Apr
12
2014

Lead Still Poisoning Us

By | Cancer, Health, High Blood Pressure, Hormones, Infertility, kidney disease, Other neurological conditions, Prevention

We are living in an environment that puts emphasis on quality control, and companies around us take pride in their high quality products, supervised by the FDA. This is how it ideally should be. But is it really? Unfortunately not!

I read the headlines about lipsticks on April 4, 2014 and could not believe it!

When it comes to skin care or cosmetic products, things start to get scary.  Skin is not a barrier, but it is an organ of our body. From skin cream and ointment applications in medicine it is known that pharmaceutical compounds can be applied to the skin, and this way the body can readily absorb active substances.

When it comes to cosmetics, the skin areas to which cosmetics are applied have softer skin, for example the mouth. The vulnerable skin of the lips can readily absorb any chemical substance, and this is where health concerns get even more serious.

In 2010 as the above link shows the FDA determined that all of the “400 lipsticks tested had traces of lead in them, ranging from 0.9 to 3.06 ppm. Another study from California noted that there were other toxic metals in lip sticks and lip glosses containing chromium, cadmium, manganese, aluminum in addition to lead. Even to the unconcerned this sounds like a precarious cocktail of noxious substances! On June 1, 2013 I wrote a blog about toxins in the bathroom. I mentioned the dirty dozen of chemicals that repeatedly are found in cosmetics. With this new information of traces of lead still being in cosmetics, more so than previously reported, women need to be more careful about the choice of lipsticks that they are using.

1.History of lipsticks:

This overview explains that the long-lasting lipstick was only invented around the 1950’s (“Sticks on you, not on him” was the slogan).

Traces of lead were often recorded, but not really thought to be that dangerous. The thinking of the FDA at that time was that children needed to be protected from lead in house paints, but nobody mentioned that lead was part of the red pigment and therefore had to be part of a lipstick. The FDA did know this, but the concentration was supposed to be so small and absorption was thought to be negligible, so considered to be safe for an adult.

Lead Still Poisoning Us

Lead Still Poisoning Us

2. Evidence of considerable absorption of lead:

We know from several studies summarized in this link that various components of cosmetics including lipsticks and lip-glosses get absorbed through the skin. Lead is no exception to this. A 2011 study showed in children in Africa that lead-containing cosmetics for tribal ceremonies in children had higher lead concentrations in their blood than children who did not use these cosmetics.

When doing a PubMed review on the subject I came across a very interesting study: In India there is a practice that parents apply kajal (also called kohl or surma cosmetic) around their eyes, on old traditional practice. Unfortunately this is a lead-containing cosmetic, which is absorbed into the blood and can cause lead poisoning. According to this ancient belief this application of cosmetics around the eyes would keep their eyes cool and clean and is supposed to improve vision, strengthen the eyes and prevent eye diseases. None of these belief are compatible with Western medicine (although a lot of the Ayurveda medicine is valid).

In another 2010 study done in the mountainous Aseer region in the Southwest of Saudi Arabia here there is pristine air quality, 176 pregnant patients with a single baby were followed to see whether there was an effect with regard to lead poisoning in the offspring. Two groups of women were identified, those with lead levels of more than 200 mcg/L in the blood and another group with less than 200 mcg/L. The researchers noted that there was no difference with regard to prematurity, size of the baby or premature rupture of membranes (premature birth).

The conclusion of this study was that there was significant absorption of lead from 100% lead sulfide eye cosmetic “kohl” only on those who used it. To my surprise nobody mentioned anything about the lead levels in the children, which is an example of compartmentalization of science. Common sense would dictate that these children who were at higher risk from mothers with over 200 mcg/L should have received chelation treatments to remove lead (we do this in Western medicine!).

3. Different lip sticks and lip glosses analyzed in Europe and in the US:

A European study showed that 31% of lipsticks and 4% of lip glosses tested positive for lead. All of them had less than 0.88 mg/kg of lead (less than 1 mg/kg). Pink lipstick or lip gloss (0.81 and 0.38mg/kg) tested lower than purple lipstick or lip gloss (0.88 and 0.37mg/kg) and red (0.58 and 0.25mg/kg), but purple tested the highest! I did not know that until now when I researched this.  On average the tests show that the gloss has half the concentration of the lipstick.

Don’t be fooled by the difference in recommended safe levels in Canada (10 mg/kg) and Germany (20 mg/kg). Germany has a very powerful chemical industry with lobbyists that likely lead to this higher “safe” level. In Canada it is the Health Products and Food Branch of Health Canada. No country got it right so far:  A zero tolerance (meaning a blood level of 0 mg/kg in babies and adults alike) is the only solution for humans. A little bit over a long time can lead to chronic chronic lead poisoning.

One other interesting tidbit for those who need to apply something to their lips:

The more expensive lipsticks had much less lead in it than the cheaper varieties (don’t buy the dollar store brands).

Contrast this to an FDA initiated study between 2009 and 2012, published in 2012 that showed that the average lipstick concentration in 400 lipsticks tested  was 1.11 mg/kg, but the highest concentration was 7.19 mg/kg and 13 of them tested 3.06 mg/kg. Here is another review that shows more details (ppm equals mg/kg, so you can compare directly with the figures above. As stated before, in my opinion and that of toxicologists around the world who are the real experts in this a “0 mg/kg” level (no lead in the body) should be the acceptable norm!

Only organic lipsticks and lip-glosses are recommended, if you must wear any of such products. Here is a helpful blog that tells you more positive news (lead and chemical free products).

4. What are the effects of chronic low lead exposure?

Adult lead toxicity is not as common as in the past. Painters in the decades leading up to the 1970’s when laws became more stringent were the ones mostly affected (Ref.1). Keep in mind that more than 30 million tons of lead was released into the air in the US before the lead ban finally remedied this in the 1970’s.  This phasing out was completed in 1995. The mean blood lead levels of Americans declined by 35% since. The EPA is monitoring lead levels in public water systems.

Lead is a nerve poison. It leads to fatigue, insomnia, irritability, lethargy, headaches, difficulty concentrating, memory loss, and tremor. It can also affect the nerves of the extremities, more so in the arms than the legs, which was significant in the past century among painters using lead paints. (“Upper extremity paresis” found in painters). Chronic lead poisoning targets the kidneys and the bone marrow. In the kidneys leakage of the filtration units, called glomeruli, leads to loss of microglobulins that can be measured in the urine among other tests. Above a level of 30 mcg/dL (this is the same as above 300 mcg/L) electrophysiological studies reveal often the ulnar nerve conduction is disturbed, which is the cause for the arm weakness in painters. The bone marrow toxicity can be seen in stippling of red blood cells and anemia develops subsequently. High blood pressure and fertility issues are also common (low sperm count in men, higher rate of spontaneous abortions and stillbirths in women). The gums around the teeth show lead lines (blue discoloration).  I will not get into lead toxicity in children, as this is a big topic of its own. Needless to say symptoms are much worse as any pediatrician can tell you. It goes without saying that should you notice any of these symptoms, see your doctor and have appropriate tests done.

5. Treatment and prevention:

As we do not see acute lead poisoning as much as in the past, except sadly to say still in development countries and highly industrialized areas with lead emissions into the air, I like to emphasize the importance of prevention here.

a)    If you absolutely must have make-up and/or lip sticks or lip gloss, at least go for the expensive, organic products. You owe it to yourself. However, having said that keep in mind that anything you put on your skin anywhere is absorbed to a certain percentage. So, why mess with your body’s metabolism? I really question this. For your skin you can use a product called “Youth serum” from LifeExtension, where only a few drops will suffice to cover your face and neck with a thin film. Within a few seconds this is absorbed into the skin and it will stimulate your skin to grow where wrinkles are, so the wrinkles flatten out in time.

b)    Keep in mind that skin appearance is hormone dependent, males need testosterone as they age and women need bioidentical progesterone. The first link under point 2 above claims that progesterone would be cancer producing. This is not true: it is progestin, a synthetic copy of progesterone that does this. So, bioidentical progesterone in cosmetics would be cancer preventing in women (men should stay away from a woman who has applied this for at least two hours as skin transfer will block testosterone production). Worse still: if a manufacturer uses progestin (the synthetic version), the traces of it over a long period of time will act like xenoestrogens, which can cause breast cancer in the woman who uses such a product and through transfer can cause prostate cancer in a man.

c)    If you insist on using chemicals on your skin, you may want to consider seeing a naturopathic physician who does intravenous chelation. Lab tests are available to assess the levels of heavy metals and toxins in your body. If the levels are creeping up, chelation treatments from time to time may be needed in people with measured elevations of lead levels in blood tests and/or urinary lead level elevations.  Discuss this with your doctor.  Removal of any accumulated mercury, lead, and cadmium or other heavy metals will be an option. I have summarized detoxification methods elsewhere.

