Sunday, November 28, 2010


Although many of us eat and maintain a healthy life style to look and feel better, there is a superior reason. That is to BE BETTER and LIVE LONGER. One can be productive and happy as a centenarian (living 100+ years. Over 70,000 centenarians in America!). How can you know how long and well you will live? There is a laboratory study for it, called TELOMERE TESTING. Until the summer of 2010, the test was prohibitively expensive, but now for less than $400, you can obtain your report card and intervene on life style to get a better and better score and either achieve your goal or come very close to it.

Telomeres are sections of DNA at the end of each chromosome whose primary function is to prevent chromosomal “fraying” when a cell replicates. As a cell ages, its telomeres become shorter. How much shorter is governed by genetic factors and environmental stressors. Eventually, the telomeres become too short to allow cell replication, the cell stops dividing and will ultimately die which is a normal biological process. The more of our cells die, the older and frailer we become until we ourselves die in that all our reserves are gone and we succumb to disease or just old age. The Telomere Test can determine the length of a patient’s telomeres in relation to the chronological age. The Patient Telomere Score is calculated based on the patient’s telomere length on white blood cells (T-lymphocytes). This is the average compared to telomere length on lymphocytes from a sample of the American population in the same age range. The higher the telomere score, the “younger” the cells and the longer and better that person will live. Yearly, the test can be repeated and you can work harder or do other interventions that will enhance your score and your life.

Diet plays a large role in telomere length. The best but the most difficult is caloric restriction to the point of just sustenance, a step away from starvation. Far easier and almost as good is eating correctly for your Apo E type, going easy on meat, with eating whole nutrient dense foods, as raw as possible, consumption of Omega 3s, and staying away from grains and processed foods. According to a study of patients with established cardiovascular disease in the January 20, 2010 issue of JAMA, increased telomere and survival rates occurred among individuals who had a high dietary intake of marine omega-3 fatty acids. In this 5 year study, the researchers found that individuals with the lowest DHA+EPA experienced the most rapid rate of telomere shortening, whereas those in the highest had the slowest rate of shortening. Levels of DHA+EPA were associated with less telomere shortening before and after sequential adjustment for established risk factors and potential confounders. For each 1-standard deviation increase in red cell Omega 3 levels was associated with a 32 percent reduction in the odds of telomere shortening! Both the micronutient and the Omega 3 levels tests are available at some labs and physicians offices and is preformed by Spectracell Laboratories.

Minimizing emotional (psychological) and physiological (infections, trauma and surgery) stress will keep your telomeres longer and you healthier. Additionally, increasing antioxidants slows telomere shortening. Physical excerise with adequate antioxidants will also give longer telomers. Common sense dictates that decreasing cardiovascular risk factors (Lipids, Homocysteine, Blood Pressure, Hs-C Reactive Protein, Glucose etc.) and correcting micronutrient deficencies such as Vitamins, Minerals, and Glutathione will preserve the telemomere length. Periodically getting rid of our poison buildup by colonic, and liver cleanses and from the skin by sweating (artificially by sauna or by heavy exercise) and minimizing the toxins in our water, air and food will go a long way in keeping our telomers longer. Keeping our hormones (Thyroid, Sex and Adrenal hormones) in balance and not getting sick also keeps our telomers longer. To not get sick means keeping our immune system healthy to include the consumption of Pre and Probiotics such as high-amylose-resistant cornstarch laced with Lactobacillus rhamnosus (PL60) and other Bacteroidetes spiecies. Staying out of harm's way for bodily damage in our daily pursuits such as not over indulging in alcohol and dangerous sports and occupations will keep our telomers and our lives longer.

Monday, November 22, 2010


PROBIOTICS are live microorganisms which when administered in adequate amounts confer a health benefit on the host. Our intestines have been populated with friendly bacteria since birth. We carry, as an adult, eight pounds of this biomass. It is another independent living organ inside of us that has evolve with us since ancient times. Periodically, to maintain a healthy environment after ingestive problems, and certainly after taking antibiotics, I recommend replanting our gut with probiotics. These are a live culture of both bacteria and yeast that are dedicated not only to discouraging unfriendly organisms from taking up residence in our gut, but proper pH, gas production and stool consistency.

