**Closure of my websites askdrray.com and nethealthbook.com**

These websites will be taken down on **April 30, 2025** and no further updates will be provided.
I hope you enjoyed the content of these websites. You can continue to read Dr. Schilling’s blogs which I publish daily on Quora

My home page there is: ** https://www.quora.com/profile/Ray-Schilling**

Click on this: Under my image there is a heading “Profile”. Right underneath this you find a search box entitled “search content”. Type in any term you are interested in. You will get several answers I have written (I have written more than 15,000 answers).

On Quora you can also write comments that I will answer.

Thank you for your trust in the past. Ray Schilling, MD
**Closure of my websites askdrray.com and nethealthbook.com**

These websites will be taken down on **April 30, 2025** and no further updates will be provided.
I hope you enjoyed the content of these websites. You can continue to read Dr. Schilling’s blogs which I publish daily on Quora

My home page there is: ** https://www.quora.com/profile/Ray-Schilling**

Click on this: Under my image there is a heading “Profile”. Right underneath this you find a search box entitled “search content”. Type in any term you are interested in. You will get several answers I have written (I have written more than 15,000 answers).

On Quora you can also write comments that I will answer.

Thank you for your trust in the past. Ray Schilling, MD
  • Immunotherapy for Cancer

    Immunotherapy for Cancer

    Dr. Joseph Maroon discussed immunotherapy for cancer at the Anti-Aging Conference in Las Vegas, which I attended. He was one of the keynote speakers Dec. 14, 2024. He was a neurosurgeon in the past and has given many lectures at these yearly Anti-Aging Conferences before. The full title of his presentation was … [Read More...]

  • Treatment of Hormone Deficiencies with Bioidentical Hormones

    Treatment of Hormone Deficiencies with Bioidentical Hormones

    Dr. Thierry Hertoghe discussed treatment of hormone deficiencies with bioidentical hormones at the Anti-Aging Conference in Las Vegas, which I attended. He was one of the keynote speakers Dec. 13, 2024. He is a well-known endocrinologist from Brussels/Belgium and has given many lectures at these yearly Anti-Aging … [Read More...]

  • Menopause Revisited

    Menopause Revisited

    At the 32nd Anti-aging Conference in Las Vegas menopause was reviewed, which I call “menopause revisited”. The presenter was Dr. Sara Gottfried who is the director of Precision Medicine. She is also affiliated with the Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, Pennsylvania, … [Read More...]

  • Anti-Inflammatory Diets Improve Inflammation

    Anti-Inflammatory Diets Improve Inflammation

    A CNN review article noted that anti-inflammatory diets improve inflammation. This is important for medical conditions that also have inflammation attached to it. For instance, rheumatoid arthritis, diabetes or chronic kidney disease all carry inflammation with them. But according to a 2019 study more than 50% of … [Read More...]

  • Ultraprocessed Food Leads to Premature Aging

    Ultraprocessed Food Leads to Premature Aging

    An article in the medical journal “Medical News Today” found that ultraprocessed food leads to premature aging. What are ultraprocessed foods? The NOVA Food Classification System explains what ultraprocessed foods (UPFs) are and what other ones are not. Examples of ultraprocessed foods are: fatty, sweet, savory … [Read More...]

  • Vital Information about Cholesterol Drugs

    Vital Information about Cholesterol Drugs

    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 … [Read More...]

    Nov
    14
    2020

    Why We See More Food Allergies

    A recent review in a BBC article explained why we see more food allergies. It is important to note that one of the more important food allergies are peanut allergies. Certainly, they have risen from 1 in 250 children in 1997 to 1 in 70 children in 2008.

    By all means, allergies come in various degrees of severity; an anaphylactic reaction is the most severe form. Notably, in England there was a rise of hospital admissions for anaphylaxis from 1,015 in 2013 to 1746 in 2019. This is a 72% increase in 6 years!

    Theories why there may be more food allergies now

    There are a number of theories why food allergies have been on the rise. There is a consensus now that the right composition of the gut bacteria is important for normal immune reactions to take place.

    Hygiene theory

    David Strachan proposed the hygiene theory of allergies in 1989. Briefly, his observation was that children of larger families were less likely to develop allergies. He interpreted this to mean that infections among siblings stabilized the immune system. In the meantime, it has become obvious that the gut plays an important role for the immune system.

    Graham Rook’s “old friends” theory

    Graham Rook’s “old friends” theory came out in 2003. This theory states that friendly microbes in the environment are mixing with the gut flora. This trains the immune system to balance.

    Gut bacteria theory

    There is good evidence that the more a child is given antibiotics as a child, the more likely it is that the person develops a food allergy later. The mechanism seems to go via the gut flora. In a way this is the other coin of Graham Rook’s “old friends” theory. If you kill the “good friends” bacteria in the gut by antibiotics, the immune system strikes back with allergic reactions.

    Dual-allergen exposure

    By exposing the child at 4 to 11 months to peanuts or peanut butter, the immune system develops tolerance to the peanut protein (LEAP=learning early about peanut). A study showed that by doing this 80% of 5-year and older children and adults do not have a peanut allergy.

    Prenatal vitamin D and food allergies

    A German study found that prenatal exposure to higher amounts of vitamin D resulted in a higher risk of developing food allergies before the age of two.

    Use antibiotics only when necessary

    Gut biome studies showed that the use of antibiotics can have long lasting effects on the composition of the gut flora. A patient in sepsis may require antibiotics. But when the patient has recovered it is important that the bowel flora is restored with probiotics. This balances the immune system and avoids allergic reactions.

    Immunotherapy for food allergies

    Allergists have long used desensitisation techniques to deal with inhalant allergies. Allergy shots every two or three weeks can be very helpful to suppress immune reactions to inhalants. The same technique works also for many food allergies. The allergist tests the patient’s skin on the forearm to see what positive reactions occur. Based on these findings an allergy serum is composed. A small amount is injected in intervals. The smallest amount is given first and the concentration is gradually increased until the maintenance dose is reached. This causes the immune system to produce competing antibodies that reduce the antibody-mediated reaction to the food allergies.

