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2011-09-13T12:44:00.000-07:00

SWIMMERS EAR

2011-08-05T07:02:00.000-07:00

Swimmer's ear or Acute Otitis Externa (AOE) is an infection of the outer ear canal causing pain and discomfort mostly in swimmers, but in other people because of humidity and misguided ear hygiene. Along with otitis media, external otitis is one of the two human conditions commonly called "earache". Swimmer’s ear occurs when water stays in the ear canal for long periods of time, providing the environment for bacteria (Pseudomonas and Staph) and fungi to grow and infect the underlying extremely thin skin. These are found in poorly maintained pools and at other recreational water venues, but are also indigenous to the ear canal itself. Although all age groups are affected by swimmer's ear, it is more common in children. With the increase use of earbuds kids use to listen to MP3 players, it is more common now than last decade. In the United States, AOE results in an estimated 2.4 million health care visits every year and nearly half a billion dollars in health care costs. It occurs much more in the south and tenfold more in the summer. Symptoms of AOE usually appear within a few days of swimming and include: itchiness inside the ear, redness and swelling of the ear and its canal, pain when the infected ear is tugged, and draining“pus” from the infected ear.

Chronic Otitis Externa can present similar to AOE, is not only long standing, but the inflammation is usually secondary to eczema, psoriasis, seborrheic dermatitis, or fungi (Candida albicans and Aspergillus). Rarely fungi only, can cause AOE. Wax in the ear can combine with the swelling of the canal skin and any associated pus to block the canal and decreases hearing. In more severe or untreated cases, the infection can spread to the surrounding soft tissues causing Malignant or Necrotic Otitis Externa. These are more likely in diabetics, immune suppression, and in the elderly. In its mildest forms, EOE is so common that some physicians have suggested that most people will have at least a brief episode at some point in life. A small percentage of people have an innate tendency toward chronic external otitis. These folks have a genetic predisposition for producing too small amount of or an inferior (too little IgA) protective wax.
Most people can avoid AOE altogether once they understand the intricate mechanisms of the disease. The skin of the bony ear canal is unique, in that it is not movable but is closely attached to the bone, and it is almost paper-thin. For these reasons it is easily abraded or torn by even minimal physical force. Inflammation of the ear canal skin typically begins with a physical insult, most often from injury caused by attempts at self-cleaning or scratching with cotton swabs, pen caps, finger nails, hair pins, keys, or other small implements. This trauma and prolonged water exposure in the forms of swimming, bathing, showering or exposure to extreme humidity, which can compromise the protective barrier function of the canal skin, allowing bacteria to flourish. Densely impacted wax, usually caused by enthusiastic use of cotton swabs, can put enough pressure on the ear canal skin to injure it and initiate infection. A sensation of blockage or itching can prompt attempts to clean, scratch, or open the ear canal, which potentially worsens and perpetuates the condition. The cotton fibers of a swab are abrasive to the thin, fixed canal skin. Self-manipulative measures to improve the condition often make it worse and are to be discouraged, in that it can result in significant injury to the ear. It is well established that the ear canal is self-cleaning. The top layer of the ear canal skin normally migrates toward the ear opening, essentially sweeping the canal on a continuing basis. In other words, a normal ear canal is self-cleaning.

Pain is the predominant complaint and the only symptom and is directly related to the severity of AOE. Unlike Otitis Media, the pain of AOE is worsened if the ear is pulled gently. Patients may also experience ear discharge and itchiness. Initially, when doctors look inside the ear with an otoscope, they observe very little abnormality. If they are astute, they may notice a decrease of the normal ear wax. However, when enough swelling and discharge in the ear canal is present to block the opening, the eardrum cannot be seen. Looking at the eardrum is very important to the doctor in that this is how the diagnosis of Otitis Media is made and to rule out a punctured ear drum. The “pus” exuding from the canal is not true pus (all white cells), but the liquid debris of wax, dead skin, and the previous drops placed within the canal for treatment.

The treatment when EOA is very mild is simply to refrain from swimming or washing ones hair for a few days, and keeping all implements out of the ear. It is a self-limiting, self-resolving condition! However, if the infection is moderate to severe, or if the climate is humid enough that the skin of the ear remains moist, spontaneous improvement may not occur.
Effective therapy for the ear canal includes acidifying and drying agents, used either singly or in combination. When severe, topical solutions (or suspensions) of eardrops are the mainstays of treatment for EOA. Effective medications include eardrops containing antibiotics to fight infection, and corticosteroids to reduce itching and inflammation. Some contain antibiotics, either antibacterial or antifungal, and others are simply designed to mildly acidify the ear canal environment to discourage bacterial growth. Some prescription drops also contain anti-inflammatory steroids, which help to resolve swelling and itching. Cortisporin (neomycin-polymyxin B-hydrocortisone), Ciprodex ear drops ( Ciprofloxacin and dexamethasone), Gentisone HC ear drops (Gentamicin and hydrocortisone), Ciproxin HC ear drops ( ciprofloxacin and hydrocortisone), Sofradex ear drops (containing Framycetin Sulphate, Gramicidin, Dexamethasone/sodium metasulphobenzoate, Phenylethanol), Kenacomb ear drops, ( triamcinolone acetonide, neomycin and gramicidin (antibiotics) and nystatin (antifungal).
Over the counter ear drops are also available, including spirit drops (alcohol solution) which dries out the ear, and drops such as Aqua Ear which contains a mixture of alcohol and acetic acid, to dry the ear and make it difficult for microbes to grow. Home remedies with half Vodka or Gin with half vinegar can also be used in a pinch. Athletes Foot OTC preparations such as a topical antifungal like 1% clotrimazole are also effective. Removal of debris (wax, shed skin, and pus) from the ear canal promotes direct contact of the prescribed medication with the infected skin and shortens recovery time. When canal swelling has progressed to the point where the ear canal is blocked, topical drops may not penetrate far enough into the ear canal to be effective. Inserting cotton (earwick) saturated with medication is frequently applied. The wick is kept saturated with medication until the canal opens sufficiently then the drops will penetrate. If the canal is significantly edematous, a foam (Pope) can be used. Antibiotic eardrops should be given for 7 days. The ear should be left open. Although the AOE generally resolves in a few days with topical washes and antibiotics, complete return of hearing and cerumen gland function may take a few weeks. Once healed completely, the ear canal is again self-cleaning. Until it recovers fully, the canal may be more prone to repeat infection from further physical or chemical insult.
Preventing acute external otitis are similar to those for treatment. Avoid inserting anything into the ear canal. (Q-tips or cotton swabs is the most common event leading to AOE.) Other measures to use after prolonged swimming in a person prone to external otitis is to dry the ear canals with a hair dryer. Alternatively, drops containing dilute acetic acid and alcohol(2:1) will do the job. Avoid swimming in polluted water. Do not wash hair or swim if very mild symptoms of AOE begin. The use of earplugs or bathing caps when swimming and earplugs while shampooing hair may help prevent EOA. Hard and poorly fitting earplugs can scratch the ear canal skin and set off an episode. A simple method of making a soft waterproof disposable earplug is with cotton balls covered with Vasoline. These coated cotton balls are NOT inserted into the ear canal, but pressed into the ear to cover the opening of the canal.

ERECTILE DYSFUNCTION EQUALS ENDOTHELIAL DYSFUNCTION ED=ED

2011-07-02T15:25:00.000-07:00

Erectile dysfunction (ED) is defined as the consistent inability to obtain or maintain an erection for satisfactory sexual intercourse. ED was believed to be a psychological condition; however, in the past two decades, doctors have recognized that the majority of patients' erectile failure can be attributed to an organic cause. ED could result from neurologic, endocrine, or structural impairments. However, now research on erectile physiology has led to the conclusion that ED is predominately a disease of THE BLOOD VESSELS both arteries and veins and their unique penile structure, the corpus cavernosum (literally "cave-like bodies"). This is a pair of spongy tissues which if filled with blood, the penis becomes erect. The corpus cavernosum is composed of a meshwork of interconnected smooth muscle cells lined by vascular endothelium. The endothelial cells and underlying smooth muscle also line the small resistance helicine arteries that supply blood to the corpus cavernosum causing the organ to get hard (penile tumescence). Under stimulating circumstances, Nictric Oxide (NO) is released from the endothelium, a one cell thick lining, of the blood vessels. This causes relaxation of muscles around the arteries to the corpora cavernosa which engorges the penis with blood, increasing both its length and diameter. Blood can exit the erectile tissue only through a drainage system of veins around the outside wall of the corpus cavernosum. The expanding spongy tissue presses against the surrounding fibrous tissue, the tunica albuginea, constricting the veins, preventing blood from leaving. As a result, the penis becomes rigid .

Normal erectile function involves three synergistic and simultaneous processes: 1) neurologically mediated increase in penile arterial inflow, 2) relaxation of cavernosal smooth muscle, and 3) restriction of venous outflow from the penis.

Loss of the functional integrity of the endothelium and subsequent endothelial dysfunction plays an integral role in this issue. Pharmacological (Phosphodiesterase drugs such as Viagra) and endocrine (Testosterone) interventions help restore some function, but more is needed because of the 45% failure rate with these treatments. The incidence of ED dramatically increases in men who have endothelial dysfunction such as seen in middle age particularly those with diabetes mellitus, hypercholesterolemia, and cardiovascular disease. These diseases have in common a dysfunctional endothelium.

Penile erection is a psychoneurovascular phenomenon that depends upon cerebral stimulation, neural integrity, and a functional vascular system with healthy cavernosal tissues . It is the fit endothelium that produces the NO. Assuming the desire (libido), an intact nervous system and enough NO being produced from the endothelium, the penis will become erect and remain that way until it becomes refractory following ejaculation. Testosterone will encourage the brain if given sufficient visual and tactile clues. The intact nerves are needed not only for the brain to perceive touch, but to release the neurotransmitters to the penile arteries to dilate them. This dilatation to a large extent depends on the production of NO from the endothelium. If enough NO is released it will compensate for some lack of integrity of the neurovascularity. NO, then, is another therapy not generally used by doctors that is additive to testosterone and the phophodiesterase stimulators. Science has discovered several ways to increase NO production that will be discussed in another article.

THE DOCTOR WITHIN!

2011-06-06T14:59:00.000-07:00

Our toxic environment and modern lifestyle are killing us from the inside out. Degenerative and near epidemic diseases such as obesity, arthritis, arteriosclerosis, Alzheimer’s, osteoporosis, premature aging, and iatrogenic (caused by the healer) disease have tragically become part of every American family. Yet, as technology advances, the wisdom of the ages that it was better to prevent than to treat disease.

Two doctors, three opinions are given, but the opinion that is the most important is YOURS, the patient. It is not the physician who will suffer the most if good therapies go en getting wrong, an adverse drug reaction occurs, or the operation was a success, but the patient died, but you and you family. You should be in charge of your health both preventively and therapeutically! A healing relationship with your physician is important and teamwork is key, but it should be you as the patient that is responsible for the path to take. The doctor is the knowledgeable coach or adviser, perhaps a family member, the team manager, but there is no doubt that if you are in your right mind that the decision of care should be yours! It is incumbent for you to be as knowledgeable as possible on the medical problem on hand. Information from the Internet, perhaps starting at Wikipedia, then a noncommercial website should be considered. Speaking to other patients with a similar problem, reading magazine articles or books does give a good working knowledge on your medical issue. Even getting another professional opinion from a physician who is not in cahoots with your original doc is a good idea.

Too often Primary Care Physicians function as gatekeepers; they may open the floodgates and let the patient drown in too many medical procedures and medicines. Fragmentation in medical care also is rampant today. The patient who decides what organ or area their problem lies in sees that specialist. Therefore, there is a cardiologist for their heart, a pulmonologist for their lungs, a nephrologist for their kidneys, a hematologist for their blood, and a “Big Toe doctor” for their gout. That leaves us with no one to take care of the whole person; moreover, the left hand doesn’t know what the right hand is doing. The gastroenterologist does not effectively communicate with the neurologist. If your primary care doc does not function as a knowledgeable clinical coordinator, then that responsibility by default is on you. As I try to set forth in this book, it is not how old a person is that counts, but how they feel and function when they are old. Medicine and certainly not this book alone has all the answers, but with your significant participation you will enable yourself to age gracefully and to live a full and abundant life. It is imperative then to discover THE DOCTOR WITHIN!

IODINE INSUFFICIENCY

2011-06-06T14:50:00.000-07:00

The “Spot of Gold” or Robbs test that we do on most of our patients gives an indication of Iodine Insufficiency. In the last 20 years, I have never found an individual who was sufficient – the spot lasting 24 hours. Dr. Guy Abraham arrived at his conclusion that we need 12.5 milligrams of iodine a day based not only on his own experience and observation but also with the help of an extensive research review. One study he points out was co-authored in 1954 by Roslyn Yalow (later a Nobel Prize winner). She and her co-worker found that the total amount of iodine in the adult human body ranges from 7 to 13 milligrams. The iodine “pool” is divided into two major compartments, the thyroid gland and the rest of the body.
Other researchers determined that the amount retained by the thyroid gland is 6-7 milligrams, which, according to Dr. Abraham, is the optimal amount to keep the thyroid gland itself operating at peak performance. Keep in mind, though, that’s just for thyroid health.

Another prominent iodine researcher, Dr. Benjamin Eskin, determined that female breasts need about 5 milligrams of iodine per day. Add that to the amount your thyroid gland needs, and you come up with the 12.5 milligrams Dr. Abraham recommends.

Dr. Eskin also established that our thyroids “prefer” to concentrate the iodide form of iodine, while breasts concentrate iodine. Iodine and iodide are not always interchangeable: “Iodine” is the basic element, consisting of two “I” molecules bonded to each other (I-I); an excellent analogy is chlorine, which is two “Cl” molecules bonded to each other (Cl-Cl), while “chloride” is just one Cl molecule. “Iodide” is one of those two iodine molecules, and is almost always found with another molecule, such as potassium (potassium iodide, or K-I). In experimental animals, the thyroid glands and the skin concentrated more iodide than iodine, while the stomach concentrated more iodine. Based on these and other findings, Dr. Abraham recommends that iodine supplementation should include both forms: iodine and iodide.
Also Iodine can flush potentially dangerous elements from your system. Iodine, chlorine, bromine, and fluorine are in the same “family” of elements. Although very tiny quantities of fluoride are likely useful for human health, the amounts poured into most American public water supplies are much too high and have been correlated with higher risk of a rare bone cancer as well as bone fracture in older women. Bromide also carries some risks at high quantities, including impaired thinking and memory, drowsiness, dizziness, and irritability.  But iodine can actually help your body get rid of these potentially harmful elements, as well as others like lead, cadmium, arsenic, aluminum, and mercury.

Following observations by Dr. Abraham, Brownstein conducted a study to test iodine’s ability to help rid our bodies of fluoride and bromide. Eight individuals had “baseline” measurements taken of their urinary output of fluoride and bromide. Each research volunteer took one 50-milligram “loading dose” of iodine and then proceeded to take the 12.5 milligram optimal daily dose from that point on. Only one day after starting iodine, their urinary output of bromide and fluoride increased significantly and continued at this higher rate for all 30 days of the study. Our Dr Robert Doenges, who holds the only patent on a salivary and urinary iodine analyzer, has never seen anyone who was Iodine sufficient.

Working with 10 female volunteers, Dr. Abraham conducted safety studies of the optimal 12.5 milligram iodine/iodide dose. He checked each woman’s blood pressure, weight, muscle mass, and body fat prior to starting iodine treatment, then again three months later. There were no statistically significant changes, although the body fat percentages did go down.

Dr. Abraham also took before-and-after measurements of several different markers of thyroid function, which included thyroid gland volume, TSH, total T4, free T4 (the active form of the thyroid hormone T4), and free T3. Although total T4 for the group declined significantly, both the “before” and “after” values were well within normal ranges, and there were no significant changes in free T4. The next part of Dr. Abraham’s safety study involved taking glucose, BUN, creatinine, sodium, potassium, chloride, calcium, total protein, albumin, globulin, bilirubin, alkaline phospatase, and ALT and AST (liver-function measurements) before and after three months. Although all values were within normal ranges before and after, there were statistically significant improvements in creatinine, alkaline phosphatase, and AST.
Lastly, Dr. Abraham measured hemoglobin, hematocrit, and red and white blood cells before and after three months. None of them changed significantly.

Despite this apparent safety record, if you decide to adopt “optimal-dose” iodine/iodide supplementation, it’s best to work closely and carefully with a knowledgeable physician to monitor thyroid function and general iodine safety. Dr. Abraham estimates that 14-15 milligrams of iodine/iodide daily is the upper limit for safe intake; that’s not much more than the optimal dose. Japanese researchers have found cases of hypothyroidism caused by excess iodine (20 milligrams daily).
It’s possible to be allergic to iodine, although it’s considerably less common than people usually think. It is the organified Iodine such as is used in radio-contrast that can cause problems. (For more details about iodine safety, see the October 2002 issue of Nutrition & Healing.) I have seen Iodine burns on the skin, but never allergy to inorganic Iodine.

In the 1820s, the French physician Jean Lugol combined iodine (5 percent) and potassium iodide (10 percent) along with 85 percent water. Since iodine kills germs, he used it for nearly any infectious disease, as well as many other problems, frequently with success. The combination quickly became known as “Lugol’s solution” and was adopted by practicing physicians throughout Europe and the Americas. Lugol’s solution was widely used until the 1920s. In fact it was the most commonly prescribed medicine for many hard to categorize and treat diseases in 1930-33. Then research began in earnest and many new drugs were marketed. Many physicians recommended two drops daily for good health and more on occasion to help kill germs. After doing the spot test, I tell folks to take between 2 and 10 drops depending on how fast the spot disappears. Lugols Solution is relatively inexpensive but does take a prescription and is available in some regular pharmacies and in all of the compounding ones.

NATURAL TREATMENTS FOR DIABETES AND ITS PREVENTION

2011-06-06T14:36:00.000-07:00

Doctors in India have used the leaves of an herb called Gymnema sylvestre to treat blood sugar problems for generations. Now modern science proves that it truly works. Indeed, over 29 studies show that gymnema leaf lowers blood sugar and reduces your body's need for insulin.

And here's the most amazing thing about gymnema. Scientists were stunned when they discovered an increase in the number of "beta cells" in the pancreas of test subjects. That means gymnema could actually help repair and regenerate new pancreas cells that produce insulin!
This is unprecedented in the history of health sciences. Imagine, a single nutrient that can help lower blood sugar, support your body's ability to produce the insulin you need, and even repair your pancreas. Gymnema can do all this and more.

But as good as Gymnema and these other nutrients are, you'll really get the full effect when you take them in combination with this next ingredient…

Alpha-lipoic acid
Alpha-lipoic acid (ALA) is a powerful antioxidant. It regenerates other antioxidants in your body, such as vitamins C and E. And if you have high blood sugar, ALA can be a lifesaver. In one carefully controlled study, 74 patients were given ALA or a placebo. ALA boosted their ability to absorb and use blood glucose by 27%.

Another study shows that ALA improves your body's sensitivity to insulin. And your ability to burn blood sugar. ALA can also lower your fasting glucose levels and enable your cells to store more glucose for energy. Rather than having a blood sugar build-up. Astragalus, ginseng, gymnema, and ALA aren’t the only natural nutrients that can help balance your blood sugar...

The truth about cinnamon
It's no secret that eating too many sugary foods and refined carbs can cause your blood sugar to skyrocket. Over time, high blood sugar can damage and even kill off the "insulin receptors" on your cells. When that happens, your body's cells don't respond as well to insulin. So they don't absorb as much sugar into your muscles and fat cells, to produce or store energy.

Recently, scientists discovered that cinnamon could solve this problem. Researchers looked at 60 patients with high blood sugar. Half took a placebo. The other half took either 1, 3 or 6 grams of cinnamon daily. After just 40 days, the group taking cinnamon had reduced their fasting blood glucose by nearly a third.

There are plenty more studies that show the beneficial effects of cinnamon. But hold on a minute! Don't think that you can run out to the supermarket and grab any old cinnamon for these kind of results. Or that cinnamon supplements always do the trick. There's only one form of cinnamon that's been shown to work in human studies. It's called Cinnamomum cassia. That's the kind used in these studies. And the only kind of cinnamon you should ever buy to control your blood sugar. Some supplements just list “cinnamon bark extract.” This says to me that it’s not the same as the Cinnamomum cassia used in studies! So if you've tried cinnamon supplements and been disappointed with the results, that could be the reason why.

Chromium — which has been shown to lower blood glucose levels. Chromium also reduces your cravings for sweets and carbs, so your blood sugar doesn't spike so high after a meal.

Algimate® — a soluble fiber derived from seaweed. It sticks to the sugars in your digestive system. Research shows it can slow the absorption of both fats and sugars in the small intestine.

Fenugreek — slows the absorption of sugars in the stomach. It stimulates insulin production. And it lowers cholesterol and triglycerides.

Cordyceps — used for thousands of years as a tonic for lung, kidney and heart problems. Cordyceps became famous when two female Chinese athletes set new track and field event world records in 1993. Their coach attributed their success to high altitude training and a diet containing Cordyceps.

Maitake — lowers blood glucose and improves cholesterol levels.

Kudzu root — supports pancreatic cells and stimulate insulin production.

Holy basil leaf — reduces both fasting and post-meal glucose levels. Holy Basil is high in antioxidants. Having high blood sugar is an inflammatory condition. Antioxidants are powerful anti-inflammatory nutrients.

Jambolan seed — also thought to lower blood sugar, and have antioxidant and anti-inflammatory properties. One study showed Jambolan may even protect the pancreas by restoring protective enzymes such as glutathione back to normal levels.

L-taurine — this sulphur amino acid is well known for protecting the heart. How? By reducing free radicals in blood fats. This translates into lower cholesterol and higher levels of "good" HDL cholesterol. Taurine also protects your eyes and actually regenerates worn-out retinal tissues.

Ophiopogon — treats the fluid imbalance that causes many people with high blood sugar to urinate frequently and be thirsty.

Chinese yam — strengthens the spleen and kidney function, combating the thirst and frequent urination associated with high blood sugar.

Anemarrhena rhizome — decreases insulin resistance in those with high blood sugar. Yet it leaves people with "normal" blood sugar levels untouched.

Henon bamboo — protects your eyes by fighting a nasty enzyme called aldose reductase. Aldose reductase destroys bloods vessels in your retina.

Tiger lily bulb — which is used in traditional Chinese medicine to protect your heart and eyes.

DON’T BE A GLUTTON FOR GLUTEN

2011-05-18T09:02:00.000-07:00

There is yet no cure for Celiac Disease which is vastly under diagnosed and takes an average of 11 years between the first appearances of bowel symptoms until it is identified. Adding insult to injury, it often remains silent in the intestine while extra intestinal problems (headaches, arthralgias, thyroid problems and liver abnormalities) are occurring. To date there is no help for this malady other than completely avoiding this protein found in wheat and other grains, (the acronym B.R.O.W.S.: B for Barley, R for Rye, O for Oats, W for Wheat and S for Spelt). In the future, several medicines will be available to denature some of this protein that incidentally slips in with other foodstuffs. Still there is no long lasting for those who consume gluten. Much controversy exists in the literature with gluten allergy, sensitivity and true Celiac Disease. The three criteria for the disease by most knowledgeable physicians are a genetic predisposition, consumption of gluten and a triggering event of a physical or emotional nature.

To document the diagnosis, blood anti-transaminase, anti-myelysin and anti-gliadin studies are preformed. But they are only positive if the patient has significant bowel disease when the blood is drawn and he/she has been consuming gluten on a regular basis. The markers of HLA-DQ2 or HLA-DQ8 haplotype, which show the genetic predisposition can also be tested, but are more expensive and do not guarantee that the patient really does have the disease. According to Ken Fine, et al. (The prevalence and causes of chronic diarrhea in treated celiac sprue. Gastroenterology 1997; 112:1830-1837) the most cost effective test to diagnose celiac disease is an anti-gliadin stool test while the suspect is consuming gluten. This is the test we used to diagnose and follow the treatment results .

BRALY'S SIGN: A visible trait of Hashimotos Thyroid Disease which is common in Celiacs was first noted in Poland in 1953 and presented to the Western Europe by the English Gastroenterologist, James Braly, MD. The majority of Celiacs have a foreshortened 5th finger now designated as Braly’s Sign. (J Pediatric Gastroenterology and Nutrition 2000; volume 31 (Suppl.3): S29. New England Journal of Medicine, August 18, 1999). A positive sign is that the end of the fifth finger is shorter than the last joint of the ring finger. We used this external marker as a hallmark of the disease also in our study. In the combined experienced of the two of us and another colleague, Susan Solomon, a clinician in Raleigh N.C. we have found this marker positive in almost 85% of Celiacs that were either biopsied proven or had the positive genetic marker of the disease.

HYDROGEN BREATH TEST: This is an inexpensive, paid by insurance study that is a presumptive assessment for intestinal disease such as gluten intolerance. Actually, it detects bacterial overgrowth in the small intestine. This is common in intestinal diseases in which the mucosa of the intestine is compromised like celiac, but also small intestinal diverticulosis, abnormal flora, parasites and previous surgery where the usual anatomy of the intestine has been changed. An example of this is bypass surgery for weight loss. Also if the intestine cannot make the enzymes to break down food stuff it also causes abnormal gases due to the fermentation from normal bacteria. Lactose intolerance is an illustration.

Normally there should be NO hydrogen in the breath since the bacteria and the enzymes and the anatomy is doing its job. But if something is awry then hydrogen which is normally produced in minute amounts goes up. Gastroenterologist picked the cut point of 10 parts per million or more to be abnormal. The test is done by holding one's breath for 30 seconds then exhaling through a carboard tube into a special handheld device. In 20 seconds, the results are apparent.

SUSTAIN YOUR BRAIN

2011-05-09T06:48:00.000-07:00

ALZHEIMER’S DISEASE (AD) may be in your future, but you can head it off! A person must be proactive rather than reactive to prevent this devastating disease. After its onset, it is too late to reverse this most common form of dementia. It is an incurable, degenerative, and terminal disease which was first described by the 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 2011, there were 36 million sufferers in the US. Alzheimer's is predicted to affect 1 in 3 over the age of 65. By 2050, half of all people over the age of 80 are predicted to have it! Medical science already has the tools to prevent it, but very few Doctors know about them, let alone make their recommendation.

The risk factors for AD includes family history, gluten intolerance, heavy metal excess, fever blisters, glucose intolerance, obesity, head trauma, drug, age, physical and psychological stress. Stress can not only be diagnosed, but quantified by a simple office test: Heart Rate Variation (HRV). Also, if one has a single gene Apo E4 there is a 75% chance and if a double E4 a 94% chance of the disease.

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 by 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. Individual prognosis is difficult to assess, as the duration of the disease varies. 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 (to be covered in a later posting) that checks nine different brain areas of function also helps in diagnosis and prognosis. 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 will order a MRI to look at the hippocampus volume, and if in real doubt do a PET scan with a PIB contrast.

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 harms 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 now termed epigenetic modification. The research indicates that AD is mainly an inflammatory process albeit a slow ongoing oxidative smoldering process. Involved in this process are two key moleules, Nrf2 and BDNF. Nrf2 is a master regulator molecule of the antioxidant response. This response is important to diminish our oxidative stressors. Because Nrf2 is able to induce genes important in combating oxidative stress, it activates the body’s own protective response, Nrf2 is able to protect from a variety of oxidative stress-related complications, even in situations where the administration of exogenous antioxidants (such as Vitamin C and Vitamin E) have failed. The other important player, BDNF keeps nerve cells alive and stimulaes the growth of new ones. Recent studies shows that it prevents and reverse Alzheimer’s independent of the amyloid plaque tangles. BDNF levels can be naturally boosted by heavy exercise and caloric restriction. Nutrients that also help make BDNF or protect it from declining are acetyl-l-carnitine, fish oil, blueberries, and curcumin.

There are both prescription drugs and supplements that are recommended for AD. The three drugs that are FDA approved to increase an important chemical in neuro-transmission, Acetyl Choline, are Aricept, Exelon and Razadyne. The other FDA medication is Nemanda which tries, but not completely successfully, to inhibit the neurons from “burn out” from excessive excitation. Because 90% of folks who have Alzheimers also have the Herpes Simplex-2 Virus, taking a daily antiviral, such as Acyclovir may also be prevention, although not FDA approved for this. Other prescriptions that are used in that AD which by some researchers is considered to be Type 3 Diabetes are Metformine and Actos.

A supplement representing more than 30 years of neuroscience research, is BrainSustain. This is a unique powdered drink formula, developed by Board-Certified Neurologist, David Perlmutter, MD, FACN, to enhance brain performance and health. It is usually given in a smoothie or Almond Milk Shake. BrainSustainTM improves the energy production of brain mitochondria providing generous antioxidant support to combat the damaging effects of excess free radicals. It contains the following underlined ingrediants. Broccoli Seed Extract, which is the Johns Hopkins non heated patented extract of the phytochemical in broccoli (sulforaphane glucosinolate). Extensive research demonstrates that this compound upregulates the Nrf2 system, enhancing the production of important antioxidants such as glutathione and superoxide dismutase as well as activating vital Phase 2 detoxification enzymes. N-Acetyl-L-Cysteine (NAC), a derivative of the amino acid, L-cysteine, is the precursor to glutathione, one of the brain’s most important antioxidants. The aim of oral supplementation is to augment the body’s reserve. NAC itself is a potent antioxidant shown to reduce formation of nitric oxide, a free radical implicated for a causative role in neurodegenerative disorders. Phosphytl Serine (PS), a component of lecithin, plays an important role in neuronal energy production and enhances neuronal communication. After careful examination of scientific evidence, the FDA granted “qualified health claim” status to PS, stating that “Consumption of PS may reduce the risk of dementia in the elderly”. N-Acetyl-L-Carnitine (aka ALCAR), an acetylated form of the amino acid, L-carnitine, is able to cross the blood brain barrier, where it acts as an effective antioxidant and protects brain cells from toxic chemical and stress-induced damage and deterioration. N-Acetyl-L-Carnitine enhances neuronal energy production by transporting fuel sources into the mitochondria and removing energy production waste products from them. Carnitine is readily converted into acetlycholine, a neurotransmittter essential for learning and concentration. Alpha Lipoic Acid also provides more antioxidant action and regenerates other important brain antioxidants including vitamins E, C, and glutathione. Unlike other antioxidants, alpha lipoic acid is both fat and water-soluble, greatly enhancing its ability to be absorbed from the gut and penetrate into the brain. Coenzyme Q10 measurably increases the efficiency of cellular energy production and serves as a potent antioxidant that may protect the brain from oxidative stress damage, which is believed to be partially responsible for neurodegenerative disease. A special DHA, (a2), derived from algae is not only vital to brain health, but 25% of the brain is made up of it. DHA-a2 facilitates optimal structure and functioning of the brain cell membranes.

BrainSustainTM also contains VegaProTM, XYMOGEN’s proprietary pea/ rice protein blend, as well as fat soluble antioxidants, vitamins D3 and E (as mixed tocopherols), and activated B vitamins, including 50 mg of riboflavin and folic acid (as calcium folinate). Available in Vanilla Delight, Chai & Creamy Chocolate, BrainSustainTM costs from $40 to $80 a month depending on whether an individual takes one or two scoops of this product daily. In general I advise one to prevent and two to treat Dementia.

ASPIRIN WORKS

2011-05-02T06:32:00.000-07:00

Aspirin is frequently called the “wonder drug” because of its many beneficial properties. Two of the most significant are the prevention of cardiovascular events and cancer. It makes the blood platelets which are 1/10 of the size of a red blood cell less sticky . The drug works by inhibiting the production of prostaglandins forming on the outside membrane of these. Additionally, aspirin induces the formation of Nitric Oxide-radicals an independent mechanism of reducing inflammation in the blood vessels. More recent data also suggests that aspirin modulates signaling through NF-κB, a transcription factor complex, plays a central role in many biological processes, including cancer. This may be why folks who take a low dose aspirin daily for at least five years have a 30% less incidence in breast, prostate, stomach, esophagus, lung, and ovarian cancer. Additionally, if they already have the tumor, have far less distant spread.

Although Hippocrates, in 400 B.C left historical records of treatments, with the mother of aspirin from the bark and leaves of the willow tree, it was not until 1828, that Johann Buchner, professor of pharmacy at the University of Munich, isolated a tiny amount of bitter tasting yellow, needle-like crystals, which he called salicinin and Leroux had extracted salicin, in crystalline form for the first time, and Raffaele Piria succeeded in obtaining the salicylic acid in its pure state. A hundred and fifty years later (1971), British pharmacologist John Robert Vane in London, showed aspirin suppressed the production of prostaglandins and thromboxanes. For this discovery, he was awarded both a Nobel Prize in Physiology and Medicine in 1982 and a knighthood.

