Aug
12
2023

About your Bowel Movements

By | Abdominal Pain, coffee, exercise, fiber, food

This article is about your bowel movements. Dr. Michael Camilleri is a consultant and professor in the division of gastroenterology and hepatology at the Mayo Clinic in Minnesota. He mentioned that in the Victorian era it was thought that a person should have a bowel movement every day. But now gastroenterologists agree that three bowel movements per week are satisfactory. If you don’t have that spontaneously, you are said to suffer from constipation. On July 12 CNN published a review about the same topic.

But other people who consume a lot of fiber may have a bowel movement two or three times a day. This, too is considered normal. But in addition to the frequency of bowel movements the consistency of it is very important as well. “The stool form, appearance or consistency of the bowel movement is actually a much better criterion than the simple numbers to frequency,” Camilleri said.

Bristol stool chart

The Bristol Stool Chart classifies stools into seven groups. With this in mind, the healthiest types of stools are types three and four. This is where the stool is shaped like a sausage with cracks on the surface or snakelike and smooth.

Experts say that if you are excessively straining during an attempt to poop or if you feel like you have not totally emptied after a bowel movement, you have to make changes. Either you need to poop more often or you need to get a healthier stool quality.

Your body posture influences the ease of your bowel movements

If you put your feet on a stack of books, this raises your knees above your hips. In that position your pelvic floor muscles relax, which supports your bowel. The end result is that poop passes through more easily. This advice comes from Dr. Trisha Pasricha, a gastroenterologist at Massachusetts General Hospital and instructor of medicine at Harvard Medical School. She commented further: “We did not evolve to have our bowel movements sitting with our hips at 90 degrees on a chair, which is what we do now. We used to all have bowel movements squatting. Sitting at that sort of upright, 90-degree angle actually closes off the passageway.”

Proper food intake necessary for a good bowel movement

Start with a Mediterranean type diet, which consists of a lot of vegetables, salads, fruit, whole grains and nuts. According to the FDA the daily fiber load should be about 25 grams or more. Kiwis and prunes are useful as a dietary fiber source. On the other hand, you don’t want to overdo the fiber intake as it can cause abdominal bloating and loose stools. A high fat diet slows your digestive system down. But caffeine and caffein containing beverages stimulate your bowels. In addition, regular physical exercise gets your bowels moving.

Constipation

Constipation is an important symptom that prompts patients to see their physician. There seems to be a lot of confusion in the general public about this topic. There are enormous cultural differences. For instance, in Africa where the population eats on average a much larger amount of fiber, the bowel movements are much bulkier.

Sir Dr. Burkitt, the famous English surgeon, examined bowel movements (stools) of African tribes in comparison to his English countrymen and came to the conclusion that in the Western world we need to remedy our constipation problem and cancer of the colon problem by eating more fiber.

What we know now

He is still right: fiber is mainly treating constipation (not preventing cancer of the colon), but the chemicals that are also in the vegetables contain a multitude of natural anti-carcinogenic substances, which provide the powerful preventative action against colon cancer and many other cancers. Lycopene is one of these. Tomatoes and tomato products contain it.

Sir Dr. Burkitt’s observation that high bulk food (with vegetables and green leaves) prevents cancer is as valid today as it was in the early part of the 1900’s.

Chronic constipation

Chronic constipation cases that start insidiously, but then remain despite taking a high fiber diet, make the doctor think about other underlying causes such as hypothyroidism (= low thyroid function) or metabolic causes such as hypercalcemia and uremia from early kidney failure.

We find that elderly people become too inactive. This lowers the natural peristalsis of the gut. In combination with poor eating habits and chewing problems because of poor teeth it is often responsible for chronic constipation. Also, elderly people often are on multiple drugs, all of which have a weak “anticholinergic” side effect, which translates into suppressing peristalsis chemically resulting in constipation. Psychogenic factors and chronic depression as well as obsessive-compulsive behavior can also feed into constipation. It can lead to a hyper awareness of one’s own bowel pattern. This is unhealthy and requires counselling. But first the doctor must rule out any serious cause of chronic constipation.

Treatment for constipation (simple steps that help)

As mentioned above, the patient has to modify the food intake to include as much fresh and steamed vegetables as possible. This will lead to bulk in the colon and make the stool softer thus allowing it to pass through the rectum and anal canal easier. The other advantage of this simple step is that the bulkiness of the stool triggers the normal peristalsis movement of the colon moving the contents towards and through the rectum. Decreasing the passage time in the colon allows less water absorption, keeping the stool soft and pliable until it leaves through the anal canal. This is easily achieved by a diet rich in fruits and vegetables. Cereals containing bran like slow rolled oats (not instant oats) are also useful when taken with breakfast. Cut down on meat and fat consumption.

Enema with lukewarm water

A simple tool for chronic constipation is an enema with lukewarm water (1500 ml or 50 fl.oz.) in a Faultless enema bag without any additives in it. The person who gets the enema needs to lay on the left side. This way the water can flow in easily into the colon. When entering the nozzle into the anal canal, do not force it. Instead use a bit of Vaseline ointment to facilitate entrance. The response usually comes within 5 to 10 minutes following the enema. It works by dilatation of the bowel wall, which leads to a reflex bowel contraction. Although it would be safe to take this every day, usually you should not have to take it more than two or three times per week even in chronic constipation.

Extra fiber (bulking agents)

Next, if this is not tolerated or does not appeal to the patient, I would recommend a bulking agent such as psyllium (brand names: Prodiem Plain, Metamucil, Novo-Mucilax) and bran (Brand names: Kellogg’s All Bran and Post’s bran flakes). These are mild laxatives, which are safe to take every day and which will not make the patient hypokalemic.

Osmotic agents

Osmotic agent: One or two tablespoons of sorbitol as a 70% solution is a hyperosmotic solution, which stays in the gut and draws water by osmosis into the colon. The bulking effect creates peristalsis and the water retention makes the stool softer. It takes often 1 or two days to get the full effect. There can be transient abdominal cramps until the stool is passed. One variation of this theme is to give sorbitol in a mix with other osmotic agents as a micro-enema in the form of Microlax (from Pharmacia and Upjohn).

The emergency break (laxative)

The “emergency break”: Occasionally all of the above is simply too weak. The constipated person normally is controlled with the above measures, simply could not go to the bathroom for several days. Bisacodyl (brand name: Dulcolax) and sennosides (brand names: Ex-lax Sugar-Coated Pills and Senokot products) can help you unload any held back stool on a one-time only basis. Increase your vegetable and fruit intake, cut down on refined foods and fatty foods, which are devoid of fiber.

About your Bowel Movements

About your Bowel Movements

Conclusion

Because of its role in nutrient absorption and body detoxification the digestive system plays a direct role in overall health and wellness. When the colon is unclean, waste and toxins can become trapped. This places an extra strain on the detoxification organs (kidneys, liver) and weakens the immune system causing illness. It is therefore important to watch that your bowel movements are regular. When chronic constipation sets in there are several measures, we can take to keep our bowels moving. I explained this in detail above.

Jun
08
2019

How Can We Prolong Our Lives?

By | Cardiovascular disease, cholesterol, diet, exercise, fish oil, Fitness, food, heart attack, Hormones, melatonin, mitochondria, Mortality, Nutrition, omega-3 fatty acids, Prevention, sleep, Stroke, sugar, telomeres, Vitamins and supplements

The question “How can we prolong our lives?” is something that fascinates many people. It is not one thing, one activity, one diet, or one lifestyle factor that determines longevity. It is the combination of all of the things listed below that are necessary.

Longevity is partially inherited from your mother

The reason for this is that mitochondria in your body cells come from your mother’s body. As you know, the egg (ovum) contains the mitochondria (the energy packages of the cell). The sperm that is the winner penetrating the ovum is shedding the tail outside the ovum. The tail of the sperm had loads of mitochondria in it to give it the energy to wiggle its way up the Fallopian tube to meet the ovum. This is the reason why we all inherit our mitochondria from our mother. If there is longevity on your mother’s side, you likely will have the longevity gene as well. So, this certainly helps, but on the other hand, we cannot pick our ancestors! Don’t be discouraged! There is enough that you can do.

