Sep
25
2015

Testosterone

By | Alzheimer’s disease, andropause, Anti-aging medicine, Cancer, Cardiovascular disease, fractures, heart attack, Hormones, Men's Health, Osteoporosis, Prevention, Stroke

One of the driving hormones in a man is testosterone. We also know that with age this hormone level falls. The lesser known fact is the importance of monitoring testosterone levels in aging males. This way they have the choice of intervening with the aging process. Here are the facts about the male hormone and about replacement of it when it is low. I will also discuss the anxieties of the medical profession to deal with this. Some feel uncomfortable about hormone replacements.

Androgen receptors contained in key tissues

Androgen receptors are situated in the key organs like the brain, heart, muscles, bones, kidneys, fat cells, genitals, hair follicles and skin. They respond to all male hormones, called androgens, like testosterone, dihydrotestosterone (DHT) and DHEA. DHT is produced by metabolizing testosterone with the help of an enzyme, called 5α-reductase in the adrenal glands. This is responsible for hair loss in males and some females. There is a genetic factor for this. It is important that the man continues to have all tissues stimulated by his male hormones when he ages or the key organs mentioned are going to suffer.

A lack of the male hormone as the man ages (around 55 to 65) leads to a slowdown in thinking, osteoporosis in the bones, muscle atrophy (melting in of muscle tissue), and a lack of sex drive. Mood swings can turn the male into the “grumpy old man”. The skin gets thinned and is more brittle.

Animal experiments have shown that the development of fatty streaks in blood vessels happens at a higher rate in castrated animals. The more encouraging finding in these animals is the fact that this condition is reversible by replacement of the male hormone. In healthy males of a younger age all organs are working well. The problems starts when males age and the hormone regulation in the brain slows down, which ultimately leads to andropause in males, the equivalent of menopause in women. When the physician replaces testosterone in an aging man who has low testosterone levels, the stimulation of androgen receptors in key organs, which I mentioned before return organ function to normal.

Reluctance of physicians to prescribe testosterone

In the past medical students were taught that testosterone is causing prostate cancer. This was based on old observations by Dr. Huggins, a Canadian born surgeon who practiced in Chicago, that orchiectomy improved the survival of advanced prostate cancer patients by a small percentage. Dr. Lee pointed out that Dr. Huggins neglected to realize that testicles make both the male hormone and small amounts of estrogen.

History of hormone ablation therapy for prostate cancer

When an orchiectomy was done (because of the belief that the male hormone production was the culprit) inadvertently the real cause of prostate cancer (an estrogen surplus) was also removed thus improving the survival of these patients somewhat. Nowadays we have more sophisticated testing methods. Dr. Abraham Morgentaler (Ref. 1) has compiled a lot of evidence about the importance of testosterone in men. He proved, based on a lot more modern references that it is not testosterone that is the cause of prostate cancer. We know now that estrogen dominance is responsible for prostate cancer and that this develops as stated above because of the low testosterone and low progesterone during the male menopause (also called “andropause”).

Rebuttal of Dr. Huggins’ research

Dr. Morgentaler, a urologist from Harvard University has taken prostate cancer patients and put them on testosterone. To his and everyone else’s surprise testosterone treated prostate cancer patients improved, their prostate cancer either disappeared or become much less aggressive, which can be measured with the Gleason score based on its microscopic appearance. The result was that they did better, not worse on male hormone replacement.

Older physicians still hold on to the belief that testosterone would make prostate cancer worse

Unfortunately the history of male hormone production, orchiectomy and prostate cancer as explained led to confusion among the medical profession. We now know that testosterone is innocent with respect to prostate cancer, testicular cancer or any other cancer. But some of the old-timers among the physicians doggedly hold on to their false belief from the past. If a man asks one of these physicians for testosterone replacement he may not only be told that he/she could not do that, but will also receive a tirade of false statements about testosterone.

No blood clots with male hormone replacement

We dealt with the myth of prostate cancer that is not related to treatment with the male hormone. There is another myth that older physicians often cite: that testosterone would supposedly be causing blood clots. At the University of Texas Medical Branch at Galveston (Texas, USA) a large study was done involving 30,572 men, ages 40 years and older. All had venous thromboembolism and received an anticoagulant drug or an intravascular vena cava filter following their diagnosis. Because they also had a low testosterone level physicians gave them testosterone replacement therapy. In addition, they followed them and monitored them for further venous thromboembolism. None were found in any of the men. The conclusion of the investigators was that filling a testosterone prescription was not associated with any clotting condition.

Aging and testosterone

A longitudinal study showed that testosterone has been declining in the male population over a period of 20 years. Partially there is a relationship to aging. Otherwise estrogen-like substances or xenoestrogens, which are environmental factors, contribute to it as well. Although age is a factor, there is so much variation from man to man, that it is best to just measure testosterone and determine whether the mail hormone level is above or below 500 ng/dL. This seems to be the most reliable indicator in determining whether a man needs hormone replacement, apart from symptoms due to testosterone loss. These are: increased risks for prostate problems and/or cancer, cardiovascular disease, loss of bone density, a rise in cholesterol and urinary dysfunction. Dr. Randolph describes this in detail and also discusses who needs bioidentical testosterone replacement.

The aging male and hormone replacement

A New England Journal of Medicine study from September 2013 explained that apart from testosterone the male body needs a small amount of estradiol, the female hormone. The enzyme aromatase within the fatty tissue achieves this. But the physician must prescribe testosterone replacement as the bioidentical testosterone, so that a small amount of it converts into estradiol by the action of aromatase. Synthetic male hormone compounds with chemical side chains do not provide this small estrogen metabolism.

After a review of the hard facts about prostate cancer risk, it is now clear that older men get prostate cancer because testosterone in their blood is low and their body weight elevation. The extra fat converts androgens by the aromatase into estradiol. This leads to estrogen dominance. This causes breast cancer and uterine cancer in women, prostate cancer in men. When the total testosterone level in a man is lower than 500 ng/dL it is a sign that he needs male hormones to protect his prostate from prostate cancer.

Cardiovascular disease and testosterone

The cardiovascular system has a lot of androgen receptors on its cell surfaces. It is important that the man continues to have the proper stimulus from androgenic hormones (testosterone, dihydrotestosterone and DHEA). This will allow him to have proper contractility of heart cells. It will also allow for relaxation of smooth muscle cells in the arteries to control blood pressure. With a lack of male hormones there is hardening of the arteries, loss of muscle cells in the heart muscle and increase of blood pressure. So far researchers have only noticed an association of low testosterone with diabetes, high blood pressure and heart attacks. It has not been proven that it is the cause (so webmd.com says). But careful replacement with bioidentical testosterone helps patients to get rid of their symptoms, have the energy to exercise and feel better.

Is it safe to replace missing hormones in a male?

Long-term studies have already shown that hormone replacement saves lives, but the medical profession is slow to accept this (Ref.1). Here is a link that explains this a bit further.

If a man who is low in male hormones wonders whether it would be worthwhile to go on testosterone therapy, here is the clear answer: would you like to have a 47% lowered risk of dying, a reduction of 18% in heart attacks and 30% reduction in the risk for a stroke? This is what a 14-year follow-up study published in the European Heart Journal in August, 2015 found.

The same is true for cardiovascular disease as stated above: if the total testosterone level in a man is lower than 500 ng/dL it is a sign that he needs testosterone replacement therapy to protect his cardiovascular system to prevent heart attacks and strokes.

