Medical Articles by Dr. Ray

Feb

2025

Immunotherapy for Cancer

By Ray Schilling | Cancer, immune system, prostate cancer

Highlights of the history of immunotherapy

1893: William Coley published a paper where he described treatment of 900 unresectable sarcomas with a bacterial toxin. This treatment achieved high healing rates in an otherwise deadly cancer type. Tumor immunologists consider Dr. Coley now as the father of immunotherapy.
1982: James Allison detected tumor-associated antigen receptors. This opened up the field of cancer immunotherapy further. There are two main tumor cell surface markers: the tumor-specific antigens (TSA) and tumor-associated antigens (TAA). TSA and TAA are part of the surface markers of cancer cells, but they do not exist on the membranes of normal body cells.
1986: The FDA approved the first immunotherapy agent, an antitumor cytokine with the name interferon-alpha 2.
1998: interleukin-2 (IL-2), a T-cell growth factor that aids in immune regulation and T-cell proliferation, was approved by the FDA.
2011: The FDA approved check-point inhibitors. Physicians could now treat late-stage melanoma, renal cell carcinoma and lung cancer with immunotherapy.
2015: Dr. Jason Williams treated cancer lesions with cryotherapy and subsequently injected them with checkpoint inhibitors. This resulted in cures of the primary injected lesions, but also cured distant metastases. The treating physicians noted that there was a cure of these patients’ cancers.
Monoclonal antibodies: here is a publication where end-stage cancer was treated with a monoclonal antibody.
2017: Carl June, MD from the University of Pennsylvania detected the CAR T-cell therapy. This FDA-approved personalized cellular therapy led to successful treatment of lymphoblastic leukemia in children and young adults. CAR stands for “chimeric antigen receptors”.

SYNC-T Therapy with SV-102 for prostate cancer

Dr. Maroon spent quite some time in his talk about a new treatment modality for prostate cancer. It involves cryotherapy of the prostate cancer with subsequent injection of 15 ml of an immune modulating drug (SYNC-T with SV-102). The dead prostate cancer cells function as a kind of vaccine and the medication that was injected right into the cancer lesion stimulates the T killer cells to eradicate this cancer. There was a cure rate of 85% in a pilot study. Surprisingly not only the initial prostate cancer was cured, but also far-removed metastases. Dr. Maroon believes that this kind of treatment will be the future cancer treatment protocol. At this point there is no approval yet from the FDA, but phase 2 and 3 studies are on their way.

Immunotherapy for Cancer

Conclusion

I reviewed the history of immunotherapy for cancer based on a lecture by Dr. Maroon given in Las Vegas. The FDA approved interferon in 1986 for cancer treatment and checkpoint inhibitors in 2011. In 2017 Carl June, MD from the University of Pennsylvania detected CAR T-cell therapy. The FDA approved this personalized cellular therapy, which led to the successful treatment of lymphoblastic leukemia in children and young adults. In the future physicians will add various forms of immunotherapy to more conventional treatments of cancer like surgery, chemotherapy and radiotherapy. This will improve the healing successes of cancer and also the ultimate survival rates.

Feb

2025

Treatment of Hormone Deficiencies with Bioidentical Hormones

By Ray Schilling | Cancer, Circadian rhythm, Diabetes, diet, heart attack, melatonin, Menopause

General remarks

When the body ages, hormone glands are aging as well, and they often don’t produce enough hormones as in younger years.
In this case the physician can prescribe replacement hormones, but it is important that they are bioidentical hormones (not synthetic).
The Women’s Health Initiative showed in the past what happens when synthetic hormones are used to treat postmenopausal symptoms: many patients came down with strokes, heart attacks, breast cancer, uterine cancer and blood clots.
Well before that study European endocrinologists have pointed out that there are no complications when the physician prescribes bioidentical hormones.
Never treat a hormone deficiency in isolation. Often there are multiple hormone deficiencies present at the same time and the physician needs to address each one on its own.

Thyroid disease

Dr. Hertoghe pointed out that the most common thyroid disease in older age is hypothyroidism. Blood tests show high TSH with this, free T3 and free T4 are low. He warned that high meat consumption (beef, poultry and fish) as your evening dinner leads to prolonged low T3 overnight and in the morning. Dr. Hertoghe’s recommendation was to consume most animal protein at breakfast, a lesser amount at lunch and none at supper. Treatment of hypothyroidism is with a mix of T3 and T4. Each one alone does not stabilize the patient as well as the mixture. The physician orders blood tests every 2 months and adjusts hormone levels based on the results.

Testosterone for men

Young men have ample production of testosterone in their testicles. When men reach the age of 60 or older testosterone blood levels often decline. Testicles of a male produce mainly testosterone, also some dihydrotestosterone and a smaller amount of estradiol. All of these hormones balance each other. Older men can develop erectile dysfunction. It would be a mistake to just treat them with Viagra for this. Their metabolism is missing testosterone, which protects the heart and the brain. They need hormone replacement with testosterone. This is either administered topically or by intramuscular injection every two weeks (or twice per week with a lower amount). If hormone replacement does not solve the erectile dysfunction, the physician can still add Viagra later. The physician orders testosterone blood levels every 3 months and adjusts the testosterone dose up or down.

