Jan
25
2014

Live Your Best Life

By | Anti-aging medicine, Cancer, Fitness, Health, heart attack, Heart Disease, Hormones, Insomnia, Nutrition, Obesity, Prevention, Stress management, Stroke, Vitamins and supplements, Weight loss

While attending the 21st Annual World Congress on Anti-Aging, Regenerative & Aesthetic Medicine the audience was treated to a magnificent speech by the keynote speaker, who you all know from the TV show  “The Doctors”, namely the ER-doctor, Dr. Travis Stork.

He said that there are 4 main ingredients that are necessary to live the “best of your life”.

1. Healthy living starts in the kitchen

You want to make sure that you leave out unhealthy foods. This includes that you also need to cut out sugar. Be aware how important protein is, so you need protein with each meal. This includes legumes, fish, chicken, turkey meat and others. Saturated fat is essential, can improve your health and makes you feel full, but stay away from unhealthy, sugary snacks.

Snacks do not harm your health, but they must be healthy ones like nuts three times per day. To include nuts three times per day lowers your risk of dying by 39% and your rate of heart attacks by 52%.

In order to prove a point about cutting out junk foods, the TV producer convinced Dr. Stork to go on a junk food diet for 7 days to see what would happen. He gained 8 pounds after 6 days, his mood was getting subdued and he started to look forward to his next meal as if he was addicted to the junk foods. But suddenly he could not take it anymore and was concerned about getting sick from this experiment (rightfully so). He told his producer that he had to stop this experiment. He explained that most of his fat accumulation was happening in the abdominal area (visceral fat) and he showed a video that illustrated this further. He explained that the visceral fat is metabolically very active, produces inflammatory agents and causes changes in the heart vessels that eventually lead to heart attacks and strokes.

Live Your Best Life

Live Your Best Life

2. “I need you to start working out!”

We were designed to get moving. Our ancestors were gatherers and hunters, so they were constantly on the move. Our genetics have not changed, but our lifestyle habits are far removed: the sessile habits are not suiting us well healthwise. Translated into modern life this means: sit less; do gardening; use pacing as a technique to move when you are on the phone. Take the stairs instead of the elevator; walk (a minimum of 30 minutes three times per week). Personally, I like to add that our body never takes a holiday, so I think we should exercise 7 days per week.

3. Mind and body are connected

Stress can ruin your health. Happy people are 50% less likely to die prematurely. Laughter heals. A funny video was shared with the audience where a parent ripped a piece of paper into smaller and smaller pieces and the toddler watched with glee and laughed every time when the paper was ripped into two smaller parts. A service dog can be a great companion for disabled individuals, but pets have a positive impact on the health of any individual. They can be of help to reduce stress.

It is known that mind and body are connected. As a result, if your mind and body are balanced, your hormones get balanced and this helps to keep your metabolism in check. If your metabolism is balanced, you will avoid getting diseases like heart attacks, strokes, arthritis, and even cancer.

4. Make sure you get enough sleep

40% of people do not get enough sleep. You can change your sleep behavior. How do you do it?

a)    Have a consistent bedtime/waking time. Set your alarm clock to the same time every morning. Aim for 7 to 8 hours of sleep per night.

b)    Avoid late night caffeine as it prevents a good night’s sleep.

c)    Get active throughout the day; this will prepare you to get tired in the evening.

d)    Towards the end of the day have a to-do-list ready for the next day. This prevents tossing and turning and thinking about what you want to do the following day. You know that it is all written down on the list, so you can relax and get to sleep.

e)    No bright lights in the bedroom, no bright alarm clocks, no control lights of electronic gadgets and have light-blocking window coverings in place. Do not have a TV in the bedroom, also no cell phone, and stay away from the computer for 1 hour before your bedtime.

After you re-programmed your body and mind to a regular sleep rhythm, you automatically get tired when you should and your hormones and body chemistry find a new balance, which contributes to good health.

Dr. Stork stated that we all need to prevent disease. We do this by making health our hobby. There is no need to be obsessed about it. “Just live your best life!”

Conclusion

I summarized Dr. Stork’s presentation from the anti-aging conference, as it struck me how simple it really is to live a healthier life. If we all follow these simple steps, we are a long way into anti-aging, because it gives us the footing we need to further refine it from there.

In many previous blogs I have mentioned these 4 factors that are needed to slow down aging. However, there are other factors that may be needed like bioidentical hormone replacement when there are hormone deficiencies; detoxification, if there is evidence of toxicity; and vitamins and other supplements. Anti-inflammatory and antioxidant vitamins and supplements like CoQ10, vitamin D3 and omega3-fatty acid/DHA supplements are needed to keep LDL from getting oxidized as this is the reason why people die of heart attacks and strokes and get cancer.

