old town centers have reshaped the commuting. The U-Bahn (subway) and commuter trains have intermingling networks that shoot you out to pedestrian zones. There is no escaping from it, you have to walk before you can catch a connecting bus or tram.

Vienna (Austria)

Vienna (Austria) for instance allows you to get out at the U-Bahn station of Stephansplatz, which is a pedestrian zone around the Stephan’s Church (Stephanskirche). There is an amazing array of shops and in a side alley you can even find a Starbucks, if this is what you are looking for. When you walked enough, you hop onto any of the U-Bahn connections. This brings you where you need to be. If you are too far from your goal, hop onto a tram and enjoy the sightseeing. There are also buses that can get you there. It is all covered under the same Vienna card, which I appreciated as a visitor. It is best to park your car in the periphery and use the commuting network to get you to where you want to go.

Munich (Germany)

Munich (Germany) has a lot of cycle paths, which run parallel to the pedestrian paths. I was interesting to see business people in black suits cycle to work. Otherwise there are the U-Bahn, S-Bahn, trams and buses that all interconnect.

Münster (North Rhine-Westphalia, Germany)

Münster (North Rhine-Westphalia, Germany) has an extensive network of cycle paths and pedestrian walks. Buses and trams are also constantly running. The old historic town is a pedestrian zone, but anybody can commute to anywhere between walking or using the bus/tram. I found it astonishing this spring when I visited; there were hundreds of people, young and old cycling to and from work. The employers are providing huge metal racks where people can attach their bikes to with a lock.

Berlin

Berlin is another multi level commuting city in Germany. You can use the U-Bahn, S-Bahn (commuter train), bus or tram to get to work. Here is an informative video that explains. I did not see many cyclists there. But hundreds of people are walking. Yes, there are many pedestrian zones and they interconnect with all of the commuter options. Berlin spreads over a vast area, so the S-Bahn, which is a local commuter train is particularly important. For the shorter connecting trips people commute by the U-Bahn (subway). Buses and trams plus walking do the fine-tuning to get to your destination.

Vancouver (BC, Canada)

Vancouver (BC, Canada ) has some cycle pathways in the West end, close to Stanley Park. Otherwise there is a network of buses, the Skytrain, Sea Bus (between North Vancouver and downtown) and the West Coast Express (a commuter train). For the size of the city I think that Vancouver could benefit from studying some of the transportation modalities in Europe to entice the car travelers to use public transportation. When I travel to Vancouver, I use my own car, as it is so much faster to reach any goal. Public transportation is at this point not effectively connecting all the areas in this city.

Commuting Affects Your Health

Conclusion

In the past we often heard that there was nothing that could be done about traffic jams and commuter stress. Think again. Revitalization of city cores all over Europe, Great Britain and in the US has taken the TOD concept to heart and active commuting has become a reality. Whenever you can, use alternatives like cycling, walking and public transit to get to and from work. Studies have even shown that when you become an active commuter you likely will also become more active after work. Even using public transit makes the commute more active, as you are not sitting for an hour or more in your vehicle.

Use public transit, not your own car to commute

You have to get out and walk in order to catch a connection. This all helps to keep you physically more fit than the commuting style, where you sit in a vehicle and possibly dip into junk food. It is not only about body mass index reduction and decreasing your waistline. Active commuting is also a lot less stressful than the passive modality, where traffic jams add to frustration and stress at the beginning and at the end of a workday.

Oct

2016

Vitamin D3 Protects Your Brain

By Ray Schilling | Alzheimer’s disease, Cancer, Dementia, Multiple sclerosis, Parkinson’s disease, Vitamins and supplements

More and more studies are showing that vitamin D3 protects your brain. It protects against MS, but also against Parkinson’s disease and Alzheimer’s disease. In the following I will review what evidence there is to support each of these topics.

Vitamin D3 protects your brain from multiple sclerosis (MS)

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 produces less vitamin D3 in the skin.

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 immune cells are calmed down by vitamin D3 and remission of an MS relapse is more likely.

There are two forms of MS, the relapsing-remitting MS and the progressive MS. The first one (relapsing-remitting) is more common. After a bout of active MS, the illness calms down and the condition of the patient is stable for some time until the next relapse occurs.

With progressive MS there are two forms, primary progressive MS and secondary progressive MS. The primary form is a case of MS where symptoms steadily worsen, without any remission. The secondary form of progressive MS occurs at the end of fairly stable relapsing-remitting MS. Symptoms become more pronounced and the condition deteriorates steadily from there.

Progression and disability in MS patients with various vitamin D3 levels

Dr. Fitzgerald and colleagues published a study in JAMA Neurology in 2015.

They took 1482 men and women who were on interferon beta-1b treatment. This treatment utilizes the immunomodulator interferon beta-1b and reduces the number of relapses in patients with MS. The study took place between November 2003 and June 2005. Results were analyzed between June 2013 and December 2014. The researchers measured vitamin D levels (as 25-hydroxy vitamin D). The vitamin D levels were obtained at baseline, at 6 months and 12 months.

The number of brain lesions were measured by MRI scans. All of the patients also underwent a functional test, called expanded disability status scale. This measured impairment of ambulation, ability to communicate and activity levels.

Results of this study showed marked differences between patients with high and low vitamin D levels. Those patients who had the highest vitamin D blood levels (more than 40 ng/mL) had the lowest rates of new MS lesions. Previous studies had found that a low blood level of vitamin D (less than 25 ng/mL) in patients was associated with a much higher risk of developing MS. Dr. Fitzgerald’s study showed that a 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 100 nmol/L had the lowest amount of new MRI lesions (47% less than the patients with the lowest vitamin D levels).

Another study showed that a low-dose vitamin D level accelerated MS. There was a 5.9-fold risk converting the initial relapsing-remitting form of MS into the secondary progressive form of MS.

All these studies show that vitamin D3 can decrease the risk of getting MS. In addition vitamin D3 also delays progression in those who have MS.

Vitamin D3 protects your brain from Parkinson’s disease

Vitamin D3 plays a role in preventing Parkinson’s disease.

Parkinson’s disease is a neurodegenerative disease that causes tremor in muscles, causes balancing problems and eventually can lead to dementia. A metaanalysis was done in 2014 and 7 studies where identified to be relevant. The authors were looking for correlation of vitamin D levels with Parkinson’s disease. The study included 1008 patients in the metaanalysis with 4,536 controls.

Patients with a vitamin D level of less than 75 nmol/L had a 1.5-fold higher risk of developing Parkinson’s disease than the controls.
Patients with a vitamin D level of less than 50 nmol/L were at a 2.2-fold higher risk of developing Parkinson’s disease.

Another metaanalysis utilized 5,690 Parkinson’s disease patients and 21251 matched controls.

It found that vitamin D levels of less than 20 ng/ml were associated with a risk of 2.08-fold to develop Parkinson’s disease. Interestingly, vitamin D3 supplementation reduced the risk of Parkinson’s disease by 38%. Outdoor work reduced the risk of developing Parkinson’s disease by 28%.

Vitamin D3 protects your brain from Alzheimer’s disease

Alzheimer’s disease is a neurodegenerative disease of old age. We know that it is much more common in patients with type 2 diabetes where insulin levels are high. Studies have shown that Alzheimer’s disease can be termed type 3 diabetes.

The resulting neurofibrillary tangles and amyloid-beta deposits damage nerve cells, which are responsible for the memory loss and the profound personality changes in these patients.

What does vitamin D3 have to do with this?

A 2014 study showed that a low vitamin D level was associated 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
Vitamin D level 10 to 20 ng/ml: 51% increased risk of Alzheimer’s

The same research group found in two trials that vitamin D deficiency leads to visual memory decline, but not to verbal memory decline.

Vitamin D3 combined with metformin suppresses cancer

The newest development with respect to vitamin D3 is the finding that it also has anti-cancer effects. Dr. Li demonstrated that vitamin D reduced prostate cancer cell line growth by 45% while metformin alone reduced it by 28%.

But when both vitamin D and metformin were present in the cell cultures there was growth inhibition of 86%. Dr. Li explained that vitamin D potentiated the growth inhibitory effect of metformin.

