Oct
03
2020

Fibrotic Eye Disease Responds to Nicotinamide (Vitamin B3)

A new study from Mt. Sinai Hospital showed that fibrotic eye disease responds to nicotinamide (vitamin B3). In general, during wound healing there can be aggressive cell transformations.  This can cause scarring, retinal detachment and finally loss of vision and even blindness. Notably, the following pieces of evidence support the notion that vitamin B3 (nicotinamide) helps to make eye diseases better.

Lab experiments made in Petri dishes

Specifically, researchers performed experiments in Petri dishes with human adult cells. After adding nicotinamide, they found the following.

  • There were no harmful cell transformations
  • Membrane formation in conjunction with scar formation was reversed
  • There is a slow-down regarding the development of eye diseases that lead to loss of vision and blindness

Vitamin B3 was first detected as a cure to Pellagra

Pellagra, the vitamin B3 deficiency was first described by the Spanish physician, Don Gaspar Casal in 1763. Typically, pellagra presents with dermatitis, diarrhea and dementia. If left untreated it will lead to death. The skin showed inflammation, particularly in areas where there was exposure to the sun or to friction. Affected skin may be darker. Pellagra occurs mainly in the developing world, particularly in sub-Saharan Africa.

Experiments with vitamin B3 on mice curing eye disease

In a mouse model researcher showed that vitamin B3 could largely prevent the development of glaucoma in aging mice. According to these researchers 93% of the mice with the higher dose of vitamin B3 did not develop glaucoma. Vitamin B3 (the precursor of nicotinamide) is important for the production of NAD+ and the phosphorylated form NADP, which are cofactors in the energy producing metabolism of mitochondria.  

Experiments on rabbits showing a cure with nicotinamide

In a 1985 publication rabbits were subjected to a vitamin B3 inhibitor, namely 6-aminonicotinamide. This is an antimetabolite of nicotinamide. It was given by intraabdominal injection. The rabbits developed diarrhea, ascending paresis/paralysis and death. They also developed vascular lesions in the eyes, particularly the iris with an acute inflammation of the iris, which physicians call iritis. The ocular lesions could be prevented by administering nicotinamide. The researchers concluded that vitamin B3 deficiency was responsible for the eye lesions.

Clinical trials show a response of glaucoma to vitamin B3

In a clinical trial physicians compared 34 primary open-angle glaucoma (POAG) patients with a control group of 30 age- and sex-matched controls. The researchers measured plasma nicotinamide concentration in both groups. The POAG patients had on average 33% lower nicotinamide plasma levels than the control group. They concluded that glaucoma seems to be associated with lower plasma nicotinamide levels. The research team suggested that these findings need to be confirmed in a larger series of glaucoma patients. They also suggested that vitamin B3 therapy could become one of the treatment modalities.

Fibrotic Eye Disease Responds to Nicotinamide (Vitamin B3)

Fibrotic Eye Disease Responds to Nicotinamide (Vitamin B3)

Conclusion

We know vitamin B3 deficiency mainly as pellagra. It occurs mainly in the developing world, particularly in sub-Saharan Africa. But newer experiments in vitro, in mice and in rabbits showed that vitamin B3 deficiency can also cause eye disease. Other studies showed that fibrotic eye disease responds to nicotinamide (vitamin B3). In addition, a clinical trial in humans showed that glaucoma can develop as a result of a 33% lack of plasma nicotinamide (vitamin B3) level. Regular supplementation in those who are prone to vitamin B3 deficiency may be curative for eye disease.

Mar
08
2014

Protecting Yourself From Environmental Toxins

Environmental toxins are toxins that may be in your drinking water, in what you eat, in the air you breathe, or they enter your body through your skin when you swim in contaminated water or walk on a sandy, wet beach.

In the following blog I will address some of these issues and how we can defend ourselves against toxins.

The youngest and most vulnerable

Toxins are particularly bad for infants and premature babies.

