Medical Articles by Dr. Ray

Oct

2017

How Much Drinking During Pregnancy Is Safe?

By Ray Schilling | alcohol, fetal alcohol spectrum disorders, Pregnancy, Prevention

A recent review of the literature asked: how much drinking during pregnancy is safe? To the surprise of the researchers there was no clear answer in the medical literature between 1950 and July 2016. The researchers wanted to know whether 1 or 2 alcoholic drinks in a week would show a negative effect. Or would it affect the fetus and cause fetal alcohol syndrome?

What is fetal alcohol syndrome?

A mother who drinks several drinks of alcohol per day during her pregnancy will inflict serious damage to her baby. The end result is fetal alcohol syndrome (FAS). There is growth deficiency, usually below the 10 percentile in terms of weight, height or both. There is a characteristic facial appearance like small eye openings and a thin upper lip. In addition severe central nervous system damage is another toxic effect of alcohol on the fetal brain. This leads to gait problems, speech and psychological problems.

Fetal alcohol spectrum disorder

When a pregnant woman consumes less alcoholic beverages, there may be less damage to the fetus. This partial damage to the fetus is called “fetal alcohol spectrum disorder”, which resembles the term “autism spectrum disorder”. However, these two conditions are not related.

In a child with fetal alcohol spectrum disorder some features of fetal alcohol syndrome would be present, but not all. A child with fetal alcohol spectrum disorder may be able to lead an independent life as an adult.

Present rules about drinking during pregnancy

The CDC and the FDA say that a pregnant woman should not consume any alcohol during pregnancy. It even includes the weeks before a pregnancy. In addition, it also applies to the male before he fathers a child. It is a fact that sperm and precursors of sperm are very sensitive to alcohol toxicity. A woman’s eggs are also sensitive to alcohol toxicity. There is no place for a romantic dinner with alcohol and sex later in the evening, that leads to a pregnancy. Romance and a romantic dinner is quite possible without alcohol, if sex that leads to pregnancy is in the plans. If you plan on getting pregnant as a couple you must be responsible, male or female. In view of all of the knowledge it is just not a good idea to subject yourself to alcohol before pregnancy.

New questions about the minimum toxic amount of alcohol

A search of the literature between 1950 and July 2016 has not revealed any convincing data about what one glass of alcohol per day would do during pregnancy. Some researchers will likely want to approach this topic in the near future. There are many women in the US who drink that much during pregnancy, but do not tell their healthcare providers. Researchers would like to conduct a trial where they follow women who consume one glass of alcohol per day during pregnancy. They will want to compare that to a control group with no alcohol intake during the pregnancy. Next would be a thorough investigation of the offspring and about the presence or absence of fetal alcohol spectrum disorder. At the present time there is no such data. We know that some women expose themselves to these smaller amounts of alcohol. But we do not know whether or not there is a serious consequence for this.

New meta-analysis study from Bristol, England in 2016 regarding drinking during pregnancy

The closest study that may answer part of the above questions is a metaanalysis from England. It attempted to shed some light on exposure of smaller amounts of alcohol during pregnancy. They examined several studies where the exposure was up to 32 Grams of alcohol per week during pregnancy. This is called a meta-analysis.

Researchers examined several parameters like stillbirth, gestational length and preterm delivery (less than 37 weeks). They also examined other factors, like a small baby for gestational age, low birth weight (less than 2500 g), and features of FAS.

Findings of the Bristol study

Researchers pooled a total of 288, 512 participants from several studies. The low alcohol consumption group (less than 32 grams per week) had 10% preterm deliveries. 8% of the babies were small for their gestational age. The offspring of pregnant ladies who drank up to 32 grams of alcohol per week were compared to abstainers. The alcohol consuming group had babies that on average weighed 13.49 grams less. Low birth weights (less than 2500 grams) were the same in both groups. A large US study showed a 24% risk of placental abruption in the light-drinking group compared to abstainers. FAS symptoms, conduct disorder or hyperactivity syndrome were the same in any of the pooled studies. The outcome between abstainers and light-drinking mothers was the same. No apparent difference could be found between the children of either group.

Common sense about drinking during pregnancy

At this point it is the safest to go by the recommendation of the CDC and all the official medical societies that recommend to not drinking any alcohol 3 months before a planned pregnancy and during the pregnancy. I consider it common sense that you avoid a known nerve toxin like alcohol during pregnancy. The toxic effect of alcohol in a high enough dosage does horrendous damage, as it is obvious with fetal alcohol syndrome. It stunts the baby’s growth and damages the brain. We have also seen that a lower exposure to alcohol still produces fetal alcohol spectrum disorder. It does not make sense to me to gamble, whether a lower concentration of alcohol may be “safe” to the fetus.

Limits of what research to do

Knowing that alcohol is a toxin to nervous tissue demands that no pregnant woman should drink alcoholic beverages at all. It simply is not safe. I suspect that some researcher who must do research at any cost will one day produce that hypothetical study of one drink of alcohol per day during pregnancy. I think it will show that a significant amount of cases have fetal alcohol spectrum disorder. The conclusion will be that it is safer not to drink alcohol during pregnancy.

How Much Drinking During Pregnancy Is Safe?

Conclusion

Sometimes science is going beyond where it should go. In the study analyzed above several studies were pooled as a metaanalysis. There are limitations in terms of reliability of such studies.

But when it comes to testing what smaller amounts of alcohol do to a pregnancy we need to ask a few questions. Are we as a society really willing to risk future humans just to satisfy our curiosity whether or not drinking during pregnancy would be “safe”? Common sense tells us that alcohol as a known neurotoxic substance will be detrimental to a developing brain in a fetus, even in smaller amounts. Also, it is not clear whether ethics committees throughout the US will allow such a claim or will shut it down in the planning stages before it can ever take off. I would guess that it is more likely that any such plans for a trial of that nature will come under the scrutiny of the medical authorities including the CDC, the FDA and the American Medical Association and be shut down fairly quickly, because of the potential damage that could be inflicted onto the fetus.

It is much safer to carry on with the existing laws and recommendations and avoid all alcohol exposure before and during pregnancy.

Sep

2017

Parkinson’s Disease May Be Stopped

By Ray Schilling | coffee, depression, Diabetes, Drugs, Parkinson’s disease

Parkinson’s disease is common in the US; new research shows that the use of an old anti-depression medication can stopParkinson’s disease The use of nortriptyline, a 50-year old antidepressant has shown to normalize a nerve cell protein. In rats nortriptyline dissolved toxic alpha-synuclein clusters in brain cells. These toxic protein clusters seem to be happening in the brain of Parkinson’s disease patients also. It is the protein by the name of alpha-synuclein that research first found in rats to cause the toxic protein clusters in nerve cells of the substantia nigra, a part of the brain stem.

But nortriptyline was able to normalize the concentration of the protein. In preliminary studies in humans the investigators found that there was a significant improvement of Parkinson’s disease with the use of nortriptyline.

Placebo controlled trial with nortriptyline

Now a research team from Michigan State University in Grand Rapids conducted a larger clinical placebo-controlled trial. The lead researcher Collier of the study group found that Parkinson’s patients who received treatment for depression with the tricyclic agent nortriptyline needed less dopamine, the main drug used to treat Parkinson’s disease. This indicated to the researchers that nortriptyline was preserving brain cells that were still making their own dopamine. In rat experiments they could show that it was the dissolving of toxic alpha-synuclein proteins by nortriptyline that was the key to therapeutic success.

Lisa Lapidus, a co-worker on the Michigan State University research team summed up their research: “What we’ve essentially shown is that we are dealing with a drug that the FDA approved already 50 years ago. Patients tolerate the medication relatively well. This could be a much simpler approach to treating the disease itself, not just the symptoms.”

Parkinson’s disease may be stopped also by old diabetes drug

Thomas Foltynie found that the diabetes drug exenatide helps patients with Parkinson’s disease. Dr. Foltynie is a professor of neurology at the University College London and co-author of the study.

Exenatide is an injection drug. When preliminary studies showed that this drug was effective in helping Parkinson’s disease patients lose their problems with walking and balance, a formal study followed.