Vitamin D3 protects your brain: guidelines to proper vitamin D3 dosing

For years the medical profession stated that 400 IU of vitamin D3 would be enough supplementation. It may be enough to prevent rickets in children. But these low doses will be insufficient in many patients who are deficient for vitamin D to prevent MS, Parkinson’s disease, Alzheimer’s disease or cancer.

A study on medical staff in Northern India showed that 85% of the staff had very low vitamin D levels of less than 10 ng/ml.

It took high doses of vitamin D3 to increase the vitamin D level in the blood.

Generally supplements of vitamin D3 of 5000 IU to 8000 IU are the norm now. But some patients are poor absorbers and they may require 15,000 IU per day. The doctor can determine the patient’s requirement for vitamin D by doing repeat vitamin D blood levels (as 25-hydroxy vitamin D). The goal is to reach a level of 50-80 ng/ml. The optimal level with regard to nmol/L is 80 to 200 (according to Rocky Mountain Analytical, Calgary, AB, Canada).

Vitamin D3 Protects Your Brain

Conclusion

Many people are deficient with regard to vitamin D, and they do not know it. The most important thing is to do a vitamin D blood test to assess your vitamin D status.

We know for a long time that vitamin D plays a role in bone metabolism and this is why women approaching menopause often need vitamin D3 supplementation. But it may come to you as news that vitamin D3 also protects from MS, Parkinson’s disease and Alzheimer’s disease. In addition, as indicated above, we know that vitamin D3 when taken regularly suppresses many cancers.

When you realize that all body cells have vitamin D receptors on their surface, it is no surprise that vitamin D3 is so important to take. The vitamin D3 receptors must be there for a reason. When you deprive your body of this valuable vitamin, the high risk of degenerative diseases will be the consequence.

Oct

2016

Sugar Can Cause Heart Attacks

By Ray Schilling | Arthritis, Cancer, Cardiovascular disease, Diabetes, heart attack, Nutrition, Obesity, Processed food, Stroke, sugar

Recently an online medical journal article from JAMA has revealed that sugar can cause heart attacks. As the Guardian reports, this analysis of influence peddling of the sugar industry going back 60 years has had far-reaching effects by confusing the public and policy makers in the US and around the world. At the same time the interference of the sugar industry was protecting its own interests. It increased sugar sales, but made people sick with obesity, diabetes and cardiovascular disease. This story is similar to the tobacco industry that was able for years to cover up that cigarette smoke is causing heart attacks and lung cancer.

Denying that sugar can cause heart attacks

The English physiologist John Yudkin noted in the 1960’s that sugar was elevating cholesterol and triglycerides. The sugar industry panicked. They wanted to do something to stop this new type of research. As we can read online the Sugar Research Foundation (SRF) had 319 correspondences (1551 pages) with Roger Adams. He was a professor serving on the SRF’s scientific advisory board (SAB) from 1959 to 1971. Another piece of evidence of influence peddling came from a review of correspondence between the SRF and D. Mark Hegsted. He was professor of nutrition at the Harvard School of Public Health. At the same time he was co director of the SRF’s first coronary heart disease research project. This took place from 1965 to 1966.

Historic falsification of research findings by John Yudkin

There are 27 documents totalling 31 pages in the Harvard medical Library. It is clear from this correspondence that the SRF was looking for a way to undermine the new research findings of negative effects of sugar. The SRF was looking for a way to confirm that fat reduction would be beneficial for patients. This way physicians would put many people on a low fat diet. This in turn would ensure continuing and rising sales of sugar.

New evidence that sugar can cause heart attacks

New research came out by D. Mark Hegsted in the Annals of Internal Medicine in June 1965. It linked sugar consumption to cardiovascular disease. It noted that blood sugar levels were a better predictor of hardening of arteries than cholesterol levels or high blood pressure. Another paper stated that it was sugar rather than starches causing high triglycerides in the blood. He hypothesized that “perhaps fructose, a constituent of sucrose but not of starch, was the agent mainly responsible.” An editorial in the same publication noted that these new findings corroborated Dr. Yudkin’s previous research that sugar could cause heart attacks.

The sugar industry was very concerned about these studies. If publicized widely, it would have the capacity to lower sugar sales.

Sugar can cause heart attacks, but review paper ignores this

On July 1, 1965, the SRF’s Hickson visited D. Mark Hegsted to discuss his publication. He wanted him to be part of an extensive literature review that would show that it was too much saturated fat that was the cause of high cholesterol and triglycerides, not sugar. It also should state that a lowering of fat content from 40% to 20% was necessary and that polyunsaturated fatty acids should be used to replace much of the fat. The fact that the food industry would quietly increase sugar content in processed foods was not mentioned. The review paper was called “Project 226”. It resulted in a 2-part literature review by McGandy, Hegsted, and Stare. It was entitled “Dietary Fats, Carbohydrates and Atherosclerotic Disease,” and was published in the New England Journal of Medicine (NEJM) in 1967. Industry and non-industry funding of the review authors’ experimental research was disclosed.

Falsified study from 1967 in the New England Journal of Medicine

However, the funding by the Sugar Research Foundation was omitted. The authors of the study received handsome amounts of money from the SRF for their efforts. The story that was told is all too well known, but false. There was the claim that the medical literature would have shown that a reduction of saturated fat intake lowered cholesterol. Triglyceride levels did not matter. Only cholesterol levels counted with respect to coronary artery hardening. There was also the statement that replacement of saturated fat with polyunsaturated fatty acids like corn oil would be beneficial in reducing heart attack rates.

Effect of the literature review on heart attack rates

Sadly the NEJM literature review has resulted in a government policy that lasted for decades. The gospel was that a low fat diet would prevent heart attacks. The food industry prepared foods that were low in fats and high in sugar and supposedly healthy. But the extra sugar made people fat, it did not decrease heart attack rates, but made them more frequent. Strokes were also on the rise and diabetes has become rampant. The reliance on corn oil has introduced another problem: omega-6 fatty acids are now consumed at an alarming rate. Corn oil has a 1:59 ratio for omega-3 to omega-6 fatty acids.

Corn oil causes inflammation

This means that corn oil contributes to the lack of omega-3 fatty acids in our food. When the ratio of omega-3 to omega-6 fatty acids falls below 1:3 or 1:4 the metabolism changes towards inflammation as the arachidonic acid system switches toward inflammation. Cardiologists have pinpointed inflammation as an important cause of hardening of arteries. Fish oil, a rich source of omega-3 fatty acids helps to prevent hard attacks and strokes.

The end result of the confusion regarding fat, sugar and heart attacks caused by the biased literature review meant misery, suffering and death for many for decades. But recently there has been a renaissance of Dr. John Yadkin’s research: Now it is clear what sugar is doing and how it affects our health.

How sugar can cause heart attacks and more

It is clear that sugary soda has detrimental effects on us: as little as one or two cans of sugary soda drinks per day lead to

26% greater risk of developing type 2 diabetes
A 35% greater risk of heart attack or fatal heart disease
A 16% increased risk of stroke

Dr. Frank Hu’s study

Dr. Frank Hu has participated in a study that spanned over 24 to 30 years and examined the replacement of saturated fat with polyunsaturated fatty acids (PUFA), monounsaturated fatty acids and whole grain carbohydrates. The study involved 84,628 women (Nurses’ Health Study, 1980 to 2010), and 42,908 men (Health Professionals Follow-up Study, 1986 to 2010). The researchers did detailed diet assessments every 4 years. 7,667 cases of cardiovascular disease (CHD) occurred during the study. Compared to controls that did not change their diet with respect to saturated fatty acid intake, those who replaced with PUFA had 25% less CHD, those who replaced with monounsaturated fatty acids had 15% less CHD and those who replaced saturated fatty acid intake with whole grains had 9% less CHD. In contrast, a subgroup that had replaced saturated fatty acid intake with carbohydrates from refined starches/added sugars ended up with a 10% increase of CHD.

Effect of sugar

We know now that sugar can increase cholesterol and triglycerides as Dr. John Yudkin has said in the 1960’s.

We also know that sugar can cause arthritis when combined with low omega-3 fatty acids and high omega-6 fatty acids. In the 1950’s Dan Dale Alexander wrote a book called “Arthritis and common sense”. The medical establishment did not accept that simple remedy and Dan Dale Alexander was classified as a “quack”. However, Dr. Mirkin describes a study from Berlin that later confirmed that Dan Dale Alexander’s observation was correct: an emulsion made by shaking orange juice with cod liver oil and taken three times per day on an empty stomach would indeed improve osteoarthritis.