Probiotics also help decrease the incidence of intestinal diseases. These diseases include peptic ulcer (caused by a hostile bacteria: H. pylori) “colitis,” gallbladder disease, and colon cancer. A whole host of non intestinal problems such as hypertension, Vitamin K production, hyperlipdemia, diabetes, osteoporosis, obesity, better immunity, and urogenital disease. They also produce signaling chemicals that go to our liver that improve or worsen our body structure and function such as in our skin acne and rosacea. Antibiotics wipe out dozens of spieces and end up making us less healthy in the long run.

Composition of an individual’s gut microflora is a recently recognized factor in diet-related obesity. Two groups of the bacterial phylum of micro-flora are dominant in the human gut, the Bacteroidetes and the Firmicutes. The relative proportion of Bacteroidetes is decreased in obese people by comparison with lean people, and that this proportion increases with weight loss
An obese phenotype has been associated with a relative abundance of the bacterial phylum Firmicutes, resulting in increased ‘energy-harvest’ or caloric extraction from the diet. Firmicutes are predominantly Clostridium, but include Lactobacillus, some of which are in the probiotics we unknowingly recommend!

In terms of effects on intestinal carbohydrate and lipid-digesting enzymes, it has been shown that if the population of Firmicutes outnumbers Bacteroidetes, partially digested complex carbohydrates are broken down rather than eliminated through the stool. These, then, form simple sugars that are easily absorbed in the blood stream. A special chemical is elaborated by this bacterial digestion. This encourages the sugar to be directly made into triglycerides by the liver and preferentially stored by fat cells rather than burned! Additionally the certain stains within the Bacteroidetes produce a lipid digesting enzyme. The net result of having more Bacteroidetes and less Firmicutes is a decrease ‘energy-harvest’ or caloric extraction from the diet and a loss of 100 calories a day which represents 12 pounds a year just by having the right ratio of the B/F. There have been some specific bacteria of the Bacteroidetes group such as Lactobacillus rhamnosus PL60 which produces conjugated linoleic acid and in itself has anti-obesity effects. The combination of pre- and probiotics, known as synbiotics, has been proposed to characterize some functional foods with interesting nutritional properties that make these compounds candidates for a weight loss program. One such is high-amylose-resistant cornstarch laced with Lactobacillus rhamnosus PL60 and other Bacteroidetes spiecies. Some scientist have even proposed to rid the gut of most of the Firmicutes with Xifaxan and then repopulate with Bacteroidetes.

It is by no accident that we have thes two opposing groups of bacteria. With famines, these floral reverse ratios were life savers, but in modern times, with too much food and too little activity, it is a killer. Therefore, a high B/F ratio causes weight loss and a low ratio, weight gain. Some scientists have proposed that High Frutcose Corn Syrup is a prebiotic for the Firmicutes group thus favoring the spread of this fattening factor to modern human kind. This adds insult to injury to the high empty carb load for more fat gain.

Monday, November 15, 2010


The only real treatment is to tackle of the main causes of AD which are inflammation/oxidation, glucose dysregulation, obesity, gluten sensitivity, stress (excess cortisol), vitamin deficiency, toxins, and abnormal gut flora. A novel and very powerful approach is to improve the micro-anatomy and circuitry of the brain by enhancing neuroplasticity.

The best and safest anti-inflamatory for the brain is Aspirin (81 mg twice daily), and Omega 3s particularly DHA (2,400mg daily) Some of the biologic drugs used for Rheumatoid Arthritis such as Embrel or Humira may be used in extenuating circumstances. The NSAIDs like Ibuprofen also work, but the side effects outweigh the good. Increasing our natural anti-oxidant Nrf2 will be discussed later. To improve the brain sugar, Actos (45 mg/day) and perhaps Metformin (1500 mg of ER/day) is prescribed. To fuel the brain more, Medium Chain Fatty Acids (3000 mg/day) or less expensive, 3 Tablespoons of Coconut Oil which causes a nutritional ketosis, makes the brain work better. Inositol (3000mg/d) can also be added for this purpose.