Loss of bone density with a lack of testosterone

Older men can get osteoporosis, which can lead to compression fractures in the spine. In addition fractures can also occur in the hip, the ankle or wrist. Current thinking is that with the lack of male hormones there is also a lack of estradiol via the aromatase pathway in fatty tissue. This small amount of estradiol is able to prevent osteoporosis all his life until testosterone drops with older age. Once again it is important to monitor his male hormone level and replace with bioidentical testosterone when it is lower than 500 ng/dL.

Rise in cholesterol

With obesity there is a metabolic change, called metabolic syndrome. This leads to an elevation of LDL cholesterol, which is a direct risk for hardening of the arteries. In an obese older man with low male hormones there is a double risk. First, there is the low testosterone and secondly the metabolic syndrome, if he is overweight or obese. As a result the heart attack and stroke rates in obese men with low testosterone are much higher. In obese men with normal male hormone levels there are less heart attacks and strokes. Men with obesity need to lose weight by changing their diet to healthier eating habits and starting a regular exercise program with swimming and walking. At the same time those with a testosterone level of lower than 500 ng/dL should have bioidentical testosterone replacement.

Urinary dysfunction

A hyperactive bladder, dribbling, hesitancy and leaking bladder can all be part of male hormone deficiency. But this is not that easy to diagnose. A full consultation by a urologist may be necessary to assess various other causes that could hide behind these symptoms. Part of the work-up though is to measure the total testosterone level and replace what is missing.

Alzheimer’s disease

Alzheimer’s disease can be due to a lack of male hormones. It is therefore important to measure the total testosterone level in a man. If it is lower than 500 ng/dL, as mentioned before , it means he needs male hormone replacement therapy. This will prevent Alzheimer’s disease.

Burnout

According to Dr. Thierry Hertoghe, an endocrinologist from Belgium, there are several hormones that can be missing in a person with burnout: a lack of cortisol, thyroid, growth hormone, testosterone/estrogen, progesterone and oxytocin. The middle-aged manager with burnout would have other hormones missing apart from testosterone. The physician needs to order blood tests to measure whether other hormones are missing. Whatever is low needs replacement with bioidentical hormones.

Some details regarding testosterone measurements and delivery

The deeper you delve into male hormone replacement, the more details there are to consider. First, there is a sex hormone-binding globulin that is mostly produced by the liver and circulating in the blood. It is like a storage form of testosterone and only 1 to 2% of the total testosterone is unbound. This is called the free or bioavailable testosterone. Some physicians measure just that portion of testosterone.

Hormone replacement in a man

Second, when it comes to replacement of testosterone in a man who is deficient for testosterone, there are several delivery systems, which some people find a little confusing. There are testosterone gels with less than optimal absorption. Another application are creams that compounding pharmacies provide. The patient absorbs these creams usually quite well. But some men do not absorb either creams or gels. They need testosterone injections or testosterone pellets. The goal is to replace testosterone in a manner that there is a fairly equal amount of testosterone available circulating in the blood at all times. Some men achieve that only with testosterone pellets, others with testosterone cypionate injections. For this reason blood test that determine the levels of free testosterone are necessary at intervals of about 3 months.

Testosterone

Testosterone

Conclusion

Testosterone is a key hormone in the male that requires monitoring, particularly when he is aging. A knowledgeable physician or naturopath needs to take a careful history of his symptoms. If blood tests show that the total testosterone is less than 500 ng/dL the physician needs to replace with bioidentical testosterone.

 

References

Ref.1: Dr. Abraham Morgentaler: “Testosterone for Life – recharge your vitality, sex drive, and overall health” McGraw-Hill, 2009

Sep
19
2015

Obesity Shortens Life

By | Cancer, Cardiovascular disease, Diabetes, heart attack, Heart Disease, High Blood Pressure, Inflammation, Mortality, Nutrition, Obesity, Smoking, Stroke, Weight loss

This article is about the fact that obesity shortens life. Of all the factors that definitely shorten life, obesity stands out like a giant. Let’s review a couple of facts regarding obesity:

  1. Americans who were born between 1966 and 1985 became obese at a much earlier age than their parents
  2. Obesity occurs at a younger age than in the past. 20% of people born between 1966 and 1985 were obese in their 20s.
  3. The longer you are obese, the higher the chance of getting seriously sick or dying prematurely from complications of associated diseases like diabetes, heart attacks, strokes, kidney disease, liver disease and cancer.
  4. Severely obese people live up to 20 years less than non-overweight people.
  5. Obesity causes about 300,000 deaths in the U.S. annually

Change of metabolism

Obesity shortens life. Obesity leads to a change in metabolism, which is known as metabolic syndrome. The liver changes its metabolism slightly producing more triglycerides, LDL cholesterol and clotting factors, which increases the risk for heart attacks, strokes and pulmonary emboli. The pancreas produces more insulin, which gives rise to reactive hypoglycemia. This means that 2-3 hours after a meal you become hungry as your blood sugar declines from the extra insulin. You are craving a sugary drink, a donut or other starchy food (pizza, fries, bread etc.). Unfortunately, these types of foods reinforce the metabolic syndrome: the liver changes the sugar into LDL cholesterol and triglycerides.

Excess sugar oxidizes LDL cholesterol

Excess sugar will oxidize the LDL cholesterol, which causes atheromas (hardening of the arteries). Protein is being caramelized, which is called “advanced glycation end-products” or AGEs. This reference clearly explains how to counter this: increase your consumption of fish, legumes, vegetables, fruits, low-fat milk products and whole grains; also reduce your intake of solid fats, full-fat dairy products, fatty meats, and highly processed foods. There are other hormone changes that take place in obese people.

Death statistics due to obesity

In this study 849 autopsies were performed over 10 years, of which 32.3% were of obese persons. Leading causes of deaths in obese people were: malignancy (31.4%), infection (25.9%), ischemic heart disease (12.8%), pulmonary embolism (6.2%) and liver disease (2.9%). Table 2 of this link shows the causes of death in non-obese individuals as well: malignancy (32.5%), infection (23.8%), ischemic heart disease (10.4%), pulmonary embolism (2.9%) and liver disease (0.7%). The figures do not look all that different except that liver disease and pulmonary embolism are significantly more often the cause of death in obese patients than in normal weight patients. What you do not see in these figures is that obese people get these conditions at a much younger age as a result of complications from the associated diseases like diabetes, high blood pressure, cardiovascular disease, osteoarthritis, kidney disease and liver disease.

Diabetes

The metabolic changes with regard to the metabolic syndrome include insulin resistance.

As obesity worsens the balance is lost where the body can compensate and type 2 diabetes develops with increased blood sugar values and symptoms of diabetes. Surprisingly with regular exercise and changes in food intake (adopting a low glycemic index diet) this can be treated successfully. Usually this change is also associated with some weight loss, which helps to stabilize the metabolism. If nothing is done to to change diabetes, there is a high risk for heart attacks, strokes and subsequent secondary conditions like diabetic nephropathy, retinopathy, diabetic neuropathy and vascular complications.

Uncontrolled high blood pressure

High blood pressure is part of the metabolic syndrome. Unfortunately in obesity it is often difficult to control and may require several different antihypertensive medications in combination to control it. One way to quickly get the blood pressure under control is to make a concentrated effort to reduce a few pounds of weight; this can be achieved by cutting out refined carbs and sugar and starting an exercise program of walking and swimming.

Smoking

Smoking continues to remain a problem. Men as a group are now smoking less while women are increasing their smoking rates. Smoking causes various cancers, but also increases death rates from heart disease and strokes. In connection with obesity it is clear that the obese smoker has the highest risk of dying prematurely. This is depicted in this link based on the original Framingham study.