I have recently written a book entitled “A Survivor’s Guide To Successful Aging” (being published at Amazon.com in March 2014), which explains the science behind why it is important to cut out sugar and starch. Sugar and starchy foods are the foods that oxidize LDL cholesterol, and ultimately it is the oxidized LDL cholesterol that causes deaths from heart attacks and strokes. In this text I have explained how proper nutrition, exercise, hormone rebalancing, supplements and lifestyle changes will allow you to prevent the major illnesses from setting in thus extending your life expectancy considerably. Included in the book is a chapter (written by my wife, Christina Schilling) that contains 7 days of recipes for breakfasts, lunches, dinners and desserts as well as snacks.

Last edited Oct. 25, 2014

Oct
26
2013

Being SAD in Fall (Seasonal Affective Disorders)

By | Abdominal Pain, Hormones, Insomnia, Mental Health, Pain, Prevention, Stress management, Vitamins and supplements

Any general practitioner knows that fall and winter are the time when patients come in with a variety of complaints like a lack of energy, problems sleeping, inability to cope with stress, but often there may be non-specific pains like muscle spasm in the back, the shoulders, or indigestion. These symptoms can all be part of seasonal affective disorders (SAD) like depression, the winter blues, often coupled with anxiety.

Emotional health does not fit easily into our health care model. The receptionist will warn the doctor that this is going to be a “difficult” patient. If the doctor has only time for a 5 or 10-minute visit, where only one or two problems can be dealt with, then this does not fit when a patient with SAD has a problem concentrating, falling asleep, and presents with a long list of other complaints. Even 20 minutes or 30 minutes may not be enough to deal with this patient adequately. It is easier to send the patient for tests and to prescribe an antidepressant and a sleeping pill and reschedule for a follow-up appointment. But this likely will result in normal blood tests and investigations, added health care costs, but no solution to the patient’s problem when he  or she simply states “doctor, I feel so sick”.

I thought it would be interesting to review how our emotions can get out of balance and review an integrative approach to SAD.

Definition of SAD

Seasonal depression (also called seasonal affective disorder) occurs during fall (autumn) and winter, but this alternates with no depressive episodes during spring and summer. A person defined to suffer from SAD would have suffered from two major depressive episodes during the past 2 years with no depressive episodes in the intervening seasons of spring and summer (Ref.1). Alternative names for SAD are winter depression and wintertime blues. Typically SAD lasts about 5 months.

Brain hormone disbalance

Around 2002 it was detected that in mice there was a second light sensitive pathway from ganglion cells in the retina that were responsible for circadian hormone rhythms. This was later confirmed to be true also in humans, where photosensitive retinal ganglion cells buried deep in the retina and containing the pigment melanopsin absorb blue light in the visible light spectrum. The electrical signals are sent along the retinohypothalamic tract, so that light from the retina regulates the hormone circadian rhythm (daily hormone fluctuations including the sleep/wake cycle) in the hypothalamus. The hypothalamus is one of the major hormone centers in the center of the brain. As this publication shows there are minor genetic sequence changes for the retinal photopigment, melanopsin in patients with SAD. This affects about 1 to 2% of the American population. Many more have probably partial defects in the function of this pigment.

Being SAD in Fall (Seasonal Affective Disorders)

Being SAD in Fall (Seasonal Affective Disorders)

Many hormones in our brain experience a circadian rhythm.

When the sun goes down, melatonin is produced making us sleepy. In the morning serotonin production goes up and stays up all day, which normally prevents depression. There are other hormones that cycle during the course of the day. Cortisol is highest in the morning and low in the evening and at night. Growth hormone and prolactin are highest during sleep.

There is a lack of serotonin in the brains of patients with SAD and depression.

Symptoms of SAD

A person affected by SAD or any other patient with ordinary depression will present with symptoms of lack of energy, with tearfulness, negative thought patterns, sleep disturbances, lack of appetite and weight loss and possible suicidal thoughts. On the other hand symptoms may be more atypical presenting with irritability and overindulging in food with weight gain. Some patients somaticize as already mentioned in the beginning of this review experiencing a multitude of functional symptoms without any demonstrable underlying disease. It is estimated that up to 30 to 40% of patients attending a general practitioner’s office have some form of depression and in the fall and winter season a large percentage of them are due to SAD.

Treatment approaches to SAD

There are several natural approaches to SAD. However, before deciding to go this route, a psychiatrist should assess the patient to determine the risk for suicide. When a patient is not suicidal, light therapy can be utilized.

1. Light therapy: According to Ref. 2 a light box from Sun Box or Northern Light Technologies should be used for 30 minutes every morning during the fall and winter months. The box should emit at least 10,000 lux. Improvement can occur within 2 to 4 days of starting light therapy, but often takes up to 4 weeks to reach its full benefit (Ref.2).

2. Exercise reduces the amount of depression. The more exercise is done the less depression remains. A regular gym workout, dancing, walking, aerobics and involvement in sports are all useful.

