Nov
16
2013

You Can Fight Back Against Arthritis

Osteoarthritis affects about 4 to 5% of the population with women outnumbering men by 2 to 1. The age of onset typically is less than 50 years, but becomes more evident and more disabling beyond the age of 50. About 40 to 60% of osteoarthritis is genetically linked as twin studies in women have shown (Ref.1).

Synonyms for osteoarthritis are degenerative joint disease, osteoarthrosis and arthrosis.

Till recently arthritis was accepted as something that was inevitable: people were getting old, were getting stiff and sore, and had to “take it easy” as a result when they got older. Things are not as uncomplicated, as arthritis affects about 53 million Americans, and it has become the leading cause of disability in the US.

Rheumatoid arthritis is an autoimmune disease. It is not a disease of “old age” but can affect people of every age group. The body reacts to components in joint tissue, and this immune reaction to collagen will produce inflammation, pain and ultimately disability.

So far osteoarthritis was believed to be the result of wear and tear affecting the aging population, but more recently it has been discovered that osteoarthritis is also accompanied by the same inflammatory immune factors that are involved in rheumatoid arthritis.

When the body attacks collagen, which is needed to keep the joints moving smoothly, microscopic particles of it wander into the blood stream. There they are perceived as foreign molecules, and the immune system produces inflammatory substances (cytokines). These are sending out an army of “killer T-cells” to combat the collagen, which is perceived as a foreign matter. They are bombarding the exposed cartilage with toxic substances. This means a chaotic combination of oxidative stress and more inflammation. Over time the cartilage that was meant to protect the joint in its function to move freely is eroded and destroyed. For the person suffering of this disordered reaction, it means that the joint is not only creaking but causing pain, which is made even worse by weight bearing (walking, standing). Any person suffering of osteoarthritis will complain that he or she feels stiff and sore especially after a period of inactivity.

Commercials for anti-inflammatory medication are plentiful, and many sufferers resort to the pain relief that is promised. The warnings are mentioned right after the commercial or on the medication package, if the patient reads the fine print. Most anti-inflammatory medications are causing irritation of the stomach, and the kidneys get damaged (nephropathy)with prolonged use from these pills despite the promises in commercials of a happy, active and pain free life.

You Can Fight Back Against Arthritis

Causes of arthritis

There are many varied causes that can all contribute to developing arthritis.

It is important to take a critical look at lifestyle choices. Excessive body weight puts an additional burden on the joints in the body. Increased body fat is not just sitting at the abdomen as an inert potbelly. Abdominal fat is a highly active metabolic organ that releases inflammatory substances into the blood stream, which distributes them throughout the body. It is known to damage blood vessels. Inflammation will damage the joints as well. The statistics show that 33.8 % of obese women have arthritis. The percentage for obese men shows that 25.2 % suffer of arthritis.

Smoking leads to circulatory problems, and lack of oxygenation in the body’s tissues. It is a mistake to believe that damage is done only to the lungs or the heart. The joints will be affected as well.

Mechanical stress with inadequate self-repair is one cause; misalignment of bones such as knock-knee (genu valgum) and bowleggedness (genu varum) will lead to premature osteoarthritis of the knees as can loss of muscle strength. Exercise without injury does not contribute the risk for developing osteoarthritis; it is actually part of the rehabilitation plan.

According to Ref. 2 there are other causative factors, such as increased age, female sex, race (black women have a twofold increase of arthritis over Caucasian women), estrogen deficiency, nutritional factors, genetics, metabolic and endocrine disorders, joint trauma, joint deformity, occupational factors and sports participation (accumulation of mini injuries).

One of the newer findings is that osteoarthritis is actually an inflammatory condition where numerous destructive processes occur within the affected joints leading to a breakdown of cartilage and supportive synovial fluid factors (proteoglycans). These findings lead to the possibility of new therapeutic approaches discussed below.

Diagnosis of osteoarthritis

According to Ref. 1 there are no blood tests and analysis of synovial fluid is non-diagnostic. Diagnosis of osteoarthritis is made by history, X-rays of the affected joints and clinical findings. There are joint tenderness and swelling of the affected joints. Heberden’s nodes (swelling of the distal interphalangeal joints or DIP joints) and Bouchard’s nodes (swelling of the proximal interphalangeal joints or PIP joints) are present. There can be a decreased range of motion and a grating sound of two ends of bones rubbing together (called “crepitus”).  X-rays show typical osteoarthritis details with a narrowing of the joint space of the affected joint, subchondral sclerosis (increased bone formation around the joint) and new bone formation at the joint margins, called “osteophytes”).

Integrative therapy of arthritis

Ref. 2 points out that integrative treatment of arthritis is aimed at reducing joint pain, increasing joint function and reducing further joint deterioration. Some measures are symptomatic only, others are disease modifying.

Nutrition

Dietary habits can promote good health or have disastrous consequences. The news has been out for some time that the typical North American diet with a high load of omega-6 fatty acids will stoke the fires of inflammation in the body and lead to arthritis, heart disease and cancer. Soybean oil, cottonseed oil and safflower oil contain the cheaper omega-6 oils that are widely used in food processing and bakery products. Refined carbohydrates contribute to unhealthy spikes in blood sugar levels and wreak havoc in their own way paving the downward slope to insulin resistance, metabolic derailment, and diabetes. Take a hard look at your shopping wagon. Stay away from processed foods, shop the periphery of the supermarket, and choose organic meats, vegetables and fruit. Use heart healthy fat in the form of virgin olive oil. A Mediterranean type diet will be a good choice. Just bear in mind, that a heap of pasta like Fettuccine Alfredo does not constitute what a healthy Mediterranean diet is all about. An anti-inflammatory diet such as a Mediterranean diet also includes deep-water fish as a source of omega-3 fatty acids or molecularly distilled omega-3 capsules (you need 7 to 8 high potency, molecularly distilled fish oil, 1000mg per capsule) every day.