Disabilities and nursing homes

Obese people get disabled earlier, ending up in nursing homes. This poses a huge problem there for the staff. Back injuries and disabilities in the caregivers of nursing homes have increased significantly in the last few decades.

Osteoarthritis

80% of hip replacements and 90% of knee replacements are due to osteoarthritis. Obesity is the strongest modifiable risk factor that leads to osteoarthritis and subsequent surgery. There is a lot of morbidity and mortality associated with total knee and total hip surgeries. Part of this is the susceptibility to clot formation from the changes in metabolism associated with the metabolic syndrome. This often leads to pulmonary emboli and higher death rates following surgery when compared to surgery in people with normal weight.

Heart attacks and strokes

As there is an increase of the amount of heart attacks and strokes in overweight and obese people it is important to reduce your BMI when you realize that it is creeping up. Regular exercise along with a Mediterranean diet helps to improve this. Avoid processed foods that often have hidden sugar and refined carbs in them. Also cut out sugar. Use stevia, a natural sweetener, if you want to sweeten your food or drinks.

Nonalcoholic fatty liver disease (NAFLD)

In the past nonalcoholic fatty liver disease was rare. Now with the increase of obesity it is common. It can lead to liver cirrhosis with hepatic failure, a common cause of death. But after several years of liver cirrhosis, liver cancer may develop within the cirrhotic liver. Physicians saw this condition only rarely in decades past.

Obesity shortens life: Kidney disease

With obesity there is a negative effect on the kidneys from the metabolic syndrome. Hyperinsulinism affects the capillaries of the filtration units, called glomeruli. They start to proliferate and undergo a form of degenerative change, called glomerulosclerosis. This decreases the filtration capacity of the glomeruli and the kidneys as a whole. After a few decades of this process kidney failure can set in. When an obese person develops diabetes, this will also have a negative effect on kidney function and accelerate the deterioration of kidney function. The end result is kidney failure, which requires dialysis or a kidney transplant.

Cancer and obesity

Obesity shortens life. Chronic inflammation that is worsened by the metabolic syndrome leads to higher rates of various cancers. A prospective study of more than 900,000 US adults was conducted for 16 years. In 1982 when the study was started none of the participants had cancer. After 16 years 57,145 of the study participants had died of cancer. Those in this study who had a BMI of 40.0 or more had cancer death rates that were 52% higher for males and 62% higher for females when compared to normal weight men and women.

Higher cancer rates in people with obesity

It was noticeable that the digestive tract showed higher cancer rates in the obese: esophagus, liver, gallbladder, pancreas, colon and rectum; other more frequent cancers were kidney cancer, multiple myeloma and non-Hodgkin’s lymphoma. There were also trends of higher cancer death rates with regard to cancer of the stomach and prostate in men and breast cancer, uterine cancer, ovarian and cervical cancer in women. The authors concluded that due to the rising obesity rates in the US population cancer rates in men will soon reach the 14% level and in women the 20% level out of the total death rates.

Treating obesity

Treatment of obesity requires a multifaceted approach. I have discussed this in detail in this blog. Briefly, the diet of the obese person needs to be closely looked at. Sugar and starchy foods need to be eliminated. Low glycemic foods like vegetables, lean meat and salads should be encouraged. A regular exercise program needs to be instituted, starting with swimming and walking. Later a gradual transition into gym type activities could be contemplated.

Weight loss surgery has been successfully applied in some obese patients with a BMI that is greater than 30.0 up to a BMI of 39.9. In a 5-year follow up after LAP-band surgery no surgical complications were reported and the mean percentage weight loss was 15.9±12.4%.

Obesity Shortens Life

Obesity Shortens Life

Conclusion

Obesity shortens life. Obesity is a condition that has been gradually developing since the 1980’s. When you look at the food intake changes rationally it is not surprising that this is happening. Sugar consumption, high-fructose corn syrup consumption and the consumption of processed food have to be cut down, if not cut out completely. You can forget shopping at the middle section of any grocery store, where all that processed food is located. Go to the vegetable section and buy a lot of food from there. Low fat dairy products, eggs, and low-fat meats as well as salmon and other seafood are foods that are healthy. There is one problem though and that is the feeding of antibiotics to chickens, turkeys and beef cattle. This leads to superbugs and changes your gut flora.

Eat organic foods

I suggest you buy organic meats. I eat organic food and have cut out wheat also as wheat underwent forced hybridization in the 1970’s. All of the wheat in the world now is this type of wheat that is too rich in gliadin, which causes leaky gut syndrome and autoimmune diseases. For this reason, I avoid all wheat.

Gradually shed your pounds

I see no reason why obese people could not gradually shed their pounds and regain their stable metabolism. Those with diabetes will be able to shed that diagnosis as they shed their pounds. The kidney and liver function will also stabilize when you shed enough pounds. The goal should first be to reach a BMI of 25.0 to 30.0, which is the overweight category. The next goal would be to aim for shedding even more pounds until you reach a BMI of fewer than 25.0. If you say this is too tough to do, I am saying: giving up is not an option. Cherish your health!

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Sep
12
2015

Ageless Aging

By | Anti-aging medicine, Arthritis, Cancer, Cardiovascular disease, fractures, heart attack, Hormones, Inflammation, lifestyle, Menopause, mitochondria, Nutrition, Osteoporosis, Prevention, Vitamins and supplements

We have been exposed to a lot of clichés about aging, which makes it more difficult to dispel rumors and to clearly focus on what can and what cannot postpone aging and the associated disabilities. Here I will attempt to summarize what is known about this topic.

The American Academy of Anti-Aging Medicine (also known as A4M) has published a book where all of this is discussed in detail (Ref.1). But there are yearly conferences as well in Las Vegas and other places where further details regarding anti-aging are discussed. Since 2009 I have been attending the conferences in Las Vegas regularly every year.

Based on this knowledge let me start by reviewing the tools of anti-aging that can be used to slow down the process of aging significantly.

  1. Mitochondria

At the center of anti-aging is the preservation and metabolic optimization of the mitochondria. Each of our cells contains little particles called mitochondria, which is where our energy metabolism takes place. Mitochondria function like mini-batteries.

The citric acid cycle builds up ATP, which is subsequently hydrolyzed into ADP and orthophosphate releasing energy for cell metabolism.

Old people who shuffle when they walk and have difficulties climbing stairs have lost significant amounts of mitochondria and simply run out of energy. The key to prevent this from happening is to preserve our mitochondria. We inherited them from our mother, because only the head of the sperm, which does not contain mitochondria entered the ovum when the egg cell that was destined to become you was fertilized. Subsequently the mitochondria from mother’s egg have provided all of the mitochondria in the cells of our body.

  1. Preserving mitochondria

There are supplements that specifically preserve mitochondria: PQQ (=Pyrroloquinoline quinone) helps mitochondria to multiply. A typical dose to take every day is 20 mg. Mitochondrial aging is slowed down by ubiquinol (=Co-Q-10, 400 mg per day is a dose that I recommend). Co-Q-10 repairs DNA damage to your mitochondria.

There are simple lifestyle changes that you can make: eat less calories as this will stimulate SIRT1 genes, which in turn stimulate your cell metabolism including the mitochondria.

Resveratrol, the supplement from red grape skin can also stimulate your mitochondria metabolism. 300 to 500 mg of trans-Resveratrol once daily is a good dose.

