Nov
21
2020

Antibody Treatment for Rheumatoid Arthritis Was Superior

Researchers found that antibody treatment for rheumatoid arthritis was superior to conventional therapy. In particular, rheumatoid arthritis is an autoimmune disease where autoantibodies attack the synovial lining of joints. In this case, subsequently macrophages are activated, which attack joint surfaces. As an illustration, this process leads to crippling joint deformities.

The original study was published in June, 2019, but this is difficult to understand. The magazine Sciworthy published a review article on August 24, 2020 with more understandable language.

To emphasize, in mouse experiments the researchers found that only a small subfraction of activated macrophages caused symptoms of rheumatoid arthritis. They were folate receptor beta (FR-β) positive macrophages. It is important to realize that the researchers found them both in mice with rheumatoid arthritis and in man. The evidence in humans were the same findings in human tissue samples of people with autoimmune diseases.

Details of mouse experiments

Folate receptor beta (FR-β) positive macrophages are key in mouse model of RA

Explicitly, the researchers started experiments with a mouse model of rheumatoid arthritis, because it is easier to do than human research. They found that the key to developing rheumatoid arthritis was the presence of folate receptor beta (FR-β) positive macrophages. Chiefly, macrophages remove cell debris, bacteria or viruses from the blood. However, once they are activated and they carry FR-β receptors on their surface, they destroy joints. Certainly, in the mouse model monoclonal F3 antibodies were developed that kill activated macrophages. On the contrary, the human equivalent for the F3 antibodies is monoclonal antibodies with the name m909. They are directed at the FR-β receptors on the surface of activated macrophages. But first to the mouse experiments.

Inflammation from intraperitoneal injection of thioglycollate

In the first place, the researchers created an inflammatory condition by injecting thioglycollate into their peritoneal cavity. They could demonstrate that inflammation did occur. With this in mind they found macrophages in the peritoneal fluid. There were a lot of activated macrophages in it. Histological slides were analyzed with the help of F3 antibodies. In this case they visualized the activated macrophages. Subsequently the researchers treated mice with varying concentrations of monoclonal F3 antibodies. They found that the higher concentrations cured intraabdominal inflammation of the mice.

Researchers used monoclonal F3 antibodies to treat mouse model of RA

The researchers treated collagen-induced arthritis next in a number of experiments. Several concentrations of monoclonal F3 antibodies were given to these mice. Other experiments showed that monoclonal F3 antibodies specifically attacked only the activated macrophages and killed them. The killing of the activated macrophages in the mouse model of rheumatoid arthritis cured the arthritis. Fig. 5 shows this.

Mice treated with maximum concentrations of monoclonal F3 antibodies showed decrease in bone density

Next the researchers treated rheumatoid arthritis mice with maximum concentrations of monoclonal F3 antibodies to treat the arthritis. The swelling of their paws went down completely. CT scans of the bone in the paws showed decrease in bone density, while untreated controls showed significant loss of bone density. Monoclonal F3 antibodies were indeed a cure for RA in mice (Fig. 6).

Human experiments

Researchers confined human experiments to tissue samples from patients with various autoimmune diseases. Skin biopsies from patients with psoriasis, scleroderma, and sarcoidosis showed the distribution of FR-β-positive macrophages by special staining. This staining technique used human monoclonal antibodies (m909) against human FR-β receptors on activated macrophages. The publication depicts images that show abundant activity in all three autoimmune diseases (Fig. 1).

Researchers examined tissue samples from other autoimmune diseases with monoclonal antibodies (m909) against human FR-β receptors. The activated macrophages including rheumatoid arthritis, Crohn’s disease, ulcerative colitis and idiopathic pulmonary fibrosis lit up on fluorescence microscopy. In addition, nonspecific interstitial pneumonia, chronic obstructive pulmonary disease, systemic lupus erythematosus, psoriasis, and scleroderma tested positive as well.

Future therapy possibilities of rheumatoid arthritis with monoclonal antibodies

A series of experiments showed that two mechanisms can eliminate FR-β-positive macrophages: complement-dependent cytotoxicity and antibody-dependent cell cytotoxicity. It means that there is a strong possibility that autoimmune diseases may be treatable with monoclonal antibodies. Fig. 2 summarizes these experiments.

Conventional therapy for rheumatoid arthritis

To explain, the conventional treatment approach of rheumatoid arthritis is to induce a disease remission with drugs. To this effect doctors use anti-inflammatory drugs like ANSAIDs, disease modifying anti-rheumatic drugs (DMARDs). For example, drugs like methotrexate and sulfasalazine belong into this category. Unfortunately, the conventional drugs have many serious side effects that often make the rheumatoid arthritis patient’s condition worse.

In contrast, the integrative medicine approach to rheumatoid arthritis is to use dietary measures to reduce the inflammation. The fasting mimicking diet is able to reduce the severity of the inflammation in RA patients.

Other authors described the use of the Mediterranean diet to reduce inflammation. In addition, there are a number of regenerative methods that help improve the condition of RA patients. Research described here proved that antibody treatment for rheumatoid arthritis was superior to conventional therapy in a mouse model.

Discussion

Monoclonal antibodies (m909) against human FR-β receptors targeting activated macrophages opened up a new therapy method against rheumatoid arthritis. The equivalent F3 antibodies in mice were a useful tool to expedite research in this field. The publication that I reviewed here was able to combine mouse experiments and work on human tissue samples essentially showing the same results . Monoclonal antibodies (m909) against human FR-β receptors work potentially like a broad-spectrum anti-inflammatory drug. The monoclonal antibodies reduce the accumulation of inflammatory immune cells, which treats the cause of rheumatoid arthritis. This will likely be the future cure of rheumatoid arthritis and other autoimmune diseases. We urgently need clinical trials to prove in humans that the findings from a mouse model and human tissue samples are correct.

Antibody Treatment for Rheumatoid Arthritis Was Superior

Antibody Treatment for Rheumatoid Arthritis Was Superior

Conclusion

Researchers recently showed in a mouse model that a small portion of activated macrophages cause rheumatoid arthritis (RA). But they also examined many biopsies from patients with autoimmune diseases. The findings in human tissue samples were identical to the findings in a mouse model. Activated macrophages are sensitised to attack the linings of joints as is the case with rheumatoid arthritis. These macrophages develop special receptors, called folate receptor beta (FR-β), and the macrophages release cytokinins. The cytokinins (TNFα, IL-1, IL-6, IL-12 and others) cause inflammation and make the RA worse. They also recruit more neutral macrophages and convert them into activated macrophages. The research group found that monoclonal antibodies against human or mouse FR-β receptors killed the activated macrophages. This alleviated the arthritic symptoms and after enough antibody treatments cured the RA. There were no negative effects on the rest of the immune system.

Physicians will cure human autoimmune diseases with monoclonal antibodies in the future

Researchers demonstrated this mostly in a mouse model. But the authors have manufactured human monoclonal antibodies against the FR-β receptors of activated macrophages. This has set the stage for curing human autoimmune diseases with monoclonal antibodies as well. At this point there is a need for clinical trials with various autoimmune diseases including rheumatoid arthritis with monoclonal antibodies against activated macrophages.

Dec
30
2017

Fasting Mimicking Diet

The fasting mimicking diet (FMD) was at the center of this year’s anti-aging conference in Las Vegas. This was the 25th Annual World Congress on Anti-Aging Medicine in Las Vegas, Dec. 14-16, 2017. Dr. Valter Longo, PhD reviewed some of the research he had done on longevity in yeast cells, worms and mice.

Fasting mimicking diet relevant in humans

Dr. Longo pointed out that this type of research has relevance in humans. If there was a cure for cancer, heart disease, stroke and diabetes, we would live 13 years longer. But if we stimulated longevity with this pulsed calorie restricted diet, we would live on average 30 years longer. There is a rare genetic abnormality where people are deficient for IGF-1, a growth factor produced in the liver. These genetically IGF-1 deficient people live longer and do not develop cancer. Observations like these and detailed mouse experiments inspired Dr. Longo to develop a new diet plan. Patients would receive a fasting mimicking diet on 5 days per month. The rest of the month would consist of a normal, balanced diet. 5 days of the month the person would consume a low 800-calorie diet. This is enough to ensure adherence to the diet, but low enough to lead to enormous metabolic changes including youth-preserving stem cell stimulation.

Clinical Application of fasting mimicking diet in cardiovascular health

Dr. Joel Kahn, Prof. of Medicine at the Wayne State University School of Medicine lectured later that day. He is also the Director at the Kahn Center for Cardiac Longevity. His talk was entitled “The Fast Track to Slow Cardiac Aging: Fasting &Targeted Nutrition”. He mentioned that a fasting mimicking diet was a powerful tool in cardiology to prevent heart attacks and hardening of arteries. He explained in detail the complex aging pathways that involve three components, IGF-1, mTOR and PKA. When lifestyle choices stimulate these genetic markers, accelerated aging is a consequence. But with the inhibition of those markers longevity can happen. He added that researchers looked at heart cells, where the same principles apply. Dr. Kahn pointed out that the basic research of Dr. Longo enables clinicians to see positive results in patients who follow caloric restriction for 5 days in a month on a regular basis.