Conclusion:

In conclusion, I think that it has to be carefully considered, how much use of lipstick application is necessary. Next the choice of a high quality product is of utmost importance. Taking all the factors together, its constant use cannot be recommended, especially since there is not only lead present, which is a known health hazard. Beside lead there are many other chemicals that get absorbed and their effects have not been adequately tested by the agencies.

More information on vitamins and detoxification: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/vitamins-minerals-supplements/

References:

1. Shannon: Haddad and Winchester’s Clinical Management of Poisoning and Drug Overdose, 4th ed. Chapter 73, “Lead” by Michael W. Shannon, MD, MPH © 2007, Saunders

Last edited Nov. 7, 2014

Incoming search terms:

Mar
08
2014

Protecting Yourself From Environmental Toxins

By | Allergies, Asthma, Cancer, Dentistry, Diabetes, Infertility, kidney disease, Nutrition, Obesity, Prevention, Vitamins and supplements

These days you need to be aware of protecting yourself from environmental toxins. Environmental toxins are toxins that may be in your drinking water, in what you eat, in the air you breathe, or they enter your body through your skin when you swim in contaminated water or walk on a sandy, wet beach.

In the following blog I will address some of these issues and how we can defend ourselves against toxins.

The youngest and most vulnerable

Toxins are particularly bad for infants and premature babies. Notably, the reasons for this are the following ones: their kidney function (tubular secretion) is only 20% to 30% of that of an adult; the cytochrome P-450 enzyme system in the liver, one of the toxin eliminators is slowed down to only 25% to 50% of the adult activity and glucuronidation in the liver, another detoxification process, reaches adult levels only at the age of 3 years.

Function of liver and kidneys

It is important to realize that the kidneys and the liver are limiting the removal of toxins by way of urine and bile in the newborn. Stomach acidity in a premature has a pH of 4.7, in a full-term newborn 2.3–3.6 and in an adult 1.4–2.0. This is important to note as a lack of stomach acid increases susceptibility of newborns and infants to gastrointestinal infections and cause diarrhea. Percutaneous absorption in newborns is much higher than in adults, which makes them very susceptible to absorbing toxins through the skin (Ref.1).

Diabetes from environmental toxins

Environmental toxins can cause insulin resistance and type 2 diabetes.

Bisphenol A (BPA) is used to make polycarbonate and epoxy resins and is found primarily in food and beverage containers. People all around the world had exposure to BPA  since 1957 and as a result 90% of US residents have detectable levels of BPA in their urine. Ref.2 explains that the higher the urine concentration of BPA, the higher the risk is for developing diabetes.

Persistent organic pollutants are another source of concern: pesticides and herbicides, dioxins, polychlorinated biphenyls, hexachlorobenzene, and hexachlorocyclohexane have all been found in humans. Several investigators have shown that virtually all of the risk in obese patients to develop diabetes comes from the fat-soluble persistent organic pollutants (Ref.2).

Inorganic arsenic

Inorganic arsenic is another pollutant from soil and rock, which finds its way into the drinking water. About 8% of the public water system of the US exceeds 10 mcg/L for drinking water, which is the safe limit for drinking water by the US Environmental Protection Agency’s standard. Anything above those levels is considered toxic.Ref.2 describes that people who ingest inorganic arsenic will excrete it in the urine; the highest group with arsenic in their urine had a risk of 3.58-fold to develop diabetes when compared to the lowest group. Curiously enough organic arsenic that is found in fish and shellfish is excreted in the urine unchanged and does not cause diabetes. Overall this indicates to me that nobody should consume or cook with contaminated water that contains inorganic arsenic. Reverse osmosis filters will protect you from this risk.

Protecting Yourself From Environmental Toxins

Protecting Yourself From Environmental Toxins

Other toxins around the house

Volatile organic compounds are often contained in carpets, but also in laser and inkjet printers. They are part of everyone’s life as this link shows. Physicians reported varied symptoms like irritation of eyes, nose or throat, breathing problems, headaches, loss of coordination, damage to the liver, kidneys and the brain after exposure to volatile organic compounds. Researchers noted that long-term exposure can cause cancer in animals and there is suspicion  that it causes cancer in humans as well.

Air fresheners and cleaning solutions that contain ethylene-based glycol ethers and terpenes were the subject of a study that examined concentrations in the air and interaction with ozone that can also be released by some cleaners.

Fumes of chemicals can cause lung cancer

As this link shows the investigators concluded that with exposure to high enough concentrations and long enough exposures to these fumes lung cancer can be caused in cleaning personnel. They recommended to use cleaning solutions only in diluted form and to air out the premises well after cleaning. Another component of many air fresheners and cleaning chemicals is paradichlorobenzene, the same chemical that is contained in mothballs.

There have been problems with flame retardants: polybrominated diphenyl ethers, which are cancer producing; the US outlawed them in 2004, but older mattresses, upholstery, television, computer casings and circuit boards may still contain them.

Lead and mercury poisoning, and radioactive pollutants

Lead in paints was outlawed since 1978, so manufacturers have not used lead in paints anymore. Paint from buildings older than that still may contain lead. There have been serious lead poisonings in children who were gnawing on items painted with lead containing paint. Lead causes problems with your central nervous system, brain, blood cells and kidneys. Just last year a news story about lead found in fashion jewelry surfaced warning about cheap fashion jewelry from China. Lead from these items can lead to absorption through the skin and cause lead poisoning. Because of the apparent lack of regulations in China I do not put anything into my mouth or on my skin, if it originates from China.

Mercury contamination of the environment

Mercury from tuna and other predator fish: It is sad that there is pollution in oceans to the point where it has become unsafe to eat predator fish. In predator fish there is an accumulation of mercury through the food chain.

How did things develop this way? Back 100 years and more ago gold panning and the purification process of gold caused mercury to enter into rivers and allow mercury to end up in the oceans where it has since accumulated; it just sits there as it has nowhere to go.

Coal burning (yes, there is mercury in coal) also contributed to this by smoke emission from smoke stacks containing mercury vapors. Subsequently the pollution from the air returns to earth as rain pollution and drained through the river system into the oceans.

Monomethylmercury poisoning

It is monomethylmercury that accumulates in the tissue of humans. This affects many organs, such as the brain, kidneys, lungs, and skin. It causes various symptoms like red cheeks, fingers, and toes; there can be bleeding from the mouth and ears; it can cause rapid heartbeats, high blood pressure, intense sweating, loss of hair, teeth, and nails. It also can cause blindness, loss of hearing, impaired memory, and lack of coordination, disturbed speech and birth defects. You may think all mercury comes from the outside. However, silver amalgam fillings in your teeth could also be the source of mercury poisoning. It is a good idea to replace amalgam/mercury fillings with ceramic fillings.

Other marine pollution

There are many forms of other marine pollution as this link shows.

One particular concerning aspect is pollution with radioactive materials as the Fukushima disaster in Japan has shown. Following the catastrophe on March 11, 2011 radioactive material leaked into the ocean, which is described here. Dr. John Apsley II pointed out that with the explosions in Fukushima there were also several releases of radioactive pollution into the stratosphere. This pollution has subsequently traveled around the globe and has come down as radioactive rain. He has made it his ambition to help people minimize radiation exposure from nuclear accidents such as Fukushima.

Protecting yourself from toxins

Having said that pollution and toxins are problems that we are living with, how can we protect ourselves from all of that?

1. Avoid as many unsafe chemicals around you as you can. This includes checking ingredients in hair care and body care products, toothpaste, hair dyes, cosmetics, mouthwashes and underarm deodorants.  I have written a blog about toxins in the bathroom and what you should watch for.

2. I would recommend you switch from a standard food to organic food. It has become unsafe to eat non-organic meats, leafy vegetables, vegetables and fruit. There are too many residues of herbicides and pesticides contained also in meat, not only in vegetables and fruit. Washing will not remove these substances, even though some merchants may tell you otherwise. Buyer beware!

Detoxification

3. Detoxification methods are available and I have reviewed them in this blog. Briefly, to remove lead and mercury you need to follow a formal intravenous chelation protocol.  Depending on how many heavy metal toxins you have on board, you may need only a few treatments. At the most you may require up to 20. Here is a more conservative website stating that it would be safe to have silver amalgam fillings. I think that gold and ceramic fillings are much safer.

4. Genetically modified food is another danger as I have summarized in this blog. This is another reason why I like to stick to organic food. There is evidence that GMO food causes autoimmune diseases, infertility and chronic inflammation that can eventually lead to cancer. It may take decades to prove this, but I am not willing to be a human guinea pig.