Professor Foltynie designed a study where 60 people with Parkinson’s disease either got injections of exenatide or placebo injections. Patient exams followed regarding their musculoskeletal system and balance at baseline and every 12 weeks. A score system of 132 points assessed their Parkinson’s disease. After 48 weeks those who had been taking exenatide had a gain of 1 point on that scale while the placebo group dropped 3 points. After 48 weeks the drug administration (exenatide) finished. But after another 12 weeks another scoring and assessment of the Parkinson’s disease symptoms took place. The experimental group on exenatide scored 3.5 points higher than the placebo group. This suggests that exenatide is helping to treat the cause of Parkinson’s disease, not just the symptoms.

Parkinson’s disease may also stop through the use of caffeine

Parkinson’s disease was in the news again because of another study that involved breaking up misfolded alpha-synuclein through caffeine.

Misfolded alpha synuclein forms clumps inside dopamine producing cells in the substantia nigra of the brain stem. Misfolded alpha synuclein acts like a toxin to the dopamine producing cells and eventually these cells die off. This is the brain region that is responsible for making muscle movements smooth and stabilizes balance. The cells that have misfolded alpha synuclein clumps in them also go under the name of “Lewy bodies”.

Dr. Jeremy Lee from the University of Saskatchewan (Saskatoon, Saskatchewan, Canada) has isolated two compounds from coffee. They are called C8-6-I and C8-6-N. They can bind to alpha-synuclein and prevent clumping, which stops the toxic effects on dopamine producing nerve cells. Like with nortriptyline the caffeine effect is a curative approach to Parkinson’s disease.

Parkinson’s Disease May Be Stopped

Conclusion

There is a new therapeutic approach to Parkinson’s disease. Researchers have detected a protein called alpha-synuclein to cause toxic protein clusters in nerve cells of the substantia nigra, a part of the brain stem. When these cells die from the accumulation of these misfolded proteins, patients come down with Parkinson’s disease. But three different methods of treatment can improve Parkinson’s disease by dissolving the protein alpha-synuclein.

Nortriptyline was able to normalize the concentration of the protein. In preliminary studies in humans the investigators found that there was a significant improvement of Parkinson’s disease with the use of nortriptyline.
Exenatide, an injection drug for diabetes, has been described to help Parkinson’s patients get better.
Caffeine can also dissolve misfolded alpha synuclein (two compounds from coffee called C8-6-I and C8-6-N). This helps patients with Parkinson’s disease to stabilize.

This is only the beginning of a new approach to Parkinson’s disease and an attempt to cure the disease by dissolving the underlying mechanism. So far the drugs that are in use for Parkinson’s disease are only attempting to stimulate dopamine producing nerve cells to produce more dopamine. But the underlying pathology of accumulating misfolded alpha-synuclein clumps is not yet in the treatment protocol. The new research is different, as it takes this into account in an attempt to prevent the condition.

Sep

2017

Close Diabetes Control Prolongs Life

By Ray Schilling | Cardiovascular disease, Diabetes, diet, Drugs, Eye Diseases, heart attack, High Blood Pressure, kidney disease, lifestyle, Mortality, Other neurological conditions, Prevention, Weight loss

A 20-year study showed that close diabetes control prolongs life. A study divided 160 people with diabetes into two groups. The one group continued to get standard care. Yet the other group received a multi targeted, aggressive treatment protocol. As a result after 20 years the group with the intensive treatment protocol lived 7.9 years longer than the group with the standard treatment.

Dr. Oluf Pederson was the senior investigator of the physician team that followed the diabetes group. He said that they concentrated on a number of known adverse factors and treated them aggressively. These factors were first of all high blood glucose values and clotting risks, also high blood pressure and high triglycerides and in addition cholesterol values. Behavior modification was the therapeutic method to get people with risk factors to exercise more, adopt a healthy diet and stop smoking. Medication in select cases also played a role.

More details about the study

The intervention of intensive treatment lasted 8 years. After that the patients were still in a follow-up study for 13 years. At the beginning of the study patients were on average 55 years old and were borderline obese.

The investigation team screened for complications of diabetes. This included screening for kidney disease, heart disease and blindness. Dr. Joel Zonszein, the director of the New York Clinical Diabetes Center at Montefiore Medical Center said: ”These results are impressive and most patients do not receive the correct treatment, according to national surveys.”

Other studies about diabetes

Foreign studies

Study from Croatia

Another study from Croatia involved 200 patients. It concentrated on patients who did not respond to metformin. Physicians used alternative treatment modalities, and they observed and measured blood sugars and hemoglobin A1C in the following 6 months. The study concluded that those patients who received aggressive treatment of their condition did better than those who did not receive the same vigorous approach.

Study from Japan

This Japanese study documented that female patients with type-2 diabetes developed kidney damage earlier than their male counterparts. Consequently, the investigators pointed out how important it is to treat diabetes aggressively to avoid kidney damage.

Study from Singapore

This 2016 study from Singapore analyzed retroactively the impact of diabetes on the long-term survival after coronary bypass grafting (CABG). 5720 consecutive patients had their isolated first CABG surgery between 1982 and 1999. The mean follow-up was 13 years. 34.6% of the patients had diabetes, 51% had high blood pressure and 46.6% had elevated blood lipids. The initial mortality after the CABG surgery was 2.4% in the diabetic group and 1.8% in the non-diabetic group. 20-year survival rates following CABG surgery were 30.9% in diabetics and 49.2% in the non-diabetics, an 18.3% difference. The 20-year freedom from cardiac mortality rates was 56% in diabetics and 68.4% in non-diabetics. Other risk factors that led to cardiac mortality were the following: female gender (1.43-fold risk), diabetes (1.51-fold risk), previous heart attack (1.54-fold risk) and a low left ventricular ejection fraction of less than 35% (2.6-fold risk). The conclusion from this study was that long-term survival in diabetics following CABG surgery was much lower than that of non-diabetic controls. Hence the key to improving long-term survival for diabetics is to treat comorbidities like high blood pressure and elevated lipids aggressively as well as getting blood sugars and hemoglobin A1C values under control.

US studies

In this US study 558 youth (age less than 21) between February 2012 to July 2015 received follow-up. Between 40% and 50% of these diabetics needed insulin to improve their diabetes. Unfortunately their diabetes showed poor control, as their high hemoglobin A1C values indicated. Median HbA1C was 6.7%, 8.5%, 9.6%, and 9.7% in those with disease duration less than 1 year, 1-2 years, 2-3 years and less than 4 In other words, the longer the young patients had diabetes, the less seriously they took their treatment. Only 33% treated their high blood pressure and only 11% their elevated blood lipids. Microalbuminuria, an indicator of diabetic kidney disease, and non-alcoholic fatty liver disease were present in 5% to 6% of these young diabetic patients. The authors came to the conclusion that there were serious gaps in treating these young diabetics. Further follow-up data of the same group of patients in the coming years will provide further data. In conclusion, the new hemoglobin A1C ranges of 3.8% to 4.9% as the new normal range explains why these youths who do not treat their diabetes properly are at high risk to develop complications from their poorly controlled diabetes.

Heart attacks and erectile dysfunction

Heart attacks are more common among patients with uncontrolled diabetes. This US study classified diabetics according to the tightness of their diabetes control. Researchers found examining 606 men and 606 women with diabetes that they could reduce their risk of a heart attack, if they controlled smoking, glycated hemoglobin (hemoglobin A1C), systolic blood pressure, and total and high-density lipoprotein cholesterol. The control of all these risk factors could contribute to the prevention of heart attacks. 35% of men and 45% of women could prevent having a heart attack. A laxer control still would prevent 36% of heart attacks in men and 38% in women. A very aggressive diabetes control could prevent 51% of heart attacks in men and 61% in women. Most noteworthy: close diabetes control prolongs life.
Erectile dysfunction (ED) is a big problem among diabetic men. This study from Seattle shows the investigation of 136, 306 men with erectile dysfunction. 19, 236 of these men had diabetes prior to their ED problem. Over a two-year observation period diabetic men had much worse ED problems. As a result they needed to receive secondary line treatments like penile suppositories or injectables. Others needed tertiary treatments like penile prostheses. In those whose diabetes control was good, oral agents as first-line therapies were usually sufficient.