Diet

The best type of diet is a Mediterranean-type diet. There is a new fasting mimicking diet, that likely turns on latent longevity genes that need to be intermittently activated, if we are serious about wanting to increase longevity. Dr. Longo is the inventor of the fasting mimicking diet. I have discussed this in detail here. Briefly, it consists of eating 500 to 600 calories on 5 consecutive days. The rest of the month you eat normally. The important part is that Dr. Longo has shown in humans that telomeres get elongated by the 5-day protocol per month. Longer telomeres means longer life. This is what we want, because this adds life to our life expectancy!

Lifestyle

Don’t smoke and don’t do drugs. Drugs interfere with our hormone- and other cell surface receptors. Our body cells don’t like artificial chemicals from outside. Don’t overlook the fact, that alcohol is also a drug! Alcohol is a nerve and cell poison. It has been shown to even be toxic, so don’t drink all the time. If you want a drink here and there, you probably get away with it. But binge drinkers (6 drinks or more in one evening) are out of luck; their life expectancy is shorter than that of non-drinkers.

Exercise

Regular exercise recharges your mitochondria to give you extra energy. It conditions your heart and lungs and also your muscles. Many people think exercise would cause weight loss. But it is not leading to that much weight loss at all! What is more important is the fact that it is reducing the overall mortality from many diseases by up to 47%! Exercise also improves blood sugar control, energy levels and sleep patterns. There are also hidden benefits, as the heart is being conditioned and the lungs are improving their vital capacity from regular exercise, particularly aerobic exercises like running or using a treadmill. But muscle strength also benefits from regular exercise.

Get enough sleep

You need 7 to 8 hours of sleep, and it is best to go to sleep between 10 or 11 pm. During your sleep your brain is being renewed and your hormones are reloaded. There is a diurnal hormone rhythm that ensures you have enough energy for the following day. A Swedish study found that longtime shift workers had a 28% higher mortality compared to a control group of daytime workers: Shift work and mortality.

Vitamins and supplements

Some minimum vitamin and mineral supplements are helpful for longevity: Mornings: 2 capsules of molecularly distilled fish oil (omega-3 fatty acids). Two tablets of vitamin C 500 mg chewable, one capsule of 150mg of chelated magnesium, resveratrol 500mg, vitamin B complex B-50, zinc 30mg, vitamin K2 two capsules of 100 micrograms, vitamin D3 5000IU every morning, CoQ-10 400mg. Evenings: 2 capsules of molecularly distilled fish oil (omega-3 fatty acids). Vitamin B complex B-50, chelated magnesium 150mg, melatonin 3mg to fall asleep, valerian root 500mg capsule (if you have anxious thoughts); you may repeat melatonin and valerian root in the middle of the night, if you wake up at 2AM or 3AM in the morning.

Brief explanation for vitamin and mineral replacement

In case you wonder about the rationale of my suggestion for vitamin and mineral replacement, here is a brief explanation: vitamin C stimulates the adrenal glands and helps support the immune system. You get more energy and get fewer infections. Molecularly distilled fish oil is anti-inflammatory, helps prevent osteoporosis, but also prevents heart attacks by preventing inflammation of the arteries. Magnesium and zinc are co-factors in hundreds of biochemical reactions inside our cells, so this helps your metabolism.

Resveratrol an anti-aging supplement

Resveratrol is a bioflavonoid derived from red grapes. It has multiple beneficial effects. It lowers blood pressure, helps to control diabetes better and prevents osteoporosis. But resveratrol also elongates telomeres, which translated into a longer life and less diseases. B complex vitamins are good for energy and many metabolic processes. Vitamin K2 and vitamin D3 work together to get calcium out of our arteries and deposit calcium into our bones. This prevents osteoporosis, which is particularly important for postmenopausal women, but is also important for men. Resveratrol also prevents heart attacks and strokes. CoQ-10 is important to lower cholesterol, but also supports the metabolism of mitochondria, the energy packages of our cells.

Hormone deficiencies

We all know that there is menopause for women and andropause for men. But there are silent hormone deficiencies that are less well known. For instance melatonin secretion gets reduced fairly quickly after the age of 20. Between the age of 50 and 60 you are basically deficient for melatonin, so using a supplement of melatonin tablets would be very reasonable. Another hormone, namely human growth hormone (HGH) is very likely deficient in us by the time we are 50 to 60 years old. I will deal with this further below.

Menopause

Women get into menopause between 45 and 55, but they can get there earlier or later. Women are missing estrogen and progesterone. Many women were horrified by the Women’s Health Initiative result in 2002. But this trial involved synthetic hormones that the body did not like. So women got breast cancer, colon cancer, heart attacks and strokes from Premarin and Provera, both synthetic hormones. Had physicians been sensible and put them on bioidentical hormones instead, they would have prevented heart attacks, strokes and osteoporosis. They would also have prevented breast cancer and colon cancer. The proper way to replace missing hormones in women with menopause is to replace them with bioidentical progesterone cream and bioidentical estrogen cream.

Andropause

Men get into andropause between 55 and 65. The testicles will no longer provide the man with enough testosterone. This leads to lack of sex drive, erectile dysfunction, but also to more heart attacks, muscle weakness and a lack of energy. The problem is that there is not enough testosterone to stimulate the mitochondria. Mitochondria are very prominent in the heart muscle, skeletal muscles, but also in the brain. When the doctor confirms a lack of testosterone with blood tests, he orders replacement with bioidentical testosterone cream or by a simple testosterone injection twice per week. The man will feel better after a short period of time (4 to 6 weeks) as all his functions return back to normal.

Many speakers at anti-aging conferences, which I attend every December in Las Vegas, seem to agree that bioidentical hormone replacement adds 10 to 15 years of life both in men and women. It also gives people renewed energy, and they look younger.

Human growth hormone

Many people do not know that human growth hormone (HGH) is important for longevity in adults. In childhood it was important for bone growth. Growth hormone deficiency is the one factor that has been underestimated. The discussion of dwarfs in comparison to their healthy brothers and sisters showed us the following. Growth hormone production can add between 19 and 34 years (average 26.5 years) of life. Dr. Hertoghe, an endocrinologist from Belgium has done blood tests (IGF-1) and lately also 24-hour urine metabolite tests of growth hormone on aging patients and found that many were deficient with regard to HGH production. These were patients where Dr. Hertoghe already replaced their thyroid hormones, if abnormal and replaced their sex hormones when they were low.

Symptoms of human growth hormone deficiency

But they lost hair, developed old looking faces with wrinkles. In addition, a loss of subcutaneous fatty tissue is giving the face a hollow appearance. They also had muscle and joint pains and thin skin, particularly over the back of their hands.

Replacement of growth hormone

He replaced their missing HGH using daily HGH self-injection with a tiny needle (similar to diabetes injections). Within 1.5 to 3 years the wrinkles disappeared, the faces started to look younger and patients did feel younger. Their muscle and joint pains had disappeared and their hair grew back. The dosage range is between 0.1mg and 0.3mg, a tiny amount of HGH daily. This is not inexpensive, but some health care plans pay for this, as a lack of HGH is a true hormone deficiency.

How Can We Prolong Our Lives?

How Can We Prolong Our Lives?

Conclusion

I have given you an overview of the important elements of what increases longevity. The key is to have a healthy, balanced diet and leave junk food out. Don’t smoke and don’t drink excessive amounts of alcohol. No alcohol consumption would be best, because alcohol essentially is a nerve poison and can lead to dementia. Exercise regularly to lower mortality and strengthen your heart and lungs. Get enough rest and sleep to refresh your diurnal hormone rhythm. When we age, it is important to keep an eye on our hormones. You need a physician who is knowledgeable about it.

Hormone replacement

Hormones that are missing need to be replaced by bioidentical hormones. In addition you need to know what the level of IGF-1 is. HGH controls the IGF-1 level. If IGF-1 is low, you need HGH replacement. Studies have shown that replacement of missing HGH may be able to add 2 decades of good life. All of the other hormones replaced by bioidentical hormones will add 10 to 15 years. As stated in the beginning, there is not one thing only that increases longevity, but a combination of all these factors.