This approach has shown beneficial effects in beginning stages of osteoarthritis.

It is important to cut out sugar and starchy foods to reduce insulin resistance, which would otherwise maintain the inflammatory chronic condition causing arthritis and cardiovascular disease. For the same reason cutting out wheat and wheat products has been shown to be beneficial in reducing inflammation. Such an anti-arthritis diet prevents heart attacks and strokes at the same time.

Weight loss

Ref. 2 points out that one study showed that weight reduction of only 10% had a 28% improvement in joint function. When this is combined with an exercise program the improvements are even more striking.

Exercise

Exercise consists of aerobic training, resistance training and muscle strengthening. When patients with osteoarthritis were observed throughout controlled exercise programs, flexibility and range of motion of the affected joints were improving. A minimum of three days per week of exercise was required to show improvements, but the best effects were observed when patients exercised most of the days. Joints become less swollen, show improved circulation and less pain. Before an exercise program is done, those with increased cardiovascular risk should first undergo an exercise stress test to measure their cardiovascular reserve and establish that it is safe to start a program. Secondly, an acutely inflamed or swollen joint should first be treated before an exercise program is started. Lack of exercise will promote more disability. While a person with arthritis may be unable to run a brisk race due to joint discomfort, he or she will find water exercises and swimming much more manageable. Group programs for people with arthritis are available and you may enjoy the supportive company.

Heat and cold therapy

Ref. 2 points out that three weekly 30 minute sessions of microwave diathermy for 4 weeks showed a significant reduction of joint swelling in knee osteoarthritis with improved joint function and reduced pain. On the other hand cold packs for aching muscles after strenuous exercises can decrease muscle spasm and increase the pain threshold. Range of motion increased with cold application and joint swelling was reduced. Patients who have cold sensitivity (such as Raynaud disease) need to refrain from the latter treatment modality.

Acupuncture and electro acupuncture

These treatments were found by Ref.2 to be useful as an adjunct to anti-inflammatory medication with NSAIDS (non steroidal anti-inflammatory drugs); the advantage was that the dosage of NSAIDS could be reduced, which reduced the potential serious side effects of gastric bleeds and kidney damage. Note that people with pacemakers or CNS stimulators cannot use electro acupuncture.

Intraarticular steroid injections

When only a few joints are affected by osteoarthritis (or rheumatoid arthritis), a physician can inject a corticosteroid into the joint. However, there are limitations, as each joint should not be injected more than 3 to 4 times per year. Otherwise there can be damage to the joint cartilage, which would make the arthritis worse. However, I have seen surprisingly good results for a long period of time, which allowed the patients to exercise and stabilize the joints that way.

Complementary treatments

A number of supplements and herbs are effective in reducing inflammation. Omega-3 fatty acids are the precursors for anti-inflammatory prostaglandins in the body, which helps both patients with osteoarthritis and rheumatoid arthritis. As indicated under nutrition above, higher doses are required for this effect and for safety (avoiding toxicity from mercury and PBC’s) molecularly distilled omega-3 fatty acid supplements should only be used (yes, they are more expensive).

Curcumin, the active ingredient of the spice turmeric, has been used in India and Asia for its anti-inflammatory and antioxidant properties for centuries. It helps not only arthritis, but also helps also against the illnesses that are often associated with it (obesity, diabetes, heart disease, autoimmune conditions). Ref. 2 points out that curcumin neutralizes inflammatory agents circulating in the blood of patients with arthritis.

Standardized ginger extract was shown to reduce pain significantly in patients with knee osteoarthritis.

Other common supplements for building up cartilage in the joint are glucosamine sulfate and chondroitin, both available at the health food store. They stimulate glycosaminoglycan formation, which in turn builds up hyaline cartilage, the enamel-like coating of the bone within the joint.

An oral desensitization to treat arthritis

Can joint health be helped in other ways? New answers have emerged. In the past, people who were suffering with colds or flus were consuming a steaming bowl of chicken soup. It should be mentioned that colds and flus are also an inflammatory reaction that occurs within the body.

While a lot of health professionals dismissed this home remedy as old-fashioned and useless, a team of scientist from the University of Nebraska decided to research the matter a bit closer. They discovered that it was not the vegetables, but a component in the chicken broth that showed anti-inflammatory activity. The chicken derived type II collagen functions to regulate the immune system, so it stops attacking proteins normally found in healthy joint cartilage. Results of a pilot study have shown remarkable results. A dose of 40 mg per day of un-denatured type II collagen (UC-II) showed a significant reduction in pain and swelling from arthritis. It also yielded good results in terms of relief from joint pain and stiffness due to exercise.

Animal studies on dogs and horses were also conducted demonstrating that both animal groups that frequently suffer from arthritis got significant relief. Human clinical trials with UC-II showed similar effectiveness.

A group of patients suffering from knee osteoarthritis were treated with the supplement for 90 days. 33% experienced a reduction in their osteoarthritis. The pain was reduced by 40%. Those patients who received the standard treatment without any supplement had 15.4% less pain. Joint function was improved by 20% in the group taking the supplement, while only 6% of improvement was seen in the patient group receiving standard care.

Healthy patients were also assessed who did not suffer of arthritis, but received the supplement to evaluate how they would fare with exercise-induced knee pain. They were treated with a daily dose of 40 mg of UC-II. After day 90 and 120 the group that was treated with the supplement could exercise for significantly longer periods before experiencing joint pain. They also recovered faster after joint pain. The placebo group who swallowed “fake pills” did not show these changes. When knee joint flexibility was examined, the supplement group had significant increases in their knee mobility, but no luck for the placebo group!

Numerous toxicological essays have evaluated the supplement. There is no oral toxicity. No mutations in bacterial genomes have been observed, which is a standard screen to ensure that a substance is non-carcinogenic.

