Jan
19
2019

Alzheimer’s disease is treatable with hormones

By | Alzheimer’s disease, Hormones, neurological disease, Nutrition, Parkinson’s disease, Prevention, testosterone

Dr. Thierry Hertoghe, an endocrinologist from Belgium, stated that Alzheimer’s disease is treatable with hormones. This talk was part the 26th Anti-Aging Conference of the American Academy of Anti-Aging Medicine in Las Vegas (from December 13 to 15, 2018).

First of all, Dr. Hertoghe treated many Alzheimer’s patients himself and noted that they often have multiple hormone deficiencies. Secondly, common deficiencies affect thyroid hormones, human growth hormone, estradiol for women and testosterone for men. But even vasopressin and oxytocin are hormones that may be lacking. Third,  after doing thorough blood tests to assess hormone levels, Dr. Hertoghe replaced what hormones were missing. Finally, many Alzheimer’s patients got their energy, muscle strength and memory back.

In the following I am summarizing what Dr. Hertoghe told the audience about the various hormones. Alzheimer’s disease is treatable with hormones. Later I provide the hormone doses that Dr. Hertoghe uses for replacement.

Progressive memory loss

Generally, patients who develop Alzheimer’s disease start losing short-term memory first, but in time they will also lose long-term memory. Often this disease process starts in the 60’s as age-associated cognitive impairment. In the 70’s it may progress further to mild cognitive impairment, only to take off in the 80’s as Alzheimer’s disease. The astute clinician may order some screening blood tests in the 60’s and 70’s. In a male low testosterone, low DHEAS and low thyroid hormones may be present. Certainly, blood tests will show this readily. Frequently, in women low estradiol, low thyroid and low DHEAS may also be present. The reason this is important is that simple hormone replacement can return a person back to normal. Yes, this is right: hormone replacement can bring a person with age-associated cognitive impairment or mild cognitive impairment back to normal! In other words, Alzheimer’s disease is treatable with hormones.

Hormones important to monitor with Alzheimer’s disease

There are 6 hormones that are important for memory restoration in Alzheimer’s patients: IGF-1 (and growth hormone), thyroid hormones, estrogen and testosterone, vasopressin (and oxytocin) and pregnenolone. However, as Alzheimer’s patients often have sleep problems, another important hormone is melatonin.

Oxytocin to calm down aggressive Alzheimer’s patients

Notably, Dr. Hertoghe found that Alzheimer’s patients often are restless and can be aggressive. This makes it difficult to care for them in a home. Oxytocin is the hormone of trust, affection, sociability and concerns about others. It calms down aggressiveness. But with oxytocin treatment the Alzheimer’s patient feels better, becomes friendly, cooperative and warm-hearted.

As an illustration Dr. Hertoghe gave an example of one of his 80-year old patients with aggressive Alzheimer’s disease. She became unmanageable for her non-married son and other contacts. 5 IU of oxytocin sublingually changed this woman into a friendly, compassionate, warm-hearted woman, and the aggressiveness disappeared completely.

Insomnia in Alzheimer’s patients

About 45% of Alzheimer’s patients develop “sundowning”. When the sun goes down they start getting hyperactive, develop unacceptable behaviors and they become restless. Research papers showed that blood melatonin levels are low in these patients. Indeed, this is why they respond very well to small amounts of melatonin at bedtime. As a conclusion, within only a few days of starting this, their sundowning disappears, and they become easier to look after.

Dr. Hertoghe provided material from several research papers that showed that Alzheimer’s patients are often deficient for melatonin. Replacement with varying doses of melatonin solved even more complicated insomnia problems.

Melatonin is a powerful anti-oxidant. Interesting animal experiments have shown that melatonin has memory-enhancing properties. Researchers believe that melatonin improves the extracellular senile plaques with amyloid-beta peptide accumulation (first of 2 Alzheimer’s lesions). In addition melatonin also decreases the intracellular neurofibrillary degeneration tangles, the second of the two specific Alzheimer’s lesions.

IGF-1 and human growth hormone

Several studies have shown that Alzheimer’s patients have a significant drop in IGF-1 levels and growth hormone levels. This affects their short-term and long-term memory. Serum IGF-1 has an inverse correlation with cognitive impairment. Dr. Hertoghe said that IGF-1 treatment in Alzheimer’s patients increases their brain volume, increases the functional network of neurons in the brain and increases memory.

Brain atrophy in Alzheimer’s patients from chronically depleted IGF-1

Dr. Hertoghe showed a slide of a normal brain with a view from the outside and a cross section view of the brain. The same slide contained the view of an Alzheimer’s patient’s brain. It showed brain atrophy resulting in a much smaller brain and the cross section displayed an increase of the hollow spaces (e.g. the third and forth ventricle). He stressed that in his view the brain shrinkage of Alzheimer’s patients is due to prolonged low levels of IGF-1. This in turn is due to a lack of production of human growth hormone.

With IGF-1 treatment the serum IGF-1 was increasing and the cognitive function in older adults recovered. Dr. Hertoghe provided many literature citations to support this, which I will not repeat here.

Case report of a male patient with Alzheimer’s disease

Dr. Hertoghe presented one of his patients with Alzheimer’s. Lab tests showed that he had deficiencies of thyroid hormones, DHEA and testosterone. But despite replacement of these hormones he remained severely affected with Alzheimer’s. He did not remember his own name, could not go to the toilet on his own, spoke only a few words and suffered from severe fatigue. He received 4 injections around his eyes with IGF-1 and mesotherapy from his doctor (described below) with human growth hormone and IGF-1. Within a few weeks he had a complete reversal of his cognitive decline. He could return to his professional driving career doing halftime work with a delivery van in the city. He could read a newspaper and understood what he was reading. Alzheimer’s disease is treatable with hormones.

Thyroid hormones

According to Dr. Hertoghe thyroid hormones help to establish short-term and long-term memory and treat the apathetic depression in Alzheimer’s patients. Many Alzheimer’s patients are hypothyroid.With this deficiency they have swollen lower eyelids, a puffy face and paleness of the face. In a 1990 study a group of Alzheimer’s patients had 26% lower T3 levels when compared to normal controls. Many patients with hypothyroidism have memory loss, before their deficiency is corrected. Dr. Hertoghe stated that 13% of all dementia cases are reversible by proper thyroid hormone treatment.

Estradiol can improve long-term memory loss

Research showed that estradiol could improve long-term memory in dementia and Alzheimer’s disease cases. Many female Alzheimer’s patients are deficient in estrogens. If they do, they have dry eyes, a pale face and thin, dull hair. In a 2005 study 33 control women were compared to 48 women with Alzheimer’s disease. The estradiol levels in the Alzheimer’s disease group showed significant depletion compared to the normal control group. There was no significant difference found with regard to progesterone, testosterone and LH&HSH levels. Another study showed that in cerebrospinal fluid of women with Alzheimer’s disease the estradiol level was significantly reduced while the beta-amyloid levels were significantly increased.

Dr. Hertoghe reviewed several studies that showed that symptoms of Alzheimer’s disease disappeared with estradiol supplementation. Both memory and mood responded to the treatments.

Men with Alzheimer’s disease are often testosterone deficient

Testosterone is important for long-term memory. Men in andropause report erectile dysfunction, general weakness and memory loss. The physician needs to be aware that the patient may be starting to develop Alzheimer’s disease. Dr. Hertoghe showed a slide based on a publication, which stressed that testosterone enhances memory. It increases brain blood flow and thickens the myelin sheets. Testosterone increases dendrite and synapses and in addition decreases amyloid beta-peptide production. Neurotoxicity is also reduced. The end result is improvement of Alzheimer’s in males with testosterone replacement.

Pregnenolone improves short-term memory

Pregnenolone gets synthesized in the brain, spinal cord and peripheral nerves. Dr. Hertoghe said that pregnenolone is a neurostimulating “neurosteroid”. Pregnenolone concentrations in brain tissue are about 25- to 35-fold higher than in the blood stream. Some cases of Alzheimer’s disease can come from a lack of pregnenolone and pregnenolone sulfate. Patients who have Alzheimer’s because of a lack of pregnenolone have blood levels that are 2.5-fold lower than pregnenolone levels in normal controls. When these patients are treated with pregnenolone, their memory improves. The mechanism of the effect of pregnenolone is by increasing acetylcholine by more than 50% in the hippocampus. It also protects the hippocampus from glutamate and amyloid beta. Pregnenolone improves short-term memory over a period of 3 to 4 months of treatment.

Vasopressin improves short-term and long-term memory loss

Postmortem studies on Alzheimer’s patients showed that there is decreased vasopressin in the brain cortex. In patients with alcoholic dementia (Korsakoff psychosis after recovery) there was decreased vasopressin in the cerebrospinal fluid. Often patients with diabetes insipidus have decreased vasopressin and are in danger of developing dementia. If not treated, they develop short-term and long-term memory loss. When treated with vasopressin or Desmopressin their memory recovers within 4 hours of starting therapy. Younger patients (50 to 73) do better with memory recovery than older patients (74 to 91).