How does the fasting mimicking diet work?

It is best to let one of the users of this diet explain how it works. Once per month you eat calorie-restricted food with only 800 calories per day and you follow this regimen for 5 days. Some patients receive 1100 calories for the first of these 5 days, if they have difficulties switching from normal food to the boxed food. Dt. Longo has developed boxed food, called ProLon (from L-Nutra). ProLon stands for “pro longevity”. Dr. Longo and Dr. LaValle mentioned at the conference that these prepared meals make it a lot easier for patients to stick to the low calorie diet. Three hundred dollars for the boxed food for 5 days are a stiff price, and this may well be out of reach for you.

Alternative way to make your own 800 calorie food at home

Nevertheless, this should not stop you. You can look at the ingredients online and copy the boxed food by creating your own balanced 800 calories per day food at home. It is true: you have to do some research! But counting calories and finding information about the caloric content of food on the Internet is not difficult. And preparing these very, basic, small and simple meals does not require a degree in nutrition. Here is another testimony from a user of the fasting mimicking diet.

Effect of the fasting mimicking diet on the metabolism

In the past it was thought that only ketogenic diets or periods of fasting would trigger longevity genes. But the basic research of Dr. Longo and others has shown that a low calorie diet for only 5 days can achieve the same thing. Longevity genes are activated; the negative aging pathways including IGF-1, mTOR and PKA are suppressed. The immune system gets activated from this. It also  leads to lowering of LDL cholesterol, triglycerides, blood pressure, insulin resistance, and diabetes improves. With the fasting mimicking diet the stomach sees some food, but the cells are fasting. According to Dr. Kahn this combination down regulates the body’s key nutrient-sensing pathways, which activates cellular regeneration and rejuvenation.

Clinical observations

Dr. Khan observed a high compliance rate with 3 cycles of the fasting mimicking diet. 94% of a group of patients were compliant over 3 months. Mild fatigue, mild headaches and mild weakness were present, but improved with each cycle. In addition to the above findings Dr. Khan found that there was weight loss, abdominal fat loss and waist circumference loss. There was also a reduction in IGF-1 levels, a reduction of the C-reactive protein and stimulation of stem cells.

Inflammation reduced, autoimmune diseases improved

The reduction of the C-reactive protein proves that semi-fasting reduces inflammation. The finding of stimulation of stem cells explains that regenerative processes can take place. Pain disappears, people report more energy and are generally feeling better.

There are other clinical findings. The positive effects from following the fasting mimicking diet last for several months. Also, when patients are on chemotherapy for cancer, the FMD will protect the healthy cells from the side effects of chemotherapy.

Dr. Kahn and Dr. LaValle noted that autoimmune disease responded to FMD. This was shown in both animal experiments using mice and in clinical case reports. Dr. LaValle described a 46-year old former Olympic athlete swimmer who had multiple sclerosis. After FMD she lost all of her muscle aches and cured her optic neuritis. This was something conventional medicine could not do for her.

Clinical applications of fasting mimicking diet

Here are some of the conditions that will respond to it.

  • Obesity, because of the weight loss effect
  • Diabetes: insulin resistance becomes lower and blood sugar levels drop.
  • High blood pressure reduced: many patients were able to reduce their medications or discontinue them
  • Prevention of heart attacks and strokes
  • Pain conditions will improve as all kinds of pain disappears, an effect for which at this point is no explanation
  • Autoimmune diseases like MS and rheumatoid arthritis improve, likely because of the effect of increased stem cell circulation
  • Prevention of heart attacks because of reduction of LDL, triglycerides and CRP
  • Cancer cure rates improved by protecting normal cells and bone marrow
  • Longevity improved in mice with a 3-fold increase of their life span. Telomere length in humans was increased. Increased stem cells will find defective areas that need repair. This effect will open up a new chapter in medicine.

Maintaining the achievements of the fasting mimicking diet

At this point the implications of this new approach to weight loss and metabolic rejuvenation can only be estimated.

Limiting calories for 5 days triggers a metabolic change, which is permanent. You can experience the full effect of this rejuvenating low calorie treatment. You can do it every month without having to fear vitamin or mineral deficiencies.

Here is another link to the website of Dr. Axe where the fasting mimicking diet is also recommended.

Fasting Mimicking Diet

Fasting Mimicking Diet

Conclusion

The 25th Annual World Congress on Anti-Aging Medicine in Las Vegas, Dec. 14-16, 2017 had a new theme. Several talks dealt with the fasting mimicking diet (FMD). It is a calorie-reduced diet for 5 days in a month that will reset your metabolism. But it will also stimulate your stem cells and can heal autoimmune diseases. If you need chemotherapy for cancer, it protects your bone marrow and improves cancer cure rates. The interesting thing is that the effects of this low calorie treatment persist permanently for many months.

With the help of this diet longevity has been shown in mice; there has been a threefold life expectancy boost. Smaller trials in humans have shown telomere lengthening and stem cell stimulation. It is too early to say what the long-term effects will be for humans. But you can treat yourself with the FMD for 5 days of every month on an ongoing basis. The other days of the month you are eating a normal diet. This will ensure that your metabolism stays in top shape.

A healthier and longer life

Practical applications for the FMD are huge. Patients with obesity, diabetes and pain conditions all benefit from this. High blood pressure drops. There will be prevention of heart attacks, and there is improvement in patients with autoimmune diseases. There is better cancer survival when on the FMD. Finally there is a strong possibility that you will live longer, but also stay healthier on this intermittent calorie restricted diet.

As Dr. LaValle said: it is “fasting with food”, and Dr. Kahn added: “Eat less, live more!”

More info:  Life extension through calorie restriction.

Incoming search terms:

Oct
08
2016

Vitamin D3 Protects Your Brain

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

Vitamin D3 protects your brain from multiple sclerosis (MS)

It has been known for some time that in the northern hemisphere MS is more common because of the lack of sunshine, which in turn produces less vitamin D3 in the skin.

MS is an autoimmune disease where immune cells attack the lining of nerves. Both nerve cells and immune cells have vitamin D receptors. It appears that immune cells are calmed down by vitamin D3 and remission of an MS relapse is more likely.

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

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

Progression and disability in MS patients with various vitamin D3 levels

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

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

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

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

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

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

Vitamin D3 protects your brain from Parkinson’s disease

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

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

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

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

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

Vitamin D3 protects your brain from Alzheimer’s disease

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

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

What does vitamin D3 have to do with this?

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

Specifically, the researchers found the following observations.

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

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

Vitamin D3 combined with metformin suppresses cancer

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

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

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

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

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

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

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

Vitamin D3 Protects Your Brain

Vitamin D3 Protects Your Brain

Conclusion

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

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

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

Mar
01
2014

Smoking Remains A Health Hazard

Recently new statistics came out that show that 48.8 million people in the US (19% of the population) still smoke. 22 % of the population are male, 17% female. Smoking is responsible for 20% of all deaths in the US (1 in 5 deaths). It is interesting to note that in the older age group (above the age of 65) only 8% are smoking, but 22 % of the 25 to 44 year old group is smoking. Among the American population Native Americans have the highest percentage of smokers (32% are smokers). 10% of Americans of Asian descend smoke. Blacks, Whites and Hispanics are placed in between them and the American Indians. Finally, people who can least afford it (who are below the poverty level) have the highest percentage of smokers (29% smoke) while 18% of people above the poverty level smoke. Education seems to have a protective effects when it comes to smoking: of the least educated group of people 45% are smokers while only 5% with postgraduate education smoke.

Effects of cigarette smoke on the body

As this link shows the concoction of various ingredients in the smoke of cigarettes causes various parts of the body to react differently to these chemicals. Here is a rundown of diseases caused by smoking cigarettes.

1. Lung cancer: This is the most common cause of death in women who smoke, more common now than breast cancer. 90% of lung cancers in women are due to smoking. The same was true in males, but as a group they now smoke less than in the past.

2. Other cancers:  cervical cancer, kidney cancer, pancreatic cancer, bladder, esophageal, stomach, laryngeal, oral, and throat cancers are all caused by smoking. Recently acute myeloid leukemia, a cancer of the bone marrow has been added to the list of smoking related cancers.

3. Abdominal aortic aneurysm: As cigarette smoke destroys elastic tissue, it is no wonder that the loss of support of the wall of the aortic artery leads to the development of large pouches, which eventually rupture with a high mortality rate due to massive blood loss.

4. Infections of lungs and gums: Smokers are prone to infections of the lungs (pneumonia) and of the gums (periodontitis).