The UC-II supplement works through a mechanism, where the immune system is desensitized by ways of oral administration. It reverses T-cell attacks on exposed cartilage. If our joints are healthy and intact, we normally do not react to our own cartilage. But the protective barrier between blood and cartilage diminishes as we age. Early treatment with UC-II may help induce immune tolerance even in healthy individuals and protect them from reactions of the immune system to their own cartilage.

Conclusion

The supplementation with UC-II offers a different approach to modify joint inflammation of arthritis. Standard treatment at this point consists mainly of symptomatic treatment. Side effects to the drugs can be serious, if they are used on a long-term basis. Few are tolerable to modify the course of the disease.

With the UC-II supplement the root of the disease (autoimmune disease) is being addressed, and relief can be achieved within a few weeks of starting it. With life style changes that were mentioned before and this supplement it is possible to fight back against arthritis!

More information on arthritis: http://nethealthbook.com/arthritis/

References

1. “Osteoarthritis. Basic information”. Ferri: Ferri’s Clinical Advisor 2014, 1st ed., © 2013 Mosby

2.  Rakel: Integrative Medicine, 3rd ed., 2012 Saunders

Last edited Nov. 7, 2014

Sep
28
2013

Sleepless Nights

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

Symptoms of insomnia

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

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

Research about insomnia

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

Sleepless Nights

Sleepless Nights

Causes of insomnia

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

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

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

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

Predisposing factors

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

Precipitating factors

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

Perpetuating factors

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

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

Drugs that can cause insomnia

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

Treatment of insomnia

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

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

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

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

Drugs and supplements for insomnia

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

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

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

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

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

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

Conclusion

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

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

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

References

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

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

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

Last edited Sept. 28, 2014

Sep
07
2013

Preserve Your Muscles And Joints

Our ancestors were hunters and gatherers, constantly on the go. They did not have to think too much about their muscle and joint health, they simply moved them. In our society this has changed a lot. At work we spend hours sitting at a desk, and then we use computers and watch television at home. Instead of walking to the neighborhood store, we use our car.

Here I will review what we can do to keep our joints and muscles in top shape until a ripe old age.

Brief intro regarding the anatomy of joints and muscles

Our joints are designed to give us full mobility. But the joints cannot do it alone. The muscles are designed to allow the joints to move in a full range. Without exercise the muscles will shrivel up (medical term “atrophy”) within only 2 to 3 weeks. So without regular exercise your joints won’t do you any good. Besides the joint capsules need regular stretching in full range exercises to produce the lubricating fluid (synovial fluid) that nourishes the joint surfaces and the menisci of the knees. Think of muscles and joints as being a functional unit designed to move you about.

Our joints have aerodynamic designs to do the most optimal job for our body. For instance the knees have more of a hinge design that includes menisci for shock absorption while the shoulders and hips have more of a ball and socket type construction.

Wear and tear with aging

It is usually thought that injuries and aging wear down the joints. But there are other factors such as the wide spread use of statins that can contribute to muscles weakness. Ironically statins are taken to protect the heart, but side effects can interfere with the ability to exercise your heart because of aching muscles and joints.

With optimal nutrition and avoidance of wheat and wheat products to prevent autoimmune arthritis (lupus, rheumatoid arthritis, dermatomyositis) your joints can stay young for much longer (explained further below). But your joints and muscles need to move through a full range of motion regularly to keep the blood circulation and nutrition of their tissues in top shape.

What causes joint deterioration?

Aging, weight gain, diabetes, smoking and lack of exercise all are known to cause a worsening of arthritis, particularly osteoarthritis, but also rheumatoid arthritis. The wrong diet with lots of sugar and starch and trans fats (hamburgers, pasta, sugar soda drinks) causes hyperinsulinemia (insulin overproduction, like in type 2 diabetes) and is almost guaranteed to make you sick with arthritis, obesity and diabetes.

There is also evidence that wheat causes inflammation and arthritis by stimulating your pancreas to produce too much insulin. This has been proven for dogs and for humans. A good diet book to follow is Dr. William Davis “Wheat Belly Cookbook” (Ref. 1) with 150 recipes. If you are overweight, these recipes will also help you to lose some weight effortlessly.

A caution to marathon runners: the constant pounding of prolonged jogging can cause osteoarthritis of hips and knees decades down the road. You may want to switch to different exercises before this happens.

Preserve Your Muscles And Joints

Preserve Your Muscles And Joints

What helps joints?

Molecularly distilled omega-3 fatty acid helps to prevent inflammation of your joints. Vitamin D3 will help your bones to be strong to support the tendons and ligaments. Chicken cartilage can build up joint cartilage within a few weeks! So, if you feel pain in your joints use 3 capsules of omega-3 (the strong, molecularly distilled ones) twice per day. This will help your joint inflammation within 3 to 4 weeks. If this alone is not enough add chicken cartilage from the health food store, which will help to build up the hyaline cartilage within your joints. For those who are questioning the effect of chicken cartilage, here is a 1993 chicken cartilage Harvard study proving it.

Below are more general steps that will help your joints, ligaments and muscles.

Maintaining health of joints and muscles

a)    It starts with good nutrition.

Hamburgers and deep fried French fries will not do the trick. Muscles require protein from meat, fish, poultry and dairy products. If you are a vegetarian you need to become knowledgeable on what essential amino acids are and what combination of vegetables will give you the amino acid composition to build up a full protein.

Joints need ingredients from cartilage, which you find in chicken cartilage (available in health food stores as fikzol (type II cartilage). I you prefer, chicken soup would also give you the ingredients to build up cartilage, but it would require a lot of regular chicken soup consumption to achieve this.