To protect itself, the supporting cells, the microglia, for the brains neurons make a super antioxidant, Nrf2, which is activated by a variety of natural things. Nrf2 both reduces inflammation and increases the antioxidation in the brain, particularly, the Hippocampus that is the part that suffers the earliest and the most in AD. There are other compounds including Garlic, Green Tea, NAC/Glutathione, Curcumin/Tumeric, Pterostilbene and Sulforaphanes. is chemically related to resveratrol. It is found predominantly in blueberries and grapes that exhibit anti-cancer, anti-hypercholesterolemia, anti-hypertriglyceridemia properties, as well as fight off and reverse cognitive decline. It is believed that the compound also has anti-diabetic properties. Additionally, it is also touted as a potent anti-fungal. I recommend 100mg two times daily. Sulforaphane is in broccoli sprouts, which, of the cruciferous vegetables, have the highest concentration of sulforaphane. It is also found in brussel sprouts, califlower, bok choy, kale, collards, chinese broccoli, broccoli raab, kohlrabi, mustard, turnip, radish, arugula, and watercress. One can also buy what is thought to be the active chemicals in this compound, which is DIM (200 mg/d) or I3Carbinol (400 mg/d).

The Vitamins that have been shown to improve Brain function and perhaps protect the neuron are Vitamin D (20,000 u/d), Vitamin C (3,000 mg/d), Vitamin E (Gamma E 1,000 mg/d) and Co Q 10 (200 mg/d). Other natural nutritionals that work in concert with these are Acetyl Carnitine (400 mg/d) and Alpha Lipoic Acid (600 mg/d). The supplements that work like the FDA approved drugs (Areceipt etc.) that increase the neurotransmitter, acetylcholine, are DMAE (300 mg, 2xs/d), Phosphytlserine (300 mg/d), and Phosphytlcholine (500mg/d). Lecithin Granules (2 t/d) is another good source of Phosphytlcholine. Staying away from all grains should be a matter of good health for all, but in particular gluten does play a detrimental role in not only AD, but in MS. Stress causes release of cortisol from the adrenal glands. This is accumulative over ones lifetime. When too much, too often occurs, destruction of brain cells, principally in the memory/retrieval bank of the sensitive hippocampus happens.

The bacterial flora in the gut is important in AD. Antimicrobial peptides (AMPs) function in the brain as immunomodulators that control the release of neuro-cytokines and play a role in the formation of the amyloid plaque. Candida, certain species of E. coli, and S. fecalis have been show to influence the neuronal health. To take a good grade of probiotic with the prebiotic Xylitol could be helpful. Of course losing fat with the destructivness of adipokines that cross the blood-brain barrier is literally a no brainer! In that viruses like Herpes Simplex have been linked to AD, one might take the long acting Valtrex indefinitely. Having a history of a fever blisters gives one twice the risk of AD. Detoxing for removal of both fat and water soluble pollutants should also be considered.

The brain not only can but does grow new cells. There are at least 8 neurotrophic stimulating chemicals described. The best studied is BDNF (Brain Derived Neurotrophic Factor). This endogenous molecule is released by vigorously contracting muscles, crosses over into the brain and grows news cells! Also learning new words, movements or paradigms, develops and remodels the dendrites, the fine root-like connections at the end of our axons. This allows them to connect to other dendrites in other areas of our brain. Hence there is an augmentation of Neuroplasticity, which allows the brain Connectome to increase. NIH has dedicated $40 million in research to elucidate the neural pathways that underlie brain function. Deciphering this complex wiring diagram reveals what makes us uniquely human and what makes every person different from all others. This comprehensively maps the human brain circuitry giving us information on the aging and regeneration of our brain.
Using our non-dominant hand for writing, writing our name upside down and inside out (mirror image) and reading upside down also increases the brain volume. Cross-word puzzles, Sudoku, surfing the internet, learning a new instrument to play or dancing also grows new brain cells and improves the dendritic connections of the old ones. It also may raise the IQ by 10-20 points. This plus some of the supplements noted above should keep us out of harm's way if we were destined to get AD.
So what is a person who has a family history of AD, an ApoE-4, and a few other risk factors to do? Taking Aspirin, Omega 3s, using coconut oil, losing fat and doing both mental and physical gymnastics should be done as minimal protection. However, it is a very personal decision as to how much and hard one should try. It is one thing to die suddenly after a relatively productive life, but quite another to have AD with all the negatives that only a devil could invent to suffer beyond one's imagination without hope except for death!! The choice is yours, but make it soon. Every day of delay is a step closer to ending up in irreversible disaster.