Build in regular exercise into your day – and I mean every day– as this will also stimulate your mitochondria to multiply similar to the effects of PQQ. Lipoic acid is an anti-oxidant that counters the slow-down of mitochondrial metabolism. I recommend 300 mg per day.

L-arginine is an amino acid that is a precursor of nitric oxide (NO). Red beet is a rich source of nitric oxide, which is directly released into your system. There are also commercial products for NO. This keeps the arteries open, prevents high blood pressure and also hardening of the arteries and has a direct effect on preserving mitochondria.

Researchers from the McKusick-Nathans Institute of Genetic Medicine of the Johns Hopkins University School of Medicine in Baltimore, MD found that mitochondrial DNA content varies according to age (less mitochondrial DNA in older age), sex (yes, women have more than men) and mitochondrial DNA; it even has an inverse relationship to frailty and a direct relationship to life expectancy. This paper was published in February of 2015.

Each mitochondrion has its own mitochondrial DNA contained in 2 to 10 small circular chromosomes that regulate the 37 genes necessary for normal mitochondrial function.

In multi ethnic groups it was apparent that mitochondrial DNA content was dictated by the age of a person.

Frailty was defined as a person who had aging symptoms including weakness, a lack of energy compared to the past, activity levels that were much lower than before and loss of weight. When persons with frailty as defined by these criteria were identified, they were found to have 9% less mitochondrial DNA than nonfrail study participants.

Another subgroup were white participants; when their bottom mitochondrial DNA content was compared to the top mitochondrial DNA content, the researchers found that frailty was 31% more common in the bottom DNA content group. This means that white people are more prone to frailty and they should take steps early on to prevent this from happening.

  1. Slowing down hardening of our arteries

It makes sense that young people who do not have signs of hardening of their arteries have better blood supply to their cells and thus supply their mitochondria with more oxygen and nutrients than frail, older people. The same is true for people who exercise regularly.

Vitamin D and vitamin K2 have been shown to lower calcium in the blood vessels and to retain calcium in the bone preventing osteoporosis. This is particularly useful in postmenopausal women. This October 2014 publication mentions that apart from vitamin D and vitamin K2 resveratrol and inositol are additional factors helping to prevent heart disease and osteoporosis.

This September 2013 publication confirms that a deficiency for vitamin K2 is common in the general population. This deficiency leads to osteoporosis and calcification of the arterial wall and causes heart attacks, strokes and bone fractures. Supplementation with vitamin K2 at 200 micrograms per day every day is recommended to prevent this from occurring.

  1. Sugar and starchy foods

You need to understand that starchy foods equal sugar, once digested. As a result a refined cereal breakfast=sugar, pasta=sugar, bread=sugar, donuts=sugar, potatoes=sugar and so on. It has to do with the glycemic load. When you cut out sugar and starchy foods (meaning that the glycemic index of the foods you eat is below 50) you will shed 30 to 50 pounds of weight within 3 to 5 months, if you are overweight or obese. You will feel a lot more energy. Your blood vessels will be cleaned out as the oxidized LDL cholesterol will disappear and the HDL cholesterol will mop up what cholesterol deposits were there before.

It is certainly good for you, if you are not into the sugar and candy stuff, but the seemingly harmless pizza and all the other starchy foods mentioned above are of concern as well. All of the high -glycemic carbs stimulate the pancreas to produce insulin. This in turn produces inflammation in tissues including the brain. Alzheimer’s disease is one of the complications of this.

Where does this leave us? For decades we have been told that saturated fats and cholesterol in our diet were the culprits and we replaced them with sugar that is part of a low-fat diet. We need to pay attention to the glycemic index and cut out high glycemic foods. However, it is OK to eat some carbs from the medium glycemic food list and most of our carbs from the low glycemic food list. With regard to fat it is important to consume only the healthy fats like olive oil, coconut oil and omega-3 fatty acids. As you make these adjustments to your life style you will also prevent many cancers, as you normalize the body’s metabolism and help prevent chronic inflammation, which can cause arthritis and cancer. Finally, pay attention to stress management. The body and the mind work together. Uncontrolled stress leads to heart attacks and strokes.

  1. Cut down on processed foods

Processed foods contain the wrong type of vegetable oils that are composed of omega-6 fatty acids. This disbalances the ratio of omega-6 fatty acid versus omega-3 fatty acids. This is typical for all the processed foods, but also fast food places in the industrialized world. The consequence of this disbalance is the formation of arachidonic acid and inflammation of tissues. This causes high blood pressure from inflammation of the arteries, arthritis from inflammation in the joints and can irritate the immune system to the point of causing autoimmune diseases. The end result after decades of exposure to a surplus of omega-6 fatty acids are disabilities from end stage arthritis, as well as heart attacks and strokes from inflammation of the arteries due to the hardening of the arteries.

The remedy for this is to cut out all processed food and stick to the basics of preparing your own food from healthy ingredients with no food preservatives.

Use olive oil for salads and coconut oil for cooking. Take omega-3 supplements to restore the omega-6/omega-3 fatty acid balance.

  1. Replace hormones with bioidentical ones

When I watch postmenopausal women, many look prematurely aged with sagging skin in their faces. Had they replaced their missing hormones when they entered menopause, the bioidentical hormones used for replacement therapy would have helped their skin to remain younger looking, hardening of the arteries would have been postponed and osteoporosis in the bones would also have been prevented.

With men it is now known that testosterone is vital for prevention of prostate cancer, but it is also important to prevent heart attacks, strokes and dementia as they age.

I would recommend that you see a naturopath or an anti-aging physician to have your hormones checked and if necessary start replacement with bioidentical hormones.

Ageless Aging

Ageless Aging

Conclusion

Slowing down aging and avoiding disabilities from aging are now a possibility, if we manage our lives in a way that the biochemistry of our bodies remains the same and our mitochondria continue to function, even when we get older. I discussed the details of how to do that above. I have also written a book on the subject of anti-aging, which deals with these topics in more detail.

I hope that you incorporate at least some of these steps in your life to prevent suffering from disabilities as you age and to avoid premature aging.

References:

Ref.1: Ronald Klatz, MD, DO and Robert Goldman, MD, PhD, DO, FAASP, Executive Editors: “Encyclopedia of Clinical Anti-Aging Medicine & Regenerative Biomedical Technologies”. American Academy of Anti-Aging Medicine, Chicago, IL, USA, 2012.

Aug
29
2015

Problems With The Western Diet

By | Cancer, Cardiovascular disease, Diabetes, Fitness, heart attack, Heart Disease, Inflammation, lifestyle, Nutrition, Prevention

Lately there have been various news reports cautioning us about the Western diet. We eat too much processed food, we eat too much sugar and we have to be careful with how much fat and what kind of fat we eat. Take this story from the CNN. Half the world lives in big cities. And this number will reach 70% in the year 2050, if the urbanization trend continues at the same rate. With it comes the consumption of fast food. The wealthier people are, the more meat they eat. This is exactly what is bad for us. Too much meat can cause gout, particularly when paired with alcohol. First it is time to explain some more about the Western diet. “The biggest features of a Western diet are overconsumption of over-refined sugars, highly refined and saturated fats, animal protein and a reduced intake of plant-based fibers,” says Ian Myles. He is located at the U.S. National Institute of Allergy and Infectious Diseases. This statement is specific enough: we are eating too much fat, red meat, salt and sugar, and too little fiber.