More studies about risks and benefits of lifestyle

Middle-aged women with diabetes have a 4- to 5-fold higher risk for developing heart attacks while men do not show such a higher risk. It is probably particularly important for women to control diabetes when they are diagnosed with it to reduce the risk of coming down with a heart attack.
In 2011 Taylor from Newcastle University showed in a group of diabetes patients that he could cure diabetes permanently with an extremely low calorie diet. The trial was simple: he took overweight or obese patients with diabetes and put them on a starvation diet of 600-700 calories per day for 8 weeks. Consequently 43% of diabetic patients received a permanent cure of their diabetes. More info: http://nethealthbook.com/news/cure-diabetes-permanently/

Close Diabetes Control Prolongs Life

Conclusion

The new hemoglobin A1C ranges that are desirable are between 3.8% to 4.9%. When diabetics bring their hemoglobin A1C level into this range, they do not get complications from their previously poorly controlled diabetes. Close diabetes control prolongs life. But as can be seen from a brief review of the literature physicians tend to be lax, patients are lax, and diabetes is often not well controlled. This leads to erectile dysfunction in males, to heart attacks and kidney failure in both sexes. Blindness and painful diabetic neuropathy are also common complications of poorly controlled diabetes. Amputations from clogged arteries are also among the complications. “Close diabetes control prolongs life” is the new mantra that everybody with diabetes needs to follow.

Lifestyle changes control diabetes and prolong life

As stated above Dr. Taylor from Great Britain has shown that a brief 600 to 700 calorie diet can cure 43% of diabetic patients permanently. Quit smoking, bring the glycated hemoglobin (hemoglobin A1C) into the normal range, control your systolic blood pressure as well as your total and high-density lipoprotein cholesterol. Do all these things, exercise regularly, and your diabetes will be well controlled. Remember: close diabetes control prolongs life!

Sep

2017

Healthy Oils For A Healthy Body

By Ray Schilling | coconut oil, fish oil, Inflammation, olive oil, omega-3 fatty acids, polyunsaturated oil

Healthy oils for a healthy body? Quite frequently the news are full of articles that want to inform you what fat or oil to eat. At the end the consumer often faces information overload and confusion.

Here I am reviewing what we know about the various oils.

1. Coconut oil not as good as it was thought

This review article pointed out that coconut oil does elevate the bad cholesterol, called LDL cholesterol. This is not a desirable effect, as it can lead to heart disease and possibly heart attacks. On the other hand coconut oil also elevates HDL cholesterol, the good cholesterol that mobilizes LDL cholesterol. The article points out that coconut oil may be a better choice than butter. Butter does not elevate HDL cholesterol to offset the effects of LDL cholesterol. Researchers felt that the occasional use of coconut oil instead of butter would be justifiable. But they advised strongly against the daily use of coconut oil. Instead they recommended olive oil, canola or soybean oil, along with nuts and seeds, as your primary fats. I agree with olive oil, but have concerns about canola or soybean oil, as I explain it later in this article.

Dr. Andrew Weil reviewed coconut oil in Self Healing August 2014. He said that the effect on cardiovascular health remains largely unclear. He is not aware of any “study that has shown using coconut oil leads to significant weight loss”. It is basically a thumbs down assessment for coconut oil. You may want to use it occasionally for baking or a special Thai food meal.

Let’s remember that the long-lived populations such as in Okinawa and others never used coconut oil.

2. Polyunsaturated fatty acids used in processed food

A news release in 2016 describes new FDA food guidelines. They recommend that saturated fat should not exceed 10% of the total daily caloric intake, but there are still different opinions: some studies show that saturated fat may not be responsible for hardening of the arteries. Other studies have shown that breast cancer is more common in persons who consume more saturated fat .

In the 1980’s the news came out that saturated fats would be bad for arteries. At that time there was a switch to polyunsaturated fatty acids. These consist of safflower oil, canola oil, sunflower seed oil, corn oil, soybean oil and grape seed oil.

However, the irony is that these vegetable oils were highly unstable and lead to oxidation causing heart disease and cancer.

In contrast olive oil is a much more stable oil. And long-lived populations in the Mediterranean seem to be the proof, that it is a healthy fat source for them and for us.

Personally I have cut out polyunsaturated fatty acids out of my food and I suggest you do the same. We know now that polyunsaturated fatty acids lead to inflammation via the arachidonic acid pathway. This can cause gout, arthritis, diabetes, and inflammation of the arteries with subsequent clots causing heart attacks and strokes. I don’t need all of these diseases, I am doing fine without polyunsaturated fatty acids.

3. Omega-6 to omega-3 ratio

The cell membrane consists of two lipid layers at a specific ratio of omega-6 essential fatty acids and omega-3 essential fatty acids. It also contains triglycerides, phospholipids and protein. Safflower oil, canola oil, sunflower seed oil, corn oil, soybean oil and grape seed oil are mostly omega-6 fatty acids and the type of polyunsaturated fatty acids that prevail in processed foods. With the consumption of too much processed food the body has a problem constructing cell memranes. When you compare the metabolism of omega-6 fatty acids with that of omega-3 fatty acids, there is a fundamental difference. The linoleic acid of omega-6 fatty acids metabolizes into arachidonic acid, which causes pro-inflammatory mediators, PGE2 and LTB4. On the other hand with omega-3 fatty acids alpha-linolenic acid (ALA) is metabolized into EPA, DHA and the anti-inflammatory mediators PGE3 and LTB5.

Disbalanced omega-6 to omega-3 ratio

It is easy to understand why a surplus of omega-6 fatty acids from processed foods will disbalance the omega-6 to omega-3 ratio. This ratio should be 1:1 to 3:1, but many Americans’ omega-6 to omega-3 ratio is 6:1 to 18:1. Omega-6-fatty acids cause arthritis, heart disease and strokes. Be particularly careful in avoiding soybean oil, which is the most popular oil in the last few decades to foul up the omega-6 to omega-3 ratio through processed foods. Read labels to avoid soybean oil and other omega-6 fatty acids.

When it comes to balancing omega-3 and omega-6 fatty acids in your diet, be aware that nutritional balancing can help you restore the ideal omega-6 to omega-3 ratio of 1:1 to 3:1. An easy way is to simply cut out processed foods as much as possible. Supplement with molecularly distilled fish oil capsules to add more omega-3 fatty acids into your food intake.

4. Fish oil

What we learned from this is the importance of fish oil as a supply of omega-3 fatty acids. But nuts also supply us with omega-3 fatty acids. Eating fish three times per week is another way to get enough fish oil on board. There is a word of caution. Our oceans are so contaminated with mercury that you want to be careful and eat only fish low in mercury content. Avoid swordfish, tuna fish or grouper.

But wild salmon and mackerel are fish low in mercury and safe to eat. I would recommend that you eat seafood at least three times per week to have a good source of omega-3 fatty acid. In addition I would also recommend you take omega-3 supplements. I take it in the form of molecularly distilled high potency omega-3. I take 2 capsules twice a day. In addition I take 750 mg of krill oil once per day, another source of molecularly distilled marine omega-3 supplement.

5. Cold pressed virgin olive oil

Organic olive oil contains monounsaturated fatty acids that are neutral in terms of effects on the cardiovascular system. But it also contains a lot of polyphenols and among these in particular hydroxytyrosol that lower blood pressure and protects you from hardening of the arteries. This likely is the main reason why the Mediterranean diet is so healthy, apart from its emphasis on vegetables, which further makes it desirable. In a 2012 study from Spain it was found that mortality from heart attacks was 44% lower than that of a control group who did not incorporate olive oil in their diet.

Only two tablespoons of virgin olive oil per day protect you from heart disease. It does so by reducing the total cholesterol level in the blood as well as the LDL cholesterol level. At the same time the more polyphenol is contained in olive oil (such as in extra virgin olive oil), the more HDL your body will produce, which is essential to extract oxidized LDL from arterial plaque. On top of that polyphenol rich olive oil will increase the size of the HDL particles (these larger particles are called HDL2), which are more efficient in extracting oxidized LDL from arterial plaque.

Effects of olive oil

Olive oil has been shown to lower blood pressure and prevents heart attacks and strokes.