First published here: https://www.quora.com/What-increases-longevity/answer/Ray-Schilling

Jan
16
2015

Telomere Length A Telltale Sign Of Aging

By | Alzheimer’s disease, Anti-aging medicine, Arthritis, Autism, Cancer, Diabetes, Fitness, heart attack, Nutrition, Osteoporosis, telomeres, Vitamins and supplements

Dr. Sandy Chang gave a talk at the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas Dec. 10-14, 2014 entitled “Telomere measurement as a diagnostic Test in cardiovascular and Age-related disease”, but a shorter title would be “telomere length a telltale sign of aging” (my choosing).

Dr. Chang pointed out that it is now well established that telomere length is directly related to health. The shorter the telomeres are the higher the probability to get the following: early menopause, infertility, diabetes, wrinkles, arthritis, osteoporosis, cardiovascular disease, Alzheimer’s, Parkinson’s, dementia, cancer, stress and a lack of stem cells. In this BMJ study from 2014 it was shown on a large population basis that shorter white blood cell telomeres lead to a higher risk of coronary heart disease causing heart attacks. Decreased telomere length is also associated with the development of breast cancer, cancer of the ovary and uterus, cancer of the prostate and skin cancer.

Because of these connections it makes sense to determine a person’s telomere length. If it is short, do check-ups more often to detect any cancer early when it can still be treated.

Telomere length measurements are now done in many infertility clinics as short telomeres both in the male and female is associated with infertility.

The newest finding and perhaps the most important is that a healthy lifestyle, vitamins and supplements can elongate telomeres while a poor lifestyle leads to shortening of telomeres.

Here are the factors that lead to shortening of telomeres:

– Chronic stress

– Poor diet and nutritional habits

– Chronic inflammatory diseases

– Metabolic disorders

– Lack of consistent exercise/sedentary lifestyle

– Obesity, high BMI and body fat

– Smoking

– Over consumption of alcohol

– Lack of sleep / insomnia

When short telomeres are detected, it is important for the physician to look at lifestyle changes to protect telomeres from decreasing their length even further. This has the potential of preventing dementia and Alzheimer’s when it comes to brain health. It can prevent osteoporosis and metabolic diseases (diabetes, metabolic syndrome). Telomerase is the buzzword today, which is an enzyme that all of our cells have. The purpose why we have telomerase in our cells seems to be helping us build up and repair telomeres. Any substance that preserves telomerase or prevents the breakdown of telomerase will prevent shortening of telomeres and will also prevent the above-mentioned diseases.

These supplements lead to lengthening of telomeres:

-Vitamin C and E

-Omega-3 and polyphenols

-Vitamin A and D3

-All of these help controlling oxidative stress, reduce DNA damage, reduce inflammation and build up telomere length.

-A good diet and nutrition (Mediterranean type diet) will prevent telomere shortening as well and also lead to telomere lengthening.

-T-65, an extract from astragalus has been shown in vitro to lengthen telomeres, but there is no publication yet about in vivo effects in humans.

-Resveratrol is useful to prevent shortening of telomeres as well.

-Exercise also is a simple means to prevent telomere shortening.

Telomere Length A Telltale Sign Of Aging

Telomere Length A Telltale Sign Of Aging

Another talk on telomeres was given by Dr. Harvey Bartnof with the title “Telomere Shortening and Modulation: Case Studies From The Clinic”.

This talk was a comprehensive review of what is known about telomeres, about the fact that many diseases are due to telomere shortening, about animal experiments, ways of how to lengthen telomeres and finally some data on human studies with regard to telomere lengthening.

In the following I will briefly review all of these areas that were discussed. Some of this material overlaps with Dr. Chang’s lecture.

What produces telomere shortening? Dr. Bartnof showed 4 slides that listed all of the conditions and diseases that are associated with telomere shortening. Telomere shortening is associated with twice the risk to die from a heart attack when compared to people with normal telomeres.

a) Known genetic conditions in humans associated with telomere shortening

There are three known genetic conditions due to telomere shortening: A premature aging syndrome, called dyskeratosis congenitalis; patients with this condition die prematurely from cancer, or from bone marrow failure.

People with Werner syndrome who have a genetic telomere loss have a mean life expectancy of only 54 years.

Idiopathic pulmonary fibrosis is another genetic condition with shortened telomeres due to mutations.

b) Telomere shortening associated with these health conditions

Professor Elizabeth Blackburn, PhD who is one of the three researchers who won the Nobel Prize in Physiology and Medicine for their work on telomeres in 2009 stated the following: “Telomere shortness is associated with just about all the major diseases of aging… from cardiovascular disease, death from cardiovascular disease, risks of cardiovascular disease, diabetes, diabetes risks such as insulin resistance, vascular dementia, to osteoarthritis.”

An enormous amount of clinical investigations have been done since in cohort groups like people with diabetes, high blood pressure, obesity and cancer.

There is natural shortening of telomeres due to the aging process. When we compare telomere length of body cells of a 20-year old and call this 100%, the telomeres of a 100-year old person are on average only 40%. A study from the Karolinska Institute found in a group of matching twins where one twin had shortened telomeres, this twin had a 2.8 times greater risk of death than the twin with normal telomere length.

However, as already mentioned a number of other factors can lead to shorter telomeres like chronic stress in workers who look after Alzheimer patients, being of the Caucasian race (compared to African-American), having had less education, chronic unemployment, depression, pessimism, single people versus married people, phobic anxiety in women and hostility in men, poor sleep and too little sleep, migraine headaches in women, low physical activity, smoking cigarettes and alcohol consumption. The list does not stop here. Other conditions are associated with telomere shortening like heroin abuse, exposure to smog, polycyclic aromatic hydrocarbons and lead, cardiovascular disease, diabetes, cancers, osteoporosis, osteoarthritis, rheumatoid arthritis, cirrhosis of the liver, inflammatory bowel disease, chronic obstructive lung disease, Alzheimer’s disease, Parkinson’s disease, chronic kidney disease and disability in the elderly.

c) Effects of medications on telomere length

Antidepressants used against depression have a telomere lengthening effect, but NSAID’s, aspirin and interferon-alpha shorten telomeres. Other telomere shortening effects come from cancer chemotherapy.

d) Telomerase activation elongates telomeres

Successful experiments in various mouse strains showed that special strains that were telomerase deficient, could be reconstituted to normal by reinserting telomerase: atrophied organs regrew back to normal size and function. In humans it was shown that increased physical activity elongated telomeres, so did vitamin C, E and vitamin D3 supplementation, resveratrol, a Mediterranean diet, marine omega-3 fatty acid supplementation, higher fiber intake, bioidentical estrogen in women and testosterone in men, relaxation techniques like yoga and meditation. The Astragalus-derived telomerase activator TA-65 has been shown in animal experiments to elongate telomeres. The human data about TA-65 is still spotty or not available (it is also very expensive and may be unnecessary given the fact that so many other agents are known to lengthen telomeres).

e) Human data on telomere lengthening

Much can be achieved by changing one’s lifestyle: cut out toxins like cigarette smoking and alcohol abuse. Get involved in a regular exercise program, which has been shown to increase HDL cholesterol and to elongate telomeres. Adopt a Mediterranean type diet including olive oil; take vitamin E, D, C and supplements with resveratrol and murine omega-3 fatty acids, all of which elongate telomeres. Get enough sleep (7 to 8 hours per night) and do yoga and meditation. Avoid distress and tone down your stress level to eustress (normal stress level associated with every day living). An older person should use bioidentical hormones to replace missing hormones. All of this taken together will create a milieu in your body where telomeres get elongated and you live longer without disease. Several clinical conditions were mentioned where baseline telomere length was assessed initially and was found to be too short; simple lifestyle changes were then initiated, which were able to improve telomere length and treat these diseases successfully. In addition TA-65 (also termed T-65) was given in some of these cases, but in a subsequent discussion Dr. Bartnof admitted that he could not comment on how effective TA-65 by itself was as it was only one component of many other effective telomerase stimulators given. Till further research is out on this substance, it may be just very costly without spectacular benefits on its own.

Conclusion

I gave a summary of the talks by Dr. Chang and Dr. Bartnof regarding telomeres, but these were not the only talks about telomeres, although quite representative for the others. Both speakers pointed out how powerful lifestyle is for our body functions as this is what lengthens our telomeres and allows us to live longer, disease-free lives. Stem cells also have telomeres, but they are on average longer than the rest of the body cells (called somatic dells). An improved lifestyle will keep our stem cells in good shape, so they are there when needed to replace aging somatic cells.