Too much fat

In processed foods we get too many omega-6 fatty acids, which have been shown to cause clogging of arteries and causing heart attacks and strokes, if not balanced with enough omega-3 fatty acids. But many processed foods still have hidden trans fats, which distribute free radicals in your system; this in turn causes hardening of the arteries again. Free radicals also age you faster. A candy bar with palmitic acid and fructose for instance, leads to a slow grade inflammation. The immune system mistakenly takes palmitic acid for the gut bacterium E.coli and mounts an immune reaction. This low-grade inflammation causes inflammation in the blood vessels, but also weakens the immune system. The sugar part of the candy bar oxidizes LDL cholesterol leading to clogging of arteries, which causes heart attacks and strokes.

Too much red meat

Grain fed and antibiotic treated regular beef changes the gut bacteria and can cause super bugs. The change of the gut flora can lead to inflammation in the gut lining and something called “leaky gut syndrome”. We carry almost 2 pounds of gut bacteria in us at any given time. But residual antibiotics from regular beef and chicken reduces that amount and changes the composition of our gut flora.

You can read in this blog that the changes taking place from consuming regular beef changes your liver metabolism and leads to accelerated hardening of the arteries, which in turn causes deadly heart attacks and strokes. On the other hand, grass fed beef or organic beef do not do this. To prevent leaky gut syndrome, heart attacks and strokes from developing you can take probiotics every day, which should include these two species: Lactobacillus acidophilus and Bifidobacterium bifidus. This keeps your gut flora stable and does not allow your food to undermine your health.

To much salt and sugar

Too much salt is often in processed food to prolong the shelf life. But we humans are very sensitive to overdoses of salt. Our kidneys have to work overtime to get rid of the excess salt. We need to drink enough water to allow the kidneys to produce urine, which will eliminate the excess salt. Persistent excessive salt intake will also cause high blood pressure. High blood pressure can cause heart problems, strokes and aortic aneurysms. Restaurant food often contains too much salt and sugar.

Too little fiber

The more food is processed, the less fiber it will contain. If you go for the pizza, it may taste good, but where is the fiber? If you eat bread and butter, where is the fiber? You may say that you like a donut. I ask you again: where is the fiber? The end result is that toxins that normally would have been bound to fiber in the colon and were eliminated in the stool are now interacting with the wall of the colon causing colonic polyps and colon cancer. It may not only be fiber as plant-based diets rich in fruits, non-starchy vegetables, legumes, and whole grains were shown to be associated with a lower risk of the most common cancers. That’s the reason why people who consume a Western diet have higher rates of cancer in general. They lack fruits and vegetables.

Polyunsaturated fatty acids

The recommendation in the 1980’s until about 2010 of a low fat diet to prevent heart attacks and strokes has failed miserably. It turned out that polyunsaturated fatty acids are of the omega-6 type, which gets metabolized into arachidonic acid and causes inflammation. The immune system gets suppressed from the chronic inflammation and the person becomes more prone to infections. As low fat diets are typically high in carbohydrates, there is a calorie surplus causing weight gain. Dr. Fife explains in his book that polyunsaturated acids interfere with the insulin receptor feeding into insulin resistance, which makes it even more difficult to control the metabolism and leads to more weight gain (Ref.1). The end result is what we have observed over the last few decades, a relentless obesity wave in the civilized world. It is a direct result of the Western diet.

Cancer caused by the Western diet

Breast cancer, colon cancer and prostate cancer are cancers that are related to the Western diet. But there are likely many other cancers that are also caused by it.

We know that free radicals cause cancer, such as from trans fats and rancid polyunsaturated fatty acids found in processed foods. Cancer is more common in obese people and people with diabetes.

Habits that make us eat more

There are habits that make us eat more like snacking and falling for so-called “fitness food” which contains dubious ingredients. It may come as a surprise, but married people can also fall prey to unhealthy habits together, forgetting about working out and sneaking in “skinny cocktails”. Read what Cynthia Sass, registered dietician had to say about this on CNN.

Solution to the Western diet

You may expect me to say that you should modify this or that in the Western diet. Modification does not work. You have to get radical here! The real solution is to abandon the Western diet altogether. Replace it with the Mediterranean diet without sugar and starchy foods. It is not that as bad as you can see from 1 week of recipes that my wife included in my book: “A survivor’s Guide To Successful Aging”.

You can eat cooked organic spinach, a piece of meat with slices of Avocado for breakfast. Cooking is done mostly with coconut oil or olive oil. Alternatively you may enjoy an egg or egg white vegetable omelette with lots of greens, mushrooms, onions and salsa and avocado on the side. Add to this caffeinated or decaffeinated coffee with stevia. Alternatively, a bowl of rolled oats, flaxseed and nuts with fresh fruit and organic milk, goat milk or yoghurt would make an excellent, sustaining breakfast. I am mentioning all of this to show you that you can get away from your familiar pancakes with maple syrup, sausages, waffles, toasts and muffins etc.

Food needs to be prepared form scratch with organic ingredients. GMO foods need to be avoided as the final judgment on these is decades away, and you do not want to become a human guinea pig.

Problems With The Western Diet

Problems With The Western Diet

Conclusion

The only way to “improve” a Western diet is to eliminate it and replace it by the Mediterranean diet. Throw all the processed food into the trash where it belongs! Avoid omega-6 fatty acids (polyunsaturated fatty acids), which have been shown to weaken the immune system and cause insulin resistance. The best fats are omega-3-fatty acids from marine oils (fish oil), coconut oil and olive oil. Forget all the other oils that are heavily advertised. They are not healthy.

I stick to organic foods although they are more expensive. Don’t forget that apart from a good diet you need to engage in a regular exercise program in order to prevent heart disease and cancer. And don’t stress out over the changes that you are about to make. Remember to manage your stress and relax!

References:

  1. Bruce Fife, C.N., N.D.: “The Coconut Oil Miracle”, 5th edition,2013, Penguin Books, NY 10014

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Aug
22
2015

Tools To Turn 100

By | alcohol, Alzheimer’s disease, Cardiovascular disease, Fitness, heart attack, Heart Disease, Mortality, Nutrition, Smoking, Stress management, Vitamins and supplements

A Swedish longevity study that went on for 50 years gave me the idea to blog about the factors that can help you to turn 100 and still have your mental capacity and good health. Let me introduce you to this study.

Researchers at the Sahlgrenska Academy in Göteborg, Sweden (which is the same as the University of Gothenburg) decided back in 1963 to follow a group of 855 Gothenburg men born in 1913 until they would either die or turn 100. The idea was to find out what killer diseases are in the way to reach such a ripe old age and if they would survive, what was it that made them to reach this age.

Think of it as a race to turn 100. The researchers had checkpoints along that journey: various surveys were conducted at the age of 54, 60, 65, 75, 80 and 100 to consider the factors that lead to longevity. 27% (232) of the original group reached the age of 80, and 13% (111) made it to 90. Only 1.1% of the men made it to the age of 100.

What were the causes of death for the other ones who did not make it? 42% of deaths after the age of 80 were due to heart attacks, 20% due to infectious diseases, 8% due to strokes, 8% due to cancer, 6% due to pneumonia and 16% due to other causes. 23% of the men over 80 were diagnosed with Alzheimer’s or dementia.

What else did the researchers find out? Factors that made people survive were refraining from smoking, maintaining a healthy cholesterol level and limiting coffee consumption to not more than 4 cups per day.

