Jul
02
2016

Zika Virus

By | immune system, Infectious Disease, Other neurological conditions

Recently the question was asked on the news whether it was safe to go to the Olympics in Brazil; so here is some background information about the Zika virus. Zika virus was first isolated from mosquitoes in a forest named Zika forest in Uganda, which was in 1947.

Zika virus belongs into the virus family of Flaviviridae. Other members in that family are dengue fever, West Nile virus, yellow fever and Japanese encephalitis. Since the 1950’s Zika virus has occupied a narrow equatorial belt around the globe (Africa and Asia). But between 2007 and 2016 it spread further to the Americas and to the Pacific. This includes specifically French Polynesia, the Cook Islands, Easter Island and New Caledonia. Since May 2015 Brazil has joined the countries where mosquitoes are infected with Zika virus. This is an important point to know for the coming up Olympics in Rio on August 5 to 21, 2016.

Symptoms of Zika virus

For most people, particularly the young and middle aged ones Zika is  not be that symptomatic. The most common symptoms are a fever, a skin rash, joint aches and red eyes (conjunctivitis). However, when a pregnant woman gets Zika virus, this will likely affect the fetus and will lead to a baby born with a small head (microcephalus), a severe complication from Zika virus. When a woman contracts Zika virus, the virus disappears after about one week. But in men the virus seems to stay longer, particularly in semen. This is why the CDC recommends for men using a condom or refraining from sex when returning from a holiday in a Zika endemic area. It may take up to 8 weeks for the semen to no longer be infective. The CDC recommends that a man who has come down with Zika to use a condom for 6 months.

Treatment of Zika virus

Make sure you get lots of rest. Take acetaminophen for fever or pain. Don’t take aspirin (ASA) or anti-inflammatory medication. Be aware that for between 1 and 3 weeks your blood likely is infectious. You want to avoid a bit from a mosquito and it is sensible to use insect repellants. The same insect could have bitten another person and spread the virus this way. A person who gets the Zika virus depends on the immune system to overcome the infection as there is no cure for this viral infection.

At this point no vaccine against Zika exists. There is research in an attempt to develop a Zika vaccine, which may become available in 2 to 3 years.

Zika virus risk with travel

If you travel to endemic areas, but visit mountainous areas above an elevation of 6,500 feet (2,000 meters) you are safe from Zika transmitting mosquitoes as they do not survive in these heights.

With regard to the Olympic Summer Games in Rio 2016 the CDC recommends to take a few precautions. Use insect repellents. Be aware as a woman that men infected with Zika virus can transmit the virus through sex. If you want to protect yourself from the risk of giving birth to a child with microcephaly, you may decide to use the birth control pill and ask your partner to use a condom. When you return back home, do not plan for a pregnancy for 6 months to avoid the risk.

The only recommendation for the Olympics by the CDC is that pregnant women should categorically not go to the games for fear of getting Zika infection resulting in a bad outcome of the pregnancy with microcephaly.

Microcephaly and other brain abnormalities from Zika virus

The CDC has stated that it is now established that Zika virus can cause microcephaly, but that it likely does not do so in all cases of Zika virus infection.

We know from German measles (rubella) that it can cause serious health risks for the fetus including death.

Zika is similarly neurotropic, meaning that it likes to multiply in nervous tissue including the brain. With rubella there is a vaccine available, which has made it much safer for pregnant women. But with Zika no vaccine is available. The only prevention is to stay away from endemic Zika areas and otherwise use reliable birth control methods.

Zika Virus

Zika Virus

Conclusion

I have briefly reviewed Zika virus in this blog. Unfortunately there are still many gaps in the knowledge of this disease. We need an effective Zika virus vaccine. It would also help to have antiviral antibiotics. Research is necessary to research all of this. For now we need to use prevention and avoid endemic Zika regions by reading updates by the CDC.

Jun
18
2016

High Vitamin D3 Prevents Cancer

By | Cancer, Heart Disease, immune system, Osteoporosis, Vitamins and supplements

In the last few years we learnt a lot about vitamin D3, but the newest thing is that high vitamin D3 prevents cancer.

Researchers at the University of California, San Diego School of Medicine reported that with respect to several cancer types higher doses of vitamin D3 led to less cancer over a period of time.