Sugar and starchy foods, which are broken down within half an hour after a meal into sugar in your blood, cause an insulin response from your pancreas. This in turn can cause inflammation in your joints and tendons. It is interesting to note that type 2 diabetes and arthritis are associated. A ketogenic, low sugar/starch diet will prevent arthritis and diabetes as it reduces the insulin level in the blood, which in turn turns off inflammation in the joints.

b)   Supplements:

Omega-3 fatty acids will help control any inflammation including the inflammation from arthritis (you need 3 capsules of the concentrated, molecularly distilled fish oil twice per day to achieve this).  DMSO gel, available in health food stores in the US, can also be used to rub onto inflamed joints. It will penetrate tissues rapidly, is nontoxic and helps control inflammation along with the omega-3 fatty acids. Regular anti-inflammatory pain relievers (NSAIDs) are harsh on your kidneys and can irritate the gastric lining causing bleeding gastric erosions, so definitely not recommendable.

Glucosamine, chondroitin sulfate, or a combination of both is available in the health food store and has been shown to help with osteoarthritis. I contributes to building up hyaline cartilage.

c)   Watch your weight:

It has been shown that the rate of degenerative arthritis (=osteoarthritis) in obese people is much higher when compared to slim people.

d)   Exercise:

You need to move your joints, ligaments and muscles every day to maintain their strength and range of motion. A daily workout at home or in a gym is best. I recommend 30 minutes of a treadmill or equivalent (jogging, Stairmaster etc.) as aerobic exercises. Then you need 30 minutes of isometric exercises like a circuit on exercise machines in the gym or dumbbells and expanders (resistance bands) at home. I consider this as the basic fitness routine every day.

Ballroom dancing and Latin dancing or Zumba is also a good combination exercise, which I would recommend on top of the basic exercise. Dancing helps to maintain your balance as well, which is something the older population tends to lose. In addition dancing stimulates your brain cells and makes you less vulnerable to develop dementia in old age.

Other aerobic exercises that can be recommended are walking (brisk walk) and/or intermittent jogging. Swimming has the advantage particularly for arthritis sufferers that you are floating. It allows you to exercise your leg and arm muscles, even if you have some arthritis pains.

e)  Pain relief: What could you do for pain relief? I do not like NSAIDs as this will damage your kidneys on the long-term and cause gastric erosions that can bleed massively. Electro acupuncture is very useful for muscle and joint pains and has no side effects. Physiotherapy treatments are useful to recondition your muscles and build up the range of motion of your joints. Chiropractic treatments for back and neck pain will also help. Instead of narcotics, why not try low dose Naltrexone (LDN). It has been shown to help with the pain of fibromyalgia.

Conclusion

In this brief review I have attempted to show you that your body is not on a one-way street in the direction of disability and death. There is a lot we can actively do to prevent this from happening prematurely. Just eat right, supplement (if you have symptoms), exercise and be active. Soon you will no longer be aware of your previously achy joints or muscles, as the pain tends to melt away when you are reconditioned.

More information on fitness: http://nethealthbook.com/health-nutrition-and-fitness/fitness/

References:

1. William Davis, MD: “Wheat Belly Cookbook. 150 Recipes to Help You Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2012.

Last edited Nov. 7, 2014

Aug
10
2013

Bioidentical Hormone Replacement

In many previous blogs I have mentioned that bioidentical hormone replacement prolongs life. Here is a more detailed look at what such hormone replacement looks like for both women and men. Before I get into details I want to stress that I am talking about replacing what is missing and replacing only with natural hormones, not some artificial hormone derivative produced by a drug company. The reason this is immensely important is that hormone receptors in the body are distributed all over our vital organs including bones, blood vessels and the nervous system. If there is no lock and key fit (bio-identical hormone fitting the hormone receptor), there is trouble as the Women’s Health Initiative in 2002 has shown. Unfortunately they had used synthetic hormones for HRT that were not fitting the hormone receptors, and this caused many problems (heart attacks, strokes, osteoporosis, cancer).

Physiology of aging

As we age, we gradually produce fewer hormones in our hormone glands, but the various hormone glands deteriorate in their functions at different rates. Beyond the age of 30 we produce less melatonin and less growth hormone. As a result our sleep pattern may change, as melatonin is necessary for a deep sleep. The decreasing growth hormone production means that we are losing some of our muscle mass and accumulate more fat in the subcutaneous tissues. Our adrenal glands produce less DHEA at the age of 35 to 40, a hormone that is a precursor to our sex hormones in males and females. The gonads (testicles and ovaries) also produce fewer hormones, a process which already starts 5 years before menopause and about 5 years before andropause (the male menopause equivalent).

Typically a woman will get into menopause at the age of 45 to 55 at which time the periods stop and postmenopausal symptoms are interfering with her well-being.  Men get into andropause (the male equivalent of menopause) at the age of 55 to 65 at which time erectile dysfunction occurs and often the individual will become the “grumpy old man”.

Other hormones such as thyroid hormones are also affected by the slow down. Hypothyroidism is common in people above the age of 50.

Bioidentical Hormone Replacement

Bioidentical Hormone Replacement

Baseline laboratory tests

In order to know what is going on, the physician or naturopath needs to order a number of tests to assess whether there is inflammation, how your key hormone levels are; the cardiovascular system markers should also be checked, the liver enzymes and vitamin D3 level. Inflammatory markers are fasting insulin levels and C-reactive protein (CRP). Fasting cholesterol and subfractions (HDL, LDL, VDLP, small LDL) and fasting triglycerides are also measured. Thyroid hormones (T3 and T4, TSH) are measured to rule out over or under function. Typically hypothyroidism is found, which would have to be rectified by taking Armour (a mix of T3 and T4 thyroid hormones).

At this point I need to explain that long time ago the research by Dr. Lee has shown that progesterone hormone levels are notoriously unreliable when blood tests are done. All of the other sex hormones, and cortisol are also not that reliable with blood tests. For this reason the saliva hormone tests have been invented that conveniently report a panel of 5 hormones from one saliva sample: DHEAS (which is the storage form of DHEA), estradiol (the major estrogen in a woman), progesterone, testosterone and cortisol. The saliva hormone tests correlate very well with the actual tissue hormone levels. You can order the saliva tests through Dr. Lee’s website. Another longstanding lab in the US is Dr. David Zava’s lab. In Canada the Rocky Mountain Analytical Lab can process your saliva tests.