More than 50 million people in the U.S. take aspirin every day to help prevent heart attacks, strokes and cancer. However, research has demonstrated that up to 25 percent of these individuals may not benefit from the anti-clotting effect of aspirin, and are more than three times more likely to die from a heart attack or stroke. So Aspirin does not have the same effect on everyone. This suboptimal response to aspirin by an individual is commonly known as aspirin resistance or insensitivity Since these individuals are at increased risk of heart attack or stroke, doctors are beginning to recognize the importance of testing for aspirin effect. On the other hand, the higher doses of aspirin, not only in some will produce a paradoxical clotting effect, but in others a hemorrhage!

Until recently, there was no quick, accurate and effective way to test for aspirin effect. An ADP adhesive study or a specific prostaglandin assay was used in research settings and not paid for by insurances. But now, with the AspirinWorks Test, we can be sure the aspirin is working with a simple no fasting urine test. The AspirinWorks Test is FDA cleared for use in apparently healthy individuals, and test samples can be collected in the doctor’s office at any time. The AspirinWorks Test determines the effect of aspirin on platelets by measuring the level of the biomarker called thromboxane B2 (11dhTxB2). The higher the levels of thromboxane B2, the stickier the blood platelets, and the less impact the aspirin is having. This crucial information allows physicians to individualize a patient’s therapy, which may be as simple as adjusting the dose.

When prescribing blood pressure or cholesterol medication, doctors routinely check the patient’s blood pressure or cholesterol to make sure the patient is getting the right dose of medication. Similarly it is important to know if the dose of aspirin you’re taking is effective. Now, when prescribing aspirin we can then decide to increase or decrease your aspirin dose or if additional medication is needed. As mentioned in my previous writings that just as important is the aspirin to prevent blood from clotting within the blood stream, acetaminophen is needed to inhibit the clot on the arterial wall!

Therefore acetaminophen (Tylenol) has been shown to work in conjunction with the aspirin. At the University of Georgia, Dr. Phillip Greenspan found that the acetaminophen is a potent inhibitor of the enzyme, myeloperoxidase. This enzyme oxidizes the LDL, modifies it in such a way that it is more delectable to the certain white cells (macrophages) that reside within the wall of our arteries. These ingest the LDL cholesterol and cause the plaque and obstruction, which is the father of atherosclerosis. In that the acetaminophen blocks the activity of this enzyme, there is less transformation of the bad cholesterol (LDL) that is available for the macrophages to ingest. This research was presented at the conference on arteriosclerosis, thrombosis and vascular biology in Denver, May 21, 2000 and in 2006 documented by John Merrill PhD at Rutgers. This can also be taken to prevent pain. Some people state it helps them to sleep, when taken at bedtime. Also a recent study at the University of Florida demonstrated that acetamenaphen elevates the mood. The bad press that Acetaminophen has recently had makes this well studied drug almost a curse word. It is true in very high doses like over 6,000 mg a day it can negatively affect the liver and perhaps the kidney, but 1000mg/day is positively healthy for all who want protect their blood vessels.

THE BOTTOM LINE-“Betwixt and between, Aspirin and Tylenol will keep the artery clean” One each 81 mg Aspirin and 500 mg Acetaminophen (TylenolR), both twice a day, will keep the heart attack and stroke away!!

PHYSIOLOGY OF IODINE

2011-04-26T19:42:00.000-07:00

A compilation by: W. Robert Doenges, ND

Background:
An excellent source of information regarding iodine historical use in medicine, present day assumptions, sufficiency, safety and physiological implications is available in papers written by Dr. Guy Abraham, Dr Jorge Flechas and Dr. David Brownstein for The Original Internist publication. These papers are available from the web at www.optimox.com. Or a search in Google for the iodine supplement Iodoral will yield the same results.

We encourage the reader to acquaint themselves with the aforementioned papers. A brief summary of their work is included as follows:

History summary:
Swiss physician J.F. Coindet in 1812 had success treating goiter (extreme hypothyroidism) with seaweed and reasoned elemental iodine was the primary reason for his patient’s improvement. He tried tincture of iodine at 250 mg per day with great success in 150 goiter patients. Over the last century physicians refined the iodine compounds until French physician Gene Lugol’s in 1829 devised his formula of 12.5 to 37.5 mg of iodine with potassium iodide in water as the most efficient and sufficient dose. Addition of potassium iodide increased the solubility of iodine sufficiently to be more clinically valuable.

Lugol’s formula was used very successfully until the 1930s for the treatment of hypothyroidism, hyperthyroidism and other medical conditions that demonstrated efficacy. It is noteworthy that only 0.05 mg/day of iodine is necessary to prevent goiter. This amount is available in iodized salt thereby eliminating goiter as a prevalent health concern. However 0.05 mg/day is not enough for optimal health. Iodine is the one halogen (chlorine, bromine and fluorine are the others in order of increasing oxidizing potential) the body requires for many biochemical processes.

History of sufficiency:
In the 1930s physicians started using the recently developed thyroid hormones for treatment of thyroid hypo- or hyper- activity. The assumption was that iodized salt provided iodine sufficiency. Even though the chloride in table salt is a competing halide (chlorine - halogen) there is enough uptake of iodine in iodized salt from the potassium iodide to prevent goiter. Therefore synthetic (patentable) thyroid hormone replacement was developed to increase the thyroid’s production of T4 (thyroxine).

Hintze et al (1) compared the response of patients with simple goiter to administration of I at 400 ug/day and to the administration of T4 at 150 ug/day…. Iodine was more effective by itself than the administration of the T4 hormone by itself.

Most people get iodine in their diet from seafood and iodized salt. However, only about 50% of Americans use iodized salt and because of concerns about high blood pressure, many people have reduced their salt intake. One gram of salt contains 77 mcg of iodine. Because of the high chloride content in table salt, some experts estimate that only about 10% of the iodine in iodized salt is actually absorbed. The recommended daily allowance (RDA) of iodine is 150 mcg (somewhat higher for pregnant women and certain other groups). Though 150 mcg daily may be sufficient to prevent an enlarged thyroid (goiter) and cretinism (severe iodine deficiency in babies leading to mental retardation and impaired development), these values are far short of the optimal values of 12,500 mcg (12.5 mg) recommended by Dr. Abraham. But, even using the lower values, many people still do not get the RDA and tests have shown that the average blood levels of iodine have decreased significantly over the past 30 years, in part no doubt, due to the substitution of bromide for iodide in baked goods in the early 1980’s.
A popular assumption is that physiologic doses of iodine are toxic. In the 1940s a study linked non-radioactive iodine to toxic reactions. It was plainly not true. T4 (thyroxine has 4 iodine atoms) and T3 (triiodothyronine has 3 iodine atoms) are the thyroid’s hormones that are control metabolism. Both have iodine atoms in their molecules. It is obvious that iodine sufficiency is needed for optimal metabolism.

Is there a relationship between iodine and chronic fatigue and other disorders?
Dr. Brownstein writes: “The illnesses that iodine/iodide has helped are many. These conditions include Fibromyalgia, thyroid disorders, chronic fatigue immune deficiency syndrome, autoimmune disorders as well as cancer. Most patients who are deficient in iodine will respond positively to iodine supplementation. In fact, I have come to the conclusion that iodine deficiency sets up the immune system to malfunction which can lead to many of the above disorders developing. Every patient could benefit from a thorough evaluation of their iodine levels.” (2)

Is there a probable relationship to fibrocystic breast disease (FDB)?
Mainland Japanese women have a very low incidence and prevalence of FDB and breast cancer. (13) Several investigators have proposed that the essential element I was the protective factor in mainland Japanese. (4 – 10) If indeed, the essential element I is the postulated protective factor, the administration of I to American women in amounts equivalent to that consumed by mainland Japanese women would be expected to protect them from breast cancer and improve FDB, as previously proposed by Stadel for breast cancer and confirmed for FDB by Ghent et al. (7) Based on data supplied by the Japanese Ministry of Health, the average daily I intake in mainland Japanese is 13.8 mg. (6)

The administration of thyroid hormones to I-deficient women may increase further their risk for breast cancer. In a group of women undergoing mammography for screening purposes (14) the incidence of breast cancer was twice as high in women receiving thyroid medications for hypothyroidism (most likely induced by I deficiency) than women not on thyroid supplement. The mean incidences were 6.2% in controls and 12.1% in women on thyroid hormones. The incidence of breast cancer was twice as high in women on thyroid hormones for more than 15 years (19.5%) compared to those on thyroid hormones for 5 years (10%).
Sodium – iodide symporter:

The ability of the thyroid gland to transport and concentrate iodide from blood is absolutely necessary for the synthesis of thyroid hormones. The key player in this process is the sodium-iodide symporter, an integral membrane protein that resides in the membrane of thyroid epithelial cells. As its name indicates, the sodium-iodide symporter simultaneously transports both Na+ and I- ions from extracellular fluid (i.e. blood) into the thryoid epithelial cell. Considering critical role of iodine trapping in thyroid function, it is not surprising that abnormalities in expression or function of the symporter can lead to thyroid disease.
The sodium-iodide symporter is most highly expressed in thyroid epithelial cells. Lower levels of expression can be detected in mammary gland, salivary gland, stomach and colon, but none of these tissues is known to organify iodide. The presence of the symporter in mammary gland leads to secretion of iodine in milk, which is probably important for thyroid function in neonatal animals. (18 – 22)

One atom of iodine is transported into the cells for every 2 atoms of sodium via the sodium/iodine symporter (NIS). There is also a chloride/iodide symporter called pendrin. Normal saliva/serum iodide ratio is approx. 42. Less than 20 may be due to toxins or very high levels of bromine/fluorine binding to the symporter.

Goitrogens, including
- bromine (from fruit fumigants and processed bakery products)
- chlorine (chloramine byproduct from drinking water chlorination)
- ammonium perchlorate (rocket fuel found in tap water)
- fluorine (naturally occurring in well water plus drinking water fluoridation)
- thiocyanate (from cigarette smoke)

can bind to the NIS (receptor) and damage it preventing iodine from entering the cell. The receptor can possibly be repaired with vitamin C (3000 mg/day) and Celtic (unrefined) sea salt. (16)
The basil membrane of the thyroid cell has the specific ability to pump iodine into the interior of the thyroid cell. This is called Iodide Trapping. In a normal gland the iodine pump concentrates the iodide to about 30 times the concentration in blood. The rate of trapping is influenced by TSH in a negative feedback control method. (17)

Clinical experience:
For clinical experiences the following references are useful.

Fibrocystic Breasts by Jonathan V. Wright, M.D., Published in “Nutrition & Healing” – July 1995
David Brownstein, MD., Iodine. Why You Need It Why You Can’t Live Without It. 2nd Ed. 2006

Saliva iodine significance:
There is ample evidence of renal iodine clearance in the literature in Dr. Abraham’s references and some evidence of salivary uptake from other sources. According to Mr. Zareba under a NASA grant, the mean correlation coefficient ( r ) between iodine elimination for blood/saliva was 0.99, for blood/urine, 0.95, and for saliva/urine, 0.97. The absolute value of iodine concentrations in urine revealed marked variability, which was corrected by adjusting for creatinine levels. (15) That is, with normal symporter there is excellent correlation between the iodine concentration increase in serum and saliva. However, the timing is different.

From Bruger and Member, thyroxine was not concentrated from the blood to saliva but elemental potassium iodide (KI) was from 5 to 7 times that of the blood. The maximal amount of iodine concentrated in the saliva occurred 1 to 2 ½ hours after ingestion of KI peaking to 1200 times the initial salivary iodide. The salivary/blood iodine ratio in the control period was 6 and reached a maximum of 28, 8 hours after ingestion of the iodide. (18) Obviously measuring salivary iodide within several hours of supplementation will result in a very high unusable reading. This effect has been verified by our own tests. Note that normal iodide trapping in the thyroid is about 30 times that in the blood.

Implications:

The hypothesis is that since the salivary iodide uptake from the interstitium and thyroid trapping iodide from the blood is approximately the same order over time, the saliva uptake can be a rough indication of thyroid uptake. If this is true then the saliva/urine ratio can be a rough indication of thyroid iodide sufficiency. There is some anecdotal evidence from non-traditional research to suggest this relationship. Examples are as follows:

J was supplementing Iodoral® (7.5 mg KI + 5 mg Iodine per tab) at the rate of 50 mg/day for nine months (without adverse effect) encouraged by the idea of clearing mercury toxicity (a dental assistant) and tested at 25 PPM saliva and 60 PPM urine iodide. One would expect that after nine months supplementation at this dosage, iodine sufficiency would have been reached. The saliva/urine ratio of
< 1 suggests this conclusion.

Dr. T supplementing for many years with an organic bound iodine in seaweed extract tested 17 PPM saliva and 15 PPM urine. The supplementation will continue but one would expect sufficiency with this long term supplementation. Again the ratio approached 1.

B supplementing 6 months 12.5 mg/day Iodoral® tested 9 PPM saliva and 6 PPM urine suggesting a higher dosage could be used to approach higher residual levels and a lower ratio suggesting sufficiency as not reached. The 24 hour urine iodine loading test would be appropriate.

M was not supplementing but ate substantial amounts of seafood and mostly Mexican foods but very little US produced processed foods. M’s saliva tested 17 PPM and urine 15 PPM.

20 other subjects were tested who were not supplementing except for iodized salt and multivitamin tabs with iodine in the 100 ug range. None were consuming substantial ocean dwelling foods. Usual tests were 1 PPM saliva and 0.1 PPM urine. The absolute values are very low and the ratio is 10. Again a 24 hour urine loading tests would probably support this conclusion.

Testing was performed in the morning with no fast required. It is recommended that a 12 hour fast, 8:00 PM to 8:00 AM for example, be required in order to minimize the effects of hydration.
Future studies

The QFA 1500 analyzer does not purport to provide sensitivities less than 0.1 mg/L (PPM) but is sensitive enough to measure the uptake effects of iodine supplementation whether in Lugol’s formula (as Iodoral® of 7.5 mg potassium iodide and 5 mg elemental iodine) or other organic form such as kelp, dulse or seaweed extract.

The hypothesis of measuring the ratios of saliva vs urine iodine as a measure of sufficiency and blood vs. urine as an indicator of availability of iodine for the tissues (iodine symporter) is unproven except from anecdotal information. Nevertheless a good body of information will be obtained through this simple test coupled with other observation to arrive at conclusions outside traditional expensive and sometimes inaccurate or incomplete medical studies.

References:

1. Hintze, G., Emrich, D., Kobberling, J., Treatment of endemic goitre due to iodine deficiency with iodine, levothyroxine or both: results of a multicentre trial. European Journal of Clinical Investigation, 19:527-534, 1989.

2. Brownstein, D., Clinical experience with inorganic, non-radioactive iodine/iodide. The Original Internist, 12(3):105-108, 2005
3. Eskin B., Bartuska D., Dunn M., Jacob G., Dratman M., Mammary Gland Dysplasia in Iodine Deficiency, JAMA, 200:115-119, 1967.

4. Eskin, B., Iodine Metabolism and Breast Cancer. Trans. New York, Acad. of Sciences, 32:911-947, 1970.

5. Funahashi, H., Imaj, T., Tanaka, Y., et al, Suppressive Effect of Iodine on DMBA-Induced Breast Tumor Growth in the Rat. Journal of Surgical Oncology, 61:209-213, 1996.

6. Ghent, W., Eskin, B., Low, D., Hill, L., Iodine Replacement in Fibrocystic Disease of the Breast, Can. J. Surg., 36:453-460, 1993.

7. Derry, D., Breast Cancer and Iodine, Trafford Publishing, Victoria B.C., 92, 2001.

8. Vishnyakova, V.V., Murav’yeva, N.L., On the Treatment of Dyshormonal Hyperplasia of Mammary Glands, Vestn Akad Med Navk SSSR, 21:19-22, 1966.

9. Cann S., Netten J., Netten C., Hypothesis: Iodine, selenium and the development of breast cancer, Cancer Causes and Control 11:121-127, 2000.

10. Ghandrakant, C., Kapdim MD, Wolfe, J.N., Breast Cancer. Relationship to Thyroid Supplements for Hypothyroidism. JAMA, 238:1124, 1976.

11. Epstein, S.S., Steinman, D., Breast Cancer Prevention Program. Macmillan, NY, 1998, pg 5.

12. Waterhouse, J., Shanmvgakatnam, K., et al, Cancer incidence in five continents. LARC Scientific Publications, International Agency for Research on Cancer, Lyon, France, 1982.

13. Stadel B., Dietary Iodine and Risk of Breast, Endometrial, and Ovarian Cancer, The Lancet, 1:890-891, 1976.

14. Ghandrakant, C., Kapdim MD, Wolfe, J.N., Breast Cancer. Relationship to Thyroid Supplements for Hypothyroidism. JAMA, 238:1124, 1976.

15. Grazyna Zareba, Elsa Cernichiari, Lowell A. Goldsmith, and Thomas W. Clarkson., Biological Monitoring of Iodine, a Water Disinfectant for Long-Term Space Missions. (1) Center for Space Environmental Health, (2) Department of Dermatology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642 USA, (3) Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642 USA16.

16. David Brownstein, MD., Iodine. Why You Need It Why You Can’t Live Without It. 2nd Ed. 2006

17. Guyton & Hall, Textbook of Medical Physiology 10th ed.:858, 859)

18. Maurice Berger, Samuel Member, On The Excretion of Iodine in the Saliva, From the Research Laboratory, Department of Medicine, New York Post-Graduate Medical School and Hospital, Columbia University

19. De la Vieja A, Dohan O, Levy O, Carrasco N: Molecular Analysis of the Sodium/Iodide Symporter: Impact on Thyroid and Extrathyroid Pathophysiology. Phys Rev 80:1083-1105, 2000.

20. Dohan O, De la Vieja A, Paroder V, etc: The sodium/iodide symporter (NIS): Characterization, regulation and medical significance. Endocrine Reviews 24:48-77, 2003.

21. Fugiwara H, Tatsumi K, Miki K et al: Congenital hypothyroidism caused by a mutation in the Na+/I- symporter. Nature Genetics 16:124, 1997.

22. Spitzweg C, Heufelder AE: The sodium iodide symporter: its emerging relevance to clinical thyroidology. Europ J Endocrinol 138:374, 1998.

A NOVEL WAY TO TREAT CONNECTIVE TISSUE TRAUMA

2011-04-25T11:31:00.000-07:00

CONNECTIVE TISSUE is the supporting structure in a joint including tendons, muscles, ligaments and, in some cases, the cushioning cartilage between the joint. In a person’s life, 100% of us sustain an injury to these tissues. This result in strains and sprains with or without fractures of the involved joint. A strain is an injury to a muscle and/or its tendon, the tissue that connects muscles to bones. A sprain is an injury to a ligament, the tough, fibrous tissue that connects bones to other bone. These injuries involve a stretching or a tearing of the tissue and produces inflammation. “Tendinosis”, a better term than tendonitis, on the other hand refers to non-inflammatory injury to these tissues at the cellular level. These conditions are caused by damage to collagen, cells, and some due to the vascular components of the structure, which ultimately could lead to rupture by a different mechanism than acute trauma. These “tendinopathies” may be caused by both extrinsic and intrinsic factors including age, genetics (Ehlers Danlos Syndrome), body weight and nutrition. The extrinsic factors are often related to sports and include excessive forces or loading, poor training techniques, environmental conditions, posture and gait. Depending on the severity of the injury, the damage may be a simple overstretch of the tissue, or it can result in a partial or complete tear!

A sprain or strain typically occurs when people fall and land on an outstretched arm, slide into base, land on the side of their foot, or twist a knee with the foot planted firmly on the ground. This results in a overstretch or tear of the tendon/muscle or ligament(s) supporting that joint. Strains can be acute or chronic. An acute strain is caused by trauma or an injury such as a blow to the body. Improperly lifting heavy objects or overstressing the muscles can also cause it. Chronic strains are usually the result of overuse injury (prolonged, repetitive movement of the muscles and tendons).

Although all joints can potentially be sprained or strained, the most common is the ankle the second is the shoulder, and the third, the ankle counterpart in the upper extremity, the wrist. The ankle is most commonly severely injured in professional, recreational sports and even in ordinary activities like walking. Most ankle sprains happen when the foot abruptly turns inward (inversion) or outward (aversion) as athletes run, turn, fall, or land after a jump. One or more of the lateral or medial ligaments are injured but a tendon and its attached muscle can also be hurt.
The usual symptom of a muscle/tendon strain or a ligament sprain is pain, and the signs are swelling, bruising, and the loss of function (the inability to move and use the joint). Sometimes people feel a pop or tear when the injury happens. The signs and symptoms can vary in intensity, depending on the severity of the sprain.

The severity is graded one, two and three. A grade I (mild) is overstretching or slight tearing of the tissues with no joint instability. A person usually experiences minimal pain, swelling, and little or no loss of function. Bruising is absent or slight, and the person is usually able to put weight on the affected joint. A grade II (moderate) causes partial tearing and is characterized by bruising, moderate pain, and swelling. There is some difficulty putting weight on the affected joint and there is some loss of function. An x-ray or rarely an MRI may be needed to document both the diagnoses and stage. A grade III (severe) results in a complete tear or rupture. Pain, swelling, and bruising are significant, and the patient is unable to put weight on the joint. An x-ray is usually taken to rule out a fracture in the adjacent bone. Type III injury often requires immobilization and possibly surgery. It can also increase the risk of the person having future problems in that area.

Contact sports such as soccer, football, hockey, boxing, and wrestling put people at risk for strains. Gymnastics, tennis, rowing, golf, and other sports that require extensive gripping can increase the risk of hand and forearm strains. Elbow strains a type of repetitive syndrome occur in people who participate in racket sports, throwing, contact sports and work. The latter in occupations such as carpentry that requires hammering. Two Common Elbow Strains are Tennis Elbow (lateral epicondylitis) and Golfer’s Elbow (medial epicondylitis).

The healing time varies with the severity of the injury with mild and only a few fibers have been damaged. Healing occurs within two to three weeks. With moderate injury with more extensive damage to the fibers, but the tissues is not completely ruptured. Healing occurs within three to six weeks. But with a severe injury and a complete severing of the bundle. It is another story. This may require surgical repair of the tissue and the healing period can be up to a year!

Tendons, muscles, and ligaments are capable of healing and recovering from injuries in a process that is controlled by the fibers and their surrounding extracellular matrix. However, the healed tendons and ligaments never regain the same mechanical properties as before the injury. Muscle have a good blood supply, which is impart why they are red heal far faster and better than the anemic white tendons and ligaments. The three main stages of healing are inflammation, repair ( proliferation), and remodeling. Nature does a good job with these processes, but doctors can help patients to augment the rapidity of healing.

Most current treatments for the joint supportive structures are neither evidence-
based or effective. Typically Doctors recommend RICE- Rest, Ice, Compression, and
Elevation. They also give anti-inflammatory such as Ibuprofen which may help with
the pain, but delays the healing in that inflammation itself as noted above is part of
the healing process. In some cases immobilization may be helpful, but in others in
which there is no associated fracture, it delays healing in that it decreases the
natural growth factors that are stimulated with joint movement.

Molecular processes underlying joint structure healing are now being elucidated.
Metalloproteinase enzymes are thought to have a key role in the regulation of the activity of tendon cells and matrix remodeling in both normal and pathologic structures. The potential roles of neuropeptides, inflammatory mediators and mechanical strain (either too much or too little) acting on the resident tenocytes are noted to stimulate the intrinsic healing G-Proteins. Excessive or inappropriate activity of destructive matrix-degrading enzymes might be a novel therapeutic target for tendinopathy. Tenocytes in the tendon actively synthesize components as well as enzymes such as matrix metalloproteinases . Bone morphogenetic proteins (BMPs) can induce bone and cartilage formation as well as tissue differentiation, and BMP-12 specifically has been shown to influence formation and differentiation of tendon tissue and to promote fibrogenesis.

Now avant guarde physicians give Enzymes such as Bromelain and Papain early in acute trauma, don’t use inflammatory suppressants but pro-inflamants (prolotherapy), early or no immobilization, even irritating the structures such as the “aggravating technique” in tennis elbow, and a cellular level, nitroglycerin (NTG)!

The rational that NTG could be used pharmacologically to accelerate repair in injured tendons has been well documented. Gambito E, "Evidence on the effectiveness of topical nitroglycerin in the treatment of tendinopathies: a systematic review and meta-analysis" (Arch. Phys. Med. Rehabil. 2010;91:1291-305). In a more recent study from the University of Toronto (JAMA.Feb 23;2011) Jamal found that nitroglycerin ointment increased both bone density and strength in postmenopausal women. The mechanism for tendon and bone repair is speculated to be enhancement of a group of connective tissue enzymes, the metalloproteinases and a cytokine, specifically Il-17.

Bearing the above in mind, I have used NTG ointment on over thirty patients with tendon/cartilage injuries to include rotator cuff, hip, knee, and neck with good results. In the past, I have also used a topical muscle relaxant (Flexeral), an antinflamatory (Ketoprofen), an analgesic (Lidocaine) separately or together in an absorptive matrix. I have since added them to NTG to augment the earlier healing liniment and have had even better results. This combination of salubriants must be obtained at a compounding pharmacy. Many medical insurances do pay for these prescription. For more information call Chris Schiller at Economy Pharmacy (918-994-5804).

FOR A LONGER AND BETTER LIFE YOU NEED TO KNOW YOUR SCORE

2011-04-03T20:40:00.000-07:00

That score is your telomere count. 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 centurion (living 100+ years). How does one know how long and well they will live? Now there is a laboratory study for it, called TELOMERE TESTING. Until recently, the test was prohibitively expensive, but now for less than $400, one can obtain their report card and intervene on life style to get a better and better score to either achieve their goal or come very close to it. The Telomere test is a simple fasting or non-fasting blood test that can be carried out in most doctor’s office. For more information contact Doug Sloan (405-227 2112) or go on line to Spectocell.com.

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. If our reserve is depleted, we succumb to disease or just old age. The Telomere Test can determine the length of your telomeres in relation to the chronological age. The Telomere Score is calculated based on the 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 of the same age. 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 one can work harder or do other interventions that will enhance their score and their life.

Although we cannot change our genes we now can modify their expression by Lifestyle. In a study published in Nature this January scientists found the body activates a gene (P 53) that under stress shuts down our cells' normal growth and division cycle by controlling the telomere length. Diet plays a large role in this process. Micronutrients have been shown to have epigenetic effects by methylation of our DNA. The best but the most difficult is becoming a CRONI, (Caloric Restriction Optimal Nutritional Intake) to the point of just sustenance, a step away from starvation with just nutrient dense foods. 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 in the January 20, 2010 issue of JAMA, increased telomere and survival rates occurred among individuals with high dietary intake of marine omega-3 fatty acids and established cardiovascular disease. 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! Although both EPA and DHA are healthy, it seems that DHA is better. So consuming Tuna or Calamari Oil, which has a 4 to 1 ratio of DHA to EPA, is superior than any of the marine oils. What we eat and supplement today becomes the biology of our future.

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 exercise with adequate antioxidants will also give longer telomeres. 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 telomere 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 telomeres longer. Keeping our hormones (Thyroid, Sex and Adrenal hormones) in balance and not getting sick also keeps our telomeres longer. To not get sick means keeping our immune system healthy to include the consumption of Pre and Probiotics. Surgery should be only for life saving problems and not for elective procedures since the operation and the anesthesia shortens the telomeres. Staying out of harms' way for bodily damage in our daily pursuits such as not over indulging in alcohol and dangerous sports and occupations will keep our telomeres and our lives longer.

Although it is far better to live a healthy life style, there are drugs that also have been shown to decrease our telomere shortening. The antihypertensives, Angiotension Converting Enzyme drugs such as Lisinopril and the Angiotension Recepter Blockers like Lorsartan have been shown to extend our telomeres. Likewise so has the Cholesterol lowering Statins. These drugs should be used judiciously, not to lower our lipids too much and to take concomitantly CoEnzyme Q 10. Also the diabetic medicine, Metformin, has been shown to be antiaging. But with this drug many physicians recommend using B12 too. Age is how old we are, but old is what our body is biologically. In reality it is not how old you are, but how you are when you are old that counts!

CHIROPRACTIC

2011-03-07T05:09:00.000-08:00

Nowadays, Chiropractic medicine is an accepted paradigm of health care and treatment. But it was not always like that. Today our society considers these practitioners as in a health care discipline that emphasizes diagnosis, treatment and prevention of mechanical disorders of the vertebrae under the hypothesis that these disorders affect general health via the nervous system. The main chiropractic treatment involves manipulation of the spine, other joints, and soft tissues; treatment also includes exercises and health and lifestyle counseling.

D.D. Palmer founded chiropractic in the 1890s and his son B.J. Palmer helped to expand it in the early 20th century. It has two main groups: "straights", now the minority, emphasize vitalism, innate intelligence and spinal adjustments, and consider vertebral subluxations to be the cause of all disease; "mixers" are more open to mainstream and alternative medical techniques such as exercise, massage, and nutrition. With the advent of X-Ray and the noise of a joint going back into the proper position, Chiropractic is here to stay! The so called pop is caused by the tendons or in the back the apophyseal joint causing a vacuum as it is pulled and suddenly let go-in physics called a cavitation.

The premise of chiropractic assumes a vertebral subluxation or spinal joint dysfunction interferes with the body's function and its Innate Intelligence. This vitalistic concept states that all life contains Innate Intelligence and that this force is responsible for the organization, maintenance and healing of the body. Removal of the interference to the nervous system spinal adjustment so that when the spine is in correct alignment, Innate Intelligence can act, by way of the nervous system, to heal disease within the body. However, until 1987 Chiropractic was considered a cult by the AMA of which I was a member. My experience though with the profession was that it greatly helped folks with back problems and I frequently referred patients to them.

In 1975, I was approached by the Missouri State Medical Board that my license was at stake if I continued using chiropractors as part of the “healing profession”. I was incensed that I could not practice what I thought was best for my patient. Most MDs then thought that if time and physical therapy did not work, then give heavy pain meds or sent them to orthopedic surgeons. Many were operated on and suffered a “failed back”. I was so disturbed by this that I testified in Chicago in 1976, with Chester Wilk and four other chiropractors against the AMA and several nationwide healthcare associations. This was finally resolved in 1987 after a second trial that Chiropratic did help folks indeed and in need.

The triad of Innate Intelligence, Force, and Matter espoused by Palmer a hundred years ago has gone by the wayside. Modern chiropractors study these principles in college and these ideas are seen as historical references to early chiropractic philosophy and pseudoscience. Chiropractors in Australia, England and Germany are Medical Doctors (M.D.s) who specialize in spinal manipulation and many of the techniques used by their American counterparts. A profession that originally did similar healings, the Osteopaths, but now do very little Osteopathic Manipulative Therapy took some of the slack here up. They mostly practice what we as MDs do. After four years of postgraduate (Chiropractic School) training, the student is awarded a Doctorate in Chiropractic- a D.C. Until recently most schools were privately funded, but now they are beginning to see them as part of Universities. Chiropractic is here to stay in America and I feel it is part of the holistic movement of good patient care.

2011-02-27T06:19:00.000-08:00

DO YOU KNOW MPO

We all have the enzyme myeloperoxidase, (MPO), in our bodies. But as plaque inside our blood vessel walls becomes more likely to rupture, we produce even more MPO at that site. The increased amounts of MPO, which can be measured in the blood causes erosion of the plaque. When the plaque in the blood vessel erodes enough, it ruptures. There a micro-clot forms to patch the weak spot. Platelets (formed elements) in the blood cells flowing by the clot start participating in growing and firming up this coagulated mass. If that clot blocks blood flow to the heart or brain, a heart attack or stroke usually occurs. A high level of MPO is a signal that a person is in risk of having a catastrophe. This is so even though the cholesterol levels and blood pressure are perfect as in almost fifty percent of these incidents. The MPO oxidizes the LDL cholesterol, modifying so it is more delectable to the certain white cells (macrophages) that reside within the wall of our arteries. These ingest the LDL particles, get sick, die and spill their fatty guts thus enlarging the existing fatty streaks to form an inflammatory plaque. This is the generator of all atherosclerosis. Unbeknownst to most doctors is that Acetaminophen blocks the activity of MPO and stops the transformation of the bad cholesterol (LDL) that is available for the macrophages to ingest.

And Aspirin stops the platelets in our blood from getting sticky, preventing the clump. The basis for the use of low dose aspirin lies in its unique inhibitory effect on a key enzyme, COX-1 (cyclooxygenase-1). In low doses, 81 mg (a child’s aspirin) twice a day, the platelets are less tacky and not as likely to coalesce together to coagulate. However, in higher amounts such as 650 mg (2 adult Aspirins) it affects the arterial walls making them sticky and more likely to initiate a clot on the rough plaque.