High glycemic foods and starchy foods cause cancer

High glycemic foods (sugar, starchy foods) caused breast cancer, colorectal cancer and endometrial cancer. The majority of trials showed this association although not all. The more obese patients were, the more pronounced the insulin resistance was and the more the relationship to these cancers became apparent. A diet that is high in starchy foods like potatoes, rice and bread is causing pancreatic cancer as was shown by researchers at the Dana-Faber Cancer Institute, Brigham and Women’s Hospital and Harvard School of Public Health.

Sugar Can Cause Heart Attacks

Conclusion

The low fat/ high glycemic diet was a fad-diet based on fictitious science, sponsored by the sugar industry. It became a human experiment and resulted in 60 years of suffering. During that time it became apparent that this diet did not work. It caused the obesity wave, a wave of heart attacks, strokes and cancer. This was all caused by too much sugar in the diet. Associated with this are the consumption of processed foods. There is too much sugar and an abundance of omega-6 fatty acids in processed food. This causes inflammation and hardening of the arteries.

What sugar does

We finally know that sugar raises cholesterol (LDL cholesterol in particular) and triglycerides. This leads to fat deposits and hardening of the arteries resulting in strokes and heart attacks. Remove refined sugar, limit your starchy food intake and eat fish as a source of omega-3 fatty acids. Feast on vegetables, salads and have some nuts as another source of omega-3 fatty acids. You are well on your way to preventing heart attacks, strokes and many cancers. After reading all the facts, there is no need to be a victim of the sugar industry. This also helps you to stay away from sugar’s associated health risks.

Sep

2016

Seven Steps To Live Over 100 Years

By Ray Schilling | alcohol, andropause, Cancer, Cardiovascular disease, Diabetes, Drugs, Fitness, Health, heart attack, Hormones, Medical Condition, Menopause, Mortality, Nutrition, Obesity, Prevention, Processed food, sleep, Substance abuse, toxins

Forbes invited me to publish a blog I wrote for Quora, “Seven steps to live over 100 years”.

The topic of habits by people who live more than a hundred years has been reviewed many times in the media. It continues to be popular. Here are seven things you can do to stay healthy followed by an explanation why.

Seven steps to live over 100 years – step1: Stay active

You want to stay active every day, even if you retire. You want to move and keep your mind busy. Part of that is to do a daily formal exercise routine to keep those muscles toned, which will prevent falls in the future.

Explanation: when you keep your muscles toned and you move about, your balance organ and coordination remains sharp, you are less likely to fall and break a hip. 50% of those who sustain a hip fracture die.

Seven steps to live over 100 years – step 2: Eat a healthy diet

Eat a Mediterranean type diet or follow the Okinawan diet. These diets contain less meat (or no meat as in the Seventh Day Adventist diet), but lots of vegetables and fiber. This keeps your cholesterol down, your arteries open and your metabolism controlled, preventing diabetes. If you are not obese and you have no diabetes, you are going to be OK with your cardiovascular system for decades to come.

Explanation: Heart attacks are still on top of the mortality list. Avoid them and you got it made, if you want to make it to 100 and beyond. But we need to stay away from the poor fats and the obsession about eating beef. Red meat, if eaten too often gives you a higher risk of getting cancer and heart disease. So eat it only once a week at the most, the rest would be chicken, turkey meat or fish. Nothing wrong with a vegetarian meal, let’s say kidney beans or lentils on a day in between. This still gives you protein for your muscles, but spares you a heart attack.

Seven steps to live over 100 years – step 3: Take care of your teeth

Brush your teeth and floss every day. This will control the bacteria in your mouth and prevent leakage into your blood affecting your heart valves. Studies have shown that this prevents heart attacks.

Explanation: When I heard this first about 20 years ago, I found it strange. But the literature is clear: chronic gingivitis is associated with bacteria that grow on the gums and spread into your blood. They can then colonize your heart valves and even the lining of the arteries, particularly where there is already hardening of the arteries (arterial plaque). This can lead to heart valve disease like mitral valve disease or heart attacks.

Seven steps to live over 100 years – step 4: prevention of disease

See your physician right away if there is a new skin lesion or anything that is different on your body. Removal of early cancer and treatment of any early medical condition is always easier to treat than waiting until it is out of control. Particularly with cancer treatment at an early stage, which usually involves only a small surgical procedure, this will reward you with a ripe old age.

Explanation: I learnt this point in general practice. Patients who waited until small problems become big problems were always much worse off than patients who saw me for small problems that we could remedy at an early stage. As mentioned above this is particularly important in cancer cases, as usually stage 1 and 2 of a cancer is curable with surgery. Once you get lymph node metastases and distant metastases, the cancer is much more difficult to treat, if at all. This is a principle that is pretty much true for any disease. The prevention factor is huge. Make use of it!

Seven steps to live over 100 years – step 5: Lifestyle matters

Watch excesses like smoking (cut it out!), alcohol intake, and recreational drugs. Smoking causes heart attacks, strokes, and cancers, which shorten your life. Recreational drugs just interfere with your body chemistry and have side effects. Cut them out, if you cherish growing older than 100. Alcohol needs to be kept at a very low consumption, if you want to preserve your liver, which is your central metabolic organ. If you can’t handle moderation with alcohol consumption, cut it out. No one has died from not consuming alcohol.

Explanation: I have already explained why lifestyle choices matter. The alcohol question is one that will be discussed back and forth for centuries. There are cardiologists who tell you that men should drink 1 to 2 drinks per day and women 1 drink per day and we all live longer, because of prevention of heart disease. The wine industry makes sure that you will hear this cardiology rule. It is true that centenarians often drink one glass of red wine per day. But there are plenty of centenarians who never drank in their life. It is a matter of personal choice.

Seven steps to live over 100 years – step 6: Avoid obesity and diabetes

I did mention to avoid obesity under point 2 above, which is associated with metabolic syndrome and diabetes. Your ideal body mass index should be in the 21 to 22 range. You can achieve this by following the diets I mentioned above. You should cut out sugar and starchy foods.

Explanation: I have followed such a diet since 2001 and my body mass index is between 21 and 22. I grew up in Germany where an emphasis was put on sweets and starchy foods. Needless to say my modified Mediterranean diet deviates from the good old German diet significantly. I find healthy food very tasty.

Seven steps to live over 100 years – step 7: Sleep and hormones

Getting sleep regularly, having an optimistic outlook on life, and having good relationships help to keep the immune system strong and keep your hormones balanced. This in turn will keep you healthy emotionally and physically.

Explanation:

There are two comments I like to make. One is that when you have calm nerves, and your emotions are in balance, your stress hormones are under control. We know that people who are content and easy going live longer. The type A personality is the one who gets a heart attack.

The other point is that hormones have running times. When they start missing, we get menopause or andropause. When we are in our 50’s it is time to have your hormones checked by a knowledgeable health practitioner (naturopath, anti-aging physician). At this point regular physicians are mostly lack education about bioidentical hormone replacement. I mention this as in European studies it has been shown that replacement of missing hormones with bioidentical hormones resulted in more youthful lives. You can extend your life expectancy by 15 years using bioidentical hormones according to Dr. Hertoghe, an endocrinologist in Belgium.

Seven Steps To Live Over 100 Years

Conclusion

People have had a long time fascination about the factors that lead to a healthy age above 100 years. I am suggesting that you concentrate on enjoying your life and keeping toxins out. Engage in some form of exercise or stay active all the time. Adopt a healthy diet. This is where perhaps most people go wrong. They think they can go on pouring junk foods and alcohol down their throats and never get heart disease or cancer. The truth is not quite like that. We do need to adopt a healthy diet like the Mediterranean diet. We also need to limit drinking to a healthy level. Replacing missing hormones with bioidentical ones will prolong your life as well. Given these recommendations, happy journey to 100 and beyond!

Sep

2016

Crazy Food Trends

By Ray Schilling | Nutrition, sexual arousal

CNN wrote about strange, crazy food trends that seem to receive a following. I thought it would be interesting to analyze them medically and point out to the reader what’s right and what’s wrong.

Crazy food trend one: Ashwagandha

In India this herb, also known as Indian ginseng has been used as part of the Ayurvedic medicine for centuries.