Estrogen and progesterone for women

Estrogen develops normal breasts; progesterone prevents excessive breast development. Women with huge breasts have progesterone deficiency, they are estrogen dominant. Both hormones are necessary for good coronary artery blood flow. A lack of both hormones causes heart attacks. In menopause hormone replacement with bioidentical hormones is necessary. Dr. Hertoghe discussed this in detail. Depending on what blood levels show a postmenopausal woman may also require a small amount of testosterone replacement. Women who had surgery that removed their ovaries in the past are often testosterone deficient. I discussed this topic previously here.

Adrenal cortex hormones

Two essential hormones are produced in the adrenal glands, namely cortisol and DHEA (=Dehydroepiandrosterone). Cortisol provides energy, is anti-inflammatory, but leads to the breakdown of muscle tissue. DHEA is the natural counterpart to cortisol as it gives you energy and builds up your muscles. It also stimulates axillar hair growth.

Cortisol

The physician can determine the level of cortisol either through blood tests, in 24-hour urine tests or in saliva tests.

Two cortisol conditions are important:

Adrenal gland insufficiency or Addison’s disease: the adrenal glands cannot produce enough cortisol. This presents with confusion, vomiting and progressive hyperpigmentation of the skin.
Cushing’s syndrome: these patients usually have fat accumulation in the abdomen and they bruise easily. Some patients have a benign tumor in the adrenal gland that produces too much cortisol. Resection of the tumor cures the condition.

Dr. Hertoghe demonstrated images of various patients with cortisol problems and discussed management of them.

In patients who require cortisol replacement the physician prescribes the bioidentical hydrocortisone. This molecule is identical to what the body produces in the adrenal glands. Synthetic corticosteroids are not properly metabolized and cannot participate in the diurnal hormone rhythm. Unfortunately many conventional physicians still order the more powerful synthetic corticosteroid hormones that have many side effects.

DHEA

This hormone is important for both men and women. It supports health and physical appearance. Blood tests easily detect the storage form of DHEA, namely DHEAS. When deficient in it, women need 15 – 20 mg of DHEA per day in the morning. Men require 25 – 30 mg upon awakening. Unfortunately, a lot of the vitamin merchants are pushing the 50 mg DHEA tablets, which is overdosed. DHEA melts fat in and builds up muscle mass. It also increases blood supply to the heart thus preventing heart attacks.

Melatonin

This hormone improves sleep and opposes premature aging. Older people, particularly after the age of 65 produce much less melatonin than in the past. A blood test determines whether or not you are deficient in melatonin. Melatonin deficient patients should swallow 3 mg capsules of melatonin at night. If necessary, another dose of 3 mg may be swallowed in the middle of the night. Higher doses than 6 mg of daily melatonin suppress cortisol production in the adrenal glands as these two hormones are natural opponents. Dr. Hertoghe mentioned a study of women who regularly consumed alcohol. This was compared to a control group of women non-drinkers. The urinary metabolites of melatonin were 6.4-fold lower in the drinking group. Another important action of melatonin is a significant improvement of blood supply to the heart under the influence of melatonin. Together with other hormones this helps to prevent heart attacks.

Growth hormone and IGF-1

Both of these hormones can be detected in 24-hour urine collection. Most of the human growth hormone is metabolized in the liver into IGF-1(insulin-like growth factor-1). The blood level of IGF-1 reflects accurately whether a person is growth hormone (GH) deficient or not. A low IGF-1 blood level means that this person requires growth hormone injections. Growth hormone deficiency leads to facial swelling, lack of energy, fat accumulation and hair loss. With GH replacement the face becomes firmer and younger looking, body composition improves with well-developed muscles. Hair growth normalizes and the person has abundant energy. GH also protects the heart muscle and coronary arteries.

Treatment of Hormone Deficiencies with Bioidentical Hormones

Conclusion

Dr. Thierry Hertoghe was one of the key note speakers on Dec. 13, 2024 at the Anti-Aging Conference in Las Vegas, which I attended. He is an endocrinologist from Brussels/Belgium. He shared some of the common hormone disbalances that he encountered in his practice. It is important to replace missing hormones only with bioidentical hormones, not with synthetic hormones. This helps to rebalance all of the hormones. In addition, the diurnal hormone rhythm is functional again when the doctor prescribes bioidentical hormones. Synthetic hormones do not properly participate in the diurnal hormone rhythm. Patients who replaced their missing hormones have a normal or better than normal life expectancy. They are also less prone to chronic diseases.

Jan

2025

Menopause Revisited

By Ray Schilling | Hormones, Menopause

At the 32^nd Anti-aging Conference in Las Vegas menopause was reviewed, which I call “menopause revisited”. The presenter was Dr. Sara Gottfried who is the director of Precision Medicine. She is also affiliated with the Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, Pennsylvania, US. I am presenting the content of her lecture as the following blog.

Some interesting statistics about menopause

1 in 5 women die from either a stroke or a heart attack (this is 7-fold higher than women who die from breast cancer)
There is general improvement in survival among patients with heart attacks. But women age 35 to 54 have increasing admissions to hospitals with heart attacks
Women have a 10 to 25% lower chance of early medical care when they come down with a heart attack
In the US one women dies every 80 seconds from either a heart attack or a stroke
Menopause starts with the last menstrual period, typically this is between the ages 45 to 55.
FSH (follicular stimulating hormone) is in the 25.8 and 134.8 mIU/mL range after menopause. The LH (luteinizing hormone) is greater than 15 IU/L.
There is a small group of women who have premature ovarian deficiency at an age younger than 40. This can be diagnosed by abnormally high values of FSH and LH.