A personal friend of mine, Professor Gary Merrill, of Rutgers' department of cell biology and neuroscience, demonstrated significant improvement in acetaminophen-treated hearts compared with non-treated hearts following periods of induced ischemia (reduced blood flow) attributed the rapid post-ischemia recovery of heart muscle and circulation to the antioxidant properties of acetaminophen. This research as part of a growing body of evidence supporting the positive effects of acetaminophen on the cardiovascular system. His findings, together with those of Dr. Addison Taylor of Baylor College of Medicine, Houston, and Professor Phillip Greenspan of the University of Georgia College of Pharmacy, indicate that acetaminophen prevent the damaging effects of LDL cholesterol. Taylor and Greenspan separately conducted investigations showing acetaminophen may protect against the life-threatening condition, hardening of the arteries. The bad press that Acetaminophen has recently had makes this well studied drug almost a curse word. It is true in very high doses like over 6,000 mg a day it can negatively affect the liver and perhaps the kidney, but 1000mg/day is positively healthy for all who want protect their blood vessels.

After the discovery, the Cleveland Clinic, through Cleveland Heart Lab started doing the MPO test. Blood samples, are overnighted to them from the doctors offices, for MPO and four other valuable markers. They include urinary Isoprostain and Microalbumin; a pro-oxidant and an arterial disrupter, HsCRP; indicating lining damage, and Plac2; a predictor of plaque rupture. Many insurance companies and Medicare now cover the test. And for those who don't have coverage, the cost is relatively inexpensive: $189 for MPO and the other tests conducted with it.

If none of the above makes sense to you, still do yourself a favor. Betwixt and between Aspirin and Acetominophen will keep the artery clean-and YOU healthy! If you are a male over the age of 45 or a female over 50-PLEASE take one each of 81 mg Aspirin and 500 mg Acetominophen (Tylenol), both twice a day, it will keep the heart attack and stroke away!!

MPO IN DEPTH

2011-02-27T06:08:00.000-08:00

The enzyme myeloperoxidase, (MPO), in our bodies played a role in the past as a defense. But in modern civilization it causes our demise. This intra White Cell enzyme generates reactive oxidants that kills invading microbes. In modern times it hastens plaque build up inside our blood vessel walls. Three mechanisms have been elucidated by the scientists. The MPO oxidizes the LDL cholesterol, modifying it so it is atherogenic. This now bad, bad cholesterol is rapidly ingested by the macrophages that reside within the inside wall (endothelium) of our arteries. These ingest the LDL particles, get sick, die and spill their fatty guts thus enlarging the existing fatty streaks to form an inflammatory plaque. The second mechanism is it oxidizes the endothelial Nitric Oxide that normally keeps these cells healthy. Then this nefarious enzyme weakens the fibrous cover of the plaque, which makes it rupture. There, along with the platelets already in the blood and another enzyme, Plaq2, a micro-clot forms to patch the weak spot. If that clot does not spontaneously dissolve, it blocks blood flow to the heart or brain, a heart attack or stroke usually occurs.

The increased amounts of MPO can be measured in the blood. If greater than 723 pmol/L, there is a 5-fold increase of a catastrophic event even in the absence of other cardiovascular risk factors. But if other risk factors are present a high value makes it much more dangerous. MPO is also used clinically in the Emergency Room to determine if the acute chest pain that the patient is having is a heart attack or not. Another emerging use is that it predicts the severity of heart failure (inability of the heart to pump enough blood) and the prognosis. It is also used to determine the rate of narrowing of the carotid arteries.

Statins decrease MPO levels and Acetaminophen blocks its activity, which stops the transformation of the bad cholesterol (LDL) that is available for the macrophages to ingest. This important test can be done by the Cleveland Clinic, through Cleveland Heart Lab by a special arrangement with a local physician. Blood samples, are overnighted to them for MPO and four other valuable markers. They include urinary Isoprostain and Microalbumin; a pro-oxidant and an arterial disrupter, HsCRP; indicating lining damage, and Plac2; a predictor of plaque rupture. Many insurance companies and Medicare now cover the test. And for those who don't have coverage, the cost is relatively inexpensive: $189 for MPO and the other tests conducted with it.

PERSONALIZED MEDICINE

2011-02-21T11:40:00.000-08:00

One size does not fit all! There is as much genetic variation in the metabolism of drugs, foodstuffs and ingested pollutants as there is in the countenance of humans. Other than identical twins, we each have our facial individual identity and, similarly, each of us metabolizes differently both quantitatively and qualitatively. Our technology has advance to the point that medical science can detect many of the nuances that make us uniquely distinct. This is particularly important so that a physician can prescribe an exact dose of a given drug and particularly when several other medications are given coincidently.

Not only does age, sex, weight, intestinal flora, general health, liver and kidney function alter a patient's response to drugs, but genetic factors must be considered. This information is crucial. Prescription Drug Fatality is the fourth leading cause of death after heart disease, cancer, and stroke. The major determinant involved in the metabolism of drugs, toxins and our hormones is the Cytochrome (CYP) P450 enzymes. The most important of these are CYP2D6, CYP2C9, CYP2C19, NAT2, UGT1A1, DPD, 5HTT, and CYP1A2. The'CYP's is a host of enzymes that use iron to oxidize organic molecules, as part of the body's preparation to dispose of potentially harmful substances by making them more water-soluble. The capital letter indicates the superfamily, and the number before and after, the subfamily.

In humans, CYP3A represents one of the most important subfamilies of the P450 superfamily. The CYP3A subfamily is the most abundantly expressed P450 in human liver, and CYP3A is involved in the biotransformation of approximately 50% of drugs that are metabolized. As a result, drug-drug interactions associated with modulation of CYP3A-mediated metabolism can be of substantial consequence. In the past, it was a trial and error of the dose and the drug we would use. To err could cause not only great harm, but even death of a patient. With this new tool, doctors can take the guess work out of prescribing and do it scientifically.

In addition to our hereditary, the CYPs can be both up-regulated (induced) or down-regulated (inhibited) by other chemicals making it on occasion a complexed proposition for drug deposition. When several competing drugs are use for the same CYP enzyme an Adverse Drug Interaction occurs. At times there are multiple CYPs that work on a drug. For example, adding a hydroxyl group to a medication is the body's strategy to get rid of it and is often followed by joining them to other molecular groups such as glucuronide to increase the solubility even further. Most of the CYP in man is found in the liver, the main organ involved in drug and toxin removal, but a fair amount is also in the small intestine. CYP usually is found in the 'microsomal' part of the cytoplasm (endoplasmic reticulum).

We determine the dose and interaction of not only prescribed drugs, but OTC (over-the-counter) and herbal medicines including those used to treat depression, anxiety, seizures and psychoses; heart disease, cancer, diabetes, and pain. These include medications as Coumadin (warfarin), Prozac, Zoloft, Paxil, Effexor, hydrocodone, Amitriptyline, Claritin, Cyclobenzaprine,, Metoprolol, Tagamet, Tamoxifen, Valium, Carisoprodol, Dilantin, Premarin, and Prevacid (and the over-the-counter drugs, Allegra, and the several NSAIDS).

Almost half of us have genetic variations that affect how we process these drugs. There are four different types of metabolizers, and we all fall into one of these categories for the unpredictable pathways in Cytochrome P450 system. The first type which is the norm, and therefore that person would be an NORMAL Metabolizer and medications prescribed in the usual doses will be handled well by your body. The second type, you would be an INTERMEDIATE metabolizer. This means that you to metabolize the medications more slowly. In this case a lower dosage is needed, and there is a chance of medications building up in your system causing adverse effects. It is especially important to monitor medications if you are in this category. Intermediate metabolizers through the 2C9 pathway, for instance, have an increased risk of bleeding incidences when taking the common blood thinner Coumadin or warfarin. For this reason, screening for CYP2C9 variants may reduce the risk of adverse drug reactions in these patients. The third type is a POOR metabolizer. This type of metabolizer is potentially very dangerous, as there is a great chance for the medication to build up in your system making one very sick, or even death.For example, a poor metabolizer of phenytoin, a common antiepileptic would not be able to process the drug and would actually have toxicity if prescribed this drug. The fourth type of metabolizer is ULTRA EXTENSIVE. In this instance, one would very rapidly excrete the medication. If you were an Ultra Extensive Metabolizer through the 2D6 pathway and one were prescribed a narcotic, there may not be any pain relief because the medication would be metabolized so fast that it would have little or no effect.

PHARMACOGENETIC EFFECT OF CYTOCHROME GENOTYPES

A. PM poor metabolizer, absent or greatly reduced ability to clear or activate drugs.  B. IM intermediate metabolizer. Heterozygotes for normal and reduced activity genes. C. EM EuMetabolizer or the Normal Metabolizer. The expected result. D. UM Ultra Metabolizer. Greatly increased activity accelerating clearance or activation. 
POPULATION FREQUENCY OF CYTOCHROME P450 (CYP) GENOTYPES
Gene PM IM EM UM
CYP2D6 10% 35% 48% 7%
CYP2C9 2-4% >35% ~60% N/A
CYP2C19 2-20% 24-36% 14-44% 30%

Currently Available Tests:

CYP2D6(cytochrome P450 2D6) acts on one-fourth of all prescription drugs, including the selective serotonin reuptake inhibitors (SSRI), tricylic antidepressants (TCA), betablockers such as Metoprolol and many of the antiarrhythmics. Approximately 10% of the population has a slow acting form of this enzyme and 7% a super-fast acting form. Thirty-five percent are carriers of a non-functional 2D6 allele (half of the gene), especially elevating the risk of ADVERSE DRUG REACTION when these individuals are taking multiple drugs. Drugs that CYP2D6 metabolizes include Prozac, Zoloft, Paxil, Effexor, hydrocodone , amitriptyline, cyclobenzaprine (Flexeril), Coreg, Tagamet, Tamoxifen, and the over-the-counter diphenylhydramine (Benadryl) drugs, Allegra and Claritin. CYP2D6 is responsible for activating the pro-drug codeine into its active form and the drug is therefore inactive in CYP2D6 slow metabolizers.
CYP2C9(cytochrome P450 2C9) is the primary route of metabolism for Coumadin (warfarin). Approximately 10% of the population are carriers of at least one allele for the slow-metabolizing form of CYP2C9 and may be treatable with 50% of the dose at which normal metabolizers are treated. Other drugs metabolized by CYP2C9 include Amaryl, Isoniazid,, Amitriptyline, Dilantin, Hyzaar, THC (tetrahydrocannabinol), NASAIDS, and Viagra.
CYP2C19(cytochrome P450 2C19) is associated with the metabolism of Carisoprodol (Soma), Aprazolam, Dilantin, and Prevacid.
CYP1A2(cytochrome P450 1A2) is associated with the metabolism of Amitriptyline, Resperone, Duloxetine(Cymbalta), Theophylline, Caffeine, Diazepam, Sex Hormones Tamoxifen, and Cyclobenzaprine. Amongst other problems these folks have arrhythmias or get jittery when drinking coffee. Lycopene found in tomatoes reduces the effect of the above drugs and hence need more of a dose.
NAT2(N-acetyltransferase 2) is a secondary drug metabolizing enzyme that acts on Isoniazid, Demnerol, and Azulfidine. The frequency of the NAT2 "slow acetylator" in various worldwide populations ranges from 10% to more than 90%.
DPD (Dihydropyrimidine dehydrogenase) is responsible for the metabolism of Fluorouracil (5-FU), one of the most successful and widely used chemotherapy drugs.
UGT 1A1 (UDP-glucuronosyltransferase) variations can lead to severe even fatal reactions to the first dose of Camptosar (irinotecan).
5HTT (Serotonin Transporter) helps determine whether people are likely to respond to SSRIs, a class of medications that includes Citalopram(Celexa), Fluoxetine(Prosac), Paroxetine(Paxil) and Sertraline

With this tool, no longer is it a trial and error proposition as to what drug and its dose to prescribe, We can now do it scientifically with a much better outcome for the patient. Since our CYP genes do not change, this study is done only once in a lifetime. Although, there are several labratories that do this work. the best and the one that we use is the Seattle based GENELEXR . The test is paid for by most medical insurances and archived on a computer registry to be use with the patient’s permission by their current and future doctor and pharmacist. As a doctor with this science, 21st Century medicine can be practice with a far better outcome than the primitive approach we had taken in the past. Please embrace this technology; it can save your life!

EAT BREAD AND YOU'RE DEAD

2011-02-14T07:48:00.000-08:00

BREAD is not only bad for celiac disease, gluten intolerance; bromide (lowers our iodide levels) but has Malted Barley Flour as an ingredient, typically the second one–which means it’s the second most prevalent ingredient. It has the amino acid glutamate, an excitotoxin like mono sodium glutamate. It causes headaches, fuzzy thinking, neuropathies, and the pins and needles pain that seems to have no explanation. Malted barley flour supposedly improves the taste of bread. It is also in some beers, with the same effects.

Also azodicarbonamide (ADA) is added to most bread flour. It’s a pesticide from China that’s added to speed up the bleaching process. Pesticides are linked to cancer, reproductive and developmental problems, and nerve damage. It also causes coughs, headaches that can last for days, shortness of breath, wheezing, swollen nasal cavities, burning throat and breathing problems. The United Kingdom, Singapore, Australia and most of Europe ban ADA. The FDA and World Health do not think it a problem yet.

To add insult to injury bread is fortified with iron. Unless you are deficient in this mineral, it increases the incidence of liver cancer and causes hardening of the arteries. To make matters even worse most commercial breads contain high fructose corn syrup, which raises triglyceride levels, leads to obesity and diabetes, and elevates uric acid levels causing hypertension and cardiovascular disease.

Can Death and Disability be Prevented by GlycoMark ?

2011-02-14T07:40:00.000-08:00

You Bet!! According to the American Diabetes Association, monitoring of glycemic (blood sugar) status is the cornerstone of diabetes care. Many doctors and most patients use a Fasting Blood Sugar to determine not only if diabetes is present but how they were doing with their treatment. For the last eight years I have used a better test, the Hemoglobin A1C the average glucose, encompassing both hyperglycemia and hypoglycemia of all blood glucose levels over three months – invaluable information, to be sure. But it doesn’t show after meal spikes, which can affect 40% of patients who otherwise appear to have their diabetes under control.

GlycoMark® is a blood test, FDA approved in 2003, and now available. It is a new generation test that specifically targets glucose response above the renal threshold (about 175) over one to two weeks to give a window on postprandial (after-meal) glucose peaks. That is critical information! This knowledge can improve patient care by targeting the spikes with specific treatments that also have become available. This will prevent dangerous cardiovascular complications in patients who had previously these undetected postprandial serum glucose spikes. It allows patients to seek medical intervention in a more timely manner and when to start or change therapy, empowering them to achieve and maintain control of their disease. . The currently available markers, A1C and fructosamine (like A1C but a two week window) only reflect average glucose, potentially missing the most important hyperglycemic (high blood sugar) excursion that is balanced out by normal or slightly low sugars. The GlycoMark is an alternative marker that acurately reflects postprandial elevations. It is these sudden spikes of glucose that hit hard the sensitive endothelium (lining) of our blood vessels damaging them to form plaque. It is the plaque that not only narrows the vessel but encourages clot formation.

The test uses a natural “in serum” molecule, 1,5-anhydroglucitol (Glycomark) which like glucose, we ingest, is obviously in our blood. During normal blood sugars, the Glycomark is maintained at constant steady state level due to a large body pool and unlike glucose is not metabolized. Normally, in the kidneys, the Glycomark is filtered and completely reabsorbed and therefore neither raised or lowered in our blood under normal conditions. However, with elevated serum glucose concentrations (about 175 – the average renal threshold for glucose), glucose is not completely reabsorbed by the kidney, and serum Glycomark unlike glucose falls due to competiton of renal tubular reabsorption by glucose. Therefore the change in Glycomark depends on both the duration and amount of glucosuria (sugar in the urine). The Glycomark has been shown to reflect daily glycemic excursions in patients with A1Cs at or near goal. Even though the A1C has been validated as marker of risk of both micro- and macrovascular complications, the Glycomark is even better.

CRAPOHYDRATES

2011-02-07T08:13:00.000-08:00

Our Body gets its energy from the three macronutrients (Carbohydrates, Protein, and Fats) we consume. As humans we do not need any carbs to survive. But carbs in today’s culture are a way of life. If we must eat carbs, then let us consume the least harmful rather than the detrimental ones, the CRAPOHYDRATES! These lousy carbs score high on the glycemic index, which assigns each food a numerical value based on how quickly it raises a person's blood sugar levels. (To develop this index, researchers spent years assessing the potential of various carbohydrates to raise blood sugar.) Therefore if the glycemic index is greater than 50, it is a crapohydrate rather than an eatable carb. Crapohydrates ( high-glycemic carbs) not only include the bad “whites” like sugar and starches, but white bread, white potatoes, white rice and most pastas! The better carbs, which include berries and vegetables, cause a more gradual rise in blood sugar leading to a slower release in the hormone insulin, which moves glucose out of the bloodstream and into cells where it's used as fuel if the individual excercises shortly after eating or stored as fat in a sedentary person. Not eating crapohydrates limits wreckage to cells triggered by elevated blood sugar thus protecting against heart disease, diabetes, and other ills. Not only is the metabolic Syndrome reversed, but a new study adds to previous research showing that following a low-glycemic, non-crapohydrate diet, type 2 diabetes had better control over their blood sugar and needed less or no medications than those who ate crapohydrates. As a fringe benefit my practice has demonstrated that switching to low-glycemic carbs causes successful weight loss forever. A discovery that has revolutionized my concept of an enduring winning diet is NUTRITIONAL KETOSIS.

After two days, when our liver glycogen is depleted, body fats and proteins are metabolized to produce energy. The fats are broken down into fatty acids that are used as fuel. In the absence of carbohydrate, the fatty acids are incompletely oxidized yielding ketone bodies and is called nutritional ketosis. Prolonged total fasting is unsafe, because it causes the body to begin to digest proteins from its muscles, heart, and other internal organs. Therefore low glycemic carbohydrate diets produce ketosis, and if properly designed, enable the body's nutritional needs to be met by dietary protein, and fat as well as unsightly stored body fat, so that our vital structures remain healthy. As the nutritional ketosis begins, there is a diuretic (water loss) effect, healping the dieter to feel that significant weight reduction is taking place. However, most of the early loss is water rather than fat; the lost water is regained quickly when if the dieter resumes eating crapohyrates, as would also occur, with resumption of a so called “balanced diet”. The appetite, is reduced during ketosis, which also returns when a regular diet is resumed. Current thinking suggest that appetite reduction and weight loss has to do with the balancing of pancreatic hormones, insulin and glucagon. The most widely publicized low-carbohydrate diet has been the one advocated by the late Robert C. Atkins, M.D., of New York City. His 1972 book Dr. Atkins' Diet Revolution sold millions of copies within the first two years! Bob Atkins, with whom I had the privilege and pleasure having supper, will go down in history as one of the greatest influences in medical health of the Twentieth Century.

Needs are necessary for human existence but wants are desires that may or may not be the best for the person. Humans have both a need and a want for food. In ancient times they were almost the same. But in modern times they are vastly deviating. To determine the difference for any given meal, eat only five bites of the beginning course then leave the table. Return a half hour later and eat all you want. Ninety percent of the time you really will not want to eat any more. Therefore your need was only for the five bites, but if you continued to eat after the initial bites, it was only for your wants. There are four easy ways to determine if you are in ketosis. 1. A simple urine Ketostix test of which you can buy and do yourself, or we could do in the office. 2. A characteristic breath odor. 3. Successful weight and appetite loss. 4. A sensation of grittiness or roughness on the back of the front teeth with the tongue. Do not get confused between healthy nutritional ketosis and damaging KETO-ACIDOSIS or METABOLIC-ACIDOSIS. The nutritional one indicates fat loss and the others an illness. It is the fat loss and all its beneficial properties such as normalizing blood sugars, lipids and pressure we want and nutritional ketosis will do it for us. And crapohydrates will make us sick and tired as well as decrease our life span. So say No to Crapohydrates!

DO NOT BE RESISTANT TO THIS AMAZING STARCH

2011-02-04T06:17:00.000-08:00

Say hello to this Amazing Starch which is a carbohydrate (carbon, hydrogen, and oxygen)-forming glucose in which a large number of these molecules are joined together. Starch is a polysaccharide, which is naturally produced by all green plants as an energy store. It is contained in such foods as potatoes, wheat, maize (corn), and rice. Amylopectin and amylose are the two kinds of arrangement in the starch. Amylose is the most simple containing glucose, one molecule after another in long chains numbering into the thousands. Amylopectin has a more complex configuration in which the chains are off to the sides in several directions. Until the last century, we obtained our starch from the vegetable itself. But now it is added unnaturally to foodstuffs. It is also in the stripped cereal grains we use as the staff of life: bread. (“EAT BREAD AND YOU’RE DEAD” said one of my dying patients).

Pure starch is a white, tasteless and odorless powder that is insoluble in cold water and is tremendously caloric, even more so than plain sugar (sucrose). When dissolved in warm water, it is used as a slightly sweetening, thickening, stiffening or gluing agent. In our bodies the enzyme, amylase, starts breaking apart this large molecular structure to the subunit, glucose. The digestion starts in the mouth, but is mostly completed in the small intestine and what is left is finished by our colonic bacteria. The glucose is rapidly absorbed and used for short-term energy if the person is excercising or, if not, stored as fat. Resistant starches, on the other hand, resist digestion and pass through to the large intestine where they act like dietary fiber instead of being absorbed for instant use or stored energy as fat. There are four categories of Resistant Starch: RS1, RS2, RS3 and RS4. RS2, the resistant starch that occurs in its natural, granular form in foods such as uncooked potato, green banana flour and high amylose corn, is the healthiest. Hi-MAISE is the commercial form of this, costing less than $ 3.00 a pound. Studies have confirmed that different types of resistant starches deliver different effects. The benefits demonstrated by Hi-maize cannot be extrapolated to the other types of resistant starches R1, R3 and R4.

Hi-maize selectively increases the beneficial, while suppressing harmful bacteria. It is food for the good gut flora and, as such, is referred to as a prebiotic or a fiber that not only feeds but also sweeps the gut clean. Research on the health benefits of natural Hi-maize, including 300 peer-reviewed nutritional studies carried out over the last 20 years reveal its benefits that range from weight management, glycemic (blood sugar) management, colon cancer and cardiovascular protection as well as regularity. The fermentation of Hi-maize increases Short Chain Fatty Acid production (butyrate is particularly important for colon health), which reduces intestinal pH, potentially harmful secondary bile acids, ammonia and harmful phenols. Importantly, lipid oxidation is decreased by Hi Maise starch which burns lipid and leads to lower fat accumulation and weight loss.

Studies suggest continual exposure to elevated levels of insulin as a result of a high glycemic diet (sugars and starches) contributes to reduced sensitivity by cells to the insulin (insulin resistance) and a higher risk of diabetes. As insulin resistance increases, the body produces more insulin to maintain adequate blood sugar control. With rising resistance, even more insulin is required, and the body can not keep up or the pancreatic cells producing insulin may stop functioning and hence diabetes. Consumption of natural resistant starch decreases glycemic response in healthy individuals, reduces glycemic response in diabetics, increased insulin sensitivity with the prevention of the Metabolic Syndrome which in some form is present in 38% of our Americans today. The Metabolic Syndome is an abdominaly obese person with a crease in the lower part of the ear lobe, the top Blood Pressure reading higher than 136 and slightly abnormal blood studies. This includes a fasting blood suger and triglyceride higher than 100, and a HDL (Healthy) cholesterol lower than 45. Resistant starch can act as a replacement for wheat products in foods that are required to be gluten-free.

Our biotome, the 6 pounds of gut flora, can be divided into Bacteroidetes whose growth is favored by Resistant starch over the Firmicutes, causes weight/fat loss.
More Firmicutes, results in increased ‘energy-harvest’ or caloric extraction from our diet. Firmicutes are predominantly Clostridium, but include some Lactobacillus spieces, of which are in the probiotics we unknowingly doctors recommend! If Firmicutes outnumbers Bacteroidetes, partially digested complex carbohydrates are broken down to simple carbs rather than metabolized or eliminated through the stool. These, then, form the sugars that are easily absorbed into the blood stream. Also a special chemical is elaborated by this bacterial digestion that encourages the sugar to be directly made into triglycerides by the liver and preferentially stored by fat cells rather than burned! Additionally certain stains within the Bacteroidetes such as PL 60, are thought to 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 calorie 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 Synbiotic, has been proposed to make a functional food with interesting nutritional properties that make these compounds candidates for a weight loss program. HI Maize, the high-amylose-resistant cornstarch laced with Lactobacillus rhamnosus, PL60, and other Bacteroidetes spiecies will soon be available. Some advanced practitioners have even proposed to rid the gut of most of the Firmicutes with the wonder antibiotic, Xifaxan and then repopulate with Bacteroidetes and feed it with Hi Maize RS2. Why wait another 10 years to be healthy, contact your health practitioner now. Armed with this information, you may be able to transform yourself NOW, rather than to remain overweight and unhealthy!

Nothing Fishy About That

2011-01-24T14:42:00.000-08:00

Fish oils are weight-reducing and have other healthy benefits such as prevention of fatal and non-fatal arrhythmias, stroke, heart attacks, Alzheimers, depression and as a fringe benefit keeps the skin younger than it years. According to an article published in Lancet, fish oil (Omega 3 fatty acids) stabilized atherosclerotic plaques. Plaque is an accumulation of cells or cell debris that contain lipids (cholesterol and fatty acids), calcium, and a variable amount of fibrous connective tissue. Plaque is an unhealthy condition. Cardiovascular disease is related to plaque in blood vessels.

In half of all first heart attacks, plaque doesn’t block or occlude blood vessels. Plaque, which is inherently unstable, can release fragments that lodge in smaller blood vessels, causing hemorrhaging plus significant and sudden narrowing of the vessel. A clot that forms on top of a leaky plaque may occlude the vessel. Even though it may block 60 percent of the vessel, a stable plaque is not dangerous. By either direct pathologic examination or with assistance of ultrasound, doctors can classify a plaque as being stable (calcified) or unstable (soft).

In a well-designed double-blind clinical trial, a variety of fats were given to 162 patients scheduled to undergo a carotid endarterectomy for advanced arteriosclerosis. One-third of the patients were given Omega 3 fatty acids, another third were given Omega 6 (vegetable oil), and another third were given capsules that contained the mixtures of oils comparable to a typical Western diet. During surgery, sections were taken from the artery and classified by a cardiopathologist as either unstable or stable. The ones who consumed the westernized diet oils or the Omega 6’s had greater than 50 percent more unstable plaques compared to those who were given the Omega 3 fatty acids.

The bottom line is to increase dietary Omega fats by consuming oil bearing fish such as salmon or escolar, and as supplements. Although a capsule may have on the label 1000 or even 1200 mg, the active DHA and EPA may be together only 300mg! So one needs to consume 10 to 20 of them to get a decent dose. Although Krill Oil has been touted to be as good if not better than fish oil, I have found it not nearly as good. Omega 3s are also available in liquids. They are now not only very concentrated but even palatable. Also as noted above sea weed/algae are very high in these healthy oils. After all that is where the fish get theirs. The best Omega 3 is DHA (DexaHexinoic Acid) which is three times more beneficial than EPA (Eicospentoic Acoid). There also is ALA (Alpha Linolenic Acid) from flax and primrose. Although classified as an Omega 3, it is a pre Omega 3 and our metabolisim converts it into the active DHA and EPA if it can. Unfortunately, this is only true if we are young (under 25) and healthy.

Eating a high fat or protein diet is certainly better than eating high carbohydrate foods. But watch the type of fat you eat. It is said that eating one pound of hydrogenated fat will allow you to gain one pound since the body needs to dilute this bad fat by holding onto other fat. One pound of saturated fat will give a weight gain of one-quarter pound, but eating one pound of Omega 3s will cause one-quarter pound of weight loss in that it recycles into your cellular membranes and discharges the previous fat residing there for excretion into the bile. Now one can track their Omega 3s by a special red cell fatty acid test offered by Spectracel. This reflects three months of not only consumption but absorption and utilization of this life prolonging/saving nutrient.

LIVING WATER AND LONGEVITY

2011-01-23T15:23:00.000-08:00

Hunza is located in the far northeast of Pakistan, in a remote valley some 200 mi. long but only one mi. wide. It is situated at an elevation of 8,500' and is completely enclosed by mountain peaks including the western end of the Himalayas. The inhabitants, Hunzakuts, have the reputation of being the longest lived people in the world. They eat fresh, mostly raw fruits and vegetables and little meat. Of course there are no pesticides or preservatives in them. However it is generally accepted that the water the hunzas drink plays a major role in their great health and longevity.

This water comes from the melting of glaciers from the nearby mountains. These glaciers are hundreds of thousand of years old and grind the mountainous rock into extremely fine particles. In turn the fine particles of rock are suspended in this water and is called glacial milk because of its cloudy appearance by being so loaded with these minerals. Coming from glacial mountain streams and waterfalls this water carries a negative charge or negative ions and is called “living water.” This results in the water having an oxygen reduction potential and acts as an antioxidant in the body with the ability to neutralize free radicals. Also the negative charge makes minerals easily absorbable. Their crops are also irrigated with this colloidal alkalizing mineral water and thus unlike Western soils, hunza soils are not depleted of minerals.

This living water today can almost be duplicated today by Kangen which is a Japanese word, best translated into English as “Return to Original” which means several things when used to describe water. It is alkaline, ionized, anti-oxidant electron rich, restructured, micro clustered, active hydrogen saturated, and oxidation reduced. Water is first purified, then given an electrical charge to recreate  electron rich water. This electrolysis process using a platinum catalyst on a titanium base is first put through a special charcoal filter. It contains the essential minerals and the pH can be set from 2.5 to 11.5, but for drinking purposes 8.5 is the best.

The very alkaline water (pH-11.5) is used in place of damaging chemicals for cleaning and disinfecting around the home especially the bathroom and kitchen. It is an emulsifier and used plain is a fantastic detergent to get the pesticides off fruits and vegtables, remove greasey grime and even to unclog drains. Topically, it can be used as a poultice on inflamed skin. On the other side of the pH, the acid (2.5) is a powerful disinfectant for bacteria, yeast, and viruses. For more information, call 918 636-5455.

OUR NATURAL DETOXIFICATION

2011-01-10T19:53:00.000-08:00

We are exposed to a great number of xenobiotics (foreign compounds) during the course of our lifetime, including a variety of pharmaceuticals and food components. Many of these show little relationship to previously encountered chemicals or metabolites, and yet we are capable of managing environmental exposure by detoxifying them. To accomplish this task, our bodies have evolved a complex operation of detoxification enzymes. But in our toxic world these systems need help. The enzyme systems generally functioned adequately in the past to minimize the potential of damage from xenobiotics, but in our modern civilization, we are being overwhelmed by them. There is an association between impaired detoxification and illness, such as cancer, neurological disease, fibromyalgia, and chronic fatigue/immune dysfunction syndrome. Therefore, an individual's ability to remove toxins from the body plays a role in the cause or exacerbation of chronic conditions and new diseases. Natural helpers include the sulfuaranes found in crucifer vegetables such as Broccoli and the very best, Broccoli Sprouts.  

The following may be difficult to follow and without some education previously into biochemistry, skip to the last paragraph. Our detoxification systems are highly complex and show a great amount of individual variability. These are extremely responsive to a person’s environment, lifestyle, and genetic uniqueness. The liver is the principal organ of detoxification, although all tissue has some ability to metabolize foreign chemicals. The liver is the largest organ, and is the first body part perfused by chemicals absorbed in the gut. Also there are very high concentrations of most metabolizing enzyme systems relative to other tissues. When food or a drug is taken into the GI tract, it is taken apart in the gut. When it is absorbed into our body, it first enters the hepatic (liver) circulation through the portal vein. Here it is metabolized if possible before it can go into the rest of us, and eventually back to the liver again and again. This is the first pass effect. When the altered substance is fat soluble, it is excreted into the bile, then discharged into our intestine only to be reabsorbed again. This process is repeated many times. Therefore, the term, enterohepatic circulation.

Factors that affect the detoxification are age, individual variation (polymorphism), enterohepatic circulation, nutrition, intestinal flora, gender and drugs that person may be taking. Other sites of chemical metabolism/excretion include the gastrointestinal tract, lungs (volatile compounds), kidneys (water soluble molecules), and the skin (both lipid and water soluble chemicals). These sites at times could have localized toxicity reactions. The detoxification systems are complex. They are divided into three interacting parts or phases each of which can engage with itself or any of the other two to work in harmony defending our body from being acutely or slowly poisoned to death. At times it is overwhelmed and we rapidly or slowly die.

The three parts are termed Phases (I, II, and III) of Detoxication. Variation of activities of these can mean the difference between disease (drug adversity, cancer, arthritis, cardiovascular etc.) and health. To add to the complexity, the Phase System is orchestrated by our genetically endowed CYP 450 enzymes that steer or tune them (for better or for worse). The initial P450-mediated oxidation/Phase I metabolism if possible makes the ingested chemicals water soluble to later be eliminated by the kidney. The subsequent joining of the molecule with a lipid- conjugation is "Phase II" and is eliminated through the bile and eventually into our fecal stream. The newly discovered Phase III gets rid of the offending chemical by importing into a cell then exporting out into a storage or excretion system.