At the 22nd Annual Anti-Aging (A4M) Las Vegas Conference in mid December 2014 Pamela Smith gave a presentation entitled ”How To Maintain Memory At Any Age”. She gave a comprehensive overview of what you can do to prevent Alzheimer’s disease.

Dr. Smith recommended many other supplements, which I will not explain in detail here: B vitamins, vitamin E and C, carnosine, acetyl-L-carnitine, boron, ginger, coenzyme Q-10 (or CoQ-10), curcumin, vinpocetine, zinc, grape seed extract, blueberry extract, Ashwagandha, glyceryl-phosphoryl-choline, SAMe, huperzine A and DMAE and others. She specifically pointed out that she felt Ashwagandha was very powerful. It helps people preserve their memory, more so than regular drugs that doctors prescribe.

When the benefits of taking CoQ-10 were discussed, Dr. Smith reminded the audience “whatever is good for the heart, is good for the brain”. She recommended reading Dr. Perlmutter’s book from which this phrase was borrowed (Ref. 1).

Ashwagandha is an herb with multifaceted effects. Here is a review by a doctor about the various effects of Ashwagandha.

It does not belong into foods; it should only be in use as a supplement, if your doctor agrees with it.

Crazy food trend two: astrologically farmed eggs

Picture biodynamic farming of eggs with the guidance of the moon. Now you are producing astrologically farmed eggs. The Hemsley sisters insist you should eat these astrologically farmed eggs for breakfast. I don’t buy into this. This is hokey! It smells like somebody is trying to lure money out of your pocket by trying to convince you that there is health benefit to “astrologically farmed eggs”. There isn’t.

What does make sense is to buy eggs that do not have antibiotic residue in them and that came from free-range hens. Yes, I buy organic eggs that are somewhat more expensive. If you like to buy organic omega-3 eggs, this would also be scientifically superior to ordinary hen eggs. There is also the difference of “free run” and “free range” hens. “Free run” does not give you any guarantee for a healthy product, as the birds live in crowded barns and are likely receiving medications to combat diseases. “Free range” birds are hens that have access to the outdoors, and there is less of the overcrowding that is common in a barn.

Crazy food trend three: Cordyceps

There are about 400 subspecies to these sac fungi. Cordyceps has been used in Chinese medicines to help as an aphrodisiac, help improve kidney function in the elderly and also with regard to some anticancer activity. There are very few clinical review papers to substantiate any of these claims; yet traditional medicine insists on using Cordyceps for these purposes. If you want to see a traditional Chinese doctor, do so on your own. But don’t consume food that is prepared with Cordyceps.

Gwyneth Paltrow’s morning smoothie cost more than 200$, so if anything, I would be more concerned about bankruptcy than real nutrition with this type of breakfast drink.

I have my doubts that Cordyceps that kill ants to sprout their spores in their corpses (see Wiki link above) could be of any objective benefit to humans.

Crazy food trend four: blue majik

Blue Majik is just another name for a common antioxidant, phycocyanin. It derives from algae, Arthrospira platensis.It has some similarity with the green spirulina. But just because it seems fashionable right now, does not mean that it is superior to vitamin C as a cheap antioxidant or vitamin E. The creators of blue majik are cashing in on color effects and selling false hopes of better health. You can live very well without it.

Crazy food trend five: cannabis

When I heard that people are starting to mix cannabis into foods, it reminded me about a story I heard from one of my patients in the mid 1980’s who worked in the shipyards of North Vancouver. One day he saw some cookies on a tray in the lunchroom. A co-worker offered some to him and he ate it. After 5 minutes his head started pounding with an excruciating headache and he became nauseous. Shortly after he vomited and started getting a rapid heartbeat. His co-workers laughed and told him that these were very special cookies that they treated with marijuana.

I suspect that whoever baked these cookies used a higher dose of marijuana and my patient experienced a marijuana overdose.

This example illustrates that cannabis has special properties that affect the body.

In the brain it binds to cannabinoid receptors. These are not only present in brain tissue, but also in lungs, liver and kidneys. Even the immune cells have cannabinoid receptors.

There may be a place for chronic pain patients under the guidance of a physician to get medical marijuana. But keep cannabis away from your food. Don’t consume it! You have no idea what you are doing to your body that is full of receptors for cannabis. Cannabis requires treatment like a drug. This means a doctor should prescribe marijuana and the patient s should take it according to doctor’s orders. Like with any drug there will be effects and also side effects.

Crazy Food Trends

Conclusion

Out of five crazy foods reviewed there are only 2 that merit consideration, but not mixed into food. These are Ashwagandha as a supplement (part of memory loss prevention and others) and cannabis for chronic pain. A physician should supervise both. The remainders are fashion crazes. Unfortunately many people will fall for these fashion trends and lose a lot of money. This will make someone who peddles these items very rich. Is this what you want to do: throw your money out and toss it right into the pocket a huckster? Rethink what you want to do. You may just want to buy organic eggs from chickens that happily scratch away in a farmyard. This is very much down to earth, and nothing “astronomically farmed” is needed.

References

Ref 1: David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

Sep

2016

Hidden Cause Of Depression

By Ray Schilling | alcohol, depression, Mental Health, Nutrition, Vitamins and supplements

About 15.7 million Americans suffer from depression every year, but there remains a hidden cause of depression.

Not everybody responds well to antidepressant medicine. Only 30 to 50% of depressed people respond to antidepressants. There are two blood tests many physicians do not know and therefore fail to order: homocysteine blood levels and 5-methylfolate levels (5-MTHF).

Homocysteine as a hidden cause of depression

In 2004 a research group studied 924 middle-aged men. They noted that those men who fell into the highest third of homocysteine levels had a two-fold higher risk of being depressed than those who fell into the lower third of homocysteine levels. Other studies showed that SAMe, a nutrient that is required to build up mood enhancing neurotransmitters was sadly lacking in depressed people. In addition, folate levels were also found to be low in depressed people.

Having found this association between lack of nutrients and depression offered new opportunities to treat depression. Two studies examined the effect of taking 5-methylfolate on the effect of antidepressants. The result was astounding: in one study 7% of patients taking an antidepressant experienced improvement of their depression when assessed with a standard depression score. However, the same group improved their depression by 19% when 5-methylfolate was given in addition to the antidepressant.

Patients with the most severe depression on antidepressants had a 16% improvement of their depression. Adding 5-methylfolate to the antidepressant caused a 40% overall improvement in these severely depressed people, 24% more than without this simple vitamin supplement.

There is other evidence that patients with depression recover faster in the presence of 5-methylfolate. Moderately depressed patients recovered within 231 days on antidepressants alone, but in only 177 days when 5-methylfolate was present as well. The most severely depressed patients recovered within 150 days with antidepressants alone, but recovered within only 85 days on 5-methylfolate and the antidepressant.

Hidden cause of depression and Alzheimer’s disease

The story is getting more involved. Depression is related to proper balance of neurotransmitters that can be influenced by antidepressants and 5-methylfolate. But new research showed that Alzheimer’s disease (dementia) patients with cognitive decline have elevated homocysteine blood levels. A study in the New England Journal of medicine in 2002 found that after 8 years of observation more than 75% of them were diagnosed with Alzheimer’s disease. When blood homocysteine levels exceeded 14 micromole per liter the risk of Alzheimer’s had doubled compared to those with normal homocysteine levels. The researchers concluded that homocysteine is an important risk factor for the development of Alzheimer’s diseases and dementia, although it is not the only one.

Methylation pathway defects as a hidden cause of depression

40% of the population is defective in one or more genes that control the so-called methylation pathway in each of our cells (Ref. 1). This can slow down the metabolism of brain cells including the synthesis of certain neurotransmitters. At the same time it can cause the rising of homocysteine, which is then a useful marker for methylation defects. Another marker is the 5-methyl folate level, which, when low, indicates a deficiency in methyl donors including 5-methylfolate (5-MTHF).

Mental illness is an area where epigenetic factors play an important role. Depression that responds only partially or not at all to SSRI’s (antidepressants) often responds to L-methylfolate, a simple supplement from the health food store as a supplement. Similar epigenetic approaches are useful to treat psychosis, schizophrenia, bipolar disorder and Alzheimer’s disease.