3. Folate and vitamin B12: Up to 1/3 of depressed people have folate deficiency. Supplementation with 400 mcg to 1 mg of folic acid is recommended. Vitamin B12 should also be taken to not mask a B12 deficiency (Ref.3). Folate and vitamin B12 are methyl donors for several brain neuropeptides.

4. Vitamin D3 supplementation: A large Dutch study showed that a high percentage of depressed patients above the age of 65 were deficient for vitamin D3. Supplementation with vitamin D3 is recommended. (Ref.3). Take 3000 to 4000 IU per day, particularly during the winter time.

5. St. John’s Wort (Hypericum perforatum) has been found useful for minor to moderate depression. It is superior in terms of having fewer side effects than standard antidepressant therapy (Ref.3).

6. Standard antidepressants (bupropion, fluoxetine, sertraline and paroxetine) are the treatment of choice by psychiatrists and treating physicians when a faster onset of the antidepressant effect is needed (Ref.3).

7. Electro acupuncture has been shown in many studies to be effective in ameliorating the symptoms of depression and seems to work through the release of neurotransmitters in the brain (Ref.4).

8. A balanced nutrition (Mediterranean type diet) including multiple vitamins and supplements (particularly the vitamin B group and omega-3 fatty acids) also stabilize a person’s mood (Ref.3). Pay particular attention to hidden sugar intake, as sugar consumption is responsible for a lot of depression found in the general population.

9. Restore sleep deprivation by adding melatonin 3 to 6 mg at bedtime. This helps also to restore the circadian hormone rhythm.

Conclusion

Seasonal affective disorder is triggered by a lack of light exposure in a sensitive subpopulation. An integrative approach as described can reduce the amount of antidepressants that would have been used in the past in treating this condition. This will reduce the amount of side effects. The use of a light box can reduce the symptoms of this type of depression within a few days. But the addition of electro acupuncture and St. John’s Wort may be all that is required for treatment of many SAD cases. Regular exercise and a balanced nutrition (with no sugar) and including vitamin supplements complete this treatment. If the depression gets worse, seek the advice of a psychiatrist and make sure your doctor has ordered thyroid tests and hormone tests to rule out other causes where depression is merely a secondary symptom.

More information on depression: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/depression/

References

  1. Ferri: Ferri’s Clinical Advisor 2014, 1st ed. © 2013 Mosby.
  2. Cleveland Clinic: Current Clinical Medicine, 2nd ed. © 2010 Saunders.
  3. Rakel: Integrative Medicine, 3rd ed. © 2012 Saunders.
  4. George A. Ulett, M.D., Ph.D. and SongPing Han, B.M., Ph.D.: “The Biology of Acupuncture”, copyright 2002, Warren H. Green Inc., Saint Louis, Missouri, 63132 USA

Last edited Nov. 7, 2014

Sep
28
2013

Sleepless Nights

By | Health, Hormones, Insomnia, Mental Health, Pain, Prevention, Sleep apnea, Substance abuse, Vitamins and supplements

Sleeping problems (insomnia) are very common. About 10% of the population suffers from chronic insomnia; 30% of the population suffers from occasional sleep problems. In a large outpatient population of a clinic consisting of 3500 patients who had at least one major clinical condition, 50% complained of insomnia, 16% had severe symptoms, 34% had mild symptoms (Ref.1). Insomnia is more common among women, and older people as well as in people with medical or psychiatric illnesses. Long-term studies have shown that the same insomnia problems persist throughout many years. It is not possible to offer a simple remedy for insomnia, because insomnia is a complex problem. Here I will discuss some of the causes of insomnia and also discuss some of the treatment options.

Symptoms of insomnia

The person who suffers from insomnia will usually state that they have problems falling asleep. Worries of the day suddenly circulate through their thoughts and they toss and turn nervously looking at the clock from time to time and getting more and more anxious that they cannot sleep. Others fall asleep OK, but in the middle of the night they wake up perhaps to visit the restroom, but then they cannot go back to sleep. Others wake up 2 hours before their normal alarm clock time and they feel their stomach rumbling making it impossible to fall back to sleep. Older people with chronic diseases and general poor health suffer more from insomnia. In this setting insomnia may be more related to the underlying disease rather than old age. Psychiatric disorders also are associated with more insomnia. Treat the underlying psychiatric illness, and the insomnia disappears.

Although insomnia is a sleep disturbance during the nighttime, people who are affected with this complain of daytime fatigue, of overstimulation, yet they catch themselves making frequent mistakes, and their inability to pay attention gets them involved in accidents and falls. Longitudinal studies have shown (Ref. 1) that people with chronic insomnia are more likely to develop psychiatric disease, such as major depression,  anxiety disorder and alcohol and substance abuse. Unfortunately these disorders can by themselves again cause insomnia, which reinforces chronic insomnia. Insomnia leads to poorer social and physical functioning, affects emotions, leads to a lack of vitality and physical endurance, contributes to worsening of pain and can affect general and mental health.