The major Cytochrome (CYP) P450 enzymes involved in metabolism of drugs or exogenous toxins are the CYP3A4, CYP1A1, CYP1A2, CYP2D6, and the CYP2C enzymes. The amount of each of these enzymes present in the liver reflects their importance in endogenous metabolites (hormones etc) and drug metabolism. The'CYP's is a host of enzymes that use iron to oxidize organic molecules, as part of the body's plan to dispose of potentially harmful substances by making them more water-soluble. Adding a hydroxyl group to a xenobiotic is the body's strategy to get rid of the 'drug' and is often followed by joining them to other molecular groups such as glucuronide to increase the solubility even further.

Most of the CYP in man is found in the liver, the main organ involved in drug and toxin removal, but a fair amount is also in the small intestine. CYP usually is found in the 'microsomal' part of the cytoplasm (endoplasmic reticulum). Metabolic clearance of drugs is not the only function of CYP. Recently, it has been found that CYP is involved in vascular autoregulation, particularly in the brain. CYP is involved in the formation of cholesterol, steroids and arachidonic acid metabolites. More on CYP later but let me amplify what I said above.

The Phase I System: The Phase I detoxification system, influenced by the cytochrome P450 supergene family of enzymes, noted above, is generally the first enzymatic defense against foreign compounds. They are nonsynthetic reactions involving oxidation, reduction, hydrolysis, cyclization, and decyclization. Most of our unwanted (detrimental) metabolites and pharmaceuticals are metabolized through these Phase I biotransformation of which is then excreted. At times reactive molecules, which sometimes may be more toxic than the parent molecule, are produced. If these reactive molecules are not further metabolized by Phase II conjugation, they cause damage to proteins, RNA, and DNA within the cell.   

The Phase II System: Phase II are conjugation reactions which generally follow Phase I activation, resulting in a xenobiotic that has been transformed into a fat-soluble compound that can be excreted through the bile. There are at least four types of conjugation reactions present in the body (glucuronidation, sulfation, glutathione and amino acid), These reactions require cofactors such as minerals and micronutrients which must be replenished through dietary sources.
   
Phase III System: Recently, antiporter activity has been defined as the Phase III detoxification system. It is an exchanger or counter-transporter on a membrane protein which is involved in active transport of two or more different molecules or ions across a phospholipid membrane in opposite directions. To make it even more complex there is a secondary active transport, one species of solute moves along its electrochemical gradient, allowing a different species to move against its own electrochemical gradient. This is in contrast to primary active transport, in which all solutes are moved against their concentration gradients, fueled by ATP. The antiporter is an energy-dependent efflux pump, which pumps chemical in question out of a cell, thereby decreasing the intracellular concentration of xenobiotics. Antiporter activity in the intestine appears to be co-regulated with intestinal Phase I Cyp enzymes. An example of the “porter” system is Iodide being actively transported into the thyroid.

Cytochrome P 450: Cytochrome P450 enzymes are present in most tissues of the body, and play important roles in hormone synthesis and breakdown (including estrogen and testosterone synthesis and metabolism), cholesterol synthesis, and vitamin D metabolism. Cytochrome P450 enzymes also function to metabolize potentially toxic compounds, including food chemicals, drugs and products of our natural molecules such as bilirubin, principally in the liver but so in our intestine. The Human Genome Project has identified 57 human genes coding for the various cytochrome P450 enzyme

These cytochrome proteins are located either in the inner membrane of mitochondria of our cells. CYPs metabolize thousands of internal and exogenous (food and drugs) chemicals. Some CYPs metabolize only one (or a very few), such as CYP19 (aromatase-turns testosterone to estrogen), while others may metabolize multiple substances. The CYPs are the major enzymes involved in drug metabolism, accounting for about 75% of them. Most drugs undergo deactivation by CYPs, either directly or by assisting excretion from the body. As noted, many substances are bioactivated or inactivated by CYPs. Drugs can also increase or decrease the activity of various CYP isozymes either by inducing the biosynthesis of an enzyme or by directly inhibiting the activity of one. This is a major source of adverse drug interactions, since changes in CYP enzyme activity may affect the metabolism and clearance of various of these chemicals. Naturally occurring compounds may also induce or inhibit CYP activity. For example, a bioactive compound (narragin) found in grapefruit juice inhibits CYP3A4-mediated metabolism of statins and calcium blocking antihypertensives, leading to the possibility of overdosing.

So if we cannot keep all the poisons out of our bodies, let us at least aid ourselves with helpers such as the natural inducers of the CYP detoxifiers like the crucifers or the active ingredients in them such as DIM or I3C. It will keep us more out of harm's way if we eat and drink to avoid the known toxins in our food and beverages.

NO DOUBT THIS SPROUT HAS CLOUT!!!!

2010-12-31T14:34:00.000-08:00

Make yourself a New Years Resolution. Don’t be a Lout eat THIS Sprout. Edible sprouts are germinated plant seeds. They are usually produced by soaking the seeds at regular intervals over a 4-10 day interval. Broccoli sprouts are highly nutritious with magnesium, chlorophyll and rich in enzymes and electrons which promote good health as mitochondrial enhancer and antioxidandants. Studies of compounds in broccoli sprouts have been shown to reduce the risk of prostate, breast, liver, stomach, bladder and colon cancer and to act as an anti-bacterial agent against Helicobacter pylori, an organism associated with causing duodenal ulcers. Also broccoli sprouts decreases the risk of stroke, high blood pressure and cardiovascular disease as well as osteoarthritis.

Research has shown that broccoli sprouts are rich in glucoraphanin, a compound that when eaten is converted in our body into Sulforaphane ((sul-FOR-a-fane) glucosinolate, which is a “phase II inducer”. In 1997, Paul Talalay, Ph.D who founded the Brassica Chemoprotection Laboratory, at Johns Hopkins identified chemo protective nutrients and finding ways to maximize their effect. Also in a study funded by the British Heart Foundation discovered sulforaphane could "switch on" a protective protein which is inactive in parts of the arteries vulnerable to plaque formation. Scientists already know that arteries don't clog up in a uniform way, but that there are bends and branches of blood vessels in which blood flow is disrupted (turbulance) and are much more prone to the build-up of fatty plaques that cause heart disease. In the more vulnerable areas, a normally protective protein known as Nrf2 is inactive. Sulforaphane protects those regions by switching on the Nrf2.

Brassica is a plant in the genus of the mustard family, and includes in addition to broccoli, Brussels sprouts, cabbage, kale, cauliflower and turnips. Three-day-old broccoli sprouts contained more than a 40 times higher concentration of the protective molecule than mature broccoli. In Addition cooking destroys three quarters of the active compound. Eating a few tablespoons of the sprouts daily can supply the same degree of cancer and vascular protection as 20 pounds cooked broccoli eaten weekly.

Broccoli sprouts can be frequently obtained at Health Food stores or in concentrated juices or capsules, but they may not be as good as producing this fantastic food yourself and eating them fresh. The seed and sprouting trays are easily obtained and the growing initiated by soaking 4 tablespoons in a 8 oz jar of water overnight. (about 8 hours). Pour the soaked seeds onto the sprouting tray. These trays and the organic seeds can be purchased at most Health Food Stores and on line such as the Sproutman.com. Cover the tray so the enclosure provides a greenhouse effect. Rinse by showering the seeds with fresh water twice per day. Try not to dislodge the seeds with the force of the rinse water. Allow the seedlings to root themselves into the small holes of the growing tray. Keep the tray away from strong light for the first 4 days, then move to a brighter area, avoiding direct sunlight and heat. In 3 to 4 more days they will be green and ready to harvest. Pluck from the surface to allow the younger sprouts to continue to grow. In the next 3 days, they should all be sprouted. With prayer and luck you should have 2 pounds of health from them. They can be used in cooking and as sauces, they are healthier used as salads or in sandwiches made with Red Cabbage leaves or Kale rather than bread. Do yourself a healthy favor and you will be well rewarded well beyond the minimal work it takes to eat this wonderful delicacy that will add life onto your years and years onto your life!

MICRONUTIENTS GIVE MACRO HEALTH

2010-12-27T05:07:00.000-08:00

Micronutrient deficiencies (vitamins, amino acids, minerals, antioxidants, metabolites) contribute to a broad range of both minor and serious health conditions. Identifying and correcting them is an important component of management and/or treatment of cardiovascular disease, diabetes, cancer, osteoporosis, chronic fatigue and other so called chronic degenerative conditions such as osteoarthritis. The Journal of the American Medical Association, (Volume 287, 3116-3129, 2002), Vitamins For Chronic Disease Prevention in Adults, states, “although clinical syndromes of vitamin deficiencies are unusual in Western societies, suboptimal status is not. There are many serum nutritional tests but they only measure static quantities of vitamins and minerals present in serum, such as magnesium or B 12 reflecting dietary intake and what can not get into our cells rather than the true cellular content and function. But there is a test that can assess long-term intracellular requirements using each patient’s own lymphocytes. Under a variety of nutrient depletion conditions, scientists can now measure the growth response of these cells to something called mitogenic stimulation. This determines intracellular deficiencies, which might not be detected by standard serum tests giving us a true window on Intracellular Function.

In 1949 Dr. Roger Williams, who previously discovered five vitamins, coined the word Genetotrophic disease which means having both genetic (geneto) and nutritional (trophic) roots. Later (1956) he published the book Biochemical Individuality: The Basis for the Genetotrophic Concept. William Shive, Ph.D., who was chairman of the department of biochemistry and a researcher in the field of nutrition at the University of Texas, began work on a diagnostic test for clinicians in 1978. His work was strongly influenced by Williams. Dr. Shive first identified appropriate cells for the functional assays. He selected lymphocyte cells because they are simple to collect (via venipuncture), easily isolated from other whole blood components, and maintainable in culture for days to weeks.

These harvested lymphocytes are in a resting state in terms of cell division. Since they have a 4 to 6 month lifespan, the nutrient levels accumulated in these lymphocytes represent a history of an individual's nutrient status. This is analogous to using HbA1c measurements to approximate a diabetic person's glucose levels over the preceding 3 months. Thus, lymphocytes provide a history rather than a snapshot of nutrient intake. Resting lymphocytes can be stimulated by a lymphocyte-specific mitogen to undergo cell division and grow in culture. The degree of growth that the lymphocytes can maintain is directly related to the nutrients they have available. The cells are stimulated to grow in the control media containing optimal amounts of specific micronutrients. As each micronutrient is removed from the media, the cells must use their own internal mechanisms (reserves or metabolic processes) to grow. If cells grow optimally, they are functioning adequately and thus are not deficient. If cells do not grow optimally, then a deficiency is indicated. For example, when Zinc is removed from the media and cell growth is not sufficient, this indicates that the lymphocyte cells have a functional intracellular deficiency of Zinc.

A functional deficiency encompasses any of the factors that reduce the efficacy of a nutrient. Thus, a given nutrient may be present, but it may not be properly activated, appropriately localized or have sufficient cofactors to function at a normal level of activity. Whatever the cause, the result will be a defect in the biochemical pathways that depend upon that nutrient for optimal function. A deficient or defective pathway may operate at a sub-optimal level for many months, or even years, before a clinical symptom becomes apparent. Micronutrient deficiencies aren’t just a reflection of diet. Since we are all biochemically unique, nutrient deficiencies will vary from person to person, and do not necessarily correlate directly with nutrient intake, even among those with similar health conditions. Many factors beyond diet determine whether nutrient function is adequate. These include biochemical individuality, genetic predisposition, absorption and metabolism, age, disease conditions and medications. Some folks spend hundreds of dollars a year and don’t need to. Others need a few inexpensive supplements to stay healthy and this test will detail the best for each of us. This is Personal Medicine at its highest level, rather than what most of us doctors practice “One Size Fits All”.

You can be deficient in micronutrients and not even know it until it is too late and, for example, develop Cancer. Studies have shown that 50% of patients taking a multivitamin are functionally deficient in one or more essential nutrients that are vital to long-term health. Deficiencies suppress the function of the immune system and contribute to degenerative processes. Propetology is another word coined by Dr Williams which is the potential science of the “leaning” (Greek) of individuals toward certain diseases. This is a genetic or other predisposing factor that gives one person the tendency to have a given medical problem, but another with the same exposure not have any difficulty.

SPECTROX is a total antioxidant function test that assesses the ability of cells to resist damage caused by free radicals and other forms of oxidative stress that is included in the study using the same technology as the micronutrient testing.

The micronutrient test was prohibitory expensive until recently when it not only became commercially available from Spectracell Laboratories that is the descendant of Drs Williams and Shive and is paid for by most insuranc plans including Medicare and Medicaid except for a $160 co-pay.

HEALTH TO THE NINES-PRO ARGI 9

2010-12-20T05:22:00.000-08:00

Why 9? The number nine has long been used as a superlative. Classical mythology gave us the Nine Muses of Arts and Learning. The Nine Worthies were characters drawn from the Pagan and Jewish history and from the Bible. This distinguished group consisted of Hector, Alexander, Julius Caesar, Joshua, David, Judas Maccabaeus, King Arthur, Charlemagne, and Godfrey of Bouillon. This then is a takeoff of the main constituent, Arginine, the 9 chaperone ingredients and it is exceptional for total body health.

In 1998, the Nobel Prize was awarded to Louis Ignarro for the discovery of EDRF(endothelium-derived relaxing factor), a chemical produced in the lining of the blood vessels, which keeps them healthy. Several years earlier, Stanford's Dr. John Cooke and other investigators had found that specific nutrients enhance EDRF production and improve blood flow in people with high cholesterol, high blood pressure, diabetes, or other risk factors for heart disease.  The atom of cardiovascular health--a tiny molecule called Nitric Oxide. NO, as it is known by chemists, is the signaling molecule produced by the body, and is a vasodilator that helps control blood flow to every part of the body. Dr. Ignarro's findings led to the development of Viagra and other patented and supplemental products such as Pro-Argi 9.

Arginine, or more correctly L-Arginine is the natural molecule in our body that produces NO in that one-cell-thick lining of our blood vessels called the endothelium. NO has a beneficial effect on the whole cardiovascular system. It relaxes and enlarges the blood vessels, prevents blood clots that can trigger strokes and heart attacks, regulates blood pressure and the accumulation of plaque in the blood vessels. Current research indicates that NO may help lower cholesterol by facilitating the actions of statin drugs like Lipitor or lower lipids by itself. It also has been shown to improve the immune system, facilitate healing, prevent cancer, enhance nerve and brain function and act as an antiaging molecule by stimulating HGH (Human Growth Hormone). It is also the promolecule of Argmantine which decreases pain and promotes better cognitive health which is a subject of a whole discussion that will be forthcoming.

Arginine is a conditionally nonessential amino acid, meaning in healthy young folks it can be manufactured by the human body, and does not need to be obtained directly through the diet. But in older people or those with other diseases including stress, the biosynthetic pathway does not produce sufficient amounts, and must be consumed through diet. Arginine is found in a wide variety of foods, including red meat and dairy products. However, these need to be consumed in large quantities such as two pounds of steak or three quarts of milk daily. This so called “food” is inflammatory and causes poor health in the majority of 21st centurions.

In our body, Arginine is synthesized from another semi-essential amino acid, citrulline, by several cellular enzymes. But it is a very energy costly, with each molecule produced two ATP equivalents are used up. In healthy humans, synthesis of arginine occurs principally in the intestine and kidney. The lining of the small intestine produces citrulline primarily from glutamine which naturally is in our diet if we eat healthily. The kidney extracts citrulline from the circulation and converts it to arginine, which is returned to the circulation. Consequently, poor diet, impairment of small bowel or kidney function can reduce arginine and NO. To make matters worse there is a competing molecule that some of us have in our body, ADMA, that causes an even lower level of NO and health. More about ADMA later.

Since the early 1970’s L-Arginine has been used as a supplement with only placebo effect, but in the last five years there have been several good products available. Engineered by Dr Ignarro himself are Niteworks and most recently Pro-Argi 9. These have at least 4 grams of L-Arginine. 200mg of L-citrullene , and chaperone molecules such as Vitamin C, Folic Acid, and Alpha Lipoic Acid. It comes in a canister or packets of powdered product. One scoop or packet is taken at least 90 minutes after eating and immediately before sleep. Carbohydrates and protein inhibit its intestinal absorption and taken at bedtime stimulates HGH release as well as insuring a good nights sleep. Certainly one could double and even triple the dose for better and quicker health benefit, but it is not necessary.

Pro Argi 9 is available from certain clinicians in the Tulsa area and on line. When a clinician or a patient feels that this product is needed, a special test called a Pulse Max to be described later is preformed. Most clinicians charge $50 for the study, but in most cases is paid for by insurances. This details the health of the cardiovascular system. The study is repeated three months later and if there is not considerable improvement in the test and how the individuals feels, the price of the product is returned by the organization that markets it. The cost is about $ 180 for three months and well worth it. For further information, call or ask at our front desk.

EAT FOR A LONGER AND BETTER LIFE. BE A CENTENARIAN.

2010-11-28T18:13:00.000-08:00

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.

PROBIOTICS-THE FRIEND WITHIN

2010-11-22T09:29:00.000-08:00

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.

THE BEST TREATMENT FOR ALZHEIMERS

2010-11-15T04:50:00.000-08:00

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-TOMORROW'S DIAGNOSIS TODAY!

2010-11-15T04:42:00.000-08:00

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.

DETOX-THE CLEANSE OF HEALTH

2010-11-07T21:35:00.000-08:00

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 (www.novolife.net). 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!!!

FISH and PLANT BASED NUTRIENTS FOR WEIGHT LOSS AND HEALTH

2010-10-30T20:53:00.000-07:00

For years, eating according to scientists, PLANTS are healthier than meats, but since the 25 year China Study published in 2002, and the September NEJM latest Nurses Health Study, there has been no doubt about it. MEATS (bovine, sheep, pork, goat) SHOULD BE EATEN IN MODERATION OR NOT AT ALL depending on one's genetics particularly the APO-E. Poultry and principally fish are indeed good sources of protein. When eating the bulk of this plan, which is the vegetables, it should be the leaves, flower, and stems rather than the roots and fruits that should be consumed. Nutrient Density is an important concept in recommending dietary advice. Not merely vitamins and minerals, but adequate consumption of phytochemicals is essential for proper functioning of the immune system and to enable our body’s detoxification and cellular repair mechanisms that protect us from gaining fat and the consequences of chronic disease. To guide people toward the most nutrient dense foods, a scoring system called ANDI (Aggregate Nutrient Density Index), or HANDY ANDI, which ranks foods based on their ratio of nutrients to calories, was developed by Dr Joel Fuhman. The following index and pyramid is taken directly from his Website www.drfuhrman.com/library/article17.aspx.

HANDY ANDI FOOD PYRIMID

Nutritional science has demonstrated that colorful plant foods contain a huge assortment of protective compounds, mostly of which still remain unnamed. Only by eating an assortment of nutrient-rich natural foods can we access these protective
compounds and prevent disease and obesity that afflict our current civilization. We need the whole orchestra, not just the woodwinds to make Beethoven’s 3rd Symphony sound wonderful. That is why multi-supplement pills do not work.
FISH contain Omega 3s which increases insulin sensitivity in the muscle, and preserves the production in the pancreas. The Omega 3s should come from farmed Salmon which has 6,000 mg per 6 0z severing compared to the wild with 4,500. If these came from Chile, Scandinavia, British Columbia, or Australia, they are without pollution compared to Asian farmed salmon. Wild fish are not richer in omega-3 fish oils than farm-raised varieties. Farm-raised fish such as salmon and trout won't grow without omega-3 fatty acids in their diet, so fish farmers add it to the fish- meal. Farmed catfish and tilapia, however, do not need omega-3 fatty acids, so these farm-raised fish have little or no omega-3s. In the wild, fish get their omega-3s from algae, plankton and other fish that they may eat.
Escolar (Ivory Tuna) has even more omega 3s. This essential fat should be consumed as the working DHA and/or EPA rather than ALA, a precursor of the active form that many of us cannot convert to EPA and DHA. If eating salmon, daily is too much, obtain it as a liquid. One tablespoon has 6000mg needed. I put it in my smoothie. Research has shown that omega-3 fatty acids decrease risk of arrhythmias (abnormal heartbeats), which can lead to sudden death. Omega-3 fatty acids also decrease triglyceride levels, raise the super good cholesterol (HDL-2), slow growth rate of atherosclerotic plaque, and lower blood pressure. Fish is also a good source of protein and unlike fatty meat products it’s not high in saturated fat. Although having a bad reputation in the past are the tropical oils (palm kernel, palm, and coconut) which are saturated fats, but are metabolized to Medium chain triglycerides that produce healthy nutritional ketosis. These protect our blood vessels, do not go into our fat cells and are used by our body to enhance the functioning of our heart and skeletal muscle as well as our neurons.

Some types of fish may contain high levels of mercury, PCBs, dioxins and other environmental contaminants. Levels of these substances are generally highest in older, larger predatory fish. Avoid eating those fish with the potential for the highest level of mercury contamination (e.g., shark, swordfish, king mackerel or tilefish). Eat a variety of fish and shellfish that are lower in mercury i.e.: Escolar, Salmon, canned light Tuna, Pollock (in artificial shell fish like crab), and catfish. Albacore ("white") tuna has more mercury than canned. Check local advisories about the safety of fish caught by us as well as family and friends from local lakes, rivers and coastal areas. Perchlorate, an ingredient in rocket fuel, has infiltrated 80% of our inland farm streams and ponds. It is a thyroid receptor inhibiter causing low thyroid in millions of folks who docs are telling them there is nothing wrong with them. This (Type II) Hypothyroid does not show up on any of the blood studies we do but does on the old fashion BMR (Basic Metabolism Rate) which are done by only a handful of physicians in our modern highly technical medical society.
In summary a non red meat, fish and high nutrient dense vegetable-based diet offers a diet healthy protein, high Omega 3s as well as low refined carbohydrates. This program emphasizes a liberal intake of vegetables, some beans, a few tree nuts, but low in high glycemic fruits and minimal grains and almost no bad carbs (sugar and starch). Weight loss is sustained in patients who followed this and even more substantial in those who have good adherence to these recommendations. Favorable changes in the lipid profile and blood pressure are noted. In fact in our successful patients who were hypertensive, diabetic, and had bad lipids, we were able to “cure” them of their disease and stop all their medications! This diet then has the potential to provide sustainable, and significant, long-term weight loss, and provides substantial lowering of cardiac risk and potential disabilities in patients who are so motivated.

PRESCRIPTION DRUGS

2010-10-18T07:32:00.000-07:00

At times medications are needed in our obesogenic society. There are at least 43 different neurotransmittors (serotonin. nor-epinephrine, ghrelin, leptin, neuropeptide-y etc) involved with our gaining and maintaing excess weight in the form of fat. Research conducted at the University of Texas at Austin provides evidence of a vicious cycle created when individuals overeat to compensate for reduced pleasure from food. It appears that obese individuals have fewer pleasure receptors and overeating further down regulates these pleasure receptors. For example food intake is associated with dopamine release. The degree of pleasure derived from eating correlates with the amount of dopamine released. Obese individuals have fewer dopamine (D2) receptors in the brain compared with lean individuals thereby the obese individual may overeat to compensate for this reward deficit.

This year alone the Food and Drug Administration (FDA) has been reviewing three new anti obesity drugs for government approval. Although drugs that seem promising early on sometimes prove ineffective and/or dangerous after they are released into the market.

Amphetamines in the 1960s and 1970s were touted as the answer until they proved to be habit forming. In the mid-1990s the disaster with fen-phen (fenfluramine and phentermine) leading to heart valve disease. Then just a few years ago the FDA denied approval for several new weight-loss drugs because of the potential for suicidal behavior.

Only two drugs to date have been FDA-approved for long-term treatment of obesity yet they are not without concern. Earlier this year the European Union banned one of the compounds, sibutramine (Meridia) after reports of heart attack and stroke and recently the FDA is posturing to take them off our market. The other drug, Orlistat, now sold over the counter in half strength size as Alli, causes gastrointestinal distress and has been associated with liver damage in some patients.

Obesity has a neuropsychiatric component, which creates difficulty in finding the “magic bullet”. Yet there are three new drugs that will target the brain, each in a different manner, facing FDA review. Contrave takes aim at the brain's reward pathway yet bupropion, an ingredient in contrave, has been linked to anxiety and neurological effects. Lorcaserin affects serotonin, which involves many brain processes such as emotion and cardiovascular regulation. In July, an FDA advisory panel narrowly voted against the third drug, Qnexa, due to side effects such as memory problems and other unwanted neurological effects.

Our appetite is controlled by the central nervous system present in the hypothalamus. When food enters our stomach, an enzyme called Cholecystokinin-Pancreozymin (CCK-PZ) is secreted from the pancreas. Presence of food is sensed and a number of complex signals are sent to this control center. The neurons there acknowledge it, then send another signal back to tell the body that our stomach is full. These signals are carried by some of the neurotransmitters mentioned above.

There are medications that work by increasing serotonin or catecholamines, two neurotransmitters (chemicals) in the brain that affect both mood and appetite. This class of medications, used most often for weight loss, is commonly referred to as “appetite suppressants.” The FDA approved them in 1959 and has been the most popular prescription weight loss medications sold in the United States. These medications promote weight loss by helping to suppress appetite, and by increasing the subjective feeling of fullness
The prescription medications prescribed in this class are Generic name Phentermine (trade name: Adipex-P, Fastin, Ionamin), Generic name Phendimetrazine (trade name: Bontril, Plegine) and Generic name Diethylpropion (trade name: Tenuate, Tenuate Dospan). Since many of the medical weight loss clinics use them, they will be discussed in more detail later.

The goal of prescribing weight loss medication is to help the medically at risk obese patient “jump start” their weight loss effort and lose at least 10% or more of their starting body weight. Usually anywhere from 5-22 pounds on average will be expected. When this can be accomplished, it usually leads to a reduction in risk for obesity related illnesses, such as diabetes, high blood pressure and heart disease.

Potential Benefits of Appetite Suppressant Treatment:
Short-term use has been shown to modestly reduce health risks in obese individuals. These medications have shown to lower blood pressure, blood cholesterol, blood fats (triglycerides), and decrease insulin resistance (the body’s ability to utilized blood sugar). There have been recent studies mentioned in the American Society of Bariatric Physician community that long term use of these medications resulted in lasting reductions in health risks and should be looked into further.

Potential Risks of Appetite Suppressant Treatment:
All prescription medications used to treat obesity, with the exception of orlistat, are controlled substances. This means that doctors need to follow rigid guidelines when prescribing them. Although abuse and dependence are not common with non-amphetamine appetite suppressants, caution is still advised, especially for those with a history of drug abuse or addiction.

Side Effects:
Appetite suppressants such as phentermine, phendimetrazine and diethylpropion are chemically similar to amphetamines. Thereby these medications can likewise cause insomnia, restlessness, constipation, excessive thirst, sweating, light-headedness, drowsiness, headache, stuffy nose, nervousness and rapid heart rate. Most of these side effects will decrease within the first week to two weeks.

Development of Tolerance:
Studies of appetite suppressant medications indicate that an individual’s weight tends to level off after four to six months of treatment. Is this due to drug tolerance, or reduced effectiveness of the medication over time? Studies are not clear. Yet experience shows that things can be adjusted to extend that timeframe and give the patient a few extra months, at minimum, to accomplish further weight loss.

When considering taking any anti-obesity drugs there are different ways to get them. For many years now there have been websites offering anti-obesity drugs online by simply filling out a form, giving your credit card and having them mailed to your home. Some of these drugs come from countries that do not stand up to the quality assurance that the United States requires for the safety of the recipient. These are not over-the-counter (OTC) medications and need to be strictly monitored. It is best to entrust your overall health and safety to a licensed physician. It is partially due to the quality assurance that these medications should be obtained from a reliable source who has done their home-work rather than a undependable one.

Fringe Benefits
These drugs in addition to weight loss help with ADD, ADHD, Depression, PMS, and Migraines.

SUPPLEMENTS HELP WEIGHT LOSS

2010-10-04T06:32:00.000-07:00

Some supplements are a must for weight loss diets, and others are helpful, but not necessary. Since diets are deficient in some necessary micronutrients, it is mandatory to take at least a high quality Multi-Vitamin, Mineral Supplement. Inferior to some, but price worthy is taking daily two generic CentrumR tablets/capsules daily. The following is a partial list of OTC (Over-The-Counter) supplements one could take to enhance fat loss in addition to the real foundation of a successful diet which is as low a carb intake as one can do and muscle building exercise. Prescriptive medicines (Phenteramine etc.) will be discussed at some other time.

Fiber, particularly Propolmannan swells in the stomach after ingestion with water to help reduce calorie consumption. These bind to bile acids in the small intestine and helps transport them out of the body. These bile acids otherwise facilitate the digestion and assimilation of dietary fat into the bloodstream. It also slows the rapid emptying of ingested food into the small intestine, thereby reducing the surge of glucose entering the bloodstream. LuraLean® from Life Extension works better than other fibers in that its own enzymes have been removed, thus sparing it from degradation in the digestive tract. This enables LuraLean to form a stable viscous barrier to help impede calorie absorption and maintain its sponge-like activity throughout the digestive tract. In placebo-controlled studies, additional fiber (supplemental plus food fiber) to equal 50 gms/day induces moderate weight loss along with significant reductions in fasting lipid and post-meal glucose and insulin levels. Guar Gum, or sugar free Metamucil, Ground Flax Seed, can be substituted for similar results. Flax seed is 28% fiber about half soluble and half insoluble. Most Americans consume less than 10 gms/day, but a healthy diet is 30 to prevent cancer and heart disease. Our ancient ancestors ingested at least 60! Eating plants for food is healthier than meats according to many authorities, but it should be the leaves, flower, and stems rather than the roots and fruits that should be consumed. There are much carbs in the former and lots of fiber in the later. Some berries and cherries are OK. No grapes though because of their high sugar content.

Whey influences food intake through its effects on cholecystokinin and other mechanisms. Cholecystokinin is a regulator of appetite. During the digestion of food, the gastrointestinal tract secretes cholecystokinin, a small peptide with multiple functions in both the central and peripheral nervous systems. Cholecystokinin is largely responsible for the feeling of fullness or satiety experienced after a meal, and that controls appetite, at least in the short term. Also whey is almost all protein which naturally reduces body fat by increasing insulin sensitivity. Whey protein is rich in branch chain amino acids (valine, leucine, and isoleucine) that are used as fuel for working muscles and stimulate protein synthesis for muscle repair. There is a large amount of information on the various types and preparations of whey which I will not go into. Good quality whey has no gluten or lactose. It is usually available as a powder and may have a flavor and a sweetener added. I add 2-3 oz to my smoothie.

Xylitol and D-ribose are not only a good sugar substitutes but makes us healthier. Xylitol is a prebiotic, feeding our intestinal friendly bacteria and killing our bad ones such as staph, strep and fungus. Not only does it give strong bones and teeth, but fortifies our immune system. It cost $8/ pound has 60% less calories than sucrose, but can do anything that it does. Xylitol dissolves in water, is sticky, caramelizes, bakes, and can be used topically for superficial infections. D-ribose on the other hand is expensive but very, very healthful. Costing $35/ lb, it cannot be obtained from any food, but is made naturally in our body as is Xylitol. It is the backbone our DNA and RNA (Ribo Nucleic Acid) and figures into our immune and energy production. It is the metabolic forerunner of our ATP, the fuel that powers our cells particularly the cardiac and skeletal muscles. It is these cells that have the most mitochondria, the engines of our body that use the most ATP for energy. Many scientific studies indicate it strengthens and builds these. Used by body builders for years, doctors have recently prescribe this for Fibromyagia, Chronic Fatigue, Weakness, and Heart Failure with excellent results. It is available in 1000mg (1 gram) capsules, with the dose of 5 grams three times a day. Better is to buy it as a powder using 1 teaspoon as a sweetener 3 times a day. As noted above, Xylitol is a prebiotic that is the food for our probiotic.

Probiotics are the 6 pounds of “friendly” bacteria that coexist in our intestines. There are those that make us fat, and those that help us loose it. The fat bugs digest the insoluble fiber that is naturally in our food to simple sugars that are easily absorbed. Additionally, they elaborate an absorbable “hormone” that stimulates insulin to immediately take them into our fat cells to make them fatter. The thin bacteria oppose these and are bad in times of famine but good in our over abundant food society to help us loose weight. Probiotics can be bought as capsules at all health food stores. I recommend one that has at least 6 different ones such as PB-8 that has 8 strains.

Green tea epigallocatrchin gallate or EGCG for short boosts resting metabolic rate by stimulating our brown fat and increasing insulin sensitivity. Also the tea extract impedes lipase which causes some decrease of fat absorption. To get this effect 5 cups a day are needed. The caffeine in it also contributes to weight loss by increasing the burn even more.