The cancers investigated were colon cancer, breast cancer, and lung and bladder cancer. People absorb vitamin D3 differently.  The researchers found that the best way to measure vitamin D3 concentration in the body is to use serum 25-hydroxyvitamin D (25(OH)D). In the past people did not pay much attention to this matter. However, several studies including the present study showed that in patients who had a lower level of 20 ng/ml cancer rates were higher.

Comparison of two cohort studies

The researchers used data from two prior studies, a randomized clinical trial of 1,169 women and a prospective cohort study of 1,135 women. The researchers found that the age-adjusted cancer incidence was 1,020 cases per 100,000 person-years in the randomized clinical trial, called “Lappe cohort”. The other prospective cohort study was called the “GrassrootsHealth cohort” where cancer incidence was 722 per 100,000 person-years. The interesting fact was that the Lappe cohort median blood serum level of 25(OH)D was 30 nanograms per milliliter, while the GrassrootsHealth cohort had a higher level of 25(OH)D of 48 ng/ml.

Higher vitamin D levels correlate with lower cancer incidence

This likely explains the lower cancer rate in the GrassrootsHealth cohort. Researchers combined the two trials in order to increase the statistical significance . The striking finding was that above 40 ng/ml the overall cancer risk was more than 71% lower than for the group of people whose level of 25(OH)D was 20 ng/ml or lower. The above ScienceDaily article was based on this scientific study.

Other studies showing high vitamin D3 prevents cancer

AfroAmerican men had less prostate cancer, if vitamin D level was higher

In a 2015 study Afro American men were found to have 71% less prostate cancer, if their serum 25-hydroxyvitamin D level was at least 30 ng/ml or higher.

Prospective study showing high vitamin D levels cancer protective

This 2006 study reported a 14-year prospective follow-up in men where all cancers were counted and blood serum 25-hydroxyvitamin D levels were correlated to cancer incidence. An increase of 25 nmol/L (=10 ng/ml) in predicted serum 25(OH)D level showed an association of a 17% reduction in total cancer incidence, with a 29% reduction in total cancer mortality and a 45% reduction in digestive-system cancer mortality. These investigators stated that it takes about 1500 IU of vitamin D3 increase per day to achieve an increment of serum 25(OH)D increment of 25 nmol/L (=10 ng/ml).

University of Arizona Cancer Center study

A publication from the University of Arizona Cancer Center in Jan. 2016 is more critical of the evidence regarding vitamin D3 and the claim that it lowers cancer rates. The researchers reviewed the cancer literature and found that for colorectal cancer there is a clear inverse relationship between serum 25(OH)D levels on the one hand and rates and mortality of colorectal cancer on the other hand. However, with breast cancer the literature was more divided. Only higher vitamin D levels were related to a lower risk for progression of breast cancer and a lower mortality rate. Randomized, double-blind clinical trials with regard to breast cancer failed to show effectiveness on cancer prevention or reduction of mortality. For prostate cancer conditions were similar with the exception of a study using 4000 IU of vitamin D3 per day, which inhibited progression of prostate cancer.

Mouse model regarding ovarian cancer and vitamin D

In a mouse model using a carcinogen to induce ovarian cancer there was an inverse dose-relationship between vitamin D3 and ovarian tumor development both in tissue culture and in the animal.

How high vitamin D3 prevents cancer

Immune stimulating effect of vitamin D3

Several studies have attempted to speculate how vitamin D3 may prevent cancer. Chirumbolo summarized the literature and noted that vitamin D3 has been shown to function as an immune cytokine stimulating the immune system non-specifically.  Vitamin D3 is also anti-inflammatory and counters insulin resistance and inflammatory kinins in obesity. Flavonoids with their antioxidant activity are also cancer preventing. We know that low levels of vitamin D have an association with higher cancer frequency. This means,. it is important to use vitamin D3 as supplements in our diet.

Chinese study describing action of vitamin D3 in detail

This Chinese study examined the effects of vitamin D3 on cancer prevention. It found that vitamin D3 combines three specific actions in one. Vitamin D3 is anti-proliferative meaning that it stops uncontrolled cell division. Secondly, it has an apoptotic (cell death) effect, which means it supports the removal of cells that are dying. If they are dying, but not removed, cancer can occur from these cell remnants. The third effect of vitamin D3 is that it has differentiating effects in several malignant cell types. When cancer cells are non-differentiated (=more immature cells) cancer can multiply quickly. Mature cells find it more difficult to turn cancerous. This is an effect that controls the speed by which cancer cells divide and how quickly cancer metastasizes.