The reasons for this are the following ones: their kidney function (tubular secretion) is only 20% to 30% of that of an adult; the cytochrome P-450 enzyme system in the liver, one of the toxin eliminators is slowed down to only 25% to 50% of the adult activity and glucuronidation in the liver, another detoxification process, reaches adult levels only at the age of 3 years. The kidneys and the liver are limiting the removal of toxins by way of urine and bile in the newborn. Stomach acidity in a premature has a pH of 4.7, in a full-term newborn 2.3–3.6 and in an adult 1.4–2.0. This is important to note as a lack of stomach acid increases susceptibility of newborns and infants to gastrointestinal infections and cause diarrhea. Percutaneous absorption in newborns is much higher than in adults, which makes them very susceptible to absorbing toxins through the skin (Ref.1).

Diabetes from environmental toxins

Environmental toxins can cause insulin resistance and type 2 diabetes.

Bisphenol A (BPA) is used to make polycarbonate and epoxy resins and is found primarily in food and beverage containers. The world population has been exposed to this since 1957 and as a result 90% of US residents have detectable levels of BPA in their urine. Ref.2 explains that the higher the urine concentration of BPA, the higher the risk is for developing diabetes.

Persistent organic pollutants are another source of concern: pesticides and herbicides, dioxins, polychlorinated biphenyls, hexachlorobenzene, and hexachlorocyclohexane have all been found in humans. Several investigators have shown that virtually all of the risk in obese patients to develop diabetes comes from the fat-soluble persistent organic pollutants (Ref.2).

Inorganic arsenic is another pollutant that is found in soil and rock naturally and finds its way into the drinking water. About 8% of the public water system of the US exceeds 10 mcg/L for drinking water, which has been set as the safe limit for drinking water by the US Environmental Protection Agency’s standard. Anything above those levels is considered toxic.Ref.2 describes that people who ingest inorganic arsenic will excrete it in the urine; the highest group with arsenic in their urine had a risk of 3.58-fold to develop diabetes when compared to the lowest group. Curiously enough organic arsenic that is found in fish and shellfish is excreted in the urine unchanged and does not cause diabetes. Overall this indicates to me that nobody should consume or cook with contaminated water that contains inorganic arsenic. Reverse osmosis filters will protect you from this risk.

Protecting Yourself From Environmental Toxins

Protecting Yourself From Environmental Toxins

Other toxins around the house

Volatile organic compounds are often contained in carpets, but also in laser and inkjet printers. They are part of everyone’s life as this link shows. Varied symptoms like irritation of eyes, nose or throat, breathing problems, headaches, loss of coordination, damage to the liver, kidneys and the brain have been reported after exposure to volatile organic compounds. Long-term exposure can even cause cancer in animals and has been suspected to cause cancer in humans as well.

Air fresheners and cleaning solutions that contain ethylene-based glycol ethers and terpenes have been the subject of a study that examined concentrations in the air and interaction with ozone that can also be released by some cleaners. As this link shows the investigators concluded that with exposure to high enough concentrations and long enough exposures to these fumes lung cancer can be caused in cleaning personnel. They recommended to use cleaning solutions only in diluted form and to air out the premises well after cleaning. Another component of many air fresheners and cleaning chemicals is paradichlorobenzene, the same chemical that is contained in mothballs.

There have been problems with flame retardants: polybrominated diphenyl ethers, which are cancer producing; they have been outlawed in the US since 2004, but older mattresses, upholstery, television, computer casings and circuit boards may still contain them.

Lead and mercury poisoning, and radioactive pollutants

Manufacturers were not allowed to use lead in paints anymore since 1978. Paint from buildings older than that still may contain lead. There have been serious lead poisonings in children who were gnawing on items painted with lead containing paint. Lead causes problems with your central nervous system, brain, blood cells and kidneys. Just last year a news story about lead found in fashion jewelry surfaced warning about cheap fashion jewelry from China. Lead form these items can be absorbed through the skin and cause lead poisoning. Because of the apparent lack of regulations in China it is my recommendation not to buy anything that goes into your mouth or on your skin, if it has been grown or produced in China.

Mercury from tuna and other predator fish: It is sad that the oceans are polluted to the point where it has become unsafe to eat predator fish as there is an accumulation of mercury through the food chain.

How did things develop this way? Back 100 years and more ago gold panning and the purification process of gold caused mercury to enter into rivers and allow mercury to end up in the oceans where it has since accumulated; it just sits there as it has nowhere to go.

Coal burning (yes, there is mercury in coal) has also contributed to this by smoke being emitted from smoke stacks containing mercury vapors, which ended up returning to earth as polluted rain and drained through the river system into the oceans.