ALZHEIMER’S DISEASE (AD) is the most common form of dementia. This incurable, degenerative, and terminal disease was first described by German psychiatrist and neuro-pathologist, Alois Alzheimer in 1906 and was subsequently named after him. Generally, it is diagnosed in people over 65 years of age, although the less-prevalent “early-onset” of Alzheimer's does occur before this age. In 2010, there were 30.6 million sufferers worldwide. Alzheimer's is predicted to affect 1 in 85 people globally by 2050 and after age 80 half will have it. The risk factors for this malady include family history, gluten intolerance, heavy metal excess, fever blisters, high blood sugar, physical and psychological stress, obesity, head trauma, drugs and age. There is a Tsunami of fat-related AD brewing as obese Baby Boomers go from grey to white hair.

The earliest observable symptoms are often mistakenly thought to be “age-related” senior moments. The inability to acquire new memories, the difficulty in recalling recently observed facts are noted first by the individual, then by loved ones and lastly friends. These individuals, particularly those with a high social IQ, cover up these mental lapses with believable excuses. As the disease advances, symptoms include confusion, irritability, aggression, mood swings, language breakdown, long-term memory loss and the general withdrawal of the sufferer as their senses decline. Gradually, bodily functions are lost, ultimately leading to death. AD develops for an indeterminate period of time before becoming fully apparent, and it can progress undiagnosed for years. The mean life expectancy following diagnosis is approximately seven years. Fewer than three percent of individuals live more than fourteen years after diagnosis. When AD is suspected, the diagnosis is usually confirmed with behavioral assessments and cognitive tests, such as a MMSE. A Psychological Inventory Test (see later) that checks 9 different brain areas of function also helps in diagnosis. It is best to pick up the disease in its earliest stages when much can be done to delay or even prevent it. Often I order a MRI to look at the hippocampus volume, and if in real doubt, do a PET scan with a PIB contrast. Individual prognosis is difficult to assess, as the duration and severity of the disease varies much from patient to patient. AD develops for an indeterminate period of time before becoming fully apparent, and it can progress undiagnosed for years.

If Alzheimer’s is in your future, much can be done to greatly delay, or better yet, prevent it. Despite the many ways to determine if you are in harm's way, there is no guarantee that it will arrive until after it is too late. Therefore, an ounce of prevention should be considered before a ton of care. One cannot change their genes (Apo E or Family History), but can certainly amend them in what is termed epigenetic modification. There are at least 7 methods to do this. The research indicates that AD is an inflammatory process and we should quench the continuing fire, rather than what most of us Physicians do, which is to get rid of the smoke or smoky thinking. The 3 drugs that are FDA approved today increase an important chemical in neuro-transmission, Acetyl Choline. They are Aricept, Exelon and Razadyne. The other FDA medication is Nemanda which tries, but unsuccessfully, to put out the fire. Unlike the cardinal signs of acute inflammation in the rest of the body, Calor, Dolor, Tumor, Rubor {Heat, Pain, Swelling and Redness), they are not manifest in the brain in this chronic condition. The Brain is not easily accessed and Alzheimer’s is a slow ongoing oxidative smoldering process with neuronal damage by the slow release of free radicals.

Recently it was determined that a toxic protein found in Alzheimer's patients, (amyloid-beta derived diffusible ligand, or ADDL), removes insulin receptors from nerve cells making them insulin resistant and stopping brain insulin signaling crucial for memory. The binding of ADDLs to synapses somehow prevents insulin receptors from accumulating at the synapses where they are needed. Instead, they are piling up where they are made, in the cell body near the nucleus. Insulin cannot reach receptors there. This finding is the first molecular evidence of why nerve cells become insulin resistant in Alzheimer's disease. This is termed by scientists as Type 3 Diabetes. The pathologic Tangles and Amyloid plaques are the result rather than the cause of the process. That is why the vaccine and recently hopeful drugs have not worked.