5. Chronic lung diseases: emphysema, chronic bronchitis, asthma.

6. Cataracts: lack of perfusion of the lens leads to premature cataract formation.

7. Coronary heart disease: hardening of the coronary arteries, which leads to heart attacks, is very common in smokers.

8. Reproduction: reduced fertility in mothers, premature rupture of membranes with prematurely born babies; low birth weight; all this leads to higher infant mortality. Sudden infant death syndrome is found more frequently in children of smoking moms (Ref. 1).

9. Intermittent claudication: after decades of smoking the larger arteries in the legs are hardening and not enough oxygen reaches the muscles to walk causing intermittent pausing to recover from the muscle aches. If it is feasible a cardiovascular surgeon may be able to do a bypass surgery to rescue the legs, often though this is not feasible and the patients lower legs or an entire lower limb may have to be amputated.

10. Others: osteoporosis is more common in smokers; poor eye sight develops due to age-related macular degeneration that sets in earlier and due to tobacco amblyopia, a toxic effect from tobacco on the optic nerve; hypothyroidism is aggravated by smoking and menopause occurs earlier.

Smoking Remains A Health Hazard

Smoking Remains A Health Hazard

What happens in the lung tissue in smokers?

Ref. 1 gives a detailed rundown of the changes in the lung tissue as a result of exposure to cigarette smoke. The various components of cigarette smoke lead to an activation of special white blood cells, called monocytes that after stimulation turn into tissue macrophages. In addition neutrophils (regular white blood cells) also get stimulated. Between them they produce cytokines and chemokines and the neutrophils secrete elastase that digests elastic tissue in the lungs. Breakdown products of the elastic tissue serve as a powerful stimulus to the immune system to mount an autoimmune response. After some time of being exposed to cigarette smoke the immune system considers part of the lining of the lungs as foreign and cytotoxic lymphocytes attack the lining of the air sacs (alveoli). Lung specialists consider chronic obstructive pulmonary disease (COPD or emphysema) to be an autoimmune disease (Ref.1).

The sad part is that when this condition has progressed far enough, even quitting smoking may be too late to stop the autoimmune disease by itself as the body has been sensitized and the immune system is convinced that the altered lung tissue should be attacked. Add to this that carcinogenic substances and toxins in cigarette smoke damage the DNA of all cells and the energy producing mitochondria, and the stage is set for the combination of chronic inflammation and the release of free radicals to cause all of the diseases mentioned above.

Quit smoking still important

It is extremely important to quit as soon as possible to avoid the full-fledged sensitization of the immune system against ones own lung tissue. Studies have shown that 36% of survivors of heart attacks will successfully quit, 21% of healthy men with a known risk of cardiovascular disease will quit when asked to do so and 8% of pregnant women will quit. When a physician examines a patient in the office and asks a smoker to quit smoking 2% of these smokers will respond and still not smoke 1 year after this doctor’s visit. This may not sound like much, but it is an encouraging effect. Perhaps the most important fact is what I mentioned in the beginning of this blog: the least educated group of people smoked the most (45%) while the most educated people smoked the least (5% of people with a postgraduate education). My hope is that the Internet and other educational media will contribute to education to convince people how important prevention is.

Pharmacological assistance to quit smoking

Nicotine replacement therapy can involve any of 2- and 4-mg nicotine polacrilex gum, transdermal nicotine patches, nicotine nasal spray, the nicotine inhaler or nicotine lozenges. Discuss with your doctor what may be best in your case. Typically one of these products is used for 3 to 6 months.

Bupropion is an antidepressant with a nicotinic acetylcholine receptor affinity. Bupropion is useful to help with the withdrawal from nicotine addiction, which occurs in depressed or non-depressed people. It strictly has to do with the stimulation of the nicotinic acetylcholine receptor.  Typically the dose is 150 mg of a sustained released bupropion tablet per day for 7 days prior to stopping smoking, then at 300 mg (two 150-mg sustained-release doses) per day for the next 6 to 12 weeks. 44% quit at 7 weeks versus 19% of controls. A newer nicotine partial receptor stimulator, varenicline, has been compared to bupropion. It was slightly more effective in helping people to get off cigarettes. Varenicline is started at a dose of 0.5 mg per day for 3 days, then 0.5 mg twice daily for 4 days, followed by a maintenance dose of 1 mg twice daily. If nausea is a problem, lower doses can be used. Varenicline has been approved for a 3-month period with an option of a second 3-month period, if relapse occurs. Discuss with your doctor what is best for you.

According to Ref. 1 a combination therapy of bupropion and nicotine patch was more effective than either one alone.

Will power, hypnotherapy

Hypnotherapy to quit smoking has been popular, but is not as effective as it is often claimed. Will power, measured by the “placebo” response is quite effective given the fact that nicotine is very addictive and yet 19% in the placebo group were able to quit on their own. According to Ref. 1 varenicline treatment for 12 weeks produced abstinence for 9 to 52 weeks and was compared to bupropion and placebo. The abstinence rates were 23%, 15%, and 10% for varenicline, bupropion, and placebo. This means that will power was still 2/3 as effective as bupropion and 43% as effective as varenicline. Don’t underestimate will power!

Conclusion

The best scenario is to never start smoking. The second best is to quit as soon as possible. Unfortunately, the third scenario of continuing to smoke is still very prevalent worldwide. I have seen the damage done first hand in practicing medicine, which motivated me to never smoke. But I am aware of the difficulties of quitting because of the highly addictive nature of cigarette smoking. Where is the support from governments on this? The problem is that the government benefits from taxation of cigarettes. Nevertheless it is laudable that there are government sites through the CDC to help you quit smoking.

At the end we are all responsible for our own health. If you are presently smoking, psych yourself up for the day that you will quit. Quitting means that you are deciding actively to live longer. Studies have shown that it takes often several attempts before you eventually quit successfully.More information on some of the topics mentioned:

1. Lung cancer and other cancers: http://nethealthbook.com/cancer-overview/overview/epidemiology-cancer-origin-reason-cancer/

2. Heart attack: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

3. Chronic obstructive pulmonary disease: http://nethealthbook.com/lung-disease/chronic-obstructive-pulmonary-disease-copd/

Reference

1. Mason: Murray and Nadel’s Textbook of Respiratory Medicine, 5th ed.© 2010 Saunders

Last edited Nov. 7, 2014

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

Nov
09
2013

Successful Diabetes Treatment Requires Patient’s Discipline

90% of all diabetes cases are due to type 2 diabetes, which is associated with being overweight or obese. The other 10% are due to type 1 diabetes, which is caused by an autoimmune disease within the pancreas destroying the insulin producing beta cells. Diabetes, type 1 often occurs in childhood (hence the name “juvenile diabetes”), while type 2 diabetes is a condition of the middle aged and older population. There is however an alarming trend: overweight or obese youngsters are also being diagnosed with type 2 diabetes. Here I am discussing type 2 diabetes.

Causes that trigger diabetes

There is not just one way to get diabetes; it usually is a multifactorial disease. Sure, genetics play a minor role. But you need to have epigenetic factors to trigger the genes to develop diabetes: eating too much sugar, eating wheat and wheat products, drinking soda drinks that contain sugar or high fructose corn syrup. Alcohol binges can also cause diabetes as can accumulation of excessive weight (a body mass index above 25.0). Even when there is no genetic risk in your family (your family tree has nobody that came down with diabetes and all your ancestors lived into their 90’s), you can still develop diabetes, if you are exposed to one or more of the risk factors mentioned.

What is the reason why diabetes occurs?

At a Keystone Symposium from Jan. 27 to Feb.1, 2013 in Keystone, Colorado (Ref.1) leading scientific researchers gathered to discuss exactly this question. There seem to be several mechanisms, all of which lead to diabetes. It has been known for some time that in type 2 diabetes insulin resistance develops that renders the cells incapable of absorbing blood sugar (glucose) from the blood into the cells. It is because of this insulin resistance that doctors can diagnose diabetes when blood sugar levels are high.

Successful Diabetes Treatment Requires Patient’s Discipline

Successful Diabetes Treatment Requires Patient’s Discipline

There are at least 5 mechanisms that are presently known that can cause insulin resistance (and thus diabetes) by itself or in combination. For a deeper understanding of diabetes it is crucial to be aware of these. Without knowing the enemy, you cannot fight it.

1. When a person eats too much sugar or fructose the liver converts this into excessive fat that is accumulated in the body’s cells. As a result insulin receptors are becoming inefficient in absorbing sugar from the blood, and blood sugar levels stay high. The pancreas reacts to this by making even more insulin, which after a few years will cause the pancreas to fail in producing insulin. At this point the patient requires insulin or else gets into a diabetic coma.

2. Chronic inflammation is another mechanism that has been shown to cause insulin resistance. Obesity, the metabolic syndrome and diabetes have a common inflammatory denominator that results in insulin resistance. With the aging process there is also deterioration of mitochondrial function (mitochondria are the mini batteries inside of every cell that are responsible for you having energy). This causes fat accumulation and also insulin resistance. Exercise and weight loss are effective in combatting insulin resistance. Fasting has also been shown to improve insulin sensitivity.