Symptoms of menopause

From age 45 most women do not produce enough estrogen in their ovaries, which leads to the symptoms of menopause. The most common symptoms are: Changes to your periods. Your periods become irregular during perimenopause (the run up to menopause) and then stop altogether. Hot flashes, night sweats, anxiety, low mood, mood swings, brain fog and forgetfulness set in as menopausal symptoms.

Menopause revisited: Hormone derangements

With menopause we know that estrogen production goes down. But when menstruations stop, progesterone production also goes down (lack of ovulation and corpus luteum formation). What physicians did not know until recently is that cortisol production goes up, as measured with morning saliva cortisol levels. It was found recently that morning cortisol levels are 3 times that of normal in postmenopausal women.

Consequences of high cortisol levels

Researchers did MRI scans on postmenopausal women with high cortisol levels and found that there was a reduction of total brain. Their glucose metabolism was prediabetic and their brain had a higher beta-amyloid load. This means that women after menopause are at a higher risk of developing cardiovascular disease (due to a lack of estrogen). But they are also at a higher risk of developing Alzheimer’s disease and diabetes. The lack of progesterone is responsible for emotional problems and depressions. Women age 45 to 55 have a threefold higher suicide rate than men in the same age group.

Menopause revisited: Hormone therapy

Why do postmenopausal women need bioidentical hormone therapy? The physician should treat vasomotor symptoms (hot flashes), mood disturbances, sleep disruption and sexual dysfunction. In addition, he wants to treat cognitive decline, prevent osteoporosis and prolong the healthspan. Healthspan means: staying healthy. Life span does not say anything about the quality of life!

Based on what I said above it is clear that when hormone production suffers or burns out, the only way to rebalance your hormones is to replace them. But physician must be careful: some synthetic hormones, particularly in the treatment of menopause in women can be dangerous to your health (blood clots may develop). For this reason, researchers developed bioidentical hormone replacement where the replacement hormones are identical to the hormones the patient used to produce. This can prolong her life by 10 to 15 years. It is important for the physician to look at all of the hormones in concert as they are all interdependent.

We know for instance that older individuals often are melatonin deficient and this can elevate the morning cortisol level as well. A simple supplement of 3 mg of melatonin at bedtime with a possible repeat during the night when needed will replace missing melatonin production.

Menopause Revisited

Conclusion

It is important that the physician recognizes that in menopause a major hormone derangement will occur. Some patients suffer more than others, but where there is a hormone deficiency, it is necessary to treat the patient with bioidentical hormones. When the physician rebalances her hormone balance properly, the symptoms disappear and the patient feels more energy again. This prevents strokes and heart attacks, diabetes and also Alzheimer’s disease at the same time. The best physicians to treat hormone disbalances in menopause are functional physicians, anti-aging physicians and integrative physicians. But the topic of hormonal deficiency has taken up speed, and some regular general practitioners also have specialized in bioidentical hormone therapy.

Dec

2024

Anti-Inflammatory Diets Improve Inflammation

By Ray Schilling | diet, fiber, fish oil, food, Health, Inflammation, meat, Mortality, Nutrition, olive oil, omega-3 fatty acids, polyunsaturated oil, Processed food, processed meat, red meat

A CNN review article noted that anti-inflammatory diets improve inflammation. This is important for medical conditions that also have inflammation attached to it. For instance, rheumatoid arthritis, diabetes or chronic kidney disease all carry inflammation with them. But according to a 2019 study more than 50% of all deaths stem from chronic inflammatory conditions.

Here is a more complete list of what type of clinical conditions are associated with chronic inflammation:

cardiovascular disease, such as heart disease and stroke
obesity
cancer
chronic obstructive pulmonary disease
asthma and allergies
diabetes
chronic kidney disease
chronic pain — for example, from some sources of back pain, headache disorders, arthritis and other joint conditions
non-alcoholic fatty liver disease
autoimmune diseases, such as rheumatoid arthritis, lupus, ulcerative colitis, and Crohn’s disease
depression
neurodegenerative conditions, such as Alzheimer’s disease

Some people may have two or more of these chronic diseases at the same time. This increases the risk of death. This is even more of a reason to follow an anti-inflammatory diet.

Anti-inflammatory diet

The CNN article suggests that an anti-inflammatory diet has the potential to reduce inflammatory cytokines. This is important and can also improve symptoms of chronic inflammatory diseases. A large study was conducted in 2021, which showed that people on an anti-inflammatory diet had a lower probability to get complications. Anti-inflammatory diets protected them from heart attacks, strokes, coronary heart disease and more.

Here are the ingredients of an anti-inflammatory diet

Why are anti-inflammatory diets so healthy? It is because they are rich in fiber, omega-3 fatty acids, antioxidants, polyphenols, vitamins, and unsaturated fats can have anti-inflammatory effects. Fruit options can include:

apples
fruits with stones or pips, such as peaches, plums, apricots, and cherries
grapes
citrus fruits such as oranges, lemons, limes, and grapefruit
pomegranates

Vegetables are high in fiber and other important vitamins and nutrients. Include a variety of colors of vegetables in your daily diet. Options can include:

green leafy vegetables, such as spinach, kale, radicchio, and arugula
cruciferous vegetables, such as broccoli, cauliflower, cabbage, and brussels sprouts
tomatoes
root vegetables, such as turnips, beets, radishes, and onions
potatoes
sweet potatoes

Whole and cracked grains are another source of fiber.