White kidney bean (Phaseolus vulgaris) extract inhibits amylase, the digestive enzyme that breaks down starchy carbohydrates that are then absorbed into the bloodstream as glucose,

Irvingia gabonensis – Like white kidney beans, Irvingia has amylase-inhibiting properties. Moreover, it also favorably regulates: leptin to decrease appetite and facilitate triglyceride removal from adipocytes.

This promotes the hormone, adiponectin, to facilitate insulin sensitivity and glycerol-3-phosphate dehydrogenase to inhibit glucose from converting to triglyceride fat in adipocytes.

Curcumin prevents dietary-induced fatty liver, prevents activation of the liver inflammatory cells that produce the condition, and can also ameliorate fatty liver, common in our obese and diabetic population. In 2009, it was shown that curcumin achieves these effects by suppressing destructive lipid-handling genes, simultaneously stimulating PPAR-gamma activity to improve liver cells’ energy utilization.

Carnitine is an amino acid-derived molecule used by cells to shuttle fats into mitochondria, where they are burned for energy. Both aging and obesity reduce carnitine levels, contributing to mitochondrial aging and loss of metabolic control. That makes carnitine a very appealing supplement for its ability to promote mitochondrial health and fat/sugar utilization. L-Carnitine tartrate seems to work better than other salts. At least 3 grams daily are needed.

Omega 3s increase insulin sensitivity in the muscle, and preserves the production in the pancreas. The Omega 3s should come from farmed Salmon which has 6,000 mg per 6 0z severing compared to the wild with 4,500. If these came from Chile, Scandinavia, British Columbia, or Australia, they are without pollution compared to Asian farmed salmon. This essential fat should be consumed as the working DHA and/or EPA rather than ALA, a precursor of the active form that many of us can not convert to EPA and DHA. If eating salmon daily is too much, obtain it as a liquid. One tablespoon has 6000mg needed. I put it in my smoothie.

Gamma Linoleic Acid (GLA) stimulates our brown fat, increasing thermogenisis-the burn. And decreasing fat accumulations obtained from seed oils in evening primrose, blackcurrant, borage (the most concentrated), and hemp. GLA is also found in considerable quantities in edible hemp seeds and from spirulina. This has also lots of good minerals and amino acids. It is best to take daily the natural pure 1000mg GLA oil, rather than the caloric seed oils.

5 Hydro TryptoPhan (5 HTP) promotes weight loss by causing satiety-the feeling of satisfaction. This leads to consuming fewer calories at meals. To obtain the early satiety it may take several weeks Take initially 50mg twenty minutes before a meal. In a week it can be increased to 100. It will still work some if you forget and take it with that meal. 5 HTP is an amino acid that is directly metabolized to serotonin, our happy hormone that decreases carb cravings.

Bitter Orange extract (and bitter orange peel) is a dietary supplement and an aid to fat loss and appetite suppression, although in traditional Chinese medicine it is always prescribed in concert with other support herbs, not in isolation. Bitter orange contains the amphetamine metabolites N-methyltyramine, octopamine and synephrine, substances similar to ephedrine, or the now illegal ephedra which acts on the adrenergic receptor to constrict blood vessels and increase blood pressure and heart rate. However it does not only increase the burn, but gives more energy to have additional hours of caloric utilization. I prefer to use the better quality controlled prescription when I recommend this type of drug.

Glutamine is used for muscle growth. Evidence indicates that glutamine when orally loaded may increase plasma HGH levels by stimulating the anterior pitutitary gland. Glutamine is a non-essential amino acid, meaning it can be produced by the body and is involved in a variety of metabolic processes. Glutamine has recently been re-classified as a conditionally essential amino acid. This means that while the body can make glutamine, under extreme physical stress the demand for glutamine exceeds the body's ability to synthesize it. During times of stress glutamine reserves are depleted and need to be replenished through supplementation. It is the most abundant amino acid in the body and is involved in more metabolic processes than any other amino acid. It is converted to glucose when more glucose is required by the body as an energy source. Glutamine also plays a part in maintaining proper blood glucose levels and the right pH range. It serves as a source of fuel for cells lining the intestines. Without it, these cells waste away. It is also used by white blood cells and is important for immune function. It is the basis of the building blocks for the synthesis of RNA and DNA. Supplementation is effective at eliminating junk food cravings. Taking approximately 30 grams (6 teaspoons)of glutamine powder per day in two divided doses, it takes a week to realize the effects.

Conjugated linoleic acids (CLA) are found especially in the meat and dairy products derived from ruminants consuming natural grass. It is also found in eggs of free range chickens and in specially farmed raised fish. CLA has been shown to reduce body fat by increasing lean muscle mass. CLA is a naturally occurring derivative of the Omega-6 essential fatty acid, linoleic acid. The adult dose for weight loss is 3,400mg of pure CLA daily (the amount found in 6 soft gels).

Nicotine is almost like a weight-loss wonder drug. It naturally suppresses appetite, causing you eat less. It also increases your heart rate, which burns more calories, and acts as a diuretic to remove fluid from your body. When this drug is removed from your system, your body reverts back to normal, and you begin to put back the pounds.  People who don't smoke and want to take nicotine as a weight-loss treatment should be cautioned that it is an addictive drug, and you may become dependent on the nicotine in the same way that smokers are dependent on cigarettes. Beware, if you are not a smoker and take too much, nausea, light headedness and rapid heart action can occur. Its natural properties do help weight loss, and if used with proper diet and exercise, I recommend this drug. Nicotine spearment drops are available from Economy Pharmacy in Tulsa as a prescription. Each drop contains 0.25 mg of nicotine. Take 2-3 drops 20 minutes before a meal, it decreases the amount one eats during that meal. It also can be used as a “snack”.

Other supplements that are of value that may be considered are Chromium, choline, methionine, inositol, Coenzyme Q10, Biotin, Magnesium, Cinnamon , Ginseng, Alpha Lipoic Acid, Hoodia, Gymnema Sylvester and Banaba Leaf.

Magnesium (Mg)

2010-09-17T06:32:00.000-07:00

In a recent study, 75% of Americans were found to be deficient in magnesium because our soil has been depleted of his important mineral. Drugs such as diuretics and steroids lower our magnesium. It functions as a catalyst in over 1000 of our enzyme systems. This is the mineral, rather than calcium, that prevents and treats osteoporosis. It helps in PMS, mitral valve prolapse, kidney stones, hypertension, diabetes, hyperlipidemia and migraines. Deficiency causes apathy, depression, kidney stones, disorientation, muscle weakness and spasms, poor memory, irritability, tremors, arrhythmias and seizures. Although magnesium can be found in foods including chard, pinto beans, avocados and oatmeal, I recommend supplements. rather than food since our modern farming methods produce magnesium poor crops.

The most commonly taken supplement is the inexpensive Magnesium Oxide, a poorly absorbed inorganic salt. Better would be the chloride salt. My choice would be Magnesium chelates. These are organic salts such as glycinate, malate, and lactate are much better absorbed. One of the better products is magnesium citrate which comes in a capsule or powder. Calm by Peter Gillam is particularly good. It comes in a variety of citrus flavors and is effervescent. I recommend 3 teaspoons a day, usually at night for better sleep, As the name implies it does relax the mind. Occasionally some get a little diarrhea with this dose. If this be the case, back off a little to 2 and a half teaspoons. This substance can be use with some absorption on the skin such as Epsons Salt (Magnesium Sulfate) or in a variety of lotions.

In general, magnesium is very safe. In fact, have never seen an overdose or toxic patient (hypermagnasemia) with this supplement. In that this is a intracellular ion, a serum test is not useful. I occasionally recommend the cellular magnesium test which is done by an under-the-tongue scrapeing as this reflects the true body amount. The RDA is 400 mg daily and our diet supplies only half of that. No prescription is needed to obtain this wonderful mineral

DOES CHOLESTEROL CAUSE CARDIO-VASCULAR DISEASE?

2010-09-06T06:26:00.000-07:00

Cholesterol is only part of the story. Most heart attacks occur in folks who have not only normal cholesterol, but decent levels of its subtypes, HDL (Healthy Dynamite Lipids) and LDL (Lousy Darn Lipids). Also some who have elevated cholesterol and LDL with a low HDL have no cardiovascular disease. Actually it is the oxidized LDL that is the villain. But there is more to the tale. There have been new, more comprehensive lipid tests available to doctors in the last 10 years and most don’t even know about, let alone use them. There are two Labs that do these: the VAP test (short for Vertical Auto Profile), developed at the University of Alabama, Birmingham (UAB) Medical Center, and the LPP (Lipoprotein Particle Profile) test offered by SpectraCell Laboratories in Houston.  

These tests are a boon for doctors and better for their patients who do not want to be just treated for heart disease, but rather prevent it. More information is needed if we are to utilize blood lipids as a reliable risk assessment. Thanks to medical science, we now have better studies that can break down the many components of cholesterol, and most importantly, single out the most dangerous fractions. You can now get a much more accurate picture of what may or may not be a cholesterol problem.  

Here are just a few of the key readings these tests give you that the old ones do not. Your LDLs are considered to increase the risk of heart attack and necessitate treatment. But LDL, for the most part, is really a good guy-a sheep slapped with a wolf's reputation. Your basic cholesterol is mostly LDL, a fatty substance produced in the liver and wrapped in a protein coating (Lipoprotein) that allows it to circulate in the bloodstream. Cholesterol is essential in the body as a raw material. Enzymes convert it to vitamin D, steroid hormones (like estrogen, progesterone, testosterone, and cortisol), bile acids needed for digestion and as part of our cells membranes. It also makes up 28% of our Brain!

LDL can be bad or good. The new tests identify if your LDL is bad or not. LDL becomes dangerous when it is oxidized or overly present as a small dense particle as opposed to a larger, fluffy more "buoyant" particle (Pattern A}.  The small dense LDL is nefarious and if too many is labled Pattern B. B for Bad!! This is because the smaller Beebe like particles are more easily able to penetrate the endothelium. There also is a Pattern I, for intermediate, IDL and indicates that most LDL particles are very close in size to the normal gaps in the endothelium (26 nm).

The tests also indicates a subtype of LDL called Lp(a). When this substance rises abnormally in the bloodstream, the result of genetics, it can increase the risk of heart attack up to 25 times. This is a highly inflammatory and thrombotic molecule. There is no conventional medication for Lp(a), but niacin (vitamin B3), high dose vitamin C with Proline, and N-Acytel Cysteine (NAC) may help. When using Niacin beware that Homocysteine, another risk factor in the blood does not build up and hence should also be monitered. I also recommend a small dose of aspirin and acetomenaphin as a blood thinner.  

 A high level of HDL-the so-called good cholesterol-is generally associated with protection against heart attack. We now know that HDL is further classed into HDL2 and HDL3. The difference between the two is HDL2 is far superior to HDL3 in providing protection for the heart. Triglyceride level, are of course measured too and anything above 100 (fasting) is considered abnormal. With these tests, various triglycerides are singled out.

The one to be concerned about is called VLDL3, the most inflammatory triglyceride, considered a prime indicator for coronary artery disease progression, insulin resistance, and type II diabetes. Triglycerides are fat globules in the bloodstream. In a concentrated form, they create the fatty "love handles" around your midsection. This then increass HsCRP that “rusts” our arteries. A better test incorprated in the VAP is the PLAC-2, which, more specifically, reveals not only how much plaque we have, but how stable it is. Unstable plaques rupture causing a sudden heart attack or what is even worse, A STROKE !!

Thick and Thin Bacteria

2010-09-01T17:00:00.000-07:00

The most important biomass on the planet for us is our individual intestinal population of bacteria. It influences many physiologic, immunologic and nutritional processes, including how fat we are.

The stomach and early small intestine with acid conditions and rapid flow contains only 100 bacteria per gram (20 drops) of content. Immediately before the large intestine, there are 300 and in the large intestine where the bacteria multiply and ferment, there are over 1,000 bacteria per gram. These intestinal bacteria evolved independently from us. They perform functions such as the breakdown of indigestible sugars and production of fats. When these bacteria are not functioning at their best it can contribute to obesity, insulin resistance and even diabetes!

The intestinal flora is a 12 lb. adaptable metabolic organ. Many diseases are caused by a disordered state of our microbiological ecology. The term for this is Dysbiosis. Our gut flora is more than just friendly and hostile bacteria: it’s a changing population of living organisms that can help or harm. Not only do they use our foodstuff for their own sustenance, but produce messengers that govern much of our body’s functions. Inflammatory bowel disease, autoimmune disorders, atopic dermatitis, food allergies, unexplained fatigue, mental/emotional disorders, arthritis, breast and colon cancer, and malnutrition are caused by Dysbiosis. One of the main causes of Dysbiosis is gluten, when eaten by the 30% of us who are intolerant. We, then, develop leaky guts and a variety of disorders including acne, fibromyalgia, (including body myopathy), migraine, celiac coronary artery disease, seizures, autism, ADHD, Alzheimers, multiple sclerosis, and peripheral neuropathy, to name a few.

Dr. P. J. Tutbaugh (Nature,12/21/06) reviewed the science of germs and obesity. Various classes of bacteria metabolize large molecular sugars (polysaccharides) into simple sugars and short chain fatty acids. These are easily absorbed and go directly to the liver where they are converted to the storage form of fat. Moreover, Firmicutes secrete a chemical called lipoprotein lipase activator that helps the fat cell to become fatter with these newly produced fats.
Contrarily, another group of bacteria (Bifido) is a poor producer of these fat makers. In ancient times 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.

In both mice and men, natural, healthy methods (pre and probiotics) alter our microbes for weight without changing diet or exercising. Folks who are put on a low carb and/or low fat diet and avoid Gluten successfully lose weight and increase their B/F ratio. Thin people have a higher B/F ratio than the obese.

THE METABOLIC ADVANTAGE

2010-08-23T05:44:00.000-07:00

There is a metabolic disadvantage from eating carbs, particularly high glycemic ones. They are directly converted into glucose, which raises insulin. Too much insulin output is the culprit hormone of weight (fat) gain and heart attacks. Yes, insulin is atherogenic (causes blood vessels to clog up and "harden"). Not only does insulin transport glucose into our cells for fuel, but it prompts the liver to make and release fat (triglycerides) as well as encourage its storage in our adipocytes (fat cells). This not only makes us fatter, but also causes the adipocytes to release their toxic cytochymes promoting chronic diseases such as atherosclerosis.

Unlike carbs which are 100% burned or stored, with fats and proteins, it costs our metabolism about 10% more to convert it to usable glucose. With time our poor pancreas becomes overtaxed and cannot keep up with the insulin demand of our foolish brain for over consuming those lousy carbs and it starts to fail. That is the real beginning of the end with the rise of blood sugar that denatures our living tissue with AGE (Advanced Glyciated End products), ALE (Advance Lipid End products), and APE (Advance Protein End products). This is before we even get diabetes which, with a carb-based diet, is inevitable. Although Agriculture was an important part of the survival of our species, time will show it was the worst mistake of human history for our personal longevity and the primary cause of degenerative disease. Not only, cardiovascular, but dementia, arthritis, and cancer is caused by awful carbs.

HIGH glycemic carbs and prepared foods are indeed weapons of mass destruction. Fructose is particularly sweet and dangerous. Half of every sugar molecule and over half (55%) of high fructose corn syrup, the most abundant sweetener in our society, is treacherous fructose. As noted above it is not the calorie, but from where the calorie comes that determines its health benefit or detriment. ALL CALORIES ARE NOT CREATED EQUAL! It is not how many calories we consumed but what our body does with these calories that count! Of course there are ADIPOGENIC (fat producing) Risk Factors-that include birth weight, age, sex, genetic metabolism, friends, activity and endocrine balance.

Indeed we are all biologically different. But despite this we can loose weight if we really want. No matter a how much you imagine you eat, if you wish to lose weight you must eat less. And no matter how much you imagine you exercise, to lose weight you must exercise more. It can be done, but for some with Adipogenic Risk Factors one must eat like a bird and exercise like a horse. But don’t despair, there is good science to help and I will detail ways to successfully not only loose weight, the somewhat easier part, but to keep it off which is the harder part. There is no magic diet, but suggestions for a lifestyle that will guarantee success, not just for looks but also for health and longevity in your future.

THE ULTIMATE DIET

2010-08-17T03:31:00.000-07:00

There is no best diet, only fundamental nutrition. There is an ideal diet for any individual for a given time, depending on their genes, biology, age and their environment. Having an understanding of this new nutrition will enable a person to choose the correct foods for both health and longevity. The following information should help you make the right choices.

The underpinnings of our food and drink is for what we were genetically adapted. However, there are rarely two of us who are exactly alike in how we look, how we act or metabolically. Our genes have been in existence since the very beginning of life on earth but our current chromosomes have been here for 2.4 million years and have sustained man as a species for the last two hundred thousand years. But eating habits, desire and in particular food availability have determined what consumption in Homo sapiens was best for their, and now our, health and fitness. This time line represents 99% of our evolutionary history.

It is only in the last 25 thousand years that we evolved from gathers, pickers, fishers, pluckers, and ghouls* to hunters. As a species, we hunted small game and fish with hands and cunning for eons. With the advent of tools such as nets, spears and clubs, big game became obtainable for hunting groups about 15 thousand years ago. In the last 10 thousand years agriculture and animal husbandry developed. Most importantly, in the dawn of the industrial revolution refined foods became available. But our metabolic machinery was not prepared for this. We are still in a state of evolution and may never be prepared for the junk we consume in the name of food!

No one would argue that an infant needs a different diet than an adult, or a Type 1 diabetic a dissimilar diet from a “healthy” individual or an elderly person different fare than a younger person. But a female diet being different from a male may be a stretch for some. In the broader sense, scientists and pseudo scientists organized special diets for metabolic types based on Blood type, body shapes (apples vs. pears), personalities, or anthropomorphic measurements such as arm span and variations of tooth anatomy. In the future, we will be able to look at ones genes and give a precise diet for ones best health.

The best recommendation for diet is the new VAP (Vertical Athrogenic Profile), which in the last two months was priced at less than $100 so that everyone, even those not insured could afford to know about them. With the right information, one can predict their own destiny in what could cause them disease and when it will happen. The premise of the VAP is the detection of not just the good HDL cholesterol, but also its division of inert HDL and the active HDL for reverse cholesterol transport. Also included are the small dense nefarious lousy LDL and the not so bad light fluffy LDL. These and the glucose/insulin ratio gives the best metabolic indicator of both cancer and cardiovascular disease. The Metabolic Syndrome in which insulin resistance is the genetic predisposition for poor health and an early demise (which is now epidemic in America) can be detected before it starts to impact our health. This is added to some basic truths for human food consumption and life and a few more for a healthy existence:

• The human body (and most mammals) has a given requirement for protein and fat, but none for carbohydrate other than disposable energy.

• Carbohydrate is a fuel that is converted to glucose for immediate usage or is stored in the liver as animal “starch”, glycogen.

• Micronutrients (Vitamins, Macro-minerals, Trace minerals) are needed in adequate amounts for proper metabolism.

• Essential Fatty acids are necessary for both structure and function of the organism.

• Essential Amino Acids are also obligatory for formation and working of the living being.

• Glyconutrients (on cell walls for inner communication) from sugars can be internally produced from non-carbohydrate foodstuffs.

• Enough water is required to maintain the shape and flow in our life form.

• Fiber is needed to give substance to the food in our alimentary tract to properly propel it forward and to feed our gut flora.

• Bacteria (Probiotic) and its food (Prebiotic), which is soluble fiber, are required to complete our digestion and to produce micronutrients such as Vitamin B12.

*Ghoul- Early man ate bone marrow and brains from carrion because he had rocks and the ability to open bones.

SILVER

2010-08-07T18:47:00.001-07:00

Silver has been used since antiquity for its healing and preserving powers. The ancient Greeks kept their medicinal liquids (and expensive foods) free of contamination by placing them in the silver jars. Since the Middle Ages, silver was a staple for cooking ware and eating with silver pans, plates, and utensils. Silver and its salts have been used for centuries for disease treatment, one hundred-fifty years ago for syphilis, in the last hundred years for eye and nose drops, gargles, douches, and the recent 40 years topically for burns, skin ulcers, and impregnation into the material from which medical devices are made including urinary and venous catheters as well as surgical instruments by mainstream physicians.

Silver and its compounds have an electrical/oligodynamic effects that are toxic for bacteria, algae, and fungi and some parasites. The is typical for heavy metals like lead and, mercury. Among the elements that have this, silver is the least toxic for humans. The medicinal action of silver is dependent on the electrical aspects of the silver ion, which irreversibly damages key enzyme systems in the cell membrane of certain pathogens to include staph and the internal organization of some viruses.

Today colloidal silver is made in ultramicroscopic particles in a solution suspended naturally in deionized water by natural electromagnetic charges. This ultra fine 99.999% silver has a particle size from 0.0001 to 0.001 microns (1 to 100 ug). A red blood cell is a giant compared to this being 7 microns or 7 million times bigger! After ingestion, this metal enters the blood stream within 20 minutes and all over our body Colloidal silver can be obtained for less than $4 an ounce at health food stores. Or with equipment costing less than $100, one can make gallons of it for $5. Since it is light sensitive, the silver should be kept in darkly tinted glass bottles in a cool place. Plastic containers magnetize easily and the silver particles will stick to the sides. Also keep it away from magnetic fields such as electronics or motors since they will interfere with the ions, holding the colloid in solution. If placed in the refrigerator, the silver may fall out of solution.

Colloidal silver is predictably safe. As a pre-1938 medicinal it is out of the control of the FDA. In general, silver exhibits low toxicity in the human body, and minimal risk is expected due to excess intake. Argyria is usually benign and limited to blue skin discoloration. There are isolated reports of more serious neurologic (seizures), renal, or hepatic complications, as well as headaches, stomach distress, fatigue, and skin irritation. Colloidal silver may react with certain drugs, such asthyroid, and antibiotics (quinalones and tetracyclines). The reference dose, published by the EPA, is the daily exposure that is unlikely to incur a appreciable risk of deleterious effects during a lifetime, is 5 µg/kg/d; meaning 5 micrograms of silver per kilo of weight per person each day – about 1 liter of 10 ppm colloidal silver per month for a 66kg person.

In order to guarantee the effectiveness of colloidal silver, it is necessary to buy a product that provides 10 particles of silver per million of water. Do not consume more than a quart daily for safety sake. Review the label or the specifications in the literature with the product. It is essential to get this health supplement from suppliers that have good feedback from customers and the above specifications. Some products like American Biotech Labs combines oxygen with purified silver, which is said to disrupt the pathogen’s ability to produce energy even more and increases the bioavailability of the silver particles.

My opinion on Colloidal Silver is not as bullish as it has been a decade ago. There has never been a good randomized double blind study to support it in Evidence Based Medicine, but in my experience (Experience Based Medicine), it should be considered in mild infections when antibiotics are not only more expensive but more dangerous! It should also should be considered in hard to eradicate infections along with other therapies such as HIV and Lyme Disease. No doubt it is very helpful when used topically in wounds. Again watch the label for 10 ppm and 5 ng particle size and no more than a quart a day! My colleagues may not agree with me but to those that believe no evidence is necessary and to those that do not believe no evidence is sufficient.

THE BEST BREAST TEST

2010-07-30T06:08:00.000-07:00

Breast cancer is the leading cause of cancer death in women aged 20-59. Cancer of the breast will happen in 15% of all women during their lifetime. Approximately 200,000 new cases of breast cancer are diagnosed in the U.S. each year, resulting in 40,000 deaths annually. An early diagnosis may be helpful, but a before time indication may be curative! A PAP test for the Breast is the ultimate early warning that the lady is in harm's way. In the past this procedure called for a needle aspiration of the milk duct for NAF (Nipple Aspirate Fluid) and was not only uncomfortable but occasionally elicited pain.

A newer, more comfortable test can be performed in the physician’s office using a small device called the HALO with two adjustable cups that go over the ends of the breasts. Unlike a Mammogram, these do not cause much, if any, discomfort. There is a compression at the end of the breast to help elicit the fluid and then suction, which actually draws the fluid out. After five minutes, the practitioner will check to see if any fluid has been elicited, it will be put into a non-gynecological cytology container then sent to the lab doing the cervical paps. The results are usually given back to the patient or doctor, within 24 to 36 hours.

Dr. Papanicolaou discovered the “pap” in 1938 to look at the epithelial cells in the lining of a woman’s milk ducts and the cervix for precancerous predispositions. At that time cervical cancer was the number one cancer found in women. Doctors and women marched in lock step to eradicate this scourge. As a result of the cervical pap, that cancer now kills less than 3,000 women a year in the U.S. So few women have cervical cancer, I no longer do cervical paps. With the advent of the papilloma vaccine, there will be even less of this venereal disease. The cervical smear is relatively easy to obtain through a pelvic exam, but not so with a breast smear, unless the women have an abnormal discharge.

In 1958 Dr. George Papanicolaou et al., first demonstrated the ability to find abnormal cells in NAF with the purpose of identifying women at high risk for breast cancer. NAF and the Pap test are both based on the cytological examination of changes in epithelial cells to determine risk for developing cancer. The presence of abnormal cells, or atypia, in NAF, which is secreted from the milk ducts where nearly all (95%) of invasive breast cancers begin, is a trait proven to increase a woman's chance of developing breast cancer. Multiple studies have concluded that atypia increases a woman's likelihood of developing breast cancer four to five fold.
 
The examination of NAF can provide insight into a woman’s breast health. Finding atypia (abnormal changes) years before it might develop into a lesion enables a woman and her doctor to develop the appropriate "care path" for optimal management of her breast health. The problem is finding an easy non-invasive way to collect the breast fluid. Historically it has been gathered in three ways. One is the Sartorius Method, which is warm towel’s compression and that takes at least a half hour and is successful in only 25% of the cases. Another way of eliciting the fluid is a fine-needle procedure going into the nipple to draw out the fluid. The third way was a product that came out a few years ago called ductal lavage, or First Cyte. This involved putting a small tube or cannula, into the nipple, lavaging the milk ducts then analyzing the fluid and the epithelial cells cytologically as we do for atypia. The HALO is a wonderful collection device. By having a fully automated, five-minute, non-invasive procedure, we can now get nipple aspirate fluid in an efficient way. In a 500 patient trial, women rated the pain of the HALO procedure as a three to four on a scale of 1 to 10. A mammogram was rated 8!

The best current screening to assess a woman’s breast health and risk of developing breast cancer is review of family history, personal history, physical breast exam, plus the new guidelines of regular mammography for women over 50. Mammograms have 30% false positives and 38% false negatives. Some scientists even believe that putting the breast under pressure and irradiating it can cause cancer. Also clinical experience has shown that the vast majority of women who develop breast cancer have no risk factors that are identifiable with these methods and go unnoticed for years until an abnormality, a lump, is accidently discovered.

Mammography is often not as effective for women on Hormone Replacement who tend to have dense breasts that make it harder to detect abnormalities. Though young women do not develop breast cancer as often as women over 50, the disease in this population tends to be more advanced and have less favorable outcomes. A recent study found that younger women’s tumors tend to have a set of biological and genetic factors that made them more aggressive and more difficult to treat than cancers in older women. Digital Imaging Thermography has only limited utility and is not accepted by the majority of practicing physicians.

The medical community’s focus has traditionally been on detection and treatment. But by the time an abnormality can be identified via mammography, it has been growing for approximately eight years. As a result, more emphasis is now being placed on individualized “risk assessment and prevention.” Taking bio-identical progesterone, and testosterone eating broccoli sprouts or taking supplements such as DIM or I3Carbinol, limiting alcohol, fat and smoking will go a long way in reversing early atypia and preventing breast cancer.

Music is Healthy

2010-07-18T17:06:00.000-07:00

Youthful Aging by Norm Shealy, is one of the e-Newsletters I receive. He, like I, feels that some, but not all, music is healthy and to some extent anti-aging. In addition to binaural music which entrains the brain waves to the Alpha (relaxed) and the Delta (sleep) state, there are other ways music heals as noted by an expert in the field. If a frequency is imputed into one hear with a simple earbud and the other side another frequency, the brain will “subtract” one from another in time and the result will be the difference. For example the same tune with an effective frequency of 186 Hz is piped into the left ear and 180 into the right, the brain will resonate at 6. This is the tranquil alpha state. Steve Halpern details much more on this with his interview with Dr Shealy. Steve is a true scholar of modern meditational and healing forms of music. Norm Shealy MD, a former neurosurgeon, whom I had the pleasure to meet and dine with, is a true genius of metaphysical medicine. His website is http://www.selfhealthsystems.com

STEVE HALPERN HEALING MUSIC
Steven Halpern is widely acknowledged as the pre-eminent composer of music for health and healing. He is a pioneering sound healer who brought the art and science of healing music into the field of complementary/integrative medicine and to the mainstream public through his best-selling recordings, including CHAKRA SUITE, SOUND HEALING and RELAXATION SUITE. Hear samples at www.stevenhalpern.com I have been a great fan of Steven's music since the mid-70s (Norm Shealy)

The Power of Steven Halpern's Healing Music
Considerations on Choosing and Using Music for Relaxation and Healing
(c) Steven Halpern 2010
The healing powers of sound and music have been revered for thousands of years, but only recently have leading edge researchers and musicians begun to understand fully the deeper and more subtle implications of this most ancient of the healing arts.Over the past 40 years, key secrets have been identified that expand greatly upon the classical bias of orthodox music therapy and disinterest of the entertainment-oriented music industry.

The field has attracted the attention of millions of individuals who want an easy way to reduce stress, enhance health and well-being while simultaneously being pleasant listening. A great deal of misinformation, however, has made it confusing for many listeners to know how to choose and use healing music in their personal and professional lives. In this short article I will share my perspective both as an artist and as a customer.

In a few moments you'll know more about the field than is taught in most colleges, and will be empowered to make more informed choices to get the most benefit for your time and money.

A Personal Note
I am often asked, "How did you get into this field?" The answer is simple: "It got into me! On one hand, about 40 years ago, I began hearing beautiful music in my mind's ear that made me feel so peaceful and relaxed, I longed to be able to hear it with my physical ears. On the other hand, my doctor told me that if I didn't learn how to reduce my stress level, I would soon suffer from many of the stress-related diseases like hypertension, difficulty sleeping and concentrating, and getting sick more often.

Having read in books about that music was used in ancient societies for healing, I searched for suitable soundtracks for health. There was very little music composed expressly for this purpose, and even less research into the healing powers of music. As a trained musician, I realized I was in a perfect position to combine my personal and professional proclivities.

When I performed my healing music in public, people always asked me for a recording that they could use at home. I was encouraged to establish my own independent record label, and soon discovered that composing the music was the easy part. I soon learned that I had to educate the public, as well as the growing ranks of holistic, alternative and integrative health care practitioners about healthful and stress-reducing aspects of music that had not been addressed before.

Keynotes of Sound Health
How do we respond to music? Many individuals never consider this topic. Traditionally, this question was answered with respect to the elements of melody, harmony and rhythm. tone color/timbre was added in more modern textbooks. The psychology of music, as a field, and music therapy, historically focused on our emotional, psychological and physical responses. Physiological responses were limited to gross motor responses, like the knee jerk response, or blood flow through a finger. Until I conducted landmark research studies using brainwave biofeedback EEG), Galvanic Skin Response(GSR) and Kirlian(subtle energy field/aura) photography, no one had researched music's effect on subtle energies and consciousness.
In my work, I have identified deeper levels of response-ability, building upon the pioneering research of Hans Jenny (cymatics) and quantum physics. Here is a brief overview. For this discussion, I'll limit my remarks to focus on an understanding that self-healing occurs most effectively in a state of deep relaxation. Sound and music can be a potent force to engage this response. But most music may NOT be your best choice if your goal is health rather than entertainment.

Most music was not composed for true relaxation purposes. (Nor am I suggesting that music should ONLY be composed for that purpose. But using the wrong music virtually sets you up for failure if you with regard to healthful responses. It would be like drinking three cups of coffee and trying to go to sleep. That's not the function of caffeine-laden coffee. Why would you use the musical equivalent of coffee to help you relax?

Lesser known is that most music evokes more of a stressful response than people realize. The reduction of stress, and enhancement of relaxation, is therefore fundamental to most all healing music. (Herbert Benson, MD, bestselling researcher and author of"The Relaxation Response") That is why my CDs are composed with the intention and compositional constructs that provide stress reduction.....at the speed of sound.

Your One Minute Guide to Understanding Healing Music

1.The Rhythm Factor:
The law of rhythm entrainment describes the phenomenon in which a stronger, external stimulus overrides the natural internal rhythm of the heart and causes it to synchronize to its stronger beat. If you listen to music whose tempo is faster than a relaxed heartbeat, (top range about 60 beats per minute) then your heart will be forced to beat in time to the music, which is commonly from 90-140 beats per minute !
That's also like drinking three cups of coffee and trying to go to sleep. You essentially set yourself up for failure. And you'll be awake all night to think about it!