3. The metabolism of visceral fat (the type of fat causing the apple appearance in obesity) is highly active and is associated with an increased risk for heart attacks and developing diabetes. The pear shaped woman runs less of a risk, as the fat around the hips is not metabolically active. On the other hand when these women enter into menopause, they also develop abdominal fat (apple-like fat distribution) with a high secretion of inflammatory substances causing insulin resistance, heart attacks and strokes.

4. Another mechanism of causing inflammation comes from invasion of organs with fat cells. The development of fat toxicity from these displaced fat cells can also cause insulin resistance. Heart cells have been shown to die from fat toxicity and in the pancreas the insulin-producing cells can be killed by fat toxicity as well causing diabetes or making existing diabetes worse.

5. Interestingly another line of research, namely researching binge drinking, has revealed that there is a short-term insulin resistance that lasts for several days until the alcohol has been properly metabolized. It is of concern that adolescents who are experimenting with binge drinking are very vulnerable to develop brain damage from this habit.

Consequences of insulin resistance

We know that insulin resistance is the cause for adult onset, type 2 diabetes. It is entirely preventable. But there are powerful influences on people’s lives that will allow one or more of these factors mentioned to cause diabetes. The most common cause is putting on excessive weight. The reason for this is that people like to eat fast foods, drink sugar-containing sodas, and feast on processed foods, bagels and cookies. The end result is a change of the metabolism with an increase in triglycerides from the liver, an increase in LDL cholesterol, particularly the very low-density lipoprotein sub fractions of cholesterol. It has been known for some time that this is the connection to the high, premature death rates from heart attacks in diabetics, in people with obesity and in people with the metabolic syndrome. Hardening of the arteries is accelerated by the deposition of foam cells in the walls of arteries. These are scavenger cells (macrophages) that have engulfed noxious fats. This leads to narrowed coronary arteries and also a general narrowing of arteries all over the body including the brain vessels. In diabetics hardening of the arteries is accelerated and leads to premature strokes, heart attacks and heart failure, kidney failure, blindness and amputations of limbs.

Important tests for borderline diabetics

I you have a fasting blood sugar that is above 100 mg/dL (5.5 mmol), but less than 126 mg/dL (7 mmol) you are considered to be prediabetic or “borderline diabetic”. In this case rather than waiting for disasters in terms of cardiovascular disease, take action and ask your doctor to do the following three tests.

a) Arrange for a glucose tolerance test where you are given 75 grams of glucose; then blood tests are taken at one, two and three hours after this challenge dose. These blood tests are checked for blood glucose levels and insulin levels and tell the doctor exactly what is going on in terms of your sugar metabolism. It shows the glucose clearance and also the insulin response from your pancreas.

b) Have a hemoglobin A1c test done: it shows how your blood sugars have been controlled over the last 2 to 3 months.

c) You also need a VAP (vertical auto profile) test, which tests your lipid profile. Both prediabetics and overtly diabetics have been shown to have lipid profile disorders. Apart from low values in sub fractions of HDL cholesterol this test will also measure the very-low density lipoproteins (VLDL), which has been shown to be responsible for heart attacks and strokes.

With these three tests your doctor can  tell you more accurately what treatment protocol you require to succeed in controlling or curing your pre diabetes or diabetes.

Conventional treatment of diabetes

The conventional treatment of diabetes is to send the patient to a dietician, to ask the patient to do regular exercises and to either start them on hypoglycemic drugs or on insulin injections. Unfortunately the dietician often will encourage the patient to eat “healthy multigrain bread”, which will stimulate your taste buds to eat more sugar, high fructose corn syrup and starchy foods making weight loss impossible. Often the treating physician is satisfied that a hemoglobin A1c of 7% or less is good enough for the diabetic. But non-diabetic people have a hemoglobin A1c of 4% and 5.6%. This should be your goal or you will suffer the consequences of uncontrolled diabetes.

This is what I would call the conventional, symptomatic treatment approach. This may be the approach for patients who are not willing to seriously change their lifestyles, but it is more powerful on the long-term to treat diabetes by treating the underlying causes.

Alternative treatment approach for diabetes

Based on the above discussion regarding the various causes of insulin resistance, it is important to analyze what would be the main contributory factors in your particular case of diabetes.

Here are some suggestions:

1. If you are on the typical North American diet, also known as Western diet, it would be important to face the fact that wheat, wheat products in processed foods and sugar including high fructose corn syrup are the main culprits in stimulating your appetite and making you a sugar and wheat addict. Ref. 2 describes this in detail and offers 150 recipes to overcome this addiction. For more information just follow this reference text. Essentially it is a wheat-free Mediterranean type diet without rice, pasta and bread. You will shed significant amounts of pounds within a short period of time and feel a lot more energetic (due to revitalization of your mitochondria). At the same time insulin resistance is disappearing, because the insulin receptors are fully functional again. The insulin production of the pancreas will go down to normal levels and fat from the visceral fat storage gets melted away resulting in less inflammatory substances circulating in your blood.

2. A regular exercise program in a gym with an aerobic component (30 minutes of treadmill for instance and 20 to 30 minutes of isometric machine exercises) will help you to lower the triglycerides, and increase the healthy HDL cholesterol. It will also improve insulin sensitivity and control inflammation in your body. The best is to exercise 7 days per week. Remember your body works for you 7/7 every week, but for those of you who need a little rest in between 5 days per week is still very good. You may have to adjust your medication and insulin dose downwards, ask your physician about that.

3. Cut out alcohol. This may sound radical to you, but studies show this to be true. I have not mentioned cutting out smoking (it is causing inflammation and insulin resistance), because this is an absolute must that is given. When it comes to alcohol, the famous 1 drink per day for cardio protective purposes may not show up statistically as a bad effect, but your body will nevertheless get the message and let you age somewhat faster than a person who stays sober all the time. Staying sober will allow your brain to think clearly and adhere to your overall lifestyle approach in treating diabetes. Cutting out alcohol protects your brain (including the hypothalamus), liver and pancreas and prevents the prolonged periods of insulin resistance mentioned above that last for days. By keeping your hypothalamus in good working order, your hormone balance will stay stable for as long as possible until you reach menopause (for women) or andropause (for men). When you reached this milestone, I suggest you engage in bioidentical hormone replacement, which I have reviewed here. Hormones are essential to keep you younger for longer.

4. It is useful to monitor your blood sugar with a home glucometer, as this will show you when your blood sugar normalizes. Stay in touch with your doctor at all times, as this will help you in your overall management of your diabetes. Also, you will want to discuss with your doctor that you should have a blood tests called “hemoglobin A1c” measured every three months to see how well your diabetes is controlled. It should be below 7% for sure, but better below 6%. Non-diabetic people have levels of 4% and 5.6%. You may not know that hemoglobin A1c is actually measuring the amount of advanced glycation end products (“AGE”) of red blood cells. These AGE substances essentially are firmly bound sugar/protein compounds that shut down the cell metabolism wherever they are formed. In my opinion it is best to aim at a hemoglobin A1c level of non-diabetic people (4% and 5.6%) to avoid the consequences of tissue damage of all vital organs, which is the reason why long-term diabetics have a life expectancy of 15 to 20 years shorter than non-diabetic persons. Some diabetic patients may benefit from the oral hypoglycemic drug, metformin (brand name: Glucophage), which has anti-inflammatory properties and is used in patients with type 2 diabetes and a high fasting insulin level, but this is a decision requiring your physician’s input.

5. Supplements: There are some supplements that are useful to take as an adjunct, like chromium, which helps insulin to transport glucose into the cell; alpha-lipoic acid, an antioxidant, which is useful to prevent glycation (formation of a complex between sugar and protein, which prevents normal cell functioning); and coenzyme-Q10, which supports your heart (A4M recommends 400 mg per day, higher than Dr. Weil’s link). Other supplements of merit are curcumin, cinnamon, genistein and silymarin (standardized extract of milk thistle), which suppresses a pro inflammatory molecule, which in turn helps to fight insulin resistance (Ref. 1). Omega-3 fatty acid supplements are anti-inflammatory and will improve insulin resistance as well (dosage 1000mg or more per day). According to Ref. 3 vitamin D3 is useful as a supplement for diabetics, because it activates DNA, is involved in cellular repair and deficiency of it is known to lead to higher mortality rates in diabetics. Ref. 3 recommends between 1000 and 4000 IU of vitamin D3 daily and suggests doing blood tests to measure effective vitamin D3 levels (keep 25-OHD in the blood between 30 and 80 ng/mL).

6.Patients whose pancreas no longer produces insulin will need insulin injections, but instead of using long-acting insulin once per day the best results in getting blood sugar control is by injecting insulin three or more times per day using short acting insulin. It is important to always monitor the blood sugar lowering effect by glucometer readings; the injections are best given just before meals (recombinant human insulin is the preferred insulin to be used). Ask your physician or diabetic coach for more details.