High Vitamin D3 Prevents Cancer

High Vitamin D3 Prevents Cancer

Conclusion

There still is some confusion about the effects of vitamin D3 regarding cancer prevention. In colorectal cancer the statistics are clear: vitamin D3 can significantly prevent colorectal cancer to a large extent. There are also preventative effects in breast cancer and prostate cancer. But individuals may have to take at least 4000 IU of vitamin D3 or more. This is particularly true in higher latitudes where sunlight exposure is lower in the wintertime. Also, people absorb vitamin D3 differently. For this reason it is important to at least check your serum 25-hydroxyvitamin D levels on a few occasions. This will tell you whether your vitamin D3 supplementation is sufficient. Aim for levels in the 50-80 ng/ml, which is health promoting.

Apart from cancer prevention vitamin D3 is also important for prevention of cardiovascular disease. This is particularly true for diabetes, osteoporosis and Alzheimer’s disease.

Apr
29
2016

The Hazards Of Formaldehyde

By | autoimmune disease, Cancer, immune system, toxins

Toxic levels of formaldehyde in laminate wood flooring were underestimated, concealing the hazards of formaldehyde. Specifically, laminate wood flooring produced in China and sold by Lumber Liquidators, based in Toano, Virginia were identified as a problem.

News about the hazards of formaldehyde in Chinese laminate flooring

Last year CBS ran a story with Anderson Cooper regarding Chinese imported laminate flooring that emitted more than the stated amount of toxic formaldehyde. This was based on independent testing by CBS. Examiners found that laminate packages released between 6 and 7 times the amount of allowable formaldehyde. Moreover, some packages of the cheap Chinese made laminate flooring even released 20 times the allowable amount.

Certainly, formaldehyde is part of the glue in use to bind the wood particles together to make the laminate flooring. The laminate top seals the wooden core and keeps most of the formaldehyde inside.

Formaldehyde leaks into the home slowly

But over time it gradually leaks into the home. It is a matter of how much formaldehyde was in the glue and how good the ventilation of the home is, which determines the concentration of formaldehyde in the air.

CBS bought 31 boxes of the Chinese-made laminate flooring that Lumber Liquidators was selling in Virginia, Florida, Texas, Illinois and New York. The examiners sent samples to two reference labs. Most noteworthy, only one package was compliant with formaldehyde emissions standards. Some were more than 13 times over the California limit. Both labs were surprised how high the readings were, as they had not encountered this when they tested regular laminate flooring before.

Effects of the hazards of formaldehyde

Dr. Philip Landrigan at N.Y.’s Mt. Sinai Hospital specializes in environmental pediatrics and exposure to toxic chemicals. He stated that what matters is the concentration of formaldehyde in the typical home where such a floor is installed. Nevertheless, it needs to be stated that these toxic levels were only found in the cheap flooring of the above named company and this product has since been removed from the market. Above all, formaldehyde is a known carcinogen (cancer producing substance). As a matter of fact, it irritates the airways, particularly in individuals who are sensitive like asthmatics.

Toxic effects on immune system of formaldehyde exposed workers

A 2014 occupational medicine study from China compared factory workers exposed to formaldehyde with controls. Notably, they found higher formic acid levels in the urine of exposed workers. Formic acid is the end metabolic product of formaldehyde. In addition, they also had higher B cell lymphocyte counts (in the high dose exposure group) and higher natural killer lymphocyte counts (in the low dose exposure group). As a result, this would explain the toxic effects on the immune system and the higher incidence of cancer in formaldehyde exposed individuals.

DNA changes in mouth cavity cells and nasal cells of anatomy workers

A 2015 study from Portugal examined DNA abnormalities in cells from anatomy workers. Furthermore, anatomy workers who prepare corpses with formaldehyde for anatomy courses are under the exposure of formaldehyde fumes. Another exposure can happen when fixating histology slides with formaldehyde to get them ready for microscopic examination. The researchers measured the the formaldehyde concentration in the air of the anatomy lab as 0.38 parts per million. Likewise, genetic analysis of cells from the mouth cavity and nasal cells showed significant DNA abnormalities, while controls without formaldehyde exposure did not have such DNA changes.