Remove toxins from your home

5. I have mentioned in a prior blog that we live in a toxic world. You need to carefully look at your home and remove toxins. You need to assess your drinking water. A water analysis can tell you how good the water in your home is and whether there are concerns about inorganic arsenic. Usually places that sell filter systems can advise you in that regard. Your drinking water should either be pure water bottles or else reverse osmosis water from a filter system in your house.

6.Vitamins and supplements support your cell integrity and have anti-inflammatory and antioxidant effects that protect you from toxins. I discussed this in detail in my NetHealthBook under nutrition. For instance vitamin D3 in doses of 5000 IU or more and CoQ-10 are powerful anti-inflammatories and CoQ-10 is also an antioxidant and preserves mitochondrial function. High fish oil supplements (3 to 6 Grams per day) have anti-inflammatory effects and protect your cell membrane integrity. With these overlapping qualities of vitamins and supplements your body will be in a much stronger position to defend itself against the negative effects of toxins. When you take multivitamins, this translates into telomere lengthening of 5.1%. This converts into a survival advantage of 9.8 years over a lifetime). Ref. 4 explains this in more detail.

Exposure to radioactive substances

7. Exposure to radioactive substances is a scary thought, but this is becoming more and more a reality, at least for those who live close to disaster areas such as the Fukushima site in Japan or the Chernobyl site in the Ukraine. But according to Dr. Apsley II low dose radiation that we have already received in the US and in Canada following the Fukushima disaster is equally disastrous (Ref.3). Many of the vitamins and supplements I have mentioned are also cell and mitochondria protective and will help with DNA repair following radiation damage, but you must avoid sugar and other refined carbs and starches to reduce the oxidative effect on cells and on LDL cholesterol to prevent premature aging and cell death. Ref. 3 contains a lot more detail about this and explains what specific supplements you can take to detoxify your system. This will remove radioactive elements that function as free radicals in your body. There are specific antidotes for radioactive iodine-129 and iodine-131, radioactive cesium-137 and others.

Conclusion

Many people shrug their shoulders when they hear that pollution has an effect on their lives. They feel that they are powerless and cannot do anything about this. The truth is far from this! Above I mentioned seven points that you can follow to counter toxins. On top of that you can get politically active and urge your government representative to create a nuclear free zone in your area. Ref. 3 contains compelling evidence why this is so important not only for us now, but for future generations and the future of mankind.

Accountability of quality of food and beverages

We need to hold those who provide us with food and beverages accountable for the quality of these. Shrugging it off is not good enough. Get involved. Buy organic food. Avoid the section in the grocery store where they sell sugar and high carb foods. It’s good for your own health, but it will collectively change the mentality of the grocery store owners where you shop. Suddenly they notice that they are now left with the comfort foods that were big sellers in the past. This new trend will result in cheaper prices for healthy foods and more availability of organic food.

References

1. Shannon: Haddad and Winchester’s Clinical Management of Poisoning and Drug Overdose, 4th ed. © 2007 Saunders. Chapter 18:“Toxicologic Issues in the Neonate”.

2. Rakel: Integrative Medicine, 3rd ed. © 2012 Saunders. Chapter 31: “Insulin Resistance and the Metabolic Syndrome”.

3. Dr. John W. Apsley II : “Fukushima Meltdown & Modern Radiation: Protecting Ourselves and Our Future Generations” © 2011. Temet Nosce Publications, Sammamish, WA 98075

4. Xu, Qun, Parks, C.G., DeRoo, L.A., Cawthon, R.M., Sandler, D.P. and Chen, H. Multivitamin use and telomere length in women. American Journal of Clinical Nutrition 89 (April 2009):1857-63. Full text (PDF): http://ajcn.nutrition.org/content/89/6/1857.full?sid=9aab0e13-b4d2-42ad-b44c-15cffc6771c3

Last edited March 8, 2014

Nov
30
2013

Statins Can Hurt The Consumer

By | Anti-aging medicine, Arthritis, Diabetes, Fitness, heart attack, Heart Disease, High Blood Pressure, Hormones, kidney disease, Nutrition, Obesity, Prevention, Stroke, Vitamins and supplements, Weight loss

Lovastatin (Mevacor, from Merck) was the first statin drug approved by the FDA in 1987 as a cholesterol-lowering drug in the US. It made history in helping high-risk heart attack patients reduce their cholesterol levels and has helped safe many lives. But with the detection around 2002 that heart disease is an inflammatory disease, and that measuring the C-reactive protein with a blood test was a better than measuring cholesterol levels in predicting who would be at risk for developing a heart attack, the landscape has changed. Lifestyle changes have also been shown to be very effective in reducing cholesterol, C-reactive protein and triglyceride levels. In fact, lifestyle changes will reduce the risk for heart attacks and strokes. The newest flurry of activity with calls for putting more people on statins makes me suspicious that there could be a misrepresentation of the facts.

In this blog I am analyzing the literature to get to the bottom of the facts on reducing risk for heart attacks and strokes. I also come to my own conclusion.

Facts about cholesterol

Cholesterol is a waxy substance that is part of the cell walls and plays a vital role in our metabolism. Liver cell membranes, for instance contain about 30% cholesterol. However, most of the cholesterol in our body comes from metabolism, 20 to 25% from the liver, the rest in the gut, adrenal glands and the reproductive organs, and also from the brain (the myelin sheaths contain a lot of cholesterol). 50% of the body’s cholesterol is recycled through bile salts and reabsorption of cholesterol in the gut (called the enterohepatic pathway).

Cholesterol is vital for cell function, for insulation of nerve fibers (myelin sheaths) and for synthesis of our steroid hormones (sex hormones and vitamin D3, which  is now considered to be a hormone). The medical establishment took most of the information regarding heart attack and stroke prevention from the ongoing Framingham study. This clearly pointed to the importance of lowering the LDL cholesterol fraction (the “bad” cholesterol) and maintaining or increasing the HDL fraction (the “good” cholesterol). When it was realized that concentrating only on lowering cholesterol missed 50% of all heart attacks that researchers refocused and found the missing link, namely inflammation. Inflammation is at the cause of heart attacks and strokes, high cholesterol and lipids were only secondary phenomena. Ref. 2 points out that a comprehensive approach to treating a patient with high cholesterol should involve a combination of treatments aimed at the underlying risk factors for heart disease or stroke in a particular patient. This involves sophisticated blood tests where a metabolic derangement can be pinpointed. It should include measuring cholesterol fractions, lipids, the C-reactive protein, hormone levels and more.

Statins Can Hurt The Consumer

Statins Can Hurt The Consumer

How the traditional thinking about cholesterol has changed

The Framingham study has provided the basis for the drug industry to produce statins until about 2002 when our thinking about cholesterol being the culprit for causing heart attacks has forever changed. Subsequently further research showed that other factors like inflammation of the blood vessels, the metabolic syndrome associated with obesity and lack of exercise were also to blame for causing heart attacks and strokes. Recently more details have come to light, which point to multiple causes like the consumption of too much sugar, too much trans fats, too much salt and eating too much over processed convenience food.  We end up gaining weight, develop the metabolic syndrome and inflammation of arteries (including the coronary arteries of the heart and the brain vessels). It is the lack of nitric oxide in the lining of the arteries, which combined with inflammatory substances from visceral fat are responsible for hardening of the arteries as the ultimate consequence of faulty nutrition and lack of exercise. We also know that oxidized LDL, particularly the very low-density lipoproteins (VLDL), will release free radicals and damage the arterial walls. CoQ-10 is a supplement, which is known to counteract this. One important test that had developed out of the Framingham study is the “ratio of total cholesterol to HDL cholesterol”, which is used by cardiologists to determine the risk of coronary artery disease. The average risk of this ratio for Americans is 5.0 for males and 4.4 for females. The ideal ratio to strive for is  the “1/2 average risk” ratio of 3.4 for males and 3.3 for women (Ref.2). A fit, slim person who eats a low carb, normal fat diet (modified Mediterranean diet) will often have a ratio of only 3.0, well below the 1/2 average risk. The moment you introduce grains in your diet (cereals, bread, pasta) your liver will convert carbs into LDL cholesterol, while HDL cholesterol will drop resulting in a high risk ratio of above 5.0 (often 7 or 8 or more). The LDL will get oxidized and is deposited into your arteries setting you up for coming down with a heart attack or stroke down the road.

How do statins work?

The statins are a group of drugs that inhibit an enzyme, called the hydroxymethylglutaryl–Coenzyme A (HMG-CoA), which leads to a lowering of cholesterol, specifically a fraction known as the LDL cholesterol. The success story of lovastatin (Mevacor) led to a flurry of new HMG-CoA reductase inhibitors (cholesterol lowering drugs) such as fluvastatin (Lescol), pravastatin (Pravachol), simvastatin (Zocor), atorvastatin (Lipitor), and rosuvastatin (Crestor) in the late 1980’s and the 1990’s. Collectively it is now a 26 billion industry in annual sales.