Conclusion

Diabetes used to be a dreadful disease that caused premature heart attacks, strokes, blindness, kidney failure, and limb amputations. With aggressive management of diabetes as well as strict lifestyle intervention this has changed. A diabetic who treats the causes of the illness can have a normal life expectancy. In many cases the initial diagnosis of type 2 diabetes can disappear, when treatment was started early enough and insulin resistance could be stopped in its tracks. Without the patient’s full co-operation disciplining him/herself to follow through on all of these recommendations the caregiver will fail in controlling the patient’s diabetes. It is the patient who owns the problem; it is the patient who needs to make every possible effort and follow through on all of the details of dieting, exercising, blood sugar monitoring using a glucometer and taking the required supplements.

More information on diabetes: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/

Reference

1. http://www.lef.org/magazine/mag2013/oct2013_2013-Keystone-Diabetes-Symposium_01.htm

2. 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.

3. Rakel: Integrative Medicine, 3rd ed. © 2012 Saunders. Integrative Therapy; Supplements.

Last edited Dec. 17, 2014

Nov
02
2013

MS Is A Multifaceted Disease

A new study was recently released that showed that MS is a multifaceted disease. A significant number of people without multiple sclerosis have narrowing of their neck veins. There is a new theory that chronic cerebrospinal venous insufficiency due to narrowing of veins outside the skull may be responsible in causing MS in a significant percentage of patients. Using venograms in MS patients and in controls without MS a recent study from the University of British Columbia, Vancouver, BC showed that normal controls also had narrowing of neck veins and the authors felt that this invalidated the vascular theory of MS. This story is based on this Lancet publication.

Brain oxygenation is what counts

What was not mentioned in this publication was that venous blood flow on the surface of the brain can get obstructed inside the skull. It’s all about brain tissue oxygenation; if the brain gets enough oxygen, all is well. If there were a lack of perfusion due to venous congestion inside or outside the skull, the patient would be in trouble.  I will discuss this further below.

In this blog I will discuss first how to diagnose MS, then mention some newer studies about neck vein circulation with SPECT scanning. I will then review various causes of MS and return to a discussion of the Vancouver study from above.

How MS is diagnosed

The physician can combine a number of tests to diagnose MS. This includes the patient’s symptoms such as balancing problems, double vision, memory problems, fatigue etc. Neurological examination, imaging studies like MRI scanning, lumbar puncture to examine the cerebrospinal fluid and evoked potential studies is what a neurologist orders. The physician requires all of these findings to decide whether the criteria for making a diagnosis are in keeping with all the symptoms of MS. In 2001 an international neurological panel developed the McDonald criteria for diagnosing MS, which were revised in 2010.

MS Is A Multifaceted Disease

MS Is A Multifaceted Disease

Newer ways diagnosing perfusion problems in MS patients (SPECT scan)

One of the newer functional scans is a SPECT scan. It shows areas where there is a lack of blood supply to the brain, but can also identify areas where too much blood circulates. Here is a site where the technique of the SPECT scan is reviewed in more detail.

SPECT scan results in MS patients

SPECT scans in MS patients showed a significant reduction in blood flow to the frontal lobes and to the left temporal lobe. Reduced activity of the left temporal lobe on SPECT scans correlated with MS patients having a deficit in verbal fluency and having a problem with verbal memory. This indicates that a reduction in blood flow to these areas of the brain associates with developing MS.

Perhaps a SPECT scan of the brain (which is where the action of MS is) may be a better indicator for MS than looking for veins in the neck by ultrasound or venograms, as SPECT scans look directly at brain perfusion. The question is whether these blood circulation problems in MS patients may cause deficiencies in the brain of oxygen, nutrients and possibly of other internal mediators.

Known causes of MS

There are a number of known causes of MS, which I will review below.

Autoimmune disease

As this link shows, MS is a disease due to inflammation of the brain. The area where there is inflammation leads to demyelination from loss of the myelin sheaths, which causes the white lesions visible on MRI scans of the brain. One such cause is an allergy to wheat and wheat products. Gliadin antibodies and anti-tissue transglutaminase antibodies were positive in a significant number of MS patients, but not in controls. This suggests at least in part that immunological causes are at play. I agree with this blog that describes that there is significant evidence that gluten intolerance can lead to MS and the positive tests that were found by researchers are likely just the tip of the iceberg.

Overlap of celiac disease and MS

Dr. William Davis describes in Ref. 1 and 2 that you can have celiac disease with no gut symptoms, in other words a person can develop autoimmune symptoms from gliadin and gluten sensitivity without diarrhea or bowel cramps. Dietary lectins, particularly the ones found in wheat lead to leaky gut syndrome and subsequently to autoimmune diseases. One of these autoantibodies can cause MS by destroying the myelin sheath. In a mouse model Mayo Clinic researchers have shown that an antibody injection can be used to block autoantibodies against the myelin sheath. Investigations are ongoing with regard to whether this type of treatment would work in humans as well.

Genetic factors

It is known that a human leukocyte antigen (HLA -DRB1) shows an association with the risk for developing MS. Caucasians have a higher risk of developing MS and they also carry the HLA-DRB1 antigen more often. Another genetic factor is a variation of the IL7R gene. You can read about it under the HLA-DRB1 link. On average the risk of getting MS in the general population is about 10 to 20%.

Nutrition and dietary factors

It has been described that vitamin D3 levels when obtained from in MS patients are low. Vitamin D3 can prevent against MS to a certain degree, so does sun exposure. In countries where malnutrition is common, MS occurs more often.

According to Dr. Terry Wahls who is a clinical professor of medicine at the University of Iowa Carver College of Medicine, a diet of vegetables, fruit, meat, no grain, no dairy, no sugar, no corn and no potatoes can cure MS. Dr. Wahls herself had severe MS in the past and cured it with the help of this diet!

Infections

Certain infections can cause MS. Probably the best correlation was found between the mononucleosis virus (Epstein Barr virus) and the later development of MS.

Chronic cerebrospinal venous insufficiency

According to Dr. Zamboni from Italy clogged veins in the neck can cause MS. Dr. Zamboni placed stents into neck veins that showed narrowing.  He found that about 50% of MS patients had improvement with the placement of stents. This allows the blood from veins around the brain to drain normally. This could improve brain circulation in the areas described above where SPECT scans detected a lack of blood supply to certain parts of the brain.

Discussion of the Vancouver publication

It is important to note that certain areas of the brain were not circulating blood as well as others. SPECT scans depicted the blood circulation of the brain. 50% of patients with chronic cerebrospinal venous insufficiency experienced a cure from MS with simple venous stent procedures. This is remarkable. Sure, the Vancouver researchers found that normal controls also have a significant amount of venous abnormalities in their necks. But this does not explain the successes in those MS patients who got better with a simple venous stunt procedure. We also need to be cognizant that Big Pharma sponsored the Vancouver study researchers.

Measuring brain circulation in MS patients

SPECT scans on both the control groups and the experimental MS groups before and after stent procedures need to be done. This way we know whether the brain circulation following stent procedures improved or not. However, this is what I would have expected to see. In other words more research is necessary by other investigators. The question they need to answer is whether or not the surgical stents provided help. Did the surgical procedure help to normalize their brain circulation or not?

Conclusion

Our knowledge regarding MS is getting more multifaceted as new research is emerging. Diet appears to be a major contributing factor, as vitamin D3 is essential for normal brain function and for a normal immune system. At the same time researchers identified grains and wheat as a cause of MS in a subgroup of patients. Leaky gut syndrome can cause autoimmune antibodies, which subsequently can bring on MS. Avoid the foods Dr. Wahls described as being causative in developing MS and you can improve MS remarkably or get cured. The same is true for avoidance of wheat and wheat products as Dr. Davis described.

Multifaceted causes of MS

In my opinion not every MS patient benefits from a stent, but vitamin D3 deficiency or a history of mononucleosis infection in the past does not explain the causation of every MS case. We simply do not have all of the answers yet. But we do have enough information to thoroughly investigate MS patients;  the treating physician will then use clinical judgment to decide which treatment would be the most suitable one for an individual MS patient.

More information on multiple sclerosis: http://nethealthbook.com/neurology-neurological-disease/multiple-sclerosis/

References

1. Stern: Massachusetts General Hospital Comprehensive Clinical Psychiatry, 1st ed. “DSM-IV SUBTYPES OF MDD”. Copyright © 2008 Mosby

2.  William Davis, MD: “Wheat Belly. Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2011.

3.  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

Oct
19
2013

Healthy Choices Start In Your Brain

You may have seen the CNN heading “Where is self-control in the brain?”  If we want to make any healthy choices in life including sound financial choices, we need a balanced brain that makes the right decisions for us.