Another marker for longevity was either paying high rent for a condominium or own a house; in other words, a certain amount of wealth seems to be associated with longevity. Passing a fitness test at age 53 riding a bicycle was another peculiar finding of the study. This one points to the importance of fitness and clarity of thought as markers for longevity. There was a genetic factor also, as those who had a mother who lived to a ripe old age also survived longer than others who did not have this longevity advantage. However, researchers stressed that overall this genetic factor was of minor importance, the other factors that are under our control were much more important.

Two of the men who were 100 years old dropped out of the study: one because of dementia, the other one for personal reasons. Here are some of the facts about the other seven: none of them smoked; 2 lived at home, 5 in assisted living facilities. All of them wore hearing aids; all of them had good spatial and temporal cognition. All of them were slim, had good posture, but all used walkers to prevent falls or assist them walking. They were all able to read and watch TV, and most of them wore glasses.

Dr. Wilhelmsen who was part of the entire 50-year research effort said about the centenarians: “All of them were clinically healthy, satisfied with their circumstances and pleased to be living where they were.”

Other research about marriage, health and life expectancy

There is some peculiar research that found that men who are married are healthier than single men. This study came from the University College in London and was based on a group of 10,000 British people who were born within one week of each other on March 1958.

Being married or living common-law was beneficial for men compared to single men. One biomarker was the metabolic syndrome (a cluster of obesity, high blood pressure and diabetes), which was found to be 14% higher in non-married males while in females it did not matter whether they were married or not: they had the same low rate of metabolic syndrome. The longer men were married, the healthier they were. This was not so for the single male. Women, who married in their late twenties or early thirties, were much healthier in their later midlife compared to women who never married.

Harvard has published some interesting facts on men and marriage. A survey of 127,545 American adults showed that married men live longer than the unmarried males of the controls. A review of studies in the early 2000 suggested that when men were married to a well educated woman this may be causing heart attacks in the men. Quite peculiar, isn’t it? But this was refuted in a larger 2009 study, which found that married men live longer and are healthier when the partner is well educated.

Unhappiness and stress were singled out as a cause of high blood pressure, which leads to heart attacks later. Harvard reveals several other facts that are important with respect to longevity: cancer mortality is higher in unmarried men than in married ones; married men are at a lower risk of developing depression. They were found to have higher rates of satisfaction with life in retirement than their peers who never married. Marriage protects cognitive function and leads to a reduced risk of Alzheimer’s disease. Marriage is also associated with improved blood sugar levels and better outcomes with respect to cancer treatment or when hospitalized for other reasons.

General factors leading to longevity

We heard now several interesting points that seem to be linked to longevity. But what is it exactly that is behind some of these observations?

1. Diet

The Mediterranean diet is the gold standard as it has been shown to lead to the lowest mortality rates among diets.Note that longevity increases even more when sugar and starchy foods are avoided. And yes, a Mediterranean diet cuts down the risk for Alzheimer’s disease.

2. Exercise

It has been shown in many studies that regular exercise will reduce all diseases by about 50%! This is better than any medication; this is simply a must, if you are at all interested in living longer and healthier. Not only will your heart benefit from that, but your mind will thank you and not enter into dementia.          

3. Alcohol

This has been drummed to death, but the limit is 1 glass of red wine for women and 2 glasses of wine for men. Personally I do not believe that this is true. I have explained in a blog that the same heart protective effect can be achieved by 250 mg of resveratrol as supplement and avoiding alcohol altogether will prevent a number of cancers.

4. Smoking

Originally the Framingham Heart Study has shown that smoking is an important risk factor for heart attacks and strokes. Hundreds of other studies have verified this. Despite this fact women as a group are now repeating the experiment that has already been completed for men: smoking causes lung cancer and many other cancers as well as cardiovascular disease. I see young women thoughtlessly walking around town puffing their lives away.It shows you how powerful cigarette commercials are. Sometimes it is frustrating to watch this as a health care provider!

5. Stress management

This means seeking ways to reduce stress like meditation, self-hypnosis, yoga and others. This also means building social ties and mutually supportive relationships. It makes you feel that you belong, you have your place in society, you help others, and they support you.

6. Avoiding iatrogenic disease

Physician-caused illness is getting more common. Medications have become stronger and often have more potent side effects. For instance, if a physician treats a gluten-induced rash called dermatitis herpetiformis with a drug called Dapsone, the patient can get severe anemia, violent abdominal cramps and bloody diarrhea. A strict gluten-free diet would probably have helped the patient to clear up the rash. All of the symptoms that the patient had to suffer as a result of Dapsone were from this “iatrogenic disease”, which simply means they happened as a result of the doctor’s malpractice that had caused a medication-induced disease.

7. Avoiding exposure to free radicals

Many different agents like substances from pollution, radiation, rancid unsaturated oils and others contain free radicals that damage tissues and cause inflammation. Antioxidants like vitamin C, E and resveratrol can stop this as is reviewed here.

8. Using vitamins and supplements

As already indicated this will help to reduce free radical exposure by the use of antioxidants; reduce inflammation by using omega-3 fatty acids, Co-Q-10, vitamin C and E, resveratrol and others.

9. Avoid accidents

As you are aware, accidents can kill. Wear seat belts, drive safely, and stick to speed limits, particularly in curves. Also don’t drink and drive, don’t use your phone and don’t text and drive. The use of street drugs is also a common cause for accidents.

10. Use bioidentical hormone replacement

When we experience the change of life, called menopause in women and andropause in men we can allow nature to knock us off the planet or use scientific knowledge. It has been proven that it is perfectly safe not to use Big Pharma’s hormone concoctions that the body cannot recognize. Synthetic hormones cause iatrogenic disease as proven in the Women’s Health Initiative. Bioidentical hormones, however simply replace what is missing in menopause and andropause.

The reason this is important is that our system has hormone receptors on the surface of all body cells. In order to have normal function, we depend on bioidentical hormones to assist cell metabolism. For instance the heart muscle in a man has testosterone receptors as has his brain. In women estrogen receptors and progesterone receptors are contained in the cells. Using the right mix of bioidentical hormones based on saliva hormone tests or blood hormone tests can help the treating physician or naturopath to rebalance the body’s natural hormone needs with bioidentical hormone creams applied to the skin.

Tools To Turn 100

Tools To Turn 100

Conclusion

Tools to turn a hundred years old and still be fairly alert and fit are listed above. It is important that we start thinking along those lines, because it is only prevention that gets us safely there. If you allow yourself to constantly live it up and run your health down, how can you expect to turn 100? In the last 50 years the life expectancy has risen at least 20 years (85 years now, 65 years then). Now we are seeing a downward trend in the obesity and overweight population and the diabetics. They are the ones vulnerable to iatrogenic disease and mortality. They also are at a higher risk to die from heart attacks and strokes and they are more likely to get Alzheimer’s disease. Also, single men would do well to see their physician more often to check out their health status and perhaps change detrimental lifestyles that married men would not get into, because their wives talk to them. If you can switch from a curative approach in healthcare that usually does not work too well anyways to a preventative approach, you have a good chance to make it to 100. I talk to you then.

Jul
31
2015

Two Is Better Than One: Omega-3 And Krill Oil

By | Alzheimer’s disease, Arthritis, Cardiovascular disease, Diabetes, Fitness, heart attack, Inflammation, Osteoporosis, Stroke

Omega-3 fatty acids have gotten a lot of limelight in the press; krill oil was kept more in the background by the media. But both omega-3 and krill oil are important for your health.