Treatment details of hormone replacement for Alzheimer’s disease

Before hormone treatments are given to a patient it is important to do a battery of blood tests. This will help the physician to identify the missing hormones in a particular patient. Each of the missing hormones are then administered separately.

Oxytocin

This hormone can be given sublingually or intranasally. Sublingually 5-10 IU are given daily. With the sublingual approach 1 or 2 sprays are given daily. Each spray contains 8 IU of oxytocin. Improvement is visible within 2 to 5 days. A full recovery takes 2 to 3 months.

Melatonin

Most patients in the higher age group do no longer produce their own melatonin. With the oral route 1-3 mg are given every night before going to bed. An alternative is to use sublingual tables 0.5mg to 1.0mg at bedtime. The first improvement can be seen 2-5 days after the start of replacing melatonin, the full impact takes about 2-3 months from the start of the treatment.

IGF-1 and human growth hormone

Replacement of IGF-1 can be done by injecting IGF-1 or human growth hormone (HGH). HGH stimulates the liver to produce IGF-1. IGF-1 is somewhat cheaper than HGH. When IGF-1 is used, 0.3mg to 1mg is injected at bedtime. Progress is slow; the first improvement is visible at 2-4 months, it takes up to 24 to 36 months for a full recovery.

For severe memory impairment with Alzheimer’s, the doctor does a double treatment approach with both IGF-1 and HGH: first subcutaneous IGF-1 injections around the eyes 4 times per day (0.01mg each). Secondly, at the doctor’s office the doctor administers mesotherapy injections with 1mg of HGH and 1mg of IGF-1 and vasodilators 3 times per week. Two weeks later the doctor administers another course of mesotherapy. He may repeat this twice in 14-day intervals. Now the interval increases to monthly therapy for 3 months and finally every 3 to 4 months. The patient can use IGF-1 nose drops instead of subcutaneous IGF-1 injections.

Thyroid hormones

Dr. Hertoghe prefers desiccated animal thyroid hormone replacement as the T3/T4 ratio is best matched to what the ratio is in humans. Depending on the severity of thyroid hormone deficiency the patient takes 30-150mg of thyroid hormone every morning. Dr. Hertoghe starts with a low dose and slowly increases the dosage. Clinical progress is very slow. It takes until the second month before the first improvement takes place. Full improvement can take 8-12 months.

Estradiol

Replacement of estradiol in postmenopausal women with Alzheimer’s disease received ether more than 0.1mg per day or 0.625mg of conjugated equine estrogen daily. In both cases there were improvements of their memory and improvement on the Hamilton depression scale.

Dr. Hertoghe’s preferred way to treat postmenopausal women with Alzheimer’s disease is as follows. The first 25 days of each month he gives them 1-2mg of oral estradiol valerate each day and 100mg of micronized progesterone. If they prefer an estrogen cream, he gives them 1-3mg per day transdermal estradiol and 100mg micronized progesterone capsules.

The first improvement is visible after 2-4 months; there is further improvement the next 8-12 months.

Testosterone

There are two methods of how to do hormone replacement with testosterone, either by injection or as transdermal cream. The injection treatment uses 250mg of testosterone enanthate or cypionate every 2 -3 weeks. The patinet can also self-administer testosterone enanthate (50mg twice per week) for a more even blood level of testosterone. The transdermal approach involves 100-250mg transdermal, nanoliposomal testosterone daily.

The memory will improve 2-4 months into replacement therapy. The full improvement takes 8-12 months.

Pregnenolone

The replacement therapy is 100mg per day in the morning for the first 4 months. Then there is a dosage reduction to 50mg daily. Studies have shown that 30mg of pregnenolone is not enough to treat memory loss. Short-term memory improved after 3 to 4 months in about 75% of patients.

Vasopressin

The best vasopressin preparation to use is bio-identical vasopressin. It comes as 1 nasal spray with 10IU of vasopressin. Upon awakening the patient or caregiver applies 1-2 sprays into the nose. The patient receives the second dose 10 minutes before lunch by nasal spray.

Apart from hormones, lifestyle changes are also recommendable.

Alzheimer’s disease is treatable with hormones

Alzheimer’s disease is treatable with hormones

Conclusion

Who would have thought that Alzheimer’s disease could have anything to do with hormones? Dr. Hertoghe, the endocrinologist from Belgium did many hormone tests on Alzheimer’s patients and concluded that various degrees of hormone deficiencies can indeed cause Alzheimer’s disease. But what is more is that you can replace the missing hormones and see complete cures in patients with Alzheimer’s disease. Alzheimer’s disease is treatable with hormones. This is something conventional medicine can only dream of. At this point this hormonal approach is not yet mainstream medicine; but it would not be a surprise to me, if in 10 or 20 years interested physicians do this type of therapy routinely in their practice. When hormones are missing, replace them. When the memory is fading, think about testing for missing hormones! It will make a difference in the quality of life for the patient as well as for his family.

Dec
29
2018

Fasting Mimicking Diet Is Very Relevant For Health And Longevity

By | diet, Health, Nutrition, Prevention, stem cells, telomeres

Several speakers in Las Vegas said that the fasting mimicking diet is very relevant for health and longevity. This happened on day 1 of the 26th Annual A4M World Congress 2018 in Las Vegas.

What were the findings that are relevant?

Dr. Longo has done a lot of animal experiments with intermittent fasting and studying longevity. He repeated what he has learnt over the years from animal experiments and from research on humans. Here are the results that he shared already at last year’s Anti-aging Conference in Las Vegas.

Effects of fasting mimicking diet

  • Obesity diminishes, because of the weight loss effect due to missing calories.
  • Diabetes: insulin resistance becomes lower and blood sugar levels drop.
  • High blood pressure reduced: many patients were able to reduce their medications or discontinue them
  • Pain conditions improve as all kinds of pain disappears, an effect for which there is no explanation at this point
  • Autoimmune diseases like MS and rheumatoid arthritis improve, likely because of the effect of increased stem cell circulation
  • Prevention of heart attacks and strokes because of reduction of LDL, triglycerides and CRP
  • Cancer cure rates improve by protecting normal cells and the bone marrow
  • Longevity improved in mice with a 3-fold increase of their life span. Telomere length in humans was increased. Increased stem cells will find defective areas that need repair. This effect leads to less disease in older age.

Increased life span, less heart attack and cancer rates

We know from these animal experiments that mice have a threefold increase in life span. But when heart attack rates and stroke rates improve in humans, cancer cure rates improve and telomere length in humans increase, there is strong evidence that it increases human life expectancy as well. It may take another 10 to 20 years before we have better statistics about the real survival advantage on this diet versus the Standard American diet. But what we know now is a significant start.

Patients on chemotherapy and FMD have much better healing rates than controls

The lecture by Dr. Longo on Dec. 13, 2018 did provide more human data. Patients undergoing chemotherapy tolerate and survive chemotherapy much better when combined with the fasting mimicking diet (FMD). The human data is very similar to the previous mouse model data. This human research was done at the Charité Hospital in Berlin, Germany. Dr. Longo is starting to engage in clinical trials by partnering with physicians, but the publication of this will take several years. In the meantime the FMD is an effective way to rejuvenate on an ongoing basis. Since last year I underwent 12 courses of 5-day FMD every month. Dr. Longo says that even 3 to 4 courses of FMD per year would have a lasting rejuvenating effect.

About the right food intake and getting enough sleep

Dr. La Valle gave a talk in the afternoon of the first conference day where he pointed out several important things. He started his talk by saying that North Americans eat the wrong foods, they eat too much of it and they often eat it at the wrong time (in the middle of the night when the body wants to rest). This can interfere with our diurnal hormone rhythm, which in turn will eventually lead to inflammation in the body. Fasting overnight rests our hormone receptors so they are fully active the following day.

Preventing Alzheimer’s disease

Dr. La Valle praised the FMD as being able to elevate brain derived neurotropic factor. Newer research is pointing at the importance of this factor for preventing Alzheimer’s disease and Parkinson’s disease. He pointed out that the FMD is a good start to change other things in a patient’s life. Such things like exercise, bioidentical hormone replacement and taking vitamins and supplements. All of these all in combination will build up a patient’s health.

More human data about anti-aging

The internist, Dr. Kurt Hong said that he is seeing 200 patients every week. He has done clinical studies on various forms of fasting. The FMD, he said he liked best as it is easy to do (5 days out of one month 500 calories on each of the FMD days). Dr. Hong has seen amazing improvements in patients with MS, Hashimoto’s disease and Crohn’s disease. His talk concentrated on how fasting improved the metabolic syndrome, improved inflammation in the body and improved immune diseases. The FOXO pathway involves transcription factors that are important to regulate cell death (apoptosis). A variant of FOXO3 is responsible for longevity in humans and has been found in centenarians.

Dr. Hong pointed out that self-cleaning (autophagy) is an important rejuvenation process in the body. The FMD stimulates this process. In a 2017 study Dr. Longo and Dr. Hong compared 100 regular patients with 100 patients on the FMD. Only the patients on the FMD showed that the body weight came down. In addition the blood pressure came down as well and the pluripotent stem cells in the blood were up. So, the FMD has a positive effect on various organ systems without any medication. The strongest effect of the FMD would be in the age group of 20 to 40 for anti-aging purposes as it stimulates stem cell production and elongates telomeres.