It's easy to identify for yourself whether the music is relaxing for you. Measure your resting heartbeat, and then measure your heartbeat while listening to the music. If your heartbeat is faster, this would NOT be a good choice for your relaxation library. (although it might be a fine choice for other uses). This is precisely the reason that my own recordings do not have a strong central rhythm. I was inspired by my yoga training to compose with the implicit rhythm of a deep, slow yogic breath. (Most reviewers, likely listening after drinking three cups of coffee, were unable to perceive this secret). But your heartbeat will immediately appreciate the opportunity to reset its rhythm into the natural rhythm of a deep breath. This is as apparent to many first-time listeners as well as long-time fans.

2. Melody and Harmony
I'd like to discuss melody and harmony together as 'distraction factors' in evoking the relaxation response. For psychological responses, much has been written. We have been culturally conditioned (by Western classical and pop music) to respond to familiar patterns in predictable fashion, when we hear scale-based melodies or harmonic progressions. We are unconsciously forced to project into the future...where the music is going.

In live presentations, I always demonstrate this secret by singing a scale....and stopping on the seventh note. I do not complete the sequence with the eighth tone of the octave note. You can prove it to yourself right now: Take a moment to imagine me singing a scale..(Do-Re-Mi-Fa-So-La- Ti....) and notice that you are predictably holding your breath because I did not finish the pattern!

I coined the phrase 'scalus interruptus' to describe this phenomenon, and why you are left feeling 'future tense.' In other words, simply listening to 'ordinary music' CREATES stress and tension!

Relaxation, on the other hand, happens only in the present moment.' You can't relax 'in the future.' You can only relax ' in the now'. Or, to paraphrase spiritual teacher Ram Dass,(Be Here Now), I say, "Hear. Now. Be." tm Remember, we are human be-ings, rather than human do-ings.

Trying to relax while listening to music that keeps you off balance and out of the NOW is therefore not an effective choice if you want to relax. Listen to even 30 seconds of my Chakra Suite, Relaxation Suite, or Ocean Suite and you can feel the relaxing change that comes over your body .It's that easy, and that quick.

Your body is hard-wired to shift gears into a state of relaxation, if you only give it a chance. That's why people the world over enjoy being out in nature, at the ocean, by a lake, on the farm or in a mountain meadow. And when you can't get out in nature, properly composed relaxing and healing music can bring nature to you by giving your 'human instrument' the chance it wants and needs for optimal health.

3. Resonance
Resonance describes the reality that every atom, molecule vibrates at a specific frequency, and functions as both a transmitter and receiver of vibrations at that frequency. Therefore, every organ, gland and muscle in our body has a specific natural frequency which exist within the range of audible sound.
In essence, when you listen to music, you are receiving a vibrational massage. If the music is organized to resonate specific frequency-specific areas of the body, like my Chakra Suite, than we can use sound to assist our body to resonate at a higher level of coherence and efficiency.

Resonance is what you feel when part of you is tingling or buzzing when you hear quartz crystal bowls or Tibetan singing bowls being played, The tones of the Rhodes electric piano are produced by precisely tuned 'tuning forks' that are struck lightly by a hammer attached to the keyboard. It is not a synthesizer. That is the secret of why its tone is so pure, and why it changed my life the moment I bought one: I now had the most beautiful healing instrument at my fingertips, ready to play and record healing music.

4, Tonal Color and Timbre
In my earlier career as a professional performing musician, I played trumpet and electric guitar. The basic sound of these instruments is not intended for relaxation. That was one of the reasons I had to switch to the gentler sounds of electric and grand piano, and atmospheric, psycho-active sounds I could play with electronic keyboards, Many acoustic instruments, like violin and oboe, actually produce waveforms that are irritating and stress-inducing for many people, whether they are aware of them or not.

In my dreams and meditations, I heard music that sounded like celestial bells and heavenly harps. When the instrument was invented, I became one of the early advocates of the Rhodes electric piano, which is featured on my Chakra Suite and many other recordings.

I also learned how to adjust and record the glorious grand piano to remove the harsh attack and enharmonic overtones that interfered with my relaxation as I composed or listened. Every instrument on my recordings is chosen for its relaxation and healing effects. There's a time and a place for brittle and dissonant tones, but not in my healing music.

5. Intention and Music: Thought Field Resonance
In my experience, there is an additional dimension that should be discussed with respect to subtle energy factors. When I first went public with my music and theories in the early l970s, I described the power of intention of the composer or performer as being a critical factor determining what the overall effect would be. For instance, the same melody or notes could have a positive or negative effect depending on the stress level of the performer.

It's as if this 'meta-information' is broadcast and transmitted by the musician to the listener, albeit in an inaudible manner. Quantum physicists have now proven what mystics and musicians have known for millennia.

I coined a phrase to describe this phenomenon thusly: "Music is a carrier wave of consciousness." Now that intention has become such a popular concept, it's easy to understand that it's not just the notes, but the energy that comes thru the notes, that must be considered when choosing healing music.

Depending on the sensitivity of the listener, music intended for meditation and healing can help the listener to quiet the mind, and get into the gap between thoughts. Deepak Chopra and Wayne Dyer have written eloquently about this. I have always described my own compositional process as 'getting into the spaces between the notes'.

In either case, by quieting the mind, such music creates the proper vibrational resonance in which the individual's brainwaves more easily attune to the natural harmonic resonance of the earth (Schuman resonance , 7.83 Hz) It may therefore be impossible to calibrate how much healing happens because of the music itself, vs how much occurs 'automatically' when the listener gets into the proper alpha brainwave state facilitated by the music.The bottom line is that some music is much more effective in this regard than others.

My approach to sound healing has always been first and foremost to compose soundtracks that will serve the highest good for the highest number of listeners, rather than to impress the listener with the complexity of my compositions or technical virtuosity. I believe that the large and growing international audience that my music has created provides a strong testimonial that it has succeeded in its intention.

Listening at low volume creates a soothing mood and relaxing ambiance for general background use at home, at school, at work, for yoga, or massage, pain control, post-operative recovery, in clinics, hospitals and hospice care.
Many individuals have also discovered the beauty, benefits and blessings of listening with intention and focused attention (especially with headphones, and not multi-tasking), and thus enjoy a greater depth of experience. Listening to this music in this way can indeed transport you into the gap between thoughts, leaving you feeling uplifted, relaxed and renewed, at peace with yourself and the world.

Sound Matters - For The Record
Most people have no idea how profoundly the sounds and music in our life affects us, for better or worse. Here are just a few of the most significant effects:

Common effects of stressful music and noise pollution include (cf "Sound Health", Steven Halpern, Harper & Row,l985): Hypertension, higher stress levels in general, as well as higher cortisol hormone levels, irritability, difficulty sleeping, concentrating, fatigue, digestive problems, weight gain, alcoholism and hyperactivity (especially in children)

Common Effects of Healththy Music
Reduced stress, enhanced relaxation, improved sleep, enhanced concentration and focus, improved digestion (less gas and more efficient digestion, which also often promotes weight loss, better dispensation, greater ease in holding and stretching into yoga postures, enhanced rapport with one's significant other both emotionally and sexually. In sum, the music one listens to can make a significant addition to one's personal health and wellness program.

When choosing which music to buy for your own relaxing and healing sound library, consider that appropriate music should include the above-identified universal commonalities as well as your personal preferences and history. Making more informed choice empowers you and allows your body/mind/spirit the most benefit and pleasure in terms of your own health and self-healing.

Steven Halpern is widely acknowledged as the pre-eminent composer of music for health and healing. He is a pioneering sound healer who brought the art and science of healing music into the field of complementary/integrative medicine and to the mainstream public through his best-selling recordings, including CHAKRA SUITE, Music for SOUND HEALING, GIFTS of the ANGELS, PEACE of MIND and RELAXATION SUITE. Read more about sound and healing at www.stevenhalpern.com

IS APO-E RIGHT FOR ME ?

2010-06-28T09:03:00.000-07:00

Apolipoprotein E (ApoE), a blood test to predict premature cardiovascular and/or Alzheimer’s disease, was prohibitively expensive until June 2010. The Atherotec corp then reduced the price to less than $100 as an add-on study to the VAP (Vertical Atherogenic Profile) which is paid for by most insurance. This would include about 50 other very helpful tests as mundane as a blood sugar to the extremely sophisticated Plac2. This examines for the plaque burden of your arteries as of the moment the blood is drawn.

Regarding the ApoE each of us are given two copies (alleles} of the ApoE at birth and they remain that way lifelong. Therefore the test never has to be repeated again. There is no ApoE e1. We have one each of 2,3, and 4. A person can have e2/e3 or e2/e4 or double of each such as e4/e4. Those with ApoE e2/e2 alleles are at a higher risk of premature vascular disease, although some may never develop disease depending on their lifestyle. Likewise, they may have the disease and not have e2/e2 alleles because it is only one of the factors involved. Our genes cannot change but they can be modified by our diet, exercise and medications. ApoE genotyping adds additional information and, if symptoms are present, e2/e2 can help confirm type III hyperlipoproteinemia a cardiovascular risk factor. This has Chylomicron (Fat/triglyceride globules) remnants and very low density lipoprotein (VLDL) particles which should be rapidly removed from the circulation by the liver. Apolipoprotein E, the main component of the chylomicron and VLDL, binds to a specific receptor on liver cells for disposal. In reference to e2 lipid abnormalities, it will improved lipids with alcohol consumption and there will be little response to diet. With e4, the lipids will improve with a low fat diet. So ApoE is an important determinant of metabolism and treatment of abnormally high lipids.

In addition to predicting age of death ApoE from cardiovascular disease, it predicts
Alzheimer’s(AD), perhaps a fate worse than dying of heart disease. AD is the most common form of dementia. This incurable, degenerative, and terminal disease was first described by German psychiatrist and neuropathologist, Alois Alzheimer in 1906 and was named after him Generally, it is diagnosed in people over 65 years of age, although the less-prevalent early-onset 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 the ApoE test will go a long way to forecast it so you can do things NOW to prolong its onset and even prevent it!

The earliest observable symptoms are often mistakenly thought to be 'age-related' concerns, or manifestations of stress In the early stages, the most commonly recognized symptom is inability to acquire new memories, such as difficulty in recalling recently observed facts. As the disease advances, symptoms include confusion, irritability and 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. Individual prognosis is difficult to assess, as the duration of the disease varies. 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 or a CDR and often I order a MRI looking at the hippocampus volume and if in real doubt 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. The mean life expectancy following diagnosis is approximately seven years. Fewer than three percent of individuals live more than fourteen years after diagnosis.

Over 60% percent of those who have late onset AD have paired ApoE e4 (e4/e4) alleles. While genetic mutations of the PSEN1, PSEN2, and APP genes are associated with AD in a very small number of specific family lines, they are associated with early onset AD, rather than late onset. The E4 variant is the largest known genetic risk factor for late-onset AD in a variety of ethnic groups. Caucasian and Japanese carriers of 2 E4 alleles have between 10 and 30 times the risk of developing AD by 75 years of age, as compared to those not carrying any E4 alleles. Research suggests an interaction with amyloid. AD is characterized by plaques consisting of amyloid. Apolipoprotein E enhances proteolytic break-down of this peptide, both within and between cells. ApoE-4 is not as efficient as others at catalyzing these reactions resulting in increased vulnerability to Alzheimer's in individuals with this gene. Among ApoE4 carriers, another gene, GAB2, is thought to further influence the risk of getting AD. However, the relationship does not appear as strong as e4, since in the Japanese population, gab2 is not a risk factor. There is also evidence that the ApoE2 allele may serve a protective role in AD. Thus, the genotype most at risk for Alzheimer's disease is ApoE e4/4. The ApoE 3,4 genotype is at increased risk, though not to the degree that those homozygous for ApoE 4 are. The genotype ApoE 3/3 is considered at normal risk for Alzheimer's disease. The genotype ApoE 2/3 is considered at less risk for Alzheimer's disease. Interestingly, people with both a copy of the 2 allele and the 4 allele, ApoE 2/4, are at normal risk similar to the ApoE 3/3 genotype. Other than e4, the other “e s” do get better with Medium Chain Triglyceride Therapysuch as Coconut Oil. Knowing if you are in harms way for either Vascular or Alzheimers disease early in life should give the impetus to change lifestyle. “An enemy known is better than one unknown!”

MICROWAVED FOOD (UN)HEALTHY ?

2010-06-22T08:25:00.000-07:00

It had been thought for 20 years that microwaved food may not have all its nutrients. According to most studies, however, the reality is quite the opposite. Every cooking method can destroy vitamins and other nutrients in food. The factors that determine the extent are how long the food is cooked, how much liquid is used and the cooking temperature.

Since microwave ovens often use less heat than conventional methods and involve shorter cooking times, they generally have the least destructive effects. The most heat-sensitive nutrients are water-soluble vitamins, like folic acid and vitamins B and C, which are common in vegetables.

In studies at Cornell University, scientists looked at the effects of cooking on water-soluble vitamins in vegetables and found that spinach retained nearly all its folate when cooked in a microwave, but lost about 77 percent when cooked on a stove. They also found that bacon cooked by microwave has significantly lower levels of cancer-causing nitrosamines than conventionally cooked bacon.

When it comes to vegetables, adding water can greatly accelerate the loss of nutrients. One study published in The Journal of the Science of Food and Agriculture in 2003 found that broccoli cooked by microwave — and immersed in water — loses about 74 percent to 97 percent of its antioxidants. When steamed or cooked without water, the broccoli retained most of its nutrients.

Some scientists feel that much of the benefit of food is due to vibration of energy. Microwaves cause isomerization which is the rearrangement of electrons which morphs into another form such an amino acid going from L. lysine to D lysine. Living tissue recognizes the L. but not the D form. This is much more in theory than proof.

However, microwaved heating of banked blood has reportedly caused at least one death. Also, people who were given microwaved foods were shown to have depletion of some vital enzymes. It may be years before the truth is known. But for now I use the microwave mostly to heat water and not food. I am still moderately concerned about the devitalization of the micronutrients in food. Study after study has shown that the more any food is cooked by any method, the less nutrition it has "if it's not raw don’t eat it at all".

THE DARK SMOOTH FOOD OF HEALTH

2010-06-08T04:42:00.000-07:00

For several decades, I’ve been interested in chocolate. Is it anything more than a delicious, but fattening treat? There are over 80 chemicals in chocolate that have been shown to be beneficial to man. There are also some negative ones. The beneficial ones include Minerals (particularly magnesium), vitamins (B6, niacin, thiamine, riboflavin), hormone-like chemicals (ferulic acid and phosphatidylcholine), stimulants (caffeine and theobromine), amino acids (threonine), pain relievers (nicotinamide), aspirin-like anti platelet compounds as well as several other chemicals that have antiseptic, antioxidant and anti parasite properties.

Chocolate comes from the cacao tree, a small evergreen that grows as high as 25 feet in the wild, but when cultivated, is only five feet for convenient hand picking. One inch long, reddish brown beans are imbedded in a white. pulp. The chocolate nuts were taken from this and by a simple fermenting process, such as burying them under leaves for several days, they were ready for use. In the New World, chocolate was consumed in a bitter, spicy drink called xocoatl, and was often flavored with vanilla and chili pepper.

Until the 16th century, no European had ever heard of the popular drink from the Central and South American peoples. It was after the Spanish conquest of the Aztecs that chocolate was imported to Europe. The first chocolate house opened in London in 1657. In 1689, noted physician and collector Hans Sloane developed a milk chocolate drink in Jamaica which was initially used by apothecaries, but later sold to the Cadbury brothers in 1897. Chocolate in its solid form was invented in 1847. Joseph Fry & Son discovered a way to mix some of the cocoa butter back into the dutched chocolate, and added sugar, creating a paste that could be moulded. The result was the first modern chocolate bar.

One ounce of dark chocolate contains the same amount of antioxidants as a 5 ounce glass of red wine. Even the fat (cocoa butter), which was once thought to be bad, is now known to be mostly stearic acid, which is far better for our arteries than other saturated fats.

The smooth rich taste of chocolate has to do with palate pleasing physical property as well as with almost 300 aromas and flavors to tease the taste buds and tweak the brain. The dark chocolate has far less fat and more of the “good stuff’ than the light chocolate. White chocolate has none of this. I would advise reading the label to make sure there are no hydrogenated oils, excessive sugar and artificial flavors that are sometimes used in less expensive forms of chocolate. Hopefully, xylitol and/or stevia will be used as a sweetener.

Chocolate has been shown to be positive in human health. Panamanian Indians who consumed a cocoa-ladened drink (xocoatl) had one-third less incidence of cancer and cardiovascular disease. The first epidemiological study that proved increased cocoa (chocolate) intake, improved the cardiovascular system with a decrease of all-cause mortality, took place in Holland. The Zutphen Elderly Study published several years ago in The Archives of Internal Medicine revealed that men who ate the most cocoa had a significant drop in blood pressure and a 50 percent lower risk of cardiovascular death.

In a more recent study of 44,489 people, those who ate one serving of chocolate per week had a 22% reduction in the likelihood of stroke. Another study found that people who ate 50 gms of chocolate a week were 46% less likely to die following a stroke.

EXPIERIENCE BASED MEDICINE

2010-05-29T15:08:00.000-07:00

Evidence, (not Experience) Based Medicine (EBM)is a new paradigm that has brought a better clarity of diagnosis and treatment to the medical community. Previously, physicians would use anecdotal, inductive reasoning with pathophysiology of disease, previous teaching, with its tremendous prejudice and biases to make clinical decisions in both diagnosis and treatment. Much of how we practiced was never scientifically proven, but taught to us that we took as the Gospel. Some of this included old wives’ tales and consensus opinion. The latter was when a committee of experts in a field voted on how to diagnose and treat. But with EBM the “Evidence” is put through rigorous statistics, reviewed and re-reviewed. This gave physicians the tools needed to enhance their clinical decision, utilizing both theory and statistical modeling. Doctors are discouraged to use their own beliefs and value system and encouraged to be “objective.” Back in 1972, A. Cochrane MD PhD advocated computerized literature for EBM. This is now a reality. Scientific studies are included in the Cochrane database, which as of 2010 has over 3500 systemic reviews and still growing. It is easily accessible to both doctors and their patients. Medline and Pubmed are several of the sites to obtained these on the Internet.

Evidence Base Medicine will always be a work in progress as new studies are completed. Guidelines for diagnoses and treatment are being worked into the fabric of everyday clinical practice. But what about Experience Base Medicine? Does Experience of years of practice count for naught? If the hallmark of good medicine is Evidence Based on double blinded studies involving a large number of patients, then how about the single individual, perhaps you, influence the diagnosis and treatment and what your physician will do to the next patient who has the same medical problem? It is his experience with you and as many others like you that he has in his conscious and unconscious mind that gives him the perspective to make that very unique and personal determination for your best result.

My first clinical rotation as an acting intern was in 1962. Now 48 years later, I may not be any smarter, but I am wiser because of the experience of the years of practice. Of course I review the databases, but the thousands of patients, and tons of medical journals I read along with the hundreds of medical conferences that I participated and attended should and does give me a different perspective on how I practice medicine. After all, Medicine is a science of uncertainty based on the art of probability. Like most practitioners I always want the very best for the patient and unless some catastrophe (stroke, acute mental illness etc) occurs in my life, I am on the top of my game. Despite my years, I practice what I preach and remain as vibrant now as I was fifty years ago.

Quoting from my Medical hero, Sir William Osler, “He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.” He also said “The young physician starts life with 20 drugs for each disease, and the old physician ends life with one drug for 20 diseases.” Also “One of the first duties of the physician is to educate the masses not to take medicine” and “Observe, record, tabulate, communicate. Use your five senses. Learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone you can become expert.”

So what is Experience? Experience is multifaceted and very fickle. It involves facets of intellect and consciousness which occur in combinations of thought, perception, memory, emotion, will and imagination. Importantly it must also include unconscious cognitive processes that at times are fragmentary and fleeting so they can crystallize over time to produce an original concept. It depends on one’s individual ability to process data, to store and internalize it. The implicit knowledge of clinical experience has been called "knowing in practice.” This method of knowing allows the experienced physician to arrive at a diagnosis after only a few moments of history taking, although it would be difficult to explain the method for arriving at this diagnosis.

Knowing in practice has three important roles in clinical medicine. Diagnostic expertise can only be developed with experience. The development of the motor skills involved in medical practice--feeling an enlarged liver, for example--requires practice as well. Physicians also learn to hear what patients are saying and develop an understanding, “hearing between the lines”. From my years of teaching medical students and young doctors, I know that good doctors are born, not made. Some have it and others will never get it!

FRIENDS

2010-05-23T21:29:00.000-07:00

To have a friend, you must be one!
A person needs same sex close good friends or just a friend, for both happiness and health. There are differences between friends and acquaintances. A friend is a person with whom someone shares extremely strong interpersonal ties. Whereas an acquaintance, the sharing of emotional ties isn't present. An example would be a colleague with whom you enjoy eating dinner, but would not look to for emotional support. Friends do things for each other without expectation of repayment. Friends encourage their friends to lead more healthy lifestyles; Friends encourage their ally to seek help and access services, when needed; A friend enhances their friend’s coping skills in dealing with illness and other health problems; and Good friends actually affect physiological pathways that are protective of health. There are some connotation differences between certain types or circumstances between friends, such as;

Buddy: In the USA, guys often refer to each other as 'buddies', for example, introducing a male friend as their 'buddy', or a circle of male friends as 'buddies'.
Soul mate: the name given to someone who is considered the ultimate, true, and eternal half of the other's soul, in which the two are now and forever meant to be together.
Pen pal: people who have a relationship via postal correspondence. They may or may not have met each other in person and share friendship, between each other.
Internet friendship: a form of friendship, not romance, which takes place over the Internet.
Comrade: means "ally", "friend", or in a military sense. This is the feeling of affinity that draws people together in time of war or when people have a mutual enemy or even a common goal.

Many friendships are not enduring, not necessarily for selfish reasons, but because of misunderstandings. A parting of the ways is usually painful for both who feel that they have been harmed or injured by the other. Both loose because of the split. A good way to maintain a friendship is to have a policy once the pair decide that they really like each other.

DECLARATION FOR A LASTING FRIENDSHIP

TO BE DISCUSSED AT A CONVIENIENT TIME BEFORE AN ARGUMENT HAPPENS
(Or if you are in a middle of one wait until you both cool down)

1. We will never fight in Public.
2. We will never touch or talk to each other in a harmful or abusive way.
3. We will never bring up unrelated items from the past.
4. We will never indicate that we will no longer be friends.
5. We will call a “time out” if conflict elevates to a damaging level.
6. We will work out our problem-Failure is not an option!

Bilirubin - An Internal Protector

2010-05-16T13:20:00.000-07:00

Two scientific premises have recently come together: “lowering uric acid decreases death and aging” and “elevation of bile” (bilirubin) does the same. An inexpensive drug, Probenecid can improve both of these. In the Journal of the American Medical Association, researchers reviewed the literature showing that elevation of uric acid (hyperuricemia) is not only a predictor of gout but is commonly present in new onset high blood pressure. Other previously documented research supports elevation of uric acid causes cardiovascular disease to include stroke, heart attack, and peripheral vascular problems.

In 1998, Louis J. Ignarro won the Nobel Prize for his discovery of Nitric Oxide's role in cardiovascular health. Uric acid was subsequently shown to reduce nitric oxide levels in the lining of arteries, causing them to be more easily damaged. A well controlled double-blind study in lowering of uric acid artificially with the drug Allopurinol resulted in a significant reduction in Blood Pressure. As noted in the past, hypertension is a significant risk factor in cardiovascular disease because of its role in atherosclerosis, stress to the heart, and acceleration of the inflammatory processes of the body.

Bile (bilirverdin/bilirubin) was long considered a merely metabolic waste product from the breakdown of red blood cells and was discarded in the liver. Bile in the intestinal tract functions to markedly improve our fat digestion. For the last twenty years, this pigment has been shown to decrease experimental hardening of the arteries, prevent blood clotting, and reduce the risk of damage to the brain after a Stroke. It has been recognized to have an anti-inflammatory, antioxidant, and cyto-protective properties.

The NHANES (National Health and Nutrition Examination Survey), conducted every decade for the last fifty years, represents a cross-section of our population and surveys over 13,000 patients. The survey shows that people who had higher bilirubin had a significantly reduced incidence of neurological damage due to Stroke, plus a decreased incidence of Heart Attacks and peripheral vascular disease. The study was carefully controlled for other risk factors to include hypertension, diabetes, lipids, homocysteine, C-reactive protein, and body weight. Those that had significant liver disease, a very common cause of very high bilirubin, were not included. It has been long noted that people with high bilirubin, for whatever reason, have far less hardening of the arteries. A rare, benign, inherited elevation of Bilirubin, called Gilbert’s disease, has also been shown to increase longevity. These findings are suggestive that elevation of Bilirubin is an important defense mechanism against atherosclerosis and protective for neurologic injury in the setting of stroke. The well tolerated Probenecid, as noted above, not only lowers Uric Acid but raises bilirubin.

A strategy for a decrease of vascular disease and all accrued benefits is to have your doctor prescribe Probenecid 500 mg a day. It is still used to treat High Uric Acid. This will raise the bilirubin slightly and significantly give anti-inflammatory and cyto-protective effects to increase longevity. Normal bilirubins are from 0.1 to 1.3 and if the bilirubin is between 1.1 and 2.0, you are much better off. People do not become jaundiced unless their bilirubin is over 3.0. Another ploy without using the doctor is to consume a fair amount of ox bile, also this drug would lower the Uric Acid to the ideal which is less than 5. This would not only improve your lipids and your bowels, but will raise the bilirubin to protective levels. Although a double-blind study has yet to be done, it is almost a no-brainer to consider this healthy strategy.

TO STOP ACID IS TO STOP HEALTH

2010-05-10T05:51:00.000-07:00

Proton pump inhibitors (PPIs) are a group of drugs whose main action is a pronounced and long-lasting reduction of gastric acid production. They are the most potent inhibitors of acid secretion available today. Almost all patients and most doctors think of them as a class of important and generally safe medicines to prevent the release of stomach acid. But they may cause more problems than they solve. PPIs are among the most widely prescribed classes of medications for symptoms of Acid Reflux, Peptic Ulcer, and part of the therapy for H pylori infection (thought to be the cause of Ulcers of the stomach and duodenum). Around for the last 20 years, Prilosec (omiprazole) is today over the counter (need no Rx). Other name brands of this third largest class of medicines (113.4 billion in yearly sales) is Nexium, Aciphex, Prevacid, Prononix, and the latest Kapidex. But according to the Archives of Internal Medicine, May 10, 2010 in which there were 6 articles and an editorial, there are more problems than fixes with these bandaid drugs.

Common adverse effects include: headache, nausea, abdominal pain, fatigue, and dizziness. Rarely rash, itch, flatulence, constipation, anxiety, and depression are listed as side effects. But what was not commonly known until recently is decreased vitamin B12 and other vital micro-nutrients absorption, elevation of Homocysteine, Bacterial Pneumonia, C difficle diarrhea, and Osteoporosis happens frequently. In a study of 135,000 people 50 or older, those taking high doses of PPIs for longer than one year have been found to be 2.6 times more likely to break a hip. Those taking smaller doses for 1 to 4 years were 1.2 to 1.6 times more likely to break a hip. Proton pump inhibitors significantly decreased the effect of clopidogrel (Plavix) a commonly used drug to prevent heart attacks. A 2009 report in Gastroenterology suggests that PPI use may cause dependency by increasing gastro-intestinal symptoms if they are discontinued. The whole process of digestion with the activation of pancreatic enzymes, the release of bile, and the propulsion of food down the intestine is initiated by ACID. God gave us this for good reason, and man should not try to outsmart Him!

Heartburn, the main symptom of acid reflux occurs in over 50% of our population. Some studies show that many people do not have significant reflux despite their complaints and more than a few have reflux and no symptoms. It’s believed that the cause of acid reflux is a weakening of the “valve” between the stomach and the esophagus, most often due to hiatal hernia, which allows stomach acids to pass into the esophagus. PPIs are also prescribed for ulcers, coughing, hoarseness and asthma from reflux, as well as a condition called Barrett’s Esophagus. This is both over diagnosed and over treated by over worried doctors and their patients because in rare instances can lead to a form of cancer of the esophagus. Heartburn usually occurs after meals or when lying down, regurgitation (bringing up of refluxed liquids into the mouth) and nausea happens in addition to the above. In as many as 20% of heartburn, it is not too much acid, but not enough that causes symptoms of acid reflux. These folks are then treated with acid (Betaine-HCL)

Heartburn can often be handled without medicines. Frequent small meals, waiting 2 hours before lying down, 4 inch blocks under the headboard of the bed, weight loss, staying away from the foods that aggravate the symptom (spice, gluten, fat, caffeine, alcohol), and not smoking do help. Taking a walk after eating may ease the hiatal hernia, but better is to drink a quart of fluid before eating and jump up and down 10 times to bring the hernia from your chest cavity into your abdomen. Also physically pushing it down before eating by squeezing and pushing the mid upper abdomen with your fingers towards the umbilicus. Another method is by taking a deep breath standing, then exhale while bending over and wrapping your arms around the lower chest and hug tightly. The consumption of Tums or Rolaids work in the majority of cases. The use of a ½ teaspoon of baking soda in a ½ glass of water several times a day may aid as well. If all else fails Over The Counter Cimetidine (Tagamet) which also fortifies the immune system and tends to prevent cancer and infections is a good choice every other day. If the symptoms are severe and nothing helps then the PPIs for a short time can be used while taking micronutrients such as Iron, Magnesium, Calcium, etc. as well as an occasional injection of B12. To be forewarned is to be forearmed and do not take PPIs without forethought.

LITHIUM

2010-05-07T19:13:00.000-07:00

This metal is found in small-amounts in fish, processed meats, dairy products, eggs, potatoes and some veggies. Even with eating the above, it is less than one tenth of what is needed to keep our brain working the best it can. It has also been used with success in alleviating the pain from migraine and cluster headaches, leucopenia (low white blood cell counts), juvenile convulsive disease, alcoholism and liver disorders. It also been reported that patients with myopia (nearsightedness) and glaucoma often benefit from the slight dehydrating effect of lithium on the eye, resulting in improvement in vision and reduction of intraocular pressure.

Over two thousand years ago, it had been noticed that the waters of certain mineral springs seemed to have curative powers for people suffering from demonic possession and in“excitable nervousness”. In the second century A.D., the Greek physician Seranus Ephesios recommended natural waters such as alkaline springs as a treatment for mania. Over the ensuing two millennia, countless people have “taken the waters” for a variety of ailments, real and imagined, at fashionable (and not so fashionable) spas throughout the world, particularly in Europe. Lithium is so effective in controlling the mood extremes of bipolar disorder that to this day it is still used in the treatment of both manic and manic-depressive disease. The fact that lithium controls both mania and depression (the former more effectively than the latter) is both wonderful and puzzling, as it suggests that both of these conditions are, somehow, symptoms of the same underlying neurochemical disturbance.

Lithium’s mechanism of action on the brain is still unknown, speculative; it may affect the levels of the neurotransmitters serotonin and norepinephrine in the brain. There is also evidence that lithium inhibits the action of inositol monophosphatase and several other enzymes that play key roles in mood-related neuromodulation (a complex type of signaling process related to neurotransmission). Also in Alzheimers, there is a decrease of the amylold/beta plaques and neuro-fibrillatory tangles that are the hallmark of this disorder. Lithium protects against neuronal death very much like the drug for Alzheimer’s disease, Namenda, by decreasing glutamate induced excitotoxcity. The latter is caused by our neurotransmiiter because of stress and is a cause of Alzheimer's. Excessive amounts of glutamate, the brain's most prevalent transmitter damages our brain cells. Lithuum stimulates the protective Brain Derived Neurotropic Factor(BDNF),which is essential for the development and maintenance of healthy neurons. One further mechanism has been described recently. This is it stimulates the growth of new brain cells, a process called neurogenesis. The increases of grey matter which is mostly the supporting tissue, the glial cells, we now feel play a role in the maintenance of a healthy brain. This drug/supplement was in the past thought to be helpful in the preservation of the neurons in M.S. and ALS, but recent double blind studies showed little or no effect.

Medically only Lithium Carbonate in therapeutic doses are used for the FDA indicated psychiatric uses. This requires a prescription. It is very inexpensive in that it has been generic for the last 25 years. The dose of 6O0-18OOmg day is usually required for this treatment.

