Oct
30
2021

Acetaminophen Damages the Fetus

Many women take acetaminophen when pregnant, but acetaminophen damages the fetus. It is important to realize that acetaminophen is a common over-the-counter pain reliever. In addition, it is also often combined with codeine as headache pills. Acetaminophen goes under these brand names: Tylenol, Tylenol Arthritis Pain, Tylenol Ext and Little Fevers Children’s Fever/Pain Reliever. The international name of acetaminophen is the name “paracetamol”.

An international group of 13 scientists are calling health care professionals to limit the use of acetaminophen in pregnant women. CNN reported about this under this link.

These scientists published an article in the medical journal Nature on the dangers of paracetamol use in pregnancy.  Specifically, they said that acetaminophen can alter fetal development, which includes reproductive, neurodevelopmental and urogenital disorders.

History of acetaminophen

The chemical name for acetaminophen is N-acetyl-p-aminophenol. Acetaminophen is simply a shortened version of that chemical name. It was introduced in the US in 1955 as Tylenol® and in the United Kingdom in 1956 under the brand name Panadol®. In particular, acetaminophen was recommended to control fevers and to help with pain control.

In the 1960’s the Swiss watch industry provided workers who complained of headaches freely with acetaminophen. With this in mind, within a few years studies showed that many of these women who took a lot of this medication developed kidney problems. This led to an increase of the creatinine level in the blood. The kidney damage from acetaminophen was dubbed “phenacetin kidneys”. Outside of the US acetaminophen has the name phenacetin. Many of these patients subsequently had to receive dialysis and later kidney transplants.

Acetaminophen toxicity

The recommended dose of acetaminophen is 650 mg to 1000 mg 4-6 times daily, not to exceed 4 grams/day. The therapeutic window for this drug is very narrow, because 7.5 grams per day to 10 grams per day are already toxic. For children the dose is 15 mg/kg every 6 hours to a maximum of 60 mg/kg per day.

The other known toxicity concerns liver function. This article about Tylenol toxicity explains this in more detail.

Many people do not know about the limit for the over-the-counter acetaminophen and take too much for a fever or a painful condition. Just because a drug is available over the counter does not mean that it is harmless. If you don’t watch for toxic levels, you could end up dead or find yourself waiting for a liver transplant.

New evidence that acetaminophen damages the fetus

91 scientists from Australia, Brazil, Canada, Europe, Israel, Scotland, the UK and US have signed a declaration. In it they ask pregnant women not to take acetaminophen “unless its use is medically indicated”. Among the reasons for the declaration is that acetaminophen certainly can cause neural tube defects and cardiovascular disorders in fetuses. Pediatrician Dr. Leonardo Trasande, director of environmental pediatrics at NYU Langone Health, did not partake in this research. He has done safety studies on acetaminophen and pointed out the similarity in chemical structure between acetaminophen and phthalates. Like phthalates acetaminophen disrupts the reproductive development in animals and humans.

Evidence for neurodevelopmental disruption

Dr. Shanna Swan, a professor of environmental medicine at the Icahn School of Medicine at Mount Sinai in New York said: “There’s enough evidence to find increased risk of undescended testicles and a shortening of the anogenital distance, which is a predictive of later decreased sperm count and decreased fertility. We also see impaired ovarian function which has consequences for later fertility, although females have been less studied.”

The conditions that relate to acetaminophen toxicity were attention deficit hyperactivity disorder (ADHD), behavior abnormalities and autism spectrum disorders. In addition, language delays, conduct disorders and decreased IQ were due to neurodevelopment disruption from acetaminophen toxicity.

Mechanism of action of acetaminophen and side effects

Acetaminophen has been on the market for over 60 years. But scientists still don’t know exactly how it acts in the body to help control pain and reduce fever. There is a consensus that acetaminophen acts on the central nervous system inhibiting the synthesis of prostaglandins. These biological compounds have a leading role in causing fever, pain and inflammation. But the scientific proof for this consensus is still outstanding.

Side effects

There are a multitude of side effects that can occur with the use of acetaminophen. Common side effects are hives, itching, swelling of the mouth and throat and tingling in the mouth or throat. Other side effects are swelling in the face or hands, breathing difficulties or chest tightness. Acetaminophen can cause a loss of appetite, nausea and vomiting. Severe stomach pain can be another symptom of acetaminophen side effects. As you can see from the above link there are many more known side effects of acetaminophen.