The new logic of a healthy lifestyle is:

A healthy lifestyle causes healthy telomeres of somatic cells and of stem cells; this causes health until a ripe old age. In the next few weeks I will blog about more topics from the 22nd Anti-Aging Conference in Las Vegas. Stay tuned.

Dec
14
2013

Pollution And Soaring Lung Cancer Rates

By | Allergies, Cancer, Hormones, Lung Disease, Obesity, Prevention

In early 1900 lung cancer was unheard of. This was before the cigarette industry started to mass-produce and market cigarettes.

However, ever since the arrival of the industrial revolution air quality has suffered. In China poor air quality has now reached such enormous values that the specialized cancer agency of the World Health Organization, the International Agency for Research on Cancer (IARC) has labeled poor air quality as one of the causes of lung cancer.

When you rank countries by average air pollution measurements, one sees that Europe, the US and South America overall have good ratings, whereas the Middle Eastern countries, China and India have poorer ratings.

However, when the pollution index of cities where the population is much denser than in the countries at large, are tabulated a much different picture emerges: Cities in Iran, India and Pakistan stand out as particularly bad followed by cities in China, Eastern Europe, Paris, London, Berlin, cities in California (the populous State), Chicago and New York.

Pollution does not stay local, but travels through the stratosphere around the globe. The result is that now 10 to 15% of lung cancer in the US occurs in patients who never smoked. This translates into 16,000 to 24,000 deaths annually of never-smokers in the US.

In certain cities such as Beijing the lung cancer rates have doubled in 9 years between 2002 and 2011. As this article shows lung cancer in never smokers can be caused from exposure to radon, to second-hand tobacco smoke, and other indoor air pollutants can also cause such cancers. But the outdoor air quality has been a problem ever since the industrial revolution, which started around Europe in the 1800’s and first part of the1900’s. In the latter half of the 1900’s much of the industrial wave has migrated to the Middle East, to India and China. But the air quality of the whole world has suffered as the jet stream and other air currents carry pollution in the stratosphere all around the globe.

Pollution And Soaring Lung Cancer Rates

Pollution And Soaring Lung Cancer Rates

History of pollution in various regions

1. In Germany’s  Ruhr district (“Ruhrgebiet”) in North Rhine-Westphalia, a highly populated industrial area, pollution reached a peak in the late 1950’s. From 1963 onward many of the coal mines, iron ore mines and other mineral mines closed down. 50 years ago the German Chancellor, Willy Brand was concerned about the environment and promised that blue skies would return to the Ruhr district again.  A special task force was initiated and maximally allowable limits were established for industries’ pollution emissions and enforced by the German government. Government and industry were co-operating in developing anti-pollution measures, which have cleared up a lot of the pollution since. With regard to car emissions lead free gasoline was introduced and carburetors ensured more complete burning of exhaust gases. This is now common and accepted anywhere except for diesel fume exhaust, which nobody wants to address despite proven carcinogenicity.

Now Germany is one of the leaders in green technology, which is also important for tourism.

2. England has its own legacy of pollution in soil and air from the industrial revolution. The soil of moorland, which soaked up acid rain for decades, is more acidy than lemon juice and it will take a long time despite industrial complexes having closed long time ago, before the soil quality will be returned to normal.

3. Hamilton in Ontario/Canada has had a longstanding pollution problem, which I witnessed from 1976 until my departure in 1978. It is well known that Stelco, the local steel plant downtown Hamilton is sending polluting emissions into the air. In 1976 a vising professor from Australia gave an interesting talk about a study that was done at that time regarding the risk of developing bronchogenic carcinoma (a synonym for lung cancer) in the immediate surroundings of the Stelco plant. He said that this was one of the first studies to show that the distance of people’s houses from the source of pollution mattered as that determined how concentrated the air pollution was (the closer the more polluted the air). This  affected cancer rates: they were much higher in the immediate surrounding of Stelco when compared to the average rate in the rest of Hamilton. This difference was very significant within a radius of 1 kilometer (= 0.62 miles) from the Stelco plant.

Just in May of 2013 the local cancer agency of Hamilton announced that the lung cancer rate in Hamilton was higher than elsewhere in Ontario because of a combination of poor air quality and of a higher percentage of people smoking. Then in August 2013 the city of Hamilton announced a new air pollution bylaw for stricter pollution measures to improve the air quality in the downtown area. It is just a pity that Hamiltonians had to wait until 2013 before the city approved an anti-pollution bylaw that could have been passed 50 years earlier like in Germany’s Ruhr district!

4. In 2008 Pittsburg, a former steel manufacturer town like Hamilton, Ont. outdid Los Angeles with regard to small particle air pollution.

Lung cancer prevention by the authorities

As mentioned before up o15% of lung cancer is caused by environmental exposure. So, we ourselves can only prevent 85% of lung cancer by not smoking and not exposing ourselves to industrial emissions or to smoke from incense. However, in many cities around the world you will get exposed to air pollutants that are well above the safe limits, so the risk of getting lung cancer from just breathing the air there can be much higher than in rural areas where there is no industry.

Technologies to control air pollution are widely available. We need to exert pressure on politicians to show leadership around the world. Government regulations to lower emission rates need to be put into place and inspectors need to ensure the rules and regulations are adhered to. Without reducing emissions of cancer producing gases and chemicals right at the source (open burning of cuttings in orchards or burning cut trees), cutting emissions of cars, planes, ships, diesel cars, locomotives, electric generator plants etc. the air quality will not improve. Despite some costs involved industry, governments and individuals have to work together to make clean air happen.

The residents of those countries that have low pollution values will not benefit, if pollution continues to occur in other parts of the world as it just travels in the stratosphere around the globe until it arrives right here at home! We need an international pollution police. Satellites can be used to monitor where pollution occurs and this can be followed up through the local regulatory bodies with penalties and remedial actions.

What can I do personally to prevent lung cancer?

1.The most obvious step is to quit smoking and ask smokers who come to your place to smoke outside (not in your home).

2.Consider moving away from the city, if the air quality is unacceptable to a place where there is low air pollution.

3.Vitamin D3 has been shown to prevent colorectal cancer, but as there are vitamin D receptors found on the surface of various cells in tissue around the body including the lungs, many researchers feel that this vitamin in higher doses (2000 IU to 5000 IU) has probably a wider applicability in preventing cancers, even lung cancer.

4.Cutting out sugar and adopting a Mediterranean type diet is a prudent thing to do; also cutting down your calories to the maintenance you need (mildly ketogenic diet). If you bought body composition scales, it would display what your daily calorie consumption is and you should not exceed this, or else you’ll gain weight. An aging man who is overweight will experience hormone changes as fat is being metabolized and the enzyme aromatase contained in fatty tissue will turn male hormones (testosterone, DHT, androstenedione) into estrogen. Estrogen (particularly estradiol) is a known carcinogen that has been proven to cause breast cancer in women and prostate cancer in men. However lung cancer is also being promoted in women by estrogen as discussed in this link. In men one needs to remember that lung cells have estrogen receptors and there is concern in aging men with higher estradiol levels that this can promote cell divisions in existing lung cancer. So, it is important to maintain a normal body mass index between 21 and 24 (well below 25.0 and well above 18.5, which are the official accepted limits). This way there is no problem with insulin resistance (too high an insulin level), and other metabolic substances (cytokines, growth hormone like factors and tumor necrosis factor-alpha from body fat) that are cancer promoting.

5. If testosterone deficiency is present, which is common in older men, testosterone will have to be replaced with bioidentical hormones. It is a myth that testosterone would cause prostate cancer. Testosterone in males is necessary to maintain a normal metabolism including the immune system, which then can fight lung cancer and any other cancers.

6. Exercise and reducing beef consumption are also often mentioned in terms of preventing lung cancer.

7. Here are several recommendations from the LifeExtension Foundation that I found very useful in terms of lung cancer prevention. This link shows that antioxidant vitamins such as vitamin C, alpha tocopherol, the minerals selenium and zinc are also helping to reduce the lung cancer rate. Drinking green tea has also been shown to be effective in a dose-response curve manner (more tea protecting more from lung cancer). Vitamin B12 and folate have been shown to reduce abnormal bronchial cell growth in smokers as shown by repeat bronchoscopy studies.