Research about insomnia

Much has been learnt from sleep studies using polysomnography monitoring during a full night’s sleep. These studies have been used mainly as a research tool. In such studies eye movements, brain wave activity, muscle activity, chest movements, airflow, heart beats, oxygen saturation and snoring (with a microphone) are all simultaneously recorded. This way restless leg syndrome, sleep apnea, snoring, seizure disorders, deep depression etc. that can all lead to insomnia can be diagnosed and separated from insomnia. The stages of sleep (wakefulness, stage 1 to 3 sleep and the REM sleep stage) can also be readily measured using polysomnography (Ref.2). According to this reference the majority of insomnia cases do not need this complex procedure done.

Sleepless Nights

Sleepless Nights

Causes of insomnia

Traditionally insomnia cases are classified into primary insomnia and secondary insomnia. Secondary insomnia is caused by all of the factors discussed below. When they are dealt with, we are left with cases of primary insomnia.

The following medical conditions can cause insomnia: heart disease, pulmonary diseases like asthma and chronic obstructive pulmonary disease (COPD); gastrointestinal disease like liver cirrhosis, pancreatitis, irritable bowel syndrome, ulcers, colitis, Crohn’s disease; chronic kidney disease; musculoskeletal disease like arthritis, fractures, osteoporosis; neurodegenerative disease like MS, Parkinson’s disease, Alzheimer’s disease; endocrine disease like diabetes, hyper- or hypothyroidism, adrenal gland fatigue and insufficiency; and chronic pain conditions. Also, psychiatric conditions like major depression, schizophrenia and anxiety disorders can cause insomnia.

This list in not complete, but it gives you an idea of how complex the topic of insomnia is.
The physician who is seeing a patient with insomnia needs to rule out any of these other causes of insomnia to be certain that the only condition that is left to treat in the patient is insomnia itself. The other diagnoses have to be dealt with separately or else treatment of insomnia will fail.

Ref. 1 points to a useful model of how to think about causation of insomnia: there are three points to consider, namely predisposing, precipitating, and perpetuating factors. Let’s briefly discuss some of these.

Predisposing factors

We are all different in our personal make-up. If you are well grounded, chances are you are not susceptible to insomnia. Anxious persons or persons who have been through a lot of negative experiences in life will have personality traits that make them more prone to insomnia. Lifestyle choices such as late nights out, drinking with the buddies in a bar (extreme circadian phase tendencies) will have an impact on whether or not you develop insomnia.

Precipitating factors

A situational crisis like a job change or the death of a loved one can initiate insomnia.  However, there could be a medical illness such as a heart attack, a stroke or the new diagnosis of a psychiatric illness that has become a precipitating factor. Sleep apnea and restless leg syndrome belong into this group as well as would the stimulating effect of coffee and caffeine containing drinks. Jet lag and nighttime shift work can also be precipitating factors.

Perpetuating factors

Daytime napping to make up for lost sleep the night before can undermine sleep initiation the following night, which can lead to a vicious cycle. Similarly, the use of bedtime alcoholic drinks leads to sleep disruption later that night and can become a perpetuating factor, if this habit is maintained. Even the psychological conditioning of being anxious about whether or not you will fall asleep easily or not the next night can become a perpetuating factor.

I will return to this classification and the factor model of causation of insomnia when we address treatment options.

Drugs that can cause insomnia

One major possible cause for insomnia  can be side effects from medications that patients are on (would belong to the ‘perpetuating factors’ among causes). Physicians call this “iatrogenic insomnia”. The antidepressants, called selective serotonin reuptake inhibitors (SSRI’s) like Prozac are particularly troublesome with regard to causing insomnia as a side effect. Other antidepressants like trazodone (Desyrel) are used in small doses to help patients with insomnia to fall asleep. Some asthmatics and people with autoimmune diseases may be on prednisone, a corticosteroid drug. This can cause insomnia, particularly in higher doses; so can decongestants you may use for allergies; beta-blockers used for heart disease and hypertension treatment; theophylline, an asthma medication and diuretics. Central nervous stimulants like caffeine or illicit drugs can also cause insomnia. Hormone disbalance in general and hyperthyroidism specifically as well as Cushing’s disease, where cortisol levels are high will cause insomnia.

Treatment of insomnia

So, how should the physician approach a patient with insomnia? First it has to be established whether there is secondary insomnia present due to one of the predisposing, precipitating or perpetuating factors. In other words, is there secondary insomnia due to other underlying illnesses? If so, these are being addressed first. Lifestyle choices (staying up late every night) would have to be changed; alcohol and drug abuse and overindulging in coffee or caffeine containing drinks needs to be dealt with. Cognitive therapy may be beneficial when mild depression or anxiety is a contributing factor to insomnia.