    Why We See More Food Allergies

    Why We See More Food Allergies

    Conclusion

    Food allergies are increasing in frequency and severity. There are several theories why food allergies develop. The most likely one is that friendly bacteria in the environment become part of the gut environment in the newborn. If we have the right composition of gut bacteria our immune system reacts normally. Administering antibiotics frequently and overcleaning our kitchens with too many cleaning agents affects our bowel flora negatively. This disbalance can cause allergic reactions. On the other hand, exposing a newborn between the age of 4 and 11 months to a variety of adult foods including peanut products will desensitize the child to peanut protein and prevent future allergies. Those who are severely affected by food allergies can see an allergist for allergy testing and consider desensitisation through allergy injections.

    Nov
    07
    2020

    Removal of Senescent Cells Can Extend Life

    Several animal and human studies by the Mayo Clinic showed that removal of senescent cells can extend life. Researchers Xu et al. showed in 2018 that senescent cells weaken the body. Senescent cells are damaged cells that are still living. They can cause the release of inflammatory cytokines. The researchers showed in mouse experiments that intermittent senolytics increased life expectancy by 36%. Senolytics are drugs that dissolve senescent cells; the senolytic cocktail consisted of dasatinib plus quercetin.

    In these mouse experiments their risk of dying was reduced by 65% compared to control mice that did not take senolytics.

    Senescent cells causing premature aging

    In the past 5 years research on aging and on chronic diseases made a lot of progress. Researchers realized that the accumulation of senescent cells is what causes both. All this happens because the process of apoptosis, the removal of dead cells, is impaired in the aging person. It appears that in older age there is a problem with dying cells and their removal. Instead they linger on and start producing cytokines, which cause inflammation. This can damage other cells and lead to organ failures. All this explains why older people often get chronic diseases and do not reach their normal lifespan. The accumulation of senescent cells also blocks regenerative factors that improve one’s health.

    Senolytics

    Dasatinib is a kinase inhibitor that was developed to treat acute myelogenous leukemia in adults and children. Researchers did animal experiments with a combination of dasatinib and quercetin for several years. They also have started smaller pilot clinical trials in humans. It appears that the human findings are very similar to the animal findings. But more research is needed to answer questions about side-effects and effects of removal of senescent cells.

    Details about animal experiments with senolytics

    The Mayo Clinic research showed that old mice treated with senolytics (dasatinib and quercetin) live 36% longer than controls that did not receive senolytics. Another part of this series of experiments showed that senescent cells are indeed what kills prematurely. They took senescent cells from old mice and transplanted them into young mice. Soon the young animals showed deterioration health wise and they died prematurely. Another control group were older mice that received senescent cells from old mice. They too died prematurely. Treatment with senolytics (dasatinib and quercetin) improved physical functioning and also survival.

    Details about human trials regarding senolytics

    For three days 11 participants received senolytics (dasatinib and quercetin). The effect of the drugs was evident for 11 days. The subjects took 100 mg of dasatinib daily and 500 mg of quercetin twice per day for 3 consecutive days. This dose was repeated twice more on a weekly basis for a total of 3 weeks. These patients had idiopathic pulmonary fibrosis. This is an incurable disease where senescent cells accumulate. These patients showed significantly improved gait speed, walking endurance, chair rise test performance and scores of other physical performances. All this occurred on day 5 after the initial dose of senolytics.

    Alternative senolytics, so removal of senescent cells can extend life

    Dasatinib as a senolytic has significant side effects.

    For this reason, researchers looked for alternatives. Theaflavins, isolated from black tea fits this bill. It is non-toxic, but it is also effective as a senolytic. Researchers from Life Extension have developed a senolytic product containing theaflavins and quercetin. Instead of regular quercetin they included quercetin phytosome, which has 50-times more potent bioavailability. One capsule contains 74 mg of quercetin phytosome (the equivalent of 1250 mg of regular quercetin) and 275 mg of theaflavins.

    Discussion

    Future research needs to show whether or not the Life Extension senolytic indeed does what it promises. It claims that only one capsule per week stimulates apoptosis, reduces cytokines and increases longevity. I would like to see a clinical study that examines all these parameters. One measure of longevity is to determine the length of leukocyte telomeres. All the other laboratory tests are readily available. Research in this field will certainly continue and scientists will likely develop other senolytics.

    Removal of Senescent Cells Can Extend Life

    Removal of Senescent Cells Can Extend Life

    Conclusion

    The accumulation of senescent cells causes both aging and chronic diseases. Research showed that in older age the process of apoptosis, the removal of dying cells, is incomplete. As a result dying cells accumulate. They produce inflammatory cytokines, can damage other healthy cells and lead to chronic organ failure. In addition, cancer cells can develop and the patients can die prematurely. Senolytics are substances that clear out senescent cells. In mouse experiments they have already led to improved survival and health. Clinicians performed a clinical trial on patients with idiopathic pulmonary fibrosis, which is an incurable disease where senescent cells accumulate. They showed significantly improved gait speed, walking endurance, chair rise test performance and scores of other physical performances. One pill once per week with dasatinib and quercetin can achieve this. More research in this area can clarify why senolytics work and what the side effects are.

    Oct
    31
    2020

    Blood Type Has Some Bearing on the Severity of Covid-19 Coronavirus

    Two independent research publications concluded that blood type has some bearing on the severity of Covid-19 coronavirus infections. One was published in Denmark, the other one in Canada.

    In the US the 4 common blood types occur with this frequency: group O: 45% (O positive 38%, O negative 7%); group A:  40% (A positive 34%, A negative 6%); group B: 11% (B positive 9%, B negative 2%) and group: AB 4% (AB positive 3%, AB negative 1%). Positive and negative stands for the Rh group (the rhesus factor, which is another type of blood group).