Nuts and seeds

Nuts and seeds contain polyphenols, which can have an anti-inflammatory effect. Nuts and seeds can include almonds, peanuts, cashews, hazelnuts, flaxseeds, sesame seeds, chia seeds, sunflower seeds, and pumpkin seeds.

Healthy oils

Vegetable oil like olive oil are important for cooking and for salad dressings.

Fish

Fish that is high in fatty acids and omega-3s can be important in an anti-inflammatory diet. These fish varieties can include salmon, tuna, sardines, and mackerel.

Herbs and spices

Some herbs and spices may have anti-inflammatory effects, as they can be high in phenols and antioxidants. These include clove, sage, oregano, cinnamon, rosemary, turmeric, black pepper, and ginger, among other options.

What to avoid

Highly processed foods like hamburgers, french fries, cakes and others must be removed from your food list. They are associated with heart attacks, strokes and cancer. In addition, the following food component must be avoided, if you value your life.

Refined carbohydrates: This can include products made with white flour, such as white bread, pasta, breakfast cereals, and pastries.
Trans fats: These can include foods labeled as having partially hydrogenated oils in them. Examples include baked goods such as cakes, pies, and frozen pizzas, as well as fried foods such as donuts or fries.
Some saturated fats: red meat, chicken with the skin on, milk, cheese, and cream contain high levels of certain saturated fats that promote inflammation.
Sugar: Sugary foods or foods with a high glycemic index can be inflammatory. Examples can include sugary drinks and sodas, sugary cereals, and candy.
Red meat and processed meat: This can include beef, lamb, goat, and pork meat, as well as processed hot dogs and sausages, among others. These meats have an association with colorectal cancer.
Certain spreads and cooking fats: Some fats such as margarine, shortening, and lard can be inflammatory.

Anti-Inflammatory Diets Improve Inflammation

Conclusion

You hear bad things about chronic inflammation and premature deaths. What you may not have heard a lot yet is that anti-inflammatory diets actually can safe lives. Above I have listed the most common inflammatory diseases. I also described the ingredients of an anti-inflammatory diet. With this diet researchers found that cardiovascular disease was reduced by 38%, strokes were reduced by 28%. It is not that difficult to adopt a healthy anti-inflammatory diet. Keep trans fats and highly processed foods away. Eat more vegetables, fish and avoid red meats. Add some nuts and cold pressed extra virgin olive oil. Good health will thank you for this diet change.

Nov

2024

Ultraprocessed Food Leads to Premature Aging

By Ray Schilling | Cancer, Cardiovascular disease, cholesterol, diet, food, meat, Mortality, Nutrition, Obesity, Processed food, processed meat

An article in the medical journal “Medical News Today” found that ultraprocessed food leads to premature aging.

What are ultraprocessed foods?

The NOVA Food Classification System explains what ultraprocessed foods (UPFs) are and what other ones are not. Examples of ultraprocessed foods are: fatty, sweet, savory or salty packaged snacks, pre-prepared poultry and fish ‘nuggets’ and ‘sticks.’ Others are cola, soda and other carbonated soft drinks, pastries, cakes and cake mix. Generally speaking, the food processors add too much salt, sugar and saturated fat. They often also add food preservatives, coloring, and flavor enhancers.

What do ultraprocessed foods cause?

Sugary beverages lead to blood sugar peaks and insulin surges. This in turn can cause type 2 diabetes later on. Melanie Murphy Richter, MS, RDN, a registered dietitian nutritionist said that “overly salty snacks like chips, crackers, and instant noodles, and other UPFs with trans fats and hydrogenated oils all should ideally be avoided”. Read labels before you buy any food product. Hydrogenated oils and trans fats are increasing LDL cholesterol leading to premature hardening of the arteries. This can cause strokes and heart attacks.

Hot dogs, sausages, and deli meats contain nitrates and nitrites as preservatives. This can form carcinogenic compounds like nitrosamines during cooking or metabolism. The World Health Organization (WHO) has classified processed meats to contain Group 1 carcinogens. These processed meats also contain high amounts of sodium and saturated fats. This causes high blood pressure and cardiovascular disease.

Telomere length reduced by ultraprocessed foods

Another study regarding consumption of ultraprocessed foods came out in 2020. There were 886 participants aged 57–91. Researchers measured telomere length in saliva samples. Subjects with the highest UPF consumption had almost twice the odds of having short telomeres in comparison to those with the lowest UPF consumption. Patients with shorter telomeres were much more prone to chronic diseases like cancer and cardiovascular disease. The overall death rate was much higher in patients with shorter telomeres. This confirms what another study also found.

Ultraprocessed foods are causing obesity and weight gain

Another study found that ultraprocessed foods caused weight gain and obesity. The authors of this study pointed out that US residents eat up to 70% of the total calorie input as UPFs. They reviewed the literature and found that UPF consumption raises the risk of obesity. Also, chronic conditions like cancer, strokes, heart attacks, type 2 diabetes and depression are directly linked to UPF consumption. Because of the development of these chronic health conditions the life expectancy is about 10% shorter than for those who don’t consume UPFs.