The remaining insomnia (also medically termed “primary insomnia”) is now being treated.

The following general points are useful to get into the sleeping mode (modified from Ref. 3):

  1. Ensure your bedroom is dark, soundproof, and comfortable with the room temperature being not too warm, and you develop a “sleep hygiene”. This means you get to sleep around the same time each night, have some down time 1 hour or so before going to bed and get up after your average fill of sleep (for most people between 7 to 9 hours). Do not sleep in, but use an alarm clock to help you get into your sleep routine.
  2. Avoid caffeine drinks, alcohol, nicotine and recreational drugs. If you must smoke, don’t smoke later than 7PM.
  3. Get into a regular exercise program, either at home or at a gym.
  4. Avoid a heavy meal late at night. A light snack including some warm milk would be OK.
  5. Do not use your bedroom as an office, reading place or media center. This would condition you to be awake.  Reserve your bedroom use only for intimacy and sleeping.
  6. If you wake up at night and you are wide awake, leave the bedroom and sit in the living room doing something until you feel tired and then return to bed.
  7. A self-hypnosis recording is a useful adjunct to a sleep routine. Listen to it when you go to bed to give you something to focus on (low volume) and you will find it easier to stop thinking.

Drugs and supplements for insomnia

1. In the past benzodiazepines, such as diazepam (Valium), lorazepam (Ativan), fluorazepam (Dalmane), temazepam (Restoril), triazolam (Halcion) and others were and still are used as sleeping pills. However, it was noted that there are significant side effects with this group of drugs. Notably, there is amnesia (memory loss), which can be quite distressing to people such as not remembering that someone phoned while under the influence of the drug, you promised certain things, but you cannot remember the following morning what it was. Another problem is the development of addiction to the drugs with worse insomnia when the drugs are discontinued. Many physicians have stopped prescribing benzodiazepines.

2. There are non-benzodiazepines drugs that are used as sleeping pills (hypnotics), such as Zaleplon (Sonata), Zolpidem (Ambien) and Eszopiclone (Lunesta).  They seem to be better tolerated.

3. Ramelteon, a melatonin agonist, is available by prescription in the US. It probably is the best-tolerated mild sleeping pill and works similar to melatonin, but is more expensive. Chances are that your physician likely would prescribe one of the non-benzodiazepines drugs or Ramelteon for you as they do not seem to be addicting.

4. However, there is an alternative: Many patients with insomnia tolerate a low dose of trazodone (Desyrel), which is an antidepressant with sleep restoring properties. A low dose of 25 to 50 mg at bedtime is usually enough for insomnia. This allows the patient to fall asleep within about 30 minutes of taking it, and sleep lasts through most of the night without a hangover in the morning. Many specialists who run sleep laboratories recommend trazodone when primary insomnia is diagnosed. However, this is still a drug with potential side effects as mentioned in the trazodone link, but 50 mg is only ¼ of the full dose, so the side effects will also be less or negligible.

5. I prefer the use of melatonin, which is the natural brain hormone designed to put us to sleep. Between 1 mg and 6 mg are sufficient for most people. We know from other literature that up to 20 mg of melatonin has been used in humans as an immune stimulant in patients with metastatic melanoma with no untoward side effects other than nightmares and some tiredness in the morning. A review from the Vanderbilt University, Holland found melatonin to be very safe as a sleeping aid. There are several melatonin receptors in the body of vertebrates (including humans), which are stimulated by melatonin.

6. Other natural methods are the use of L-Tryptophan at a dose of 500 mg at bedtime, which can be combined with melatonin. It is the amino acid contained in turkey meat, which makes you tired after a Thanksgiving meal. GABA is another supplement, which is the relaxing hormone of your brain, but with this supplement tolerance develops after about 4 to 5 days, so it is only suitable for very short term use. Herbal sleep aids are hops, valerian extract and passionflower extract. They are available in health food stores.

Conclusion

A lack of sleep (insomnia) is almost a given in our fast paced lives.

When it comes to treatment, all of the other causes of secondary insomnia need to be treated or else treatment attempts would fail. What is left is primary insomnia. This is treated as follows:

We need to review our sleeping habits, lifestyles and substance abuse. Remove what is detrimental to your sleep. Start with the least invasive treatment modalities such as self-hypnosis tapes, melatonin, L-Tryptophan or herbal extracts. Should this not quite do the trick, asks your doctor for advice. The non-benzodiazepines drugs or Ramelteon would be the next level up. It may be that an alternative such as low dose trazodone would be of help. Only, if all this fails would I recommend to go to the more potent sleeping pills (keep in mind the potential for addiction to them).