8. Those who have been smokers in the past and those who have been around heavy smokers for more than 10 years in the past should consider having a preventative bronchoscopy done by a lung specialist (also called respirologist or pulmonologists). This way any suspicious areas with precancerous lesions can be biopsied during the procedure and attended to.

Hopeful research for new lung cancer treatments

Lung cancer is a disease that is best prevented. Once a person gets lung cancer, the prognosis is still very poor. However, cancer researchers are getting close to newer treatments involving genetically modified T-cells (killer cells) as was recently achieved for leukemia. Similar research is going on regarding ovarian cancer, melanoma, lung cancer and pancreatic cancer.

More information about lung cancer: http://nethealthbook.com/cancer-overview/lung-cancer/

Conclusion

It is not acceptable to let pollution take its course , the way politicians around the globe have handled this in the past 6 decades with a few notable exceptions mentioned. We all suffer a higher risk of getting lung cancer, even if we have been life-long non-smokers. Right now up to 15% of lung cancer in most populations are of this type. However, in Beijing this number is already much higher. The technology is available; Germany has led the way in the Ruhr district in the 1960’s and beyond. In my opinion the G8 meetings should have this high on their agendas and send technological aid to all the regions that have higher than the average world pollution index under the mandate of a special UN commission. This should be supported by the major industrial players with the knowledge that they will prevent the death of millions of potential consumers down the road, which will on the long-term pay off the relatively minor investment of installing pollution controls, before lung cancer levels rise even more.

Last edited Nov. 7, 2014

Nov
30
2013

Statins Can Hurt The Consumer

By | Anti-aging medicine, Arthritis, Diabetes, Fitness, heart attack, Heart Disease, High Blood Pressure, Hormones, kidney disease, Nutrition, Obesity, Prevention, Stroke, Vitamins and supplements, Weight loss

Lovastatin (Mevacor, from Merck) was the first statin drug approved by the FDA in 1987 as a cholesterol-lowering drug in the US. It made history in helping high-risk heart attack patients reduce their cholesterol levels and has helped safe many lives. But with the detection around 2002 that heart disease is an inflammatory disease, and that measuring the C-reactive protein with a blood test was a better than measuring cholesterol levels in predicting who would be at risk for developing a heart attack, the landscape has changed. Lifestyle changes have also been shown to be very effective in reducing cholesterol, C-reactive protein and triglyceride levels. In fact, lifestyle changes will reduce the risk for heart attacks and strokes. The newest flurry of activity with calls for putting more people on statins makes me suspicious that there could be a misrepresentation of the facts.

In this blog I am analyzing the literature to get to the bottom of the facts on reducing risk for heart attacks and strokes. I also come to my own conclusion.

Facts about cholesterol

Cholesterol is a waxy substance that is part of the cell walls and plays a vital role in our metabolism. Liver cell membranes, for instance contain about 30% cholesterol. However, most of the cholesterol in our body comes from metabolism, 20 to 25% from the liver, the rest in the gut, adrenal glands and the reproductive organs, and also from the brain (the myelin sheaths contain a lot of cholesterol). 50% of the body’s cholesterol is recycled through bile salts and reabsorption of cholesterol in the gut (called the enterohepatic pathway).

Cholesterol is vital for cell function, for insulation of nerve fibers (myelin sheaths) and for synthesis of our steroid hormones (sex hormones and vitamin D3, which  is now considered to be a hormone). The medical establishment took most of the information regarding heart attack and stroke prevention from the ongoing Framingham study. This clearly pointed to the importance of lowering the LDL cholesterol fraction (the “bad” cholesterol) and maintaining or increasing the HDL fraction (the “good” cholesterol). When it was realized that concentrating only on lowering cholesterol missed 50% of all heart attacks that researchers refocused and found the missing link, namely inflammation. Inflammation is at the cause of heart attacks and strokes, high cholesterol and lipids were only secondary phenomena. Ref. 2 points out that a comprehensive approach to treating a patient with high cholesterol should involve a combination of treatments aimed at the underlying risk factors for heart disease or stroke in a particular patient. This involves sophisticated blood tests where a metabolic derangement can be pinpointed. It should include measuring cholesterol fractions, lipids, the C-reactive protein, hormone levels and more.

Statins Can Hurt The Consumer

Statins Can Hurt The Consumer

How the traditional thinking about cholesterol has changed

The Framingham study has provided the basis for the drug industry to produce statins until about 2002 when our thinking about cholesterol being the culprit for causing heart attacks has forever changed. Subsequently further research showed that other factors like inflammation of the blood vessels, the metabolic syndrome associated with obesity and lack of exercise were also to blame for causing heart attacks and strokes. Recently more details have come to light, which point to multiple causes like the consumption of too much sugar, too much trans fats, too much salt and eating too much over processed convenience food.  We end up gaining weight, develop the metabolic syndrome and inflammation of arteries (including the coronary arteries of the heart and the brain vessels). It is the lack of nitric oxide in the lining of the arteries, which combined with inflammatory substances from visceral fat are responsible for hardening of the arteries as the ultimate consequence of faulty nutrition and lack of exercise. We also know that oxidized LDL, particularly the very low-density lipoproteins (VLDL), will release free radicals and damage the arterial walls. CoQ-10 is a supplement, which is known to counteract this. One important test that had developed out of the Framingham study is the “ratio of total cholesterol to HDL cholesterol”, which is used by cardiologists to determine the risk of coronary artery disease. The average risk of this ratio for Americans is 5.0 for males and 4.4 for females. The ideal ratio to strive for is  the “1/2 average risk” ratio of 3.4 for males and 3.3 for women (Ref.2). A fit, slim person who eats a low carb, normal fat diet (modified Mediterranean diet) will often have a ratio of only 3.0, well below the 1/2 average risk. The moment you introduce grains in your diet (cereals, bread, pasta) your liver will convert carbs into LDL cholesterol, while HDL cholesterol will drop resulting in a high risk ratio of above 5.0 (often 7 or 8 or more). The LDL will get oxidized and is deposited into your arteries setting you up for coming down with a heart attack or stroke down the road.

How do statins work?

The statins are a group of drugs that inhibit an enzyme, called the hydroxymethylglutaryl–Coenzyme A (HMG-CoA), which leads to a lowering of cholesterol, specifically a fraction known as the LDL cholesterol. The success story of lovastatin (Mevacor) led to a flurry of new HMG-CoA reductase inhibitors (cholesterol lowering drugs) such as fluvastatin (Lescol), pravastatin (Pravachol), simvastatin (Zocor), atorvastatin (Lipitor), and rosuvastatin (Crestor) in the late 1980’s and the 1990’s. Collectively it is now a 26 billion industry in annual sales.

Later investigations showed that there were other mechanisms by which statins helped, namely they were found to decrease the inflammatory reaction, which can be measured by lowering of the C-reactive protein. However, there are significant side effects in about 1 to 3% of people who take this medication, particularly an inflammation of liver cells (evident from elevation of liver enzymes) and a myopathy, which is a painful muscle condition (Ref. 1). This latter fact, which can occur in as many as 33% of the population at large (particularly the exercise minded) has limited the use of statins in competitive athletes where myopathies can occur in as many as 75% of athletes treated with statins (Ref.2). The reason for that is that the muscles of athletes cannot keep up with the demands put on them when they are kept in check by the HMG-CoA reductase inhibitors. On the other hand statins have prevented heart attacks and deaths from heart attacks and strokes in about 25% to 35% of patients treated with them as many clinical trials have shown (Ref.1), but simple supplements that have no side effects can do the same or do even better (see below).

The lack of cholesterol synthesis by the body’s cells when statins are given, leads to an expression of more LDL receptors on the cell surfaces. LDL binds to these receptors and enters the cells, which removes the circulating high risk LDL fraction of cholesterol from the blood thus causing a drop in LDL cholesterol. All of the side effects of statins (pull down to side effects in this link) can be explained as a result of the slow-down of organ functions (brain, muscles, gut, adrenal glands, etc.) as cholesterol synthesis is reduced.