Women’s hormone replacement

Let us assume that a woman is getting postmenopausal symptoms and bioidentical hormone replacement is being discussed. The physician will want to first rule out that insulin resistance is not present by ordering a fasting insulin level. If this is normal and the other baseline tests are normal as well except for missing estrogen and progesterone, the physician will usually start to replace progesterone first using a bioidentical hormone cream to be applied once or twice per day. If estrogen levels were also low, the next step in 4 weeks or so is to add Bi-Est, a bioidentical estrogen replacement cream. After 8 weeks of hormone replacement the saliva hormone test is repeated to see whether the estrogen and progesterone levels have come up and also, whether the ratio of progesterone to estrogen is at least 200 or more. Dr. Lee has extensively researched this and found that women with a ratio of less than 200 to 1 (progesterone/estrogen ratio) were more prone to breast cancer. He also stated in this link that there are 3 basic rules with regard to bioidentical hormone replacement:

1. only replace hormones, when they were measured to be low.

2. use only bioidentical hormones (never synthetic hormones) and

3. only replace with low doses of bioidentical hormones to bring hormone levels to physiological levels (body levels that were experienced to be normal before).

Many women who are not replaced in menopause have estrogen dominance meaning that the progesterone/estrogen ratio is less than 200:1, which puts these women at risk of developing breast cancer. Women who are overweight or obese also are estrogen dominant (from estrogen produced in excess through aromatase in the fatty tissue, explained further below), which makes them more prone to breast cancer, uterine cancer and colon cancer. Without bioidentical hormone replacement inflammatory processes take place in the joints (causing arthritis), in the nervous system (causing Alzheimer’s and dementia) and in the blood vessels (causing heart attacks and strokes). Rebalancing your hormones to a youthful state by paying attention to the hormone levels and the hormone ratios mentioned will remove the inflammatory reactions and reduce the risk for cancer.

Men’s hormone replacement

Males enter andropause 10 to 15 years later than women are entering menopause. Typically testosterone production slows down leading to hair loss, erectile dysfunction, loss of muscle mass, osteoporosis and Alzheimer’s/dementia. Blood tests (bioavailable testosterone) or saliva tests are both reliable in determining a deficiency. Replacement with bioidentical hormone creams once per day is the preferred method of treatment. Overweight and obese men produce significant amounts of estrogen through an enzyme localized in fatty tissue, called aromatase.

Aromatase converts testosterone and other male type hormones, called androgens, into estrogen. Estrogen causes breast growth, weakens muscles, and leads to abdominal fat accumulation, heart disease and strokes.

Similar to women, where the progesterone/estrogen ratio is important, there is another ratio for men, called testosterone/estrogen ratio. This should be in the 20 to 40 range for a man to feel good and energetic. Unfortunately many men above the age of 55 have testosterone/estrogen ratios much smaller than 20. This makes them more prone to heart disease and prostate cancer (Ref.1).

However, a male also does need a small amount of estrogen and normal thyroid hormones as well as all of the other hormones for his “hormonal symphony” (mentioned in Ref. 2) to function at his best.

Safety of hormone replacement

There are still otherwise reputable websites that state that bioidentical hormones are not safer than standard synthetic hormones. This confuses the consumer and does not serve the public well. I much prefer the text of the Wikipedia, which is a more thorough review regarding safety of hormone replacement and explains what the issues are.

In the US there is a collective experience of about 25 years on thousands of patients, but there have not been any randomized studies, as Big Pharma that would have the money to finance such studies is not interested in proving that bioidentical drugs would be safer than their distorted synthetic hormone copies that will not fit the body’s hormone receptors. There are some noble exceptions as Big Pharma is producing bioidentical insulin and human growth hormone that had toxicity studies done and showed safety. In Europe bioidentical hormones have been used since the 1960’s, on a larger scale since the 1970’s. So the European experience of safety of bioidentical hormones is presently about 40 to 50 years.

The FDA is contributing to the confusion of the public as can be seen from this publication. One example where the FDA is confusing the consumer, is the progesterone product Prometrium, a bioidentical micronized progesterone capsule that can be taken by mouth. By law the manufacturer had to put a warning label on the package identical to progestin, which is the synthetic, non-bioidentical hormone having been shown to have severe side effects. As is explained in this last publication Prometrium should not have been required to have a warning label in it ; the paper explains what I have already stated above, namely that bioidentical hormones are the safest form of hormone replacement and administered in the right ratios will actually prevent cancer and prevent premature cardiovascular and joint deterioration. In other words, bioidentical hormone replacement can add many years of useful life when started early enough before permanent organ damage sets in from the aging process (which would be due to missing hormones).

Why bother about hormone replacement?

Nature has a plan of “knocking us off” to make room for the next generation. The only way that you can change nature’s plan of killing us prematurely through cardiovascular disease, arthritis, dementia and loss of your sexual life is by bioidentical hormone replacement. Of course you also need the other ingredients of known life prolongers such as healthy (preferably organic) foods, exercise and detoxification. Many women are scared to treat the hormone deficiencies that cause their menopausal symptoms because of the Women’s health Initiative results with synthetic hormones. Men who would benefit from testosterone are often anxious that they may get prostate cancer, when in reality it is the exact opposite: testosterone prevents prostate cancer (Ref.3).