Acetaminophen Damages the Fetus

Acetaminophen Damages the Fetus

Conclusion

Acetaminophen (=paracetamol, phenacetin) is a popular over-the-counter fever and pain remedy. But a narrow therapeutic width can cause serious overdoses where both the liver and the kidneys suffer irreparable damage. When people unknowingly take too much acetaminophen, they enter into the toxic range. This can cause disability and death. Kidney damage from acetaminophen became known as “phenacetin kidneys” already in the 1960’s in female workers of the watch industry in Switzerland. They developed headaches from constantly working with magnifying glasses and had free access to acetaminophen provided by the employer. Later, in North America liver disease developed when patients overdosed with over-the-counter acetaminophen for fever and pain control.

Interruption of fetal development from exposure of the fetus to acetaminophen 

At the present time the focus is on newer findings of researchers. They noticed that exposure of pregnant women to acetaminophen damages the fetus. This results in undescended testicles and a shortening of the anogenital distance which is a predictive of later decreased sperm count and decreased fertility. These are findings for males. Findings in females are less studied at this point in time. Dr. Leonardo Trasande pointed out the similarity in chemical structure between acetaminophen and phthalates. Like phthalates acetaminophen disrupts the reproductive development in animals and humans. Patients should take acetaminophen only under supervision with doses that are safe. The old notion that acetaminophen would be safe in pregnancy is no longer true in light of the new medical findings. Any pregnant woman should discuss with her physician what she can safely take.

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Oct
28
2017

Take Enough Vitamin D3

Many people supplement with 300 to 400 IU of vitamin D3, but do they take enough vitamin D3? There is a simple way of finding out: ask your doctor to order a 25-hydroxyvitamin D blood test.   This will show whether the gut absorbed enough of the essential vitamin. It will also show whether or not your vitamin D3 capsules or tablets were strong enough. It is now generally accepted that a good range of the vitamin D blood level is between 50 and 80 ng/ml. Unfortunately many Americans who come down with various diseases have blood levels of less than 30 ng/ml. Here are some facts about what a lack of vitamin D3 can cause.

Increased risk of mortality with lower vitamin D levels in ICU patients

  1. A New England Journal study from 2009 reported about 1100 patients in Intensive Care Units (ICU). Their average vitamin D blood level was only 16 ng/ml. They tracked the mortality rates depending on the vitamin D blood level. Insufficient vitamin D levels showed an association with a mortality rate of 45%. An intermediate level had a mortality rate of 35%. And a satisfactory level of vitamin D had a mortality of only16%. Between the low level of vitamin D and the normal level there was a 3-fold difference in mortality!
  2. Another study from 2015 repeated the mortality study with 135 ICU patients. Researchers correlated Vitamin D blood levels with mortality rates of patients. When vitamin D levels were below 12 ng/ml, there was a mortality rate of 32.2%. Patients with higher levels of vitamin D had a mortality rate of 13.2%. The authors concluded that vitamin D blood levels were an independent risk factor for mortality. Patients less than 12 ng/ml had a 2.4-fold higher risk of dying than patients with normal vitamin D levels.

Do patients with multiple sclerosis take enough vitamin D3?

Perhaps one of the earliest results of vitamin D3 research was the following observation. More than 90% of patients with multiple sclerosis were deficient in vitamin D blood levels. Their levels were below 20 ng/ml. Other researchers showed that vitamin D could directly tone down the aggressiveness of the immune cells of MS patients. These were the ones that attacked the myelin sheath. As a result of this knowledge it is important for MS patients to take high enough vitamin D3 supplements. When they reach good vitamin D blood levels their MS is better controlled.

Canada as a northern country has 291 MS patients per 100,000 people. Contrast this to 110-140 MS patients per 100,000 people in the northern US (between the 37th parallel and the US/Canadian border). In addition south of the 37th parallel there are only 57-78 cases of MS per 100,000 people. Researchers have concluded that the less sun light people get, the higher the rate of MS in the population will be. However, instead of sun exposure you can supplement with vitamin D3 capsules to get the blood vitamin D levels up to the range of between 50 and 80 ng/ml.

Do stroke patients take enough vitamin D3?

Strokes are very common. About 6.8 million Americans survive a stroke and live with various disabilities. 15% die shortly after their stroke. 40% are left with moderate to severe disabilities. Many require special care.