It is monomethylmercury that accumulates in the tissue of humans. It affects many organs, such as the brain, kidneys, lungs, and skin. It causes various symptoms like red cheeks, fingers, and toes; there can be bleeding from the mouth and ears; it can cause rapid heartbeats, high blood pressure, intense sweating, loss of hair, teeth, and nails. It also can cause blindness, loss of hearing, impaired memory, and lack of coordination, disturbed speech and birth defects. You may think all mercury comes from the outside. However, silver amalgam fillings in your teeth could also be the source of mercury poisoning. It is a good idea to replace amalgam/mercury fillings with ceramic fillings.

There are many forms of other marine pollution as this link shows.

One particular concerning aspect is pollution with radioactive materials as the Fukushima disaster in Japan has shown. Following the catastrophe on March 11, 2011 there have been several leaks of radioactive material into the ocean, which are described here. Dr. John Apsley II pointed out that with the explosions in Fukushima there were also several releases of radioactive pollution into the stratosphere. This pollution has subsequently traveled around the globe and has come down as radioactive rain. He has made it his ambition to help people minimize radiation exposure from nuclear accidents such as Fukushima.

Protecting yourself from toxins

Having said that pollution and toxins are problems that we are living with, how can we protect ourselves from all of that?

1. Avoid as many unsafe chemicals around you as you can. This includes checking ingredients in hair care and body care products, toothpaste, hair dyes, cosmetics, mouthwashes and underarm deodorants.  I have written a blog about toxins in the bathroom and what you should watch for.

2. I would recommend you switch from a standard food to organic food. It has become unsafe to eat non-organic meats, leafy vegetables, vegetables and fruit. There are too many residues of herbicides and pesticides contained also in meat, not only in vegetables and fruit. Washing will not remove these substances, even though some merchants may tell you otherwise. Buyer beware!

3. Detoxification methods are available and I have reviewed them in this blog. Briefly, to remove lead and mercury a formal intravenous chelation protocol should be followed.  Depending on how many heavy metal toxins you have on board, you may need only a few treatments or else up to 20. Here is a more conservative website stating that it would be safe to have silver amalgam fillings. I think that gold and ceramic fillings are much safer.

4. Genetically modified food is another danger as I have summarized in this blog. This is another reason why I like to stick to organic food. There is evidence that GMO food causes autoimmune diseases, infertility and chronic inflammation that can eventually lead to cancer. It may take decades to prove this, but I am not willing to be a human guinea pig.

5. I have mentioned in a prior blog that we live in a toxic world. You need to carefully look at your home and remove toxins. You need to assess your drinking water. A water analysis can tell you how good the water in your home is and whether there are concerns about inorganic arsenic. Usually places that sell filter systems can advise you in that regard. Your drinking water should either be bottled pure water or else reverse osmosis water that can be part of a filter system in your house.

6.Vitamins and supplements have been shown to support your cell integrity and have anti-inflammatory and antioxidant effects that protect you from toxins. I discussed this in detail in my NetHealthBook under nutrition. For instance vitamin D3 in doses of 5000 IU or more and CoQ-10 are powerful anti-inflammatories and CoQ-10 is also an antioxidant and preserves mitochondrial function. High fish oil supplements (3 to 6 Grams per day) have anti-inflammatory effects and protect your cell membrane integrity. With these overlapping qualities of vitamins and supplements your body will be in a much stronger position to defend itself against the negative effects of toxins. When you take multivitamins, this translates into telomere lengthening of 5.1% (or converted into a survival advantage of 9.8 years when it is accumulated over a life time). Ref. 4 explains this in more detail.

7. Exposure to radioactive substances is a scary thought, but this is becoming more and more a reality, at least for those who live close to disaster areas such as the Fukushima site in Japan or the Chernobyl site in the Ukraine. But according to Dr. Apsley II low dose radiation that we have already received in the US and in Canada following the Fukushima disaster is equally disastrous (Ref.3). Many of the vitamins and supplements I have mentioned are also cell and mitochondria protective and will help with DNA repair following radiation damage, but you must avoid sugar and other refined carbs and starches to reduce the oxidative effect on cells and on LDL cholesterol to prevent premature aging and cell death. Ref. 3 contains a lot more detail about this and explains what specific supplements can be taken to detoxify your system from specific radioactive elements that function as free radicals. There are specific antidotes for radioactive iodine-129 and iodine-131, radioactive cesium-137 and others.