    Two separate publications

    Denmark study

    Briefly, the Denmark study showed that when positive and negative tests for the SARS-CoV-2 virus were checked in relationship to blood groups, blood group O had 13% less coronavirus infections, group A had 9% more infections, group B had 6% more infections and group AB had 15% more infections than negative controls. This means that blood group O is relatively protected from the SARS-CoV-2 virus. The investigators were fast to add that this does not give people with a group O blood type a licence to go to the pub and celebrate.

    Canadian study

    The Canadian study looked at 125 critically ill people with positive SARS-CoV-2 virus tests. Of these 95 had ABO blood types available. All these patients were admitted to the ICU. Here are the significant findings: 32% of blood group A required intubation versus 84% of AB patients, 35% of O group patients and 61% of B patients required intubation. 12% of A patients and 32% of AB patients, but only 5% of blood group O patients and 9% of B patients required kidney support (continuous renal replacement therapy). In addition, group O and group B patients required a median ICU stay of only 9 days. In contrast, group A and AB had to stay in the ICU for 13.5 days.

    Gene study to determine susceptibility for severe Covid-19 disease

    In a European genetic study from Italy and Spain 835 patients and 1255 control participants had genetic studies done. It turned out that the genetic loci that determined the severity of Covid-19 followed the blood groups. Blood group A patients had a 45% higher risk of developing severe Covid-19 disease, while group O patients had a 35% lesser risk compared to other blood groups of developing severe Covid-19.

    Discussion

    Dr. Mypinder Sekhon, an intensive care physician at Vancouver General Hospital stated that people with a blood group O make less of a key clotting factor, which makes them less prone to clotting problems in the blood. Clotting is a major driver in complications of Covid-19. Other possible explanations are the blood group antigens and how they interact with antibodies from the infection with Covid-19 coronavirus. Finally, it could be related to the genes of the blood groups and how they interact with receptors of the immune system. It is interesting to also note that there are genetically different risks that go along the line of the blood groups with group A having much higher risk than group O to develop severe Covid-19 disease.

    Blood Type Has Some Bearing on the Severity of Covid-19 Coronavirus

    Blood Type Has Some Bearing on the Severity of Covid-19 Coronavirus

    Conclusion

    Both research in Denmark and in Canada confirmed that blood group O had less coronavirus infections. In the Denmark study there were 13% less severe Covid-19 cases in people with the blood group O than in negative controls. In the Canadian study of 95 patients with severe Covid-19 physicians had to admit them into the ICU. They noted that 84% of blood group AB patients in the ICU required intubation. In contrast, only 35% of O group patients required intubation. With regard to kidney support, 32% of AB patients, but only 5% of O patients required this during their ICU stay.

    More research required to understand these findings

    The researchers added that it is not clear why there are such differences among patients with different blood groups. They mentioned that more research is necessary. This will reveal why group O has a milder course. It will also show why group O patients require less intubation and shorter ICU stays. Separate genetic studies showed that severe Covid-19 disease develops with blood group A patients (45% higher risk). In contrast group O blood group patients have milder Covid-19 disease (35% less risk). It is with these investigations that we can now understand some of the peculiarities regarding the Covid-19 disease.  It explains why some people develop severe Covid-19 disease while others develop only mild symptoms.

    Oct
    24
    2020

    Irregular Periods are Linked to Premature Deaths

    A review in CNN describes that irregular periods are linked to premature deaths. This review is based on the original publication in the British Medical Journal published on September 30, 2020.

    Essentially, the researchers followed 79,505 premenopausal women without a history of cardiovascular disease, cancer, or diabetes for 24 years. The researchers recorded 1975 premature deaths. The definition for a premature death was someone dying before the age of 70. There were three age groups that the researchers followed separately for 24 years.

    • ages 14-17 years
    • 18-22 years
    • 29-46 years

    The most common causes of death were 894 from cancer and deaths from 172 strokes and heart attacks.

    Death rates after 24 years for the three subclasses just mentioned

    The researchers noted that there were differences in survival for different age groups. But there were also differences in survival for irregular periods versus prolonged intervals between periods. Crude mortality rates for 1000 person years of follow-up for women with normal versus irregular periods were as follows.

    Normal periods                                  Irregular periods

    14-17 age :  1.05                                            14-17 age:    1.0

    18-22 age:  1.23                                            18-22 age:    1.37

    29-46 age:  1.0                                              29-46 age:    1.68

    Women with a cycle length of 40 days or more had a higher mortality rate. The researchers compared this to women with a normal cycle length (26-31 days). Here are the data in detail for two age groups at the outset of the study.

    Women with a cycle length of 40 days or more                 

    Age 18-22:    1.34

    Age 29-46:    1.40

    Heart attacks and strokes followed these death statistics closest.

    Discussion

    The researchers concluded that teenagers and women in their middle-age were at the highest risk. This risk was for premature mortality, if they had irregular periods or a cycle length of 40 days or more. There was also an association between irregular periods and a prolonged cycle length and type 2 diabetes, ovarian cancer and coronary heart disease. In addition, mental health problems were also related, the study said.

    Dr. Adam Balen, a professor of reproductive Medicine at Leeds Teaching Hospitals in the UK said: “Young women with irregular periods need a thorough assessment not only of their hormones and metabolism, but also of their lifestyle so that they can be advised about steps that they can take which might enhance their overall health”.

    Too much estradiol in women and men can cause cancer

    In this context it is interesting that other studies have shown that unopposed estradiol may be the culprit for both irregular periods and larger intervals between periods. When estrogen is elevated in females, irregular periods can result. Unopposed estradiol can cause breast, uterine and ovarian cancer.

    In males who also have a small amount of estrogen in their blood, it is important that a larger amount of testosterone balances the two hormones. Otherwise there is a risk of prostate cancer.

    In addition, cardiovascular disease has been described as a side effect of standard hormone replacement therapy (HRT) in women with synthetic hormones.