  1. Studies have shown that patients with the lowest level of vitamin D have the poorest functional outcomes. Moreover, for every 10 ng/ml decrease in vitamin D levels the odds of a healthy recovery 3 months after the stroke fell by about half. This was independent of age and the initial stroke severity.
  2. In another 2015 study from South Korea 818 stroke patients took tests to evaluate whether they had adequate vitamin D blood levels. There was a clear division between those whose levels were higher than 10 ng/ml or lower. When the vitamin D level was higher, there was a 90% better recovery from their stroke after 3 months. In comparison those whose vitamin D levels were below 10 ng/ml had poor recovery rates. Experts say that vitamin D levels should stay in the range between 50 and 80 ng/ml. This will prevent numerous diseases.

Do diabetics take enough vitamin D3?

  1. Vitamin D3 can silence diabetes genes in connection with the right diet and cofactors of zinc and magnesium. A Mediterranean diet can stabilize the metabolism and fight inflammation. Zinc and magnesium are important cofactors in enzymes necessary to prevent diabetes. Vitamin D3 and omega-3intake are helping to control inflammation and preserve beta cells in the pancreas in diabetes patients. This is important for continued production of insulin.
  2. A Chinese research team found that vitamin D3 protects beta cells in the pancreas from dying off. The finding was that vitamin D3 receptors in the insulin producing cells prevented the dying off of these cells, as long as there was enough vitamin D available. Insulin production by the pancreas remained effective. And insulin is vital for long-term survival of diabetes patients. The key for diabetes patients is to take adequate doses of vitamin D3 to protect their insulin producing beta cells.
  3. A 2015 Italian study showed that micro vascular complications in diabetes patients were high, if the vitamin D3 blood levels were low. If patients had high levels of vitamin D3, there were no complications such as retinopathy or nephropathy. But if levels were below 20 ng/ml, damages were significant in the capillaries of the eyes and kidneys.

Do patients with inflammatory conditions take enough vitamin D3?

What do the lining of the arteries, the inflamed joints, a degenerative meniscus and heart attacks and strokes have in common? It is the inflammation that changes the body chemistry. It gets even more complicated, because the extra calories that we consume get stored as visceral fat. This is done automatically when you eat too much sugar and starchy foods. When the glycogen stores are full, any surplus sugar gets metabolized by the liver into triglycerides, fatty acids and LDL cholesterol and gets stored as body fat. The most active fat is the visceral fat between our guts and around our body organs. This produces interleukins and other inflammatory cytokines that circulate in the blood causing inflammation in all our arteries. Interleukin-6 is an inflammatory cytokine. High interleukin-6 levels contribute to causation of various cancers.

This 2015 study from Seattle University followed 218 obese postmenopausal women with a body mass index of larger than 25.0 for 12 months. Both received weight loss intervention and either 2000 IU of vitamin D3 daily or a placebo pill. Both groups lost about 5 to 10% of weight in 12 months. However, the interleukin-6 level of the vitamin D3 group had a reduction of 37.3%. This was in stark contrast to the placebo group where the interleukin-6 level reduction was only 17.2%. This type of research shows the incredible power of vitamin D3. This likely is the reason why several cancer frequencies can show a reduction with regular vitamin D3 supplementation.

Attention deficit disorder and vitamin D3

  1. Other research compared a group of 37 children with attention deficit hyperactivity disorder (ADHD to 37 normal children. Blood levels of vitamin D were 19.11±10.10 ng/ml in the ADHD group and 28.67±13.76 ng/ml in the normal group. Other researchers have found similar findings, establishing that very low vitamin D levels have a connection with ADHD.
  2. A prospective study from Spain involving 1,650 mother-child pairs investigated the effect of mother’s vitamin D level during her pregnancy with the risk for ADHD by the time the child was 4 to 5 years old. Schoolteachers followed the standard test procedures to establish the ADHD diagnosis. The study showed that for every 10-ng/ml increment of the mother’s blood vitamin D level during her pregnancy the children had 11% less ADHD-like symptoms. The authors cautioned that it takes mega doses of vitamin D3 to reach these kinds of results. The usual 400 IU of vitamin D3 per day will not achieve the desired increase of vitamin D3 levels, but amounts of 5,000 IU to 8,000 IU are necessary to achieve this.