What can confuse you is the following paragraph that I picked up from Facebook:

“I cannot believe that in the last 7 days 3 Doctors have asked me what krill omega-3 is. One would think that those who look after our health would realize that the high levels of mercury in the regular omega-3 has reached dangerous levels. Krill oil is harvested from pristine waters of the Antarctic Ocean and tested to be free from harmful levels of mercury. If you have not heard of it, it is for brain, heart, joint and immune health.”

Clarification of what Omega-3 fatty acids are

Depending on where fish is within the ocean’s pecking order of feeding, the levels of mercury of the fish oil that contains omega-3 fatty acids will be higher or lower. Tuna, for instance is one of the predator fish on top of the line. They are large predator fish, and as a result, not a fish you want to eat as it has very high levels of mercury. Salmon on the other hand is lower in the line of predator fish. That’s why it is still recommended to eat salmon two or three times per week. Fish oil is pooled from various fish and then molecularly filtered through a special filter that removes heavy metals like mercury, cadmium and others. Knowing these facts, the Facebook text above may be accurate in stating, “regular omega 3 has reached dangerous levels”, but it is inaccurate for the molecularly filtered omega-3 fish oil, which is the only one I would recommend as a supplement. Having said that there are still significant differences in quality according to a report online that tested 51 common products in the US. The omega-3 fatty acids EPA and DHA are stored in the membranes of platelets and in circulating plasma triglycerides, which is useful for the functioning of the lining of our arteries. This is called endothelium and needs to be healthy to lower blood pressure and prevent hardening of the arteries. Omega-3-fatty acids support the cardiovascular system foremost and the brain secondarily.

Where does Krill oil come from?

Krill oil comes from tiny crustaceans called krill that provides additional benefits that are not found in fish oil alone. Although the initial concentration of raw krill oil has less mercury per milliliter than omega-3 fatty acid fish oil, it still needs to be molecularly filtered to remove heavy metals. Also bear in mind, that the tiny crustaceans live in the same polluted ocean waters as other fish. It is a sad fact that our oceans are no longer pristine! The same is true for the Antarctic Ocean. After the filtering process both krill oil and omega-3 fatty acid fish oil are equal in their quality (free of mercury, other heavy metals, PCB and dioxins).

The omega-3 fatty acids of krill oil have an affinity to bind with phospholipids in red blood cells. This enables krill oil to cross the blood-brain barrier and get into the brain cells providing support for the brain. In this respect krill oil has an edge over omega-3 fatty acids to support the brain. But secondarily it is also good for your heart and the lining of the arteries.

Benefits of marine oils like krill and fish oil

It is best to think about krill oil and omega-3 fatty acids (fish oil) as complementary marine oils that have multiple beneficial effects on the body.

Studies have shown that arthritis and osteoarthritis are helped by krill oil, but also by fish oil. Similarly, heart attacks and strokes are prevented with both krill oil and omega-3 fatty acids. It appears that both oils reduce inflammation in the arteries that are associated with high blood pressure, diabetes, obesity and the metabolic syndrome in obese people. C-reactive protein measuring inflammation was reduced by krill oil up to 30% compared to placebo within 30 days. Patients with arthritis had 20% and more reduction in stiffness and pain.

Krill oil is well absorbed into the brain and can prevent age-related brain shrinkage, preserve cognitive function and memory, prevent dementia and also possibly depression.

Other health conditions improve on both krill oil and omega-3 fatty acids like osteoporosis (in combination with vitamin K2, vitamin D3 and calcium), a weak immune system, diabetes, high triglyceride levels and cholesterol problems. Both marine oils prevent LDL cholesterol from being oxidized, which helps to prevent atheroma formation and hardening of the arteries. This prevents heart attacks and strokes.

Fear mongering Facebook write-ups

In this context let me clarify the fear mongering Facebook write-up cited at the beginning of this blog. It is a misconception to think that krill oil is devoid of mercury. It is only so, if it was molecularly filtered, which removes all of the mercury and more, but it leaves the beneficial DHA and EPA (omega-3 fatty acids) intact. In the same vein omega-3 fatty acids from fish oil are initially more mercury containing, but after molecular filtration are entirely mercury free, the same as krill oil after molecular filtration. But the mix of omega-3 fatty acids is slightly different with krill oil being a bit richer in DHA and attaching to red blood cells easier while fish oil omega-3’s attach to triglycerides in the liquid phase of the blood, called plasma and also to platelet membranes. So neither krill oil or omega-3 fatty acids are better than the other; they are slightly different and that’s why you benefit from a mix of both. It would be a big mistake to follow the Facebook advice above and only take krill oil by blindly trusting the quotation. In my opinion it is simply a marketing plot to get you switched from fish oil to krill oil.

What combination of Krill oil and omega-3 fatty acid should I take?

Most trials with krill oil have been done with 300 mg of krill oil per day.  I take a dosage of one capsule per day of 300 mg. There are several manufacturers that produce similar products. I also take 3 capsules of omega-3 fatty acids twice per day. Each capsule has 647 mg of EPA and 253 mg of DHA, which translates into a daily dose of 3882 mg of EPA and 1518 mg of DHA. Again, there are several products from which you can choose. The reason I take a relatively high dose of fish oil is the fact that I come from a family background with severe arthritis that started in several relatives at an age of 50+. I have no sign of arthritis at age 70. It may be the result of taking these supplements and staying away from sugar and starchy foods. I need my joints to do ballroom and Latin dancing and I also need them to attend the gym regularly. Exercise by itself has been shown to prevent arthritis and prevent heart attacks and strokes. We need the benefit from all these things in combination: good nutrition, supplements and exercise.

Two Is Better Than One: Omega-3 And Krill Oil

Two Is Better Than One: Omega-3 And Krill Oil

Conclusion

Both krill oil and fish oil (omega-3 fatty acids) are needed as supplements to prevent arthritis, strokes, heart attacks, osteoporosis, diabetes, dementia, Alzheimer’s and inflammation. The key to a good krill oil or fish oil supplement is to buy the more expensive products that are molecularly distilled and therefore more concentrated, but also free of heavy metals and other contaminants. These supplements are only a small part of your overall anti-aging program that needs to include good nutrition (organic food), exercise, other supplements and if necessary bioidentical hormone replacement.

Reference: Dr. R. Schilling: “A Survivor’s Guide to Successful Aging“. Paperback through Amazon.com, 2014. This text explains the anti-aging program I follow and includes recipes composed by my wife for 1 week.

Jul
25
2015

Light Can Interrupt Your Circadian Rhythm

By | Cardiovascular disease, Circadian rhythm, Sleeep

A light bulb company from Florida has decided to put warning labels on the light bulbs they manufacture to tell you that artificial light can have health consequences: light can interrupt your circadian rhythms.We do not easily see that it should matter whether you use artificial light at night or not.

Introduction

What we do know is that in the evening when we close our eyes and shut out the light the melatonin production gets elevated, we get sleepy, and we fall asleep. During our sleep the immune system receives a boost from the higher melatonin blood concentration, while cortisol takes a rest and levels are lower overnight. Melatonin is also a powerful anti-cancer agent and this would fit in with the study that found that a loss of the clock gene in shift workers was correlating to a worse prognosis regarding their breast cancer.

There are other diseases that can develop when the circadian rhythm is not maintained. Here are a few examples: neurodegenerative disease, cancer, depression, and sleep disorders.

This link shows how the internal central clock in the suprachiasmatic nucleus of the hypothalamus is responsible for keeping time inside of us. The suprachiasmatic nucleus is situated just above the optic chiasm, hence the name.

