Nov
09
2024

Vital Information about Cholesterol Drugs

By | cholesterol, heart attack, Stroke

Most people know about statins to treat high cholesterol, but they do not have vital information about cholesterol drugs. Recently an article appeared in CNN, which was very informative. In the following I will review what is new about cholesterol lowering drugs.

PCSK9 inhibitors, which are monoclonal antibodies

Sarah Lewis is a pharmacist and medical writer with over 25 years of experience in various areas of pharmacy practice. She explained that there are injectable cholesterol lowering drugs for use when traditional statins are not powerful enough to lower cholesterol levels. But these injectable drugs are very expensive and payment agencies demand fulfillment of strict criteria before they approve these drugs. The new injectable drug, which the FDA approved in 2015 is an PCSK9 inhibitor. It has the name alirocumab (Praluent) and is a monoclonal antibody. PCSK9 is a natural liver protein that regulates how many LDL receptors you have. Alirocumab reduces LDL receptors, which lowers LDL cholesterol levels. Several months later the FDA approved a second PCSK9 inhibitor, evolocumab (brand name: Repatha).

Side effects of statins and PCSK9 inhibitors

Statins are the gold standard for treating high cholesterol. They work by inhibiting an enzyme that controls how much cholesterol your body makes. But many people have significant side-effects from statins.

There can be side effects in the form of muscle pain. But statins can also cause headaches or dizziness. Others are feeling sick from statins, get unusually tired or develop a physical weakness.

These people often must lower their dose. Alternatively, their doctor switches them to a different statin in order to carry on therapy. PCSK9 inhibitors have none of these side-effects. The main side effect of PCSK9 inhibitors are injection site reactions, flu-like symptoms, and allergic reactions. They can be severe. Overall, there is a better tolerability of PCSK9 inhibitors than with statins. Unfortunately, the cost is around $12,000 to $14,000 per year for PCSK9 inhibitor therapy, which is very difficult to justify. Another disadvantage is that the patient has to self-inject the PCSK9 inhibitor.

PCSK9 inhibitors are added in specific patients

Because of the costs of PCSK9 inhibitor statins are still the first line of therapy in patients with high cholesterol. But there are patients who have familial hypercholesterolemia, which is an inherited condition. The physician treats them first with statins such as atorvastatin (Lipitor) or rosuvastatin (Crestor). The physician pushes the dosage to the maximal dosage. Often in these cases of inherited high cholesterol the new PCSK9 inhibitor drugs have to be added as a second line of therapy.

Patients with hardening of the arteries and a history of a heart attack or a stroke need aggressive cholesterol lowering treatment. These patients require both PCSK9 inhibitors and statin therapy.

Rigid rules from insurance companies

Because of the expense of PCSK9 inhibitors insurance companies have established the following rules.

  • You have to have either familial hypercholesterolemia or a history of a heart attack or stroke.
  • You must see a dietician for comprehensive dietary counseling.
  • You are on the maximum dose of a statin or you can tolerate only a lower dose of a statin because of side effects.

Only when these criteria are fulfilled does the insurance company consider to authorize an addition of a PCSK9 inhibitor to the statin treatment.

Vital Information about Cholesterol Drugs

Vital Information about Cholesterol Drugs

Conclusion

Traditional statin therapy for high cholesterol levels is the gold standard for treating high cholesterol. Statins work by inhibiting an enzyme that controls how much cholesterol your body makes. Unfortunately, statins can have a number of side effects like muscle cramps and fatigue. A new type of cholesterol lowering drug was authorized by the FDA in 2015. This new drug has the name alirocumab (Praluent) and is a monoclonal antibody. PCSK9 is a natural liver protein that regulates how many LDL receptors you have. Alirocumab reduces LDL receptors, which lowers LDL cholesterol levels. It has much less side effects than the statins, but costs are around $12,000 to $14,000 per year, which is very difficult to justify.

How physicians prescribe the new drugs

The new PCSK9 inhibitor drugs are prescribed as an add-on to statin therapy to lower cholesterol. Physicians prescribe this to patients who have a familial hypercholesterolemia and to patients who had a heart attack or a stroke. One inconvenience of these new cholesterol lowering agents is that the patient has to inject it rather than take it as a tablet by mouth. Studies showed that PCSK9 inhibitors have a favorable cholesterol lowering effect. Alirocumab (Praluent) lowered cholesterol between 36 to 59%. The newer evolocumab (Repatha), lowered LDL by 60%. Both drugs showed a risk reduction of cardiovascular events by 50%, which helps long-term survival of patients with cardiovascular disease. PCSK9 inhibitor drugs are powerful cholesterol lowering agents. However, at the present time the cost of this treatment is too expensive.

Oct
12
2024

Cardiovascular Risk Markers Predict Heart Attacks and Strokes

By | blood test, Cardiovascular disease, cholesterol, diet, fasting mimicking diet, Fitness, heart attack, Heart Disease, Mortality, Stroke, Weight loss

An article in The New England Journal of Medicine stated that cardiovascular risk markers predict heart attacks and strokes. A summary of this study was also published by NBC News.

30-year follow-up of the Women’s Health Study

This is based on a 30-year follow-up study of the Women’s Health Study. In the beginning of the study all women had blood tests taken. In the beginning none of the women had cardiovascular disease.  The blood tests were LDL cholesterol, lipoprotein(a) and high-sensitivity C-reactive protein (CRP). When either of these markers was high at the beginning of the clinical trial, it turns out that 30 years later the person either was dead from cardiovascular disease or had a heart attack or stroke.

More details of the study

In the beginning of the study 27,939 initially healthy U.S. women had 3 of the mentioned blood tests taken. If only one of them was elevated, there was a risk in the next 30 years to get a myocardial infarction, coronary revascularization, stroke, or death from cardiovascular causes. The initial age of the patients was 54.7 years. During the next 30 years of follow-up 3662 cardiovascular events took place. Hazard ratios for the primary end point in a comparison of the top with the bottom quintile were calculated. The following hazard ratios were derived:

  • 70-fold for high-sensitivity CRP
  • 36 for LDL cholesterol
  • 33 for lipoprotein(a)

Each biomarker showed an independent contribution to the overall risk. The risk of developing cardiovascular disease was highest when all three biomarkers were elevated.

Traditional risk calculation

Cardiologists calculated risk for cardiovascular events by the traditional 10-year estimates of risk. The authors suggest that physicians should do screening blood tests with these three biomarkers. If any of the biomarkers is elevated, measures to reduce cardiovascular risk should be initiated. This will be very effective to prevent cardiovascular events for the next 30 years.

Be proactive, prevent heart disease

As we get older, many people develop elevations of high-sensitivity CRP, LDL cholesterol and lipoprotein (a). But don’t wait for this to happen. Here are 9 steps you  can follow to prevent it.

  • Maintain a healthy weight
  • Quit smoking
  • Choose good nutrition
  • Be physically active
  • Treat hypertension adequately
  • Manage diabetes, if you have it
  • Stress management
  • Limit alcohol intake
  • Get enough sleep

Comments to the steps you can take to prevent cardiovascular disease

The ideal body mass index is between 21.0 and 22.0. I found that the fasting mimicking diet helps me to stay in that BMI range. Good nutrition eliminates red meat and emphasizes vegetables and salads. Fish, lean chicken and turkey meat are healthy. Avoid all processed meats like sausages. Watch your calorie intake to keep your body mass index stable. In addition, avoid excessive salt and sugar intake. Avoid highly processed carbohydrates and processed food. Eliminate fried fast food, chips and baked goods from your diet as they contain trans fats. Trans fats cause hardening of the arteries.

Aim to get 30 to 60 minutes of daily activity. Do two or more strength training sessions a week. This raises the protective HDL cholesterol and prevents cardiovascular disease. Excessive alcohol intake leads to cardiovascular disease and high blood pressure. Limit your alcohol intake, if you find it hard to eliminate it altogether.