Formaldehyde poisons p53 cancer suppressor gene

In this study there was insufficient data to link formaldehyde exposure to causation of leukemia.  It is peculiar that on a molecular level it is clear what formaldehyde does to the p53 suppressor gene. But it is more difficult to show the link of formaldehyde exposure to the causation of a multitude of cancers.

WHO recommendation about formaldehyde

The WHO recommends keeping formaldehyde below 0.08 ppm in the air of factories where formaldehyde is used. WHO says that this will prevent nasal cancer and leukemia. Levels of 1 ppm can cause nasal cancer and leukemia in humans. The level for hardwood plywood is 0.05 ppm in the US since 2012

The CDC involvement in safe formaldehyde levels in the air of a home

The CDC faced with the problem of the Chinese laminate imports of Lumber Liquidators and did its own investigation. The conclusion was that these high concentrations of formaldehyde were not only affecting sensitive people, but in fact everybody. The CDC stated: “The lifetime cancer risk increased from the previous estimate of 2 to 9 extra cases for every 100,000 people to between 6 and 30 extra cases per 100,000 people. To put these numbers into perspective, the American Cancer Society estimates that up to 50,000 of every 100,000 people may develop cancer from all causes over their lifetimes.”

New guidelines for the limit of formaldehyde in residences

New guidelines for the limit of formaldehyde in residences were defined as 135 µg/m³ by the National Center for Environmental Health. This is a different nomenclature for formaldehyde concentration in the air and I will show the conversion to parts per million particles in a moment. This reference explains that 1 ppm = 1.23 mg/m³. 135 µg/m³ is the same as 0.135 mg/m³. When you divide 0.135 mg/m³ by 1.23 mg/m³, you have converted this into 0.11 ppm, the upper acceptable formaldehyde limit. Had the company followed proper procedure, it is clear from the recommendation above that the formaldehyde level of 0.05 ppm was in the safe zone. It was much smaller than 0.11 ppm. The cheap batch of plywood discussed above with the high formaldehyde glue gave measurements much higher than any of these guidelines.

Company response to bad publicity regarding “the hazards of formaldehyde”

As the stock of Lumber Liquidators plunged, the company decided to do something about this. In May of 2015 they stopped the sale of the cheap laminate products. It turned out that they had been poor quality, cheaper laminate boards; the producer had used glue with too much formaldehyde in it. The company had knowingly bought these for a 10% discount and hoped to make a huge profit through its over 360 stores in 46 states. Before this fiasco revenue was more than a billion dollars a year. Now the company tries to rescue its brand name through an ongoing painstaking public relations effort.

What to do, if you own cheap laminate flooring with the hazards of formaldehyde?

The CDC says you should ventilate the home, use additional vents to remove bad air, keep the temperature at the lowest comfortable setting and make your home a smoke-free home.

Many homeowners have ripped out the cheap laminate flooring and replaced it with better quality products and joined a class action suit against the company that sold them the product. Others leave it in place, open the windows and doors more frequently to keep the air concentration of formaldehyde lower; and they follow the other suggestions from the CDC.

According to this update formaldehyde levels are decreased significantly 6 to 10 months after initial installation.

The Hazards Of Formaldehyde

The Hazards Of Formaldehyde

Conclusion

Had Lumber Liquidators not been greedy for profit, we may never have known the story of formaldehyde overdosing of glue in one bad batch of laminate flooring. The unsuspecting consumer got a special deal, but nobody informed the consumer about the hazards of formaldehyde release! Keep in mind that not everything that is cheap is good quality.

Only a few years back urea formaldehyde was very popular as a means to insulate your home. Homeowners soon found out that this could lead to toxic formaldehyde fumes and they had to replace urea formaldehyde with glass fiber insulation.

Never sit back and think you are safe

You may not have to panic. Frequent ventilation, as described, can lower the formaldehyde concentration in the air. And eventually in the case of laminate flooring the concentration is low enough from the passage of time that there is no longer a danger from leaking formaldehyde gases.

What I have learnt from this is the following: never sit back and think you are safe. Watch what you are eating. Watch what you are drinking. Women, watch what cosmetics you put on your skin. Be aware of the potential hazards of fire retardant in textiles and noxious substances in building products. All of this can impact the quality of the air you are breathing!