Fasting and women’s health

Dr. Felice Gersh gave a talk about the effects of fasting on women’s health. She pointed out how important estrogen is in a woman for every organ system. All of the major organ systems including the skin have estrogen receptors. Estrogen stimulates the metabolism. It stimulates the immune system by stimulating macrophages that also have estrogen receptors. In menopause less estrogen production leads to a lack of energy, because the mitochondria are no longer stimulated as they were before. Estrogen also stimulates sirtuins, which is important for anti-aging. Studies with the FMD have shown that estrogen production is re-stimulated in women.

Dr. Joel Kahn was another speaker in the afternoon. He talked about how important the FMD is for cardiovascular health. He does not think that coronary artery surgeries and stents will suddenly get abandoned, but he thinks that the FMD is a powerful tool to delay arteriosclerosis in the arteries. This will delay coronary artery lesions from developing and will add life. In his opinion 40 to 60 year old patients should start using the FMD to prevent cardiovascular disease.

Aging drives chronic disease

Sebastian Brandhorst, PhD pointed out that if we stay active and eat healthy, we will age well. The US is the only country on earth where the life expectancy goes down after there was an initial health gain in the past.

Yeast, worms, flies and mammals follow a nutrient-sensing pathway. That means when food is not around, starvation increases resistance to a variety of toxins. One important aspect of the FMD is the observation that it protects the body against the toxic effects from chemotherapy. FMD and chemotherapy combined almost completely blocked progression of breast cancer in mice. Further studies showed that cytotoxic T cells were responsible for stopping cancer growth. When antibodies against T cells were administered, the beneficial cytotoxic T cell effects against cancer were wiped out. In humans the same protective effect of the FMD was observed. The FMD combined with chemotherapy gave the best survival data in cancer patients.

Fasting Mimicking Diet Is Very Relevant For Health And Longevity

Fasting Mimicking Diet Is Very Relevant For Health And Longevity

Conclusion

The fasting mimicking diet (FMD) was ranking very prominently among last year’s anti-aging conference in Las Vegas. Several speakers of this year’s anti-aging conference pointed to the health supporting effect of the FMD. It is now evident that the previous findings in animal research are also true in humans. Missing at this time are prolonged clinical trials that analyze the mechanisms of why the FMD works so well. In the meantime everybody can safely use FMD 5 days out of every month, which will rejuvenate your system by gradually prolonging pluripotent stem cell activation and telomere lengthening. It is just a matter of time when the missing links will be filled in.

More info: intermittent fasting may benefit health.

Dec
08
2018

Not Exercising Is More Risky For You Than Smoking

By | Cancer, Cardiovascular disease, Diabetes, exercise, Fitness, heart attack, Mortality, Nutrition, Prevention, Smoking, Stroke

A new study showed that not exercising is more risky for you than smoking. We all know that smoking puts you at risk to get a heart attack or a stroke. It can also cause lung cancer and other cancers. So, hearing that not exercising is even more risky than smoking comes as a shocker.

The study

Dr. Wael Jaber, a cardiologist at the Cleveland Clinic was the senior cardiologist of this study. It was based on 122,007 patients who underwent tests using an exercise treadmill test at the Cleveland Clinic. This took place between the beginning of January 1991 and the end of December 2014. The end point in the study was all-cause mortality. The question in the study was whether exercise and fitness were lowering the risk of mortality. The result showed that 12% of the study group had the lowest exercise rate. This sedentary group had a mortality rate that was 500% higher than the top exercise performers. Compared to someone who exercises regularly the sedate group that hardly exercises still had a 390% higher death rate.

No ceiling of the benefit of exercise

What was astounding to the researchers was the fact that there was no ceiling of the benefit of exercise. The ultra fit group still had a super low mortality rate, lower than the next higher fitness group. Age did not matter either. Whether you were 40 or 80, the more you exercised, the lower your mortality rate was.

Comments about the study

Jaber said: “Being unfit on a treadmill or in an exercise stress test has a worse prognosis than being hypertensive, being diabetic or being a current smoker. We’ve never seen something as pronounced as this and as objective as this.” He went on to say: “If you compare the risk of sitting versus the highest performing on the exercise test, the risk is about three times higher than smoking.”

A sports medicine physician, Dr.Jordan Metzl who was not part of the study, said: “Cardiovascular disease and diabetes are the most expensive diseases in the United States. We spend more than $200 billion per year treating these diseases and their complications. Rather than pay huge sums for disease treatment, we should be encouraging our patients and communities to be active and exercise daily.”

Other studies showing that not exercising is associated with a high mortality rate

 

The STABILITY trial

This trial was based on 15,486 patients with heart disease and found that even 10 minutes of exercise per day reduced mortality. They compared the death rate of people engaging in 10 minutes of a brisk walk with a group who did not exercise at all. The brisk walkers had a 33% lower death rate than the group who was entirely sedentary.

A lack of exercise causes a lot of chronic diseases

This review article mentions that a number of chronic diseases were related to sedentary lifestyle. Major diseases like heart attacks, strokes, arthritis, depression and anxiety and others were clearly much more common in people who were more sedentary than those who were exercising regularly.

Poor lifestyle in general causes diseases

Lifestyle, in particular regular exercises, a healthy diet and NOT smoking has a profound positive effect on our health. In one study researchers showed that 79% of major diseases including heart attacks and strokes could be prevented with a healthy lifestyle. I reviewed this in this blog.

High blood pressure reduced by regular exercise

This 2017 study from Brazil has examined the effects of regular exercise on high blood pressure patients. They came to the conclusion that regular exercise can be as powerful as blood pressure lowering medication. Both bring down systolic and diastolic blood pressure. Even complications of previously untreated high blood pressure will be reversed with regular exercise while medication will not have this positive effect. Controlling high blood pressure with regular exercise will prevent diseases like heart attacks and strokes and the associated mortality.

Regular exercise and diet change to prevent type 2 diabetes

In this 2015 study the researchers noted that a combination of adopting a healthy diet and regular exercise could lead to weight loss. This was shown to prevent type 2 diabetes. The authors question why such a lifestyle change was not more widely taught to people to prevent cardiovascular diseases and diabetes.

Not Exercising Is More Risky For You Than Smoking

Not Exercising Is More Risky For You Than Smoking

Conclusion

The medical profession knows for a long time that regular exercise is good for your health. But there always was a concern that perhaps too much exercise may be hazardous. A 2018 study from the Cleveland Clinic followed 122,007 patients for 14 years. All patients underwent an exercise treadmill test as a baseline. The end point was mortality during the 14 years of follow-up. The results made clear that there was no upper limit of exercise. Patients who were exercising the most still had a lower mortality than those who exercised less.

Sessile patients

But perhaps the most impressive result was that sessile patients who did hardly any or no exercise had the highest mortality. Their mortality was higher than that of smokers who exercised a little bit. If you want to avoid getting a heart attack, a stroke, diabetes or many types of cancer, exercise regularly, don’t smoke and eat a Mediterranean type diet. Regular exercise can reduce cardiovascular disease by 79%. And since the Cleveland study we know that more exercise is even better as the top athletes had the lowest mortality.

Oct
06
2018

Health Risks After Hurricanes

By | Infectious Disease, Lung Disease, Mortality, Prevention

We hear a lot about the dangers of hurricanes when they are in a region, but very little regarding health risks after hurricanes. I thought it would be interesting to review all of the health risks in a blog.

Health risks during a hurricane

A lot of the health risks during a hurricane are directly related to the risks from the wind severity, the amount of rain per hour and the physical damage from the hurricane. The excessive wind can uproot trees and they may fall right onto a house. This happened in the beginning of hurricane Florence. The amount of rain that comes down in a short time frame can be astounding. It causes flooding, which together with the high wind speeds can make you lose your footing. There is flying debris, torn away pieces of wood and drywall that can become a hazard to any person. It is a hazard that could kill you right there. It is best to be out of the way of a hurricane, if you can at all. But you need to watch hurricane predictions on the Internet or the news, so you know what is going on long before the hurricane arrives. This gives you enough time to travel away from the danger zone. People who live on islands need to be particularly proactive, so that they get out of harms way in time.

Be safe from floodwaters

If you live in a low-lying area, it is safer for you to leave and go to a shelter before the hurricane hits. Otherwise you end up drowning. Being on top of your house in a hurricane is dangerous as the roof may fly off any minute from the force of the wind. You are also the target of flying debris, wood pieces and other flying objects.

Contaminated water is one of the major health risks after hurricanes

With hurricane Maria in 2018 it appeared in the first few days that only 16 to 18 people had died from the physical effects of the hurricane in Puerto Rico. But in the subsequent weeks and months people died en masse because of infections from contaminated drinking water. It is unbelievable that huge water supplies had been brought in by FEMA following the hurricane Maria, but it was not distributed to the people who needed it. The total death toll is now around the 3000 mark. FEMA calculated this by subtracting 13,000 deaths due to natural causes from the total deaths of 16,000. The difference is about 3,000 deaths, attributable to hurricane Maria.