Conclusion

I wrote this blog about bioidentical hormone replacement in order to clarify this often-misunderstood topic. Don’t get confused by the FDA, by highbrow medical websites (such as the likes I mentioned). Big Pharma has a powerful lobby that attempts to keep the medical profession in the belief that their products are better than those that nature has provided (I call it “defend your patent rights”). We are still in a flux state where anybody who tells the truth about hormones gets much criticism. In another few decades it will be an accepted fact and people will wonder why the Women’s Health Initiative was done without a control with bioidentical hormones. With bioidentical hormone replacement you can add about 20 years of youthful life without disabilities to the normal life expectancy. Exercise, detoxification and organic food with avoidance of wheat, starch and sugar can add another 5 to 10 years to your life. The baby boomers are lucky that they have this new tool to prolong life. I wonder whether they will put it to good use.

More information about bioidentical hormone replacement: http://nethealthbook.com/hormones/anti-aging-medicine-women-men/

References:

1. John R. Lee: “Hormone Balance for Men – What your Doctor May Not Tell You About Prostate Health and Natural Hormone Supplementation”, © 2003 by Hormones Etc.

2. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008

3. Abraham Morgentaler, MD “Testosterone for Life – Recharge your vitality, sex drive, muscle mass and overall health”, McGraw-Hill, 2008

Last edited Nov. 7, 2014

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Apr
14
2013

Allergies Not Only In Spring

Springtime is the time of spring allergies: those affected develop a runny nose, itchy eyes and in more severe cases they may experience a flare-up of asthma. Allergies can be triggered by the increase of pollen counts in the air that occurs every spring. In those who are sensitive, this leads to antibody formation in the blood. But often people have not only sensitivities to the pollens of spring bloomers; they may also be allergic to spores from molds, to dust mites and may have underlying allergies to foods. The immune system has memory cells that memorize that a person has had an allergic encounter to one of these items in the past, and allergic reactions can become more significant with a future encounter. Allergies can also be made worse when a person has food sensitivities and there are cross reactions between pollens of trees or grasses that can share surface protein regions with similar protein regions in foods.

It is known that cross allergies are possible between birch pollen and apple, carrots or hazelnut. In its extreme form allergies due to antibodies, called IgE antibodies, can cause anaphylaxis. A person presensitized by inhaling birch pollen, after eating an apple, hazelnuts or a carrot can develop itching of the throat, swelling of the lips and very quickly deteriorate getting into an anaphylactic shock.

Other cross allergies exist between ragweed pollen, which is a powerful inhalant allergen and melons or bananas. Again there are specific IgE antibodies that are responsible for this immune reaction. In this case the ragweed allergy primes the immune system to produce IgE antibodies, which are potentiated by certain foods that share similar protein components as the ragweed pollen.

In the following I will deal with inhalant allergies separately from food allergies.

Allergies Not Only In Spring

Allergies Not Only In Spring

Inhalant allergies

Inhalant allergies are easier to diagnose and to treat than food allergies. Your doctor will likely refer you to an allergist when you have allergies that do not respond to treatment with intermittent over the counter antihistamines. Your symptoms may come on in the spring with itchy eyes and a runny nose. From year to year you find that you become more and more dependent on antihistamines and nose drops to unplug your nose. The allergist likely will do sensitivity tests, which consist of skin prick or scratch tests on the back or the forearms.

In more serious allergies, where the patient has coughing and wheezing attacks following allergic reactions, the allergist may suggest to start intermittent allergy injections alongside the standard inhalation therapy for asthma. An allergy serum is prescribed where the lab mixes ingredients based on all of the positive tests that led to a strongly positive skin reactions when allergy testing was done. Typically the family doctor or his nurse will start the allergy injections initially in weekly intervals, later when the maintenance dose is reached, it may be modified to injections every 10 to 14 days.

The allergy injections stimulate the immune system to produce harmless competing antibodies, which counteract the disease producing allergic antibodies. In the process of desensitization shots the immune system will normalize, which means that the inflammatory response of the immune system settles down to normal.

This is not the end of the story with inhalant allergies. The patient needs to be retested on a yearly basis by the allergist. The immune system changes all the time as new allergies can develop and old ones may go away.

Retesting is necessary to keep track of what is going on and to change the composition of the allergy serum. Those patients who are working together with the allergist can do very well, and often they gradually outgrow their allergies. Others may not be so lucky. They may have reactions to the allergy injections. In these cases avoidance of what causes the allergy may be the only solution to treat the allergies.

There is an alternative to allergy injections, which has been used in Europe, namely a sublingual immunotherapy. Recently there has been a review of the literature for FDA approval that is needed for oral desensitization for ragweed, dust mites, grass pollen and cat dander. It will take some time before the FDA approval process will become a reality for sublingual desensitization in the US.

A special form of inhalant allergies are allergies to pets (mainly dogs and cats, but also allergies to petting zoo animals). The dander that the human comes in contact with is a protein contained in the animal hair. It causes hives when it touches the skin. This occurs as the dander is absorbed through the skin and meets the local mast cells that release histamine. This in turn is responsible for the hive formation. Sneezing and even asthma can develop from inhaled protein particles that reach the lungs. Allergy injections for the treatment of animal dander allergies are very limited as they often do not help or make the allergies worse. Avoidance of animal contact is usually what the allergist recommends as the solution, a recommendation, which often is not appreciated by the affected animal lover.

Food allergies

Often we eat  some foods more frequently, because they are our favorites. This means that our gut lymphocytes that get in contact with these foods can start to react to one or more of the foods we ingest. At this time we may experience abdominal cramps, diarrhea, vomiting and a host of other possible symptoms.

The physician will tell the patient that testing for food allergies is a problem as most of the usual skin tests employed for inhalant allergies do not reliably work in determining food allergies. The doctor will ask the patient or the mother of the child with food allergies to keep a food diary and keep track of the allergic symptoms in the diary as well. An elimination diet will have to be devised based on the information gathered in the diary as it becomes clear from that record which foods cause which symptoms. The foods causing allergic symptoms are subsequently eliminated. This is a cumbersome process, but it is the most reliable method of testing and treating food allergies.