Later investigations showed that there were other mechanisms by which statins helped, namely they were found to decrease the inflammatory reaction, which can be measured by lowering of the C-reactive protein. However, there are significant side effects in about 1 to 3% of people who take this medication, particularly an inflammation of liver cells (evident from elevation of liver enzymes) and a myopathy, which is a painful muscle condition (Ref. 1). This latter fact, which can occur in as many as 33% of the population at large (particularly the exercise minded) has limited the use of statins in competitive athletes where myopathies can occur in as many as 75% of athletes treated with statins (Ref.2). The reason for that is that the muscles of athletes cannot keep up with the demands put on them when they are kept in check by the HMG-CoA reductase inhibitors. On the other hand statins have prevented heart attacks and deaths from heart attacks and strokes in about 25% to 35% of patients treated with them as many clinical trials have shown (Ref.1), but simple supplements that have no side effects can do the same or do even better (see below).

The lack of cholesterol synthesis by the body’s cells when statins are given, leads to an expression of more LDL receptors on the cell surfaces. LDL binds to these receptors and enters the cells, which removes the circulating high risk LDL fraction of cholesterol from the blood thus causing a drop in LDL cholesterol. All of the side effects of statins (pull down to side effects in this link) can be explained as a result of the slow-down of organ functions (brain, muscles, gut, adrenal glands, etc.) as cholesterol synthesis is reduced.

New information from the Framingham Heart Study

So far everything I said made sense. But when I came across Ref. 4 I noticed that there was a bombshell of new information from another follow-up study of the Framingham Heart Study (Ref. 5) that did not fit in with the latest marketing drive of the statin manufacturers. In this study from 2005 Boston researchers had studied the outcomes of 789 men and 1105 women over a period of 16 to 18 years with respect to cognitive function. Participants were divided into total cholesterol groups that showed levels that were desirable (less than 200), borderline (200 to 239) or high (above 240). The astounding results were that higher cognitive functioning as documented in multiple cognitive tests in these three groups showed the best performance in the group with the highest cholesterol and the worst cognitive test outcomes in the lowest cholesterol group, quite opposite of what was expected.

Another important piece of research (April 2013) comes from Spain where doctors followed a group of 7447 patients with a high cardiovascular risk who were put on a Mediterranean diet with olive oil, a Mediterranean diet with nuts or a regular diet. The end point was death from heart attack or stroke. After 4.8 years the study had to be interrupted as the Mediterranean groups showed a significant survival advantage over the group on a regular diet.

Ref. 4 cited literature evidence that statins cause a 48% increased risk in postmenopausal women who take statins to develop diabetes. It also cites compelling evidence that diabetes patients are twice as likely to develop Alzheimer’s disease within 15 years and are 1.75 times more likely to develop any kind of dementia in the same time period.

Dr. Seneff from the Computer Science and Artificial Intelligence Laboratory at MIT explains in great detail that statins effectively reduce cholesterol synthesis in the liver, which in turn starves the brain of one of its main nutrients explaining why patient develop Alzheimer’s disease and dementia as a result of statin treatment.

So, the lessons to be learnt from these clinical trials are that you want to offer your brain enough cholesterol and healthy fat to have a normal metabolism. Fortunately, what’s good for your heart is also good for your brain. Conversely avoid statins, if you can and try alternatives first. Ref. 4 explains that for years the experts had the wrong theory that low fat/high carb was what would be good for your heart and brain, but the opposite is true: what is good for your heart and brain is a high healthy fats/low refined carb diet.

Make sure that with your blood tests that fasting insulin is low (no insulin resistance), that the ratio of total cholesterol to HDL cholesterol is less than 3.4 (low risk for heart attacks or strokes) and that the hemoglobin A1C level is low (4.8 to 5.6%, ideally less than 4.5%), which means you are not diabetic.

How alternative treatment can save you from heart attacks

Lifestyle treatment through dietary intervention, moderate exercise, and weight loss has been somewhat neglected by mainstream medicine, but is now recognized in regular textbooks of medicine as first-line treatment (Ref. 3). Most patients can lower LDL cholesterol by 10 to 15% through a change in diet. High-risk patients with established heart disease (narrowing of coronary arteries) require a drop of 30 to 60% of LDL cholesterol; this high-risk patient group may need an addition of a statin. In patients with metabolic syndrome or diabetes high triglycerides are often present and will respond to decreased intake of simple sugars, alcohol, and calories (Ref.3). Total calorie intake should be adjusted according to what the weight is when weighed every day with the goal of reducing the weight when overweight or obese, but maintaining the weight when it is in the normal body mass index range (BMI of 20 to 25). The total fat intake should be around 25%-35% of the total calorie intake. Specifically, saturated fat needs to be less than 7% of total calories, polyunsaturated fat up to 10% of total calories and monounsaturated fat up to 20% of total calories. Healthy fats according to Ref. 4 are extra-virgin olive oil, organic butter, almond milk, avocados, olives, nuts, nut butters and cheese ( except for blue cheeses). Other healthy fats are sesame oil, coconut oil, and the oils found in seeds like flaxseed, sunflower seeds, pumpkin seeds and chia seeds. Note that trans-fats (such as in margarine and baked goods) are a “no-no” as it causes free radicals in your body, which would accelerate the hardening of your arteries. Complex carbohydrates from vegetables and fruit are the main source of total calories providing 50%-60% of the total calories. Fiber intake needs to be 20-30 grams per day. Protein intake should be about 15% of total calories. Fat should provide 25% to 35% of the total calories per day. Cholesterol intake should be less than 200 mg per day. You may want to consider the use of plant sterols (2 grams per day) to enhance LDL cholesterol lowering. Physical activity from moderate exercise should expend at least 200 kcal per day (better 300 kcal).

Which supplements prevent heart attacks and strokes?

There are several nutrients that have been shown to be powerful preventers of heart attacks and strokes. I will review them briefly here (based on Ref. 2):

1. Coenzyme Q10 (CoQ10): The cells lining the arteries are only working well when their mitochondria are working properly producing chemical energy in form of ATP. CoQ10 is an important component of the mitochondrial metabolism; it is also the only fat soluble antioxidant that gets absorbed into the LDL particles where it protects these from oxidation. Statins suppress CoQ10 synthesis, so patients on statins need to take CoQ10 supplements daily to counteract this. However, anybody who is healthy now should take CoQ10 as a daily supplement for prevention. I take 400 mg per day.

2. Vitamin E (tocopherols): this fat soluble vitamin is an antioxidant and has been praised in the past as being heart supportive, was subsequently bad-mouthed by some conservative physicians, but lately has been resurrected. It turns out that there are 8 different types of tocopherols, with the alpha tocopherol being the most known, but gamma tocopherol is the one you want to make sure you are also getting with your balanced vitamin E supplement every day as this is the one that is a powerful anti-inflammatory. Simply ask staff at your health food store for a vitamin E supplement with gamma tocopherol in it. Take 400 IU per day (of the mix).

3. Curcumin: This is a powerful heart and brain protector combining three different mechanisms in one; it is reducing oxidative stress, is an anti-inflammatory and counters the process that threatens to destroy the lining of the arteries. One study on healthy volunteers showed a reduction of 33% in lipid oxidation, a 12% reduction of total cholesterol and an increase of 29% of the protective HDL cholesterol when 500 mg of curcumin was taken only for 7 days (Ref.2). This is the daily dose I would recommend for prevention of heart attacks and strokes.

4. Polyphenols: Flavonoids are the largest group among the polyphenols contained in such common foods as vegetables, fruits, tea, coffee, chocolate and wine.  Over 130 studies have been done on humans showing improvement of the lining of the arteries (endothelial functioning) and lowering of blood pressure. Polyphenol consumption has been associated with a lower risk of mortality from heart attacks. Eat a Mediterranean type diet or a DASH diet and you will automatically get enough polyphenols with your food. However, resveratrol, the powerful red wine polyphenol warrants a separate daily supplementation as it prevents LDL oxidation in humans (Ref.2). Take about 250 mg of it daily.

5. Niacin/nicotinic acid: This supplement comes as “flush-free niacin” and also as extended release niacin; it can raise the beneficial HDL cholesterol by 30 to 35% when higher doses of 2.25 grams per day are used. In a metaanalysis of 7 studies it has been shown to significantly reduce heart attacks and transient ischemic attacks (precursor syndrome before developing a stroke). Niacin can change the small particle LDL into a large particle size LDL, which is less dangerous. Niacin has also been shown to reduce oxidation of LDL, which stops the atherosclerotic process. For a healthy person 500 mg per day of flush-free niacin is adequate.