Providing clean drinking water important

Providing clean drinking water should be the first priority following a hurricane. This will prevent that people get the typical water-born bacterial and viral illnesses following a hurricane.

One patient in Puerto Rico with chronic emphysema was on a breathing machine. The interruption of electricity as a result of hurricane Maria meant his death. Some people are so vulnerable that the interruption of electricity ends their life.

Communicable diseases from floodwaters

The WHO has brought out a fact sheet regarding communicable diseases from floodwaters. People need to be aware that floodwaters are contaminated and avoid them as much as possible. However, they also point out that unless you have bruises or cuts where bacteria from contaminated waters could grow the danger is smaller than generally believed.

Mold from water damage to houses

After hurricane Katrina in New Orleans 2005 there was a lot of mold growth in houses that were flooded. This caused an overwhelming odor that was difficult to cope with. Bleach water removes mold initially until a professional crew can clean it up at a later date. I mention this here because following a hurricane there will not be enough professional people around to help. Mold is particularly devastating for asthmatics and people with chronic respiratory conditions. These people need evacuation from such living environments until the house is clean from molds. Flare-ups of asthma and chronic obstructive pulmonary disease can be deadly. Under normal circumstances people with respiratory problems can manage, but these people are at a severe risk of dying from an aggravation of their underlying conditions. Hurricane Katrina will be remembered for this.

Living in destroyed homes

Often with a direct hit of hurricane the roofs of homes are missing. The hurricane ripped them off and they literally flew away. A home without a roof is prone to water damage from future precipitation. There is the danger of mouse and rat infestation. Birds can enter and partake in the leftover meals. Their droppings may contain contagious bacteria like salmonella causing typhoid fever. Builders  work hard and long hours; it can take months or years before life is normal again. It may be wiser to live with a relative for a few months until the house is in livable condition again. When electricity is restored and the water lines are functioning again, there may still be an issue about getting safe drinking water and uncontaminated water to have showers and baths. Also, without proper shelter there are risks of mosquitoes transferring communicable diseases. This happened in the Dominican Republic.

Malaria in the Dominican Republic

In September 2004 Hurricane Jeanne struck the Dominican Republic. Subsequently there was more flooding from heavy rainfalls. The end result was a mini-epidemic of 17 cases of malaria, because the flooded areas gave the mosquitoes more breeding ground to multiply. Fortunately no one died, as all the malaria cases responded to chloroquine and primaquine. But some patients had to be treated in the Intensive Care Unit of a hospital. As already mentioned there are other water born illnesses that can cause diarrhea, vomiting and fever. These people need to get immediate access to a hospital where the medical staff will rehydrate them intravenously. Otherwise they could die.

Health Risks After Hurricanes

Health Risks After Hurricanes

Conclusion

Hurricanes pose enormous problems for the communities where landfall occurs. Close to the eye of the hurricane are the worst structural damages to properties and trees. But even miles away from that there can be flooding due to excessive winds and rain. Most people are reasonable during the initial phase when the hurricane hits. This means they stay inside so they can protect themselves from the direct impact of the storm. But hurricanes can pull roofs off and people can get hurt.

Illnesses from contaminated water

Later there is a disruption of the electrical supply as well as the water supply. The restoration of the utilities may take days or weeks. Immediately you depend on fresh and clean water supply, and when you run out, there may not be enough fresh water available. Illnesses from contaminated water become a huge problem at that point. This is where a lot of mortality comes from in the aftermath of a hurricane.

If you can, it is wiser to escape this all by visiting a relative far away from the hurricane area. In this case you must leave well in time before the hurricane hits. You can check with the authorities when it would be safe to return home. At least you know that you have survived. Everything else can wait. You will gradually take care of it. But it may take a long time for things to return to normal.

Aug
11
2018

HPV Testing For Cervical Cancer

By | Cancer, cervical cancer, Prevention, Women’s Diseases

HPV testing for cervical cancer is more sensitive than the traditional Pap test. For years physicians recommended the traditional Pap test once a year to prevent cancer of the cervix. But a few years ago a new cervical cancer screening test, namely the HPV test made the news. It stems from the observation that cancer of the cervix develops in 99.7% of women who test positive for the HPV virus. There are many types of HPV, here we are interested in the few subtypes that produce cancer (carcinogenic HPV virus).

Transmission of the HPV virus between men and women

The human papilloma virus transmits from males to females through bisexual contact. The problem starts when he develops HPV lesions on his penis. Without him wearing a condom, the contact with her cervix during sex can transmit HPV to her cervix. Both partners are not aware of the transmission of that virus, as it does not cause any symptoms. HPV invades the superficial skin layer of the cervix in the woman. In the man HPV will invade the skin of the glans of the penis. After certain incubation time it causes transformation into cervical cancer in the woman. Strangely enough it does not cause cancer in the male. However, in both sexes HPV virus is in the mucous membranes and can contaminate the other sex’s genital.

A recent study comes from UBC Vancouver, British Columbia, which compared the Pap test with HPV testing.

Details of the Vancouver study on HPV testing for cervical cancer

On July 3, 2018 this study appeared in the medical journal JAMA.

19,009 women were part of this randomized clinical trial. With HPV testing only 2.3 cases per 1000 women of early cervical cancers were present four years later. Using the traditional Pap test this figure was 5.5 cases per 1000 women after 4 years. 224 clinicians participated in this study. Women were recruited for this study from January 2008 to May 2012. Follow-up took place till Dec. 2016. The participating women in this study were 25 to 65 years of age.

In 2017 in the US there were still 12,820 women in the United States who got cancer of the cervix. Approximately 4210 are dying from this disease every year. Many women do not like to take the Pap test or the HPV testing. There are compliance problems with either one of these tests.

Significance of this trial regarding HPV testing for cervical cancer

The newer HPV testing was superior to the regular Pap test. The HPV test was more sensitive and resulted in much lower cancer rates after 4 years of follow-up. Every woman would have an HPV test every 4 years. In this case we likely would see cervical cancer go to the bottom of cancers that kill women. The reason for that is that HPV testing and colposcopy pick up cancers much earlier. This leads to a more effective treatment of cervical cancer. After 4 years much less cancer of the cervix was found when the researchers tested again using HPV testing.

Implications of HPV testing for cervical cancer

In third world countries

Many 3rd world countries do only the HPV testing. At the time when this decision was made, it was unknown that they had actually chosen the better method to test for cancer of the cervix. Now this trial reassures all the health care providers in 3rd world countries that they should continue with the program, and they only have to do the test every 4 years, not every 2 years, which makes it even more cost effective.

Implications for the US

In the US so far the recommendation was to do both the regular Pap test and the HPV test simultaneously. This trial, however, says that this is not necessary. It would be better to use the more sensitive HPV test and abandon the more expensive and less sensitive PAP test. In 2012 a taskforce recommended to do the Pap smear in women age 21 to 65 every 3 years. The taskforce further recommended to women age 30 to 65 that they screen with a combo of cytology and HPV testing every 5 years. The lead investigator, Dr. Ogilvie said: “Offering women HPV [testing] for cervical cancer screening detects more precancerous lesions earlier, and also a negative HPV test offers more assurance that women will not develop precancerous conditions in the next four years,” she said. “This can mean that women may need less frequent screening but have more accurate results.”

What other doctors are saying about HPV testing for cervical cancer

Comments by Dr. Kathleen Schmeler

Dr. Kathleen Schmeler said that the study was “well-designed” and provided a much-needed comparison of Pap versus HPV testing. She is a gynecologic oncologist and at The University of Texas MD Anderson Cancer Center. She was part of the new research. Dr. Schmeler added: “The bottom line is that this could really potentially simplify how we screen women and have it be more effective and not quite as complicated and burdensome — and opens the door for doing just HPV testing, which is actually what’s currently recommended by the World Health Organization for countries that don’t have Pap testing capabilities,”

Comments by Dr. Stewart Massad

Dr. L. Stewart Massad Jr. is a professor of obstetrics and gynecology in the division of gynecologic oncology at Washington University School of Medicine. He wrote an editorial to the study in the JAMA. He wrote: “What will replace the Pap test? In 2012, the American Cancer Society endorsed co-testing with cervical cytology testing and HPV testing at 5-year intervals as the preferred strategy for screening women 30 to 65 years of age because this approach combines the sensitivity of HPV testing with the familiarity of traditional Pap testing,” He then went on to say: “However, the addition of cervical cytology testing adds little to the accuracy of HPV testing while increasing cost and false-positive results. In 2018, organizations that develop cancer screening guidelines are wrestling with whether to recommend replacing co-testing with primary HPV testing as the optimal screening strategy.”

Future dilemma

In view of all those comments the regulatory agents will have to come up with solutions for what is in the best interest of women for testing for cervical cancer.