    The good news is that treatment with bioidentical hormones can treat these abnormal periods. This eliminates premature mortality and in many cases prolongs life.

    "<yoastmark

    Conclusion

    Researchers followed 79,505 premenopausal women without a history of cardiovascular disease, cancer, or diabetes for 24 years. They found that there is a linkage between irregular periods and premature deaths. There were three age groups that the researchers followed. Some of them suffered from irregular periods and others had periods that were 40 days or longer apart. The researchers recorded the premature mortalities. At an age of 29-46 there was a 68% higher mortality in women with irregular periods. The scientists compared this to women who had regular periods. In addition, women aged 29-46 with a cycle length of 40 days or more had a 40% higher mortality.

    Estrogen dominance could explain premature deaths

    The researchers compared this to women with a normal cycle length. It is possible that women who died prematurely were having too much estrogen in their system, which can produce cardiovascular disease and cancer of the breast, uterus and ovary. Further studies need to clarify the mechanism behind irregular periods and why a cycle length of 40 days or more causes mortality.

    Oct
    17
    2020

    What can Happen to Your Body Over Months of Isolation

    A recent article by CNN describes what can happen to your body over months of isolation at home. The article is rather negative showing all the possible things that can go wrong. I have been isolated as well since March 2020. I handle the isolation differently than described in the article. I will comment to each point what can be done differently to avoid the complications mentioned.

    Muscle loss

    The CNN article makes the point that inactivity can make you lose muscle bulk within only one week. A lack of exercise weakens your muscle strength. And muscle strength has been associated with longevity.

    My comment:

    I do a brisk walk of 5 to 7 kilometers daily. This maintains my muscle bulk. But I have a treadmill in the basement and a couple of weights that I can use, if it rains outside.

    There is a danger that heart and lungs get weaker

    You need to raise your heart rate and you also need to perfuse your lungs through exercise. Many people do not like exercise. They sit in front of the TV for hours or they surf the net on the computer. Even just reading a book does not give you enough exercise to get your heart rate up and increase your lung perfusion.

    My comment:

    A brisk walk with proper distancing gives you fresh air, exercises your muscles, your heart and your lungs. It maintains your cardiovascular fitness.

    Weight gain

    Being home all the time allows you to look into the fridge more often and eat snacks that are processed. People tend to eat more often than 3 times a day. The end result is that you gain weight. In the beginning of the epidemic people stocked up on non-perishable foods. Often they contain more sugar and carbohydrates. Consuming these foods leads to weight gain. Wearing masks, frequent hand washing, isolation practices and change of normal routines makes people get stressed. Stress leads to overeating and weight gain.

    My comment:

    In the last 6 months that I did home isolation my body mass index (BMI) stayed in the 21.0 to 22.0 range. I ate three meals a day. I avoided processed foods as they are overloaded with sugar, salt and refined carbs. Once a month I do a 5-day fasting mimicking diet according to Dr. Longo. This ensures that my BMI stays within the range I indicated. Otherwise I eat a Mediterranean diet, which is anti-inflammatory.

    Your posture could suffer

    When you are seated in front of the computer or the TV you tend to engage in poor postures. This can lead to strains of your back, neck, shoulders and hips. Staring at the computer screen or the TV can also give you eye strain.

    My comment:

    The key is movement, such as getting up and walking around; doing other activities like lawn mowing, weed eating or doing dishes. This interrupts any longer stretch of bad posture.

    Your sleep quality can suffer

    The more exposure to sunlight during the day you get, the more vitamin D you produce in the skin. Some people lack the necessary enzymes in the skin to convert cholesterol into vitamin D. But exposure to sunlight also helps to reinforce your diurnal hormone rhythm. This is also called circadian rhythm. Avoid blue lights (TV, computer, iPhones etc.) in the evening before bedtime as this can interfere with a deep sleep later. Also go to bed early enough (between 10 and 11 PM) to allow your circadian rhythm to take over.

    My comment:

    Some people (above the age of 60) benefit from 3 mg of melatonin at bedtime. After the age of 60 people no longer produce enough melatonin in the pineal gland. If I wake up in the middle of the night, I take another 3 mg of melatonin prior to 3AM. Caution: after 3 AM melatonin can give you a bit of a hangover in the morning.

    Your brain can slow down

    The brain needs nutrition and exercise. Exercise can eliminate certain amino acid by-products that otherwise turn into neurotoxins. With exercise you even prevent neurotoxins to enter the brain.

    My comment:

    I find that I must at least do a brisk walk of 4 kilometers a day. It prevents back pain, helps me sleep better and keeps my mind clear. But as mentioned earlier I prefer doing a brisk walk for 5 to 7 kilometers a day. In the past (prior to March 2020 when the Covid-19 pandemic started) I went to the gym every day. When it finally reopened, they had one Covid-19 case at the gym. I decided that it is too dangerous to go back to the gym until a safe Covid-19 vaccine is available in the summer of 2021. I feel the same way about flying. It is not worth the risk. I can just stay local and do my own program. The pleasure of traveling can wait until the summer of next year.

    What can Happen to Your Body Over Months of Isolation

    What can Happen to Your Body Over Months of Isolation

    Conclusion

    A recent CNN article described the dangers of passively staying in home isolation. I felt that this article was on the negative side. I found that by including a regular brisk walking program into my daily lifestyle the day got more structured. I felt I had more energy and I had no aches or pains. If I spent too much time watching TV or spending in front of the computer, I developed back aches and felt sluggish. I incorporated a 5-day fasting mimicking diet according to Dr. Longo once per month into my regular Mediterranean diet. This allowed me to keep my body mass index in the 21.0- 22.0 range. Doing what I described above I could continue to hold my weight, have energy and stay pain free for many more months. But when the Covid-19 vaccine arrives in spring/summer of 2021 I hope that things will return to normal.