6. Fish oil (omega-3-fatty acids): Because heart attacks are due to an inflammatory process and high LDL cholesterol is thought to be only a secondary phenomenon, it is very important to have this additional tool of an important anti-inflammatory supplement. In the past it was still safe to eat fish fairly frequently per week. But with mercury, radioactive iodine from Japan’s leaking reactor and carcinogenic PBC’s all congregating in the ocean waters, it is no longer safe to consume fish in large quantities. The remedy to this situation is molecularly distilled (or pharmaceutically pure) EPA/DHA supplements. EPA stands for eicosapentaenoic acid or omega-3 fatty acid. DHA is the acronym for docosahexaenoic acid. Fish oil supplements at a dosage of 3.35 grams per day of EPA plus DHA were shown to reduce triglycerides by up to 40%, equally to Lipitor or even more effective, but without the statin side effects. The amount of the dangerous small dense LDL is also being reduced with fish oil. Fish oil supplements have reduced the mortality from heart attacks and strokes and led to a higher survival from non-fatal heart attacks. At the same time these preventative fish oil doses will also treat and prevent arthritis.

7. Other useful supplements: Soluble fiber from psyllium, pectin, beta-glucans and others have been shown in clinical trials to reduce LDL cholesterol by binding bile salts in the gut (interrupting the enterohepatic pathway). Plant sterols (usually sold as sterol esters) are recognized by the FDA as reducing the risk of coronary heart disease, if taken in high enough amounts (2.4 grams of sterol esters per day). There are other useful supplements like artichoke extract, pomegranate, soy protein, Indian gooseberry (amla), garlic and pantethine (vitamin B5) that have been proven to be of benefit in terms of prevention of heart attacks and strokes. It would be too lengthy to get into more details here.

Conclusion

Recently there was a review in a medical journal that demonstrated that clinical guidelines (in this case for clinical guidelines for lowering cholesterol) erred 40% of the times when measured against scientific tests as this link explains. When it comes to saving lives by preventing heart attacks and strokes, what is needed is a multifactorial approach that treats the multifactorial causes of cardiovascular disease. Just pushing for treating more people with statins as Big Pharma is attempting to do is not addressing the fact that cholesterol is needed for our metabolism and the synthesis of our hormones. It is much superior to use a combination of different approaches that overlap and thus potentiate each other in their effects excluding statins first. Exercise creates more nitric oxide production by the lining of the arteries, which opens up arteries and prevents spasms. A proper diet with as many of the proven vitamins and other support factors will control inflammation and oxidation of LDL cholesterol particles as explained. This will prevent heart attacks and strokes as has been shown in many clinical trials. Only patients who come from families with genetically high cholesterol or high triglycerides and those patients who had heart attacks and strokes should be exposed to statins as they are at a higher risk of developing a heart attack or stroke. They need all of the help they can get in addition to the lifestyle factors mentioned. Most other patients and the public at large will do quite well without statins (no side effects of diabetes, Alzheimer’s and muscle pains). And, yes, a diet high in healthy fats, but low in refined carbs is what your brain and heart need (the opposite of what you have thought, see Ref. 4).

More information about side-effects of statins (acute pancreatitis): https://www.askdrray.com/pancreatitis-can-occur-with-statin-use/

Lower cholesterol with Mediterranean diet: http://nethealthbook.com/news/mediterranean-diet-benefits-us-workers/

 

References

1. Bonow: Braunwald’s Heart Disease – A Textbook of Cardiovascular Medicine, 9th ed. © 2011 Saunders.

2. Life Extension: Disease Prevention and Treatment, Fifth edition. 130 Evidence-Based Protocols to Combat the Diseases of Aging. © 2013

3. Melmed: Williams Textbook of Endocrinology, 12th ed. © 2011 Saunders.

4. David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

5. http://www.psychosomaticmedicine.org/content/67/1/24.full.pdf

Last edited Nov. 7, 2014

May
05
2013

Get Rid Of Toxins Safely

By | Alzheimer’s disease, Anti-aging medicine, Arthritis, Cancer, Diabetes, Health, Heart Disease, kidney disease, Nutrition, Prevention, Stroke, Vitamins and supplements

This article is about “get rid of toxins safely”. You often hear that people use chelation at home with natural foods. Is that true?

The standard chelation detoxification

I like to mention in the beginning that the proven way to reduce heavy metals in the blood (typically mercury and lead) is by intravenous chelating agents such as EDTA. However, the lowering of calcium levels as a severe side effect limits the application of it. There are also blood-thinning side effects to consider. EDTA is a chemically synthesized compound, not a natural substance. Conversely, vitamin C and Glutathione are both antioxidant substances that the body knows; they are non-toxic and can be used more easily intravenously to remove heavy metals like lead and mercury with fewer side effects than EDTA.

Natural ways to use chelation in order to detoxify

Although I think that EDTA has a place in the hands of those who are knowledgeable about the side effects, the vitamin C/Glutathione combination is probably a more physiological detoxification method as glutathione is synthesized by the liver to detoxify our bodies. Intravenous chelation is expensive, requires access to a vein and may not be a suitable way for many people to detoxify. There are natural ways to detox for those who cannot afford chelation or cannot chelate for other health reasons.  The major detoxification organs are: the liver, the kidneys, the gut, the lungs and the skin.

What about oral methods to detoxify?

Several methods of cleansing are fasting, the major cleanse or the raw food cleanse. I would not advise to do strict fasting without fluid intake as it takes fluid intake to be able to dissolve any released toxins into urine, feces, invisible fluid from exhaled air and nasal discharge. Next there is the “master cleanse” with lemon juice, maple syrup and cayenne pepper as indicated in the link above. Some people like trendy procedures that they find in a magazine or in a self-help book. I do not like it, as it reminds me too much of a cookbook approach.

A Vitamix is a good tool to create turn your fruit/vegetables into a chelating tool

I feel differently about a raw food cleanse as I will explain. First, I like to point out that raw food is not easily digested as your gut absorbs only about 30 to 40% of the nutrients. The cell walls of the vegetables you use are the barrier towards absorption. This is much different, if you put the raw fruit and vegetables into a blender with a high-power motor. (There are several brands like the BlendTec or the Vitamix.) The powerful blending process breaks up the cell walls and releases the content of the plant cells including their enzymes and nutrients, so that 80% of the nutrients are absorbed in your gut.

Get Rid Of Toxins Safely

Get Rid Of Toxins Safely

If you use organic ingredients (they do not contain toxins, artificial fertilizer residues etc.) you cannot go wrong! Use spinach, kale, banana, mango, greens, lemon juice, and for fat add some nuts like walnuts, Macadamia nuts, almonds (with the proviso that you are not allergic to them). With the help of a powerful blender all this will turn into a liquid drink that actually tastes OK. For protein supplementation I would also add some protein supplement like vegan protein from the health food store, whey protein or egg white protein (good to rotate these protein supplements). This mix is a complete nutritional program as it contains complex carbohydrates from fruit and vegetables, fat from nuts, protein from the protein supplement and fiber (from the whole vegetables and fruit).

Natural detoxification from organic fruit and vegetables

You will not get hunger pangs as with a fast or the master cleanse. Use the signs of your body as guidance. If you feel energized after 5 days, stop then and return to your normal food intake. This is a zone type diet, a Mediterranean diet or South Beach diet as explained below. Some people have the willpower to do 7 to 10 days of the liquid diet described. Good for them, at least they do not starve themselves as the calories and total nutrient content are there while they detoxify. What are the agents that lead to the detoxification process? The enzymes from the fruit and vegetables, the lack of toxins as you only consume organic ingredients, the extra vitamin C from the food and the glutathione from your liver are all working together for detoxification.

Are there supplements that can help you to detoxify?

Chlorella powder, which you can buy in health food stores, is one of the few supplements that can detoxify your body from heavy metals. As Dr. Mercola describes that in Japan chlorella powder is one of the most popular supplements to detoxify. It is difficult to get a complete, non-biased picture about chlorella. I did an extensive research in MD Consult about the scientific evidence for detoxification by chlorella in humans. Unfortunately, the search results came back only for experiments with mice and rats, but there were no human detox results.

Chlorella detoxification

Perhaps the Wikipedia description about the history of algae and chlorella as a possible food supplement sheds some light on the difficulties getting real hard data on chlorella detoxification. Researchers poisoned rats deliberately with cadmium (a heavy toxic metal). There was no evidence of detoxification with chlorella when the researchers stopped cadmium poisoning. However, the article goes on to say that chlorella did prevent absorption of cadmium from the intestines to a certain extent (in rats).