Cardiovascular Risk Markers Predict Heart Attacks and Strokes

Cardiovascular Risk Markers Predict Heart Attacks and Strokes

Conclusion

A unique 30-year follow-up study of the Women’s Health Study identified three risk factors that a doctor can be determin from a blood sample. They predict whether a person will develop cardiovascular disease 30 years down the road. The three risk factors are high-sensitivity CRP, LDL cholesterol and lipoprotein (a). The best approach to prevention of heart disease is to adopt the approach of the Mayo Clinic described above. It comes down to the basics of good nutrition, regular exercise, maintaining a healthy weight, limiting excessive alcohol intake and stress management.

Aug
17
2024

Exercise for healthy Aging and a young Brain

By | andropause, Cancer, Cardiovascular disease, cholesterol, Diabetes, diet, e-cigarettes, exercise, Fitness, Health, heart attack, Heart Disease, High Blood Pressure, lifestyle, Menopause, sleep, Smoking, stress, Stroke, sugar, Weight loss

This article is about exercise for healthy aging and a young brain. A review article in Medical News Today states that several research papers showed that exercise greatly improves brain health, cognition and mood. It also reduces the risk of neurodegenerative diseases.

The benefits of regular exercise 

Here is a list of the beneficial effects of regular exercise:

  • Increased muscle strength
  • Improved heart health
  • Lower blood sugar
  • Improved mood
  • Alleviates stress
  • Improvement of cognitive function

Researchers from Stanford Medicine have examined in a rat model how exactly exercise influences various tissues. Unfortunately, such experiments in humans are not possible and results of rat experiments do not readily translate into the human context. In 8 weeks of regular exercise rats experienced stimulation of the immune system, a reduction of the stress response, an increase of energy production and stimulation of the metabolism. From indirect measurements we know that in humans the same findings likely also hold true. The mitochondria, the area in cells where energy production occurs, are stimulated in muscles, the heart, liver, kidneys, and white adipose tissue.

Effect of exercise on the immune system

Researchers showed in a mouse model that exercise stimulated the T cell response and rejuvenated aging microglia in the brain. The result is a strengthening of the immune system and rejuvenation of the supportive microglia. In the aging human regular exercise rejuvenates microglia in the hippocampus. This can prevent dementia and Alzheimer’s disease.

Exercise strengthens brain cell connections

How does exercise affect the functioning of the brain?

Ryan Glatt is a senior brain health coach and director of the FitBrain Program at Pacific Neuroscience Institute in Santa Monica. He said: “Exercise enhances synaptic plasticity and blood flow while reducing inflammation and increasing the expression of neurotrophic factors like Brain-derived neurotrophic factor (BDNF). These effects can synergistically improve memory, learning, and overall brain health.”

The best forms of exercise for brain health

Glatt said: “Activities combining physical and cognitive challenges, like dance or tai chi, can be especially effective for certain aspects of brain health.”

Brisk walking is a simple method of exercise. However, we also need isometric exercises, which helps muscle strength and endurance. A good way of combining the two forms of exercise is to regularly go to a gym. Use a treadmill for 30 minutes and then use 30 minutes of a workout with 10 weight machines. Mix this with tai chi or ballroom dancing several days per week. This keeps you mentally and physically fit.

Slow your biological age through the use of the “Essential 8”

Research identified 8 factors that determine how long you live. These 8 factors are what can lower your biological age by 6 years. Here are the 8 factors:

  • Diet

    A diet high in fruit, vegetables and lean meats helps you to lower your cholesterol level. In addition, avoid trans fats, fried foods and sugary foods. This helps you to lose weight and prevents Together with regular exercise eating a healthy diet prevents heart attacks and strokes.

  • Activity

    The American Heart Association recommends 150 minutes of moderate-intensity aerobic activity per week. Alternatively, 75 minutes of vigorous aerobic activity achieve the same thing. Examples of moderate aerobic activity are a brisk walk, jogging, biking, social dancing and water aerobics. Vigorous aerobic activity involves spinning, running, swimming laps or jumping rope. Exercise reduces blood pressure, blood sugar, and cholesterol. It also helps people to reduce weight.

  • Quit smoking

    Smoking cigarettes, vaping or using e-cigarettes causes your  body to develop higher blood pressure and damages your blood vessels because of circulating toxins. You also develop shortness of breath from narrowed airways. On the other hand, when people quit smoking, their risk of coronary heart disease drops to half after 1 year.   

  • Getting enough sleep

    People who don’t get enough sleep at night tend to have higher blood pressures, higher cholesterol and higher blood sugar values. This leads to weight increase and obesity. Sleeping at night for 7 to 9 hours improves cardiovascular health.

  • Body mass index (BMI) 

    An elevation of your body weight occurs when you eat the wrong foods and combine this with a sedentary lifestyle. Increased weight causes heart and joint problems as well as diabetes. Eating the right foods and exercising regularly gets your BMI into the normal range. This reduces your biological age.

  • Cholesterol

    An increase of cholesterol can cause heart attacks and strokes. But when you watch your fat and cholesterol intake you can reduce your cholesterol level. Make healthier choices with foods like reducing saturated fats, reducing refined carbohydrate intake, eating more vegetables and leaner meats. This reduces inflammation in the arteries and plaque deposits with much lower risks of heart attacks and strokes.

  • Blood sugar

    Increased blood sugars lead to diabetes. In this case there is accelerated hardening of the arteries in the heart, brain, eyes, and kidneys. This leads to premature heart attacks and strokes. People need to avoid eating refined sugars, carbohydrates (bread, pasta, rice) and sugary drinks. This normalizes blood sugars and your biological age reduces. Regular exercise is also important to burn off any excess sugar in the system.

  • High blood pressure

    An elevated blood pressure strains the arteries and the heart. If you don’t pay attention to this you are at a high risk of getting heart failure, a heart attack or a stroke. Sticking to a heart healthy diet, avoiding salty foods, and exercising regularly allows you to lower your blood pressure and avoid the above mentioned complications. If these measures alone do not reduce your blood pressure to normal, ask your doctor to prescribe blood pressure lowering medications for you.

  • Bioidentical hormone replacement

    What was not contained in the 8 factors was bioidentical hormone replacement. As you can see from the illustration, testosterone in males reduces more slowly in males (with a delay of 10 years) in comparison to estrogen reduction in menopausal women. Several authors describe that men and women in andropause and menopause live longer when bioidentical hormones are administered compared to those that do not use hormone replacement therapy.

Exercise for healthy Aging and a young Brain

Exercise for healthy Aging and a young Brain

Conclusion

Regular exercise even in older age keeps your brain free from dementia or Alzheimer’s disease. But in addition to this other research showed that 7 more factors are important to reduce your biological age. They are a healthy diet, quitting smoking, getting enough sleep and reducing your body mass index. In addition, you need to keep your cholesterol and blood sugar levels normal. Control high blood pressure with a healthy diet, refrain from salty foods and if necessary, treat it with medication.

Life’s essential 8 factors

It is important to simultaneously control all these “Life’s essential 8” factors for optimal control. People who do this were found to consistently have a lower biological age than others who do not. They also tend to not get Alzheimer’s disease whereas controls do. Lifestyle factors matter for healthy aging and a young brain. Studies showed that the biological age of those who take care of their lifestyles is on average 6 years younger than that of controls. You can reduce your biological age even further with bioidentical hormone replacement in andropause and menopause.