Schizophrenia and vitamin D3

A 2014 Meta analysis found that low vitamin D levels have an association with a 2.16-times higher probability of having schizophrenia than controls with normal vitamin D levels. Another study examined whether those patients who had an acute psychosis would have lower vitamin D blood levels than schizophrenia patients in remission or control patients without schizophrenia. Studies compared 40 patients with an acute psychosis to 41 patients in remission and 40 healthy controls. Patients with an acute psychosis had extremely low vitamin D blood levels, while patients in remission had much better vitamin D levels. Healthy controls had the best vitamin D levels.

Absorption and metabolism of vitamin D3

Magnesium plays a central role in activating vitamin D3. This publication points out that magnesium is also necessary for absorption of vitamin D3 in the gut. The activation of vitamin D3 is also partially responsible for vitamin D absorption. Both vitamin D3 and magnesium play an important role in bone and calcium metabolism. The fact that every body cell has vitamin D3 receptors shows how important it is for the maintenance of the body. Many researchers say that vitamin D3 qualifies as a hormone because of the specific effects on cells via vitamin D3 receptors.

Take Enough Vitamin D3

Take Enough Vitamin D3

Conclusion

Vitamin D3 is an important signaling hormone and vitamin that regulates the body’s calcium absorption and is responsible for bone metabolism. Research has shown that the lack of vitamin D3 causes several unrelated diseases, like rickets, multiple sclerosis, and schizophrenia. But other diseases, where a lack of vitamin D3 was present, were diabetes, attention deficit disorder and strokes. When patients with elevated inflammatory markers take vitamin D3 their interleukin-6 levels dropped by 37.3%. To achieve this, patients needed to consume at least 2000 IU. We all should have our vitamin D blood level measured from time to time. It should be between 50 and 80 ng/ml. Too many Americans are deficient in vitamin D3 and come down with the diseases mentioned! Prevention and supplementation go hand in hand. You can prevent a lot of diseases this way.

 

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Mar
29
2014

Alternative Treatment Of Hyperactivity (ADHD)

Attention Deficit Hyperactivity Disorder (ADHD or ADD, attention deficit disorder) has been in the spotlight on and off over the years. It affects 8% to 10% of school-aged children, and about 2% to 5% of adults who still have this condition.

Typically a parent receives a note from school that they must come to a teacher/parent meeting and it is discussed that the child is disruptive in class, not paying attention, interrupting the teacher inappropriately and forgetting to do their homework. The teacher suggests that this may be a sign of hyperactivity. The school nurse is also of this opinion and they suggest getting a prescription for Ritalin or Adderall (amphetamine type medications), drugs that have been shown in other kids to be fairly effective in treating the symptoms.

Next the child is seen by the doctor who confirms the diagnosis and Ritalin (methylphenidate) is prescribed.

In an attempt to quickly control the situation, the side effects of Ritalin are often not discussed in detail: agitation, insomnia, nervousness, anxiety, nausea, vomiting and loss of appetite, palpitations, dizziness, headaches, an increase in the heart rate, blood pressure elevation, and even psychosis (Ref.1).

It is easy to just write a prescription for Ritalin and hope that all is well. Had the parents heard of all the possible side effects, they may have asked whether there were alternative treatments available.

The causes of hyperactivity (ADHD)

The exact cause of ADHD remains unknown, but there is a clustering of this condition in some families, so there seems to be a clear genetic component (Ref.2). It appears that several genes are involved, namely those associated with serotonin and glutamate transporters, but also those affecting dopamine metabolism. Males are affected with ADHD more often than females (in children 3:1, in adults 1:1).

Alternative Treatment Of Hyperactivity (ADHD)

Alternative Treatment Of Hyperactivity (ADHD)

Some remarks regarding brain development are in order: Dr. Kharrazian describes that the grey matter of the brain develops before the age of 9 and the development of the white matter is completed by the age of 19 (Ref. 3, p.3). In ADHD patients the frontal brain is underdeveloped resulting in an inability to suppress unacceptable behavior, immediate desires and impulses. Prescription drugs may alter the behavior on the surface, but the frontal brain development is still lagging behind. The only thing that can influence this is behavioral/cognitive therapy and extra tutoring while the symptoms are controlled. The window of opportunity is closed by the time the ADHD patient has reached the age of 19. After that a juvenile ADHD turns into a permanent adult ADHD. The cases that had only childhood ADHD and outgrew it were the ones where the frontal lobe abnormalities had corrected themselves before the age of 19.