A Sept. 2014 study in humans showed that higher polyphenol olive oil as found in extra virgin olive oil caused an increase in the more effective HDL2 particles, which cleans out plaque from arteries more efficiently than the regular, cheaper olive oil. You should use mainly olive oil for your regular cooking. Cold pressed, virgin olive oil is more expensive than the regular olive oil, but this is what has been proven to enhance health and to prolong life, if you consume it regularly.

Healthy Oils For A Healthy Body

Conclusion

Sometimes it is useful to think about what fats you are consuming. We tend to eat too many omega-6 fatty acids from processed foods. These are polyunsaturated fatty acids found in safflower oil, canola oil, sunflower seed oil, corn oil, soybean oil and grape seed oil. Food merchants use these polyunsaturated fatty acids to have a longer shelf life of their products. But the more omega-6 fatty acids we consume, the higher the omega-6 to omega-3 ratio gets. This leads to inflammation in the body and the arteries. It causes heart attacks, strokes and other illnesses. Years ago I cut polyunsaturated fatty acids out of my food intake. Instead I use organic cold pressed extra virgin olive oil. It is full of polyphenols (and among these in particular hydroxytyrosol). It lowers blood pressure and prevents heart attacks and strokes. I am not convinced that the hype around coconut oil can be verified. At this point I would suggest only occasional use of it.

You need to eat fish three times per week and other seafood as a source of omega-3 fatty acids. This is important to keep your omega-6 to omega-3 ratio well balanced. I also take fish oil supplements regularly like krill oil once daily and fish oil capsules twice a day. You can buy these molecularly distilled to ensure they are mercury contamination free.

Sep

2017

Resveratrol Effective In Humans

By Ray Schilling | Alzheimer’s disease, Anti-aging medicine, Arthritis, Cancer, Cardiovascular disease, Diabetes, diet, heart attack, High Blood Pressure, Inflammation, mitochondria, Mortality, Nutrition, Osteoporosis, Stroke, telomeres

Resveratrol is a powerful antioxidant; but is resveratrol effective in humans?

Quack watch says: don’t buy into the hype that resveratrol is effective in humans.
WebMD claims that there would not be enough medical evidence to say that the average person should supplement with resveratrol to receive benefits.

Despite these recommendations the following evidence supports that resveratrol is indeed effective in humans.

Resveratrol effective in humans: high blood pressure patients

First of all, a 2017 study of high blood pressure patients examined resveratrol supplementation with two groups, 46 stage 1 hypertension patients and 51 stage 2 hypertension patients. Stage 1 hypertension had a systolic blood pressure of 140–159 mmHg and a diastolic blood pressure of 90–99 mmHg. Stage 2 hypertension had a systolic blood pressure of 160–179 mmHg and a diastolic blood pressure of 100–109 mmHg. Analysts divided both stage 1 and 2 subgroups into two groups, one receiving regular antihypertensive medication, and the other group receiving regular antihypertensive medication plus Evelor. Evelor is a micronized formulation of resveratrol. The trial lasted two years.

Blood pressure lowering effect of resveratrol

The purpose of the trial was to determine the effect of resveratrol. added to the regular antihypertensive medication (or not) to see whether it had blood pressure lowering effects. The interesting result showed that the resveratrol addition was sufficient to bring the blood pressure down to normal levels with only one antihypertensive drug. The control group without resveratrol needed two or three drugs to get the blood pressure under control. In addition, liver function tests showed that resveratrol normalized negative side effects of the antihypertensive drug on the liver. Both liver enzymes, glutamate-pyruvate transaminase (SGPT) and gammaglutamyl transferase (Gamma-GT) were normal in the resveratrol group.

Resveratrol effective in humans: diabetes patients

Diabetes patients can get help with resveratrol. Resveratrol, the bioflavonoid from red wine is a powerful anti-inflammatory. This antioxidant has several other effects, which make it challenging to measure each effect by itself. Another group of investigators managed to simultaneously measure these effects. They found that resveratrol lowered the C-reactive protein by 26% and tumor necrosis factor-alpha by 19.8%. Resveratrol also decreased fasting blood sugar and insulin; in addition it reduced hemoglobin A1C and insulin resistance. The recommended daily dose of resveratrol was 1000 to 5000 mg.

Resveratrol effective in humans: improves bone density

Furthermore, resveratrol improves bone density in men: 66 middle-aged obese men with an average age of 49.3 years and a mean body mass index of 33.7 were recruited for this randomized, double blind, placebo-controlled trial. The purpose was to study whether there would be changes in bone turnover markers (LDH, an enzyme involved in bone turnover), but also whether bone mineral density (BMD) would increase. The researchers gave resveratrol to a high group (1000 mg per day), a low group (150 mg) and the third group received a placebo (fake pills). The end point was an elevation of the bone alkaline phosphatase (BAP). The investigators measured this in the beginning of the study and at 4, 8 and 16 weeks.

Difference between high and low dose resveratrol

The high group of resveratrol had a 16% increase of the BAP throughout the study and a 2.6% in lumbar spine bone density (measured by a trabecular volumetric method). The low resveratrol group showed no bone restoring effect. MJ Ornstrup, MD, the lead investigator said that this was the first time that a clinical team has proven that resveratrol can serve as an anti-osteoporosis drug in humans. She added that resveratrol appears to stimulate bone-forming cells within the body.

Resveratrol effective in humans: anti-aging effects

Finally, the Nurses’ Health Study showed that both a Mediterranean diet and resveratrol can elongate telomeres.

The fact that you can have a longer life with a Mediterranean diet is common knowledge for some time. But now a study has shown that the reason for a longer life is the fact that telomeres get elongated from the Mediterranean diet. Telomeres are the caps at the end of chromosomes, and they get shorter with each cell division. This is the normal aging process.

Important information from the Nurses’ Health Study

The finding of elongated telomeres comes from the ongoing Nurses’ Health Study that started enrolling subjects in 1976. At that time 121 700 nurses from 11 states enrolled in the study. In 1980 participants filled in diet sheets to determine who was adhering to a Mediterranean diet. The researchers accepted 4676 middle-aged participants in this study. This diet consists of a combination of vegetables, legumes, fruits, nuts, grains and olive oil. They also consumed fish and lean meats. The control group followed a regular diet. Between 1989 and 1990 blood tests were obtained to measure telomere length in white blood cells. It is known that smoking, stress and inflammation shortens telomeres.

Slowed telomere shortening

The lead author Marta Crous-Bou stated that overall healthy eating was responsible for longer telomeres in comparison to the control group. But the strongest association was in women eating a Mediterranean diet in comparison to the controls. For the best diet adherence score there was a 4.5 year longer life expectancy due to slowed telomere shortening.

Resveratrol lengthens telomeres

Longer telomeres associated with the lowest risk to develop chronic diseases and the highest probability of an increase of the life span. I have reviewed the importance of lifestyle factors in this blog where I pointed out that Dr. Chang found a whole host of factors that can elongate telomeres by stimulating telomerase. Research in humans supports the notion that an increase in physical activity elongates telomeres. So did vitamin C, E and vitamin D3 supplementation, resveratrol, a Mediterranean diet and marine omega-3 fatty acid supplementation. In addition higher fiber intake, bioidentical estrogen and progesterone replacement in aging women and testosterone in aging men, as well as relaxation techniques like yoga and meditation are also elongating telomeres.

Aging is due to shortening of telomeres. Elongation of telomeres by resveratrol leads to prolonged life (or anti-aging).

Resveratrol effective in humans: resveratrol and cancer

In addition, this overview shows, it seems that several mechanisms of action give resveratrol the power to be an anticancer agent. Resveratrol is anti-proliferative and has anti-angiogenesis mechanisms. In addition resveratrol stimulates apoptosis, which is programmed cell death. All these actions together help resveratrol to have anticancer properties. Resveratrol is also useful in combination with other cancer treatments, which improves survival figures. As the link above explains, there is a need for more cancer clinical trials with a variety of cancers and larger patient numbers. Many smaller clinical trials have already been very successful showing efficacy of resveratrol as a chemotherapeutic agent.