May
13
2024

Reduction of Alcohol Intake Is Associated with Less Heart Attacks and Strokes

By | addiction, alcohol, Cancer, Cardiovascular disease, heart attack, Mortality, Stroke

Recently Korean researchers showed that a reduction of alcohol intake is associated with less heart attacks and strokes. This was published on March 28, 2024. The researchers followed 21,011 participants who were heavy drinkers. The baseline examination took place 2005-2008 and a follow-up exam was between 2009 and 2012. Definition of heavy drinking was as follows:

  • For men: 4 drinks (56 g) per day or more than 14 drinks (196 g) per week.
  • For females: more than 3 drinks (42 g) per day or more than 7 drinks (98 g) per week.

Reduced alcohol intake resulted in a 23% reduced risk of heart attacks or strokes, which was a significant finding. Patients benefited most from alcohol reduction regarding angina and ischemic strokes. This study was also reviewed in Medscape:

Other studies showing benefits of less alcohol intake

A 2018 study in Plos Medicine examined a US population of 99,654 adults (68.7% female).

At the time of the enrolment, they were 55–74 years old. The overall time of follow-up was 8.9 years. Scientists looked at the various risks of cancer development or deaths from cardiovascular disease as a function of the amount of average alcoholic drinks consumed. The results were as follows:

  • Never drinkers: 1.09-fold risk of cancer or death.
  • Infrequent drinkers: 1.08-fold risk of cancer or death.
  • Heavy drinkers: 1.10-fold risk of cancer or death.
  • Very heavy drinkers: 1.21-fold risk of cancer or death.

Heart attack risk and cancer risk from alcohol consumption are different

In addition, with respect to cardiovascular risk it followed a J-curve. This means that light alcohol use reduced the probability of death from a heart attack or stroke, but with moderate or heavy alcohol use the risk of death increased. In contrast, with respect to cancer there was a linear curve, which means that no dose of alcohol was safe for cancer development. The more alcohol you consumed, the higher the risk of cancer development was. Another study also showed that only moderate alcohol consumption benefited people in preventing heart attacks and strokes.

Chinese study

In 2021 a joint US/Chinese study examined the effects of alcohol consumption on cancer, deaths from cardiovascular disease and mortality in general. 83,732 adult Chinese participants were free of cardiovascular disease (CVD) and cancer in the beginning of the study. The researchers categorized participants based on self-reported alcohol consumption into 6 groups.

  1. 0 g alcohol/week (non-drinkers).
  2. 1-25 g alcohol/week.
  3. 26-150 g alcohol/week.
  4. 151-350 g alcohol/week.
  5. 351-750 g alcohol/week.
  6.  > 750 g alcohol/wk.

Results of the US/Chinese study

After 10 years of follow-up there were 6411 cases of CVD, 2947 cancers and 6646 deaths. After 10 years of observation researchers calculated the risk for cancer, CVD and mortality as follows. The risk groups are the same as mentioned above.

The lowest risk was group 2 with 1-25 g alcohol per week, which was set as 1.0. In comparison to these non-drinkers had a risk of 1.38-fold.

  1.     1.38-fold risk
  2.     1.0
  3.     1.15-fold
  4.     1.22-fold
  5.     1.33-fold
  6.     1.57-fold

The peculiar finding in this study was that non-drinkers had a risk of developing cancer, heart attacks or strokes like heavier drinkers. The risk curve has the name of a J-curve, which means the risk goes first down (like group 2, the 1-25 g alcohol/week group). Subsequently the risk curve goes up in a linear fashion. When people smoke and drink the risk is higher than the risks of people who only drink alcohol.

Reduction of Alcohol Intake Is Associated with Less Heart Attacks and Strokes

Reduction of Alcohol Intake Is Associated with Less Heart Attacks and Strokes

Conclusion

The fact that alcohol is a cell poison has been public knowledge for some time. I reviewed three studies that showed that less alcohol consumption saves lives. It does so by causing less cancer, heart attacks and strokes. The peculiar finding was that the group consuming 1-25 g alcohol/week had the best health statistic. This group had the lowest risk of causing cancers or cardiovascular disease (CVD). In comparison non-drinkers had a 1.38-fold risk to cause cancer or CVD. Those participants who were smoking as well had risks much higher than people consuming alcohol alone. If you want to live longer and stay healthy don’t smoke and drink not more than 1-25 g alcohol/week. This translates into 1.6 to 1.8 alcoholic drinks per week.

Apr
16
2023

What you Must Know about Male Hormones

By | andropause, Anti-aging medicine, Cancer, Diabetes, hair loss, heart attack, Infertility, prostate cancer, prostate hypertrophy, Stroke, testosterone

Dr. Pamela Smith, an anti-aging physician gave a talk about what you must know about male hormones. She spoke on Saturday, Dec. 10, 2022 at the Sands Conference Center of the Palazzo Hotel in Las Vegas. The title was “What you must know about male hormones”. She presented 199 slides, so the following can only be a brief summary of what she said. She started by saying that the term “male menopause” goes back in time to 1944. Other terms are andropause and late onset hypogonadism.

Different testosterone levels at different ages

It is important to realize that at age 20 the blood testosterone level is around 900 ng/dL, but this declines after age 30. It is 550 ng/dL at the age of 40. At the age of 50 the testosterone level is 350 ng/dL. And at the age of 70 the testosterone level has shrunk to 200 ng/dL or less. With this in mind, there are also seasonal variations with higher levels of testosterone occurring in summer and early fall, and low levels happening in winter and early spring. A healthy male produces the following male hormones: Testosterone, 5-6 mgs/day; Androstenedione, 3 mgs/day; DHT, 0.300 mgs/day; DHEAS, 50 mgs/day; and DHEA, 15 mgs/day.

Functions of testosterone

In other words, testosterone is the male hormone responsible for the male body characteristics. Every male body cell has testosterone receptors on it. Truly, this way testosterone is involved in protein manufacture and muscle maintenance. In fact, bone formation depends on testosterone and oxygen uptake as well. It is also controlling blood sugar together with insulin. In addition, normal sperm production depends on testosterone. To clarify, testosterone also regulates cholesterol and the immune system. By all means, it also helps to improve mood, is important for mental concentration and helps protect against Alzheimer’s disease. Finally, there is stimulation of platelets and megakaryocytes by testosterone, which makes blood clotting easier.

Symptoms of andropause

It must be remembered, towards the end of their 60’s many men get symptoms of tiredness, loss of energy and depression. Specifically, they may get a bad temper, present with irritability, anxiety and nervousness. Specifically, they complain of a loss of memory, loss of sex drive and libido. Certainly, their erections are getting weak or they lose them altogether. There is a decreased intensity of orgasm and they are gaining weight. All this should prompt their physician to have a total testosterone blood test done. When the testosterone level is less than 500 ng/dL the person should see their physician for replacement testosterone therapy.

Other signs of testosterone deficiency

There are other signs and symptoms of testosterone deficiency: backaches and joint pains, loss of fitness, being overstressed. In addition, testosterone-deficient males experience a decrease in job performance and a decline in physical fitness. They have bone loss, elevation of their blood cholesterol and an increased risk of heart disease. They often also have increased insulin resistance, diabetes and metabolic syndrome. Mortality in men with low testosterone is much higher than in controls with normal testosterone. Several dozens of literature references were provided to support the above statements.

Testosterone replacement and hormone balance

When a patient is on testosterone replacement, a digital rectal exam should be performed to check for the size of the prostate gland. A PSA should be done every year (in former prostate cancer patients every 3 months). PSA should stay below 4.0 ng/mL. If the PSA rises by 1.5 ng/mL in one year or by 0.75 ng/mL in two consecutive years, a urologist should be consulted to rule out prostate cancer.

Men produce small amounts of estrogens, which are important for memory function of the brain and for strong bones. Androgens and testosterone aromatize into estrogen via the enzyme aromatase in fatty tissue. There are a few reasons why aromatase increases: obesity, excessive alcohol intake, chronic inflammation and high insulin levels.