    Oct
    10
    2020

    Medical Myths about Aging

    Medical myths about aging are easy to debunk. Many people believe that it is inevitable that they become disabled as they age, their lives become unbearable, without passion, boring and full of pain. Some aspects of your health may decline with age, none of the myths discussed below is inevitably happening in everyone. Studies showed that a positive outlook on aging and life in general will help you to live longer and stay healthier.  Here I discuss 7 common myths about aging.

    Myth 1: Everyone will experience physical deterioration

    It is common for people to experience reduced muscle strength, increased blood pressure, excessive fat accumulation and osteoporosis. A study with 148 older patients showed that an expectation of reduced fitness in older age actually resulted in less physical activity when older age arrived.

    But you can maintain good cardiovascular function and good muscle strength with a regular exercise program.  This study showed that men and women can reduce mortality by exercising regularly, even in older age.

    Myth 2: Older adults cannot exercise

    There are several reasons why older people stop exercising or are afraid to start exercising. People use the excuse of their arthritis getting worse from exercise. But studies showed the opposite: joint function improves and joint pains are getting better with exercise. Your muscles get stronger and you are less likely to fall. Your heart and lungs are improving their functions and your mentation improves. Exercise increases the HDL cholesterol, which reduces the risk for heart attacks and strokes.

    Myth 3: As we age, we need less sleep

    For many years there was the notion that older people need less sleep. What was not known then was that people above the age of 60 have no appreciable secretion of melatonin from the pineal gland. But when they replace their melatonin deficiency by taking a nighttime dose of 3 mg at bedtime, they will sleep better and longer. They may need a second dose of melatonin in the middle of the night. We need 7 to 8 hours of sleep at night for our diurnal hormone rhythm.

    This will also slow down our aging clock.

    Myth 4: Your brain slows as you age

    Dementia is common when you get older. 13.9% have it at age 71 and older. 37.4% have dementia over the age of 90. But the majority, namely 86.1% in the 71+ age group and 62.6% above the age of 90 do not have dementia. A Mayo Clinic study showed that when the person engaged in artistic activities in midlife or later in life the risk for mild cognitive impairment (MCI) development was reduced by 73%, involvement in crafts reduced it by 45% and engagement in social activities by 55%. In a surprise finding the use of a computer late in life was associated with a 53% reduction in MCI development. These are very significant observations.

    Physical activity reduces risk for dementia

    Apart from stimulating your brain, physical activities also significantly reduce the risk for dementia. A synopsis of 11 such studies showed that dementia is reduced by 30% when physical activity is started in midlife and the person is aging compared to non-exercisers.

    Myth 5: Osteoporosis occurs only in women

    There is a serious misunderstanding about osteoporosis. Several factors work together that can cause osteoporosis. Women in menopause are more likely to develop it due to the missing ovarian hormones estrogen and progesterone. These hormones work together and stimulate vitamin D induced calcium deposition into bone as well as decreasing bone resorption.

    Vitamin K2 also deposits calcium into the bone. In postmenopausal women who take bioidentical hormone replacement, vitamin D and K2 the bone density remains strong. Unfortunately, the opposite is true in postmenopausal women who take synthetic hormones. Synthetic hormones have side chains that do not fit the natural hormone receptors of a woman. This is why osteoporosis persist. And, yes, men get osteoporosis, but typically 10 years later. Typically, they get into andropause where testosterone production declines 10 years later.

    Myth 6: People stop sex as they age

    With age men can develop erectile dysfunction (ED) and women vaginal dryness, both of which can interfere with having sex. A large study showed that only 0.4% of men in the age group 18-29 had ED. In the age group of 60-69 there were 11.5% who suffered from ED. What this means though is that 88.5% of men age 60-69 did not suffer from ED. Fortunately for those who have ED drugs like Cialis and Viagra can correct their problem and they can have regular sex. What a change from 25 years ago when none of these drugs were available (approval of Viagra by FDA in 1998 and of Cialis in 2003).

    Bioidentical hormone replacement beyond menopause and andropause preserves your normal sex drive as well. There are additional benefits of bioidentical hormones. They have positive effects on the heart, brain, bones and the muscle mass.

    Myth 7: It is too late to stop smoking now

    One of the myths that many older smokers like to say is that it would be too late to stop smoking. They think the damage to heart and lungs is permanent and quitting now is too late. Fact is that quitting smoking immediately improves your blood circulation and gives you more oxygen. In just 1 year the risk of getting a heart attack is cut into half. In 10 years, the risk of a heart attack or stroke is the same as that of non-smokers. There is a reduction of getting lung cancer by half.

    Medical Myths About Aging

    Medical Myths about Aging

    Conclusion

    There are all kinds of medical myths about aging. We may think that physical deterioration is inevitable. Or we believe that older people cannot exercise. And we cannot help it, but our brain slows down as we get older. And there is the question whether we need less sleep as we age. Osteoporosis is a disease of women, is it not? These older couples, they don’t have sex any more, do they? And is it too late to stop smoking now that I am 65 years old? All of these myths exist, but there is a need to debunk them.

    The truth behind the medical myths about aging

    I explained in detail what the medical truths are behind these questions. Many of these myths have developed in the past. But with regular exercise, balanced nutrition (Mediterranean diet) and a positive attitude much of these old myths can be overcome. Bioidentical hormone replacement when hormones are missing is another powerful tool. Yes, we all age. But we are still living and can enjoy life as long as it lasts.

    Oct
    03
    2020

    Fibrotic Eye Disease Responds to Nicotinamide (Vitamin B3)

    A new study from Mt. Sinai Hospital showed that fibrotic eye disease responds to nicotinamide (vitamin B3). In general, during wound healing there can be aggressive cell transformations.  This can cause scarring, retinal detachment and finally loss of vision and even blindness. Notably, the following pieces of evidence support the notion that vitamin B3 (nicotinamide) helps to make eye diseases better.

    Lab experiments made in Petri dishes

    Specifically, researchers performed experiments in Petri dishes with human adult cells. After adding nicotinamide, they found the following.