Resveratrol is anti-inflammatory

Also, in this 2015 publication about malignancies and resveratrol an overview is given about the use of resveratrol and cancer treatment. It summarizes that the development of cancer is a multifactorial process that involves the 3 stages of initiation, promotion and progression. One of the cancer promoting factors is chronic inflammation. Resveratrol has anti-inflammatory qualities. At this point it is not clear how the animal experiments will translate into the human situation. More clinical observations are necessary.

Resveratrol effective in humans: cardiovascular disease

Resveratrol has beneficial effects on preventing hardening of the arteries, diabetes, various cancers and inflammatory conditions like Crohn’s disease and arthritis. Furthermore, as this link explains resveratrol also stimulates the antiaging gene SIRT1 by 13-fold. This confirms the anti-aging effect of resveratrol. This 2012 study confirmed that it is resveratrol from red wine that is responsible for the “French paradox” (longer life expectancy despite high saturated fat intake).

Resveratrol effective in humans: polycystic ovarian syndrome

Similarly, polycystic ovarian syndrome could be significantly healed with resveratrol in a randomized, double blind, placebo-controlled trial. It involved 30 subjects who completed the trial. Each of the subjects received 1500 mg of resveratrol or placebo daily for 3 months. Measurements showed a decrease of serum total testosterone by 23.1% at the end of 3 months in the experimental group versus the placebo group. There was also a decrease of dehydroepiandrosterone sulfate of 22.2%.There was a reduction of the fasting insulin level by 31.8%. At the same time there was an increase of the insulin sensitivity by 66.3%. The authors concluded that resveratrol had significantly reduced ovarian and adrenal gland male hormones (androgens). This may be in part from the drop in insulin levels and the increase of insulin sensitivity.

Resveratrol effective in humans: anti-arteriosclerotic effects in diabetics

Most noteworthy, a double blind, randomized, placebo-controlled study was done on 50 diabetics. Arterial stiffness was determined by the cardio-ankle vascular index (CAVI). The purpose of this study was to determine the effect of resveratrol on the stiffness of arteries in a group of diabetics and compare this to a placebo. Diabetics have premature hardening of the arteries (arteriosclerotic changes). After 12 weeks of taking 100 mg of resveratrol per day there was a significant reduction in arterial stiffness in the experimental group, but not in the placebo group. Blood pressure also decreased by 5 mm mercury (systolic) in the experimental group.

Resveratrol effective in humans: ulcerative colitis patients

Finally, 56 patients with mild to moderate ulcerative colitis received 500 mg of resveratrol or placebo and were observed for 6 weeks. This was a randomized, double blind, placebo-controlled pilot study. The researchers used bowel disease questionnaires to assess the bowel disease activity before and after the treatment. The resveratrol group decreased the disease activity significantly, but it also increased their quality of life. Blood tests showed that this improvement occurred as a result of reducing oxidative stress by resveratrol.

Resveratrol effective in humans: Alzheimer’s disease prevention

Here is a study where 52 Alzheimer’s patients were divided into two groups; one group received 200 mg of resveratrol for a number of weeks, the other group placebo pills. There was a significant improvement in memory tests in the resveratrol group and functional MRI scans showed better functional connectivity in the hippocampi of the subjects. The hippocampus is the seat for short-term memory, which is not functioning normally in Alzheimer’s patients.

Resveratrol Effective In Humans

Conclusion

Resveratrol has a long history of showing evidence of improving health. It does so by countering oxidation of LDL cholesterol, which lessens hardening of arteries. This prevents heart attacks and strokes. Resveratrol is also a powerful anti-inflammatory, which helps patients with diabetes, with Crohn’s disease and arthritis. There is even a cancer preventing effect of resveratrol because of anti-proliferative and anti-angiogenesis effects as well as stimulating apoptosis. These combined anticancer properties make resveratrol a chemotherapeutic agent. It is also effective in combination with conventional anticancer drugs.

Resveratrol helps prevent hardening of arteries and cancer

There are enough randomized, double blind, placebo-controlled trials in humans to show that resveratrol is effective in preventing and treating several disease conditions. The medical establishment claims that there would not be enough medical evidence to say that the average person should supplement with resveratrol to receive health benefits. After my review outlined above I come to the opposite conclusion. It is quite clear that resveratrol has several important healing properties. It can improve diabetes; prevent hardening of arteries, lower blood pressure, attack osteoporosis and prevent Alzheimer’s disease. I have been taking 500 mg of resveratrol daily for years. It has not harmed me.

Aug

2017

Decreased Sperm Counts In Men

By Ray Schilling | alcohol, autoimmune disease, blood test, diet, Drugs, Hormones, Infectious Disease, Infertility, Medical Condition, toxins

What do decreased sperm counts in men tell us about our world? A recent study has shown that over the past 40 years males in many centers that tested for sperm counts have lost 50% of the sperm count that was normal in the 1970’s. The question is, what could have caused this? Nobody has definite answers. But here are the factors that the Mayo Clinic lists for low sperm counts.

Medical causes of decreased sperm counts in men

A varicocele: A varicocele is dilatation of veins close to the testicles. It is presumed that this leads to a higher temperature inside the testicles and this causes a lowered sperm count and poor sperm quality.
Antisperm antibodies can cause infertility. Due to low sperm counts.
Infections in the testicles reduce sperm production. Gonorrhea and HIV infection are some of the common infections.
Some men develop retrograde ejaculation. With this the sperm enter the bladder on ejaculation instead of coming out from the tip of the penis. Alpha-blockers, a type of blood pressure medication can do this as a side effect. But there are also various health problems that can cause retrograde ejaculation like diabetes, surgery to the prostate, urethra and bladder. Spinal injuries can be also a cause of retrograde ejaculations. In many cases the sperm production in the testicles is still present and sperm could be sampled from there for artificial insemination.
Tumors of the pituitary gland can interfere with hormone production of testosterone and sperm counts will fall or stop. But other pituitary hormones, thyroid hormone and adrenal gland hormones are needed for fertility.
Chromosome defects like Klinefelter syndrome and others can be a cause of abnormal development of the male genitals with low or missing sperm production.
Celiac disease is a bowel disease that is due to gluten sensitivity. It causes low sperm counts and infertility, which responds to a gluten free diet. Sperm counts normalize with this diet.
There are medications that can decrease sperm production like chemotherapy, anabolic steroid use, antifungals and certain antibiotic medications and some ulcer medications.

Lifestyle causes leading to decreased sperm counts in men

Certain lifestyles and occupations can cause a man to have a decreased sperm count.

Drinking alcohol excessively can reduce testosterone production, which decreases sperm count.
Recreational drug use: steroids to increase muscle mass cause testicular atrophy and decreased sperm count. Cocaine and marihuana also decreases the sperm count.
Certain occupations like welding from exposure to heat and truck driving from prolonged sitting have been associated in some studies with infertility. But there are other studies that could not confirm this correlation.
Smoking: Men who smoke have lower sperm counts than men who don’t smoke.
Excessive weight: Obese men transform some of their testosterone into estrogen through the action of the enzyme aromatase, which is amply present in fat cells. This leads to low testosterone levels and low sperm counts.

Environmental causes of decreased sperm counts in men

The environment in terms of heat production around the scrotum or exposure to chemicals or ionizing radiation can lower sperm counts in men.

Heat around the testicles: studies do not all agree, but there is a tendency for low sperm counts when using saunas and hot tubs frequently. Sitting for longer times or using a laptop computer for longer periods can also increase the temperature of a man’s scrotum and lead to a low sperm count.
Exposure to heavy metals like lead, mercury and others can be the cause of infertility.
Exposure to radiation can reduce sperm production. With high doses of radiation sperm production may cease entirely. With lower radiation exposures sperm counts may be down for several years before they recover to normal.
Industrial chemicals: exposure to fumes from certain chemicals can lead to low sperm counts; benzenes, herbicides, pesticides, xylene, toluene, painting materials and organic solvents are on this list.

Recent study about decreased sperm counts in men as an indicator

We have now reviewed the major causes of low sperm counts in men. I like to revisit the recent sperm study I mentioned in the beginning of this blog. It is unlikely that men in North America, Europe and Australia would spontaneously produce less than 50% of the sperm than men 40 years earlier had produced. The next puzzling fact is that the study found normal sperm production in men in Africa, South America and Asia.