The following medications lower estrogen levels: phenobarbital, carbamepazine, trazodone, chlordiazepoxide and sulcrafate.

Side effects from elevated estrogen levels

Increased estrogen levels in males cause gynecomastia (colloquially called “beer tits”), decreased sex drive, heart attacks, strokes and benign prostate hypertrophy. Elevated estrogen levels also cause insulin resistance, rheumatoid arthritis and prostate cancer. Dr. Smith referenced all of these statements again with many literature quotations.

Dihydrotestosterone (DHT)

This metabolite of testosterone is 3-times stronger than testosterone. It is formed from testosterone by the enzyme 5-alpha reductase. It is responsible for the male-specific characteristics, the male genitalia and the prostate gland. Low levels of DHT cause reduced sexual function, decreased libido and weakened muscle function. On the other hand, elevated DHT causes male pattern baldness, hirsutism and benign prostate hypertrophy (BPH). There are two 5-alpha reductase inhibitors, namely finasteride and dutasteride, that clinicians use to lower elevated DHT levels. This can reduce the risk of prostate cancer by about 50%. Dr. Smith provided many literature quotations to support these statements.

Testosterone replacement therapy

Based on more than 3 dozen literature quotations Dr. Pamela Smith outlined the following:

  • Most men tolerated transdermal testosterone application very well.
  • Erectile dysfunction affects 1 in 5 older men.
  • Erectile dysfunction in association with low blood testosterone and low libido responds to transdermal application of testosterone very effectively.
  • It may take 14-25 weeks before transdermal testosterone treats erectile dysfunction successfully, more than 50% of men respond to this.
  • Testosterone replacement prevents beta amyloid precursor protein production, which increases memory and decreases the risk of Alzheimer’s development.
  • High stress produces high cortisol levels in the blood, which affect the hippocampus, where memory is located. Testosterone is neuroprotective, and it preserves memory.
  • Transdermal testosterone decreases coronary heart disease by relaxing coronary arteries. This prevents heart attacks and strokes.
  • Testosterone decreases inflammation and lowers LDL cholesterol.

More facts about testosterone replacement therapy

  • Testosterone lowers inflammatory cytokines and stimulates interleukin-10 production. This has anti-inflammatory and anti-atherogenic actions, which prevents heart attacks.
  • There was a reduction in mortality from heart attacks in the testosterone treated group of between 66% and 92%. In addition, 30 nonfatal strokes and 26 nonfatal myocardial infarctions occurred in the control group, but none in the testosterone group. Testosterone deficient heart failure patients responded very well to testosterone replacement therapy.
  • Prostate cancer or benign prostate hypertrophy do not increase with transdermal testosterone replacement therapy.
  • A Meta-analysis showed that older men with the highest risk for prostate cancer have the lowest testosterone blood levels.
  • Type 2 diabetics with a high insulin resistance respond well to testosterone replacement therapy. They increase insulin sensitivity and lower their blood sugars. This improvement peaks after 3 months and the effect stays for 12 months.

Further facts about testosterone replacement therapy

  • Testosterone replacement is safe. It provides significant benefits for erectile dysfunction, for muscle mass, prevention of Alzheimer’s disease, prevention of heart attacks and strokes. Testosterone treatment is for males above the age of 50, there is no cut-off for higher ages. There are many controlled clinical trials spanning over 70 years, which support all of what is presented here.
  • Testosterone can’t be taken orally, because it is rapidly metabolized in the liver. Instead, patients use transdermal testosterone gel or cream. Gels are commercially available and very expensive. Compounding pharmacies can provide testosterone creams for you, which are considerably cheaper and can be dosaged according to the patient’s needs. Testosterone esters in oil are available for subcutaneous or intramuscular injection twice per week. This ensured a steady testosterone level.

Improvements after testosterone replacement therapy

  • Timing of improvements: cholesterol reduction occurs by 12 months, for triglycerides it takes 22 months. Testosterone levels take 4 to 12 weeks to normalize. Fasting blood sugars and Hemoglobin A1C come own within 3 months with further improvements by 12 months. Sexual desire and energy are back to normal within 3 to 6 weeks.
  • It is important that you go for blood tests to measure testosterone levels every 3 months initially (blood level). If the levels are stable, the physician may decide to only order tests every 6 months.
What you Must Know about Male Hormones

What you Must Know about Male Hormones

Conclusion

The goal in the aging male is to maintain optimal male hormone levels. This achieves optimal health and prevents diseases of older age. First, it is important to preserve his erections, but at the same time testosterone replacement therapy prevents Alzheimer’s disease and memory loss. It also prevents heart attacks and strokes. Testosterone helps to preserve muscle mass. Hormone replacement therapy keeps lipids like cholesterol and triglycerides under control. Testosterone replacement reduces blood sugars and prevents type 2 diabetes mellitus. Replacement therapy also reduces elevated insulin levels. The end result is that testosterone replacement therapy maintains the health of the aging male.

Apr
06
2023

Erythritol is Linked to Heart Attacks and Strokes

By | blood clots, Cardiovascular disease, heart attack, Mortality, Stroke

A recent publication found that erythritol is linked to heart attacks and strokes. The study from the Cleveland Clinic was published Jan. 19, 2023 in Nature. It showed that people with diabetes had a 2-fold risk of getting a heart attack or stroke. Researchers measured the highest concentration of erythritol in their blood versus a control group with no erythritol in it. The study further showed that erythritol causes platelets to form clots, which could break of and travel to the heart or brain vessels. This triggered a heart attack or stroke. Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute said: “We never expected this. We weren’t even looking for it.”

Erythritol is what causes heart attacks and strokes

What the research team was looking for was “find unknown chemicals or compounds in a person’s blood that might predict their risk for a heart attack, stroke or death in the next three years. “This is how erythritol was identified as a risk factor.

Erythritol is a sugar alcohol

Like sorbitol or xylitol, erythritol is a sugar alcohol, which occurs in many fruits and vegetables. Erythritol has less laxative effect than some of the other sugar alcohols. It tastes like sugar and adds bulk to any stevia-based sweeteners. These are the reasons why it became the preferred zero calorie sweetener of the industry. Also, in a mixture it diluted the pronounced sweet effect of stevia, but added the crystalline texture appearance like sugar to the sweetener. This is what the consumer expected of a sweetener.

The clinical trials showing there is a link between erythritol and heart attacks as well as strokes

One group of patient’s tests were 1,157 blood samples from people at risk for heart disease collected between 2004 and 2011. Another batch of blood samples came from over 2,100 people in the United States and an additional batch from 833 samples gathered by colleagues in Europe through 2018. 75% of the participants in all three populations had coronary disease or high blood pressure, and about 20% had diabetes. Over 50% were male and in their 60’s and 70’s.  All of those samples showed the following. Higher levels of erythritol showed a correlation to a greater risk of heart attack, stroke or death within three years.

Blood coagulation

Our blood has a delicate balance between coagulation from clotting factors and platelets on the one hand and fibrinolysis, which counters clotting, on the other hand. This ensures that we are not spontaneously bleeding and also not getting clots from hypercoagulation. The researchers found that it is this balance, which erythritol disturbs. Dr. Hazel said: “But what we’re seeing with erythritol is the platelets become super responsive: A mere 10% stimulant produces 90% to 100% of a clot formation”. This was the reason for the higher heart attack and stroke rates in the higher levels of erythritol in the blood.

Erythritol levels checked in healthy volunteers

The last part of the study involved tracking blood tests of erythritol in 8 healthy volunteers. They drank beverages containing 30 Grams of erythritol, which is the amount many Americans consume. According to the National Health and Nutrition Examination Survey, which examines American nutrition each year 30 Grams is the average daily consumption of Americans. The researchers took blood tests of erythritol for the next 3 days including tests of clotting risks. Dr. Hazen said: “Thirty grams was enough to make blood levels of erythritol go up a thousandfold. It remained elevated above the threshold necessary to trigger and heighten clotting risk for the following two to three days.”