Ultraprocessed Food Leads to Premature Aging

Conclusion

Over the past several decades food companies produced more and more ultraprocessed foods (UPFs). You see them on grocery store shelves. They contain high amounts of sugar, saturated fat and salt. This can cause cardiovascular disease. Added food preservatives, coloring, and flavor enhancers are also of concern as they may lead to UPF food addiction. Obesity, cancer, heart attacks and strokes are often the final result of UPF overconsumption. Another publication that I reviewed showed that consumption of UPF leads to shorter telomeres in all body cells. We know from other publications that short telomeres cause chronic diseases and premature deaths because of organ failures. The bottom line is that you want to reduce your UPF food intake and increase your whole food intake. This will strengthen your immune system, prevent heart attacks, strokes and cancer. Your telomeres will stay long and your life expectancy increases by about 6 years.

Nov

2024

Vital Information about Cholesterol Drugs

By Ray Schilling | cholesterol, heart attack, Stroke

Most people know about statins to treat high cholesterol, but they do not have vital information about cholesterol drugs. Recently an article appeared in CNN, which was very informative. In the following I will review what is new about cholesterol lowering drugs.

PCSK9 inhibitors, which are monoclonal antibodies

Sarah Lewis is a pharmacist and medical writer with over 25 years of experience in various areas of pharmacy practice. She explained that there are injectable cholesterol lowering drugs for use when traditional statins are not powerful enough to lower cholesterol levels. But these injectable drugs are very expensive and payment agencies demand fulfillment of strict criteria before they approve these drugs. The new injectable drug, which the FDA approved in 2015 is an PCSK9 inhibitor. It has the name alirocumab (Praluent) and is a monoclonal antibody. PCSK9 is a natural liver protein that regulates how many LDL receptors you have. Alirocumab reduces LDL receptors, which lowers LDL cholesterol levels. Several months later the FDA approved a second PCSK9 inhibitor, evolocumab (brand name: Repatha).

Side effects of statins and PCSK9 inhibitors

Statins are the gold standard for treating high cholesterol. They work by inhibiting an enzyme that controls how much cholesterol your body makes. But many people have significant side-effects from statins.

There can be side effects in the form of muscle pain. But statins can also cause headaches or dizziness. Others are feeling sick from statins, get unusually tired or develop a physical weakness.

These people often must lower their dose. Alternatively, their doctor switches them to a different statin in order to carry on therapy. PCSK9 inhibitors have none of these side-effects. The main side effect of PCSK9 inhibitors are injection site reactions, flu-like symptoms, and allergic reactions. They can be severe. Overall, there is a better tolerability of PCSK9 inhibitors than with statins. Unfortunately, the cost is around $12,000 to $14,000 per year for PCSK9 inhibitor therapy, which is very difficult to justify. Another disadvantage is that the patient has to self-inject the PCSK9 inhibitor.

PCSK9 inhibitors are added in specific patients

Because of the costs of PCSK9 inhibitor statins are still the first line of therapy in patients with high cholesterol. But there are patients who have familial hypercholesterolemia, which is an inherited condition. The physician treats them first with statins such as atorvastatin (Lipitor) or rosuvastatin (Crestor). The physician pushes the dosage to the maximal dosage. Often in these cases of inherited high cholesterol the new PCSK9 inhibitor drugs have to be added as a second line of therapy.

Patients with hardening of the arteries and a history of a heart attack or a stroke need aggressive cholesterol lowering treatment. These patients require both PCSK9 inhibitors and statin therapy.

Rigid rules from insurance companies

Because of the expense of PCSK9 inhibitors insurance companies have established the following rules.

You have to have either familial hypercholesterolemia or a history of a heart attack or stroke.
You must see a dietician for comprehensive dietary counseling.
You are on the maximum dose of a statin or you can tolerate only a lower dose of a statin because of side effects.

Only when these criteria are fulfilled does the insurance company consider to authorize an addition of a PCSK9 inhibitor to the statin treatment.

Vital Information about Cholesterol Drugs

Conclusion

Traditional statin therapy for high cholesterol levels is the gold standard for treating high cholesterol. Statins work by inhibiting an enzyme that controls how much cholesterol your body makes. Unfortunately, statins can have a number of side effects like muscle cramps and fatigue. A new type of cholesterol lowering drug was authorized by the FDA in 2015. This new drug has the name alirocumab (Praluent) and is a monoclonal antibody. PCSK9 is a natural liver protein that regulates how many LDL receptors you have. Alirocumab reduces LDL receptors, which lowers LDL cholesterol levels. It has much less side effects than the statins, but costs are around $12,000 to $14,000 per year, which is very difficult to justify.

How physicians prescribe the new drugs

The new PCSK9 inhibitor drugs are prescribed as an add-on to statin therapy to lower cholesterol. Physicians prescribe this to patients who have a familial hypercholesterolemia and to patients who had a heart attack or a stroke. One inconvenience of these new cholesterol lowering agents is that the patient has to inject it rather than take it as a tablet by mouth. Studies showed that PCSK9 inhibitors have a favorable cholesterol lowering effect. Alirocumab (Praluent) lowered cholesterol between 36 to 59%. The newer evolocumab (Repatha), lowered LDL by 60%. Both drugs showed a risk reduction of cardiovascular events by 50%, which helps long-term survival of patients with cardiovascular disease. PCSK9 inhibitor drugs are powerful cholesterol lowering agents. However, at the present time the cost of this treatment is too expensive.