Liver detoxification and colonic detoxification

Dr. Max Gerson invented coffee enemas many years ago when he treated end stage cancer patients with natural methods. He found that when he detoxified them with raw juices, many cancer patients died from the toxic breakdown products of dying tumor cells. So he was in dire need of a procedure that would remove the toxic tumor substances efficiently.  This is when Dr. Gerson used coffee enemas. As the link above describes, coffee given through the colon as an enema (we would perhaps call it “coffee colonics” today) stimulates the liver and the bile flow thus detoxifying the blood effectively of toxic materials. In addition, the secretory capability of the large surface of the colon wall also helps the detoxification process. Juicing in combination with coffee enemas improved Dr. Gerson’s end stage cancer cure rates dramatically.

Dr. Kelley introduced supplementation with Mega pancreatic enzymes

Subsequently, Dr. Kelley developed his nutritional-metabolic therapy for end stage cancer patients where he added large amounts of pancreatic enzymes in addition to coffee enemas. Dr. Denis Burkitt is credited for recognizing the importance of fiber in the diet. He noticed that there was a striking difference between the colon cancer rates in England versus the rates in Africa. He analyzed food habits in both locations and found that in England there was not enough fiber consumption.

Diet high in vegetables, fruits and whole grains reduces colon cancer rates

A large study done by the Harvard Medical School showed that it was not so much the fiber that helped to prevent colon cancer. Further large scale studies were done and it was shown that a diet high in vegetables, fruits, and whole grains was what was responsible for a reduction in colon cancer rates. This type of diet will also help detoxify your system from carcinogenic substances in general and from other toxins as the soluble fiber inside the gut will attach to it and go down the toilet instead of being reabsorbed in the colon into your system causing cancer.

Skin detoxification

The skin is the largest body organ with a lot of skin surface where skin pores can help detoxify under the right circumstances. You can achieve this with infrared saunas, with exercise that leads to production of sweat and by soaking in Epsom salt baths. Traditionally this has been done for centuries in the European spas, originally described by Sebastian Kneipp. The medical establishment in Europe (France, England, Germany, Austria), unlike American physicians, embraced the concept of natural therapies under the term “balneology”, at least for a number of decades. But  overuse by patients (abusing the system), badmouthing the relatively weak effect of detoxifying by Big Pharma and lack of funds from the health insurance companies put a damper on his movement. Part of this approach was the use of skin detoxification with healing baths (using Epsom salt and other salts) and physical exercise to the point of sweating.

Wechselbäder according to Sebastian Kneipp

In addition, “Wechselbäder” according to Sebastian Kneipp (alternating hot and cold baths) are also useful to stimulate the circulation and the immune system. The major component of Epsom salt is magnesium sulfate, which can be absorbed through the skin to a certain degree. So, some of the healing effect of Epsom salt baths may have come from an indirect balancing of low blood magnesium and the normalization of many metabolic processes that require magnesium as cofactors. Here is another, more vernacular description of Epsom salt use. Some of the assumptions such as improvement of diabetes, improvement of digestive absorption or relief from migraine headaches may be a combination of exaggeration and placebo effect rather than reality.

Kidney detoxification

The kidneys along with the liver are the major, natural detoxification organs of the body. However, they need enough fluids to dissolve water-soluble toxins and eliminate them from the body through the urine. Consume clean water intermittently during the day (reverse osmosis water in glass bottles or BPA free bottled water). Because alcohol is a cell poison damaging the vital organs like the brain, heart, liver and kidneys it is best to minimize any alcohol intake to the absolute minimum (best to avoid alcohol altogether). The main filtration devices in the kidneys are the glomeruli, little packages of convoluted capillaries, which filter the blood several times per day.

Too much salt and sugar interfere with normal glomerulus function

High salt intake, too much sugar and too much starch interfere with normal function of the glomeruli. Insulin resistance in cases of metabolic syndrome and diabetes (often in people with obesity) can damage the kidneys.  In this case the filtration devices of the kidneys suffer damage and cause toxin accumulation. To prevent damage of the kidney capillaries you need a healthy, basic diet like the Zone diet, South Beach diet or the Mediterranean diet as mentioned in this link.

This will keep fat deposits out of your arteries and maintain the capillaries of the glomeruli of your kidneys. This means that the filtration process continues to work until a ripe old age. Your doctor can order tests (creatinine clearance) to assess whether the filtration capacity of your kidneys is normal.

Many toxins are fat-soluble

Many toxins are fat-soluble and store in the fatty tissues. When you lose weight, you need to drink more fluids to get rid of the water-soluble toxins. This occurs through the kidneys. You can also use coffee enemas to rid yourself of fat-soluble toxins (through bile and bowel movements).

There are a lot of websites that want to sell you herbs that should cleanse your system. They have a marginal effect. But I like to stress that you want to adopt one of the diets mentioned above first. This starts you with a healthy baseline. Such herbs as Buchu (Agathosma Betulina), Burdock, Echinacea and Yellow Dock Root (Rumex Crispus) are supposed to help the kidneys to detoxify. I am not certain whether there is medical proof for this.

Conclusion

Detoxification starts with adopting healthy food and lifestyle habits first. A low carb, low fat type diet (zone diet, a Mediterranean diet or South Beach diet) are essential. They are the footing from which the other detoxification methods work. Some of the toxins will leave you when you work out and sweat. More will leave you when you enjoy an Epsom salt bath. This gives you some extra magnesium, which in turn detoxifies your system. The detoxification takes place  through several biochemical reactions where magnesium is a cofactor. Colonics or enemas will help remove toxins through your colon and they are more effective when coffee enemas are used (stimulation of your liver through the splanchnic nerves).

Infrared saunas

Infrared saunas can help to mobilize toxins and detoxify them through your skin. Take ample amounts of fluids as this will help remove some toxins through the kidneys and the urinary system. If the physician detects major heavy metal poisoning, the traditional intravenous chelation treatments are more recommendable. A naturopathic physician or A4M physician (anti-aging physician) could advise you what is best in your case. Overall the thought is that by removing toxins the mitochondria in our cells will work more efficiently. They are particularly concentrated in the brain, heart, liver, and kidneys. When they work more effectively they give you more energy and prevent major diseases. These diseases are cancer, cardiovascular disease (heart attacks and strokes), diabetes, arthritis and loss of cognitive function. The latter prevents Alzheimer’s disease and dementia.

More information about:

1. Chelation therapy: https://www.askdrray.com/tact-study-proves-effectiveness-of-chelation/

2. Vitamins, minerals and detoxification: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/vitamins-minerals-supplements/

Apr
21
2013

On World Health Day 2013 the Focus is on Hypertension

By | Diabetes, Eye Diseases, Fitness, Heart Disease, High Blood Pressure, kidney disease, Nutrition, Obesity, Prevention, Stroke, Vitamins and supplements, Weight loss

Introduction

This article is about this: on World Health Day 2013 the focus is on hypertension. In the US high blood pressure causes 348,000 American deaths per year, in the world its death toll amounted to 9.4 million every year. This is unfortunate as high blood pressure is an illness, which can both be effectively treated and prevented. Uncontrolled high blood pressure (hypertension) causes heart attacks and strokes, can cause kidney failure, heart failure and blindness. You control blood pressure with lifestyle changes and/or medication,  and these risks go away.

The age standardized death rate  (Ref. 1) for both sexes in the US for heart disease is 80.5 per 100,000 and for strokes 25.4. In Canada these rates are 66.2 and 22.9. For  Germany the rates are 75.0 and 31.2, in Italy 51.7 and 34.9 and for Japan 31.2 and 36.7. The death rates from cardiovascular disease per 100,000 people in the same countries is as follows: in the US 172.2, in Canada 130.7, in Germany 200.2, in Italy 153.5 and in Japan 107.1.

There are obviously significant differences in these countries, which I will discuss further below.

Topic of high blood pressure

World Health Day was celebrated on 7 April 2013 to commemorate the founding of the WHO in 1948. In 2013 the topic of high blood pressure made the World Health Organization edit a PDF publication of 155 pages. It is entitled “Global Atlas on cardiovascular disease prevention and control” (Ref.1, be patient, loads slowly). In it prevention and treatment for high blood pressure are discussed in detail. This text points out that there has been a remarkable decline in death rates from heart attacks and strokes (collectively called “cardiovascular disease”) between 1981 and 2000 in the United Kingdom.

Decline in death rates from heart attacks and strokes

A thorough analysis of this showed that 58% of this decline was due to risk factor reduction in the whole population. This included reduction of smoking and heavy alcohol consumption, reduced salt intake, combatting physical inactivity and reduction of saturated fat intake. The other 42% of the decline in cardiovascular disease is due to treatment by a physician. So, it is clear from this that the majority of mortality prevention comes from the patient, less than 50% comes from the treating physician. However, it is important that physicians will educate their patients to cut out risk factors themselves in order to prevent hypertension.