HPV Testing For Cervical Cancer

HPV Testing For Cervical Cancer

Conclusion

A large randomized clinical trial in Vancouver, BC, Canada has compared screening methods for cancer of the cervix in women. Half of the subjects underwent screening by the newer HPV tests that checks for the presence of HPV virus. The other half received conventional screening by the Pap test (a cytological screening test.) The result was that the HPV test was more sensitive and resulted in less early cancer tests 4 years down the road. With the conventional Pap test there were more than double the amount of abnormal cells present 4 years down the road, which makes the Pap test less safe compared to the HPV test.

It appears from this trial that the Pap test is no longer a choice, except for colposcopy procedures that take care of early cervical cancers. But for screening in general HPV testing every 4 years is all what every women needs for her protection.

Related topics:

  1. Cancer rates increased in women.
  2. Catch cancer early.
  3. HPV testing was described in this blog in 2013: Low cost cervical cancer screening.
Jun
30
2018

Dangers That Can Lurk In Beach Sand

By | Infectious Disease, Inflammation, Parasites, Prevention

A recent article has pointed out that there are 5 dangers that can lurk in beach sand. There are invisible bacteria that can pose a problem. But there are also parasites, fungi and parasitic roundworms. Here is a review of these common dangers.

Dangers that can lurk in beach sand: hookworms

In February 2018 a Canadian couple from Windsor/Ont. came back from a beach holiday in Punta Cana, Dominican Republic. They brought with them parasites in their feet from walking barefoot on infested beaches in the Caribbean. This parasite is known to lay larvae into the sand that can survive there for several days. When beach goers walk barefoot the condition is right for the larvae to attach to the bare feet and puncture the skin. The full-grown hookworm can then develop and produce the symptoms described in the link (rash, itching, pain). The larvae of it are called “larvae migrans”, or in plain English the disease has the name “creeping eruption“. The best medicine for this condition is the anti-parasitic medication Ivermectin, the “wonder drug” from Japan. Originally developed in Japan, Ivermectin is available in the US, but not in Canada.

Dangers that can lurk in beach sand: Gut bacteria

A California study found that several gut bacteria were present in California beaches. Salmonella, Campylobacter, Shigella, Pseudomonas aeruginosa, Staphylococcus aureus, Aeromonas, and Vibrio parahaemolyticus, human viruses (adenovirus, enterovirus, norovirus, and hepatitis A virus), amoeba, and protozoa were all cultured from beach sand. However, it is difficult to prove that any one of these pathogens would have caused any gastrointestinal upset. Just picking up one of these bugs on your skin does not mean you will come down with that particular infection. It makes sense though to wash your hands or take a shower after your beach walk. But the study noticed that there was a difference in the infection rate. There were those who only had casual contact with beach sand. Others were digging into sand or buried themselves in sand. The latter group was more likely to come down with gastrointestinal infections shortly after their beach outing.

Dangers that can lurk in beach sand: superbug MRSA

According to the California study cited above there were 2.7% of beach sand samples on California’s beaches that contained MRSA bugs. These are the cause of flesh-eating disease. MRSA stands for methicillin-resistant Staphylococcus aureus. When there is a cut in the skin, this antibiotic resistant bug can pose a big problem. On the other hand, it is not known whether the mere existence of MRSA on the skin actually poses a danger. Researchers do not know at the present time whether or not this will cause flesh-eating disease. But they recommend that after a beach visit it is a good idea to take a shower, as this will cleanse the skin to a large extent of any pathogenic bacteria and viruses.

Dangers that can lurk in beach sand: fungi

The types of fungi that can hide in the beach sand belong to the group of dermatophytes. Common fungal skin infections are caused by the dermatophytes, Trichophyton rubrum, which is a very common dermatophyte, is the culprit that causes nail fungus, ringworm; jog itch and athlete’s foot. Other fungi around beaches are Aspergillus and Candida that affect mostly people with a weak immune system. Aspergillus may be responsible for lung infections and Candida for yeast infections.

Dangers that can lurk in beach sand: roundworms

Roundworms become a problem on beaches where dogs are allowed. The main problem is Toxocara canis, a parasitic roundworm. The roundworm normally lives in the gut of dogs. But dog feces from roundworm-infested dogs contain lots of eggs, which can get into soil along with the dog feces. People can inadvertently swallow contaminated sand. An Australian study found roundworm-infested samples among 266 random beach samples. They found that there were not as many positive samples when there were only adult dogs allowed on beaches. In contrast, they found a lot more positive roundworm samples in beaches were puppies were allowed.

Dangers That Can Lurk In Beach Sand

Dangers That Can Lurk In Beach Sand

Conclusion

We associate pristine beaches with nature, health and relaxation. Knowing of these scientific studies we would do well to not let our guards down. Think about the ocean water: is it safe or could it be the cause of contamination of the beach sand? Then think about the beach itself. Is it a busy beach with lots of people that may contribute to contamination of the beach sand? Are dogs allowed or not? There may be dogs that defecate and deposit eggs of roundworms. Or there may be larvae from the creeping eruption, a parasitic disease. Other dangers can lurk in the sand: methicillin-resistant Staphylococcus aureus, a bacterium that is an antibiotic resistant bacterium that can cause flesh-eating disease. Other bacteria may be buried in the sand that can cause various gastrointestinal upsets.

Being more careful around beaches

Having these thoughts in mind may help you to be more careful about the beach and shower off after you leave the beach. It is also not a bad idea to wear sandals on the beach to prevent direct contact of your skin with the beach sand. It is also obvious that the beach towel on which you lay on the sand is no longer “clean”. Wash it after your beach outing, or choose the option to relax on a cot. Wherever you travel this summer, have a safe journey!

Jun
16
2018

Writing A Medical Book

By | Anti-aging medicine, Cancer, Cardiovascular disease, Hormones, lifestyle, Medical Condition, Mental Health, Mortality, Nutrition, Prevention

In my 40’s when I was practicing medicine, I was dreaming about writing a medical book. This was in the mid 1980’s and I was busy seeing 30 to 40 patients a day. I would never have found the time to write a medical book at that time. I thought, perhaps I could show how patients could stay younger for longer by adopting the right life style in order to stay well. Fast forward 3 decades, and the medical book writing began. But instead of one book the project turned into 4 books. There were too many topics to cover to fit them all in one book.

Prior to writing a medical book

First of all, in 2002 I published a large website. Its structure is like a book on the Internet: Net Health Book . It contains descriptions of the major diseases, mental and physical, and their current treatment modalities. I still maintain this work. Furthermore, I started another website in 2003, a weekly blog, called “Ask Dr. Ray” . This is a compilation of interesting research. Some medical research papers can get too scientific. For this reason I translated it into easier language. The topics tend to be anti-aging topics. This blog comes out Saturdays.

Retirement hobby

When I retired in 2010 I revamped my websites. In the process the web developer suggested I should add to Net Health Book a blog (nethealthbook.com/news) where I review current health news that I find interesting. This is a weekly blog, which I publish on Wednesdays. All of this is still going on, and it gave me lots of opportunities to write and publish on a smaller scale. In addition, I finally started publishing books.

A Survivor’s Guide To Successful Aging

My first book came out with Amazon in 2014. I had joined the A4M (American Academy of Anti-Aging Medicine) in the early 2000’s. The lectures at their conferences were very open-minded and pointed out details of what one could do to delay aging and avoid premature deaths. My own experience with changing our diet in 2001, starting bioidentical hormone replacement and changing my lifestyle became topics that were part of this book. I dedicated this book “to those who are willing to work on prevention in order to achieve a longer life without disabilities”. This is still the basis of prolonging your life.

Lifestyles can be deleterious

I start out in this book describing the obesity wave and how this changes the metabolism (metabolic syndrome). I used statistics from the Framingham Heart Study to show the detrimental effects of various lifestyles on mortality. Subsequent chapters deal with food, exercise, stress and missing hormones as life-shortening factors. There is a separate chapter on vitamins and supplements. They as a group can create 5.1% longer telomeres, which translated into 9.8 years of longer life expectancy (see also a study by Dr. Xu  in the book). Subsequently it describes how a change of your lifestyle can have a positive impact. Changing your eating habits and exercise activity will make a tremendous positive difference on the long term.

Successful Aging in the Kitchen

The book ends with an appendix, written by my wife: “Successful Aging in the Kitchen”. You are presented with recipes for 7 breakfasts, 7 lunches and 7 dinners. In addition she has provided 7 healthy desserts for you. Bon Appétit!

Healing Gone Wrong, Healing Done Right

In another book, which got appeared in 2016 I gave a few examples of how famous people were failed by medicine. It started already in the past: Ludwig van Beethoven’s physicians did harm instead of healing their patient. However, this is happening now as well: physicians mismanaged the health care of Elvis Presley, Churchill, Michael Jackson and JF Kennedy. The physicians treated symptoms, but they never properly attended to the causes of the ailments of their patients. The end result was premature death in all of them. Churchill who had good genetics made it to age 90, but during his last 15 years he suffered of severe disabilities.

Treatment of symptoms will fail, treatment of causes succeed

These examples of famous people’s health problems resemble to what happens to today’s patients in various office settings. Their symptoms are mostly being treated, but their causes often not. Simply treating symptoms will not work on the long term. It did not work in the past, and it does not work now.