    • There were no harmful cell transformations
    • Membrane formation in conjunction with scar formation was reversed
    • There is a slow-down regarding the development of eye diseases that lead to loss of vision and blindness

    Vitamin B3 was first detected as a cure to Pellagra

    Pellagra, the vitamin B3 deficiency was first described by the Spanish physician, Don Gaspar Casal in 1763. Typically, pellagra presents with dermatitis, diarrhea and dementia. If left untreated it will lead to death. The skin showed inflammation, particularly in areas where there was exposure to the sun or to friction. Affected skin may be darker. Pellagra occurs mainly in the developing world, particularly in sub-Saharan Africa.

    Experiments with vitamin B3 on mice curing eye disease

    In a mouse model researcher showed that vitamin B3 could largely prevent the development of glaucoma in aging mice. According to these researchers 93% of the mice with the higher dose of vitamin B3 did not develop glaucoma. Vitamin B3 (the precursor of nicotinamide) is important for the production of NAD+ and the phosphorylated form NADP, which are cofactors in the energy producing metabolism of mitochondria.  

    Experiments on rabbits showing a cure with nicotinamide

    In a 1985 publication rabbits were subjected to a vitamin B3 inhibitor, namely 6-aminonicotinamide. This is an antimetabolite of nicotinamide. It was given by intraabdominal injection. The rabbits developed diarrhea, ascending paresis/paralysis and death. They also developed vascular lesions in the eyes, particularly the iris with an acute inflammation of the iris, which physicians call iritis. The ocular lesions could be prevented by administering nicotinamide. The researchers concluded that vitamin B3 deficiency was responsible for the eye lesions.

    Clinical trials show a response of glaucoma to vitamin B3

    In a clinical trial physicians compared 34 primary open-angle glaucoma (POAG) patients with a control group of 30 age- and sex-matched controls. The researchers measured plasma nicotinamide concentration in both groups. The POAG patients had on average 33% lower nicotinamide plasma levels than the control group. They concluded that glaucoma seems to be associated with lower plasma nicotinamide levels. The research team suggested that these findings need to be confirmed in a larger series of glaucoma patients. They also suggested that vitamin B3 therapy could become one of the treatment modalities.

    Fibrotic Eye Disease Responds to Nicotinamide (Vitamin B3)

    Fibrotic Eye Disease Responds to Nicotinamide (Vitamin B3)

    Conclusion

    We know vitamin B3 deficiency mainly as pellagra. It occurs mainly in the developing world, particularly in sub-Saharan Africa. But newer experiments in vitro, in mice and in rabbits showed that vitamin B3 deficiency can also cause eye disease. Other studies showed that fibrotic eye disease responds to nicotinamide (vitamin B3). In addition, a clinical trial in humans showed that glaucoma can develop as a result of a 33% lack of plasma nicotinamide (vitamin B3) level. Regular supplementation in those who are prone to vitamin B3 deficiency may be curative for eye disease.

    Sep
    26
    2020

    A New Antibiotic Against Methicillin Resistant Staphylococcus aureus

    A US study describes a new antibiotic against methicillin resistant Staphylococcus aureus. It is a lysin-based antibacterial agent.

    Physicians have been looking for years for a solution regarding the increasing antibiotic resistance problem. But several attempts in the past have failed.

    Staphylococcus infections are the most common bacterial infections of human skin, of soft tissue, joints, bones, and pneumonia. In addition, it can cause endocarditis (=infection of heart valves) and lead to blood poisoning (septicemia).

    Staphylococcus aureus is the underlying bacterium behind staph infections. With the introduction of new antibiotics  it takes only 1 to 2 years before this bacterium learns to become resistant. Researchers noticed that the bacteria start to produce lysins and suddenly they are resistant to the latest antibiotic. Further research zeroed in on lysostaphin, which was active against resistant Staphylococcus bacterial strains.

    Deimmunized lysostaphin

    Lysostaphin is an antibacterial peptide described here in detail. But there still was some interference with immunologically active surface antigens that scientists were later able to overcome. Researchers succeeded lately in removing some of the surface antigens and develop deimmunized lysostaphin. This is what this publication is all about.

    It describes how T cells cannot detect the surface antigen properties of deimmunized lysostaphin. This way none of the strength of deimmunized lysostaphin gets lost in the fight against resistant staphylococcus that normally form anti-drug antibodies. Researchers pointed out the importance of the deimmunization process to make deimmunized lysostaphin invisible to the T cells of the immune system.

    Vigorous testing of deimmunized lysostaphin

    The researchers who investigated the efficiency and safety of deimmunized lysostaphin did the following tests.

    • Although lysostaphin was deimmunized, it retained potent in vitro and in vivo anti-staphylococcal activity. In vitro studies involving Petri dishes with methicillin resistant Staphylococcus aureus showed the effectiveness of deimmunized lysostaphin. In vivo testing in a mouse and rabbit model also showed effectiveness.
    • Deimmunized lysostaphin showed reduced immunogenicity in vivo. Researchers tested this in mice and compared the results to regular lysostaphin, where there was a swift immunological response.

    More points regarding deimmunized lysostaphin

    • Immune evasion allows for repeated efficient dosing of deimmunized lysostaphin. This means that the physician can administer the antibiotic (the deimmunized lysostaphin) to fight the methicillin resistant Staphylococcus aureus with several daily doses.
    • The deimmunization process allows deimmunized lysostaphin to evade the immune response that occurs to regular lysostaphin. This prevents future resistance development. It also prevents that the immune responses weaken the anti-methicillin resistant Staphylococcus aureus response.
    • Researchers showed in a difficult rabbit endocarditis model that deimmunized lysostaphin treats MRSA infection successfully. Endocarditis is an infectious disease, which is both difficult to treat in rabbits, but also in humans. For this reason, rabbits are often used as a model when new antibiotics are developed. If they are successful in the rabbit model they often get approval later for human treatments.