Other illnesses due to methylation defects

Dr. Rozakis mentioned that 92% of migraine sufferers have a defective methylation pathway involving histamine overproduction and they can be helped with a histamine-restricted diet (Ref.2).

Autism, ADHD (hyperactivity) and learning disabilities are other diseases where methylation pathway defects are present. Physicians should check patients with autism for methylation pathway defects, and appropriate supplements and diet restrictions can help in normalizing the child’s metabolic defects. Mothers should consult with a DAN physician (“defeat autism now”) who is knowledgeable regarding all aspects of autism.

S-adenosylmethionine (SAMe) defects are another type of methylation defect, which associates with certain liver, colon and gastric cancers.

Dr. Rozakis went on to say that methylation defects lead to disbalances between T and B cells of the immune system and are important in autoimmune diseases like lupus or rheumatoid arthritis.

Methylation defects can also cause autoimmune thyroiditis and type 1 diabetes. They can also cause cardiac disease by raising homocysteine levels, which causes dysfunction of the lining of arteries and premature heart attacks.

Epigenetic factors through global methylation defects from vitamin B2, B6 and B12 deficiency can cause many different cancers. Hypomethylation is the most common DNA defect of cancer cells.

With skin diseases it has come to light that atopic dermatitis, eczema, psoriasis, scleroderma and vitiligo are related to methylation.

When we age, certain hormones are gradually missing, which leads to menopause and andropause. This leads to impaired cell function, elevated cholesterol, arthritis, constipation, depression, low sex drive, elevated blood pressure, insomnia, irritable bowel syndrome and fatigue. Replace the missing hormones with bioidentical ones, and symptoms will normalize.

Tests and treatment for hidden cause of depression

It is important for a physician to test patients for homocysteine levels once per year. As we age, we tend to lose some of the methylation pathway enzymes, which can result in an increase of homocysteine in the blood. A normal homocysteine level is less than 7 to 8 micromoles per liter. This is lower than the commonly recommended 15 micromoles per liter.

If the homocysteine level is too high, the treatment consists of methionine containing foods like dairy products and meat. Methionine, an essential amino acid, functions as a donor of methyl groups. The methyl groups normalize the methylation pathway defect and allow the homocysteine level in the blood to decrease. Research studies have been using 1000 to 5000 micrograms of 5-methyl folate daily to reduce homocysteine. Other B vitamins are necessary to reduce homocysteine, like vitamin B2, B6 and B12 in addition to 5-MTHF.

Hidden Cause Of Depression

Conclusion

Depression and several other illnesses can be related to methylation pathway defects. This can cause a lack of 5-MTHF resulting in high homocysteine blood levels. It is important that a physician checks his elderly patients for homocysteine blood levels once per year. This will prevent depression, Alzheimer’s disease, migraines and a number of other illnesses.

Once a methylation pathway defect has been identified, it is relatively easy to treat the patient. The treatment consists of a proper methionine rich diet and 5-MTHF supplements as well as other B vitamins as discussed. It can prevent a lot of disability and human suffering.

References

Ref.1: William J. Walsh, PhD: “Nutrient Power. Heal your biochemistry and heal your brain”. Skyhorse Publishing, 2014.

Ref. 2: https://www.askdrray.com/life-expectancy-is-influenced-by-lifestyle/

Aug

2016

New FDA Food Guidelines

By Ray Schilling | Cancer, Cardiovascular disease, coffee, Health, heart attack, Heart Disease, Mortality, Nutrition, Stroke, sugar

A recent news release describes 2016 new FDA food guidelines. In it the FDA recommends to double the amount of seafood (fish and shellfish) as well as to cut down saturated fat and sugar. Coffee, which was labeled a culprit in the past is now recommended to a total of 400 mg of caffeine per day as it is heart protective. Cholesterol is no longer considered an enemy, but sugar, saturated fats and trans fats are.

Here is a breakdown of what each of these recommendations means.

New FDA food guidelines regarding increasing fish and shellfish

The anti-inflammatory effects of omega-3 fatty acids have finally entered the recommended diet plan of the FDA. This reflects the nutritional research over the last few decades that noticed a longer life expectancy for people who eat more seafood and less red meat.

The only problem with seafood can be its mercury contamination. The higher predator fish are in the food chain, the more contaminated fish meat is. The FDA recommends to avoid tuna fish as a food source, as it is very high in mercury. An exception is canned tuna as it has been washed and some of the mercury got lost in the food processing. Wild salmon, sardines and oysters are low in mercury and good sources of omega-3 oils.

New FDA food guidelines regarding reduction of saturated fat

The FDA now recommend to reduce saturated fat to 10% of the total daily caloric intake. This is not undisputed as some studies show that saturated fat may not be involved in the production of hardening of the arteries. Other studies have shown that breast cancer is more common when more saturated fat is consumed.

When the news came out in the 1980’s that saturated fats would be bad for arteries, there was a switch to polyunsaturated acids: safflower oil, canola oil, sunflower seed oil, corn oil and soybean oil or grape-seed oil.

However, the irony is that these vegetable oils were highly unstable and led to oxidation causing heart disease and cancer.

In contrast olive oil is a much more stable oil. In the Mediterranean olive oil associates with longer lives.

New FDA food guidelines regarding protective effect of coffee

In the past few years many studies have shown the coffee consumption prolongs life. The FDA has now officially recognized these studies and recommends that consumption of up to 400 mg caffeine will help promote health. On the other hand the FDA also recommends that those who do not drink coffee, should not change their lifestyle just because of these recommendations.

New FDA food guidelines regarding sugar reduction

An entirely new recommendation of the FDA says to reduce sugar in anybody’s diet. The FDA explains that too many processed foods contain sugar. Food merchants add sugar in drinks like coffee, fruit juices, food items like muffins and cakes.

In the past decades it has become clear that sugar much more so than fat is the culprit. It is sugar and starchy food that causes hardening of arteries. The liver metabolizes sugar into triglycerides and LDL cholesterol. Elevated triglycerides and LDL cholesterol levels lead to deposited into arteries and fatty tissue. In this context it makes sense that the FDA now recommends a reduction of sugar intake.

New FDA food guidelines regarding cholesterol

In the past scientists thought that cholesterol in meat would be the cause of high cholesterol in the blood. This was an oversimplification. We now know that only a small portion of the blood cholesterol comes from food sources. Cholesterol from food sources is no longer of importance with regard to risks for heart attacks and strokes. It is sugar and too many starchy foods (bread, pasta, pizza, muffins, cakes cookies) that the body digests into sugar. This accounts for high cholesterol, as the liver metabolizes sugar into LDL cholesterol and triglycerides.

New FDA Food Guidelines

Conclusion

The new food guide by the FDA has fundamentally changed the previous recommendations based on newer nutritional studies. Now the FDA says to double fish and shellfish in comparison to previous recommendations. Coffee is no longer the enemy, but your friend. You need to avoid sugar and starch over consumption, as this can raise cholesterol and triglyceride levels. Eat more vegetables and fruit. These recommendations closely resemble a Mediterranean diet, which several studies tell us prolong life. Abandon the American Standard diet with hamburgers, processed foods and sugary drinks. Pay attention to the FDA food recommendations!

Aug

2016

Avoid BPA

By Ray Schilling | Health, Hormones, Infertility, Obesity, toxins

After a lot of bad press as a hormone disruptor we know we should avoid BPA. Bisphenol A (BPA) is a synthetic compound that has been used since 1957 in plastic bottles and as lining inside cans, so they don’t rust.

Study showing why we should avoid BPA

Recently BPA has again hit the media as a new study has shown that there are things we can do to avoid high concentrations of BPA by changing our lifestyle.

This media report is based on a scientific study that Jennifer Hartl and coworkers have done. They followed patients who had consumed various items known to be contaminated with BPA and measured their urine BPA concentration 24 hours later. 9% of their study participants had consumed one can of food or more, while 2% had consumed 2 cans of food or more on the previous day. Researchers compared one can of food consumed to none. They found 24% of higher BPA concentration in the urine. With two cans of food consumed versus none they found that 54% of higher BPA concentration was found in the urine.

Researchers compared one or more specific types of canned foods to none consumed. Some interesting differences emerged. Canned vegetables and fruit showed 41% higher BPA in the urine test. Canned pasta measured 70%, but canned soup 229%. The researchers also tested canned beverages. None of them caused BPA elevation in urine tests.