This review article has noted that there is an association between a Western style diet (sugar and fat rich) and ADHD.

Interestingly both Ref. 1 and 2, which I would categorize as having originated from mainstream conventional medicine circles, deny such an association. But the link also noted that a healthy diet with fiber, folate, and omega-3 fatty acids as well as supplementation with iron and zinc when these minerals are found to be low in the blood, do make a significant difference in ADHD patients towards normalization of their symptoms.

One of the under diagnosed causes of ADHD is gluten sensitivity as Dr. Perlmutter described in his book (Ref. 4, pages 150-158). This can spare the child or teenager the toxic side effects of anxiolytics, antidepressants or antipsychotics that may be inappropriately prescribed by their physicians, and a gluten free diet would allow the brain to recover very quickly in such cases. A food sensitivity history and some simple gluten sensitivity blood screening tests will diagnose this condition or rule it out.

To complicate matters even more, Dr. Amen has mentioned in several books that there are at least 7 different subcategories of ADHD that he has found in ADHD patients when studying thousands of single-photon emission computed tomography brain scans (SPECT brain scans). Dr. Amen mentions that the 7 subcategories of ADHD are the combined type ADD, the primarily inattentive ADD subtype, overfocused ADD, temporal lobe ADD, limbic ADD, ring of fire ADD and trauma induced ADD. Dr. Amen explains that each of these types needs to be treated differently and some of the treatment failures are explained by the fact that the wrong type of ADD was treated (Ref.5).

Treatment of ADHD

In the following I mention 5 steps that are useful for treating ADHD patients.

  1. A first step toward normalization of the metabolic changes in the brain metabolism of the affected child or adult is to adopt a diet that has been linked with low risk for ADHD: avoid food additives, cut out refined sugar, avoid known food allergies like gluten sensitivity and others. You may need to test the patient for food allergies using an elimination diet. Add a good amount of molecularly distilled omega-3 fatty acids (the pure form of omega-3 without mercury, lead or PCBs) as this has shown beneficial effects in ADHD patients.
  2. Involve a behavioral psychologist for behavioral/cognitive therapy treatments. This is particularly effective in the 9 to 19 year old category where the frontal region of the brain is still developing.
  3. Work together with the schoolteacher and get supplemental teaching in areas of academic weakness to reduce the frustrations in the classroom setting.
  4. In adolescent girls who just started their period, a relative lack of progesterone (estrogen dominance) may be a contributory factor. A small dose (20mg to 30 mg) of bioidentical progesterone from day 6 to 16 of the menstrual cycle may help significantly in alleviating the symptoms of ADHD. You may need to consult a naturopathic doctor or anti-aging physician to get a prescription for that.
  5. If all of this helps only marginally, then a smaller amount of Ritalin may be helpful; however, blood tests should be drawn from time to time to monitor for drug toxicity as the rate of absorption and elimination of the drug varies significantly from patient to patient.

It is interesting that studies have shown that a combination of Ritalin or Adderall with alternative treatment methods had a better outcome than either method alone.

Conclusion

It is important to think about the various possible causes of ADHD and not just get caught up in the knee-jerk reflex of treating ADHD with Ritalin (note that this was only step 5 above, if all the other things failed). In co-operation with the school system and using alternative ways at home first (change of diet, possible addition of low dose bioidentical progesterone cream in girls) and additional tutoring in weak school subjects the need for Ritalin may be avoided. If all else fails, the conservative approach is still available, but I suggest that drug monitoring (blood levels that should be done from time to time to avoid toxicity) is important.

More information about ADHD: http://nethealthbook.com/mental-illness-mental-disorders/developmental-disorders/attention-deficithyperactivity-disorder/

References

1. Ferri: Ferri’s Clinical Advisor 2014, 1st ed., © 2013 Mosby.

2. Jacobson: Psychiatric Secrets, 2nd ed., © 2001 Hanley and Belfus

3. Dr. Datis Kharrazian: “Why Isn’t My Brain Working?” © 2013, Elephant Press, Carlsbad, CA 92011

4. 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.

5. Daniel G. Amen: “Use Your Brain To Change Your Age” © 2012, Harmony Books, An imprint of Crown Publishing.

Last edited Nov. 7, 2014

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