New information from the Framingham Heart Study

So far everything I said made sense. But when I came across Ref. 4 I noticed that there was a bombshell of new information from another follow-up study of the Framingham Heart Study (Ref. 5) that did not fit in with the latest marketing drive of the statin manufacturers. In this study from 2005 Boston researchers had studied the outcomes of 789 men and 1105 women over a period of 16 to 18 years with respect to cognitive function. Participants were divided into total cholesterol groups that showed levels that were desirable (less than 200), borderline (200 to 239) or high (above 240). The astounding results were that higher cognitive functioning as documented in multiple cognitive tests in these three groups showed the best performance in the group with the highest cholesterol and the worst cognitive test outcomes in the lowest cholesterol group, quite opposite of what was expected.

Another important piece of research (April 2013) comes from Spain where doctors followed a group of 7447 patients with a high cardiovascular risk who were put on a Mediterranean diet with olive oil, a Mediterranean diet with nuts or a regular diet. The end point was death from heart attack or stroke. After 4.8 years the study had to be interrupted as the Mediterranean groups showed a significant survival advantage over the group on a regular diet.

Ref. 4 cited literature evidence that statins cause a 48% increased risk in postmenopausal women who take statins to develop diabetes. It also cites compelling evidence that diabetes patients are twice as likely to develop Alzheimer’s disease within 15 years and are 1.75 times more likely to develop any kind of dementia in the same time period.

Dr. Seneff from the Computer Science and Artificial Intelligence Laboratory at MIT explains in great detail that statins effectively reduce cholesterol synthesis in the liver, which in turn starves the brain of one of its main nutrients explaining why patient develop Alzheimer’s disease and dementia as a result of statin treatment.

So, the lessons to be learnt from these clinical trials are that you want to offer your brain enough cholesterol and healthy fat to have a normal metabolism. Fortunately, what’s good for your heart is also good for your brain. Conversely avoid statins, if you can and try alternatives first. Ref. 4 explains that for years the experts had the wrong theory that low fat/high carb was what would be good for your heart and brain, but the opposite is true: what is good for your heart and brain is a high healthy fats/low refined carb diet.

Make sure that with your blood tests that fasting insulin is low (no insulin resistance), that the ratio of total cholesterol to HDL cholesterol is less than 3.4 (low risk for heart attacks or strokes) and that the hemoglobin A1C level is low (4.8 to 5.6%, ideally less than 4.5%), which means you are not diabetic.

How alternative treatment can save you from heart attacks

Lifestyle treatment through dietary intervention, moderate exercise, and weight loss has been somewhat neglected by mainstream medicine, but is now recognized in regular textbooks of medicine as first-line treatment (Ref. 3). Most patients can lower LDL cholesterol by 10 to 15% through a change in diet. High-risk patients with established heart disease (narrowing of coronary arteries) require a drop of 30 to 60% of LDL cholesterol; this high-risk patient group may need an addition of a statin. In patients with metabolic syndrome or diabetes high triglycerides are often present and will respond to decreased intake of simple sugars, alcohol, and calories (Ref.3). Total calorie intake should be adjusted according to what the weight is when weighed every day with the goal of reducing the weight when overweight or obese, but maintaining the weight when it is in the normal body mass index range (BMI of 20 to 25). The total fat intake should be around 25%-35% of the total calorie intake. Specifically, saturated fat needs to be less than 7% of total calories, polyunsaturated fat up to 10% of total calories and monounsaturated fat up to 20% of total calories. Healthy fats according to Ref. 4 are extra-virgin olive oil, organic butter, almond milk, avocados, olives, nuts, nut butters and cheese ( except for blue cheeses). Other healthy fats are sesame oil, coconut oil, and the oils found in seeds like flaxseed, sunflower seeds, pumpkin seeds and chia seeds. Note that trans-fats (such as in margarine and baked goods) are a “no-no” as it causes free radicals in your body, which would accelerate the hardening of your arteries. Complex carbohydrates from vegetables and fruit are the main source of total calories providing 50%-60% of the total calories. Fiber intake needs to be 20-30 grams per day. Protein intake should be about 15% of total calories. Fat should provide 25% to 35% of the total calories per day. Cholesterol intake should be less than 200 mg per day. You may want to consider the use of plant sterols (2 grams per day) to enhance LDL cholesterol lowering. Physical activity from moderate exercise should expend at least 200 kcal per day (better 300 kcal).

Which supplements prevent heart attacks and strokes?

There are several nutrients that have been shown to be powerful preventers of heart attacks and strokes. I will review them briefly here (based on Ref. 2):

1. Coenzyme Q10 (CoQ10): The cells lining the arteries are only working well when their mitochondria are working properly producing chemical energy in form of ATP. CoQ10 is an important component of the mitochondrial metabolism; it is also the only fat soluble antioxidant that gets absorbed into the LDL particles where it protects these from oxidation. Statins suppress CoQ10 synthesis, so patients on statins need to take CoQ10 supplements daily to counteract this. However, anybody who is healthy now should take CoQ10 as a daily supplement for prevention. I take 400 mg per day.

2. Vitamin E (tocopherols): this fat soluble vitamin is an antioxidant and has been praised in the past as being heart supportive, was subsequently bad-mouthed by some conservative physicians, but lately has been resurrected. It turns out that there are 8 different types of tocopherols, with the alpha tocopherol being the most known, but gamma tocopherol is the one you want to make sure you are also getting with your balanced vitamin E supplement every day as this is the one that is a powerful anti-inflammatory. Simply ask staff at your health food store for a vitamin E supplement with gamma tocopherol in it. Take 400 IU per day (of the mix).

3. Curcumin: This is a powerful heart and brain protector combining three different mechanisms in one; it is reducing oxidative stress, is an anti-inflammatory and counters the process that threatens to destroy the lining of the arteries. One study on healthy volunteers showed a reduction of 33% in lipid oxidation, a 12% reduction of total cholesterol and an increase of 29% of the protective HDL cholesterol when 500 mg of curcumin was taken only for 7 days (Ref.2). This is the daily dose I would recommend for prevention of heart attacks and strokes.

4. Polyphenols: Flavonoids are the largest group among the polyphenols contained in such common foods as vegetables, fruits, tea, coffee, chocolate and wine.  Over 130 studies have been done on humans showing improvement of the lining of the arteries (endothelial functioning) and lowering of blood pressure. Polyphenol consumption has been associated with a lower risk of mortality from heart attacks. Eat a Mediterranean type diet or a DASH diet and you will automatically get enough polyphenols with your food. However, resveratrol, the powerful red wine polyphenol warrants a separate daily supplementation as it prevents LDL oxidation in humans (Ref.2). Take about 250 mg of it daily.

5. Niacin/nicotinic acid: This supplement comes as “flush-free niacin” and also as extended release niacin; it can raise the beneficial HDL cholesterol by 30 to 35% when higher doses of 2.25 grams per day are used. In a metaanalysis of 7 studies it has been shown to significantly reduce heart attacks and transient ischemic attacks (precursor syndrome before developing a stroke). Niacin can change the small particle LDL into a large particle size LDL, which is less dangerous. Niacin has also been shown to reduce oxidation of LDL, which stops the atherosclerotic process. For a healthy person 500 mg per day of flush-free niacin is adequate.

6. Fish oil (omega-3-fatty acids): Because heart attacks are due to an inflammatory process and high LDL cholesterol is thought to be only a secondary phenomenon, it is very important to have this additional tool of an important anti-inflammatory supplement. In the past it was still safe to eat fish fairly frequently per week. But with mercury, radioactive iodine from Japan’s leaking reactor and carcinogenic PBC’s all congregating in the ocean waters, it is no longer safe to consume fish in large quantities. The remedy to this situation is molecularly distilled (or pharmaceutically pure) EPA/DHA supplements. EPA stands for eicosapentaenoic acid or omega-3 fatty acid. DHA is the acronym for docosahexaenoic acid. Fish oil supplements at a dosage of 3.35 grams per day of EPA plus DHA were shown to reduce triglycerides by up to 40%, equally to Lipitor or even more effective, but without the statin side effects. The amount of the dangerous small dense LDL is also being reduced with fish oil. Fish oil supplements have reduced the mortality from heart attacks and strokes and led to a higher survival from non-fatal heart attacks. At the same time these preventative fish oil doses will also treat and prevent arthritis.