This points to epidemiological differences that reduce the sperm count in men in North America, Europe and Australia. In view of the multitude of possible causes it will require a task force that does a comparative study worldwide looking at exposure history, diets, social habits and other factors.

Fertility clinics are thriving because couples want children. With low sperm counts of males there is more infertility than there was in the past. Density gradient centrifugation is a reliable method of enriching sperm counts.

In the past a couple had no problem getting a successful pregnancy when they wanted it. Now couples often have to be assessed in a fertility clinic because of problems with regard to decreased sperm counts in men, which can cause infertility.

Decreased Sperm Counts In Men

Conclusion

A new study has noticed that over the past 40 years many men have developed low sperm counts. This has caused significant problems with fertility among couples. Fertility clinics are busy trying to help these couples. Density gradient centrifugation has become a common technique to enrich sperm samples prior to artificial insemination. It is a puzzle why the recent study has found normal sperm counts in samples of men living in Africa, South America and Asia. In contrast men living in Europe, North America and Australia have 50% lower sperm counts. The reason may be multifactorial. It will require a team of experts to sort out this discrepancy and hopefully find an answer for men in Europe, North America and Australia to bring their sperm counts back to normal.

Aug

2017

No More Macaroni And Cheese

By Ray Schilling | diet, Nutrition, toxins

Two years ago Kraft’s was in the news and I said then “no more macaroni and cheese”. At that time they promised to make macaroni and cheese more nutritious by removing artificial coloring and artificial flavors. Now they are in the news because industrial chemical phthalates have been found in almost every sample of cheese powder that is used to make macaroni and cheese.

Phthalates are powerful hormone-disrupting chemicals that are toxic to children and pregnant women. Most noteworthy, abnormal brain development and abnormalities of the reproductive system have a connection to prenatal exposure to phthalates. Potentially 725,000 American women of childbearing age are at risk. Should they get pregnant, their babies would be at the receiving end of toxic phthalates. In Europe new regulations about phthalates were introduced in 2011. In contrast, in North America the FDA has been negligent in enforcing legislation to keep the US population free of phthalates in their food.

Background information about phthalates

Phthalates are industrial chemicals that are widely used in cleaning agents like soaps, plastics, rubbers, inks, adhesives and fragrances. Phthalates in plastic materials increases the durability and longevity, but also the flexibility and transparency of plastic.

The Center for Disease Control and Prevention describes on its website how a large percentage of the population has phthalates in their urine. This proves that unsuspecting customers are ingesting phthalates, which potentially poses a tremendous challenge.

In Europe vigorous legislation is in place regarding phthalates. Should they more vigorously legislated in the US?

Effects of phthalates on body

It seems that males are more sensitive to the toxic effects of phthalates than females. Males experience testicular atrophy and shrinking of the prostate gland. The sperm count goes down, which can lead to infertility. Pregnant women are at risk of having babies with genetic defects due to exposure to phthalates. Many cosmetic products contain phthalates. Due to lax FDA supervision there is no labeling on many cosmetics, yet they contain phthalates (lipsticks, make-up).

Apart from infertility issues phthalates are also responsible for allergies, some cases of obesity, asthma and breast cancer.

There are other clinical conditions that have been linked to phthalate exposure. Behavioral issues, autism spectrum disorder, type 2 diabetes, low IQ and neurodevelopmental issues. A lot of these problems could disappear with more awareness of the public, stricter labeling rules of the regulatory agencies and more responsibility shown by manufacturers.

Why nutritionists don’t like macaroni and cheese

Macaroni and cheese belongs into the group of junk foods. In the past it was artificial coloring and artificial flavors that were the concern. Now it came to light that phthalates have contaminated the fat-containing cheese from the packaging. The soft plastic cheese packages contain phthalates and they easily blend with fatty cheese, because phthalates are fat-soluble. This is the reason why I say: no more macaroni and cheese!

From a nutritional point of view macaronis are simply empty starch. The digestive process quickly turns it into sugar and causes a sugar peak in the blood. High blood sugar causes an insulin peak. Repeated insulin peaks show a connection to premature aging, obesity and type 2 diabetes.

Cheese in macaroni and cheese is the cheapest processed cheese. Here is a summary of what macaroni and cheese contains. In this recipe the cheese portion comes from processed cheddar cheese. But in many macaroni and cheese packages the cheese portion comes from of a mix of protein, fat and milk powder and this mix has nothing to do with cheese. It just tastes like cheese. But all of the cheese powder packages have in common that in 29 out of 30 of the packages tested phthalates were contained in the cheese powder.

The package included a plastic coating containing the phthalates. This leeched into the cheese powder, because phthalates are fat-soluble.

No More Macaroni And Cheese: Toxic “food” is non-food

The problem with macaroni and cheese in today’s society is that it is a form of processed food. The more food is processed, the higher the risk that there is a loss of valuable nutrients. Unfortunately with food processing there is the need to use a food container where the food is stored. But up to now nobody thought that the ubiquitous phthalates that keep the plastic material of the food container flexible and longer lasting could pose any threat to our health by leaking into fatty foods.

However, we did have problems with PBA’s not long ago; they were leaking from baby bottles into baby food. The solution was to abandon BPA bottles.

We have to rethink the whole scenario. As this link shows there are many other chemicals in plastic that can also be toxic.

We can work on the food side and avoid as much processed food as possible. Buy fresh ingredients that you bring home and store in your fridge. Avoid plastic bags. Use glass containers as they are safe (not leaking chemicals into food).

What can you do, if you want no more macaroni and cheese?

Stop buying macaroni and cheese as processed food. Buy ingredients to make them yourself at home. Here is a recipe of how to make macaroni and cheese: You may in the past have thought that it is much easier to just buy macaroni and cheese in the store. But this is where the phthalates come in. It is our laziness that allows food processors to slip chemicals into our food that could damage us; and some of these potentially harmful chemicals are phthalates. Phthalates probably slipped into our food unintentionally because they are so extremely fat-soluble that they get into the cheese part of macaroni and cheese.

If you want to eat macaroni and cheese, make it yourself as per the recipe provided with the link above.

But I went one step further. I have abandoned macaroni and cheese altogether. We don’t need the extra insulin response from the macaroni as we digest them. Next I also do not need the extra processed cheese, as the fats are not the healthiest. If I want some cheese, I can cut a few slices from an honest organic cheese that originates from organic milk from cows that were grazing on grass.

I like eating diversified food from many healthy sources.

Conclusion

Sometimes we need to rethink the food that we eat. Do we want to eat macaroni and cheese, because it reminds us of how we grew up? When you hear that processed foods contain toxic phthalates, you may also say as I do: “No more macaroni and cheese!” As I mentioned, if you really want to eat it, cook it yourself from the basic, healthy ingredients. But I decided no more macaroni and cheese for me, because it is not that healthy. There are healthier foods that I’d rather eat instead.

If more of us would shun processed foods, then the food industry would have to adapt to the population’s healthier food habits and come up with healthier products. We also would significantly reduce our exposure to phthalates that find their way into the food chain from food containers. Rethink your food habits and perhaps one day you can agree with me: “I don’t want non-nutritious processed food! No more macaroni and cheese!”

Aug

2017

Curcumin And Cancer

By Ray Schilling | breast cancer, Cancer, diet, Mortality

Many clinicians give their attention to curcumin and cancer. Physicians may use curcumin not as a primary treatment, but may add it as an adjunct to other cancer treatments. Curcumin is the effective ingredient of the old Indian spice, turmeric. The question is how effective curcumin is against cancer? Is it safe to use? What is the evidence?

Frequency of cancer

According to the American Cancer Society there will be 1,688,780 new cancer cases in 2017 and 600,920 cancer deaths will occur in the US.

Causes of cancer

There are many different causes for cancer. Hidden in the many causes may be the possible solution to new cures.

Lack of exercise

A lack of exercise may contribute to the development of cancer because of a lack of tissue circulation. And exercise will help to support your normal cell metabolism (explained below). Wrong foods may or may not have a contributory role regarding cancer development (a high sugar and starch diet causing insulin response, which changes the metabolism). The Mediterranean diet is an anti-inflammatory diet and has been credited to prevent a lot of cancers.