Reaction of the industry

Robert Rankin, the Calorie Control Council’s executive director, an industry association, wrote in an email: “The results of this study are contrary to decades of scientific research showing reduced-calorie sweeteners like erythritol are safe, as evidenced by global regulatory permissions for their use in foods and beverages.” But this seems to be a lame excuse. The platelet clotting effect of erythritol simply was not what the FDA expected or tested for. The same was true for other regulatory bodies when they released it as safe. I have drawn my own conclusion and thrown out all sweeteners I had in my possession that contained erythritol.

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Conclusion

Sometimes studies come out of the blue, which change our everyday practice. One of these studies is Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute. He showed that erythritol as an artificial sweetener is not harmless as previously thought of.  This included the FDA as a regulatory agency, which labeled erythritol as GRAS (=generally recognized as safe). Now new evidence of clinical studies showed that erythritol is responsible for a twofold risk of heart attacks, strokes or death in the next three years. Dr. Hazen included all kinds of controls and also fed healthy volunteers erythritol. No matter how he looked at it, the risk remained.

Erythritol causes clots, which cause heart attacks and strokes

In animal experiments he could also show that erythritol caused platelets to stick together and cause clot formation. These clots could travel into the heart and brain vessels and cause heart attacks and strokes. For any consumer it is the most sensible approach to NOT use any sweetener that contains erythritol. This involves reading product ingredients before you buy any sweetener. Assuming that products are harmless, when the label reads “Stevia” is a fallacy! In numerous products the ingredient list will show the word “erythritol”. Buyer beware!

Jan
14
2023

Cortisol is the Number 1 Longevity Hormone

By | Cardiovascular disease, Hormones, immune system, Stroke

At the 30th American Anti-Aging Academy Medicine Conference in Las Vegas one topic was that cortisol is the number 1 longevity hormone. Dr. Thierry Hertoghe, an endocrinologist from Brussels, Belgium gave a comprehensive lecture on Saturday, Dec.10, 2022. He explained that cortisol from our adrenal glands is vital to our health. Certainly, it is important for our quality of life and for health in general.  Indeed, cortisol keeps us alive when various circumstances challenge our health. Specifically, cortisol is on the bottom of the hormone cascade of corticotropin releasing hormone (CRH) from the hypothalamus/ Adrenocorticotropic hormone (ACTH) from the pituitary gland/and cortisol from the adrenal glands. It is important to realize that this is the hormone axis of the stress reaction that Dr. Selye first described.

Production of cortisol

Sedentary men produce 30 mg of cortisol per day, women 20 mg/day. Under stressful conditions ACTH production increases and causes an increase of cortisol production in the adrenal glands. To clarify, stressed men produce 40 to 60 mg per day and stressed women produce 30 to 40 mg/day. In addition, the older a person is, mononuclear leukocytes have less type 1 and type 2 glucocorticosteroid receptors.

Action of cortisol

Dr. Hertoghe pointed out that cortisol increases energy and stress resistance. It causes blood sugars to increase and also elevates blood pressure. The immune system gets stronger, allergies and inflammation decrease. Cortisol shapes our bodies: when there is cortisol deficiency the body is thin; with normal cortisol production the body has a normal configuration. Your body develops swelling and obesity with cortisol excess, but when cortisol is missing the body gets frail and thin.

Cortisol deficiency

Low cortisol production leads to low blood sugar and low blood pressure. This diminishes glycogen stores in the liver and muscle mass. A lack of circulating cortisol reduces gluconeogenesis in the liver, which is an alternative pathway of glucose production. One of the hallmark symptoms is mental fatigue, particularly in times of stress. With cortisol deficiency the person feels fatigue in the second part of the day.

Chronic fatigue syndrome

The peak age for chronic fatigue syndrome patients is 31 years. The mean duration of the illness lasts 7 years. 58% of patients have free serum cortisol levels at 20:00 hours, which is less than normal. In 40% of patients the total cortisol level is less than normal.

Burnout

With burnout the urinary free cortisol is diminished. Patients with cortisol deficiency have a hyper sensitivity to stress.

A lack of cortisol leads to feeling no energy and having no stress resistance. The person feels tense and has negative thinking. A person who has sufficient cortisol is full of energy, expresses emotions and handles stress well. With enough cortisol a person is relaxed, has positive feelings and finds solutions everywhere.

Adrenal crisis

Dr. Hertoghe explained that an adrenal crisis happens when there is not enough cortisol production in the adrenal glands to support the metabolism and the cardiovascular system. Gastrointestinal diseases, infectious diseases or stressful events like surgery, exposure to heat, strenuous physical activity, major pain or pregnancy can all trigger an adrenal crisis. When glucocorticoid therapy is withdrawn, this can also cause an adrenal crisis.

Addison’s disease

With Addison’s disease there is a lack of energy, muscle weakness, loss of appetite and unintentional weight loss. The reason for the symptoms is that the adrenal glands are not producing enough cortisol and aldosterone. There was a more than 2-fold increased risk of dying from Addison’s disease compared to a normal population in a Swedish study.

In another study the serum cortisol levels were determined in patients with heart attacks. The ones who had extremely low levels of cortisol were at almost a 9-fold risk of dying within 30 days compared to patients with a normal serum cortisol level. One of the famous patients with Addison’s disease was J.F. Kennedy. He collapsed in London, England and was finally diagnosed correctly in a British hospital after having suffered for several years without the correct diagnosis. This disease is not always easily diagnosed.

Cortisol therapy

With an adrenal crisis or Addison’s disease cortisol therapy can be life-saving. The physician uses physiological doses of glucocorticosteroid hormones (cortisol and others) and in emergency situations higher than normal doses. Dr. Hertoghe said that survival data were gathered with various severe disease conditions as follows.

Coronary heart disease survival

Dr. Hertoghe reported about a study that observed 1090 adults over 11 years. There was a 40% reduction of mortality when patients were treated with cortisol following a heart attack compared to controls who did not get cortisol treatments. The researchers also found that there was a 39% lower stroke risk when treatment with cortisol was instituted.

In a clinical trial with 39 patients who had heart attacks those patients treated with pharmacological doses of methylprednisolone (3 grams daily) experienced a significant reduction in infarction size.

In another study with 1118 patients Dr. Hertoghe reported a 28% reduction in mortality over 28 days compared with a placebo group. In this study medical researchers gave 2-3 grams of methylprednisolone early on into the heart attack. In the same study, after 6 months there was a 33% mortality reduction.

Stroke survival

Following a stroke, low cortisol levels (270 nmol/L) and high cortisol levels (550 nmol/L) both had an association with a poor long-term prognosis 1 year after follow-up.  However, the study also showed that patients with normal cortisol levels (between 270 nmol/L and 550 nmol/L) following a stroke had a very good long-term prognosis.

AIDS survival

AIDS patients belong into the group of chronic diseases that are associated with low cortisol levels in the blood. There are also clinical signs of low cortisol, namely dark circles around the eyes, hollow cheeks, brownish pale skin with pigment spots, hand creases that are pigmented and weight loss. Severely ill AIDS patients often have severe lung infections (Pneumocystis carinii pneumonia) due to their immune deficiency. A study involving 23 AIDS patients used methylprednisolone in the treatment group and no methylprednisolone in the placebo group. The clinicians administered 40 mg of methylprednisolone every 6 hours for 7 days in addition to antibiotic treatment for 3 weeks. They compared this to the placebo group without methylprednisolone. 75% of the treatment group survived until the hospital discharge compared to only 18% of the placebo group.