Other chapters in this book

Other chapters in this book deal with preventing disease, keeping a healthy brain and keeping a healthy heart. Next I discuss why food matters, followed by the health of limbs and joints. Subsequently I am discussing how to keep toxins out. The next chapter deals with how to reduce the impact of cancer. It is always important to diagnose cancer as early as possible as removal by surgery has the highest success rate at an early cancer stage. The next chapter is entitled: “Stable hormones key to health”. If any of your hormones are missing (particularly around the age of menopause and/or andropause) it is time for nature identical hormone replacement. The next chapter gives you general thoughts on anti-aging. This is followed by “supplements yes, but do not overdo it”.

Alternative treatment for ADHD

A final chapter gives you an example of an alternative treatment for ADHD, where the idea of not just treating symptomatically, but treating causes is included. References and an index are also provided for the book.

Prostate Cancer Unmasked

Furthermore, I did not intend to write this book. But in early 2016 my PSA (prostate specific antigen) level jumped from 3 to 8.6. For years it had been in the 1.5 areas, then slowly increased to 3. But 8.6 was too high for comfort! I had an MRI scan done, which showed one lesion in my left prostate, which was suspicious for prostate cancer. I was referred to a urologist at the Vancouver Prostate Centre, one of the top clinics in Canada. But I had already researched the literature and came across research by Dr. Gary Onik from Ft. Lauderdale who warned me about the pitfalls of “standard therapy”.

The conservative urologist in Vancouver

The urologist in Vancouver told me that without a positive biopsy he cannot accept that the shadow on my MRI scan would be prostate cancer. And the only way they do a prostate biopsy was by random trans-rectal biopsies. He also wanted to include me in a random clinical trial where they would compare active intervention with active surveillance. I politely declined the trans-rectal prostate biopsy and the inclusion into a trial.

Assessment by Dr. Onik

I booked a flight to see Dr. Onik in Ft. Lauderdale. His method is well researched and orchestrated.

Initial assessment

He assesses you with a rectal ultrasound and he sees the prostate on a TV screen. He said right away that I had three separate lesions, one in the left as shown on the MRI scan and two in the right lobe, which was missed by the MRI scan. False negative lesions are common on MRI scans, which can become a source of cancer recurrence.

3-dimensional prostate biopsy

The following day he booked me for a 3-dimensional prostate biopsy via the perineal approach. The perineum is easy to sterilize, so there is no risk of septicemia. A metal grid with holes for biopsy needles was used to get 96 biopsies of my enlarged prostate. For a normal size prostate, Dr. Onik said about 60 biopsy needles are normal. You don’t feel anything, because you are asleep.

Cryoablation prostate surgery

Next was the cryoablation surgery of the 3 prostate cancer lesions. This happened one month after the biopsy. I was seen at the hospital in Ft. Lauderdale. The same grid from the biopsy was used to relocate exactly where the cancer lesions were. The pathologist had confirmed them as Gleason 6 and 7 prostate cancers. This was treated with Argon sounds and frozen twice. I felt nothing, because I was under a general anesthetic. But Dr. Onik told me that everything went very well. Some cancer was too close to the neurovascular bundle, so he used the NanoKnife, an invention where nano-size holes get blasted into cancer cells, but it leaves normal tissue intact.

I needed to do self-catheterization for about one month to empty my bladder, as there was a lot of swelling from the prostate hypertrophy and the surgery. But eventually my normal water works returned.

Follow-up blood work

My follow-up PSA blood work 3 months after the surgery was down to 1.0. Prior to the surgery the Oncoblot test was positive for prostate cancer. A repeat Oncoblot test 3 months after the surgery was now negative for prostate cancer. I realize that not every physician accepts this new cancer-screening test, but I felt a lot better to know that all the cancer markers were now gone.

9 cancer treatments reviewed

In my book I described a total of 9 prostate cancer treatments and their 10-year survival statistics. None of the other treatment methods were as good as Dr. Onik’s statistics. I believe it is linked to the precision of the 3-dimensional biopsy and the surgery being done through the same grid. If you do not perform the surgery this way, you miss cancer lesions and this becomes the source of failure 10 years down the road. My book details all these alternative treatments. It also has a section on lifestyle modifying factors. I needed to write this book as a service to any man who suddenly is faced with a possible diagnosis of prostate cancer.

Unmasking prostate cancer

Like me he needs to unmask the cancer. Is it really there? How far advanced is it? Which way to safely biopsy it (definitely NOT through the rectum for fear of blood poisoning=septicemia)? What is the best method to remove it? I came to the conclusion that Dr. Onik’s method was best for me. But with the information in this book you can decide what is best for you.

Medical Questions Answered

Finally I wrote my 4th book. From more than 4400 medical questions that I have answered on the site Quora.com I selected the most popular questions for this book. The editorial board of Quora said that I own the publishing rights for my answers. The questions were rephrased without changing the meaning. I selected more than 120 questions under 44 different headings.

Here are some of the areas that are covered: Acne, the best home remedies. Aging: can it be reversed? What is the limit for a human? Alcohol: how does it affect your body? Alzheimer’s disease: which foods promote brain health? Arthritis: what can you do about osteoarthritis? Back pain: what can I do about it? Cancer: why can cancer still not be cured? There are as well 15 other answers about cancer. Depression: will my depression ever go away? Diabetes: will a 600-calorie diet help diabetes control?

Further topics discussed

Diet: I want to get rid of sugar in my diet. How can I do this long-term? Other answers about diet are included. Exercise: How useful is cardiovascular exercise? Gut disease: Is “gluten free” food healthy? Heart disease: What can I do to clean out my arteries and reduce my risk for heart disease? Hormones: Is estrogen present in the male body? Life Expectancy: What is the theoretical life expectancy of humans? Lifestyle Habits: Can good habits change your life completely? Pain: Pain relief for a headache or other pain: Aleve, Advil or Tylenol? Pregnancy: Best age for a successful pregnancy? Prostate Cancer: How dangerous is prostate cancer? Does it kill you? Schizophrenia: What complementary approach may help a patient with schizophrenia? Sleep: What happens when you go to bed late every night? And many other answers under this topic.

And the book finishes with these topics

Sugar: will I be OK living without sugar? Vaccinations: Is there a connection between vaccinations and autism? Vitamins and supplements: Are taking vitamins and supplements healthy or are they harmful? Weight loss: I am working out every day, but I am not loosing weight. What should I do? There are many more answers under this topic. Younger for longer: What are three things I can do every day to stay younger for longer?

These are only a few selections of all of the topics dealt with in this book.

Writing A Medical Book

Writing A Medical Book

Conclusion

I have reviewed briefly why I published the books mentioned above. My prostate cancer book developed out of the necessity that I had to deal with my newly diagnosed prostate cancer in 2016. I felt that the review process I went through would be good for those men who have to face a similar situation. The anti-aging book comes from my interest in anti-aging medicine. “Healing Gone Wrong, Healing Done Right” developed from the observation that physicians in the past and often even now tend to only treat symptoms. But if a cause can be found, this should be treated, as this often leads to a permanent cure.

Treating symptoms only will not improve the patient’s condition

Treating symptoms only will not improve the patient’s condition. “Medical Questions Answered” is a collection of medical topics where I answered various medical questions. It was a way for me to cover a vast array of medical topics. Some of the topics are dealt with in depth (acne for instance); others are very short. I have also two medical blogs that come out on Wednesdays and Saturdays. I hope that some of that medical information will be useful to you.

Mar
24
2018

Prevent Plugged Arteries

By | Cardiovascular disease, cholesterol, Diabetes, diet, exercise, fish oil, Fitness, food, heart attack, High Blood Pressure, Inflammation, lifestyle, Mortality, Nutrition, Obesity, olive oil, omega-3 fatty acids, Prevention, Processed food, Stroke, sugar

There are several ways to prevent plugged arteries, which will translate into less heart attacks and strokes. The message is simple: if you get less heart attacks and strokes, you will live longer. Below I am examining ways to prolong life by various ways to prevent plugged arteries.

You probably heard of plaque formation in the arteries. This is the process where a combination of fat, calcium, cholesterol and cell waste forms a deposit (plaque) under the lining of the arteries.

The end result is that the blood won’t be flowing freely through the affected arteries. This can cause a heart attack or a stroke. Essentially, this is the point where a clot forms in the narrowed passage of the artery. It is also the point, when the clinicians make a diagnosis of a heart attack or a stroke.

Let’s examine what leads to plaque formation in the arteries.

Trans fats

Trans fats are contained in fried foods like French fries, in margarines and other butter substitutes. As margarine is a common ingredient of cakes, cookies, pastries and pies, these are all bad news for our heart health. I consider them off limits. If you eat those foods, you build up plaque in your arteries, which leads to premature heart attacks and strokes.

Lack of exercise

It has been common knowledge for a long time that being sessile leads to premature hardening of the arteries. In the late 1800s to the early 1900s physical exercise was promoted in various countries around the world.

The latter part of the 20th century saw a renaissance of the fitness movement. It was trendy to go running, cycling, and swimming or working out at a gym. It is not only trendy but healthy: cardiologists support all of these sports to help people stay healthy and keep the arteries free from plaque formation.