World Health Day 2013, Focus on Hypertension

World Health Day 2013, Focus on Hypertension

Risk factors for high blood pressure

On World Health Day 2013 the focus is on hypertension. In the past it was thought that most cases of high blood pressure would be due to “essential hypertension”, a term saying “we don’t know what causes high blood pressure”. Many physicians still use this term. Physicians thought that only a small amount of cases were due to “secondary” hypertension with an apparent cause (e.g. kidney disease, hormonal imbalance, pregnancy). But in the meantime research by Harvard University and other research institutions has shown that there are a number of specific causes that contribute to high blood pressure, either alone or in combination.

Common causes of high blood pressure

Here are the commonly known causes: too much salt in our diet; we tend to not eat enough vegetables and salads; we like to sit in cars, in front of the TV or in front of the computer (physical inactivity). Many people still smoke, although tobacco is known to cause high blood pressure and lung cancer. Too much alcohol is known to cause hypertension as well. So the following steps will prevent high blood pressure:

  1. consuming less salt
  2. eating a balanced diet (preferably the DASH diet)
  3. engaging in regular physical activity
  4. avoiding tobacco use
  5. avoiding harmful use of alcohol (more than 2 oz. or 60 Grams per day)

Diabetes worsens the risk for heart attacks and strokes

Physicians know that diabetes worsens the risk for heart attacks and strokes and increases the risk of high blood pressure as well. So, some hidden risk factors for high blood pressure related to diabetes are as follows: a high fasting blood sugar; obesity; food with too much fat, too much sugar and too many starches (not enough complex carbohydrates).

What can we do to reduce death rates from high blood pressure?

As Canada is one of the countries where the death rate from strokes and heart attacks is lower than in the US or Germany, I like to point out some of the reasons for this. I practiced medicine in Canada for many years. The “Canadian Hypertension Education Program” have been guidelines for practicing physicians to follow providing effective screening and treatment of high blood pressure. Cardiologists at various continuing education conferences have promoted this.

High blood pressure recalls at my medical office

At my office I had a hypertension recall program where my staff called every patient with high blood pressure into the office every 3 months. We would review the home-measured blood pressure readings from the patient (recorded in a little booklet). I also took the blood pressure of the patient and so did my staff on the patient’s arrival. We reviewed the blood pressure medication and reviewed the possible side effects. I explained to the patient what to do, if the blood pressure was higher than normal (possible adjustments of the medication at home). I also encouraged my patients with regard to the life style issues (the 5 points mentioned above). Over the years the number of patients who developed heart attacks or strokes declined, as one would expect.

Literature review in the medical journal Canadian Family Physician

A recent review in the Canadian Family Physician mentions that there is room for improvement regarding the Canadian statistics. As mentioned above Italy and Japan are doing better with regard to mortality from heart attacks and strokes compared to Canada. We have a health care system in Canada that is available to every Canadian resident and funded by provincial taxes. In this system patients do not have to pay for office visits (although they pay for it indirectly through taxes). For the patient with high blood pressure, it means that there is a system in place, which helps prevent cardiovascular disease and treats high blood pressure effectively. In my opinion the home recording of self-measured blood pressure readings at least once per day with a home blood measure monitor is vital to encourage the patient to be engaged with regard to his/her blood pressure problem.

Newer findings about high blood pressure

For years physicians did not know where high blood pressure came from. In the last few years research has shown that nitric oxide plays an important role in preventing high blood pressure. The lining of your arteries produce nitric oxide (by the so-called “endothelial cells”). This is the natural artery relaxer.

Foods that produce nitric oxide in the body are spinach, kale, red beet, cabbage varieties and other vegetable greens. These foods, which are also contained in the DASH diet, and regular exercise will stimulate the lining of your arteries to produce nitric oxide, which prevents high blood pressure, heart attacks and strokes.

Treating high blood pressure with medication

If these measures and recommendations to prevent high blood pressure do not help, it is time to treat it. It is important that the patient who needs high blood pressure treatment with medication, takes the medicine regularly. This has the name”compliance”. By keeping the blood pressure reading below 120/80 you prevent your risk of getting a heart attack, a stroke, heart failure or blindness from broken retinal vessels. If the patient develops any side effect from the medication, it is important to see the physician about this right away. It may be that the medication has to be adjusted or altered.

Nitric oxide

Nitric oxide can be taken as a supplement (Neo40), which allows the endothelial lining to be regenerated as indicated in this interview with the inventor, Dr. Nathan Bryan from the University of Texas Health Center in Houston.

The older we are, the more likely it is that our blood pressure will be high. As this link shows, 2 out of 3 people above the age of 60 in the US have systolic hypertension (the upper value of the blood pressure is elevated). As we age, it appears that the lining of the arteries do no longer produce the required amount of NO (nitric oxide). NO is necessary to prevent high blood pressure and prevent hardening of the arteries.

Adopt the Mediterranean diet 

So, it would be wise to adopt the Mediterranean diet. This includes lots of vegetables, spinach, kale, bok choy, Swiss chard and others to boost your NO production. You still measure your blood pressure regularly. If you do not have a home blood pressure monitor, go to a pharmacy that allows you to check your blood pressure for free. If it is above 120 over 80 seek the advice of a health professional. You can find more information in Ref. 1.

In essence, what World Health Day 2013 asks us to do is to pay attention to your blood pressure and make sure it is normal.

More on high blood pressure: http://nethealthbook.com/cardiovascular-disease/high-blood-pressure-hypertension/

References

Ref. 1)  http://www.nethealthbook.com/articles/cardiovasculardisease_hypertension.php

Last edited Nov. 6, 2014

Feb
12
2013

Stem Cell Treatments That Are Currently Available

By | Arthritis, Cosmetic surgery, Heart Disease, kidney disease, Orthopedics

In the first place I am discussing stem cell treatments that are currently available. By the same token stem cells got a bad reputation in the beginning of stem cell research. As a matter of fact, researchers at that time thought that embryonic stem cells were necessary to treat degenerative conditions. Be that s it may, immediately this raised an ethical flag, as physicians would harvest embryonic stem cells from a dying fetus. Similarly, this created a lot of unnecessary division among the public and scientists. To put it another way, it turns out that for most treatments there are enough stem cells in the body. As I will explain below,  this was not general knowledge in the beginning.

Dolly, the sheep

With this in mind, the next bad rep came from Dolly, the sheep that was born on July 5, 1996. She only lived for 6 years, because the telomeres were short like that of an old animal and she died of a progressive lung disease. It is important to realize that researchers used a complicated stem cell technique to create Dolly. The method went under the name of “somatic cell nuclear transfer”. Three animals were necessary to achieve this. Researchers used an unfertilized egg from one animal from which they extracted the nucleus. The second animal donated a cell nucleus of a breast gland cell. A third animal served as a surrogate mother. After some cell divisions the researchers introduced the blastocyst into the uterus of the surrogate mother who carried baby Dolly until birth.

Mesenchymal stem cells and bone marrow stem cells

Fast forward to 2013. We now know that stem cells are fragile cells that do not like too much manipulation. Stem cells have long telomeres so they are younger than the typical cells of the body. Stem cells are present in the bone marrow, in fatty tissue and many other organs. In the last few years research has shown that this has already translated into practical applications. Originally researchers thought that stem cells were cells that could develop into any variety of body cell. Physicians at that time thought that stem cells would derive from bone marrow or from fetal tissue. Scientists called these cells “pluripotent cells”.

Induced pluripotent stem cells and mesenchymal stem cells

In the last years researchers could show that it was possible to turn off the SP100 gene could also prompt a body cell to become such a versatile, pluripotent stem cell. They are called “induced pluripotent stem cells” to distinguish them from embryonic stem cells, which have been highly contentious with religious groups. In recent years matters have been simplified with the observation that mesenchymal stem cells are distributed freely throughout the body and can be harvested fairly easily from fatty tissue by liposuction. Physicians prefer this latter technique, as it does not involve any manipulation of the stem cells themselves.

 

Stem Cell Treatments That Are Currently Available

Non-Surgical Space Lift, Before and After

Here are a few examples of what is happening now and what developments are probable in the future:

Minimal invasive face-lift, called “space lift”

Mesenchymal stem cells are freely available in fatty tissue. Plastic surgeons in the US and elsewhere are using mesenchymal stem cells for a minimal invasive plastic surgery. In this “space lift” procedure the surgeon removes fat by liposuction. A cell separator separates the fat graft into a fat cell fraction and into a mesenchymal stem cell rich fraction. The physician injects fat cells and stem cell rich fraction together into various areas of the face where subcutaneous tissue is needed.