In the past there was a blood tests, called RAST test, which tested for common food allergies that can cause severe allergic reactions like egg, milk, peanut, tree nuts, wheat, crustacean shellfish and soy. Since about 2010 this has been replaced by the more sensitive ImmunoCAP Specific IgE test.

Children often develop food allergies to egg, milk, wheat, nuts, peanuts and soy, which are food allergies with positive IgE tests. When they age, their immune system develops tolerance to many of these foods and they often outgrow these allergies.

There are other popular lab tests where a blood drop is analyzed with IgG, IgM and IgE antibodies against a panel of foods. A number of suppliers offer these tests.  However, the specificity, sensitivity and reliability can pose problems with regard to the interpretation of the results: allergists often point out that a test may be a false positive when a person likes certain foods and IgG antibodies against this food show up despite the patient having no symptoms. Another specialist may interpret this to indicate that the body shows early sensitization to a certain food, but clinically it is not yet obvious. In other words the sensitivity of the test is so high that it undermines the validity of the test. Recently a panel of international scientists reviewed the validity of these IgG based food intolerance tests and they found the tests not reliable.

The immune responses to food allergies are complicated as there are immediate type immune reactions and delayed type immune reactions. The immediate immune responses are investigated with the above mentioned ImmunoCAP Specific IgE test. The delayed immune responses can be measured using the ELISA test.

Other considerations about allergies

You see from this discussion that a patient with allergies needs a properly trained allergist who will do a comprehensive analysis involving a thorough history, examination, blood tests and immune tests.  The test results have to be interpreted with the experience and the clinical judgment of the specialist.

Since the 1970’s when Clearfield wheat was introduced around the world on a large scale, which has a much higher gliadin (gluten) content than the old wheat varieties. As a result of exposure to this new type of wheat gluten intolerance and leaky gut syndrome have increased substantially in the world population. Genetically modified foods like soy, corn, sugar beets, canola and more have challenged the immune system of sensitive humans even more to an extent, which is not fully understood yet. We do know that some people can develop autoimmune diseases and this may be the reason that a host of diseases that belong into this disease category (MS, rheumatoid arthritis, Hashimoto’s thyroiditis, ankylosing spondylitis etc.) are much more common now than in the past.

After food elimination for 2 to 12 months depending on the severity of the food allergy, your body may have eliminated the allergy to the food you have avoided, in other words your body built up tolerance. Before you expose yourself to any food that you used to be allergic to and that you want to re-test, it is best to have an EpiPen ready in case your allergy has not resolved. Caution is necessary with regard to foods that cause more severe allergies, e.g. shellfish or peanuts, which may last life long. It is safer to avoid these foods that cause more severe allergies altogether.

Allergic reactions of the immune system belong into the category of chronic inflammatory diseases. These are known to be the root of chronic diseases like asthma, arthritis, heart disease, high blood pressure and cancer. When you are vigilant about allergies and get proper assessment and treatment by an allergist, you will prevent serious health problems including the above mentioned chronic diseases.

More on asthma, which is a chronic inflammatory lung condition, often associated with multiple environmental allergies:

http://nethealthbook.com/lung-disease/asthma-introduction/

Last edited Nov. 6, 2014

Jan
22
2013

Long-Term Multistep Weight Management

In February of 2001 my wife and I attended an anti-aging conference in San Diego. The keynote speaker was Dr. Barry Sears who is the inventor of the zone diet. We had read a book from him before the conference and were excited to hear him speak in person. We liked the book; we liked the talk, so we cut out sugar, starchy foods and stuck to a diet where the calories derived 50% from low-glycemic, complex carbohydrates, 25-30% from lean meat, poultry and fish. Calories derived from fat were reduced to about 15-20% (there is hidden fat even in lean meat). No butter, but instead some lean cheeses and olive oil for cooking and in salad dressings. We shed both 50 pounds within 3 months without any hunger pangs. Our energy increased and this has stayed  this way ever since. There was no problem getting down with our BMI’s (body mass index) to 23.5 or 24.0, which is usually viewed as normal by the medical profession. We noticed, however, that when we did not exercise, there was a problem maintaining our normal weight.  We are under the care of an anti-aging physician who did special tests like fasting insulin, C- reactive protein, and hormone tests. They were all normal. We took up ballroom dancing really seriously having been inspired by “Dancing With the Stars”. This was 6 years ago. What started innocently with only a few basic ballroom lessons three times per week has now blossomed into dancing more than 10 different dance styles 5 times per week.

Long-term Multistep Weight Management

Long-term Multistep Weight Management

3 ½ years ago both of our energy levels were slowly going down, particularly after a long night of dancing. Hormone tests revealed the initial stages of age-related hormone deficiencies which did not come as a surprise , as  decreasing hormone levels was a topic discussed  in detail at the conference in San Diego in 2001 (we also attended several other anti-aging conferences on a yearly basis from 2009 onwards). With bioidentical hormone replacements these levels normalized within one year, our energy was back and our weight stayed normal. We enjoy travelling, but there can be problems with our multistep weight management program. We need to watch our diet (no toxins, preferably only organic food), and physical exercise may be less regimented. In 2008 we read Suzanne Somers’ book “Breakthrough”. We ordered urine tests for toxic metals and we were shocked that we had noticeable levels of mercury and lead. Since then we started to cut our salmon consumption from 3 to 4 times per week down to once or twice per week. To get rid of the heavy metals we started intravenous chelation treatments with vitamin C (10 Gm) and Glutathione (1250 mg) every two weeks. In July 2012 there were reports of radioactive salmon from the Japan nuclear disaster earlier that year in the Canadian media. After this news we stopped eating all fish and other seafood, not only because of radioactivity, but also because of other toxins like mercury, cadmium, PBC’s etc.  We do take high doses of molecularly distilled omega-3 fatty acids along with our other supplements. We also started eating mostly organic foods as we do not want to ingest insecticides, herbicides and other toxins.