References

1. David N. Neubauer, MD (John Hopkins University, Baltimore, MD): Insomnia. Primary Care: Clinics in Office Practice – Volume 32, Issue 2 (June 2005)  © 2005, W. B. Saunders Company

2: Behrouz Jafari, MD and Vahid Mohsenin, MD (Yale Center for Sleep Medicine, Yale University School of Medicine, New Haven, CT, USA): Polysomnography. Clinics in Chest Medicine – Volume 31, Issue 2 (June 2010), © 2010 W. B. Saunders Company

3. Jean Gray, editor: “Therapeutic choices”, 5th edition, Chapter 8 by Jonathan A.E. Fleming, MB, FRCPC: Insomnia, © 2008, Canadian Pharmacists Association.

Last edited Sept. 28, 2014

Aug
03
2013

Treat Causes, not Symptoms

By | Anti-aging medicine, Arthritis, Asthma, Diabetes, Fitness, Gastrointestinal Disease, heart attack, Heart Disease, High Blood Pressure, Insomnia, Nutrition, Obesity, Pain, Prevention, Stroke, Weight loss

Introduction

In this article I describe that physicians should treat causes, not symptoms. When you see a physician about a health problem, he or she generally listens to your symptoms and examines you. This leads to a diagnosis and the treatment of your symptoms. Medicine has been evolving since, anti-aging medicine has become more prominent and comprehensive medical practitioners have started to treat differently. Some examples below best explain the new approach. This is important as many general practitioners continue to treat symptoms and neglect to search for causes.

Big Pharma and the status quo

Big Pharma is trying to keep the medical system in the “status quo” (the way it is), because they make big money by having general practitioners try out different ineffective medications (this way the profits keep on coming in.) One example is the cholesterol story. High cholesterol only causes 50% of heart attacks, but physicians continue to prescribe statins whenever they detect high cholesterol levels to prevent a heart attack. But high cholesterol could be a cause from hypothyroidism (when the thyroid gland does not produce enough thyroid hormone). Diet can also play  a role, if the patient eats too many helpings of fatty meats and drinks alcohol regularly. Just prescribing statins to lower cholesterol is not the answer, treating the cause is!

I am going to describe 5 clinical examples where physicians usually treat symptoms instead of the causes. If you are in a hurry, just read example 3 below (gastritis and duodenal ulcer). After that you can skip forward and read the conclusion, where I will summarize what I think we should learn from this.

Treating Symptoms Not Effective, Find And Eradicate Causes

Treating Symptoms Not Effective, Find And Eradicate Causes

1)  Rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease where autoantibodies attack the joint surfaces. It is a multifaceted disease and typically requires a rheumatologist to order detailsed tests and formulate the treatment. The standard treatment for RA is summarized in this link. Before engaging in these toxic treatments, it is very worthwhile to study this link and see, if any of your food components may have triggered your arthritis. Various agents in the food can contribute to the development of autoantibodies, such as wheat, soy, MSG, even salicylates. An elimination diet approach could pinpoint if there is any food component that may be the cause of your RA.

Hormonal deficiencies in RA patients

Dr.Lichten treated many RA cases and found (Ref.1, p. 85 and 86) that many patients had hormonal deficiencies. He points out in particular that these patients often lack DHEA. DHEA is known to treat immune deficiencies and T cell responses were observed to raise 10-fold after DHEA supplementation; IGF-1 levels (an indirect measure of human growth hormone) increased and muscle mass improved when exercised as well along with DHEA replacement. RA patients responded well to relatively low doses of DHEA (25 mg daily for women and 50 mg daily for males). When other hormone tests are done to look for deficiencies, Dr. Lichten found sometimes thyroid deficiencies requiring hormone supplementation.

Sex hormone deficiencies often present in RA patients

Similarly, when saliva tests are done to look for sex hormone deficiencies, there may be progesterone and/or estrogen deficiency in women and testosterone deficiency in males that needs to be replaced with bioidentical hormones. In RA patients there may be adrenal gland deficiency setting in, which can be diagnosed by a four-point saliva cortisol hormone test. Only these cases of true hormone deficiency will benefit from small doses of cortisol (the original bioidentical human hormone) given four times per day.

Here is a summary of the usual recommendations for home remedies for treating rheumatoid arthritis. Using electro acupuncture can be very useful for controlling chronic pain, but you still need to work out the cause for your particular case of RA.

2) High Blood Pressure

Most cases of high blood pressure (hypertension) are simply there without a particular cause. It used to be called “essential hypertension”, a fancy name meaning “essentially, we do not know the cause”. The doctor will start treatment with drugs to bring high blood pressure down. Before that the doctor is supposed to ask you to make a good effort to change your life style (cutting out additional salt, exercising, weight loss), but this is often glossed over and drugs are used right away. Drugs for hypertension are not harmless; here are some of the side effects.

