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!”
Monday, June 28, 2010
Tuesday, June 22, 2010
MICROWAVED FOOD (UN)HEALTHY ?
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".
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".
Tuesday, June 8, 2010
THE DARK SMOOTH FOOD OF HEALTH
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.
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.
Saturday, May 29, 2010
EXPIERIENCE BASED MEDICINE
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!
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!
Sunday, May 23, 2010
FRIENDS
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!
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!
Sunday, May 16, 2010
Bilirubin - An Internal Protector
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.
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.
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.
Monday, May 10, 2010
TO STOP ACID IS TO STOP HEALTH
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.
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.
Subscribe to:
Posts (Atom)