Conclusion

Many people shrug their shoulders when they hear that pollution has an effect on their lives. They feel that they are powerless and cannot do anything about this. The truth is far from this! Above I mentioned seven points that you can follow to counter toxins. On top of that you can get politically active and urge your government representative to create a nuclear free zone in your area. Ref. 3 contains compelling evidence why this is so important not only for us now, but for future generations and the future of mankind. We need to hold those who provide us with food and beverages accountable for the quality of these. Shrugging it off is not good enough. Get involved. Buy organic food. Avoid the section in the grocery store where sugar and high carb foods are sold. It’s good for your own health, but it will collectively change the mentality of the grocery store owners who will notice that they are stuck with the comfort foods that sold well in the past. This new trend will result in cheaper prices for healthy foods and more availability of organic food.

References

1. Shannon: Haddad and Winchester’s Clinical Management of Poisoning and Drug Overdose, 4th ed. © 2007 Saunders. Chapter 18:“Toxicologic Issues in the Neonate”.

2. Rakel: Integrative Medicine, 3rd ed. © 2012 Saunders. Chapter 31: “Insulin Resistance and the Metabolic Syndrome”.

3. Dr. John W. Apsley II : “Fukushima Meltdown & Modern Radiation: Protecting Ourselves and Our Future Generations” © 2011. Temet Nosce Publications, Sammamish, WA 98075

4. Xu, Qun, Parks, C.G., DeRoo, L.A., Cawthon, R.M., Sandler, D.P. and Chen, H. Multivitamin use and telomere length in women. American Journal of Clinical Nutrition 89 (April 2009):1857-63. Full text (PDF): http://ajcn.nutrition.org/content/89/6/1857.full?sid=9aab0e13-b4d2-42ad-b44c-15cffc6771c3

Last edited March 8, 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

Apr
21
2013

World Health Day 2013, Focus on Hypertension

In the US high blood pressure causes 348,000 American deaths per year, in the world its death toll amounted to 9.4 million every year. This is unfortunate as high blood pressure is an illness, which can both be effectively treated and prevented. Uncontrolled high blood pressure (hypertension) causes heart attacks and strokes, can cause kidney failure, heart failure and blindness. You control blood pressure with lifestyle changes and/or medication,  and these risks go away.

The age standardized death rate  (Ref. 1) for both sexes in the US for heart disease is 80.5 per 100,000 and for strokes 25.4. In Canada these rates are 66.2 and 22.9; in Germany 75.0 and 31.2; in Italy 51.7 and 34.9, in Japan 31.2 and 36.7. The death rates from cardiovascular disease per 100,000 people in the same countries is as follows: in the US 172.2, in Canada 130.7, in Germany 200.2, in Italy 153.5 and in Japan 107.1.

There are obviously significant differences in these countries, which I will discuss further below.

On the occasion of the World Health Day, which was celebrated on 7 April 2013 to commemorate the founding of the WHO in 1948, with the topic of high blood pressure the World Health Organization has edited a PDF publication of 155 pages entitled “Global Atlas on cardiovascular disease prevention and control” (Ref.1, be patient, loads slowly). In it prevention and treatment for high blood pressure are discussed in detail. This text points out that there has been a remarkable decline in death rates from heart attacks and strokes (collectively called “cardiovascular disease”) between 1981 and 2000 in the United Kingdom. A thorough analysis of this showed that 58% of this decline was due to risk factor reduction in the whole population (reduction of smoking and heavy alcohol consumption, reduced salt intake, combatting physical inactivity and reduction of saturated fat intake). The other 42% of the decline in cardiovascular disease is due to treatment by a physician. So, it is clear from this that the majority of mortality prevention comes from the patient, less than 50% comes from the treating physician. However, it is important that physicians will educate their patients to cut out risk factors themselves in order to prevent hypertension.