I have used this mineral for the management of viral, drug induced and congenital leukopenia that seems to respond within two weeks. In these low white count returns in as much time in the hereditary variety. In drug or viral cases, it may have thwarted a significant bacterial that can result from low white blood cells. It is important that the blood is monitored periodically on long term therapy so that the therapeutic range of .5 to l.5mm/l is obtained. If lower than this, there may be poor results. If higher, there may be negative effects on the kidneys and can cause tremors and psychosis. Even in the desired range after many months lithium can cause electrolyte abnormalities and low thyroid and these too must be monitored. Much smaller doses of other non- prescriptive lithium salts such as orate, aspartate and chloride are used with varying success. I have used 300 to 350 mg daily of the prescriptive carbonate without monitoring. Time will tell if this will help those that ask for it. But at least it is safe and inexpensive. According to the complimentary literature, the orate salt is safer and more effective since it improves the specific effects of lithium many-fold by increasing lithium bio-utilization. The orotates transport the lithium to the membranes of mitochondria, lysosomes and the glial cells. Lithium orotate stabilizes the lysosomal membranes and prevents the enzyme reactions that are responsible for the sodium depletion and dehydration effects of other lithium salts. Because of the superior bioavailability of lithium orotate, the therapeutic dosage is much less than prescription forms of lithium. For example, in cases of severe depression, the therapeutic dosage of lithium orotate is 150 mg/day. This is compared to 900-1800 mg of the prescription forms. In this dosage range of lithium orotate, there are no adverse lithium side reactions and no need for monitoring blood serum measurements.

INOSITOL-A SWEET THING

2010-05-01T17:35:00.000-07:00

Vitamin Bh, or Inositol, is an organic natural chemical alcohol almost identical to glucose which exists as myo-inositol in our bodies. Inositol or its phosphates and associated lipids are found in many foods, in particular, in grains with high bran content, nuts, beans, and fruit, especially cantaloupe, melons and oranges.

It was classified as a member of the B vitamins, Bh. However, because it is produced by the human body from glucose, it is not an essential nutrient and therefore not a true vitamin. But in times of stress it may not be enough for the ideal body function. Greater amounts do help some medical issues.

Inositol and some of its metabolites function as the basis for a number of signaling and secondary messenger molecules. They are involved in a number of biological processes, including getting the stimulated insulin receptor to turn the nucleus on, gene expression, serotonin modulation and nerve conduction. Also inositol is used as building blocks of our cellular membrane, regulating intracellular calcium, and as a lipotropic.

As a lipotropic, it mobilizes fat to include cholesterol. Here it is potentiated by choline. We have used it in our weight loss patients with some success. It also rids the liver of excessive fat (NASH-NonAlcoholic SteatoHepatosis) which is almost becoming an epidemic due to our obesity. Because of fat mobilization and it’s insulin potentiating effect it has been clinically used with PCOS (PolyCystic Ovary Syndrome) effectively. Some preliminary results of studies on high dose inositol supplements show promising results for people suffering from pychiatric problems such as bulimia, panic disorder, OCD, and depression. It also helps directly (nerve improvement) and indirectly (better diabetic control) on diabetic neuropathy and other peripheral neuropathies.

Inositol has been used to decrease lithium toxicity and to strengthen hair, helping it to retain moisture. It is taken orally and is an ingredient in some shampoo formulas. There is no RDA on Inositol, but an extra 1 gram a day may be prudent. To treat the conditions noted above, 12 to 18 grams are used. It takes 3 to 4 weeks to see results. It is available in 500 mg and 1000 mg caps as well as a powder in which 1 teaspoon is 4 grams. The price is variable and may be affected by the fact that it is often used to “cut” cocaine.

SAY NO TO GMO

2010-04-18T14:48:00.000-07:00

A genetically modified organism (GMO) is a life form whose genetic material has been altered using recombinant DNA technology, with the nuclear material from different sources, to create a new set of genes. The new organism, then has a modified or even a novel set of genes. These are non-affectionately called Frankenfoods. They are referred to as Transgenic if a subset of GMOs, had the DNA inserted that originated in a different species and Cisgenic if from the same species. For conventionally grown fruit, (grown with chemical fertilizers, and pesticides), the PLU code on the sticker consists of four numbers. Organically grown fruit has a five-numeral PLU prefaced by the number 9. Genetically nodified (GMO) fruit has a five-numeral PLU prefaced by the number 8. For example, a conventionally grown banana would be: 4011 An organic banana would be 94011. A GMO banana would be: 84011. The numeric system was developed by the Produce Electronic Identification Board, an affiliate of the Produce Marketing Association, a Newark, Delaware based trade group for the produce industry. “We hate 8, but 9 is fine!” However, no store uses the 8, since most folks would avoid GMOs if they were so labeled.

The adhesive used to attach the stickers is considered Food-grade, but the stickers themselves are not. There is a trend now to individually envelope the individual product in shrink wrap that may not be so healthy in that some of the plasticer could migrate into the product. Hopefully this will be changed in the future. The best is to grow your own organic produce, or buy it from a farmer who does.

VITAMIN D

2010-04-11T04:30:00.000-07:00

Vitamin D is a prehormone of which has two major forms, D2 (or ergocalciferol) and D3 (or cholecalciferol). Classically, Vitamin D is obtained from sun exposure, food, and supplements. Just under the skin, UV light converts cholesterol to pre–Vitamin D which is absorbed into the blood steam, then travels to the liver then the kidney. In these organs it is hydroxylated each time to reach its active form Calcitriol (1,25-Dihydroxycholecalciferol). In the past, its major role is to increase the flow of calcium into the bloodstream, by promoting absorption of calcium and phosphorus from food in the intestines, and reabsorption of calcium in the kidneys enabling normal mineralization and remodeling of bone by osteoblasts and osteoclasts. In deficiency states, Rickets can occur, particularly in children. Rickets can be remedied by sunshine and, in the winter, cod liver oil.

But this sunshine vitamin does much more. It improves the function of the cardiovascular, immune, neurologic, and endocrine systems and independently extends life. But to get the best out of this molecule, it must be given in sufficient amounts such as a daily intake of at least 10,000 IU which is what one can naturally get from the sun in a fair skin individual clad in a bathing suit without sun blockers between 10:00 AM and 3:00 PM in Oklahoma in the summer, assuming the kidneys and liver are normally functioning. Of course the downside will be terrific sunburn with an increase risk of skin aging and cancer. The darker the skin by previous tanning or genetically, the less this essential substance is produced. So according to the above, most of us have a deficiency of this miracle hormone-like vitamin. This is particularly true in the elderly, Afro-Americans, living in northern latitudes in the winter most of whom have a real deficit of this molecule.

To assume that all of us have a D insufficiency and to take 10,000 IU, may be fine, but to be more accurate and to insure that we do take the correct dose and not reach toxic levels a blood test is advisable. A random serum 25-hydroxy-vitamin D level is a satisfactory way to determine the cumulative effect of sun and diet in our body. Ideal levels are between 50 and 100ng/L rather than the greater than 15 printed on the lab slip. Be sure that it is expressed in ng/L rather than in nanamoles. If given in ng/L to convert to nanomoles multiply by 2.5.

Using information from the National Health and Nutrition Examination Survey a group of researchers concluded that having low levels of vitamin D (<17.8 ng/ml) was independently associated with an increase in all-cause mortality in the general population. The study evaluated whether low serum vitamin D levels were associated with all-cause mortality, cancer, and cardiovascular disease (CVD) mortality among 13,331 diverse American adults who were 20 years or older. Vitamin D levels of these participants were collected over a 6-year period (from 1988 through 1994), and individuals were passively followed for mortality through the year 2000. Shortening of leukocyte telomeres is a marker of aging. Leukocyte telomere length predicts the development of aging-related disease, and length of these telomeres decreases with each cell division and with increased inflammation (more common in the elderly). Vitamin D can inhibit proinflammatory overeaction and slow the turnover of leukocytes, longer leukocyte telomere length is achieved by the body maintaining the optimal vitamin D concentration.

Lack of vitamin D synthesis is a possible explanation for high rates of influenza and other respiratory infection during winter. The National Jewish Hospital recently published a study showing that there is a decrease of asthmatic attacks in patients who took 10,000 IU of D daily. Vitamin D has been shown to increase the activity of natural killer cells, and enhance the phagocytic activity of macrophages. Active vitamin D hormone also increases the production of cathelicidin, an antimicrobial peptide that is produced in macrophages triggered by bacteria, viruses, and fungi. The fact that MS is more common in the higher latitudes suggests a link between Vitamin D and this disease. It is postulated that it is due to the immune-response suppression properties of Vitamin D. Early in 2010 another paper indicated that this vitamin decreases the incidence of cases and the exacerbations of Crohn's the well known auto-immune/infectious disease. D is necessary for differentiating between self and foreign proteins in a subgroup of individuals genetically predisposed to various auto-immune diseases.

Vitamin D may both prevent and decrease the aggressiveness of cancer. Vitamin D plays a role in a wide range of cellular mechanisms in the development of cancer. A 2006 study using data on over 4 million cancer patients from 13 different countries showed a marked increase in some cancer risks in countries with less sun. Vitamin D reduced an individual's colon cancer risk by 50%, and breast and ovarian cancer risks by 30%. Low levels of vitamin D in serum have been correlated with breast cancer disease progression and bone metastases. A 2006 study found that taking even the RDA of vitamin D (400 IU per day) cut the risk of pancreatic cancer by 43% in a sample of more than 120,000 people from two long-term health surveys. Also in male smokers a 3-fold increased risk for pancreatic cancer in the highest compared to lowest quintile of serum 25-hydroxyvitamin D concentration has been found. A randomized intervention study involving 1,200 women, published in June 2007, reports that vitamin D supplementation resulted in a 60% reduction in cancer incidence, during a four-year clinical trial, caused a 77% reduction for cancers diagnosed after the first year, therefore excluding those cancers more likely to have originated prior to the vitamin D intervention

A recent report from the National Health and Nutrition Examination Survey involving nearly 5,000 participants found that low levels of vitamin D were associated with an increased risk of peripheral artery disease. The incidence of this was 80% higher in participants with the lowest vitamin D levels (<17). Cholesterol levels were found to be reduced in gardeners in the UK during the summer months. Low levels of vitamin D are associated with an increase in high blood pressure.

There is a certain amount of evidence to suggest that dietary vitamin D may be carried by lipoprotein particles into and out of the cells of the artery wall and atherosclerotic plaque, where it may be converted to inactive form by monocyte-macrophages. Higher Vitamin D levels have been correlated with calcified plaques, but these are more stable than the “soft” non-calcified lesions.

I have found over 250 peer-reviewed articles verifying that Vitamin D lowers the incidence and severity of Diabetes. Also this vitamin, perhaps because of its interaction with Vitamin A, greatly ameliorates psoriasis. I advise 5,000 to 15,000 IU a day with or without food, although its absorption may be better with meals. Some docs recommend it in higher doses (50,000 to 100,000 IU) weekly or even monthly, but we were intended to get our Vitamin D daily from sunlight, so I advise daily consumption. The Upper Intake Level of vitamin D for children and adults is set at 50 micrograms/day (2,000 IU). There have been published cases of individuals who have mistakenly taken 50,000 IU daily for 2 months without undue toxicity and blood values of only 200 ng/L. Vitamin D overdose, however, can cause hypercalcemia which has these main symptoms: anorexia, nausea, and vomiting, frequently followed by polyuria, polydipsia, weakness, nervousness, pruritus, and ultimately, kidney damage which may be irreversible. In my nearly 50 years as a physician, I have never seen such a case, nor have any of my colleagues.

VITAMIN A HEALS

2010-04-04T05:42:00.000-07:00

Vitamin A is fat-soluble and, in its natural and synthetic forms, is referred to as retinoids. In the diet, these are pro-Vitamin As, from plants (carotinoids) and from animals (retinyl esters) and when absorbed are automatically bioconverted to it most active (reduced form), alpha-retinol. Alpha-Carotene, beta-carotene, and some xanthenes (cryptoxanthin etc.) either dietary or supplemental forms are transformed easily to alpha-retinol. There are rate-limiting steps that prevent the body from making too much of the active vitamin A, (alpha-retinol). Although, if too much of the precursors (carotenoids) are consumed, the benign carotenemia colors the individual. They can biologically use this excessive amount for months if they are cut off from this essential substance. Vitamin A plays a healthy role in the immune system (cellular and humeral), bones, vision, teeth, reproduction and improves tissue repair.

Clinical application of mega doses of Vitamin A or oral retinoids or carotenoids is used for prevention or treatment of Age Related Macular Degeneration, Night Blindness, Acne, Viral infections, and following trauma (surgery, strokes, heart attacks and infections) for enhanced healing. Although in 50 years of doctoring, neither I nor any of my colleagues have ever seen a case of an overdose, called hypervitaminosis A, many “real doctors” overly caution their patients of this possibility. Older age, chronic liver problems, protein malnutrition, and kidney disease may predispose one to this problem. A person who consumes too much alcohol, who has some liver problem and takes very large doses of beta-carotene may be also disposed in that there is an interaction between ethanol and this substance. Also, along with the Omega 3s, which are found in cod liver oil, large amounts of Vitamin A along with D also are present. A cheap source of Omega 3s and Vitamin D is Cod and other light flesh fish liver oils. Folks who consume large amounts of this may have toxicity. However, Vitamin A is not in other fish oil supplements in appreciable amounts. Many commercial foods are fortified with Vitamin A, but not enough to cause problems.

Toxicity includes laboratory abnormalities such as elevated liver enzymes, high serum calcium, and elevated lipids. Also GI symptoms are abdominal pain, loss of appetite, diarrhea, and liver failure. The bones become painful and brittle and the teeth fall out. Neurologically, headache, weakness, confusion and even coma have been described. Toxicity can affect the skin (dry, itching, pealing), hair (loss) and nails (brittle). Acute toxicity can occur in taking more than 500,000 IU one time. Daily intake of 25,000 IU for a month or, if predisposing factors are present, as little as 8,000IU a day can cause problems.

The RDA is 3,000 IU for males, and 2,310 for females. The official UL (Upper intake Level) is set at set at 10,000 IU daily for both sexes to prevent toxicity. Clinically, I recommend 100,000 IU for no longer than 8 days for acute infections and after surgery or trauma. For long-term treatment such as skin conditions (acne, psoriasis) 15,000 to 25,000 watching carefully for symptoms or lab abnormalities every month or so. Low serum levels (less than 45 mcg%) are associated with an increased incidence of cancer and Alzheimers as well as an increased mortality in AIDS. Vitamin A comes usually in 8,000 or 25,000 IU. One mcg equals 6 IU of alpha or beta-carotene, 10 of plant carotenoids, 4.1 from dairy product and 3.33 in animal and other fortified foods. Absorption is slightly better if taken with other fats and not inhibited when combined with other supplements or foods.

Plastic Containers

2010-03-29T06:51:00.000-07:00

The container that holds and/or heats liquid or solid food as well as water may be more important than its contents. In the last 3 decades, there has been a 500% increase of plastics used in our immediate environment to include cups and bottles. The three worse offenders are Phthalates, Biphenol A and styrofoam. These bind to various hormone receptors such as estrogen and thyroid and are known as Hormone Disrupters. Also the Styrofoam hydrocarbons in cups or other bottles can cause cancer.

Phthalates, or phthalate esters, are esters of phthalic acid and are mainly used as plasticizers (substances added to plastics to increase their flexibility, transparency, durability, and longevity). They are primarily used to soften polyvinyl chloride. Phthalates are being phased out of many products in the United States and European Union over health concerns. Phthalates are used in a large variety of products, from enteric coatings of pharmaceutical pills and nutritional supplements to viscosity control agents, gelling agents, film formers, stabilizers, dispersants, lubricants, binders, emulsifying agents, and suspending agents. End applications include adhesives and glues, agricultural adjuvants, building materials, personal care products, medical devices, detergents and surfactants, packaging, children’s toys, modelling clay, waxes, paints, printing inks and coatings, pharmaceuticals, food products, and textiles. Phthalates are also frequently used in soft plastic fishing lures, caulk, paint pigments, and sex toys made of so-called “jelly rubber.” Phthalates are used in a variety of household applications such as shower curtains, vinyl upholstery, adhesives, floor tiles, food containers and wrappers, and cleaning materials. Personal care items containing phthalates include perfume, eye shadow, moisturizer, nail polish, liquid soap, and hair spray. They are also found in modern electronics and medical applications such as catheters and blood transfusion devices. The most widely used phthalates are the di-2-ethylhexyl phthalate (DEHP), the diisodecyl phthalate (DIDP) and the diisononyl phthalate (DINP). DEHP is the dominant plasticizer used in PVC due to its low cost. Butyl benzyl phthalate (BBP) is used in the manufacture of foamed PVC, which is mostly used as a flooring material. Phthalates with small R and R’ groups (attached organic molecules) are used as solvents in perfumes and pesticides.

Phthalates are easily released into the environment because there is no covalent bond between the phthalates and plastics in which they are mixed. As plastics age and break down the release of phthalates accelerates. Phthalates in the environment are subject to biodegradation, photodegradation, and anaerobic degradation and, therefore, they do not generally persist in the outdoor environment. Indoor air concentrations are generally higher than outdoor air concentrations due to the nature of the sources. Because of their volatility, DEP and DMP are present in higher concentrations in air in comparison with the heavier and less volatile DEHP. Higher air temperatures result in higher concentrations of phthalates in the air. PVC flooring leads to higher concentrations of BBP and DEHP, which are more prevalent in dust.

People are commonly exposed to phthalates, and most Americans tested by the Centers for Disease Control and Prevention have metabolites of multiple phthalates in their urine. Because phthalate plasticizers are not chemically bound to PVC they can easily leach and evaporate into food or the atmosphere. Phthalate exposure can be through direct use or indirectly through leaching and general environmental contamination. In the Midwest, many fish in streams are banned from human cosumption because of the adulteration of the water from public and private landfills. Diet is believed to be the main source of DEHP and other phthalates in the general population. Fatty foods such as milk, butter, and meats are a major source of toxicity, since they more rapidly absorb these lypophillic chemicals. Low molecular weight phthalates such as DEP, DBP, BBzP may be dermally absorbed. Inhalational exposure is also significant with the more volatile phthalates. Looking at the Recycling triangle on the bottom of the container will give more information than you need.

The actual risks of BPA are still a matter of public debate, but over the past decade, a growing body of scientific studies has linked the chemical to breast and prostrate cancer, infertility, obesity, and neurological and behavioral changes, including autism and hyperactivity. Bisphenol A is also an endocrine disruptor, it can mimic the body’s own hormones, which may lead to negative health effects if the dosage is high. There are theories that it may contribute to body fat development. A September 2008 study in the Journal of the American Medical Association found that higher levels of urinary BPA is associated with cardiovascular disease, diabetes and liver-enzyme abnormalities.

Styrene is made from benzene which has been clearly shown to be carcinogenic. The migration of styrene from a polystyrene cup into the beverage it contains has been observed to be as high as 0.025% for a single use. That may seem like a rather low number, until you work it this way: If you drink beverages from polystyrene cups four times a day for three years, you may have consumed about one foam cup’s worth of styrene along with your beverages. Styrene migration has been shown to be partially dependent on the heat and fat content of the food in the polystyrene cups/containers—the higher the fat content and the temperature, the higher the migration into the food. Entrees, soups, or beverages that are higher in fat (like a bowl of three-cheese chili or tall cupful of Triple-Cream Frappa-Mocha Java Delight) will suck much more of the styrene out of the polystyrene container than water. Some compounds found in beverages, like alcohol or the acids in “tea with lemon,” may also raise the styrene migration rate.
PLASTIC CODE IDENTIFCATION: Containers with a 3, 6, or 7 on the bottom are the most dangerous of all. They contain a dangerous and volatile chemical called BPA, and should be avoided at all costs. Containers with a 4 or 5 on the bottom are generally considered safe. But you should probably use them sparingly. And you should never use them in a microwave.
Containers with a 1 or 2 on the bottom are the safest. These include clear water containers, as well as most cloudy containers you normally find containing water or milk. These containers, called PET and HDPE, are safe for storing food and drink. But again, you should never use them to microwave.

The #7 recycling label is a catchall indicator for plastics made with a resin other than those in the #1 to #6 designations, or made of more than one resin. The #7 category not only includes polycarbonate, but also includes compostable plastics made of organic material and other types of plastic that do not necessarily contain BPA (Bisphenol-A). For example, the new Everyday™ line manufactured with Eastman’s Tritan™ copolyester is a #7, but does not include BPA.
Of all the seven grades of commercial plastics available to manufactures on today’s market, unlucky #7 has the worst track record for leaching the chemical known as BPA into liquids or foods likely to be consumed by humans or animals. The reason is because unlike the other six composites, containers bearing the number seven are made of a composite of leftover scraps that have been ‘repurposed’ and most likely purchased at a discount. The new Nalgene water bottle is made of a “copolyester” plastic manufactured by the Eastman company with the trade name Tritan. So are new bottles by Korand Campelbak. All trumpet the fact that their bottles are BPA-free, with the implication that BPA-free is the equivalent of safe. But there is no way of knowing because the ingredients that make up Tritan have been kept secret. They could include another dangerous chemical. Since the ingredients have not been identified, no one can say. All that is known about the Tritan bottles is that, like polycarbonate, they fall into the #7 category of “other” plastics in the identification system.

When purchasing cling-wrapped food from the supermarket or deli, slice off a thin layer where the food came into contact with the plastic and store the rest in a glass or ceramic container or wrap it in non-PVC cling wrap. Avoid storing fatty foods, such as meat and cheese, in plastic containers or plastic wrap. Hand-wash reusable containers gently with a nonabrasive soap; dishwashers and harsh detergents can scratch plastic, making hospitable homes for bacteria.
“Microwave-safe” or “microwavable” label on a plastic container only means that it shouldn’t melt, crack or fall apart when used in the microwave. The label is no guarantee that containers don’t leach chemicals into foods when heated. Use glass or ceramic containers instead. Some scientists feel that the microwaves change the healthy vibrational frequency of the food to a unnatural and less compatible with our digestive/metabolic system.

2010-03-29T06:49:00.001-07:00

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Diabetes and Obesity Prevented

2010-03-24T18:22:00.000-07:00

Victoza (liraglutide)-was recently approved by the FDA to treat Type 2 Diabetes, and its ugly cousins cardiovascular morbidity (illness) and mortality (death). But will prove more valuable in the long run to prevent this 21st century epidemic. In at least 30 double blind, well-conducted research protocols, this drug performed better than any weight loss drug on the market. With a caloric restricted diet and proper exercise, this is the best product to be approved for our fattening population. Moreover, compared to other drugs, there was less muscle loss and the fat that was lost was the more dangerous intra-abdominal lard. It is well known that these fat cells release dangerous cytokines that travel to other tissues such as blood vessels causing plaque, and to nuclei producing cancer. A growing number of corpulent folks develop a fatty liver (hepatic steatosis) that quietly in some leads to cirrhosis. This drug prevents these problems as well as diabetes.

Victoza is an injectable prescription medicine that improves blood sugar (glucose) in adults with type 2 diabetes when used with a diet and exercise program. However, as an “off label use” it can be prescribed for prediabtes and 80% of obese patients have either Diabetes or Prediabetes. Insurance companies will probably not pay for off label use, although it may be cost effective to do so to save future expenditures. Victoza is in the class of natural hormones to control our metabolism, called Incretins and more specifically in humans Amylin. There are two in humans. They are GIP (glucose-independent insulinotropic peptide) and GLP-1 (glucagon-like peptide -1). Both hormones are secreted by the endocrine cells, L and T respectively in the intestinal lining in response to glucose in the gut. The glucose is from the break down of sugars and starches that we eat. The hormone, which is then absorbed into our circulation and travels to the various target organ receptors in our brain, stomach and pancreas. In these Amylin decreases our blood sugar and the desire to eat. Victoza acts like the drug Byetta that has been on the market for 3 years, also taken immediately before meals by injection, but is degraded rapidly and must be given twice daily instead of once and is less effective.

Victoza is given any time during the day. The only significant side effect is nausea that usually goes away after several weeks. By itself, there is no low blood sugar, only normalization. There is a rare case of inflammation of the pancreas in the 4,000 of the test subjects and in animals a chance of an unusual cancer of the thyroid. It comes in 3 sizes of pre-filled pen like syringes. Other weight loss adjuncts can be given with it, such as HcG, inositol, and methionine.
There are two main incretin hormones in humans. They are GIP (glucose-independent insulinotropic peptide) and GLP-1 (glucagon-like peptide -1). Both hormones are secreted by the endocrine cells, L and T respectively in the intestinal lining in response to glucose in the gut. The glucose is from the break down of sugars and starches that we eat. The hormone, which is then absorbed, goes into our circulation and travels to the various target organ receptorsThere are two main incretin hormones in humans. They are GIP (glucose-independent insulinotropic peptide) and GLP-1 (glucagon-like peptide -1). Both hormones are secreted by the endocrine cells, L and T respectively in the intestinal lining in response to glucose in the gut. The glucose is from the break down of sugars and starches that we eat. The hormone, which is then absorbed, goes into our circulation and travels to the various target organ receptors.
Victoza and Byetta are registered trademarks.

A MAGIC INJECTION

2010-03-14T16:39:00.000-07:00

Over the almost half-century that I have been doctoring, I have injected thousands of patients who were contending with local pain syndromes, using dozens of medications. These were in nerve roots, trigger/tender points, joints, tendon insertions and even into the spinal canal. In the last twenty-five years, I have used Sarapin as part of a healing, pain relieving cocktail. Although there are other specialists who do similar injections such as pain specialists, orthopedists, rheumatologists and prolotherapists, my medicines and or technique seem to work better.

Prolotherapy that has been used for over 60 years heals tendons, joints, and muscles by injection of curative substances of which an irritant initiates the therapeutic process by proliferation of new cells. It is also called sclerotherapy because it hardens limp tissue. Proliferants used in Prolotherapy are basically substances that lead to new collagen formation. Collagen is the naturally occurring protein in the body that makes up ligaments and tendons. Prolotherapy solutions help strengthen these structures by initiating the first step in the wound-healing cascade, which is local inflammation. Once the inflammation has begun, fibroblasts are stimulated. These are the cells that make the collagen. New collagen is produced, making the ligaments and tendons stronger and tighter. The solution I now employ contains Serapin from the pitcher plant and 50% glucose as the proliferant. No cortisone is used because the inflammatory process is therapeutic and the steroid is anti-inflammatory

The Pitcher plant (Sarracenia purpurea) is also known as Eve's Cup, Fly Catcher, Huntsman's Cup, and Water Cup. It looks like a pitcher or water jug. Like the Venus flytrap, it catches and “eats” small bugs. The Pitcher plant has been used for stomach and digestive problems, for urinary tract disorders, and formerly as a cure for smallpox.  Since it has been used medicinally for several millennia, it has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of pitcher plant may not be known, but I have found this to be an excellent and extremely safe medicine. Sarapin is a biological medicine – which means it is derived from a naturally occurring source (the Pitcher plant). It works by stopping pain signals and initiate healing in the nerves. It does not affect any other nerve functions or motor functions as does local anesthesia such as lidocaine.

Research published by Bernard Judovich MD in 1935, who did not only original in vitro research, but also used this preparation in over 5,000 patients, found it to be almost a miracle drug. He was chief of the Intercostal Neuralgia Clinic at the University of Pennsylvania Graduate Hospital. Later, he taught C. Hollander, the father of modern day Rheumatology who in the late sixties mentored my best friend Chucky Kahn. Dr. Hollander was chief of Rheumatology at the University of Pennsylvania Medical School for three decades and published the definitive textbook on joint injections. It was Dr. Kahn who taught me the science and the art of this technique 35 years ago.

Toxicity tests on Serapin published by William Bates, MD in the Ohio State Medical Journal in 1942 revealed that it was harmless and no evidence of tissue coagulation or sclerosis could be found. In that it is an alkaline extract, which releases an ammonium ion from the organic matrix, it was theorized that this was the active ingredient in the solution. It is known that this ion does affect nerve conduction, but Sarapin does more. Perhaps the plant's special amino acid content, because of the organisms it ingests, it was postulated that there was another yet unidentified biological fraction of the plant that is in the mix that is the active ingredient along with the ammonium molecule. We know the C fibers in the nerve carriy the pain sensation and this chemical tells them not to. Acute pain is a useful mechanism for us to know that there is something wrong that must be remedied. But once it has been identified and there is no easy fix, then to quiet these C fibers makes sense. Serapin does not only that, but also initiates the healing process.

Science probably will never know the true mechanism of action because SarapinR lacks profitability and marketing. As a biological medicine that has been in use for over 70 years, Sarapin cannot be patented. As a result, it can be made and sold on the open market without the huge price mark-up that are afforded to patent protected medicines. (Patent protection is the same reasons why branded drugs are so much more expensive that generic drugs that have the same chemical composition.) Not surprisingly, Sarapin has never had the financial sponsorship of a large pharmaceutical company to pitch it to doctors via the pharmaceutical company’s national network of drug representatives. I tend to believe in success and despite the fact that more research is needed, my patients have had much success. I use lots of it. Thank God there is a manufacturer.

SHOULDER PAIN

2010-03-08T10:17:00.000-08:00

The three main causes of chronic (long standing) shoulder pain are Impingement Syndrome (from the Rotator Cuff)-72%, Adhesive Capsulitis (Frozen Shoulder)-12% and Bicipital Tendinitis-6%. The other 10% are from rare problems that are not obvious such as a missed fracture or bone tumor. Of course this assumes that you went to a good doctor that has ruled out a pinched cervical spinal nerve or one of the several shoulder bursas that can become inflamed. The main source of impingement is where the insertions of the Rotator Cuff tendons enter onto the head of the upper arm bone (humerus) from the scapula. There are only narrow conduits for the muscle/tendon to enter and exit. With damage to these insertions such as injury or tear of the tendon/muscle they are unable to slide through that narrow space without a slight hang-up that produces anything from discomfort to pain or distinct inability to do that required motion.

The rotator cuff is made up of four muscles from the scapula. The rotator cuff helps to lift and rotate the arm and to stabilize the ball of the shoulder within the joint. The rotator cuff is made up of four muscles and their tendons. These combine to form a " cuff " over the upper end of the arm (head of the humerus). These are the Supraspinatous, Infrascapular, and the Terres Minor on the back side and the Subscapular on the underside of the scapula. Depending on the specific tendon involved there are 5 different anatomical sites that are impinged. The most common is with damage to the end of the Supraspinatus muscle. The pathology varies from just swelling of the tendon (Stage I) to a partial tear (Stage II) to a full tear (Stage III). Usually Stages II and III are related to acute trauma and commence right after the injury, while Stage I is due to overuse of that muscle group in overworking that muscle such as pitching or repetitive light weight lifting. Usually these problems occur in folks over the age of thirty.

Some of the signs of a rotator cuff tear include:
• Atrophy or thinning of the muscles about the shoulder
• Pain when lifting the arm
• Pain when lowering the arm from a fully raised position
• Weakness when lifting or rotating the arm
• Crepitus or crackling sensation when moving the shoulder in certain positions

Symptoms of a rotator cuff tear may develop right away after a trauma, such as a lifting injury or a fall on the affected arm. When the tear occurs with an injury, there may be sudden acute pain, a snapping sensation and an immediate weakness of the arm. Symptoms may also develop gradually with repetitive overhead activity or following long-term wear. Pain in the front of the shoulder radiates down the side of the arm. At first, the pain may be mild and only present with overhead activities, such as reaching or lifting. Over the next several weeks, it is present when just moving the shoulder. The patient, however, has no problem lying on their shoulder in bed.

A pinched cervical nerve has more of a burning sensation and is brought on by moving the neck rather than the upper arm.. It also has a specific nerve root anatomic distribution called a dermatome noted on many charts of which one is up on your doctors wall. A specific test is a nerve conduction study or maybe an MRI of the neck which has as many false positives as negatives. The test that I recommend is a “drag pin exam” where the observer takes a safety pin and drags it lightly over the affected area of pain manifestation, the dermatone, and more “friction” is noted on the pin at the same time the patient feels an accentuation of the discomfort. Very rare problems such as thoracic outlet syndrome, or brachial plexus injury will take more studies to confirm, but can be usually ruled out by a good history of the cause and the symptoms. With the bursitis, the sensitive spot is directly over the anatomical location. Also movement of the arm will increase the pain at that tender place.

Another shoulder problem is Bicep Tendenopathy where this structure is damaged due to trauma and occurs acutely in people under the age of 30. Most likly there is a labial tear in the Gleno-Humeral junction. This results in instability of the shoulder joint and can lead to dislocation of the shoulder joint. When the arm is extended by the observer, immediately the patient feels this is an impending problem and will wince or push the observers hand away lest his shoulder will come out of the socket. In older people, the tendon may rupture and a “popeye” muscle will occur. In the past these were operated, but now we leave them be and they generally resolve with the knot shrinking over the years and only a small loss of bicep muscle strength. The other head of the biceps takes over.

Capsulitis or frozen shoulder is usually the result of unresolved tendon impingement. Rehabilitation with physical therapy helps, but they will never be as good as new. Certainly surgery is not the answer in that their rehab will be more prolonged and not as successful. Next week we discuss the magic of a shoulder injection.