    Deimmunized lysostaphin in humans

    Unfortunately, we are still a few years away from using deimmunized lysostaphin in humans. After successful use of lysostaphin in mice and rabbits the next logical application is to launch human clinical trials. I am convinced that this will be the next step and very likely will be successful.

    A New Antibiotic Against Methicillin Resistant Staphylococcus aureus

    A New Antibiotic Against Methicillin Resistant Staphylococcus aureus

    Conclusion

    Researchers found a new antibiotic against methicillin resistant Staphylococcus aureus in a lysin-based antibacterial agent. This peptide has surface antigens that scientists had to removed to make it more effective. The end result was a deimmunized lysostaphin. Researchers tested this new antibiotic that is effective against many antibiotic resistant strains of bacteria successfully in mice and rabbits. The next step is testing in humans. This involves several phases of clinical trials. These clinical trials have to show that there is a lack of toxicity. In addition, they have to show that the new antibiotic is effective against resistant bacteria. I estimate that this process can still take about 5 years from now before the clinician can use this antibiotic routinely. As the new antibiotic is a polypeptide, it the patient cannot take it orally, as the gut is digesting it. The patient has to take it by injection.

    Sep
    19
    2020

    Hair Style Products are Mostly Safe

    A recent study concluded that hair style products are mostly safe when it comes to causing cancer. In the past there was some concern that the dyes for hair coloring could cause cancer. In a previous blog I mentioned that hair stylists are at a greater risk for developing bladder cancer.  But in customers who had their hair colored this was more difficult to prove. The new study reviewed by CNN was based on a large cohort of 117,200 female nurses at Brigham and Women’s Hospital in Boston.

    These 30-55-year-old nurses were observed for 36 years. Detailed information about hair coloring was part of the study.

    Results of the hair coloring study

    Women with light and medium use of hair dyes did not develop non-melanoma skin cancers, hematopoietic cancers or squamous skin cancers. The same was true for bladder cancer, melanoma, estrogen receptor positive breast cancer, progesterone receptor positive breast cancer and hormone receptor positive breast cancer. Furthermore hair coloring did not cause brain cancer, colorectal cancer, kidney cancer and lung cancer. 5% of women who ever used hair dyes did develop basal cell skin cancer; there was a total of 22,560 basal cell cancers that occurred.

    The BJM showed that women who colored their hair regularly (termed “cumulative dose”) developed 24%-31% more breast cancer. This breast cancer was estrogen negative breast cancer (31%) and progesterone negative breast cancer (24%). They also developed 24% more ovarian cancers and 17% colorectal cancer than controls who did not dye their hair. Myeloid leukemias were also more common in the heavy use hair coloring group with 29% and follicular lymphomas with 13%. Other forms of leukemia were not more frequent.

    Discussion

    50% to 80% of women and about 10% of men ages 40 and older are using hair dye regularly in the United States and Europe. The above cited cancer frequencies were based on women with dark hair and a cumulative dose of more than 200 applications of permanent hair dye. Translated into years of application of hair dye this means coloring your hair for 16 to 17 years, if you color your hair once a month. The study is very powerful due to the large number of women examined and the amazingly long time of 36 years of observation.

    Heavy use, medium and light use of hair dyes

    It is interesting to note that only the heavy use of hair dye resulted in a few significant cancer figures. The light use (1 to 99 times) and medium use (100 to 199 times) of hair dyes did hardly lead to any cancer. There were some exceptions where light use of hair dye led to 34% more bladder cancer and to 67% more follicular lymphomas. These were oddities, because the lighter use of hair dyes led to higher amounts of these cancers than medium and heavy use. This is not what the researchers expected.

    Hodgkin’s lymphoma and breast cancer

    Hodgkin’s lymphoma was about 3- to 5-fold more common in all hair coloring categories compared to non-use of hair dye. The authors discussed subgroups of women as well. They noticed that black women using permanent hair dye had a higher risk to develop breast cancer than white women who only had a borderline increased risk. Estrogen negative, progesterone negative and hormone negative breast cancer was more likely to be caused by heavy use of hair dyes.

    No association between the following cancers and hair dye use

    The present study could not find an association between ever using hair dye and the following. The study found no association with cutaneous squamous cell carcinoma, melanoma, ovarian cancer and colorectal cancer. In addition there also was no association with  kidney cancer, lung cancer, and brain cancer. But it found a slight increased risk (5%) of basal cell carcinoma.

    The study contains no information regarding the specific ingredients in hair dye that are carcinogenic. In the US supervision of permanent hair dyes by the FDA is rather loose. This leaves the manufacturer mostly in charge regarding the composition of the hair dyes. This is different in Europe and in Japan. Here manufacturers removed several carcinogenic substances from hair dyes because of regulations by the local regulatory bodies. This could have a cancer-lowering effect in these countries.

    Hair Style Products are Mostly Safe

    Hair Style Products are Mostly Safe

    Conclusion

    This large study from the British Medical Journal, published Sept. 2, 2020 explains the relationship of cancer risk to permanent hair dyes. The study lasted 36 years and involved 117,200 female nurses. More than 96% of the women were Caucasians. This study showed that for most people who use permanent use hair dyes there is no association with most cancers. However, there was an association between a few cancers and the use of hair dyes. These were in 5% basal cell skin cancers. But breast cancer (31% estrogen receptor negative, 24% progesterone receptor negative), ovarian cancer (24%) and 17% colorectal cancer were among these too. There was also an increased risk of Hodgkin’s lymphoma.

    Effect of screening by FDA regarding carcinogenic substances in hair dyes

    All this data was based on the hair dyes used in the US. Supervision of permanent hair dyes by the FDA is rather loose, with the manufacturer being mostly in charge. This is different in Europe and in Japan. Here local regulatory bodies instructed manufacturers to remove several carcinogenic substances from hair dyes. This could have a cancer-lowering effect in these countries.