Carcinogens

Chemicals, called carcinogens can cause cancer. But oncoviruses can also cause it. Genetic mutations can also cause cancer. That’s why it tends to run more often in certain cancer prone families. But Warburg has researched the metabolism of cancer almost 100 years ago, even got the Nobel price for it in 1931 and yet the elusive cancer cure has not materialized yet.

DNA mutations, tumor suppressor genes metabolic difference between cancer cells and normal cells

Following Warburg’s research Watson/Crick detected DNA in our cells. Ever since geneticists found this fascinating by it. They also found that a cancer suppressive gene, regulated by the p53 gene could develop mutations and then cancer would occur: tumor suppressor genes. For decades this was the “in” thing. But in the last 5 to 10 years there is a revitalization of the original Warburg idea that one should concentrate on the metabolic differences between cancer cells and normal cells. This is starting to show some timid results. Cancer cells are more acidic from lactic acid and burn glucose for energy without requiring oxygen (anaerobic pathway), while normal cells burn glucose in the aerobic pathway in the mitochondria. This difference is important. Certain manipulations are more likely to kill cancer cells.

Cryoablation therapy for prostate cancer

Take cryoablation therapy for prostate cancer. Cryosurgery for prostate cancer. A local deep freeze method like cryoablation therapy kills the more vulnerable cancer cells preferentially leaving the normal cells intact. Another example is photodynamic therapy for cancer that has been used for lung cancer and esophageal cancer. This method may be a lot more universally applicable than believed so far. The physician injects a photosensitized dye, which is normal cells eliminate, but cancer cells retain. Next the physician uses a laser beam that kills the cancer cells preferentially by absorbing the specific laser wavelength that is specific for the dye.

Consumer driven cancer therapies

Nobody knows which way cancer research is going. But I think that consumers will drive this: consumers want better cures. When new methods have better cure rates, consumers will demand treatments with these. Less effective methods will become history. I think that researchers will revitalize Warburg’s ideas and develop new therapies from this as I indicated.

Curcumin and cancer: malignant conversion

There are three development stages for any cancer to develop.

Originally cancer researchers used skin cancers a model. Later they could confirm that initiation, promotion and progression also were present with the development of cervical cancer. The name for this is “malignant conversion”. This needs to happen before a normal cell transforms into a cancer cell. Here are the three stages.

Initiation
Promotion
Progression

This is important to know in the context of curcumin. Basic research has shown that curcumin interferes with all of these stages of tumor development, both in terms of prevention as well as in terms of being curative. Here is a link that points out the complex multiple steps of cancer growth that curcumin interferes with.

Multiple actions of curcumin

As can be seen from it, curcumin interferes with the initiation of multiple cancers, reduces inflammation, and interferes with angiogenesis and this reduces the amount of metastases that can form. But curcumin further interferes with proliferation of cancer cells, reduces invasion, prevents resistance and improves survival. The underlying molecular and genetic reasons for curcumin’s actions are all contained in that link.

Curcumin and cancer: research in tissue culture and animal experiments

When it comes to cancer research, you usually hear about in vitro culture experiments and animal experiments. This type of research is used to establish that there is an anti-cancer effect, that it is reproducible and non-toxic. The September issue of the 2016 Life Extension Magazine reviewed this in detail. It was entitled “How Curcumin Targets Cancer”.

But as a former clinician I am more interested in seeing cancer patients cured. This has to be verified by clinical trials first. When I looked through PubMed.com for objective evidence of the effects of curcumin in cancer patients, this type of information was more difficult to find. But in the following there are a number of examples that I did find.

Curcumin and cancer: clinical trials

1. Reduction of tumor necrosis factor-alpha

A 2016 meta-analysis of eight randomized studies investigated the effect of curcumin in patients with various inflammatory diseases including cancer. They found that curcumin consistently reduced tumor necrosis factor-alpha. In cancer patients this inflammatory substance is responsible for further cancer growth and developments of metastases.

2. Poor bioavailability of curcumin

A study with increasing amounts of curcumin showed poor absorption of curcumin into the blood. In this study researchers were giving dosages between 500 mg up to 12,000 mg per day of curcumin. 500 mg to 8000 mg of curcumin did not result in any positive serum level of curcumin. Only the higher dosages, 10,000 and 12,000 mg of curcumin, caused positive curcumin levels in the blood. Patients have to take higher amounts of curcumin to have a clinical response. Toxicity studies were done when using higher amounts of curcumin. The results showed taht it was safe and patients tolerated high dose curcumin fairly well.

3. Precancerous colonic polyps reduced in number and size

A smaller study consisted of 5 subjects with familial adenomatous polyposis (FAP). This is an autosomal-dominant disorder where hundreds of colorectal adenomas develop in the lining of the colon. From these colorectal cancer can arise. Five patients received 480 mg of curcumin and 20 mg quercetin orally three times per day. After 6 months the number of polyps and the size had reduced by 60.4%.

4. Premalignant colonic lesions suppressed by curcumin

44 eligible smoker subjects received a baseline colonoscopy where aberrant crypt foci (ACF) were determined. ACI are the very first focal areas in the colon that lead to colon cancer. Smokers have more of these lesions, which was the reason that researchers chose smoker subjects for this trial. The patients received either a supplement of 2000 mg of curcumin or 4000 mg of curcumin for 30 days. These are fairly high doses. They were used to overcome the poor absorption of curcumin. Colonoscopies were done again after one month of curcumin supplementation. 41 subjects completed the study. In the 4000 mg curcumin group the ACF numbers were reduced significantly by 40% compared to the 2000 mg group, which showed no reduction. The 4000 mg group showed a 5-fold increase of curcumin blood levels compared to baseline. The 2000 mg group had no change in blood levels.

5. Reduction of radiation dermatitis with radiation therapy in breast cancer patients

30 breast cancer patients were divided into an experimental group and a placebo group. All of them had a mastectomy first and subsequently radiation therapy. The experimental group received 6 grams (2 grams three times per day) of curcumin during the time of radiotherapy following mastectomy. The experimental group had significantly reduced radiation dermatitis following radiotherapy when compared to the placebo group. Only 28.6% had significant radiation dermatitis in the curcumin group versus 87.5% in the placebo group.

6. Chronic multiple myeloma patients

An Australian study involving chronic multiple myeloma patients found that curcumin at 4 Grams per day and even more so at 8 Grams per day stabilized the disease and improved kidney function.

7. Descriptive studies

Descriptive studies investigating the effect of various doses of curcumin have been done regarding breast cancer, and advanced pancreatic cancer. But these clinical trials were all rather small.

8. Chemoprevention of cancer

A phase II trial enrolled 21 patients with end-stage pancreatic cancer patients. The only FDA approved treatments for this are gemcitabine and erlotinib, but this would normally only lead to clinical responses in less than10% of patients. In this study the investigators used curcumin to enhance the anti-tumor response of either gemcitabine or erlotinib. The study summary stated: “Oral curcumin is well tolerated and, despite its limited absorption, has biological activity in some patients with pancreatic cancer.” 2 of the 21 patients had stable disease for more than 18 months; one of the 21 patients had a brief tumor regression of 78%, but then relapsed and died.

9. Chemoprevention of prostate cancer

Chemoprevention of prostate cancer is discussed in this publication: There was specific reference made to prevention of prostate cancer and the opinion of the researchers was: “At present, there is no convincing clinical proof or evidence that the cited phytochemicals might be used in an attempt to cure cancer of the prostate.”

Curcumin And Cancer

Conclusion

For years there have been reports to indicate that curcumin was a promising natural supplement that can improve cancer survival. Many clinical trials regarding the effects of curcumin on colorectal cancer, pancreas cancer, prostate cancer, breast cancer, ovarian cancer and others had a poor design. But on closer look the hype seems to come mostly from in vitro studies (tissue culture experiments) or from animal studies. Clinicians, however, demand well-constructed randomized clinical trials with clear research objectives before they can accept a new agent like curcumin to be effective. These clinical trials are missing! Instead there are many in-between trials of questionable quality as listed above.