Researchers at the Caltech in Pasadena, CA have examined this question in detail using functional MRI scans and found out that there are two loci on the frontal lobe of the brain that control your impulses: the “ventral medial prefrontal cortex” (red in this link) that processes your initial image (like seeing a delicious ice cream cone”) and the “dorsolateral prefrontal cortex”(green in this link), where you decide that this is not healthy for you because it has too much sugar in it. The Caltech researchers found a group of volunteers who were impulsive and made the wrong choice simply based on their taste buds without consideration for their health in general. An equally large group of volunteers was also found who had functional activity in the ventral medial prefrontal cortex and the dorsolateral prefrontal cortex, the latter of which modified the final decision into the healthy choice. The impulsive group made their decision to buy simply with the activation of only the ventral medial prefrontal cortex.

The researchers think that it is this kind of lack of balanced thinking that decides whether we are going to make the right or wrong health choices for ourselves. The sad part is that ultimately, the summation of bad health decisions during life can become the cause of developing dementia, such as Alzheimer’s disease. The good news is that many of the causes of dementia can be avoided, which means that the average person could prevent dementia. I will discuss this in detail here.

Causes of dementia

It is interesting to study patients with various forms of dementia as it is often in the frontal and temporal portions of the brain where brain cells are dying off resulting in impulsive buying, impulsive behavior and lack of recent memory. It is also important to recognize that a number of conditions or factors can cause dementia:

1. Genetic causes

Here is the

There are two types of frontotemporal lobe dementias, a tau-protein positive FTD and a ubiquitin-positive FTD, which has been shown to be due to a deficiency in progranulin. Both of these genetic defects are located on chromosome 17. In Alzheimer’s dementia, which occurs later in life there can be genetic defects at chromosomes 21, 14 or 19. Epigenetic factors like exercise, avoidance of alcohol, and taking omega-3 supplements can even partially prevent or postpone the onset of dementia from genetic causes.

Healthy Choices Start In Your Brain

Healthy Choices Start In Your Brain

2. Toxins like alcohol

Another example of how people can get dementia is through the effect that regular alcohol consumption has on our brains and bodies. This image of an MRI scan shows a normal brain for comparison on the left and  the MRI scan of the brain of a chronic alcoholic on the right.  When a chronic alcoholic has severe atrophy of the brain a psychiatric condition, called Korsakoff’s syndrome can occur. This psychotic condition as a result of the brain having been poisoned by regular alcohol intoxication. Essentially the toxic effect of high daily doses of alcohol have shrunk not only the surface of the brain, but also the deeper substance of the brain. The patient is psychotic, has loss of memory and is unable to care for him/herself.

3. Vascular damage to the brain

Strokes can cause vascular dementia that leads to Alzheimer’s disease-like memory loss. This link points out that diseases like hypertension, obesity, diabetes, atrial fibrillation, ischemic heart disease and dyslipidemia all predispose you to possibly get a stroke with subsequent dementia.

4. Traumatic head injuries

In boxers, football players and combat soldiers brain cells can get lost from repetitive head trauma leading to dementia (in this case it is called “dementia pugilistica”).

5. Infectious dementia

HIV in AIDS patients can affect the brain and cause an HIV-associated dementia. Bacterial meningitis and viral meningitis can kill brain cells and cause a form of dementia as well.

6. Immune disorders

We know that MS can go on to develop dementia as a late complication. In MS there are autoantibodies against myelin, the insulation material that surrounds nerve fibers. An important category of immune disorders is autoimmune disease that can cause dementia. The cardiologist, Dr. William Davis, has presented compelling evidence that wheat allergies can cause dementia, but if detected early and treated by a gluten free diet, this clears up the mind and stops further development of dementia (Ref.1 describes wheat allergies causing dementia; a wheat free diet is described in Ref.2).

7. Hormone deficiencies

A classical example is hypothyroidism, which in the past before thyroid medicine was available, often led to dementia. A simple blood test, TSH (thyroid stimulating hormone) can detect whether or not you are hypothyroid. The A4M recommendation for a normal level is below 2 (not below 5 as often reported by official lab value reports).

8. Lack of vitamins

Thiamine (=vitamin B-1) is often missing in alcoholics. If you are missing vitamin B-6 and vitamin B-12 in your diet, this can predispose you to develop dementia as well. Aging people lose a factor from the gastric mucosa (the intrinsic factor) that is essential to absorb vitamin B-12 in the mall bowel, which predisposes them to develop pernicious anemia and dementia. A simple vitamin B-12 injection can prevent this from happening.

9. Too much sugar consumption

Sugar consumption has skyrocketed in the 1900’s and keeps on going up in the new millennium as well. Here is a review that discusses the possibility that Alzheimer’s can be triggered by overconsumption of sugar. The higher the blood sugar levels in diabetics, the higher the risk for developing Alzheimer’s disease. A study in Seattle has confirmed this. High insulin levels are found in type 2 diabetes; they are responsible for making brain cells stimulate the production of the gooey substance amyloid that causes Alzheimer’s disease. The authors of this study showed this to be true both in humans and in animal models.

10. Lifestyle issues like lack of exercise, excessive weight (obesity, being overweight) and poor diet (fast foods) play an enormous role in terms of causation of dementia in addition to the other factors mentioned. On the other hand organic foods Lack of toxins) and a Mediterranean type diet will preserve your brain cells.

Treatment of dementia

At present treatment of dementia is very limited, as we do not have a complete understanding of dementia at this point. The traditional treatment of dementia outlined here will only marginally delay further deterioration of dementia, but ultimately fail. In my opinion this is because the medical profession has been concentrating on fighting the symptoms of dementia rather than the cause.

Given the list of known causes above, I like to give you 6 recommendations that will help you to prevent Alzheimer’s disease and dementia in general.

  1. I would suggest that you cut sugar out of your diet and replace it with stevia. This also includes dates, grapes, bananas; also wheat and wheat products and starchy foods like pasta, potatoes, rice and bread (see Ref. 1 and 2 for details). The manufacturers of soda drinks, pies and cakes will not be happy about this recommendation, but it will please your brain cells. You will also be surprised how easy it is now to lose weight, which will please you (this also lowers your risk for heart attacks and strokes).
  2. Severely limit your alcohol consumption to less than 1 drink for women and 2 drinks for men per day (better still would be to stay sober) unless you want to become part of the hospital population mentioned in one of the links at the beginning of this blog.
  3. Have your hormones checked, particularly your thyroid hormones, but also estrogen and progesterone levels in women and testosterone in men. Our brain cells have hormone receptors for a reason. They need to be stimulated by our hormones, even in menopause or andropause. Replace the missing sex hormones with bioidentical hormone creams and missing thyroid hormones with thyroid tablets (Armour is the best mix of T3 and T4 thyroid hormones, not Synthroid).
  4. Prevent repetitive brain injuries before it is too late. Rethink whether you really need to box, street fight, play football, rugby or hockey.
  5. Use vitamins for prevention of dementia: The B complex vitamins like B-2, B-6, B-12 (by injection); vitamin D3 has recently been shown to be effective in slowing down Alzheimer’s disease. Vitamin D3 is low in Alzheimer’s patients and vitamin D3 supplements will slow down this disease. Although vitamin C showed equivocal results, it does have some neuroprotective qualities and decreases β-amyloid production and acetyl cholinesterase activity. A Mediterranean-type diet (Ref.2) is also helpful in preventing dementia.
  6. Exercise daily. It will discipline you to stick to the other points mentioned above. It gives you some extra endorphins and will make you feel good about yourself.

Conclusion

Although we do not yet have a complete picture regarding Alzheimer’s disease and dementias, we do know enough to reduce our risk of getting them. When you cut out wheat and wheat products, autoimmune antibodies against your brain cells will not be produced, your opiate receptors in the brain will not be seduced to eat more and more sugar, starchy foods or high fructose corn syrup, so you will have no problem in cutting out high glycemic index foods (Ref.1). This will reduce insulin and reduce IGF-1 growth factors that would have made you vulnerable to produce the gooey amyloid substance that makes you lose your memory. The orbitofrontal part of your brain (particularly the dorsolateral prefrontal cortex) will be reminding you what you read here: healthy lifestyle choices start in your brain.

References

1. William Davis, MD: “Wheat Belly. Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2011.

2. 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 Oct. 19, 2013

Aug
03
2013

Treating Symptoms Not Effective, Find And Eradicate Causes

When you see a physician about a health problem, he or she general listens to your symptoms, examines you, comes to a diagnosis and then treats the symptoms. Medicine has been evolving since, anti-aging medicine has become more prominent and comprehensive medical practitioners have started to treat differently. The changing approach is best explained with some examples below. This is important as many general practitioners continue to treat symptoms and neglect to search for causes. Big Pharma is trying to keep the medical system in the “status quo” (the way it is), because they make big money by having general practitioners try out different ineffective medications (this way the profits keep on coming in.) One example is the cholesterol story. Only 50% of heart attacks are caused by high cholesterol, but physicians keep on prescribing statins whenever high cholesterol is found to prevent a heart attack. But the finding of high cholesterol could be caused by hypothyroidism (when the thyroid gland does not produce enough thyroid hormone). Diet can also play  a role, if the patient eats too many helpings of fatty meats and drinks alcohol regularly. Just prescribing statins to lower cholesterol is not the answer, treating the cause is!