The clock gene influences the peripheral clock via the clock genes in each organ to be synchronized. If you disregard your internal clock, expose yourself to prolonged artificial lighting and delay going to sleep in time you will create a disorganized central/peripheral rhythm, which weakens the immune system, disrupts your normal hormone rhythms, and ultimately this can lead to disease.

Breast cancer from interrupted circadian rhythm

Women in California were followed with regard to developing breast cancer and nightly exposure to artificial light.

In this study the authors found a 1.34-fold higher breast cancer risk in premenstrual women exposed to high levels of ambient light at night compared to women who were not.

Similarly, a 2014 study showed a difference with regard to breast cancer rates in women who were working night shifts and women who worked normal hours.

The study showed a loss of clock genes in shift workers with breast cancer that was associated with a worse prognosis of their breast cancer compared to those who were not shift workers and had normal clock genes.

Is it a good idea to tell people that light bulbs can be harmful?

Fred Maxik, the Florida based Lighting Science Group chief officer thinks it is a good idea. Dr. Paolo Sassone-Corsi, the director of the Center of Epigenetics and Metabolism at the school of medicine at University of California Irvine who has authored many studies on the negative effect of artificial lighting on the circadian rhythm also thinks that labeling light bulbs is a good idea. He cautions that there are even more powerful light sources like TV’s and computers that can disrupt the circadian rhythm the later it gets in the evening. “And think about how many people look at Facebook at 2 a.m. That is way more disruptive, but this is certainly a good start; we need to keep increasing awareness in a larger population that light at the wrong time of day can harm you” Dr. Sassone-Corsi added.

It is somewhat nebulous what effects a disruption of the circadian rhythm has in our system. But we do know that sleep deprivation can cause overeating and obesity, memory loss, short attention span, diabetes, depression, car accidents, sudden cardiac arrest and sudden cardiac death due to deadly electrical heart rhythms (ventricular fibrillation).

This 2015 study suggests that melatonin should be used to treat people who are involved in shift work. This will help to reset the circadian rhythm to normal.

Origin of circadian rhythm disorders

Sleep disorders can start in childhood, usually when school starts with structured days and normal bedtime hours, followed by school holidays and weekends where late bedtime hours or irregular sleep habits are the rule. Circadian rhythm disorders are not disorders of sleep quality, but rather disorders in timing of sleep (Ref.1). Circadian rhythm disorders start usually when the child enters school, but can develop as late as in adolescence. 10 to 18% of children and adolescents have circadian rhythm disorders. It is not known why some children find it easy to switch between the irregular sleeping habits of summer to the regular sleeping habits during school days. But others are not able to switch and have problems in school with inattention, daytime sleepiness, irritability, hyperactivity and combativeness. Circadian rhythm disorder tends to persist and can turn into adult circadian rhythm disorder. There are also morning types and evening types (in medical lingo morning chronotypes and evening chronotypes).

Delayed sleep phase disorder

One of the most frequent subtypes of circadian rhythm disorder is the delayed sleep phase disorder. This is what is often found in adolescents who push for a later and later bedtime. The fact that they sleep in until 11 AM or 1 PM reinforces it. They like to shut their windows with a black curtain to keep the sunlight out. At night they like to spend time in front of a computer or the TV. They like to go to sleep only at 1, 2 or 3 AM. They may not be aware what is happening to them: the lack of morning sunlight exposure in the early morning hours of the day leads to a delayed setting of the dim light melatonin onset (DLMO) at the end of the day, which is regulated through the suprachiasmatic nucleus (a part of the hypothalamus). By taking frequent blood or saliva melatonin levels researchers have been able to measure corresponding melatonin levels at the time of the DLMO.

We know from research with astronauts in space travel that melanopsin is produced in the blue-light-sensitive photopigment in the ganglion cell layer of the eye. Melanopsin travels from there along the optic nerve into the suprachiasmatic nucleus, where it helps to set the circadian rhythm for the day.

The day is defined by first opening our eyes when we wake up, getting the first melanopsin dose in the circadian rhythm headquarters of the hypothalamus; two yours before we fall asleep we have the dim light melatonin onset where melatonin is just starting to rise, which makes us gradually tired. Maybe the cave men and women sat around the fireplace and told each other stories. We could listen to soft music in a less brightly lit area.

Treatment of delayed sleep phase disorder

It is important to note that people with a delayed sleep phase disorder (DSPD) do not have a sleep disorder: they have normal sleep at an abnormal time (Ref.1)

Here is how the sleep specialist treats delayed sleep phase disorder.

  1. Exposure to sunlight or to blue LED light at the time of awakening for 20 minutes to 1 hour is key to resetting the circadian rhythm to an earlier point than has been the case. This involves that the child, adolescent or adult has to get used to setting an alarm clock to a desired time in the morning. In order the preserve the resetting of the circadian rhythm towards the evening it is important that from 5 to 6 PM in the evening exposure to the bright lights is avoided. This includes light emission from TV’s, i-phones or computers. The eye would otherwise reset the circadian rhythm via the melanopsin mechanism to a later time.
  2. Melatonin treatment is used to advance or delay circadian rhythms. Melatonin also has a sedating effect, but only about 20% respond to that within 30 minutes by falling asleep. The doses in commercial products override the circadian rhythm effect. Sleep experts use much smaller doses of melatonin to reset the internal clock. Thinking of an adolescent who goes to sleep at 2 AM, the DLMO would be at midnight. To phase advance an individual like that a small amount of melatonin (0.5 to 1.0 mg) would be given at 6 to 8 PM (that is 4 to 6 hours before the DMLO point or 6 to 8 hours before the previous bedtime). The morning exposure to bright light works together with the early evening dose of a tiny dose of melatonin, which by itself is not enough to put the person to sleep at that time.
  3. Supportive sleep hygiene methods: It is important that the parents understand the underlying problem. If necessary, they may have to seek the advice of a sleep expert and discuss the details with him/her. 2 hours prior to bedtime the child needs to be exposed to dim light, which is light that does not have blue light in it. The level of dimness is such that reading is difficult. No TV, no cell phone or I pad is allowed. In this dim light atmosphere melatonin is expressed normally and will be produced and released by the pineal gland in higher amounts. Establish a regular bedtime with which all family members can agree. This is best kept on school days, holidays and weekends. If you would sleep in, you would switch your time machine in your head to another time zone further west and it would be an effort to switch it back! There are many children and adolescents who can switch back and forth easily, but the person with DSPD cannot switch easily and would get stuck again in the familiar late sleeping pattern.

Avoid cola and other caffeinated beverages, including green tea, as they stimulate. The bedroom should be dark, quiet and comfortable. Sound machines have not been shown to enhance sleep (Ref.1).

Light Can Interrupt Your Circadian Rhythm

Light Can Interrupt Your Circadian Rhythm

Conclusion

Circadian rhythm disturbances are more common than previously thought of. There is a certain percentage of children who enter the school system that develop delayed sleep phase disorder. This often stays with them into adolescence and can even carry on into adulthood. Two simple tools have been shown to treat this: early morning light exposure for 20 minutes to 1 hour and a small dose of evening melatonin to reset the circadian rhythm. There likely are thousands of untreated people with circadian rhythm disorders. As not all circadian rhythm disorders are the same it is advisable to seek the advice of sleep disorder expert, if sleep patterns are problematic.

 

References:

1. John H. Herman, Chapter 5, 35-43. “Circadian Rhythm Disorders”

Principles and Practice of Pediatric Sleep Medicine

Second Edition. Stephen H. Sheldon et al., 2014, Elsevier Inc.