Medical textbooks unclear about causes of high blood pressure

The medical textbooks are not very clear on what causes high blood pressure. With renal causes (narrowing of a renal artery) a stent can be placed, the cause is treated and the blood pressure normalizes. As indicated, essential hypertension is the name for the majority of other cases of high blood pressure where officially no cause is known. Patients are usually put on life-long antihypertensive medications, often several drugs in combination, to bring the blood pressure down to 120 over 80.

Factors that contribute to high blood pressure

Despite the notion that we do not know the cause of high blood pressure, we do know that a number of factors can contribute to developing high blood pressure: too much salt in the diet, too much nicotine from smoking and too much alcohol consumption.

A lack of nitrates from green vegetables can cause high blood pressure as well. Nitrates are necessary for the body to produce nitric oxide, a powerful messenger that dilates blood vessels lowering blood pressure. It is produced every second by the lining inside the walls of your arteries. Greens and vegetables, particularly beets, provide nitrates for nitric oxide production.

Nitric oxide and omega-3 fatty acids

Nitric oxide, along with omega-3-fatty acid and prostaglandins are important in relaxing the arterial walls, thus lowering high blood pressure. We also know that in diabetes and obesity high blood pressure is very common, because inflammatory substances circulate in the blood, which interfere with the normal production of the blood pressure lowering nitric oxide.

Treating high blood pressure with the conventional drugs will mask the real underlying causes.

The DASH diet

The DASH diet has helped a lot of people to get their blood pressure under control. However, the critical point in that diet is the limitation of the amounts of grains. In my opinion, wheat and grains, starches and sugar are all empty calories and only stimulate your appetite because of the high leptin and gliadin content from wheat and wheat products. According to the cardiologist, Dr. William Davis, cutting these out will cure not only many cases of hypertension, but also diabetes and obesity. Many physicians criticized him, but in my opinion his work is on solid researched ground. If a patient honestly gives lifestyle changes a try, many side effects and deaths from antihypertensive drugs could be avoided.

3) Gastritis and duodenal ulcer

You see your doctor, because lately you regurgitate acidy stomach contents. You may be diagnosed with gastritis and get a prescription for an acid suppressive drug. But before you take proton pump inhibitors (PPI) study the side effects here. The interesting part is that many chronic gastritis cases are associated with a bacterium called H. pylori. Unfortunately, cimetidine, ranitidine and particularly PPI’s treat the acid problem (the symptomatic treatment of acid suppression). But on the longer term the triple therapy encourages H. pylori to grow more, particularly in the stomach. H. pylori undermines the lining of the stomach and the duodenum. This interferes with the protective mucous production, which protects you from gastritis and ulcers.

Breakdown of the mucosal barrier

Dr. Murray explains that the cause of gastritis, gastric ulcer and duodenal ulcer is the breakdown of the mucosal barrier (Ref. 3, p.73-75). The symptomatic treatment of the H. pylori infection with triple therapy (2 antibiotics and a PPI) is the conventional medical treatment, but in many cases it does not cure H. pylori. Some patients develop diarrhea from a Clostridium difficile super infection as a result of the antibiotics from the triple therapy requiring even more expensive antibiotics for that condition. This only happened, because the physician treated the patients’ symptoms instead of the cause. The cause of gastritis and duodenal ulcers is a weakening of the lining in the stomach and the duodenum resulting in a breakdown of the mucous barrier.

Too much wheat consumption can be a cause

In some people dietary habits play a role, like too much cereal and wheat consumption with too little alkaline vegetables in the meals to neutralize the acid formation (see Ref. 2 for more details). However, when a simple licorice compound (DGL, which stands for deglycyrrhizinated licorice) is given, the symptoms from gastritis, acid reflux, and ulcers in the stomach or duodenum disappear. DGL supports the lining of the stomach and duodenum and re-establishes the defense against the acidy milieu. Not only that, but after a few weeks of DGL treatment all of the findings on endoscopy such as inflammation and ulcerations disappeared.

DGL restores the stomach lining

Dr. Murray states that he has not encountered a case of gastritis or ulcer that would not have responded. It appears that the cause of gastritis and ulcers in the stomach and duodenum is not from too much acid, not from H. pylori infection, which appears to just be a concomitant infection, but actually is due to a breakdown of the barrier in the lining of the stomach and duodenum, which responds to DGL. The other interesting thing is that you can buy DGL in the health food store; the dosage is two to three chewable tablets on an empty stomach three times per day. According to Ref. 3 the patient has to take DGL 8 to 16 weeks, after which there is a full therapeutic response. Pepto-Bismol is another coating substance that is available over the counter and works well for minor stomach upsets.

4) Chronic back pains and insomnia

Many people see their chiropractor for chronic recurrent back pains and their physician for insomnia to get sleeping pills. It all depends what the underlying causes are of back pains and insomnia. If there is a misalignment in the spine, a chiropractor doing manipulation would be a reasonable approach and the back pain symptoms often disappear. However, thyroid deficiency, adrenal gland insufficiency or adrenal gland fatigue may also be the cause of back pains and muscle cramps. Unless the physician treats the  underlying cause (in the case of hypothyroidism treatment with thyroid hormones), the back pains stay.