New Help for Diabetics and a Skinnier You

2010-03-01T08:42:00.000-08:00

INCRETINS which were discovered in the saliva of a Gila Monster in 1965 have been on the market for the last two years in the synthetic form, mainly pramlitide with the brand name of SYMALIN . The incretins are at least two hormones that work naturally to balance insulin secretion and sugar (glucose) regulation from other endocrine target organs. There are two main incretin hormones in humans. They are GIP (glucose-independent insulinotropic peptide) and GLP-1 (glucagon-like peptide -1). Both hormones are secreted by the endocrine cells, L and T respectively in the intestinal lining in response to glucose in the gut. The glucose is from the break down of sugars and starches that we eat. The hormone, which is then absorbed, goes into our circulation and travels to the various target organ receptors. Therefore in addition to the food we consume this is yet another mechanism that controls our metabolic state and fat production. The excess calories that we absorbed if not going to manufacture protein produces fat! In yesteryear we needed this extra fat for times of famine. But now in times of plenty it is harmful and in those who are so genetically disposed, which is 25% of our population, leads to excess blood sugar (Diabetes).

The PANCREAS has both Alpha and Beta cells. The Beta secretes INSULIN and AMYALIN, while the Alpha, produces GLUCAGON. Glucagon stimulates the liver to release glucose from its store of glycogen and to manufacture glucose from fat and protein. This raises the blood sugar and is normally secreted in time of need and in adrenal response to stress. Hence glucagon is elevated in physical trauma and mental pressure which raises blood sugar. AMYLIN or artificially SYMALIN, suppresses Glucagon release thus lowering the blood sugar by slowing its production from the liver.

Symalin also binds to the receptors in the area postrema in the BRAIN. This causes satiety and suppresses the appetite. Moreover this substance again mimicking Amylin slows STOMACH emptying into the intestine causing less food (glucose) into the digestive tract for absorption. These mechanisms together lower the blood sugar in diabetics and decrease fat production in the normal person. Another form of Amylin is BYETTA also used to treat diabetes. Both of these are by subcutaneous injections. The Symylin is given before meals with insulin and the Byetta with or without insulin. It is more than coincidence both are manufactured by the same company, Amylin Pharmaceuticals, Inc. Both are overridden by a sudden decrease of blood sugar, but because of the extreme effect of taking insulin, the usual dose can be reduced by as much as 50%.

Since both Byetta and Symalin decrease appetite by controlling both the brain and stomach they do help to weight loss. I have given both in patients on off- label use for weight (fat) control usually in pre-diabetics to prevent weight gain and in real diabetes. In the future there will be a long acting Byetta given weekly and a Symalin combination. The later will be with two natural hormone look a-likes. LEPTIN and NEUROPEPTIDE –Y. All three of these will work in concert for weight reduction, which is so needed in the 21st century.

Energy Balance and Weight Loss

2010-02-20T17:34:00.000-08:00

The law of thermodynamics states that there is no free energy. Energy in equals energy out! All this is to say that if one consumes less energy (measured in calories)than is burned that a person will loose weight. But to do that some may have to eat like a bird and work like a horse. Others can eat like a horse and work like a bird and still lose weight. The difference is in the metabolic rate and lifesyle, not excercise. As mentioned on last week's blog, caloric burn can easily be measured on the $50 test called a RESTING MEATABOLIC RATE (RMR). The burn is determined by Exercise, Lifestyle Activity and RMR and the supply is determined by food consumption-what we eat. Although all calories consumed are not the same, but this is a topic for another blog, but for now let us assume they are.

Exercise, although healthy, burns a surprising little energy. Three hundred calories for an hour of very strenuous workout is about all one can get out of it-an extra candy bar a day. However, Life Style Activity is just moving through one's daily doings and can be greatly modified. An increase of simple activities such as never using an elevator, parking two blocks from work, walking up and down your house stairs twice instead of the once that you would ordinarily do and the technique of dynamic tension will double your caloric outgo in this equation of health.

Dynamic tension is working two opposing muscle groups against each other with out moving the limbs to which they are attached. Pushing your palms together as hard as possible or “making the biceps muscle” hard are examples. This can be done many times a day at times of wait like at red lights, standing in line, while talking or waiting for the party to answer the phone. This will loose fat in two ways. One, by burning extra calories by using these and two, building muscle. For every pound of muscle one makes, it takes a hundred calories a day to service and maintain it. Not only that but it will decrease one's anxiety during the delay which is interpreted as stress by many type A personalities and produces harmful free radicals and fat-gaining cortisol. It is said that Charles Atlas, the body builder of the 1950’s kept his body in good muscular form and in prime health by this method.

Again one's exercise must include heavy resistant (weight) training to build muscle that will translate into raising the RMR and loss of fat. Other ways to increase the RMR is by supplements as mentioned last week. Medically, hormones are adjusted by giving that which is missing, not so much by its decrease in the blood, but with the natural down regulating of insulin, thyroid, and testosterone receptors. Aging, free radicals and organic disrupters like Biphenol A found in most plastics Pthalates that leached into our water supply from modern farming is only now catching the eye of government concern. Lipotropics such as methionine, choline, inositol and HcG do this as well as giving more of the necessary hormone particularly thyroid despite normal blood tests. As noted on last week's blog, medical doctors are finially recognizing that low thyroid does exist despite normal blood tests. This is Type II hypothyroid and is diagnosed today as it was 75 years ago by the RMR.

So if one is “dieting” and it is not working or eating the same foods and now gaining fat, consider the above. Dieting is not an answer to the problem but a short term fix until lifestyle will prevail.. That is why in a large study done recently 94% of those that lost significant weight dieting found it within the ensuing two years. With the help of the RMR, your health care worker can not only guide you into achieving your weight goal which is not too difficult, but keeping it there for the rest of your life.

BMR - An Underused But Vital Medical Test

2010-02-16T13:06:00.000-08:00

Basal metabolic rate (BMR), and the resting metabolic rate (RMR) are medical tests used extensively in the last century but has been all but forgotten by modern medicine. However they are still important in this era despite the marked advance of other technology. These are useful in many nutritional problems but it is particularly helpful in weight loss and thyroid disease. They cost $50, take 15 minutes and are done in the doctors office These measurements are the amount of energy used resting after fasting done at room temperature.. The release of energy in this state is sufficient only for the functioning of the vital organs, such as the heart, brain and liver. They decrease with age and loss of muscle and altered by hormones, drugs and diseases.

Cardiovascular fitness has been shown in the 1990s not to correlate with BMR and RMR, when fat-free body mass was adjusted. New research has shown aerobic exercise does not increase resting energy consumption. But stress levels can. BMR and RMR are measured by gas analysis through by direct calorimetry with devices such as the Reevue but a poor estimation can be acquired through an equations using age, sex, height, and weight.

Whether we gain or loose weight is dependent on our food consumption and energy expenditure. About 70% of a human's total energy outlay is due to the basal life processes of our vital organs. About 20% of one's energy expense comes from physical activity and another 10% from digestive and caloric heat processes. These mechanisms are referred to as Thermogenesis which comes from shivering and the volume of innate and genetic brown fat endowed to the individual. Life requires an intake of oxygen along with coenzymes (vitamins and minerals) to metabolize food. Anaerobic such as resistance training, but not aerobic builds additional muscle mass, which is fat free mass. Additional fat free mass will lead to a higher resting metabolic rate.

The regular Aerobic exercise is beneficial for cardiovascular reasons as well as direct calorie burning. Recent studies indicate that heavy endurance exercise increases resting metabolism. But light cardiovascular training has not the same effect. Continuous moderate exercise such as jogging or doing many light weight repetitions does consume calories, but not an “after burn”. On the other hand Aerobic Interval Training (AIT) or Progressively Accelerated Cardiovascular Exercise (PACE) not only consumed calories but also gives a significant after burn by increasing the BMR and RMR for 72 hours. This is why I recommend Burst Training (pushing to temporary respiratory fatigue)when doing aerobics. For example, when jogging, periodically run so fast that one is unable to do more than a minute because of extreme shortness of breath. This pushes past the aerobic state into an anaerobic one with an oxygen debt! This then resets the metabolic rate to a higher level. Doing a RMR/BMR not only predicts who will be overweight (obesity), but what how much one needs to do to loose that fat. For example there are ways to increase thermogenesis such as cosumption of bitter orange, ginger, capacisin, ephedra, guarana, and caffeine.

BMR/RMR is very helpful in diagnosing thyroid disease. In an overactive thyroid it is high and low in hypothyroidism, which has several varieties. A Secondary in which the pituitary is at fault and two Primaries which are Type I Hypothyroidism in which there is suboptimal Thyroxin production, but even more common is the Type II in which there is enough Thyroid Hormone, but the cellular receptors are blunted. The cell is less metabolically active despite adequate amounts of Thyroxin in the blood. With Type I the T4, and T3 are low and the Pituitary tries to stimulate the Thyroid by making more TSH that therefore is higher than normal. With Type II like in Type II Diabetes in which there is enough insulin but the cells are resistant to the effects of the hormone all these blood tests are normal. It is almost impossible to diagnose Type II Hypothyroidism for certain and to properly treat it without these test of metabolism, the BMR/RMR. In this day and age when we ingest so many hormone receptor disrupters in our pollutants (pesticides, plastic molecules etc) in our food and drink, no wonder why we are having an epidemic of Type II Hypothyroid that we physicians ignore. If you are having trouble losing weight or have symptoms of low thyroid such as fatigue, cold intolerance and yet have normal thyroid tests, get a RMR. You deserve to be fixed.

DIABETES BY THE NUMBERS

2010-02-07T13:17:00.000-08:00

The American Diabetes Association has recently endorsed the new criteria of Hemoglobin A1c (Hgb A1c) of 6.5% or greater to make the diagnosis of Diabetes 1 or 2. This blood test which has been around for 20 years is now highly standardized, and commonly preformed in physician's office with a pin prick of blood. The Hgb A1c is a reflection of the last 3 months of sugars. If the sugar was 100 all the time it would be 4.5. The higher the sugars, the higher the number and the worse outlook for the patient. The older standard of a fasting blood sugar of greater than 126 or a 2 hour after eating level greater than 200 (or 2 hours after 75 gms glucose), in a patient with classic high blood sugar symptoms, a random blood sugar of the same 200 makes the diagnosis of diabetes.

Many known diabetics test their fasting blood sugars. This is in error in that this is usually the lowest blood sugar of the day, after all night fast and gives the patient a false sense that their diabetes is doing well. Let them do it 2 hours after a meal particularly a high carbohydrate one and it will give a more accurate status of the diabetes. The only time a fasting blood sugar helps is when one suspects a low level.

Most doctors would be happy if the A1c would be 7% or less. Not this doc. I want it under 6! Studies have shown, the closer the sugar is kept to 100, the less complications from the diabetes will occur. However, if very tight control is sought and the patient is taking sugar lowering medicines, the possibility of too low a sugar (hypoglycemia) could happen with dire and even lethal consequences. Levels above 8 % are associated with a significant all-cause mortality risk.

The doctor and you should know that anemia causes a false lowering of the A1c. Also older folks have a higher levels than younger people, and blacks have higher levels than whites for any given level of sugar. Nine percent of the population are “high glycators” or “low glycators” and give a falsly high or low reading in these cases This can be easily determined over the next several months with blood sugars or immediately with another similar test, a fructosamine.

The Metabolic Syndrome, a more malignant form of prediabetes or “increase risk for diabetes” is a level of Hgb A1c of 5.7. This corresponds to a fasting blood sugar between 100 and 125 or a 2 hour after eating height of greater than 140. This syndrome has in common with diabetes ear creases and the morbid complicators of diabetes. These are increased triglycerides, blood pressure, abdominal girth and a low HDL (healthy/good) cholesterol. In particular that individual has a 7 times higher incidence of having a cardiovascular event in the next 5 years than a person of the same age and sex without these gruesome characteristics!!

COCONUTS FOR THE BRAIN

2010-02-05T16:41:00.000-08:00

The brain uses mainly glucose for its fuel, but works far better when fed ketones. Ketogenic diets have been used in medicine since 1924 initially to prevent seizures, and recently to treat degenerative neurologic diseases such as Multiple Sclerosis, ALS, Strokes, and Dementia. Thirty years ago, Medium Chain Triglycerides were found to be metabolized into ketones by the liver. No longer did one have to eat the very stringent ketogenic diet, which was 70% fat 25% protein and only 5% carbs. A person could ingest a given amount of MCTs and produce their own ketones. The ketones do supply cerebral energy metabolism (provide alternative fuel), protect cerebral function, suppress cerebral edema and reduce the extent of cerebral infarction in brain injury.

The presence of ketone in circulation, even at low levels, increases cerebral blood flow by as much as 40%. Ketones also prevent diseases involving free radical damage such as occurs in coronary reperfusion, diabetic small blood vessel disease, inflammatory bowel disease, and pancreatitis. MCTs do not behave like the more common long chain fats. Because of their shorter structure, they are metabolized directly in the liver into ketones, rather than going into storage in fat cells. They are used as an alternative source of energy when glucose stores are exhausted.
Two years ago a drug company applied for and received a patent to bring this out as a prescriptive functional medical food. The Acerra Company brought out Axona® to treat Alzheimers disease.

The neurons work 30% better using ketones rather than the usual glucose. It is like putting high-test gas in an old high compression engine, it runs much better without the "pings". In a review article on Alzheimers in this week New England Journal of Medicine, the metabolism of the brain cell was detailed as "Type 3 Diabetes" in which the glucose receptors were blunted and could not transport the sugar into the brain cell to produce ATP, for cellular energy. Not only could the cell take in the ketone, but more efficiently made ATP (energy) from it. MCTs have been medically used in the past for feeding premature infants, recovering surgical patients and for malnutrition. Off label it has been used for liver support, antimicrobial therapy, enhancing the immune system and to increase athletic performance. Contrary to popular opinion these tropical saturate fatty acids inhibit atherosclerosis instead of producing it. They also decrease appetite and help people lose weight much like the ketoses of Atkins diet. Also there is not a tendency for diabetics to have problems of "diabetic coma", keto-acidosis with MCTs.

Coconut oil, which is a misnomer, in that it is solid at room temperature contains over 60% MCTs. Not only is this a healthy cooking oil in that it has a high smoke point, but it has a pleasant taste. It can be used in baking, oatmeal, spreads and salad dressings. Costing $8 for 14 oz for organic and $5 for the regular it is almost a best buy for this cooking oil that doesn't smoke unless the temperature exceeds 280 degrees. Butter smokes/burns at a much lower temperature producing free radicals that rust our body. Research at NIH by Richard Veech, MD. indicates that ketones which are made from coconut oil and MCTs work better since a higher dose is more easily achieved. However, they are not yet available.
To treat Alzheimers today and give that high of a dose of MCTs (20 grams per meal), you need to combine 16 oz. of MCT oil with 12 oz. of coconut oil and use 7 teaspoons at a time. It should be stored at room temperature, and increased gradually from 2 teaspoon per meal up to 7 teaspoons. Given too much at a time initially will cause abdominal cramps and diarrhea.

Although costing twice as much, one can use Axona® which may be paid by some insurances and for sure by flex plans. It has a pleasant coconut taste when used as a cold drink with a meal. There are no omegas 3s in this mixture, therefore I recommend some fish or fish oil during the day because this compliments the MCTs for improved brain function. Several varieties of Alzheimers and the APOE negative types respond better to this therapy. Since the brain starts developing defects in glucose metabolism decades before the development of the disease, those who have a strong family history, or memory problems earlier in life might consider doing this treatment now!

Exercise 2010

2010-01-26T13:48:00.000-08:00

These following four types of exercises will keep you younger than your years – stretching, balance, cardiovascular and strengthening.

STRETCHING prevents injury to the muscle and its tendons. Formal exercises such as yoga, the exercise ball, or just plain yawning are healthful. Contrary to popular opinion, pulsing stretches should be performed as a gradual tightening until mild discomfort of the muscle group, holding for a brief time and then relaxing. This maneuver should be repeated three times. Hands to the sky, touching the toes, twisting (torquing) the abdomen and chest on the pelvis from side to side and pulling back the ankle to the buttock are some examples.

BALANCE is particularly helpful in older people. They prevent falls with subsequent broken bones. Programs like Tai Chi and dancing are great, as is the big ball. After feeling confident sitting on the ball, try to recover after moving on the buttocks to a near-fall. Recently, the half ball has become inexpensively available to stand on. Another exercise is standing on one foot for 30 seconds without holding on.

STRENGTHENING exercises builds muscles, as well as turning fat into muscle. Weightlifting, resistance machines and holding one’s own weight against gravity (push-ups) are recommended. Fewer repetitions (reps) with heavy weights are suggested. Between 8 and 12 reps with 30 second between each set are advised. The last rep should be so difficult that one could not do another one to “save their life”. Bench and military presses, biceps curls and that one could not do another one, and shrugs are examples of these.

CARDIOVASCULAR ENDURANCE includes fast walking (to slight shortness of breath), running up and down stairs, dancing, stationary bike, treadmill, running, jogging, or just a CD or videotape with aerobics. During this time, 4 separate periods of peak effort are recommended for 60 seconds, such as running as fast as one can, or pushing the pedals as fast as possible. This builds up the mitochondria (the individual cellular motors) within the muscle fiber, enhancing the metabolism of fat, decreasing insulin resistance, and thus preventing the cardiometabolic syndrome and diabetes. Moreover, this improves the most important muscle of the body, the heart.

HOME TRAINING is doable. Certainly it is easier to exercise in a Gym and with a training partner who will passively hold you responsible if you do not show up. But if that is not possible, a workout can be done at home without any special equipment. Such exercises as SQUATS and PUSHUPS, with the latter putting the toes and knees for women and the toes only on the floor for men, lying prone and pushing up with their arms. Another is a DIP, with the back of the feet on one chair, the hands on the arms of another chair and with the buttocks between the chairs, extending and flexing the arms. The abdominal muscles can be exercised by SITUPS, which is lying supine on the floor with the toes under a piece of heavy furniture and sitting up, touching the elbows to the knees. Several variations of the SITUP are done, such as touching the elbow to opposite knees, and sitting only half way up (CRUNCH). Also standing facing a wall and putting the hands on it three feet or so from the floor and pushing back. These resistance exercises build muscle. Resistance exercises help more for weight loss than the cardio exercises. Another method of building healthy muscle is ISOMETRICS. Here one contracts opposing muscle groups simultaneously and hold that tension using good posture as tight as one can for at least a minute. It is helpful to do this looking into a mirror. For every one pound of muscle an individual puts on, the body consumes an extra 100 calories extra to maintain and service that muscle. To put on 5 pounds of muscle, one can have 500 free calories a day, or if eating the same diet, this adds up to 3,500 calories a week, which is equivalent to 1 pound of weight loss! Jogging requires only a set of running shoes and the “track” is just outside your front door. Do not forget about the all important bursts of fast running during the jog. Once the ideal weight is obtained, the “appestat” will be reset to maintain a healthy better looking body.

THE CAT IS OUT OF THE BAG

2010-01-26T13:34:00.000-08:00

CAT (Computer Axial Tomography, now commonly called CT scans, are greatly over ordered in the United States. Given the highly profitable nature of diagnostic imaging, it’s no wonder this procedure is overused. Costing roughly $600 per study for overhead (which includes office space, employees, and a Radiologist), the upkeep on the scanner (which includes the cost, and repairs to the unit when heavily used), and a $1500 reimbursement from the insurance companies, indeed this procedure is a lucrative business. Some areas of the country do eight times more CT scans than other parts, yet do not have any detectable increases in health, only more expense. Despite the fact that the average American pays more for health care than any other nation, it is 16th in health and longevity. Japan is number one, followed by the Scandinavia. Moreover, when over ordered, the CT scans are dangerous!

CT scans are risky in three ways. One, the patient is overexposed to radiation. Second, it leads to more dangerous and unnecessary invasive procedures. Thirdly, the contrast used with most of the scans ruins the kidneys. It takes just one CT scan to equal up to 450 chest X-Rays. This translates to an extra 30,000 cancers each year. Furthermore, the radiation is accumulative and grows more each year. It may take 25 years for the cancer to appear. The mortality rate of these tumors, despite early pick-up and good treatment, is 50 percent.

The iodinated contrast material which is injected into the veins, is excreted by the kidneys. It is hypertonic and “dehydrates” the sensitive micro vessels and tubules of this organ. Also 3% of the population is sensitive to these organic iodinated molecules. Very rarely could one have such an acute allergic reaction and die suddenly! To avoid renal destruction, the Doctors should make sure the kidneys are working adequately by doing a serum BUN and Creatinine, both of which are Renal Function Tests. If the BUN is below 25 or the Creatinine is more than 1.8, the contrast is used for better definition. However even with normal function, unless the person is more than adequately hydrated and/or they take strong antioxidants such as N-acetyl cysteine they lose function every time they have contrast. It is additive over the number of studies a patient has over their lifetime. NAC, 600 mg three times a day on the day before, the day of, and the day after the study is advised. Lastly, CT scans are in many cases overly sensitive and pick up incidental findings of no real clinical relevance. Our medical profession should let “sleeping dogs lie”, but do not for reasons that may be not that altruistic. The medical mind-set taught to young doctors is supposed to be the more the better in our land of plenty, but what it really does is make more money for physicians by increasing the number of procedures and operations. Of course this also leads to heightened anxiety, further testing, biopsies and unnecessary surgeries creating earlier disability and death for the poor patient. With new healthcare legislation around the corner, the problem will only get worse. Because most patients are not told the full extent of the risks and consequences of these proedures, they are ultimately scared into invasive actions that are unnecessary. It is estimated by some that CT scans kill almost a million people a year! CT scanning is a great technology and do help to extend lives by better and earlier diagnoses, but should be used judiciously!

THE WONDERFOOD QUINOA

2010-01-26T13:33:00.000-08:00

As many as 10% of us have Gluten Intolerance (see blog 12/27/09) and QUINOA (keen-wah) is a storehouse of wonderful nutrition and can be used as a wheat substitute. It has 2 grams of magnesium, 6 of protein and 3 of fiber in a ¼ cup! Quinoa is a grain-like crop grown primarily for its edible seeds. It is a pseudocereal rather than a true cereal, or grain, as it is not a grass. As a chenopod, quinoa is closely related to species such as beets, and spinach. Its leaves are also eaten as a leafy vegetable, much like amaranth, but the commercial availability of quinoa greens is currently limited.

Quinoa was of great nutritional importance in Andes mountain civilizations for over 5000 years. Locally referred to as “Mother Grain”, being secondary only to the potato, and was followed in importance by corn, it kept the Incan armies strong and robust. In contemporary times, this crop has become highly appreciated for its nutritional value, as its protein content is very high (12%–18%), making it a healthy choice for vegetarians and gluten intolerants. Unlike wheat or rice (which are low in lysine), quinoa contains a balanced set of essential amino acids for humans, making it an unusually complete protein source almost as complete as the milk protein, casein. Lysine is one of eight essential amino acids - building blocks of protein - that the body cannot manufacture on its own. As a building block of protein, lysine benefits the body by contributing to growth in babies and children. Lysine benefits also include production of carnitine, a substance that converts fatty acids into energy and lowers levels of LDL cholesterol.
In addition, lysine benefits the skeletal system by contributing to the production of collagen, the protein used to make bone, tendons, cartilage and connective tissue. Calcium absorption is also facilitated by lysine, and lysine benefits the skin by helping to maintain its health and elasticity.

Quinoa is easy to digest and is ideal for the first “grain cereal” given to infants. Many doctors feel giving oats, wheat, and barley to infants sets them up for a life long allergic problem. Because of all the above characteristics, quinoa is recommended by the Food and Agriculture of the United Nations for under developed countries and is being considered a possible crop in NASA's Controlled Ecological Life Support System for long-duration manned spaceflights.

Raw quinoa has a sapin coating that is irritating to the digestive tract causing gas, cramps and diarrhea and must be washed off before consumption. Most boxed quinoa has been pre-rinsed and some even sprouted (germinated) for convenience. Sprouting any grain by leaving it in room temperature for a given period of time enhances its healthy attributes. Quinoa may be germinated in its raw form to boost its nutritional value by leaving it in water for only 2 hours at room temperature. Wheat takes 12! Germination activates its natural enzymes and multiplies its vitamin content.

A common cooking method is to treat quinoa much like rice, bringing two cups of water to a boil with one cup of grain, covering at a low simmer and cooking for 14–18 minutes or until the germ separates from the seed. The cooked germ looks like a tiny curl and should have a slight hardness to it (like al dente pasta). As an alternative, one can use a rice cooker to prepare quinoa, treating it just like white rice (for both cooking cycle and water amounts). Vegetables and seasonings can also be added to make a wide range of dishes. Chicken or vegetable stock can be substituted for water during cooking, adding flavor. It is also suited to vegetable pilafs, complementing greens like kale and spinach. Quinoa can be added to salads and other cold foods to enhance filling of the stomach and give a health boost. Quinoa can serve as a high-protein breakfast food mixed with xylitol (see blog 12/21/09), almonds, or berries. It is also sold as a dry product, much like corn flakes. Quinoa flour can be used in wheat-based and gluten-free baking. For the latter, it can be combined with sorghum flour, tapioca, and potato starch to create a nutritious gluten-free baking mix. A suggested mix is three parts quinoa flour, three parts sorghum flour, two parts potato starch, and one part tapioca starch. Quinoa flour can be used as a filling for chocolate.

This powerhouse nutritional product is available at some avant guarde grocery stores, but is readily purchased at most Health Food Shopps. “PEARL QUINOA-Soul Food of the Andes” has recently been promoted by ALTER ECO a Bolivian coop that is democratically managed by its farmers for sustainable development with profits used for organic programs and is the product that we have used with ease. It comes in easily sealed bags for about $8/lb. For all those interested in their own and the health of their loved ones, I sincerely recommend this nutritious and versatile health food.

OMINOUS OMELETE

2010-01-26T13:30:00.000-08:00

Eggs have been vindicated in the last two decades as a villain causing cholesterol plaque build up in our arteries or have they? Actually, it depends how they are cooked. It is true egg yolks contain the highest amount of cholesterol of any type of cuisine, but it is also high in healthful micronutrients such as choline for our brain and cysteine the all important building blocks of protein formation. It is not the cholesterol we eat, but the cholesterol our body produces depending on our genetics and the other kinds of ‘foods” we eat. In an individual prone to develop high cholesterol and atherosclerosis, trans fats, sugars and oxidized foods are the culprits. The cholesterol in the egg is oxidized when cooked in certain ways that expose it to air and heat. Therefore scrambled eggs or omelets have a large amount of oxidized cholesterol that clog up our blood vessels if we are genetically unfortunate as is 30% of our population.

In the past, I described ale, ape, and age. These stand for Advanced Lipid End products, such as in eggs, Advanced Protein End products that are in roasted foods and Advanced Glycosylated End products such as in caramelized ones. These are pro-oxidants that “rust” our arteries by oxidizing our body’s cholesterol after production. Although, tasting better than the non-oxidized portion, these delicious crunchy morsels are dangerous to our health in causing not only cardiovascular disease, but also cancer! In cooking any food, the hotter, it is, the more dangerous it becomes. The worst method is grilled, followed by roasted then baked in which the food is heated up in excess of 212 degrees. Far better is poached, braised, boiled, and crock pot methods. In the preparations these items because of the water never exceeds 212 degrees, and there is little or no ale, ape or age and no oxidized cholesterol. The latter is the worst of all since it is directly absorbed into our blood stream and impacts directly on our artery wall.

Poached or boiled eggs or maybe a fried egg are OK, since the cholesterol containing yolk remains intact. But even fried eggs have some ape; the delicious brown “skirt” around the white. It also has ale from the butter or oil used in frying. This is why in general fried foods are not healthy. Antioxidants we should be consuming do mitigate some of this. Since I have heard of ale, occasionally, I will eat a fried egg, rarely an omelet and never scrambled one!

A CURE FOR GLUTEN SESITIVITY

2010-01-26T13:29:00.001-08:00

Celiac disease is vastly underdiagnosed. It takes on average 11 years between the first appearances of bowel symptoms to its diagnosis. To add insult to injury, many times it is silent in the intestine and extra intestinal problems occur. The most common significant “allergen” known to civilized man is a protein found in wheat, gluten. As many as 10% of us are sensitive to it. Gluten is also in rye, spelt and triticale and kamut. Although not all Docs agree it is found in Beans (dark), Oats, and peanuts. Non-Gluten cereals are rice, millet, tapioca, buckwheat, flaxseed, millet, teff, and quinoa (KEEN-WA). It is not in vegetables and meat. Gluten is used in 90% of all protein-fortified products. When this foreign protein is ingested, it attacks the intestine, causing inflammation and poor absorption of nutrients, but also the gluten antibodies destroy some of our other tissue. This genetic malady is termed CELIAC DISEASE, when it involves the intestine so that malabsorption occurs. But that is only part of the problem. Partially digested protein is also absorbed. These peptides play havoc on many of our already stressed systems as noted below. The age of onset is from infancy to senility. In children neurological symptoms, short stature and anemia happen. In adults skin rashes particularly dermatitis herpetiformis,osteoporosis,anemia,infertility,irritable bowel syndrome,GERD, neurological symptoms and autoimmune diseases such as low thyroid (Hashimotos disease) arthritis and vitiligo are noted. Lymphoma and other Cancers are more common in folks who have sensitivity and still consume gluten.

Gluten intolerance is frequently caused by some preceding damage to the lining of the intestines from toxic exposures, infections and medications. Gluten intolerance like true Celiac Disease is treated by avoiding gluten. I tell these poor people to stay away from BROWS where B stands for Barley and Beans (green), R for Rye, O for Oats, W for WHEAT, and S for Spielt The three criteria for true Celiac Disease are genetic predisposition, the consumption of gluten and a triggering event, which could be physical or emotional. With the loss of the integrity of the intestinal lining, the small intestine fails to absorb the micronutrients, which affects all tissues of the body. Rare, are the typical symptoms related to just the gastrointestinal tract with abdominal pain and distention, diarrhea and weight loss.

We have evolve as cereal-less Homo sapiens for almost 500,000 years. The first wheat was accidently noted and occasionally gathered wa 8,000 BC and in England 5,500 years ago were the first wheat farmers. So we as a species went from great hunters to canaries in only 10,000 years. Science knows it takes much longer to change our genes to adapt to this gluten protein from being a foreigner to what our body recognizes as a “non-intruder”. There was no wheat in the Garden of Eden and Adam and Eve with their myriad of decedents were not suppose to eat this "food"

At least a third of Gluten Intolerents have lactose problems. The consumption of pizza, of which the dough is an extremely potent reactant, along with the cheese can cause acute symptoms within 20 minutes. Discovered in Poland in 1953, but not known to the Western World until popularized by the English expert James Braly MD, Celiacs have a foreshortened 5th finger (Bralys sign). This is to say that the end of the pinky is shorter than the last joint of the ring finger. To document the diagnosis, many doctors do a a few blood studies that are only positive if the patient has terrible bowel disease when the blood is drawn and still is consuming gluten. A STOOL study for less than $100 can be ordered on-line from www.enterolab.com. Or your doctor can contact the special laboratory, whose address is Intestinal Health Institute, P.O. Box 570744, Dallas TX., 75357. This test is called an antigliadin antibody. It is only positive if the individual is still eating gluten. Also from the stool genetic studies can be done for another $50 even if the patient is gluten free. Ninety eight percent who have celiac disease have HLA-DQ2 or HLA-DQ8 haplotype. So if a person has both of these negative, they are unlikely to have celiac disease. An even better test is the Celiac PlusR from Prometheus (888-423-0896) which does all the antibodies and the genetic haplotype test. It will also identify the more aggressive disease variant by identifying the dreaded DQB1*)0201 gene. Costing $500, it might be the best money spent to pin down this disease and preventing disability and even death secondary to cancer! Also many insurances pay for it. St Francis Hospital Lab is the only official laboratory in Tulsa that deals with the insurance issues.

For now most doctors feel there is no cure for Gluten Intolerance and the best way is to stay away from gluten containing food. Very soon there will be a good enzyme product (Glutenase) available that will break down gluten much the same way lactase granules or powder will allow Lactose Intolerants to consume dairy products. My colleague Dr Jack Wise has a combination of homeopathic and natural products to include Kombu, L-carnosine,Vitamin D, and Aronya Berry which should soon be FDA approved. I have seen amazing healing of folks with Gluten intolerance that can now eat bread again after using his proprietary product. If you or if you know someone who wants to participate in his double blind study contact him (918-260-6830). The participant needs to enter the study with an already positive test be it blood or the very best, an intestinal biopsy. They will then get the real product or a placebo which is one month of of six capsules a day. He will pay for the product and the follow up test to see if the the patient is both clinically and labortory cured. If the person did get the placebo once the code is broken they will get the real medicine as a gift. So either way they will be cured if the product really works. Of course the person must be consuming gluten during the study time.