Too many refined carbs

Sugar and processed foods, especially those with added sugar to improve flavor, have a direct relationship to heart attacks and strokes. It is known that sugar causes high LDL cholesterol and high triglycerides. In addition sugar also causes inflammation of the arterial walls, which causes plugged arteries. However, sugar is only part of the problem. Starchy foods like rice, noodles, cakes, cookies and other foods made with flour get broken down into sugar. Both lead to insulin production. And both lead to changes of the lining of the arterial walls.

In the 1980s and 1990s there was a school of thought that a low fat diet would be healthy in terms of heart attack and stroke prevention (the low fat/high carb diet). This turned out to be a nutritional disaster: the high carb content of such a diet was the problem. It led to weight gain, obesity and death.

Red meat is a problem

Several studies have documented that saturated fat from red meat is only part of the problem. The other part is carnitine, which is abundantly present in beef, pork, lamb and venison. But mortality of people eating unprocessed red meat is only marginally elevated. It is when people eat processed red meat that there is a significant rise in mortality from heart attacks and strokes. This study examined this. They found that gut bacteria were stimulated by red meat to produce substances that stimulate bacteria in your gut to secrete TMA and TMAO, which makes your platelets more sticky and contributes to plugging your arteries. This research paper from the Cleveland Clinic explains it in more detail.

What must I do to prevent plugged arteries?

Eat the right food

A Mediterranean diet is anti-inflammatory. It contains lots of vegetables, but little red meat. Fish and chicken that contain much less L-carnitine are more dominant in Mediterranean food. As mentioned above, you want to avoid trans fats. And you also want to avoid sugar and too many starchy foods. This includes sugar-sweetened beverages. Making these changes will keep your insulin levels in the normal range eliminating inflammation in your arteries. Avoid eating processed foods, because they contain food preservatives and lots of sugar that we want to avoid. Eat more unsaturated fats like avocados, walnuts, olives, trout, herring, and salmon. The last three contain marine-derived omega-3 fatty acids that are particularly helpful in preventing heart attacks and strokes by being anti-inflammatory and by elevating the protective HDL cholesterol. Drink lots of green or black tea, rooibos tea, or ginger tea. They contain antioxidants and bioflavonoids that prevent plugged arteries.

Regular exercise

Many publications have shown that regular physical exercise will lower blood pressure, condition your muscles including your heart and lower mortality.

Only 10 minutes of brisk walking every day reduced the death rate by 33% compared to those who did not exercise at all.

Regular physical exercise does not only prevent heart attacks and strokes, it also reduces the risk of getting another 35 chronic diseases, as the link shows.

Here are some common exercises: jogging, cycling, running, brisk walking, swimming, playing tennis and doing aerobics. All of them will strengthen your muscles and condition your heart and lungs.

Other ways to prevent plugged arteries

Smokers must quit smoking, as smoking has been identified as a major risk factor for heart attacks and strokes.

Exposure to prolonged stress is a factor that leads to hardening of arteries. Stress management is possible by counseling, by self-hypnosis, yoga, tai chi and other relaxation methods.

Risk factors associated with plugged arteries

We already have mentioned the risk factors that are associated with clogged arteries. But for clarity I would like to repeat the major risk factors here.

  • Smoking
  • High blood pressure
  • Elevated LDL cholesterol (the bad cholesterol)
  • Reduced HDL cholesterol (HDL is increasing with exercise)
  • Obesity (often associated by ingestion of too many carbs)
  • Insulin resistance and diabetes
  • Lack of exercise (too much sitting in front of the TV or doing computer work)
  • Unhealthy diet (Standard American diet instead of Mediterranean diet)
Prevent Plugged Arteries

Prevent Plugged Arteries

Conclusion

We often think that we have no input whether or not we get a heart attack or a stroke. This is completely wrong. If you adopt the solutions I have listed here, you can change things for the better. You will reduce your risk to get a heart attack or a stroke. Treat high blood pressure. Stop smoking. Cut out sugar and starchy foods to reduce triglycerides and LDL cholesterol. Exercise regularly and your HDL will protect you from heart attacks and strokes. Shed pounds, if you are obese by starting a Mediterranean diet and cutting out sugar. This will also improve your insulin resistance or diabetes. Start daily exercise as this reduces your risk of a heart attack or a stroke. In addition exercise reduces the risk of 35 chronic diseases that have also been mentioned in one of the links.

Mar
17
2018

Benefits Of Hot Baths And Saunas

By | Alzheimer’s disease, Asthma, back pain, Dementia, Heart Disease, High Blood Pressure, low back pain, Prevention

Don Benedict hurt his lower back and tells about benefits of hot baths and saunas to relieve his chronic pain. He is a 70-year old former handball player. He played competitive handball for 30 years in the Pacific Northwest. His story is reviewed here. In order to stay in shape, he ran 5 miles every other day. But at the age of 57 he ruptured a disc in his back. In the following years he ruptured several more discs and had three back surgeries for that. Eventually scar formation set in and no more surgery was possible. This left him with a chronic pain syndrome, for which he received prescriptions for strong pain medications. OxyContin, Tramadol and anti-anxiety pills were on his prescription list. He needed to take 14 doses of pills per day to control his chronic back pain.

Benefits of hot baths and saunas for chronic pain

Finally he remembered that as a younger man he was a summer river guide on Idaho’s Salmon River. When he and his wife had sore muscles they would relax in the hot baths of natural hot springs. Other people who visited these hot springs told him how having hot baths helped them for their aches and pains. For the past four years Don and his wife have been visiting the hot springs in Idaho City three times per week. This has decreased Don’s back pain significantly. He could reduce more than half of his pain medications and reduce the potency of the pain pills as well. The water temperature in the hot springs hovers between 97 and 99 degrees Fahrenheit (36 to 37 degrees Celsius). His wife, who has an asthmatic condition, reported that the hot soaks helped her muscle spasms around the throat.

Other treatment modalities to prevent chronic pain

13 years ago, when Don ruptured his first disc stem, cell treatments were not readily available. But if the same would happen today an unconventional stem cell therapy could be a treatment modality, and chronic pain could be avoided. I am mentioning this here, because Don’s suffering from chronic back pain was causing him a lot of unnecessary suffering. Discectomy surgery, which destabilizes the back and causes scarring, is not the first choice of treatment today.

Stem cell therapy

Instead stem cells are taken from the patient’s fatty tissue (liposuction) and from the bone marrow. A stem cell mix between bone marrow stem cells and mesenchymal stem cells (from fatty tissue) is made. Platelet rich plasma is added to this as an activator. The mix is injected into the disc space of the ruptured disc. Now the stem cells do their magic healing. The beauty of this medical procedure is that healing takes place without any scarring. The stem cells mend all of the damage. They do so by transforming themselves into identical body cells that overbridge broken tissues.

Benefits of hot baths and saunas for heart

  1. A 2016 study published in the Journal of Physiology describes a study that included adults in their low twenties. Their arms were intermittently exposed to 40.5°C (105°F) water temperature for 60 minutes over a period of 8 weeks. This lowered their blood pressure and caused the arteries in the treatment group to be more flexible.
  2. Scientists in Finland have focused on the benefits of saunas, which is a Scandinavian tradition. Their study in the American Journal of Hypertension followed more than 1,600 middle-age men for almost 25 years. The results showed that the more the men visited saunas, the less they were suffering from high blood pressure. These were the statistics:
  • Visited sauna 2 to 3 times per week: 24% less likely to develop high blood pressure compared to those who had a sauna only once or not at all.
  • Visited sauna 4 to 7 times per week: 46% reduction of blood pressure.

Benefits of hot baths and saunas regarding dementia prevention

A 2016 study out of Finland found that frequent exposures to saunas could reduce the risk of developing dementia.

Compared to having a sauna only once per week (no reduction of dementia) these were some observations:

  • Visiting the sauna 2-3 times per week: 22% reduction of dementia.
  • Visiting the sauna 4-7 times per week: 66% reduction of dementia.

With regard to Alzheimer’s disease the corresponding figures were a 20% reduction and a 65% reduction.

Benefits of hot baths and saunas for brain injuries

Dr. Burke from the Emory University Rehabilitative Hospital is investigating the benefits of hot baths and saunas regarding brain-injured patients.

He recommends 4 saunas per week for brain-injured patients. Dr. Burke said: “This is one thing that’s passive and easier to do, especially in people who have injured joints who need to keep their brains and hearts in good condition, but can’t physically do some of the exercises.“

Caution regarding benefits of hot baths and saunas

Within 48 hours of a new injury, Dr. Burke says, it is best to use ice packs in order to reduce the swelling of the tissues. But subsequently he switches the patients to heat in form of saunas. Some patients have low blood pressure to start with. They may not be good candidates for hot baths as they may pass out when their already low blood pressure gets a further reduction. Always check with your own doctor before doing hot baths or saunas.

Europe’s history of hot baths and saunas

Saunas have a long history in Finland and in the rest of Europe.

Hot baths have a century-old history in Europe and Japan.