I am going to describe 5 examples where usually symptoms are being treated instead of the causes. If you are in a hurry, just read example 3 below (gastritis and duodenal ulcer). After that you can skip forward and read the conclusion, where I will summarize what I think we should learn from this.

Treating Symptoms Not Effective, Find And Eradicate Causes

Treating Symptoms Not Effective, Find And Eradicate Causes

1)  Rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease where autoantibodies attack the joint surfaces. It is a multifaceted disease and typically requires a rheumatologist to get involved in the treatment. The standard treatment for RA is summarized in this link. Before engaging in these toxic treatments, it is very worthwhile to study this link and see, if any of your food components may have triggered your arthritis. Various agents in the food can contribute to the development of autoantibodies, such as wheat, soy, MSG, even salicylates. An elimination diet approach could pinpoint if there is any food component that may be the cause of your RA.

Dr.Lichten, in treating many RA cases has found (Ref.1, p. 85 and 86) that many patients had hormonal deficiencies, particularly a lack of DHEA when blood tests were done for this. DHEA is known to treat immune deficiencies and T cell responses were observed to raise 10-fold after DHEA supplementation; IGF-1 levels (an indirect measure of human growth hormone) increased and muscle mass improved when exercised as well along with DHEA replacement. RA patients responded well to relatively low doses of DHEA (25 mg daily for women and 50 mg daily for males). When other hormone tests are done to look for deficiencies, Dr. Lichten found sometimes thyroid deficiencies requiring hormone supplementation. Similarly when saliva tests are done to look for sex hormone deficiencies, there may be progesterone and/or estrogen deficiency in women and testosterone deficiency in males that needs to be replaced with bioidentical hormones. In RA patients there may be adrenal gland deficiency setting in, which can be diagnosed by a four-point saliva cortisol hormone test. Only these cases of true hormone deficiency will benefit from small doses of cortisol (the original bioidentical human hormone) given four times per day.

Here is a summary of the usual recommendations for home remedies for treating rheumatoid arthritis. Using electro acupuncture can be very useful for controlling chronic pain, but you still need to work out the cause for your particular case of RA.

2) High Blood Pressure

Most cases of high blood pressure (hypertension) are simply there without a particular cause. It used to be called “essential hypertension”, a fancy name meaning “essentially, we do not know the cause”. The doctor will start treatment with drugs to bring high blood pressure down. Before that the doctor is supposed to ask you to make a good effort to change your life style (cutting out additional salt, exercising, weight loss), but this is often glossed over and drugs are used right away. Drugs for hypertension are not harmless; here are some of the side effects.

The medical textbooks are not very clear on what causes high blood pressure. With renal causes (narrowing of a renal artery) a stent can be placed, the cause is treated and the blood pressure normalizes. As indicated, essential hypertension is the name for the majority of other cases of high blood pressure where officially no cause is known. Patients are usually put on life-long antihypertensive medications, often several drugs in combination, to bring the blood pressure down to 120 over 80.

Despite the notion that we do no know the cause of high blood pressure, we do know that a number of factors can contribute to developing high blood pressure: too much salt in the diet, too much nicotine from smoking and too much alcohol consumption.

A lack of nitrates from green vegetables can cause high blood pressure as well. Nitrates are necessary for the body to produce nitric oxide, a powerful messenger that dilates blood vessels lowering blood pressure. It is produced every second by the lining inside the walls of your arteries. Greens and vegetables, particularly beets, provide nitrates for nitric oxide production.

Nitric oxide, along with omega-3-fatty acid and prostaglandins are important in relaxing the arterial walls, thus lowering high blood pressure.

We also know that in diabetes and obesity high blood pressure is very common, because inflammatory substances circulate in the blood, which interfere with the normal production of the blood pressure lowering nitric oxide.

Treating high blood pressure with the conventional drugs will mask the real underlying causes.

The DASH diet has helped a lot of people to get their blood pressure under control. However, the limiting point in that diet is the amount of grains that are allowed. In my opinion, wheat and grains, starches and sugar are all empty calories and only stimulate your appetite because of the high leptin and gliadin content from wheat and wheat products. According to the cardiologist, Dr. William Davis, cutting these out will cure not only many cases of hypertension, but also diabetes and obesity. Many physicians have criticized him, but in my opinion his work is on solid researched ground. If a patient honestly gives lifestyle changes a try, many side effects and deaths from antihypertensive drugs could be avoided.

3) Gastritis and duodenal ulcer

You see your doctor, because lately you regurgitate acidy stomach contents. You may be diagnosed with gastritis and get a prescription for an acid suppressive drug. But before you take proton pump inhibitors (PPI) study the side effects here.

The interesting part is that many chronic gastritis cases are associated with a bacterium called H. pylori. Unfortunately it is now known that cimetidine, ranitidine and particularly PPI’s are treating the acid problem (the symptomatic treatment of acid suppression seems to work), but on the longer term they encourage H. pylori to grow more, particularly in the stomach. The bacterium undermines the lining of the stomach and the duodenum and interferes with the production of the protective mucous production, which is meant to protect you from gastritis and ulcers. Dr. Murray explains that the cause of gastritis, gastric ulcer and duodenal ulcer is the breakdown of the mucosal barrier (Ref. 3, p.73-75). So the symptomatic treatment of the H. pylori infection with triple therapy (2 antibiotics and a PPI) may be the medical treatment commonly accepted as the norm, but it does not cure H. pylori in many cases. Some patients develop diarrhea from a Clostridium difficile super infection as a result of the antibiotics from the triple therapy requiring even more expensive antibiotics for that condition. This only happened, because the patients’ symptoms were treated instead of the cause. The cause of gastritis and duodenal ulcers is a weakening of the lining in the stomach and the duodenum resulting in a breakdown of the mucous barrier. In some people dietary habits play a role, like too much cereal and wheat consumption with too little alkaline vegetables in the meals to neutralize the acid formation (see Ref. 2 for more details). However, when a simple licorice compound (DGL, which stands for deglycyrrhizinated licorice) is given, the symptoms from gastritis, acid reflux, and ulcers in the stomach or duodenum disappear. DGL supports the lining of the stomach and duodenum and reestablishes the defense against the acidy milieu. Not only that, but after a few weeks of DGL treatment all of the findings on endoscopy such as inflammation and ulcerations disappeared. Dr. Murray states that he has not encountered a case of gastritis or ulcer that would not have responded. It appears that the cause of gastritis and ulcers in the stomach and duodenum is not from too much acid, not from H. pylori infection, which appears to just be a concomitant infection, but actually is due to a breakdown of the barrier in the lining of the stomach and duodenum, which responds to DGL. The other interesting thing is that you can buy DGL in the health food store; the dosage is two to three chewable tablets on an empty stomach three times per day. According to Ref. 3 it needs to be taken 8 to 16 weeks, after which there is a full therapeutic response. Pepto-Bismol is another coating substance that is available over the counter and works well for minor stomach upsets.

4) Chronic back pains and insomnia

Many people see their chiropractor for chronic recurrent back pains and their physician for insomnia to get sleeping pills. It all depends what the underlying causes are of back pains and insomnia.

If there is a misalignment in the spine, a chiropractor doing manipulation would be a reasonable approach and the back pain symptoms often disappear. However, thyroid deficiency or adrenal gland insufficiency or adrenal gland fatigue may be the cause of back pains and muscle cramps. Unless the underlying cause is treated (in the case of hypothyroidism treatment with thyroid hormones), the back pains will stay. In fibromyalgia where muscle pains are all over the body, the standard treatment with antidepressants and pain pills just will not do it on the long-term. These patients require a detailed work-up with analysis of the hormonal status. Often they are suffering from a lack of thyroid hormones, a lack of sex hormones (in women a lack of estrogen and progesterone, in men a lack of DHEA and/or testosterone). But they may also have weak adrenal glands and a lack of growth hormone. An anti-aging physician (A4M) can order the appropriate tests and treat the underlying causes.

Fibromyalgia patients often have insomnia (sleep disorders). Dr. Lichten (Ref.4) recommends GABA in small doses (125mg to 250 mg) at bedtime along with 500 mg of L-tryptophan. He also recommends 4000 IU – 5000 IU of vitamin D3 (as often insomnia patients are deficient in vitamin D3) as well as 500 mg to 1000 mg of magnesium. If this alone is not sufficient, melatonin, 1 mg to 3 mg at bedtime will be beneficial. Dr. Lichten cautions that GABA leads to tolerance quickly, so it should only be taken 5 days out of 7 to allow the body’s receptors to recover. This alternative approach to treating insomnia will prevent many patients from getting addicted to sleeping pills (hypnotics).