What BPA does

93% of Americans 6 years and older have BPA in their urine indicating that it is in our bodies, and the body is attempting to get rid of it. It is known as an endocrine disruptor, but how effective BPA is as an endocrine disruptor remains to be seen. This link describes that BPA is 800-times weaker as an estrogen blocking substance in comparison to soy products.

There are two mechanisms of action where BPA interferes with normal body function.

BPA functions as a weak estrogen and binds to the nuclear estrogen receptor. This partially blocks the action of the body’s own estrogen function.
There is also a membrane based estrogen receptor on body cells that is involved in cell signaling and gene expression. BPA can add methyl groups to DNA, which silences gene expression. This latter mechanism is much more sensitive to BPA (probably by a factor of 1000-times) than the traditional effect on the nuclear estrogen receptor.

It is these newer findings that are of concern with regard to fertility in males. It is important that babies are not fed using regular plastic bottles, but rather that BPA-free bottles or glass bottles are used to avoid BPA exposure. Babies and children are particularly vulnerable to the hormone blocking effects of BPA as well as the interference of brain development and maturation by BPA.

Manufacturing of BPA free plastic

In an attempt to avoid BPA in manufacturing of plastic bottles and food containers industry has used other chemicals, among other materials something called BPS. This stands for “Bisphenol S”. A research paper found that BPS is an endocrine disruptor as much as BPA is and causes fat cells to grow rapidly. According to the author of this publication it may be partially responsible for the obesity wave. The author of this study recommends using glass containers as much as possible to avoid transfer of either BPA or BPS to food that comes in contact with plastic materials.

Avoid BPA from receipts

Have you ever thought that you may be able to absorb BPA through your skin from receipts when you buy items at a store? Yes, the machine of the checker prints receipts on heat sensitive paper. It contains BPA on it, which the body absorbs through the skin. If you scratch the printed part of the paper and it leaves a dark mark, it is thermal paper.

In this study workers were handling thermal receipts for four hours and their urine was monitored for BPA the following day. Another group was handling thermal receipts for 8 hours. In the first group that had exposure for 4 hours the BPA concentration in the urine rose to three times higher than the base rate. The second group exposed for 8 hours had BPA levels that were five times higher than the base rate. For comparison researchers measured another group that was wearing surgical gloves and their BPA concentration in the urine showed no change from the baseline.

I have changed my way of shopping. I think about whether I would ever want to exchange the item I just bought. If not, I tell the clerk that I do not want a receipt and he throw it out.

How you can avoid BPA exposure

Do not use plastic containers to heat food in a microwave, use glass containers instead.
Avoid all plastic food containers that have a “7” printed in a triangle on the bottom. Among these is a significant number that will release BPA over time.
Avoid canned soups, such as tomato soup or canned mushroom soup. The paper reviewed at the beginning of this review showed these led to the highest BPA readings in urine tests the following day.
Keep in mind that 2 out of 3 cans in supermarkets are positive for BPA. Eat as much fresh or frozen food as you can, but avoid canned food.
Many canned beverages (such as beer, soda, juice) are acidic; this means that their thermal processing requirement is much different requiring lower temperature where BPA does not leach from the bottle into the stored fluid. These drinks when tested were BPA free.
Among drinking water containers the following have been tested: Aquafina, Dasani, Arrowhead, Fiji and Kirkland Signature bottled water from Costco. They were all BPA free. Most water companies have now switched to BPA free containers, but avoid the containers with the “7” in a triangle as already stated, as some of them may leach BPA into the bottle content.
Use fresh, unpackaged foods as much as possible. For instance, fruit and vegetables can often be had unpackaged. Check the packaging, check the type of plastic and if not sure, don’t buy it.
Whenever possible, avoid handling thermal receipts; if possible, get an email receipt instead to avoid BPA exposure through the skin.

Avoid BPA

Conclusion

There has been a silent revolution where more and more plastic and resins have entered our lives. With it came the exposure to BPA, which is an endocrine disruptor. This may have consequences regarding male fertility. There is a change of fat metabolism in both sexes with weight gain as the end result. It also interferes with brain development in the fetus and in young children. BPA behaves like a cell poison.

In this blog I have shown ways to reduce exposure to BPA. We need to eat more fresh vegetables and fruit that merchants sell not in plastic. If merchants sell food in plastic or plastic containers, the wrapping material must be BPA and BPS free. The FDA and/or EPA must make labeling of containers mandatory. Whenever possible return to glass containers that are BPA free. Also bear in mind that heating plastics can release toxins. If you are heating food in a microwave, do not use plastic containers. Instead use glass or ceramics. It is common knowledge that they are safe!

Additional reference (Questions about BPA answered):

http://www.niehs.nih.gov/health/assets/docs_a_e/bisphenol_a_bpa_508.pdf

Aug

2016

Pain Treatment

By Ray Schilling | Drugs, headache, IMS, low back pain, osteoarthritis, Pain, trigger points

General practitioners see a lot of patients with various pain symptoms for which they seek pain treatment. The underlying conditions might be from an arthritic problem that suddenly becomes symptomatic, or an acute back injury may send pain from the lower back into one of the legs. Others may experience excruciating headaches like migraines or tension type headaches. Often these painful conditions require some immediate pain relievers to treat the pain, but this can turn into a nightmare of drug dependency and may even lead to the development of chronic pain. Here I like to review an article that I found in the June edition of ConsumersReports.org. In my review I included most of the content, but added a few newer pain treatment modalities.

Acute pain

Here I’m discussing back pain as an example. When a disc bursts in the lower back because the person was lifting an object too heavy to lift, acute pain develops in the lower back. This is often located at the lower lumbar spine level (L5/S1) causing radiating pain into one of the legs.

In a case like this it will often take several weeks before the body can heal this condition.

Chronic pain

It can happen in many cases that the pain will still be there 3 to 6 months down the road. If a disc fragment pushes on the nerve root in the nearby canal through which the nerve root travels, this will cause the muscles supplied by the nerve root to melt away in the leg of the affected side. If nothing is done about this, the acute pain turns into chronic pain, which is much more difficult to resolve. The initial physician may refer the patient to a neurosurgeon who will review the case together with the help of an MRI scan that shows the underlying pathology. The neurosurgeon may determine that a mini discectomy will reduce the pressure onto the nerve root.

Relief of pressure on nerve root from mini discectomy

This surgery may be able to prevent chronic pain from setting in. Once the pressure is relieved, the nerve can start the healing process. It is critical to not miss the point where acute pain crosses over into chronic pain. This happens at around 2 to 3 months into the pain condition. Chronic pain is much more difficult to treat as some of the neurological pain pathways that form after such injuries can persist within the spinal cord or even within the central nervous system, even after successful disc surgery that is done too late. With respect to the example given above, if the patient is operated on too late (1 to 2 years after the injury), the procedure may not be effective in relieving the pain. A chronic pain syndrome has started.

How pain treatment is done

Avoid bed rest

In the past (up to the late 1970’s to mid 1980’s bed rest was the accepted initial mode of treatment. Even though patients often felt some relief of pain initially, this led to muscle atrophy (literally a melting away of muscles) in the muscles that are supporting the spine. These structural changes destabilized the spine and often made the pain more chronic until physiotherapy treatments and active exercises rebuilt the supporting muscles again.

See a physiotherapist

Physiotherapists can use different treatment modalities like traction, a TENS machine, active exercises that all can help to alleviate back pain due to muscle spasm. If there is only a strain, this will often help to resolve your back pain within 4 weeks. But if there is an underlying disc herniation as previously explained, you need to be assessed by a physician in an urgent care center, primary care setting or by an emergency physician in the emergency department of a hospital. When the examination confirms an abnormal reflex from a nerve root compression, a referral to a neurosurgeon or orthopedic surgeon is usually made as previously explained.

Chiropractic treatment

Some people have their backs treated periodically to prevent back troubles. When they get an acute back pain they likely will see the chiropractor again. In cases of a back strain, where one or more muscles are pulled, this approach will be helpful together with some home exercises and swimming to build up muscle strength along the spine. However, in the case of a herniated disc chiropractic adjustments should not be done (physicians say they are “contra-indicated”). Instead the patient should be referred to either a neurosurgeon or an orthopedic surgeon.