Oct

2024

Common Chemicals Affecting your Health

By Ray Schilling | Cancer, kidney disease

There are common chemicals affecting your health that have been known since the 1950’s. They have the name PFAS, which stands for perfluoroalkyl and polyfluoroalkyl substances. There was a review article recently in CNN describing the complexity of PFAS, the toxicity, and what you can do to improve your risk. People know PFAS as the “forever” chemicals, because they are very slow to metabolize. As their chemical structure has some resemblance to natural hormones, they block our own hormone actions. They belong to the group of endocrine disruptors. There is a direct relationship between exposure to PFAS and kidney cancer as well as testicular cancer.

PFAS can affect menstrual cycle irregularities, thyroid disorders, and infertility. Pregnant women and children are most sensitive to the effects of PFAS.

A lot of products contain PFAS

Dr. Carmen Marsit is a Professor of Research at the Rollins School of Public Health at Emory University. She has done research of the effects of PSAF regarding human health for several years. CNN interviewed her and she said: “PFAS are a class of about 15,000 human-made chemicals that contain fluorine groups, which give them special properties. They are in non-stick surfaces; they’re used in firefighting foams, protecting packages from grease, and waterproofing of carpets and your clothing. Because of the structure of these chemicals, they’re able to have these non-stick, water-repellent and temperature-regulating properties.”

There is contamination of drinking water with PFAS chemicals. Only reverse osmosis removes these “forever” chemicals. But water from water softeners still contains PFAS. People who have reverse osmosis in the kitchen sink can cook with clean water, which is devoid of PFAS. This reduces exposure to PFAS significantly.

Food as a source of PFAS

Dr. Marsit mentioned: “Food can be another source of exposure, partly because of the packaging that food comes in, such as any types of non-stick, risk-proof packaging. A lot of frozen foods and fast foods were put into these types of packaging. A pizza box, for example, will have PFAS on the bottom. There’s actually some new data suggesting that PFAS are very prevalent in pesticides, and so, in fact, are being sprayed on to foods. Even your fresh foods might be contaminated with some of these chemicals. “

How manufacturers can remove PFAS from food and the environment

Dr. Marsit said:” On the policy side, we are seeing some positive things happening that are going to start to reduce some of these levels. The US Environmental Protection Agency now has a ruling out about at least five of these chemicals in drinking water that basically sets limits for these chemicals in the water. Within three years, municipal water sources have to test these chemicals, and then within five years, they have to have a plan for how to reduce those levels below the EPA-set limits.

Recently, the US Food and Drug Administration worked together with food product manufacturers who create the containers of food products to remove the PFAS chemicals from those containers, so now we’ll see less of that kind of foodborne exposure.”

Pressure from changed buying behaviors can accelerate removal of PFAS

But all of this will take several years to take effect. It is the public opinion that can speed things up. If people start buying glass and metal containers instead of plastic bottles of water, the manufacturers will have to adjust to the new buying patterns. This can accelerate the removal of PFAS from the market. Dr. Marsit said: “Some manufacturers are starting to be concerned about the health effects as well and are starting to remove them from their products. It’s a slow process, but eventually we’ll see more and more of those manufacturers kind of moving away from the use of these chemicals in their products because of these health effects.”

Common Chemicals Affecting your Health

Conclusion

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) have been around since the 1950’s. There are more than 15,000 of these “forever” chemicals around us now. They have these non-stick, water-repellent and temperature-regulating properties. PFAS hide in carpets, furniture, food containers, clothing and even drinking water. They are very slow to metabolize. As their chemical structure has some resemblance to natural hormones, they block our own hormone action. They belong to the group of endocrine disruptors. There is a direct relationship between exposure to PFAS and kidney cancer as well as testicular cancer.

What leads to a change in PFAS contamination?

Both the US Food and Drug Administration and the US Environmental Protection Agency recently introduced strict guidelines about reducing PFAS contamination of our food chain and the environment. But it will take years for these guidelines to lead to concrete results. In the meantime, the consumer has the power to force manufacturers into changing production patterns. People need to start buying glass and metal containers instead of plastic bottles of water. Then the manufacturers will have to adjust to the new buying patterns.

Oct

2024

Cardiovascular Risk Markers Predict Heart Attacks and Strokes

By Ray Schilling | blood test, Cardiovascular disease, cholesterol, diet, fasting mimicking diet, Fitness, heart attack, Heart Disease, Mortality, Stroke, Weight loss

An article in The New England Journal of Medicine stated that cardiovascular risk markers predict heart attacks and strokes. A summary of this study was also published by NBC News.

30-year follow-up of the Women’s Health Study

This is based on a 30-year follow-up study of the Women’s Health Study. In the beginning of the study all women had blood tests taken. In the beginning none of the women had cardiovascular disease. The blood tests were LDL cholesterol, lipoprotein(a) and high-sensitivity C-reactive protein (CRP). When either of these markers was high at the beginning of the clinical trial, it turns out that 30 years later the person either was dead from cardiovascular disease or had a heart attack or stroke.

More details of the study

In the beginning of the study 27,939 initially healthy U.S. women had 3 of the mentioned blood tests taken. If only one of them was elevated, there was a risk in the next 30 years to get a myocardial infarction, coronary revascularization, stroke, or death from cardiovascular causes. The initial age of the patients was 54.7 years. During the next 30 years of follow-up 3662 cardiovascular events took place. Hazard ratios for the primary end point in a comparison of the top with the bottom quintile were calculated. The following hazard ratios were derived:

70-fold for high-sensitivity CRP
36 for LDL cholesterol
33 for lipoprotein(a)

Each biomarker showed an independent contribution to the overall risk. The risk of developing cardiovascular disease was highest when all three biomarkers were elevated.