5) Asthma symptoms

Not every case of asthma needs steroid inhalers and salbutamol or other bronchodilator inhalers as treatment. This link shows that low thyroid can also cause asthmatic symptoms of wheezing and shortness of breath. It is important to listen to the patient’s symptoms, but the treatment will only be successful when the cause is treated. Dr. David Derry described in this link how many of his severe asthma patients had iodine deficiency and low thyroid hormones and no longer had to see him when iodine treatment and desiccated thyroid hormone replacement was given as treatment. This goes against what the standard recommendation for asthma treatment is, but it seems to get patients unhooked from dependence on steroid inhalers.

Steroid dependency from anti-asthmatic inhalers can suppress the adrenal glands and lead to adrenal gland insufficiency.

The adrenal glands are vital for coping with stress as the more stress you are under, the more your pituitary gland produces ACTH hormone, which in turn stimulates the adrenal glands to produce cortisol. However, a significant percentage of patients with asthma that been on corticosteroid inhalers for a long time, experience a suppression of the pituitary gland and the adrenal glands cannot produce the required stress hormones; in other words, adrenal fatigue or adrenal insufficiency can set in.

This is an example where during the treatment of asthma symptoms were controlled with corticosteroid inhalers, but the stress hormone circuit was undermined to the point where the patient experienced another disease (called a “iatrogenic disease”, a disease from the side-effects of drugs). Treatment of adrenal fatigue is described in this link.

Conclusion

Medicine can become quite complex as these examples show. Many times physicians tell their patients that the cause of their symptoms is not known. However, this is not always true, but conventional medicine continues to hold onto the old dogmas. With the third example above (gastritis and duodenal ulcer), until the mid 1980’s the original theory in medicine was that too much acid production would be the cause of these conditions and treatment concentrated on suppressing acid production. Then the new theory came up that H. pylori, a bacterium would be the cause of chronic inflammation, which together with too much acid would cause the condition. That is why physicians now treat it with the triple therapy, a good deal for Big Pharma, but a bad deal for many patients. They still do not get cured, but develop a worsening of their conditions as H. pylori growth proliferates, particularly from the PPI’s, which undermines the lining of the whole stomach. As pointed out above DGL, a simple licorice compound, which is available in health food stores, can strengthen the lining of the stomach and duodenum, which at the same time gets rid of the H. pylori problem without any other drugs.

The problem with conventional medicine is that in many cases physicians still treat symptoms instead of treating known causes. Big Pharma supports this, as it is expedient for them to protect their multi billion-dollar industry. Patients need to demand that the causes of their diseases are being treated rather than the symptoms.

References

1. Dr. Edward M. Lichten: Textbook of bio-identical hormones. ©2007 Foundation for Anti-Aging Research, Birmingham, Michigan, USA

2. William Davis, MD: “Wheat belly. Lose the wheat, lose the weight, and find your path back to health.” HarperCollins Publishers Ltd., 2011.

3. Michael T. Murray, ND: “What the drug companies won’t tell you and your doctor doesn’t know”. Atria Books, New York, 2009.

4. Dr. Edward M. Lichten: Textbook of bio-identical hormones. ©2007 Foundation for Anti-Aging Research, Birmingham, Michigan, USA

Last edited Aug. 3, 2013

Incoming search terms:

Dec
17
2012

From Wheat to Autoimmune Disease and Obesity

Introduction

This is a summary of the lessons from the 2012 Anti-Aging Conference in Las Vegas…from wheat to autoimmune disease and obesity. It is not possible to summarize all the multitude of lectures from a three day conference on one page. However, what was striking was that several topics developed into a common thread. These were the topics of autoimmunity, obesity, diabetes, hormone disbalances and more. Dr. William Davis, the author of the book “Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health” explained how the BASF, a major chemical company from Germany was able to chemically modify the genes of wheat in the 1960’s and 1970’s.

Clearfield wheat has much more gluten

The farmers liked that the new wheat (called Clearfield wheat) grew with stronger roots, shorter final stems and much larger grains so the yield per acre was higher. The developers of this type of wheat patented it under the name of Clearfield wheat. They did not publicize at the time that there was a significant increase of the gliadin content. Clearfield wheat contains much more gliadin in comparison to the old wheat strains people consumed for thousands of years. Gliadin gets rid of the glue like substance between the gut cells. This causes leaky gut syndrome, something that came out in many other lectures throughout the conference. This exposes the immune cells to foreign proteins from the gut.  The immune system in turn hyper react with the production of autoimmune antibodies.

Stages of autoimmune diseases

Dr. Aristo Vojdani explained in his lecture that there are three stages of autoimmune disease. First, there is the silent stage where there are no symptoms, but the immune system is starting to react. Next there is autoimmune reactivity, which is the second stage. The third stage is autoimmune disease where there are signs of loss of body function. Autoimmunity develops in about 1/3 of identical twins in families who are prone to this. When the researchers examined non-identical twins as a control group, only 2% to 5% of twins developed it.

Autoimmune diseases due to genetics and the environment

This tells us that genetics are responsible for only about 1/3 of the cases of autoimmunity. The other 2/3 come from the environment such as genetically modified foods. In addition, fat cells secrete toxic chemicals and inflammatory cytokines.  Dr. Vojdani emphasized that gliadin in our foods has become one of the major factors of driving autoimmune diseases up in the last few decades. The immune cells with the name of T cells determine whether they accept our own cells as “self”.  Alternatively, they consider other cells as “foreign” and attack them. This occurs in autoimmune diseases such as Celiac disease, ulcerative colitis, lupus, rheumatoid arthritis, MS and others.

Las Vegas December 15, 2012v

Las Vegas, December 15, 2012

There are regulatory T cells, which are good. But there are also T cells whose genetic material underwent a change and became Th17 cells. These cells are a kind of “Pac Man” cells that attacks body cells. Altered gut flora (called gut dysbiosis) in connection with a leaky gut syndrome contributes to the formation of these aggressive Th17 cells. It is the combination of gliadin with bowel dysbiosis that drives the development of autoimmune diseases. Behind this is the fact that the gut plays a major role in the normal functioning of the immune system. Normally there is a tight connection between the gut cells that form the lining of the gut so that there is no exposure of immune cells from the blood to the contents of the gut flora.

Antibody titer tests

We are fortunate that researchers have developed antibody titer tests for the major food groups and these can be valuable pointers that can be used as a tool during the first two stages of autoimmunity before autoimmune disease causes permanent damage. Using these tests on large population groups researchers have found that common food allergies develop against wheat, dairy products, soy and eggs (as Dr. Pamela Smith remarked and Dr. Thomas Alexander explained in detail). A few blood drops suffice to determine IGG, IGA and IGE antibodies.  The test includes a whole battery of antibodies against common foods. This helps the physician to monitor the development and treatment of autoimmune diseases.

Obesity wave

Back to the leaky gut and obesity. The obesity wave in North America and the rest of the world started when the newly patented Clearfield wheat was introduced. With the higher gliadin in wheat products the balance in the gut was changed, more gliadin entered the body, it bound to the opiate receptors of the appetite center (although it is structurally differently from opium) and caused a hunger for more of the same product. The excess calories –in this case from wheat products- are stored as fat.

Aromatase in fat cells causes estrogen dominance

Fat cells by themselves have their own hormones and inflammatory substances causing various diseases. Diabetes, high blood pressure, heart disease, strokes and even cancer are among these. Add to this that with obesity the enzyme aromatase from fat cells causes elevated estrogen production. This causes estrogen dominance and results in heart disease and breast cancer in females. In males too much estrogen causes heart disease and prostate cancer.

Leaky gut syndrome

The story of the A4M conference 2012 in a nutshell: Wheat products with the increased gliadin (gluten) content caused increased leaky gut syndrome in the population since the 1970’s. This is the cause of the wheat addiction, which was further fueled by the obsession of the regulatory bodies to recommend eating according to the food pyramid (a splendid marketing pyramid for wheat consumption, as one of the recommended products are cereals and wheat). With these findings the cause of the obesity wave can be clearly seen. Along with obesity comes the flood of autoimmune diseases, which have developed from the action of the Pac Man type TH17 immune cells that attack various tissues in the body. The common denominator in the body is a low-grade chronic inflammation that Dr. Vojdani explained in more detail. This causes blood vessel diseases culminating in high blood pressure, heart attacks, strokes and cancer.

There were many other lectures that I attended. Some dealt with bio-identical hormone replacement. Others discussed telomere health and the effect of fitness on an ongoing basis to achieve longevity. In almost every lecture various speakers discussed the importance of lifestyle issues. This went through the conference lectures like a red thread. Nutrition is not the only factor in longevity. Exercise on a regular basis has a powerful healing effect. It can be instrumental in preventing about 50% of diseases, especially the main killers like heart attacks, strokes and cancer.

More info

More information on celiac disease: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/celiac-disease/