7. Other useful supplements: Soluble fiber from psyllium, pectin, beta-glucans and others have been shown in clinical trials to reduce LDL cholesterol by binding bile salts in the gut (interrupting the enterohepatic pathway). Plant sterols (usually sold as sterol esters) are recognized by the FDA as reducing the risk of coronary heart disease, if taken in high enough amounts (2.4 grams of sterol esters per day). There are other useful supplements like artichoke extract, pomegranate, soy protein, Indian gooseberry (amla), garlic and pantethine (vitamin B5) that have been proven to be of benefit in terms of prevention of heart attacks and strokes. It would be too lengthy to get into more details here.

Conclusion

Recently there was a review in a medical journal that demonstrated that clinical guidelines (in this case for clinical guidelines for lowering cholesterol) erred 40% of the times when measured against scientific tests as this link explains. When it comes to saving lives by preventing heart attacks and strokes, what is needed is a multifactorial approach that treats the multifactorial causes of cardiovascular disease. Just pushing for treating more people with statins as Big Pharma is attempting to do is not addressing the fact that cholesterol is needed for our metabolism and the synthesis of our hormones. It is much superior to use a combination of different approaches that overlap and thus potentiate each other in their effects excluding statins first. Exercise creates more nitric oxide production by the lining of the arteries, which opens up arteries and prevents spasms. A proper diet with as many of the proven vitamins and other support factors will control inflammation and oxidation of LDL cholesterol particles as explained. This will prevent heart attacks and strokes as has been shown in many clinical trials. Only patients who come from families with genetically high cholesterol or high triglycerides and those patients who had heart attacks and strokes should be exposed to statins as they are at a higher risk of developing a heart attack or stroke. They need all of the help they can get in addition to the lifestyle factors mentioned. Most other patients and the public at large will do quite well without statins (no side effects of diabetes, Alzheimer’s and muscle pains). And, yes, a diet high in healthy fats, but low in refined carbs is what your brain and heart need (the opposite of what you have thought, see Ref. 4).

More information about side-effects of statins (acute pancreatitis): https://www.askdrray.com/pancreatitis-can-occur-with-statin-use/

Lower cholesterol with Mediterranean diet: http://nethealthbook.com/news/mediterranean-diet-benefits-us-workers/

 

References

1. Bonow: Braunwald’s Heart Disease – A Textbook of Cardiovascular Medicine, 9th ed. © 2011 Saunders.

2. Life Extension: Disease Prevention and Treatment, Fifth edition. 130 Evidence-Based Protocols to Combat the Diseases of Aging. © 2013

3. Melmed: Williams Textbook of Endocrinology, 12th ed. © 2011 Saunders.

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

5. http://www.psychosomaticmedicine.org/content/67/1/24.full.pdf

Last edited Nov. 7, 2014

Nov
16
2013

You Can Fight Back Against Arthritis

By | Arthritis, Fitness, Nutrition, Obesity, Prevention, Vitamins and supplements, Weight loss

This article is about the fact that you can fight back against arthritis. It is important to realize that osteoarthritis affects about 4 to 5% of the population with women outnumbering men by 2 to 1. Notably, 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, getting stiff and sore, and had to “take it easy” as a result when they got older. In general, things are not as uncomplicated, as arthritis affects about 53 million Americans, and it has become the leading cause of disability in the US.

First thing to remember is that 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.

Another key point, 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 similar inflammatory immune factors that are involved in rheumatoid arthritis.

Cytokines from the immune system attack joints

In particular, 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. Certainly, 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.

Pain in the joints

For the person suffering from 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). Indeed, any person suffering from osteoarthritis will complain that he or she feels stiff and sore especially after a period of inactivity.

Certainly, 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. By all means, it is important to take a critical look at lifestyle choices. For instance, excessive body weight puts an additional burden on the joints in the body. Indeed, increased body fat is not just sitting at the abdomen as an inert potbelly. To emphasize, 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 and smoking lead to arthritis

To clarify, 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 from arthritis. Another key point is that 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 causing arthritis

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 diet particularly useful

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. Physicians could show that cutting out wheat and wheat products is 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. Weight reduction in combination with an exercise program makes the improvements even more striking.

Exercise

Exercise consists of aerobic training, resistance training and muscle strengthening. When researchers observed patients with osteoarthritis throughout controlled exercise programs, flexibility and range of motion of the affected joints were improving. They found that a minimum of three days per week of exercise was necessary to show joint range of motion improvements. However, the best results were there when patients exercised most of the days. Joints become less swollen, show improved circulation and less pain. Researchers determined that prior to an exercise program those with increased cardiovascular risk should first undergo an exercise stress test. This measured their cardiovascular reserve and established that it was safe to start a program.

Treat inflamed joint first, then exercise

Physicians found that an acutely inflamed or swollen joint required treatment first before the start of an exercise program. 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 there was a reduction of joint swelling. Patients who have cold sensitivity (such as Raynaud disease) need to refrain from the latter treatment modality.

Acupuncture and electro acupuncture

Researchers found these treatments useful as an adjunct to anti-inflammatory medication with NSAIDS (non steroidal anti-inflammatory drugs). The advantage was that they could reduce the dosage of NSAIDS, which eliminated 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 osteoarthritis or rheumatoid arthritis affects only a few joints, a physician can inject a corticosteroid into the joint. However, there are limitations, as the physician can inject each joint not more than 3 to 4 times. 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 I indicated earlier, only higher doses of omega-3 fatty acids cause this effect. Also, for safety reasons only use molecularly distilled omega-3 fatty acid supplements. These avoid toxicity from mercury and PBC’s. Yes, they are more expensive.

Curcumin

Health care workers in India and Asia used curcumin, the active ingredient of the spice turmeric, for its anti-inflammatory and antioxidant properties for centuries. It helps not only arthritis, but also against the illnesses in association with it, such as obesity, diabetes, heart disease and autoimmune conditions. Ref. 2 points out that curcumin neutralizes inflammatory agents circulating in the blood of patients with arthritis.

Standardized ginger extract

Research showed that standardized ginger extract reduced 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

Researchers asked themselves whether itv is possible to enhance joint health of patients 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. Colds and flus also cause an inflammatory reaction within the body.

A steaming bowl of chicken soup

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.

Un-denatured type II collagen (UC-II)

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

Researchers treated a group of patients with knee osteoarthritis with the supplement for 90 days. 33% experienced a reduction in their osteoarthritis. There was a reduction of knee pain by 40%. Those patients who received the standard treatment without any supplement had 15.4% less pain. There was an improvement of joint function by 20% in the group on the supplement. There was only 6% of improvement in the patient group receiving standard care.

Healthy patients showing more knee mobility on UC-II

Researchers also assessed healthy patients who did not suffer from arthritis, but received the supplement to evaluate how they would fare with exercise-induced knee pain. They treated them with a daily dose of 40 mg of UC-II. After day 90 and 120 the treatment group group 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 researchers examined knee joint flexibility, the supplement group had significant increases in their knee mobility, but no such luck for the placebo group!

UC-II desensitizes the immune system

Numerous toxicological essays have evaluated the supplement. There is no oral toxicity. Researchers did not detect any mutations in bacterial genomes. This is a standard screen to ensure that a substance is non-carcinogenic.

The oral administration of the UC-II supplement works through desensitization of the immune system. 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 in use on a long-term basis. Few are tolerable to modify the course of the disease.

The UC-II supplement addresses the root of the disease (autoimmune disease). The patient experiences relief of symptoms within a few weeks of starting it. A person with arthritis can fight back  with lifestyle changes and the UC-II supplement.

More information on osteoarthritis: https://nethealthbook.com/osteoarthritis/

References

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

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

Nov
09
2013

Successful Diabetes Treatment Requires Patient’s Discipline

By | Diabetes, Fitness, heart attack, Heart Disease, Hormones, Nutrition, Obesity, Prevention, Stroke, Vitamins and supplements, Weight loss

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

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Oct
26
2013

Being SAD in Fall (Seasonal Affective Disorders)

By | Abdominal Pain, Hormones, Insomnia, Mental Health, Pain, Prevention, Stress management, Vitamins and supplements

Any general practitioner knows that fall and winter are the time when patients come in with a variety of complaints like a lack of energy, problems sleeping, inability to cope with stress, but often there may be non-specific pains like muscle spasm in the back, the shoulders, or indigestion. These symptoms can all be part of seasonal affective disorders (SAD) like depression, the winter blues, often coupled with anxiety.