Muscle pain in fibromyalgia patients

In fibromyalgia where muscle pains are all over the body, the standard treatment with antidepressants and pain pills just will not do it on the long-term. These patients require a detailed work-up with analysis of the hormonal status. Often, they are suffering from a lack of thyroid hormones, a lack of sex hormones (in women a lack of estrogen and progesterone, in men a lack of DHEA and/or testosterone). But they may also have weak adrenal glands and a lack of growth hormone. An anti-aging physician (A4M) can order the appropriate tests and treat the underlying causes.

Insomnia in fibromyalgia patients

Fibromyalgia patients often have insomnia (sleep disorders). Dr. Lichten (Ref.4) recommends GABA in small doses (125mg to 250 mg) at bedtime along with 500 mg of L-tryptophan. He also recommends 4000 IU – 5000 IU of vitamin D3 (as often insomnia patients are deficient in vitamin D3) as well as 500 mg to 1000 mg of magnesium. If this alone is not sufficient, melatonin, 1 mg to 3 mg at bedtime will be beneficial. Dr. Lichten cautions that GABA leads to tolerance quickly, so the patient should take GABA only 5 days out of 7 to allow the body’s receptors to recover. This alternative approach to treat insomnia prevents addiction to sleeping pills (hypnotics).

5) Asthma symptoms

Not every case of asthma needs steroid inhalers and salbutamol or other bronchodilator inhalers as treatment. Low thyroid hormone levels can also cause asthmatic symptoms of wheezing and shortness of breath. It is important to listen to the patient’s symptoms, but the treatment will only be successful when the cause is treated. Dr. David Derry described in this link how many of his severe asthma patients had iodine deficiency and low thyroid hormones and no longer had to see him when iodine treatment and desiccated thyroid hormone replacement was given as treatment. This goes against what the standard recommendation for asthma treatment is, but it seems to get patients unhooked from dependence on steroid inhalers.

Steroid dependency from anti-asthmatic inhalers can suppress the adrenal glands and lead to adrenal gland insufficiency.

Corticosteroid inhalers in asthma treatment can suppress the stress response

The adrenal glands are vital for coping with stress as the more stress you are under, the more your pituitary gland produces ACTH hormone, which in turn stimulates the adrenal glands to produce cortisol. However, a significant percentage of patients with asthma that been on corticosteroid inhalers for a long time, experience a suppression of the pituitary gland and the adrenal glands cannot produce the required stress hormones; in other words, adrenal fatigue or adrenal insufficiency can set in.

This is an example where corticosteroid inhalers control asthma symptoms, but they undermine the stress hormone circuit to the point where the patient experiences another disease (called a “iatrogenic disease”, a disease from the side-effects of drugs). Treatment of adrenal fatigue is described in this link.

Conclusion

Medicine can become quite complex as these examples show. Many times physicians tell their patients that they do not know the cause of their symptoms. However, this is not always true, but conventional medicine continues to hold onto the old dogmas. With the third example above (gastritis and duodenal ulcer), until the mid 1980’s the original theory in medicine was that too much acid production would be the cause of these conditions and treatment concentrated on suppressing acid production. Then the new theory came up that H. pylori, a bacterium would be the cause of chronic inflammation, which together with too much acid would cause the condition. That is why physicians now treat it with the triple therapy, a good deal for Big Pharma, but a bad deal for many patients.

DGL, a simple licorice compound can strengthen the lining of the stomach

Patients still do not experience a cure, but develop a worsening of their conditions as H. pylori growth proliferates, particularly from the PPI’s, which undermines the lining of the whole stomach. As pointed out above DGL, a simple licorice compound, which is available in health food stores, can strengthen the lining of the stomach and duodenum, which at the same time gets rid of the H. pylori problem without any other drugs.

The problem with conventional medicine is that in many cases physicians still treat symptoms instead of treating known causes. Big Pharma supports this, as it is expedient for them to protect their multi-billion-dollar industry. Patients should ask their physicians to treat the causes of their diseases rather than the symptoms.

References

1. Dr. Edward M. Lichten: Textbook of bio-identical hormones. ©2007 Foundation for Anti-Aging Research, Birmingham, Michigan, USA

2. William Davis, MD: “Wheat belly. Lose the wheat, lose the weight, and find your path back to health.” HarperCollins Publishers Ltd., 2011.

3. Michael T. Murray, ND: “What the drug companies won’t tell you and your doctor doesn’t know”. Atria Books, New York, 2009.

4. Dr. Edward M. Lichten: Textbook of bio-identical hormones. ©2007 Foundation for Anti-Aging Research, Birmingham, Michigan, USA

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