Medication for pain

Often physicians prescribe Tylenol with codeine, hydrocodone (Vicodin), oxycodone (OxyContin, Percocet) or morphine for pain relief. All narcotic medication have side-effects; they can cause constipation, can cause vomiting, make you feel dizzy and can lead to falls, particularly in elderly patients. These falls can cause hip fractures and other fractures that complicate the recovery from the original pain. Never exceed the dosage of pain medicine prescribed on the label, and if it does not relieve the pain, see your physician again for a reassessment to rule out any complications.

Depression with back pain

Often people with back pain also have depression. To address this issue your physician may prescribe an antidepressant like duloxetine (Cymbalta), which has been approved by the FDA for treatment of lower back pain. But there are two rare, but important side effects to know about. Cymbalta can cause lowering of blood pressure, which leads to dizziness. This can cause serious falls with the danger of fractures. The other complication is the risk of liver failure.

Side effects of pain treatment

Pain pills can be addicting

While there seems to be an urgency to treat a patient who is in pain with pain medication, the treating physician must not forget that pain medication is potentially addicting and patients often use higher doses than advisable. However, pain medication has a narrow therapeutic window meaning that the toxic levels are not much higher than the drug levels necessary to relieve pain.

Some medications are only marginally effective

There are medications that are only marginally effective, if at all. Glucosamine and chondroitin are used for relief of arthritic pain in osteoarthritis sufferers. They are eliminated by a liver enzyme system that also eliminates blood thinners. If a patient is on blood thinners, the addition of glucosamine and chondroitin can lead to dangerous bleeding. Instead of using glucosamine and chondroitin when you experience pain and inflammation in joints, reduce your activities, but stay as active as you can to avoid your symptoms from getting worse.

Tests for severe migraines

When a patient has a severe migraine headache it is tempting to want to rule out a brain tumor. But a CT scan exposes the patient to dangerously high radiation doses that over time could cause brain cancer or leukemia. There are physical examination methods to rule out a brain tumor. If the findings are positive, an MRI scan can be used to get much more detail of the brain than a CT study would reveal. MRI scans do not have undesirable side effects.

Use gentle movement to remobilize the painful joints

Before you rush into using anti-inflammatory drugs, use gentle movement to remobilize the painful joint, back or limb. Activities like swimming, walking or yoga can reduce pain and allow you to recover from a painful condition according to a Cochrane Library analysis of 61 studies.

Non steroidal anti inflammatory drugs (NSADs)

For more pain relief NSAID (non steroidal anti inflammatory drugs) pain relievers like ibuprofen (Advil) or naproxen (Aleve) for a brief period will also help. The problem with long-term use of NSAIDs is that it can cause kidney damage. With longer use of NSAIDs there is also a danger of stomach bleeding, heart attacks and strokes.

Toxicity with Tylenol

The pain drug acetaminophen (Tylenol) has a narrow therapeutic window and is less effective in pain relief than the NSAIDs. The FDA has recommended as the highest daily dose 4000 mg of acetaminophen. But if you are a heavy drinker or you have liver disease, your daily dose of acetaminophen should not exceed 3250 mg to avoid liver toxicity. Long-term use of acetaminophen can also damage your kidneys, therefore the recommendation to use acetaminophen only for a short period of time (a few days).

Side effects of triptan drugs for migraines

Migraine headache drugs: The newer migraine drugs, called triptans temporarily narrow widened blood vessels. This relieves severe migraines within about 2 hours. However, these medications are not recommended for those with high blood pressure, chest pain, heart disease or circulation problems in the legs, as blood vessel constriction could bring on heart attacks or worsen circulation problems.

Common sense approach to pain treatment

The key for any pain condition is to treat the pain right away to minimize the impact that pain has on you and to prevent developing chronic pain, which is more difficult to treat.

Here are some examples.

Migraine headaches

If you have a migraine headache, use an over-the-counter pain reliever like naproxen or ibuprofen to treat the migraine pain very early. A combination of acetaminophen, aspirin and caffeine (like Excedrin Migraine or a generic copy) will also do. This will stop the release of prostaglandins, which would send pain signals to the brain. Heat packs or cold packs on your head can also help in the treatment of a headache. A 2013 study from Germany has shown that migraine sufferers can get rid of their migraine headaches in 60% by having sex. It sounds like a nice idea, but what they have not considered may be the fact that somebody who has a splitting headache is not feeling like sex at all!

Triptan pills for migraines

If your home remedies did not help, see your physician for one of the triptan pills. Sumatriptan or a similar drug constricts blood vessels to the brain. The doctor will also look for common triggering factors that can bring on a migraine. Weak neck and shoulder muscles may respond to physiotherapy strengthening. In women a condition called estrogen dominance is associated with migraines and can be treated with bioidentical progesterone to balance estrogen and progesterone in the body by elevating progesterone concentration.

Acute lower back pain

Acute lower back pain usually follows an event where the person lifted something too heavy or injured the back from a fall. The important part is to rule out a fracture. Most of the time there is no underlying fracture, just a muscle strain. A muscle strain usually sorts itself out in time. Stay active as much as possible. But if the back pain does not resolve within a few days, see your physician for more tests. X-rays can delineate structural changes like a fracture. As explained earlier, an MRI scan can rule out a disc herniation. Instead of neurosurgery, further options nowadays are prolotherapy, stem cell therapy or a combination prolotherapy/stem cell therapy. This type of therapy will also work for knee injuries (meniscal or ligamentous tears).

Hip or knee pain

Conventional medicine usually treats osteoarthritis with NSAIDs, but may not warn you about the possibility of gastric erosions that can lead to massive stomach bleeding, heart attacks or strokes when using NSAIDs. It also can lead to kidney damage that can cause sudden kidney failure. The key is to use anti-inflammatory medication only for a few weeks. If arthritis persists, it is wiser to seek the advice of a naturopathic physician for prolotherapy treatment. One or two treatments of prolotherapy can give relief of pain. If prolotherapy does not succeed, it is best to move on to mixed stem cell therapy with bone marrow and mesenchymal stem cells (from fat cells) as well as PRP (platelet rich plasma). This usually leads to complete healing of osteoarthritis and eliminates the need of total knee or total hip replacement.

Neck and shoulder pain

This often develops because of poor posture, shoulder tendinitis or neck muscle spasm. Physiotherapy is often successful treating this. If not the physiotherapist can use intramuscular stimulation (IMS) with acupuncture needles. This may be more successful in interrupting the abnormal neuropathic pain pathways. Alternatively electro acupuncture with a TENS-like device can also be successful. The newest treatment modality is the Weber medical system using a low-dose laser applicator. Prolotherapy can also be used for shoulder and neck problems, if the ligaments are lax. It requires a lot of experience on behalf of the health professional to choose the right treatment protocol for the condition.

Tension headaches

Anxiety, stress and fatigue can all lead to tension headaches. Initially you may want to drink liquids, as dehydration is related to tension headaches. If your headache is still present after one hour, use naproxen or acetaminophen. Take a warm or cold shower and lie down with a cool cloth on your forehead. If you still have a headache, check with your doctor whether it is indeed a tension headache or a migraine. You may have jaw clenching or teeth grinding during your sleep. If your bite seems off, see a dentist. For stress control use relaxation techniques.

Other ways to treat tension headaches

Some suggestions sound mundane enough, but they can be effective: Get enough sleep, get enough exercise, and work on improving your posture. A physician trained in trigger point injections with local anesthetics (often anesthetists or general practitioners) can freeze your suboccipital and supraorbital nerves with lidocaine, which I have seen to work in 60% to 70% of cases in my former practice.

Pain Treatment

Conclusion

Pain treatment can be confusing as pain itself can be very multifaceted. The key is to search for the cause of the pain. Then treat pain very quickly. This way it has time within 2 to 3 months to turn into a chronic pain condition. Chronic pain is much more difficult to treat. The physician should treat acute pain successfully. Conventional medicine has to yet learn from naturopathic medicine and alternative medicine practitioners. They use prolotherapy, stem cell therapy, IMS and trigger point injections with local anesthetics. In addition low-dose laser therapy (Weber medical system) are valuable alternative methods to treat pain. These methods can successfully treat pain conditions. The physician can incorporate them into general medical practice.