We acquired body composition scales, which give information about fat percentage including visceral fat percentage, muscle mass percentage, BMI, weight and the basic metabolic rate. We wanted to define the end point of what our ideal body weight would be. We noticed that our dance program was not good enough to lower the BMI below about 23.5; using the body composition scales we noted that our body fat content was still too high and the visceral fat percentage was still in the 6% range. It took a prolonged trip to the US where we could not find enough dance events to decide that we would introduce a one hour gym program consisting of 30 minutes of treadmill, 15 minutes of upper body circuits, and 15 minutes of lower body circuits every day as a basis to our exercise program. Any dance activity would be just an additional exercise on top of the base exercise from the gym. It took only about 2 months before our fat composition decreased, our muscle mass increased, the visceral fat went to a normal at 5% and the BMI was now stabilized at the 21.5 to 22.0 range. We feel a lot more confident in managing our weight long-term without really thinking much about the weight. It is now a routine we follow, like an athlete would do to stay in shape. While nobody has a permanent guarantee to everlasting health, we do it to prevent the diseases we do not need in our retirement like diabetes, arthritis, heart attacks, strokes, cancer or Alzheimer’s.

What we did not know until after the 20th A4M Anti-Aging Conference in Las Vegas (mid December 2012) was that inadvertently we were protected from exposure to chemically modified wheat from 2001 onwards as we had cut out all refined carbohydrates and starchy foods (including wheat) since then. Unfortunately many Americans still expose themselves unknowingly to larger or smaller quantities of wheat, suffer from leaky gut syndrome with the associated changes in the immune system and the development of autoimmune diseases.

Personally, I believe that long term weight management is possible: you can turn older and hopefully wiser…not wider. The good news: it can be done. The bad news: this is not an instant fix, but a program that needs to be part of your lifestyle package.

More information on weight loss: http://nethealthbook.com/health-nutrition-and-fitness/weight-loss-and-diet/

Last updated Nov. 6, 2014

May
01
2004

Chronic Inflammation Causes Cancer, Heart Attacks And More

When the Time Magazine devotes 7 full pages in the March 22, 2004 issue to the topic of inflammation as the source of most of the diseases of the Western World, you know that something important is happening in medicine. Christine Gorman and Alice Park have summarized some of the groundbreaking research of the past few years in this article. I will report about this article here, but also include direct links regarding some of the relevant research the authors have mentioned including some of the key links regarding the metabolic syndrome, which was not mentioned in the article.

Since the beginning of the obesity wave in North America it has become obvious that a cluster of diseases such as heart attacks, strokes, Alzheimer disease, cancer of the colon, multiple sclerosis, arthritis and others have also become more frequent. Dr. Paul Ridker, a cardiologist at Brigham and Women’s Hospital, was one of the pioneers of investigating inflammation as a possible cause and the common denominator of these diverse illnesses. He noticed that certain patients got heart attacks although their blood LDL cholesterol levels (the “bad” cholesterol) were normal. The theory at that time was that all patients who would develop heart attacks would come from a high-risk group of patients with elevated LDL cholesterol. The problem was that 50% of patients with heart attacks had normal LDL cholesterol levels. Dr. Ridker suspected that the C-reactive protein (CRP), which is found to be elevated in the blood of rheumatoid patients, would be somehow involved in the disease process of hardening of the arteries before a heart attack would occur. CRP is produced by the liver cells and by the lining cells of arteries in response to a general inflammatory reaction in the body. Examples of this would be rheumatoid arthritis patients and patients with autoimmune diseases, where CRP levels can be readily measured with a blood test. Dr. Ridker found that there was a very good correlation between the CRP level and the degree of inflammation as well as the risk for developing heart attacks and strokes. Further investigation by others confirmed that CRP levels were perhaps more important than LDL levels in predicting impending heart attacks. This is so, because CRP is the body’s substance in the blood stream that would be responsible for breaking up LDL containing deposits (plaques) in the walls of the arteries, which leads to heart attacks in the heart and to strokes in the brain.

Chronic Inflammation Causes Cancer, Heart Attacks And More

Chronic Inflammation Causes Cancer, Heart Attacks And More

Other investigators found that CRP was only one link in a complex chain of events that includes inflammatory substances (cytokines) from the fat cells as well as insulin and insulin-like growth factors from the metabolic syndrome. Leptins are also a factor as has been discussed under this link.
Dr. Steve Shoelsen from the Joslin Diabetes Center in Boston has developed a mouse model for the metabolic syndrome. These mice will produce huge amounts of inflammatory substances in their fatty tissue in response to any inflammatory process that is started in them. Anti-inflammatory drugs such as the statins or metformin, it is hoped, will be shown conclusively to dampen the inflammatory process and prevent heart attacks, strokes and diabetes as well as cancer, Alzheimers disease and arthritis. Heart disease has already been shown to be improved by anti-inflammatory drugs. Asthma is an inflammatory disease of the small bronchial tubes, which can be stabilized with the anti-inflammatory drug Avastin.

What can we do as consumers to prevent some of those life-threatening diseases? By reducing our weight through calorie restriction on a low-glycemic diet we can help to reduce the insulin-like hormone substances of the fatty tissue. Regular exercise of at least 30 minutes of a brisk walk daily or the equivalent of other sports activities will half our risk for colon cancer and many other cancers. A diet rich in fruits and vegetables as well as fish and fish oils will reduce the amount of free radicals in our system cutting down on the circulating inflammatory substances. This prolongs life, prevents all of the major diseases of modern civilization and leads to longevity as the study of the Okinawa diet has shown.

Based on an article in the Time Magazine, March 22, 2004 edition, page 54 to 60.

Here is a chapter on arteriosclerosis from the Net Health Book, which explains inflammatory changes of the arterial wall:

http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/

Last edited October 26, 2014