INOSITOL-A SWEET THING

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

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

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

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

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.

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Diabetes and Obesity Prevented

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.