Jul

2016

LED Streetlights Can Be Harmful

By Ray Schilling | Circadian rhythm

The American Medical Association (AMA) has just released a new policy recommendation and statement that LED streetlights can be harmful. After meticulous reviews of the research on the effect of white LED streetlights and their effect on health the AMA decided that it needed to publish its recommendations so that city fathers have some guidelines for illuminating their cities.

Cost and energy savings from white streetlights

Many cities in the US have already switched from the yellowish traditional streetlights to the high-intensity LED lighting. The cities did this unilaterally without consulting health professionals or the public. The cities wanted to save money by using white LED lights. But as we will discover below there are serious health consequences to this.

Historic lighting solutions

We did not always have streetlights. Physicists use Kelvin units (K) to measure the intensity of light. The term“color temperature” (CT) is in us to describe color composition. Before Benjamin Franklin and Thomas Edison invented electricity we burnt candles and wood at night. This produced a light of 1800 K, which was yellow and red with hardly any blue. Next came incandescent light bulbs. They have a color temperature of 2400 K, which contains less blue and more yellow and red. The new light source is the LED light, which contains a lot more blue color and appears to us as white light. The color temperature is around 4000 K to 5000 K.

LED streetlights can be harmful to your health

Who would have thought that switching streetlights could have anything to do with your health? The newest LED street lights are emitting large amounts of blue light. Our eyes perceive this as white light, but it also creates nighttime glare, much more so than conventional lighting. Eye discomfort from blue-rich LED lighting can interfere with visual acuity and cause road hazards. The blue-rich LED streetlights happen to operate at the wavelength that suppresses melatonin during the night. Researchers believe that the white LED lamps cause interference with the important circadian sleep rhythm. This effect is much stronger with the white LED lights in comparison to the conventional streetlights. The interference with the sleep rhythm means that there is less sleep time. The sleep subjects reported that their sleep quality was unsatisfactory. There is daytime sleepiness and impaired daytime functioning. White light LED lights can even cause obesity.

Effect of white LED light on animals

Animals can also react to white LED light. The bright outdoor LED lights disturb many species that need a dark environment. Poorly designed LED lighting disorients some birds. Researchers detected that insects, turtles and certain fish species also experience disturbance in their habitat by white LED lights. US national parks have adopted lighting designs that reduce the effects of light pollution on wildlife. So far nobody has shown any concern, what light pollution does to humans!

AMA guidelines to reduce impact of white LED lights

The AMA has come out with new guidelines to help reduce the impact of white LED light. Instead of high-intensity white streetlights the AMA recommends to communities to use the lowest emission of blue light possible to reduce glare. The AMA has recommended a color temperature of no more than 3000 K. This type of light has more of a mix of blue, green, yellow and red in it and very little white. In contrast the CT of bright LED streetlights have 4000 K to 5000 K. This contains a lot of blue light, which appears as white to the eye. Seattle and New York belong to the cities that recently had their streetlights retrofitted to the white LED streetlights.

American Medical Association (AMA) recommendation

According to the AMA guidelines these lights should now be refitted again. The AMA also recommends that the lights should be shielded to minimize glare and the detrimental effect on humans and the environment. There should also be a possibility of dimming the lights in off-peak periods.

Evidence from medical literature that LED streetlights can be harmful

Here I am reviewing what has been found in the medical literature about white LED lighting that is now preferably used in street lighting.

Cataracts caused by high color temperature

A Chinese lab tested epithelial cell lines derived from human lenses under a variety of light sources. The lab had previously established that oxidative stress on epithelial cells from human lenses was the most important factor for developing cataracts in humans. Human epithelial cells were cultured in the presence of different LED light frequencies. A high color temperature of 7378 K caused damage to the epithelium while controls of lower color temperatures of 2954 K and 5624 K LED lights did not. The authors concluded that white LED light with a high color temperature could cause significant photobiological damage to human lens epithelial cells. This in turn can cause cataracts and legal blindness.

Human retinal cell cultures damaged by white LED light

Another research group studied human epithelial pigment retinal cells in tissue culture. They exposed the tissue cultures to various light frequencies, namely white, blue, green or red LED light. Reactive oxygen and DNA damage were assessed. The white light showed the highest amount of damage to the human retinal cell in culture.

Intermittent exposure to white LED light in long-term care residents

In a trial on senior long-term care home residents researchers found that intermittent exposure to bright light (versus red light) showed positive cognitive effects on the seniors. It is not clear why with respect to cognitive function there is a positive finding using white LED lights, while the other tests mentioned above showed negative effects on the lens and the retina of the eyes.

Blue light filters for night shift workers

In another investigation blue light filters were employed in night shift workers and the investigators detected beneficial health effects. In animal experiments the same results were found.

Normally in shift workers cancer, heart disease, metabolic disturbances, depression, anxiety disorders and reproductive problems are found.

LED Streetlights Can Be Harmful

Conclusion

Despite the evidence in the medical literature showing that yellow lights are better than the newer white LED lights, cities have been converting the yellow streetlights to white LED streetlights. It makes economic sense, but harms people. The American Medical Association is attempting to convince authorities to use common sense. The AMA wrote guidelines and hopes that city fathers will reconsider their decisions. If you are concerned, voice your opinion by talking to your political representative.

Commuting affects your health, study design

Commuting affects your health, results of study

Commuting affects your health, Cambridge experiment

Active commute most beneficial

Commuting affects your health, US study

Summary about transit-oriented developments or districts (TODs)

Commuting affects your health, general comments

Commuting leads to stress

My own experience watching commuting in various cities

Vienna (Austria)

Munich (Germany)

Münster (North Rhine-Westphalia, Germany)

Berlin

Vancouver (BC, Canada)

Conclusion

Use public transit, not your own car to commute

Vitamin D3 protects your brain from multiple sclerosis (MS)

Progression and disability in MS patients with various vitamin D3 levels

Vitamin D3 protects your brain from Parkinson’s disease

Vitamin D3 protects your brain from Alzheimer’s disease

Vitamin D3 combined with metformin suppresses cancer

Vitamin D3 protects your brain: guidelines to proper vitamin D3 dosing

Conclusion

Denying that sugar can cause heart attacks

Historic falsification of research findings by John Yudkin

New evidence that sugar can cause heart attacks

Sugar can cause heart attacks, but review paper ignores this

Falsified study from 1967 in the New England Journal of Medicine

Effect of the literature review on heart attack rates

Corn oil causes inflammation

How sugar can cause heart attacks and more

Dr. Frank Hu’s study

Effect of sugar

High glycemic foods and starchy foods cause cancer

Conclusion

What sugar does

Seven steps to live over 100 years – step1: Stay active

Seven steps to live over 100 years – step 2: Eat a healthy diet

Seven steps to live over 100 years – step 3: Take care of your teeth

Seven steps to live over 100 years – step 4: prevention of disease

Seven steps to live over 100 years – step 5: Lifestyle matters

Seven steps to live over 100 years – step 6: Avoid obesity and diabetes

Seven steps to live over 100 years – step 7: Sleep and hormones

Conclusion

Crazy food trend one: Ashwagandha

Crazy food trend two: astrologically farmed eggs

Crazy food trend three: Cordyceps

Crazy food trend four: blue majik

Crazy food trend five: cannabis

Conclusion

Homocysteine as a hidden cause of depression

Hidden cause of depression and Alzheimer’s disease

Methylation pathway defects as a hidden cause of depression

Other illnesses due to methylation defects

Tests and treatment for hidden cause of depression

Conclusion

New FDA food guidelines regarding increasing fish and shellfish

New FDA food guidelines regarding reduction of saturated fat

New FDA food guidelines regarding protective effect of coffee

New FDA food guidelines regarding sugar reduction

New FDA food guidelines regarding cholesterol

Conclusion

Study showing why we should avoid BPA

What BPA does

Manufacturing of BPA free plastic

Avoid BPA from receipts

How you can avoid BPA exposure

Conclusion

Additional reference (Questions about BPA answered):

Acute pain

Chronic pain

Relief of pressure on nerve root from mini discectomy

How pain treatment is done

Avoid bed rest

See a physiotherapist

Chiropractic treatment

Medication for pain

Depression with back pain

Side effects of pain treatment

Pain pills can be addicting