    Sep
    05
    2020

    How to Manage Clot Formation with Covid-19

    A publication in the Canadian Medical Association Journal describes how to manage clot formation with Covid-19. A significant amount of cases among Covid-19 patients come down with clotting problems. This means that an infection with SARS-CoV-2 (or Covid-19 coronavirus) may initially present with a fever and cough. But a few days later it can suddenly turn into a dangerous disease with severe clots, multiple organ failures and death.

    Clot occurrence with Covid-19

    It is important to realize that most patients with SARS-CoV-2 do not need hospitalization. But physicians admit 10 to 15% of patients to the hospital. Of these 20% end up with treatment in the Intensive Care Unit (ICU). Of all the hospitalized patients between 5% and 30% develop some form of thrombotic event. Notably, complications of clot formation can be a stroke, a heart attack, a pulmonary embolism or a deep vein thrombosis in the leg. In a recent study from the US 400 random hospitalized patients with Covid-19 144 patients were admitted to the ICU. 4.8% had radiologically confirmed deep vein thrombosis. Overall there were 9.5% with thrombotic events that developed during the hospital stay.

    How does a coagulopathy develop with Covid-19?

    Truly, SARS-CoV-2 enters the body cells through an interaction of its viral spike protein with the angiotensin-converting enzyme 2 (ACE2) receptor. To explain, numerous organs and tissues express this receptor. This includes lung alveolar type 2 epithelial cells, endothelium, the brain, heart and kidneys. To emphasize, ACE2 leads to angiotensin II degradation. With the SARS-CoV-2 stimulation of the ACE2 receptor there may be an accumulation of angiotensin II, which causes a procoagulant state. Injury of the endothelium explains inflammation in the lining of the blood vessels in multiple organs. Commonly affected organs are lungs, heart, kidneys and intestines. The inflammatory reaction is what can lead to clot formation. When part of an organ has died off because of mini clots that destroyed part of the organ, this process can eventually lead to organ failure. Lung failure, heart failure and kidney failure can develop in these sick patients.

    Adequate vitamin D blood levels are important for the immune system

    By all means, vitamin D is very important for the integrity of the immune system. With vitamin D blood levels below 15 to 20 ng/mL (37.5–50 nmol/L) the immune system is paralyzed, and any viral or bacterial infection tends to overwhelm the body. Of course, this is the reason why the mortality due to Covid-19 coronavirus is highest in patients with these low vitamin D blood levels. People with secondary illnesses (diabetes, arthritis, autoimmune diseases, cancer) and patients above the age of 60 have the lowest vitamin D blood levels and have the highest mortality rates. This publication describes this in more detail.

    Best vitamin D blood level is in the upper normal range (50-80 ng/mL)

    Above a vitamin D blood level of 30 ng/mL (=75 nmol/L) a patient’s immune system is functioning normally. However, the immune system is strongest at a vitamin D blood level of 50–80 ng/mL (125–200 nmol/L), which is the upper range of the normal level for vitamin D in the blood.

    Keep in mind that vitamin D toxicity occurs only above 150 ng/mL (375 nmol/L).

    Specific effects of vitamin D on Covid-19

    There are three major effects that vitamin D has.

    1. A strengthening of the epithelial barrier not allowing the coronavirus to penetrate into the lung tissue as easily.
    2. Release of defensins and cathelicidin, two crucial antiviral polypeptides that eradicate any virus in the system.
    3. Interruption of the “cytokine storm”, an overwhelming inflammation which is responsible for viral pneumonia to develop. Without the cytokine storm there is no damage to the lungs and people do not need treatment in the ICU. This is particularly important for people above the age of 60 and for people with pre-existing diseases.

    In like manner, with the stabilizing effect of vitamin D regarding the immune function more severe forms of Covid-19 can turn into less severe forms with a better outcome.

    Treatment of patients with Covid-19 who have clotting problems

    Patients need to be assessed with respect to their risk of developing clots. This publication describes that high risk patients have elevated D-dimer levels. When blood clots dissolve the body produces D-dimer, a protein fragment. Normally the D-dimer test is negative in a person that does not produce clots. But in sick patients with Covid-19 who form clots this blood test typically shows D-dimer >2500 ng/mL. In addition the tests show high platelet counts (more than 450 × 109/L), C-reactive protein (CRP) >100 mg/L and an erythrocyte sedimentation rate (ESR) >40 mm/h.

    Indeed, with this constellation of blood tests in a severe Covid-19 case in the ICU setting, the physician uses heparin intravenously or subcutaneously to counter clot formation. However, this needs to be balanced against the risk of causing severe internal bleeding.

    Separate from the anticoagulant effect, heparin seems to also suppress inflammatory cytokine levels. In addition, heparin suppresses neutrophil chemotaxis and migration. Physicians rescued many patients from death using heparin therapy.

    Risk versus benefit clinical trials of heparin therapy are required

    At this point there are only retrospective clinical trials available to describe risk versus benefit of heparin therapy. Some show no difference, others do. There are two international clinical trials on their way to shed more light on this situation. Until the results of these clinical trials are available, physicians need to treat patients to the best of their knowledge.

    How to Manage Clot Formation with Covid-19

    How to Manage Clot Formation with Covid-19

    Conclusion

    Clot formation in sick Covid-19 patients is responsible for many deaths in Covid-19 patients. The SARS-CoV-2 (or Covid-19 coronavirus) causes a cytokine storm with injury to the lining of the arteries. This can affect multiple vital organs and the condition may lead to organ failure. This activates the clotting system and causes clots all over the body. When this process occurs, patients get very sick and the death rate climbs. Physicians were able to rescue some patients with heparin therapy. Two international clinical trials are on the way. Hopefully  these trials answer questions about this newer treatment method. The downside of heparin therapy is the complication of massive bleeding, which causes deaths as well. When it comes to Covid-19, don’t rely on curative medicine. Strengthen your immune system by preventative therapy like vitamin D3 that can interrupt the cytokine storm.

    And even with a “well-prepared” immune system it is extremely important to follow all the guidelines of distancing, disinfecting and wearing face masks. We need all the help we can get!