Emotional health does not fit easily into our health care model. The receptionist will warn the doctor that this is going to be a “difficult” patient. If the doctor has only time for a 5 or 10-minute visit, where only one or two problems can be dealt with, then this does not fit when a patient with SAD has a problem concentrating, falling asleep, and presents with a long list of other complaints. Even 20 minutes or 30 minutes may not be enough to deal with this patient adequately. It is easier to send the patient for tests and to prescribe an antidepressant and a sleeping pill and reschedule for a follow-up appointment. But this likely will result in normal blood tests and investigations, added health care costs, but no solution to the patient’s problem when he  or she simply states “doctor, I feel so sick”.

I thought it would be interesting to review how our emotions can get out of balance and review an integrative approach to SAD.

Definition of SAD

Seasonal depression (also called seasonal affective disorder) occurs during fall (autumn) and winter, but this alternates with no depressive episodes during spring and summer. A person defined to suffer from SAD would have suffered from two major depressive episodes during the past 2 years with no depressive episodes in the intervening seasons of spring and summer (Ref.1). Alternative names for SAD are winter depression and wintertime blues. Typically SAD lasts about 5 months.

Brain hormone disbalance

Around 2002 it was detected that in mice there was a second light sensitive pathway from ganglion cells in the retina that were responsible for circadian hormone rhythms. This was later confirmed to be true also in humans, where photosensitive retinal ganglion cells buried deep in the retina and containing the pigment melanopsin absorb blue light in the visible light spectrum. The electrical signals are sent along the retinohypothalamic tract, so that light from the retina regulates the hormone circadian rhythm (daily hormone fluctuations including the sleep/wake cycle) in the hypothalamus. The hypothalamus is one of the major hormone centers in the center of the brain. As this publication shows there are minor genetic sequence changes for the retinal photopigment, melanopsin in patients with SAD. This affects about 1 to 2% of the American population. Many more have probably partial defects in the function of this pigment.

Being SAD in Fall (Seasonal Affective Disorders)

Being SAD in Fall (Seasonal Affective Disorders)

Many hormones in our brain experience a circadian rhythm.

When the sun goes down, melatonin is produced making us sleepy. In the morning serotonin production goes up and stays up all day, which normally prevents depression. There are other hormones that cycle during the course of the day. Cortisol is highest in the morning and low in the evening and at night. Growth hormone and prolactin are highest during sleep.

There is a lack of serotonin in the brains of patients with SAD and depression.

Symptoms of SAD

A person affected by SAD or any other patient with ordinary depression will present with symptoms of lack of energy, with tearfulness, negative thought patterns, sleep disturbances, lack of appetite and weight loss and possible suicidal thoughts. On the other hand symptoms may be more atypical presenting with irritability and overindulging in food with weight gain. Some patients somaticize as already mentioned in the beginning of this review experiencing a multitude of functional symptoms without any demonstrable underlying disease. It is estimated that up to 30 to 40% of patients attending a general practitioner’s office have some form of depression and in the fall and winter season a large percentage of them are due to SAD.

Treatment approaches to SAD

There are several natural approaches to SAD. However, before deciding to go this route, a psychiatrist should assess the patient to determine the risk for suicide. When a patient is not suicidal, light therapy can be utilized.

1. Light therapy: According to Ref. 2 a light box from Sun Box or Northern Light Technologies should be used for 30 minutes every morning during the fall and winter months. The box should emit at least 10,000 lux. Improvement can occur within 2 to 4 days of starting light therapy, but often takes up to 4 weeks to reach its full benefit (Ref.2).

2. Exercise reduces the amount of depression. The more exercise is done the less depression remains. A regular gym workout, dancing, walking, aerobics and involvement in sports are all useful.

3. Folate and vitamin B12: Up to 1/3 of depressed people have folate deficiency. Supplementation with 400 mcg to 1 mg of folic acid is recommended. Vitamin B12 should also be taken to not mask a B12 deficiency (Ref.3). Folate and vitamin B12 are methyl donors for several brain neuropeptides.

4. Vitamin D3 supplementation: A large Dutch study showed that a high percentage of depressed patients above the age of 65 were deficient for vitamin D3. Supplementation with vitamin D3 is recommended. (Ref.3). Take 3000 to 4000 IU per day, particularly during the winter time.

5. St. John’s Wort (Hypericum perforatum) has been found useful for minor to moderate depression. It is superior in terms of having fewer side effects than standard antidepressant therapy (Ref.3).

6. Standard antidepressants (bupropion, fluoxetine, sertraline and paroxetine) are the treatment of choice by psychiatrists and treating physicians when a faster onset of the antidepressant effect is needed (Ref.3).

7. Electro acupuncture has been shown in many studies to be effective in ameliorating the symptoms of depression and seems to work through the release of neurotransmitters in the brain (Ref.4).

8. A balanced nutrition (Mediterranean type diet) including multiple vitamins and supplements (particularly the vitamin B group and omega-3 fatty acids) also stabilize a person’s mood (Ref.3). Pay particular attention to hidden sugar intake, as sugar consumption is responsible for a lot of depression found in the general population.

9. Restore sleep deprivation by adding melatonin 3 to 6 mg at bedtime. This helps also to restore the circadian hormone rhythm.

Conclusion

Seasonal affective disorder is triggered by a lack of light exposure in a sensitive subpopulation. An integrative approach as described can reduce the amount of antidepressants that would have been used in the past in treating this condition. This will reduce the amount of side effects. The use of a light box can reduce the symptoms of this type of depression within a few days. But the addition of electro acupuncture and St. John’s Wort may be all that is required for treatment of many SAD cases. Regular exercise and a balanced nutrition (with no sugar) and including vitamin supplements complete this treatment. If the depression gets worse, seek the advice of a psychiatrist and make sure your doctor has ordered thyroid tests and hormone tests to rule out other causes where depression is merely a secondary symptom.

More information on depression: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/depression/

References

  1. Ferri: Ferri’s Clinical Advisor 2014, 1st ed. © 2013 Mosby.
  2. Cleveland Clinic: Current Clinical Medicine, 2nd ed. © 2010 Saunders.
  3. Rakel: Integrative Medicine, 3rd ed. © 2012 Saunders.
  4. George A. Ulett, M.D., Ph.D. and SongPing Han, B.M., Ph.D.: “The Biology of Acupuncture”, copyright 2002, Warren H. Green Inc., Saint Louis, Missouri, 63132 USA

Last edited Nov. 7, 2014

Oct
19
2013

Healthy Choices Start In Your Brain

By | Alzheimer’s disease, Anti-aging medicine, Diabetes, Fitness, High Blood Pressure, Infectious Disease, Mental Health, Other neurological conditions, Prevention, Stroke, Substance abuse, Vitamins and supplements

This article deals with 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.

Two ways of making food choices

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.

Two groups of volunteers

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.

Balanced thinking required to make the right choices

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

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 right and  the MRI scans of the brain of a chronic alcoholic on the left.  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

These include lack of exercise, excessive weight (obesity, being overweight) and poor diet (fast foods). They 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 known causes mentioned above, I like to give you a list of 6 recommendations. These will help you to prevent Alzheimer’s disease and dementia in general.

Cut out sugar

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).

Limit your alcohol consumption

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.

Have your hormones checked

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 stimulation from 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).

Prevent repetitive brain injuries

Prevent repetitive brain injuries before it is too late. Rethink whether you really need to box, street fight, play football, rugby or hockey. An Accumulation of head concussions can cause Alzheimer’s later in life!

Use vitamins for prevention of dementia

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

Do regular exercise

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, your immune system stops production of autoimmune antibodies against your brain cells. Your opiate receptors in the brain will no longer  seduce you to eat more and more sugar, starchy foods or high fructose corn syrup. You no longer have a problem cutting out high glycemic index foods (Ref.1). This will reduce insulin and reduce IGF-1 growth factors. These can lead to the production of 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