World Health Day 2013, Focus on Hypertension

World Health Day 2013, Focus on Hypertension

Risk Factors for High Blood Pressure

In the past it was thought that most cases of high blood pressure would be due to “essential hypertension”, a term saying “we don’t know what causes high blood pressure”. Many physicians still use this term. Only a small amount of cases were considered “secondary” hypertension where the causes were known (e.g. kidney disease, hormonal imbalance, pregnancy). But in the meantime research by Harvard University and other research institutions has shown that there are a number of specific causes that contribute to high blood pressure, either alone or in combination.

Here are the commonly known causes: too much salt in our diet; we tend to not eat enough vegetables and salads; we like to sit in cars, in front of the TV or in front of the computer (physical inactivity). Many people still smoke, although tobacco is known to cause high blood pressure and lung cancer. Too much alcohol is known to cause hypertension as well. So the following steps will prevent high blood pressure :

  1. consuming less salt
  2. eating a balanced diet (preferably the DASH diet)
  3. engaging in regular physical activity
  4. avoiding tobacco use
  5. avoiding harmful use of alcohol (more than 2 oz. or 60 Grams per day)

Diabetes is known to worsen the risk for heart attacks and strokes and increases the risk of high blood pressure as well. So, some hidden risk factors for high blood pressure related to diabetes are as follows: a high fasting blood sugar; obesity; food with too much fat, too much sugar and too many starches (not enough complex carbohydrates).

What Can Be Done To Reduce Death Rates From High Blood Pressure?

As Canada is one of the countries where the death rate from strokes and heart attacks is lower than in the US or Germany, I like to point out some of the reasons for this. I practiced medicine in Canada for many years. The “Canadian Hypertension Education Program” have been guidelines for practicing physicians to follow providing effective screening and treatment of high blood pressure. Cardiologists at various continuing education conferences have promoted this. At my office I had a hypertension recall program where my staff called every patient with high blood pressure into the office every 3 months. We would review the home-measured blood pressure readings from the patient (recorded in a little booklet). I also took the blood pressure of the patient and so did my staff on the patient’s arrival. We reviewed the blood pressure medication and reviewed the possible side effects. The patient was also told what to do, if the blood pressure would be higher than normal (possible adjustments of the medication at home). I also encouraged my patients with regard to the life style issues (the 5 points mentioned above). Over the years the number of patients who developed heart attacks or strokes declined, as one would expect.

A recent review in the Canadian Family Physician mentions that there is room for improvement regarding the Canadian statistics. As mentioned above Italy and Japan are doing better with regard to mortality from heart attacks and strokes compared to Canada. We have a health care system in Canada that is available to every Canadian resident and funded by provincial taxes. In this system patients do not have to pay for office visits (although they pay for it indirectly through taxes). For the patient with high blood pressure it means that there is a system in place, which helps prevent cardiovascular disease and treats high blood pressure effectively. In my opinion the home recording of self-measured blood pressure readings at least once per day with a home blood measure monitor is vital to encourage the patient to be engaged with regard to his/her blood pressure problem.

Newer Findings About High Blood Pressure

For years physicians did not know where high blood pressure came from. In the last few years research has shown that nitric oxide plays an important role in preventing high blood pressure. It is produced by the lining of your arteries (by the so-called “endothelial cells”) and is the natural artery relaxer.

Foods that produce nitric oxide in the body are spinach, kale, red beet, cabbage varieties and other vegetable greens. These foods, which are also contained in the DASH diet, and regular exercise will stimulate the lining of your arteries to produce nitric oxide, which prevents high blood pressure, heart attacks and strokes. If all these measures and the above recommendations to prevent high blood pressure do not help, it is time to treat it. As already indicated above it is important that the patient who has been identified as needing high blood pressure treatment with medication, takes the medicine regularly (called ”compliance”). By keeping the blood pressure reading below 120/80 you prevent your risk of getting a heart attack, a stroke, heart failure or blindness from broken retinal vessels. If the patient develops any side effect from the medication, it is important to see the physician about this right away. It may be that the medication has to be adjusted or altered.

Nitric oxide can be taken as a supplement (Neo40), which allows the endothelial lining to be regenerated as indicated in this interview with the inventor, Dr. Nathan Bryan from the University of Texas Health Center in Houston.