Traditional risk calculation

Cardiologists calculated risk for cardiovascular events by the traditional 10-year estimates of risk. The authors suggest that physicians should do screening blood tests with these three biomarkers. If any of the biomarkers is elevated, measures to reduce cardiovascular risk should be initiated. This will be very effective to prevent cardiovascular events for the next 30 years.

Be proactive, prevent heart disease

As we get older, many people develop elevations of high-sensitivity CRP, LDL cholesterol and lipoprotein (a). But don’t wait for this to happen. Here are 9 steps you can follow to prevent it.

Maintain a healthy weight
Quit smoking
Choose good nutrition
Be physically active
Treat hypertension adequately
Manage diabetes, if you have it
Stress management
Limit alcohol intake
Get enough sleep

Comments to the steps you can take to prevent cardiovascular disease

The ideal body mass index is between 21.0 and 22.0. I found that the fasting mimicking diet helps me to stay in that BMI range. Good nutrition eliminates red meat and emphasizes vegetables and salads. Fish, lean chicken and turkey meat are healthy. Avoid all processed meats like sausages. Watch your calorie intake to keep your body mass index stable. In addition, avoid excessive salt and sugar intake. Avoid highly processed carbohydrates and processed food. Eliminate fried fast food, chips and baked goods from your diet as they contain trans fats. Trans fats cause hardening of the arteries.

Aim to get 30 to 60 minutes of daily activity. Do two or more strength training sessions a week. This raises the protective HDL cholesterol and prevents cardiovascular disease. Excessive alcohol intake leads to cardiovascular disease and high blood pressure. Limit your alcohol intake, if you find it hard to eliminate it altogether.

Cardiovascular Risk Markers Predict Heart Attacks and Strokes

Conclusion

A unique 30-year follow-up study of the Women’s Health Study identified three risk factors that a doctor can be determin from a blood sample. They predict whether a person will develop cardiovascular disease 30 years down the road. The three risk factors are high-sensitivity CRP, LDL cholesterol and lipoprotein (a). The best approach to prevention of heart disease is to adopt the approach of the Mayo Clinic described above. It comes down to the basics of good nutrition, regular exercise, maintaining a healthy weight, limiting excessive alcohol intake and stress management.

Sep

2024

Red Meat and Processed Meat Can Become a Cause of Diabetes

By Ray Schilling | Diabetes, meat, Processed food, processed meat, red meat

A clinical study at the end of 2023 showed that red meat and processed meat can become a cause of diabetes. The authors published the results of this study in The American Journal of Clinical Nutrition on December 2023.

Results of the study

Notably, the study consisted of several pooled studies. To emphasize, there was a total of 216,695 participants and the authors followed them up every 2 to 4 years. In detail, the investigators analyzed food frequency questionnaires for consumption of red meat, processed meat, and consumption of nuts and legumes. In particular, the authors compared the highest and lowest red meat consumption quintiles. Those who ate the highest amounts of total red meat had a risk of 1.62-fold to develop diabetes. With regard to processed meat the risk was 1.51-fold to develop diabetes. And those who consumed unprocessed red meat had a risk of 1.40-fold to develop diabetes.

• When people replaced 1 serving of meat per day with nuts and legumes, this reduced their risk for diabetes by 30%.
• A group that had replaced processed red meat by 1 serving/day with nuts and legumes reduced the risk for diabetes by 41%.
• Replacing unprocessed red meat by 1 serving/day with nuts and legumes reduced the risk for diabetes by 29%.

Some scientists criticized the study saying that it was not controlled for elevated body mass index (BMI). A person with an elevated BMI is at a higher risk of developing diabetes on its own and this can interfere with a study like this.

Alternative large study confirming risk of red meat to develop diabetes

This study was a meta-analysis, which involved data from 31 cohorts participating in the InterConnect project. There was a total of 1,966,444 adults in this study and 107,271 patients developed diabetes over a period of 10 years.

• People who ate unprocessed meat had a 10% increase of diabetes risk compared to people not consuming meat.
• When processed meat was consumed it caused diabetes in 15% of the study group.
• On the other hand, poultry consumption caused only 8% of diabetes.

There were slight regional differences for the same foods. In the discussion of the data the authors pointed out that in comparison to the first study mentioned above their risk ratios were lower, because all the data was corrected for compounding factors that could distort the figures. As an example, they noted that without BMI adjustment unprocessed meat would have caused 18% of diabetes. On the other hand, processed meat would have caused 23% of diabetes and 21% of diabetes for poultry consumption.

Recommendation to reduce or eliminate red meat consumption

The American Institute for Cancer Research recommends to eat less than 18 oz. of red meat or processed meat per week to avoid cancer development.
You can replace meat with nuts, legumes (lentils and beans), tofu and vegetables.

Red Meat and Processed Meat Can Become a Cause of Diabetes

Conclusion

Two independent large studies concluded that consumption of red meat and processed red meat contributed to diabetes development in adults. We also know from other studies that it can cause cancer. The key is to replace red and processed red meat by nuts, tofu, legumes and other vegetables. Both studies have shown that doing so reduces the risk for diabetes.