Father Sebastian Kneipp invented hydrotherapy, where cold and hot water baths are applied sequentially. The present resurgence of interest in the benefits of hot baths and saunas for healing purposes is nothing new. What may be new is that the medical profession at large is finally paying attention to the research of Father Sebastian Kneipp. He knew that there were benefits of hot baths and saunas.

Benefits Of Hot Baths And Saunas

Benefits Of Hot Baths And Saunas

Conclusion

There are benefits of hot baths and saunas. This is what was spelled out in the studies cited in this review. The fact that heat can heal was something that Father Sebastian Kneipp knew long time ago. Medical facts have a way to recirculate. But now we know that it can lower blood pressure and can improve the flexibility of arteries. It can help with tissue perfusion and reduce chronic pain. But it also prevents dementia and Alzheimer’s disease. In addition it helps patients with brain injuries to recover faster than without hot baths and saunas.

Advantage of heat treatments

The advantage of heat treatments is the fact that no side effects occur like with the use of drugs. Heat treatments are natural, but drug treatments are artificial. Hot baths and saunas can easily be part of one’s lifestyle. If you feel you need more of it, you can go ahead and do it, but if you feel you don’t need as much, use less. Make it fit into your lifestyle. It is also obvious that too much of a good thing is no longer a good approach to wellness. Limit the temperature in hot baths and don’t exaggerate the time you spend in a hot sauna.

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Feb
24
2018

What Causes Premature Aging?

By | alcohol, Anti-aging medicine, Dementia, Diabetes, diet, Drugs, exercise, heart attack, Prevention, Smoking, Stroke, testosterone, thyroid disease

Some people look 10 years older than their stated age, and we often wonder: what causes premature aging? Accelerated or premature aging can have a multitude of underlying causes. I will list a few here:

1. Weakening hormones

Men go through andropause at around the age of 60 to 65 and women go through menopause around the age of 55 to 65. In both males and females it is the sex hormones that are missing around that age. If hormones replacement follows fairly quickly with bioidentical hormones, this will not affect the visual appearance that much. In contrast, if bioidentical hormones are not the therapeutic choice for  hormone replacement, but synthetic ones, the hormones are not in balance, as synthetic hormones do not restore the hormonal balance. Nothing is gained, as the person will still age prematurely.

Synthetic versus bioidentical hormone replacement

In addition the synthetic hormones will cause heart attacks, strokes, clots, and cancer. Prescriptions for synthetic hormones are often the cause that the aging patient population gets these serious complications. Frequently physicians insist on using synthetic hormones from a “reputable” drug company to replace missing hormones. The reason this does not work is that a male has testosterone receptors. They need to be stimulated by bioidentical testosterone to restore all of his missing functions. Also, the same is true in menopausal females who need stimulation of their estrogen receptors and progesterone receptors. Consequently, only bioidentical hormones will return a postmenopausal woman back to normal. There is a perfect fit between the bioidentical replacement hormones and her hormone receptors. Using synthetic hormones is like trying to unlock a door with a key that does not have a perfect fit: you damage the lock!

2. Missing human growth hormone (HGH) and thyroid hormones

These hormones have a special place in aging.

Human growth hormone deficiency

First, HGH production is running out in many people at age 60. A person with HGH deficiency will have lower muscle mass and strength. Other symptoms are dry and thin skin, particularly at the back of the hands. Men are balding, and they loose interest in sex. There are difficulties concentrating and they may have “senior moments”, which are memory lapses. Often they are prone to depression and anxiety. A blood test will frequently show elevated triglycerides. A blood test (IGF-1) and a urine test exist which make it possible to look for HGH metabolites to assess whether a 40, 50 or 60 year-old person is producing enough HGH. Many may need replacement of HGH. This is administered by injection through a tiny needle into the skin, similar to a diabetic injecting insulin. This will bring back what was missing due to HGH deficiency.

Thyroid hormone deficiency

Thyroid hormones (T3 and T4) are other important factors that could make you look older prematurely. Your hair is getting thinner; your skin turns dry and pale. The nails may be getting brittle. When the outside half of the eyebrows is very thin or missing, this can be a sign of hypothyroidism. In a similar vein the skin in the face may be puffed up due to swelling of the layers under the skin (myxedema). It is important to diagnose hypothyroidism, which is common in the aging population. The physician needs to order a blood tests (TSH, T3 and T4). If TSH is above the upper limit, your physician needs to replace both T3 and T4 by tablets (I prefer Armour as the T3 and T4 is balanced).

3. Smoking

The lining of the airways absorb cigarette smoke. The chemicals circulate around in the blood and lead to aging of the skin. Chronic cigarette smoke exposure also melts away the subcutaneous tissue. The end result is a haggard look. The natural glow disappears from the skin and because of carbon monoxide binding to hemoglobin the skin color looks more greyish. In addition the blood vessels are narrowing or clogging. This means that the body cannot absorb nutrients as well, and cells are starving. There is only one remedy for this: quit smoking!

4. Overexposure to ultraviolet light

The radiation of UV light can penetrate deep into and under the skin. This makes the subcutaneous fat melt away. The largest UV exposure is in the facial area. As a result we see aging there. The end result is a sagging appearance of the face. This link has an image of a woman before and after a non-surgical facelift with stem cells and fatty tissue: Stem Cell Treatments That Are Currently Available – Medical Articles by Dr. Ray

In a surgical procedure the physician harvests mesenchymal stem cells from fatty tissue by liposuction. A cell separator separates the mesenchymal stem cells, the connective tissue and the fat cells. The connective tissue is discarded. Mesenchymal stem cells and fat cells are mixed and injected into the thinned subcutaneous fatty tissue until the person’s younger facial contour is back to normal. Typically this will last for 10 years or more.

5. Drugs and alcohol abuse

Both can lead to malnutrition with weight loss and loss of subcutaneous fatty tissue, which causes sagging breasts in women. In men “beer tits” are common. The reason for this is estrogen accumulation, as alcohol interferes with the elimination of estrogen in the liver. Alcohol is a general cell poison. It causes all of the cells to age prematurely. The more alcohol you drink, the faster you age. The skin develops wrinkles, loss of elasticity and collagen, redness and puffiness. In other words chronic alcohol abuse ages you prematurely. The only remedy for this is to quit drinking. Some of your skin vitality may come back. Our body has an amazing capability to heal itself!

6. Medical illnesses

Many medical illnesses like diabetes, mental illness (depression and schizophrenia), multiple sclerosis, inflammatory bowel disease; cancer and others make you look a lot older very fast.

I will briefly explain the reasons for this.

  • Diabetes

With diabetes type 2 the pancreas releases too much insulin after a meal with starches and sugar; think about a sweet muffin or a toast with jam. The extra insulin causes inflammation. This stimulates enzymes that break down elastin and collagen, leading to wrinkles and sagging skin.

  • Mental illness like depression and schizophrenia

We know from studies that depression leads to shortening of telomeres. This in turn causes cell death in the most rapidly dividing cells like in the skin and hair follicles. The end result is prematurely aged hair and skin. Schizophrenia also leads to premature shortening of the telomeres, which causes premature aging, mitochondrial dysfunction, inflammation and oxidative stress. The end result is that the person looks older than what their chronological age is.

  • Multiple sclerosis

It is sometimes difficult to discern in patients with MS what is normal aging and what is aging from the disease. This link gives some background on this. Many MS patients are anxious, and anxiety and stress by itself also leads to premature aging.

  • Inflammatory bowel disease

The chronic inflammation of either ulcerative colitis or Crohn’s disease can lead to premature aging. High doses of vitamin D3 and molecularly distilled fish oil can be useful to help treat the inflammation. Probiotics are also important to restore the bowel flora.

  • Cancer

Cancer leads to cachexia (excessive weight loss). There is also excessive inflammation, which leads to accelerated aging. The inflammation causes increased oxidative stress. This leads to tissue damage and DNA damage, which makes all cells more vulnerable to develop other cancers. Oxidative stress can substantially accelerate telomere shortening. As a result skin can become saggy, wrinkles develop and the person looks prematurely aged.

7. A chronic lack of physical activity

People who never exercise tend to get overweight and eventually obese. This leads to premature aging. Exercise would elongate telomeres, but inactivity shortens them. Obesity leads to increased oxidative stress and to DNA damage. Obesity also shortens telomeres. All of this leads to premature aging.

What Causes Premature Aging?

What Causes Premature Aging?

Conclusion

These are only a few examples of causes of accelerated aging. The key is to stick to a healthy, balanced diet (like the Mediterranean diet) and exercise regularly. Stop smoking (if you do), don’t take street drugs, and make sure you get enough sleep. Getting enough sleep helps your hormones regenerate overnight. The sympathetic overdrive from your daily activities is counterbalanced by the parasympathetic activities during sleep that causes relaxation. For hormone replacement you may have to see an anti-aging physician, a naturopath or integrative medicine physician. This may be your only chance to address any hormonal deficiencies. Conventional medicine does a very poor job of HRT (hormone replacement therapy) with synthetic hormones. Conventional practitioners want to treat you with synthetic hormones that will make you sick. Hormones for replacement have to be bioidentical! This way you will live 10 to 15 years longer, look younger and stay healthy.