The older we are, the more likely it is that our blood pressure will be high. As this link shows, 2 out of 3 people above the age of 60 in the US have systolic hypertension (the upper value of the blood pressure is elevated). As we age, it appears that the lining of the arteries do no longer produce the required amount of NO (nitric oxide) to prevent high blood pressure and prevent hardening of the arteries. So, it would be wise to adopt the Mediterranean diet with lots of vegetables, spinach, kale, bok choy, Swiss chard and others to boost your NO production, but still measure your blood pressure regularly. If you do not have a home blood pressure monitor, go to a pharmacy that allows you to check your blood pressure for free. If it is above 120 over 80 seek the advice of a health professional. You can find more information in Ref. 1.

In essence, what World Health Day 2013 asks us to do is to pay attention to your blood pressure and make sure it is normal.

More on high blood pressure: http://nethealthbook.com/cardiovascular-disease/high-blood-pressure-hypertension/

References:

Ref. 1)  http://www.nethealthbook.com/articles/cardiovasculardisease_hypertension.php

Last edited Nov. 6, 2014

Feb
01
2006

Macular Degeneration Risk Less With Vitamins

Age related macular degeneration (AMD) is one of the more frequent reasons for loss of vision in the ageing population. The disease is also the most prevalent reason for blindness in developed countries.
A group of researchers from the Netherlands made it their mandate to investigate, in which proportion antioxidants were useful in the prevention of AMD. Supplementation with vitamins C, D and E was used and also beta-carotene and zinc. The observations were made using questionnaires from the Rotterdam Study (1990-1993).

The group on which the research concentrated consisted of inhabitants 55 years of age or older living in a middle class suburb of Rotterdam. Of 5836 at the baseline with a risk of AMD 4765 had reliable data of their dietary habits. At the end of the study 4170 participated in the follow up.
Dietary intake of vitamin E and zinc was inversely associated with the development of AMD: the group with an intake of vitamin E and zinc had less macular degeneration than those whose diet was deficient. A higher than median intake of all the four nutrients, vitamin E, zinc, vitamin C and beta-carotene showed even more benefit. The risk to develop macular degeneration was reduced by an impressive 31 %.

Macular Degeneration Risk Less With Vitamins

Macular Degeneration Risk Less With Vitamins

These results are of importance to the ageing population and the elderly. A high dietary intake of the four nutrients is important in the risk reduction of age related eye diseases like AMD.

Reference: JAMA. 2005; 294:3101-3107; Vol. 294, No. 24, December 28, 2005

Last edited December 6, 2012

May
01
2004

Age-Related Macular Degeneration Can Be Postponed

In a well-controlled study that was published earlier in 2004 Dr. Johanna M. Seddon

has shown that age-related blindness (AMD) is caused from an inflammation in the blood vessels, which is associated with an elevated blood marker, called C-reactive protein (CRP). The authors of this study also showed that the dry form of AMD would tend to deteriorate with age and/or from smoking cigarettes into the more serious wet form, a common cause of blindness.

The inflammatory component of cardiovascular disease is known to be controlled by the use of aspirin (ASA) or the statins, medication that is known to lower the bad LDL cholesterol. It is with this background that the author of the study that I am reviewing here, Dr. Jacque L. Duncan from the University of California at San Francisco, has examined the effects of ASA and of statins on AMD. 326 patients with AMD (204 with dry AMD, 104 with wet AMD from blood vessels forming underneath the retina and 18 with geographic atrophy) were followed between January 1990 and March 2003. Patients were at least 60 years old or older and followed at the San Francisco VA Hospital Eye Clinic.
Dr. Duncan found that patients with blindness due to wet AMD used ASA or statins significantly less than patients with stable AMD. Moreover, he found that patients who had AMD and took statins were 49% less likely to develop wet AMD and if they took ASA the were 37% less likely to develop wet AMD.

Age-Related Macular Degeneration Can Be Postponed

Age-Related Macular Degeneration Can Be Postponed

The study also suggests that there is a link between the inflammatory process that leads to heart attacks and strokes on the one hand and the further deterioration to blindness when dry AMD is not treated on the other hand. The notion that inflammation is the missing link in both of these processes is a relatively new finding.

More information about Macular Degeneration here.

Based on article by Dr. Jacque L. Duncan in the American Journal of Ophthalmology 2004;137: 615-624.

Last edited October 26, 2014