Sep

2024

Ozempic and Wegovy can Lead to Blindness in one Eye

By Ray Schilling | fasting mimicking diet, Nutrition, Obesity, Weight loss

Shocking medical news found that Ozempic and Wegovy can lead to blindness in one eye. Ozempic was approved by the FDA for treatment of diabetes. Wegovy, which is the same drug, got FDA approval for treatment of obesity. The pharmacological name of the drug is semaglutide. Both brand names of the drug are very popular, but they have side effects.

List of side effects of Ozempic and Wegovy

Physicians noted the following side effects of semaglutide. Nausea and vomiting, diarrhea, constipation, gas and bloating, stomach pain, fatigue, burping and changes to your face (Ozempic face). In addition, headache, rebound weight gain, low blood glucose, vivid dreams, hair loss, pancreatitis, gallbladder disease, kidney damage. Finally, there are also allergic reactions, thyroid tumors and stomach paralysis (gastroparesis) that are listed as side effects.

Rare side-effects of Ozempic and Wegovy

There is one side effect of Ozempic or Wegovy, namely a higher risk of developing a rare form of blindness. This has the name “Nonarteritic Anterior Ischemic Optic Neuropathy” or “NAION”. Only 10 out of 100,000 people in the general population may experience it. But patients who take Ozempic or Wegovy get this more often. People who took Ozempic for diabetes were 4-times more likely to develop blindness in one eye from NAION. And people who took Wegovy for obesity were 7-times more likely to get blind on one eye from NAION.

Alternative measures to treat diabetes and obesity

The question is whether you really need Ozempic or Wegovy to achieve control of your blood sugars or control of your body weight.“A crossover study showed that a fasting-mimicking diet is benefitting cardiovascular health. This new study was done by Dr. Valter Longo et al. from the University of Southern California. It compared the effect of two diets. They were the fasting-mimicking diet versus an unrestricted diet. In other studies Dr. Longo compared the fasting-mimicking diet (FMD) with a Mediterranean diet. He said: “The significance is that fasting-mimicking diet cycles were able to decrease fat mass without reducing muscle mass and without requiring changes in the subjects’ preferred diet for 25 days a month. In contrast, the everyday Mediterranean diet required a change in everyday dietary habits and had an association of 5 pounds loss of muscle.” It makes sense to use the FMD instead of the potentially dangerous Ozempic or Wegovy.

Effects of the fasting mimicking diet

The fasting mimicking diet consists of 5 days of a calorie reduced diet (500 to 600 calories per day) once a month. This helps you to reduce your weight and maintain it subsequently. Weight loss and control of diabetes are the main effects.

Ozempic and Wegovy can Lead to Blindness in one Eye

Conclusion

A rare complication of the popular medications Ozempic and Wegovy is the development of a rare form of blindness. This has the name “Nonarteritic Anterior Ischemic Optic Neuropathy” or “NAION”. Only 10 out of 100,000 people in the general population may experience it. But patients who take Ozempic or Wegovy get this more often, namely 4-times more often with Ozempic and 7-fold more often with Wegovy. On the other hand, weight loss can be achieved with a simple fasting mimicking diet, where you consume 500-600 calories for 5 days in a row per month. The rest of the month (25 days) you take in a normal diet. This helps you to slowly shed weight and maintain your reduced weight.

Fasting mimicking diet much safer than Ozempic or Wegovy

In my opinion the fasting mimicking diet is much safer than taking Ozempic or Wegovy. Current mainstream medicine claims that the likelihood of developing one-sided blindness from NAION is “negligible”. However, I prefer the FMD over Ozempic or Wegovy. It is important to me to maintain vision in both of my eyes.

Highlights of the history of immunotherapy

SYNC-T Therapy with SV-102 for prostate cancer

Conclusion

General remarks

Thyroid disease

Testosterone for men

Estrogen and progesterone for women

Adrenal cortex hormones

Cortisol

DHEA

Melatonin

Growth hormone and IGF-1

Conclusion

Some interesting statistics about menopause

Symptoms of menopause

Menopause revisited: Hormone derangements

Consequences of high cortisol levels

Menopause revisited: Hormone therapy

Conclusion

Anti-inflammatory diet

Here are the ingredients of an anti-inflammatory diet

Nuts and seeds

Healthy oils

Fish

Herbs and spices

What to avoid

Conclusion

What are ultraprocessed foods?

What do ultraprocessed foods cause?

Telomere length reduced by ultraprocessed foods

Ultraprocessed foods are causing obesity and weight gain

Conclusion

PCSK9 inhibitors, which are monoclonal antibodies

Side effects of statins and PCSK9 inhibitors

PCSK9 inhibitors are added in specific patients

Rigid rules from insurance companies

Conclusion

How physicians prescribe the new drugs

A lot of products contain PFAS

Food as a source of PFAS

How manufacturers can remove PFAS from food and the environment

Pressure from changed buying behaviors can accelerate removal of PFAS

Conclusion

What leads to a change in PFAS contamination?

30-year follow-up of the Women’s Health Study

More details of the study

Traditional risk calculation

Be proactive, prevent heart disease

Comments to the steps you can take to prevent cardiovascular disease

Conclusion

Results of the study

Alternative large study confirming risk of red meat to develop diabetes

Recommendation to reduce or eliminate red meat consumption

Conclusion

List of side effects of Ozempic and Wegovy

Rare side-effects of Ozempic and Wegovy

Alternative measures to treat diabetes and obesity

Effects of the fasting mimicking diet

Conclusion

Fasting mimicking diet much safer than Ozempic or Wegovy

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