The best time to prevent or treat Alzheimer’s is ASAP. The difficulty is to determine who needs therapy. Minimal Cognitive Dysfunction (MCD) was once thought to be a natural part of aging and called, until recently, Benign Forgetfulness of the Age. We now know that as many as 70% of these folks develop AD. To determine these, a Neuro-Cognitive test should be performed. This gives a rapid and valid assessment of a suspects brain function. Abnormal results are sometimes referred to the neuro-psychologist for a full evaluation. These studies bridge the gap between current paper-based testing methods and more expensive clinical options. This assessment provides greater certainty by providing a standardized, precise and objective test. The test that I use is CNS Vital Signs, which gives a specific, tangible measurement of a base line and with serial testing a determination of the rapidity of the onset of AD. It is standardized, objective, valid and reliable with millisecond timing accuracy. It provides measurement of minute changes such as those associated with superimposed drug effects and cognitive impairment. This instrument which is done at the office, or in the patient's home in about 30 minutes, is automatically scored. The scores are then compared to normal standards and are then integrated into clinical domains such as Verbal Memory. It is also paid for by insurances with the CPT code of 96101/02/03 or 96118/19/20. With this information one can decide how aggressive one should be in an intervention.

Sunday, November 7, 2010


With pollutants in our food, drink and air during our daily living, we all accumulate lots of toxins in our vital organs. These toxins not only damage organs, but also produce oxidants that literally "rust" our entire body and cause a myriad of degenerative diseases such as atherosclerosis, arthritis, and Alzheimers. Moreover, it greatly shortens our lives and makes our latter years miserable. Many Doctors recommend detox cleanses as part of a weight loss program. The rationale is that excess toxins are absorbed into our fat cells, then our bodies, acting to be self preserving, enlarge (i.e. take on more fat) to store these poisons.

The body eliminates toxins through our liver, kidney, and skin. The liver enzymaticlly degrades them to less harmful products by well studied pathways (phase I, phase II etc.), then excretes them into the bile and blood. The water soluble substances are expelled through the kidney into the urine. Those that are fat soluble, including heavy metals such as Mercury, are the passed on to the fat which comprises 90% of our nervous system.

One of the oldest and least expensive programs is just fasting. Drinking lots of water helps renal excretion. As an add-on some Doctors recommend a Bowel Cleanse that may even include High Colonic Enemas. To detox the liver are herbs that encourage the above mentioned enzymatic reactions. The skin eliminates both fat and water soluble toxins in our sweat. Some clinicians even recommend herbs that cause sweating. However, I advise heavy exercise, occasionally saunas and rubbing down with a towel after a shower. Some practitioners believe that gently brushing the skin in the direction of the lymph flow detoxifies the lymphatics.

It is a good idea to have both a fall and spring cleaning. Many experts know this is the start of a shift in certain nutrient consumption for winter and summer, since food availability and temperature change do cycle seasonally. Our bodies need to be rebooted periodically for its best functioning. On a cellular level our tissue heals better when it can rest from its other functions such as the daily work of digestion, absorption, and metabolism. Moreover, our gut enzymes are relieved of their responsibility and replenish its store for the next onslaught of “nourishment”.

Many physical cleanses are combined with spiritual uplifting. There are 32 references to it in the Christian Bible, it is done by Moslems on holy days as well as by Native Americans. In Judaism, the Jewish New Year (day of atonement), God is asked to forgive the sins of his people.

As part of the HcG program, many health care givers advise a cleanse. We have been doing this to varying degrees in the past, but some were very difficult, others expensive and still others downright dangerous. In collaborating with Dr. Doug Pray, a specialist in nutrition, I have been recommending Novolife ( I have even done it myself. I also encourage folks to buy his popular book, I DON’T GO OUT WITH FAT BOYS, published this year that well explains the plan. The ease of the implementation coupled with the leg up on a weight/fat reduction agenda makes this ideal. For an investment of this magnitude ($124 and a week of minimal deprivation) not only will one have a clean body (and heart) but if overweight, a 8 to 12 pound weight loss!!!