Sepsis and septic shock

Treatment of patients with septic shock with ACTH (the stress hormone) infusions showed that 88% had a cortisol response among survivors. The ultimate non-survivors only had a 27% cortisol response of their adrenal glands when stimulated by intravenous ACTH. Dr. Hertoghe pointed out that this suggests that some patients with septic shock may have relative adrenocortical insufficiency. This would explain why the adrenal glands of septic shock patients can be non-responsive to ACTH. In these cases, it is important that the physician treat with either intravenous cortisol or with synthetic glucocorticoids.

Treating septic shock with intravenous hydro-cortisol

One study showed that treating septic shock with intravenous hydro-cortisol gave the following results compared to placebo:

  • 7- fold higher septic shock resolution when compared to the placebo group
  • 8 – fold survival in the intensive care unit
  • 2 – fold higher hospital survival
  • 2 – fold better septic shock reversal in 7 days
  • 8 – fold better survival in the next 28 days.

Overall, this study clearly revealed that septic shock recovery is much better with intravenous hydro-cortisol treatment.

Cancer survival

A study found that breast cancer patients with metastases had flat saliva cortisol curves when compared to patients without breast cancer. If left alone breast cancer patients with a flat cortisol curve die earlier than those who used cortisol supplementation.  The researchers found out that the natural killer cells (NK cells) in these patients were missing. These are special lymphocytes that can kill cancer cells with their enzyme vesicles.

Glucocorticoid treatment

Dr. Hertoghe talked about short-term high-dosed glucocorticoid therapy and the difference between synthetic cortisol equivalents (Dexamethasone etc.) and the natural cortisol. He also talked about adding small amounts of these hormones: DHEA, fludrocortisone (0.1 mg daily orally), and bioidentical vasopressin to optimize cortisol replacement.

Cortisol is the Number 1 Longevity Hormone

Cortisol is the Number 1 Longevity Hormone

Conclusion

One of the vital hormones in our bodies is cortisol, the stress hormone. There is a hormone cascade starting with CRH in the hypothalamus, which stimulates ACTH release from the pituitary gland. This in turn releases cortisol from the adrenal glands. The end product, cortisol is the number 1 longevity hormone. It helps us to survive any stressful event. It gives us energy, stimulates the immune system and helps us to overcome dangerous illnesses. Dr. Hertoghe, an endocrinologist from Belgium gave a detailed lecture at the 30th American Anti-Aging Academy Medicine Conference in Las Vegas on Dec. 10, 2022. Dr. Hertoghe discussed how to survive a heart attack or stroke, sepsis, AIDS or Addison’s disease (=adrenal gland insufficiency) by adding appropriate cortisol doses or equivalent synthetic glucocorticosteroids. One thing is clear: we all need cortisol until the end of our lives.

Feb
13
2022

How healthy are Carbohydrates?

By | diet, fasting mimicking diet, heart attack, Inflammation, lifestyle, Nutrition, Processed food, Stroke

A recent review article asked: how healthy are carbohydrates? The three food components that occur in natural food are carbohydrates, fats and protein. Among the carbohydrates it is important to distinguish between simple carbohydrates (such as sugar) and complex carbohydrates. Simple carbohydrates are readily absorbed into the blood, which causes an insulin peak. After a few hours the peak is gone, and there is a “crash”. You will know the feeling of feeling hungry just a few hours after eating doughnuts! Complex carbs like peas, beans, fruit and vegetables take longer to get digested. The final breakdown product of the digestive process is sugar as well. But this process takes longer meaning that the concentration of sugar in the blood is much lower. There is also no “crash”. The result is that complex carbs cause less insulin secretion into the blood.

Long-term effect of eating too much sugar

Integrated over several decades of life, this means that a person who constantly consumes beverages with sugar and snacks containing sugar is at a higher risk of developing type 2 diabetes. In contrast, a person who eats well balanced meals where the insulin secretion is low, will not develop diabetes and have much less hardening of the arteries. This translates into a lower risk to develop heart attacks and strokes.

The types of carbohydrates

Before I discuss the health effects of various carbohydrates, we need to look at the types of carbohydrates.

Simple carbohydrates

Table sugar is a disaccharide, which consists of one molecule of glucose and one molecule of fructose.

The enzyme amylase very quickly breaks down the chemical bond between fructose and glucose and creates these monosaccharides in the small intestine from which they are rapidly absorbed. Milk sugar is a disaccharide, which consists of a molecule of glucose bound to a molecule of galactose. Milk contains 2 to 8% of milk sugar. We have to watch these simple carbs, because they trigger insulin production and lead to accelerated hardening of the arteries, heart attacks and strokes.

Complex carbohydrates

In contrast, complex carbs are healthy, because they take some time to be digested in the digestive tract. They consist of polysaccharides, long chains of sugar molecules. Both starches and dietary fiber consist of complex carbohydrates. They often are present in vegetables and many fruit. Complex carbs slow down the absorption of their breakdown products and minimize the insulin response. Dietary fiber is the indigestible part of fruit and vegetables. It contributes to good gut health as the beneficial gut bacteria can multiply on the fibre particles.

Healthy carbs

When simple carbohydrates dominate in our food intake, we are in trouble because they are loaded with calories. Overconsumption of them leads to weight gain and obesity, to diabetes, heart attacks, strokes and even cancer. On the other hand, consumption of complex carbohydrates is healthy. We get them from eating apples, bananas, berries, vegetables like spinach, tomatoes and carrots. Other healthy complex carbs are whole grain flour, quinoa and brown rice. Black beans, lentils, peas and garbanzo beans are also healthy complex carbs. Dairy products like low fat milk, yogurt and ricotta cheese are healthy as well.

Mediterranean diet as an example of a healthy, balanced diet

In 2019 a study was published where women with polycystic ovary syndrome (PCOS) were either put on a Mediterranean diet or not. This study showed that a Mediterranean diet was anti-inflammatory, reduced insulin resistance and reduced testosterone levels in PCOS patients.  But the same is true in a general population. The Mediterranean diet is one example of a healthy, balanced diet with complex carbohydrates. It prevents insulin resistance, inflammation and hormone disbalance. Other diets have similar effects like the DASH diet, the Zone diet and the Pritikin diet.

Quantity and quality of your food intake matters

A 2018 study from India showed that it matters how many carbohydrates we consume.  On average Indians eat a diet with 65-75 percent of calories coming from carbohydrates. Many of these carbs are the unhealthy simple carbohydrates. How healthy are  carbohydrates? The authors recommended to reduce complex carbohydrates to 50-55% and to add 20-25% protein, mostly from vegetable sources and add 20-30% from fat. The fat consumption needs to include monounsaturated fats (e.g., olive oil, nuts and seeds). Among the carbs a lot of green leafy vegetables help to balance the diet. This prevents the development of type 2 diabetes, heart attacks and strokes.

The above addresses the issue of quality of food. But it is also important what quantity of food we are eating. This is where counting or estimating calories comes in. If we overeat, we will very quickly gain weight and eventually can develop obesity.

The glycemic index and glycemic load

In order to help you with the choice of right carbohydrates the glycemic index was developed.

Here is another reference about the glycemic index/glycemic load.

In table 1 towards the end of the last link you find a column designated “GI” for glycemic index. All the foods that have a value less than 55 are foods that you can eat freely.

Problematical carbohydrate foods

Baked russet potatoes and boiled potatoes are very high on the GI index list. Puffed rice cakes, doughnuts, jelly beans and corn flakes measure high on the glycemic index list. But water melons, dried dates, white bread and white rice are also items to be avoided.

You best avoid anything with a glycemic index above 55. The column to the right of GI shows you a serving size and the last column on the right the glycemic load. The lower the glycemic load per serving, the better it is for your health. The glycemic index and the glycemic load are useful concepts of helping you to sort out your diet items.