Facial rejuvenation

The mesenchymal stem cells enable the fat cells that were transplanted to latch on to the small vessels in the transplanted area so that they survive permanently. The result is a more youthful appearance of the face (see image). This is the secret of film stars in Hollywood. Nowadays the plastic surgeons in Beverly Hills do not do the conventional facelifts so much as they lead to artificially looking faces. They rather do the minimal invasion space lift for the natural look.

Knee problems, hip problems and lower back problems

Why wait with degenerative diseases of the knees, hip or of the lower back until there is permanent scarring and disabilities? Physicians can inject the mesenchymal stem cell rich fraction (without the fat cells this time) into diseased joints. This is a useful tool for degenerative changes in knee joints, hips and facet joints along the spine. The result is that the transferred mesenchymal stem cells recreate cartilage and the patient becomes pain free and regains mobility! But as with other diseases it is important to intervene early enough before permanent damage has set in.

Organ failures

Another exciting development is intravenous injection or injection via an arterial catheter into failing organs. Heart failure is an end-stage heart disease, where conventional medicine has nothing to offer other than symptomatic supportive medication. In contrast, physicians can inject mesenchymal stem cells into the blood. The pluripotent stem cells will find the weak areas in the heart muscle.  It is there that they transform into heart cells and give the existing heart cells a boost.

The result is that the heart pumps more forcibly and the symptoms of heart failure disappear.

Parkinson’s disease and liver failure

Similarly, there are trials that show that Parkinson’s disease can be positively influenced with injections of the mesenchymal stem cell rich fraction.

Treatment of patients with liver failure using mesenchymal stem cells is being investigated, but is still in its infancy.

Chronic kidney failure

With regard to mesenchymal stem cell treatment of chronic kidney failure early human experiments on 30 patients showed very encouraging results.

Although this field is very promising, more caution is in order with regard to laboratory-manufactured stem cells. Researchers need to do more trials to show that they are ready for use in regenerative medicine. They have to show similar or even better successes as the present results achieved with mesenchymal stem cells. Physicians harvested mesenchymal stem cells directly and did not change them as described above.

More information on:

1. stem cells for stroke victims: http://nethealthbook.com/news/stem-cells-help-stroke-victims/

2. stem cells for knee osteoarthritis.

Oct
01
2006

Kidney Transplant Tourists At Risk

By | kidney disease

Long waitlists for a kidney transplant have caused some people in need of the procedure to venture overseas. Many kidney recipients are reluctant to share information about the source of human organs transplanted overseas, but this is just one problem. Once the patient returns home, proper follow-up care is often hindered by the fact that there is a lack of communication between the foreign transplant team and the physician in North America.
There may be a sheet of paper stating that the kidney transplant went well. Often important information about what medications were given at the time of transplant is missing, and there is little or no information about the donor.
A Canadian study found that 33% of the patients who went abroad came back without medical documentation. The other 67% had often incomplete records. A study that was presented at the World Transplant Congress in Boston showed, that one third of the patients required immediate hospitalization upon their return, primarily for sepsis. More worrisome is the fact that many of the patients had poor long-term outcomes due to sepsis, systemic fungal infections and compromised grafts. All of them had received their kidneys from non-biological or emotionally related donors. Dr. R. Prasad of the University of Toronto examined the three-year graft survival at the Toronto center. Where patients received the kidney from a relative, the results were best, as the graft survival was 98% over 3 years.

Kidney Transplant Tourists At Risk

Dialysis Patient Awaiting Kidney Transplant

Patients you received a kidney from an emotionally related donor had an 86% success. In the patient group who went abroad and underwent non-biological or emotionally related kidney transplantation the 3- year graft survival
dropped to 62%.
Reference: The Medical Post, September 1, 2006, page 19

Last edited December 5, 2012

May
01
2005

Dialysis At Home Now Possible

By | kidney disease

Kidney failure and the need for dialysis has been a burden that many patients had to live with in the past. Invariably the quality of life would suffer, as every week brought trips to the hospital and a four-hour hook-up to the dialysis machine there. The times of travel or recreation were usually a thing of the past, as dialysis took precedence over other things.

Dr. Stephen Korbet, professor of nephrology at Rush Presbyterian Hospital in Chicago has been using a new dialysis device to stable chronic patients since 2003.The 33 cm machine called Nx Stage System One has some significant advantages over the conventional machines. The treatment is done on a daily basis for 2 hours. There is better clearance of potassium and phosphates, and there seem to be fewer side effects. The system is portable, can also be taken on trips, and no special water processing or electrical requirements are needed. Those who wish to use the system have to be medically stable and train for two weeks with a partner who can assist with set-up and watch for adverse effect.

Dialysis At Home Now Possible

Dialysis At Home Now Possible

The Nx Stage System One offers the patient freedom and independence. At this point it is not yet available in Canada.

More information on pyelonephritis, which can lead to kidney failure: http://nethealthbook.com/infectious-disease/urinary-tract-infection/pyelonephritis/

Reference: The Medical Post, April 26,2005,page 45

Last edited October 28, 2014

Apr
01
2005

Pre-eclampsia Is Predictable

By | High Blood Pressure, kidney disease, obstetrics, Women’s Diseases

Pre-eclampsia is a condition, which can threaten a woman’s health and also the unborn baby. It can occur in the second and third trimester. These latter stages of pregnancy (there are 3 stages) are where the doctor should check for early pre-eclampsia signs. In the past this would go unchecked and develop to the full-blown condition of eclampsia and be a significant cause of maternal mortality rate
and fetal mortality rate. With prenatal visits and check-ups the early signs are easily recognized: the pregnant woman would complain that her rings would not fit her any more. Significant weight increase due to fluid retention where her legs and the area of her shinbone would be puffy, is called edema. The dipstick test would tell more: it would indicate the presence of protein in the urine sample. These changes are a cause of high blood pressure, which is another important clinical sign and can be readily checked. For these reasons it is imperative that regular pre-natal visits take place at the doctor’s office.

Pre-eclampsia occurs, when substances are released from the placenta into the bloodstream of the mother, and they affect the kidneys. If the condition progresses to eclampsia, it can lead to kidney damage and seizures, and the outcome will be fatal.
For a long time it was a puzzle to physicians, why some women would show pre-eclamptic symptoms and others would remain problem-free.
New research on patients’ medical history from the John Radcliffe Hospital, Department of Obstetrics and Gynecology in Oxford, Great Britain has been able to point out predisposing risks for pre-eclampsia in pregnant women.

Pre-eclampsia Is Predictable

Pre-eclampsia Is Predictable

A family history and history of previous eclampsia increases the risk, but also certain health problems make it more likely that pre-eclampsia will occur in the later stages of pregnancy: diabetes mellitus, kidney disease and high blood pressure are medical conditions that increase the risk. Beside these health conditions an increased body mass index at the start of pregnancy can be a predisposing factor, and a high maternal age-women over 40 years of age- are more likely to have the complication of pre-eclampsia. It is obvious that the risk gets higher, if several of these predisposing factors are present. The highest risk is found in women with a rare inherited variation of lupus, called anti-phospholipid syndrome, where blood clots are a problem and pre-eclampsia is a high risk with pregnancy.

Risk Factors For Pre-Eclampsia According To Meta Analysis (published
in the Brit.Med.Journal, March 12, 2005)

Pre-eclampsia Risks

Pre-eclampsia Risks
Explanation of independent risk factors: A= Previous History Of Pre-eclampsia; B= In Women With Anti-Phospholipid Antibodies; C= Pre-existing Diabetes; D= Twin Pregnancy; E= First Child; F= Family History; G= High Blood Pressure; H= High Body Mass Index;
I= Maternal Age 40 or more

While it is absolutely imperative that regular pre-natal checks are part of proper health care, there are other consequences. There would be reason to be especially watchful with predisposing conditions. Last not least, prevention also has its place.

It is important that health concerns are already addressed as part of planning for a healthy pregnancy. Avoidance of alcohol and quit smoking are of extreme importance, followed by achieving a normal weight. Good eating habits are needed throughout the entire pregnancy. Opting for pregnancy after age 40 seems trendy in some celebrity circles, but with the knowledge of risk factors, it should be looked at with caution. Nature equipped the human species to have children in the age of 20 to 30, and even though a forty year old may have a youthful appearance, the genetic material is aged, and the biological clock cannot be fooled. Prevention also means that any health condition like preexisting diabetes should be well controlled before a pregnancy.
With a proactive and common-sense approach pre-eclampsia can be either avoided or recognized and treated early, resulting in healthy outcome for mother and baby.

More information about high risk pregnancies: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/pregnancy-labor-delivery-2/%20High%20Risk%20Pregnancies/

References: British Medical Journal 2005;330:565(12 March)

Last edited October 28, 2014