My wife and I used this in 2001 to shed weight. We both lost 50 pounds (=22.72 kilograms) each in a period of 3 months.

Fasting mimicking diet (FMD)

According to Dr. Longo intermittent fasting stimulates the stem cells of the bone marrow. This leads to new clones of lymphocytes (B cells and T cells), which are part of the immune system. Your immune system becomes stronger from this.

Dr. Longo has done detailed mouse experiments, which inspired him to develop a new diet plan. Patients would receive a fasting mimicking diet (FMD) on 5 consecutive days per month. The rest of the month consists of a normal, balanced diet. 5 days of the month the person consumes a low 600-800-calorie diet. This reduced calorie intake is enough to ensure adherence to the diet, but low enough to lead to enormous positive metabolic changes including youth-preserving stem cell stimulation.

I am following the FMD

I have followed a FMD since December 2017. It helps me to keep my weight (BMI) in the 21 to 22 range. I feel more energetic and have managed to stay in good health.

The above chapter on the FMD was previously published here.

How healthy are Carbohydrates?

How healthy are Carbohydrates?

Conclusion

Healthy eating consists of 50-55% calories from complex carbohydrates; add to this 20-25% protein, mostly from vegetable sources and add 20-30% of total calories from fat. The fat consumption needs to include monounsaturated fats (e.g., olive oil, nuts and seeds). Unfortunately, most “convenience foods” (=processed foods) are incompatible with a healthy lifestyle. They contain too much simple carbs (sugar). Many people live on 65-75 percent of calories coming from simple carbohydrates, which are too many carbs. It should be complex carbs that digest slower and that do not induce insulin resistance. The glycemic index and glycemic load are useful concepts to help you chose the right foods that keep you healthy. The fasting mimicking diet can help you to take the last few pounds off that may be difficult to shed. Weight loss and weight maintenance are possible when you choose the right foods.

Aug
21
2021

When Stress Becomes Abnormal

By | alcohol, Alzheimer’s disease, Cardiovascular disease, Diabetes, heart attack, Hormones, Smoking, Stroke, thyroid disease

Recently CNN published an article that dealt about when stress becomes abnormal.

We all have experienced stress. It makes our heart beat faster and our breathing speeds up as well. But when the stressful situation is over, stress usually subsides also. Some people though have so much stress in their lives that they never completely recover from any stressful situation. They develop chronic stress, which can lead to physical illnesses or mental disease. I have previously written about “stress drives our lives”. In the following I am reprinting the next 5 paragraphs.

Heart attacks and strokes when stress becomes abnormal

In a 2015 Lancet study 603,838 men and women who worked long hours were followed for an average time of about 8 years with respect to heart disease or strokes. All of the subjects were free of heart attacks and strokes when they entered into the study. There was a total of 13% more heart attacks in those who worked extra hours in comparison to those who worked 40 hours per week or less. With respect to strokes there were 33% more strokes in those who worked long hours. Researchers noted a dose-response curve for strokes in groups with various workloads. Compared to standard working hours there were 10% additional strokes for 41-48 working hours, 27% for 49-54 working hours and 33% for 55 or more working hours per week.

Stress drives some of us to substance abuse

In order to cope with stress many of us “treat” daily stress with alcohol. It makes you feel good subjectively, but it can raise your blood pressure causing heart attacks and strokes down the road. A low dose of alcohol may be healthy, but medium and high doses are detrimental to your health.

Next, many people still smoke, although scientists have proven long time ago that it is bad for your health. It can cause heart attacks, various cancers and circulatory problems leading to leg amputations.

Overeating is another common problem. Comfort food relieves stress, but it causes us to put on extra pounds. As you know it is easier to put weight on than to take it off. Being overweight or being obese has its own problems: arthritis in the hips and knees makes walking more difficult. The metabolic syndrome sets in, which is a characteristic metabolic change causing diabetes, high blood pressure, heart attacks, strokes and certain cancers. The more weight you carry, the less likely you are to exercise. This can lead to further deterioration of your health.

Diabetes can occur when stress becomes abnormal

Stress causes too much cortisol secretion from the adrenal glands. This raises blood sugar, and when chronic can cause diabetes. In addition, unhealthy eating habits in an attempt to cope with stress can cause weight gain. Insulin resistance causes high blood sugars and diabetes.

Korean immigrant study

In a 2012 California study 148 adult Korean immigrants were examined. They all had elevated blood sugars confirming the diagnosis of type 2 diabetes. They had an elevated waist/hip ratio.

A high percentage of the study subjects had risk factors for type 2 diabetes. This included being overweight or obese and having high blood glucose readings. 66% of them said that they were feeling stressed, 51% reported feeling anxious, 38% said they were feeling restless, 30% felt nervous and 3% said they were feeling hopeless. It is easy to see the connection between stress and disease!

Australian study showed that anxiety can cause diabetes

An Australian long-term follow-up study computed risk factors for developing type 2 diabetes. Stress was a major contributor to diabetes.

A 30-day episode of any anxiety disorder had a 1.53-fold risk to cause diabetes. A depressive disorder had a 1.37-fold risk to cause diabetes and posttraumatic stress disorder had a risk of 1.42-fold to cause diabetes.

Infertility may develop when stress becomes abnormal

Stress changes hormones in women causing ovulation problems and infertility. 1 in 8 couples in America have problems getting pregnant. Physicians identified stress as at least one of  the contributing factors. But in men stress can also reduce sperm count and semen quality as this study describes.

Alzheimer’s disease and stress

A 2010 study from Gothenburg University, Sweden examined 1462 woman aged 38-60 and followed them for 35 years.

Psychologists assessed the stress score in 1968,1974 and 1980. 161 females developed dementia (105 Alzheimer’s disease, 40 vascular dementia and 16 other dementias). The risk of dementia was higher in those women who had frequent/constant stress in the past. Women who had stress on one, two or three examinations suffered from higher dementia rates later in life. Researchers compared this to a group of women who did not have any significant stress. Specifically, dementia rates were 10% higher after one stressful episode, 73% higher after two stressful episodes and 151% higher after three stressful episodes.

Hormone system affected by stress

I have written an article before about how stress affects our hormone system.

I am reprinting excerpts from this here (the next 4 paragraphs).

Dr. Andrew Heyman gave a talk about how stress affects our hormone system. He presented his talk at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. It was entitled “Understanding the Stress, Thyroid, Hormone Connections & Prioritizing Systems”.

Dr. Heyman emphasized in particular that there is a triad of hormonal connections that is important to remember: the thyroid hormones, the stress hormones (adrenal glands) and the pancreas (insulin production). It seems like we need a balance of these hormones for optimal energy production and circulation. Under stress our sugar metabolism can markedly derail, we develop obesity and fatigue. But when balanced, we experience vitality and wellbeing.

Metabolic activation pathways

Dr. Heyman projected a slide that showed the metabolic activation pathways. Likewise, he stated that a number of different factors could influence the hormone system:

  • Diet: trans fats, sugar, too many carbs, food allergies.
  • Drugs: drug-induced nutrient depletion (over-the-counter drugs, prescription drugs).
  • Physical exercise: frequency and type matters.
  • Environmental exposure: chemicals, pesticides, herbicides, heavy metals, plastics, molds, and pollens.
  • Stress: physical stress, psychogenic stress.
  • Genetics: methylene-tetra-hydro-folate reductase enzyme deficiency (MTHFR mutation), APOE genes, lack of vitamin D
  • Disease: past or present conditions, active disease or syndromes.

Target areas within your system

The target areas in your system are the

  • Pancreas, where blood sugar can rise because of insulin resistance. In particular, too much insulin production causes inflammation, hormone disbalances, kidney damage, and hardening of the arteries through plaque formation.
  • Thyroid gland, which depends on TSH (thyroid stimulating hormone) for activation. Autoantibodies can also affect it negatively.
  • Brain: decrease in serotonin resulting in anxiety, depression and food cravings; decreased melatonin causing sleep disturbances; increased ghrelin and decreased leptin secretion leading to overeating and obesity.

Other target areas of stress

  • Liver/kidneys: both of these organs are important for detoxification; the liver produces thyroid binding globulin, which when increased can lower the free thyroid hormones.
  • Immune system (gut, lymph glands): the Peyer’s patches in the gut mucosa produce a large portion of the immune cells; lymph glands, the bone marrow and the spleen supply the rest. A leaky gut syndrome can affect the whole body, in addition causing inflammation and autoimmune reactions.
  • Hypothalamus/pituitary/adrenal glands: this is the main axis of the stress reaction. A brain under stress activates the hypothalamus. It sends a cascade of activating hormones via the pituitary gland and likewise activates the adrenal glands. Finally, this leads to cortisol overproduction, and release of epinephrine and norepinephrine from the center of the adrenal glands. High blood pressure, anxiety, heart palpitations, arrhythmias and more can finally develop from this.

Treatment suggestions to cope with stress

There are thyroid supplements that can support the function of the thyroid gland. Similarly, there are several supplements to support the adrenal glands.
Chromium, vitamin D, magnesium, alpha-lipoic acid, fish oil and others are useful to support the pancreas. Relaxation methods like self-hypnosis, meditation, yoga, Tai-Chi and others are very useful to counter stress. If you can change your job to evade stress, take the opportunity and find another job with less stress. See a health professional and discuss what you can do to become more stress-resistant. If you are overweight or obese, see a dietitian to help you lose weight. Aerobic exercises like running for 30 minutes on a treadmill can help reduce stress. Various relaxation methods mentioned earlier also can counter stress. They help you to block out worrying about the past and the future, but instead focus on what is positive in the present.

When Stress Becomes Abnormal

When Stress Becomes Abnormal

Conclusion

I have described what stress can do to your body. It can give you heart attacks and strokes. Stress in some people can lead to substance abuse. It can cause diabetes, infertility and even Alzheimer’s disease. I described how thyroid hormones, insulin and brain hormones are interconnected and suffer with stress. Other factors can make the effects of stress worse or better as I discussed in detail. Treatment of stress-induced conditions requires a combination of preventative steps and medical therapies. Ignoring stress is not an option as this could lead to premature death. Managing stress, as mentioned before, and keeping it to a minimum is the answer.

Jan
09
2021

Melatonin Is More Than a Sleeping Aid

By | Alzheimer’s disease, Anti-aging medicine, Autism, autoimmune disease, Cancer, Cardiovascular disease, Circadian rhythm, Dementia, Diabetes, Health, heart attack, Heart Disease, Hormones, immune system, Inflammation, Insomnia, melatonin, Menopause, mitochondria, Multiple sclerosis, neurological disease, Osteoporosis, Parkinson’s disease, sleep, Stroke

Notably, the January 2021 issue of the Life Extension magazine informs you that melatonin is more than a sleeping aid. It contains an interview between Dr. Roman Rozencwaig and a Life Extension (LE) magazine reporter. It must be remembered that Dr. Rozencwaig dedicated much of his career to the healing effects of melatonin. Another keypoint is that in 1987 Dr. Rozencwaig published a paper together with two other researchers. Specifically, it showed that melatonin production by the pineal gland declines in older age. Markedly, they stated that this is the reason why people age and why diseases of aging develop. Another key point is that Dr. Rozencwaig also stated that taking oral melatonin can promote a healthier life.

Melatonin deficiency causing aging and various illnesses

With the aging process the pineal gland calcifies and melatonin production is steadily declining. Surely, along with this is a deterioration of the circadian hormone rhythm. Meanwhile, the neuroendocrine system in the brain gets disorganized. Accordingly, this causes various diseases to occur. To emphasize, Dr. Rozencwaig says that a proper balance between melatonin and neurotransmitters is what we need to maintain health and longevity. As a result, a daily intake of melatonin supports healthy aging and longevity.

The many clinical effects of melatonin

Oral melatonin tablets help you to fall asleep easier, particularly the population that is older than 60 years.

But besides that, melatonin has many other clinical effects.

  • Melatonin improves immunity, which improves resistance against infections. It helps also in cancer prevention
  • Melatonin maintains the circadian hormone rhythm by synchronizing pituitary and hypothalamic hormone production
  • It protects the brain and may prevent Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, autism, and others
  • Melatonin modulates anti-inflammatory cytokinins in different diseases

Dr. Rozencwaig mentioned that melatonin slows down the aging process. There are multiple intertwining reasons for this. 

Melatonin’s actions against the aging process 

  • Melatonin regulates gene expression. This means that some signs and symptoms of aging can be reversed through genetic switches
  • Because melatonin regulates the immune response, the body is more protected against viral, bacterial and parasitic infections
  • Melatonin helps to overcome chronic inflammation that produces cytokines
  • Melatonin is also liver-protective through stimulation of an enzyme (AMPK). This enzyme regulates cellular metabolism.
  • There are other processes that melatonin is involved in: energy metabolism by protection and restoration of mitochondria.
  • Melatonin protects against osteoporosis by balancing and regulating bone formation versus bone loss.

More actions of melatonin

  • An important function of melatonin is the stimulation of antioxidant enzymes like glutathione peroxidase and superoxide dismutase (SOD)
  • Melatonin regulates sirtuins, which are proteins that maintain cellular health. They protect you from obesity, type 2 diabetes, cancer, heart attacks and strokes, dementia and more
  • As already mentioned, melatonin is a neuroprotective agent and may prevent Alzheimer’s and dementia
  • Melatonin stimulates apoptosis of cancer cells.
  • Oral health and melatonin are related. Melatonin suppresses herpes infections and periodontal disease. Melatonin prevents oral cancers to a certain degree. In addition, dental implants survive better when melatonin is present in saliva.

Prevention of cognitive decline

Dr. Rozencwaig mentioned that melatonin stops much of the cognitive decline of aging. To achieve this the following processes take place.

  1. Melatonin improves the sleeping pattern and increases the amount of REM sleep.
  2. During sleep melatonin removes toxic amyloid and tau proteins. We know that with Alzheimer’s disease these are the proteins that accumulate in the brain.
  3. Melatonin improves myelination of white matter in the brain. This prevents brain atrophy of old age.
  4. The brain is metabolically very active and produces toxic free radicals. But melatonin is a strong antioxidant dealing with free radicals. Melatonin can cross the blood brain barrier and stimulates enzyme production to eliminate toxic reactive oxygen species.
  5. Chronic inflammation also increases with age, but melatonin deals with this condition in the brain.
  6. Here are 3 subtypes of melatonin receptors. The body integrates the multitude of actions of melatonin with the help of these receptors.
Melatonin Is More Than a Sleeping Aid

Melatonin Is More Than a Sleeping Aid

Conclusion

Melatonin is a powerful antioxidant that has many other useful protective qualities as explained. The body integrates various functions like anti-aging, anti-free radical activity, neuroprotection in the brain and more. Melatonin even synchronizes pituitary and hypothalamic hormone production. This helps to integrate the effect of melatonin, which benefits the body in many ways. Melatonin prevents Parkinson’s and Alzheimer’s disease, multiple sclerosis, autism, obesity, type 2 diabetes, cancer, heart attacks, strokes and dementia. Melatonin production deteriorates from the age of about 60 onwards. It is important to supplement with melatonin at nighttime from that age on. Usually, you only need small amounts of melatonin, between 1mg and 3 mg at bedtime. This prevents most of the serious diseases of old age, stimulates your immune system and lets you age gracefully.

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