Problems with bioavailability of curcumin

There have been problems of bioavailability due to poor absorption of curcumin. Pushing the dosage to 6000 to 8000 mg per day succeeded in overcoming this limitation to a certain extent. But a significant percentage of people (around 30%) suffered from abdominal cramps and nausea and had to discontinue these high doses of curcumin. Researchers have developed newer curcumin compounds, but at this point it is unknown what the bioequivalent dosage is of these newer curcumin agents in comparison to the original curcumin dosages.

It is quite possible that researchers will one day design clinical trials that will bring better news on survival rates of various cancer patients involving curcumin therapy. But in my opinion right now it is not yet prime time for curcumin!

Aug

2017

Death From Heartburn Drugs

By Ray Schilling | Cardiovascular disease, fractures, Gastrointestinal Disease, heart attack, Mortality, ulcers

A study was recently published showing that death from heartburn drugs can come early, when compared to controls. The study was published in June 2017 in the online British Medical Journal Open. The researchers were located at the Washington University School of Medicine, Saint Louis, Missouri, USA.

They compared 349, 312 US veterans on proton pump inhibitors (PPI) to an equal amount of veterans on conventional H2 blockers. Over a follow-up period of 5.71 years there was an increased risk of death of 25% when patients took PPI drugs. No matter to what the researchers compared the PPI group to, there were always more deaths in the PPI group versus other control groups.

Causes of death

According to the senior author, Dr. Ziyad Al-Aly many deaths were due to kidney disease, dementia, fractures, pneumonia, Clostridium difficile infections and cardiovascular disease. Out of 500 patients who took the PPI drug there was one death within one year. But over the years the deaths increased. Dr. Al-Aly thinks that the PPI drug is interfering in some way with the genetic expression of some genes and suppressing others. These genetic differences may explain the early deaths.

As this was a retrospective study, it can only show an association of PPI drugs with earlier deaths, but this does not prove causation. It would require a prospective random study to prove causation.

Other studies regarding the risk of PPI drugs

An Icelandic study from May 2017 showed that there was a 30% increased risk of fractures in males and females following PPI drugs when observed over 10 years. Opiates had a risk of almost 50%, sedatives a 40% risk of increased fractures. Control groups of NSAIDs, statins and beta-blockers showed no increased fracture risk, nor did histamine H2-antagonists.

Side effects of PPI’s

An article from March 2017 is a critical review of the safety of PPI drugs. It notices that with long-term use there are adverse effects like fractures of the long bones, enteric infections and hypomagnesemia. PPI’s can increase the risk for heart attacks and can cause kidney disease and dementia. One of the problems is that gastroesophageal reflux usually dictates the long term use of anti acid drugs like PPI’s, but the longer patients are taking these drugs, the higher the death rate and side-effect rate. The physician should only use PPI drugs initially and after a few weeks switch to the less potent histamine H2-antagonists (like ranitidine).

Listeriosis as side effect of PPI’s

A Danish study from April 2017 noted an increased risk for listeriosis in patients who were on PPI drugs. Over 5 years there was a 2.81-fold higher risk of developing listeriosis in patients on PPI’s compared to a control group. If patients were on corticosteroids and a PPI the risk was even higher, namely 4.61-fold increase to develop listeriosis. In contrast, using histamine H2-antagonists had a risk of only 1.82-fold of developing listeriosis.

Poor prescribing habits for PPI’s

A Dec. 2016 study from Dublin, Ireland with patients older than 65 examined their PPI drug use. The comparison of data occurred between 1997 and for 2012. The researchers noted that the maximal PPI dose for long-term use was 0.8% of individuals in 1997 and 23.6% in 2012. The risk of prescribing high dose PPI drugs in 2012 was 6.3-fold in comparison to the risk in 1997. Examination of the health records showed that the indication for prescribing PPI drugs had no correlation with significant gastrointestinal bleeding risk factors. The study concluded that there was definitely room for improving prescribing habits.

Triple therapy

This January 2016 paper describes the standard treatment of H. pylori and gastric and duodenal ulcer treatment, which involves the triple therapy consisting of a PPI and two antibiotics. It pointed out that this treatment protocol “improves healing and prevents complications and recurrences”.

PPI’s causing risk for fractures

A paper from Leipzig, Germany dated July 2016 reviews the usage of PPIs. It mentions that there has been a significant increase of prescriptions in the past 25 years. Patients on PPI’ are at a greater risk for fractures. There is also a risk of low B12 levels from malabsorption of B12. The physician should check this from time to time, and if necessary give B12 injections.

Clostridium difficile infections

A Canadian study from May 2015 found that Clostridium difficile infections (CDI) were linked to chronic antibiotic use or to prolonged use of high doses of PPI drugs. There was a 1.5-fold risk of recurrent CDI in patients older than 75 years who were taking PPI drugs continuously. There was a 1.3-fold recurrence of CDI after antibiotic re-exposure.

Alternative remedies for heartburn

Dr. Weil recommends the use of deglycyrrhizinated licorice (DGL) for heartburn or early ulcers.
Here is a clinical study with 56 patients with duodenal and gastric ulcers that was published in 1968. Both radiographic evidence as well as clinical findings showed that the ulcers healed and that stomach spasms subsided with DGL treatment. Nobody knew at that time that DGL had antibacterial effects and that often chronic heartburn, stomach and duodenal ulcers can be due to H. pylori infections that are simultaneously present.
A December 2016 study showed that probiotics could be a valuable adjunct in triple therapy for H. pylori infection. The study also points out that H. pylori is present in about 50% of the world’s population.

Antibacterial effects of DGL

A paper of December of 2012 shows that an important tooth decay bacterium responds to DGL.
In a 1989 study 20 patients with aphthous mouth ulcers were followed. DGL mouthwash led to a 50 to 75% improvement in 15 patients within one day of treatment and by the 3^rd day there was complete resolution.
Here is a suggestion of a four-step approach against H. pylori.
DGL has been shown to be useful in gut regeneration in patients with Clostridium difficile infection.

Discussion

I started with a review of a recent paper that pointed out the side effects of PPI drugs. PPI’s are common medications for acid reflux disease, stomach and duodenal ulcers, either alone or as part of the triple therapy. Chronic infection of H. pylori is often the cause of these problems. I reviewed the literature surrounding deglycyrrhizinated licorice (DGL), a natural antacid remedy. It turns out that DGL can be quite useful either as a parallel treatment or instead of the triple therapy.

The problem over the past 25 years is that physicians have been treating acid problems with higher and higher doses of PPI’s. They are also using ASA prophylaxis against heart attacks and strokes more often. This has caused gastric erosions that are bleeding, which in turn caused physicians to prescribe more PPI’s. The side effects of PPI’s belongs to the iatrogenic (doctor- induced) diseases. This is an artificial disease that occurs from the side effects of overprescribed medicine. PPI’s are a very useful short-term anti-acid medication. However, do not use this medication for more than 4 to 8 weeks. But as patients receive years and years of this medication, serious problems like heart attacks, fractures, kidney disease, dementia, and pneumonia as well as Clostridium difficile infections become the consequence. Overall there was an increase of the death rate of 25%.

It sounds quite reasonable that doctors should return to a more conservative approach as the FDA has suggested. This includes alternative natural methods including DGL and probiotics.

Death From Heartburn Drugs

Conclusion

A recent study from the online British Medical Journal Open has pointed out a high death rate among long-term proton pump inhibitor (PPI) drug users. The se drugs are used to suppress acid formation in the stomach. They are helpful, if there are significant gastrointestinal bleeding risk factors present. But prolonged use of PPIs causes severe side effects as described, including a chronic persistent Clostridium difficile infection (CDI) of the gut that can become resistant to antibiotic therapy. In cases of recurrent CDI one important step is to discontinue PPIs. The physician should consider switching to one of the conventional histamine H2-antagonist drugs (like ranitidine). Overusing PPIs in an older population is not responsible, as this leads to disease that is caused by a physician! There is no need for this to happen.

Avoiding toxic drug levels of PPI’s

The prescribing physician has to exercise caution and restraint and the patients, and their loved ones need to be aware of multidrug interactions. PPIs belong to the drugs that are eliminated in the liver through the cytochrome P450 enzyme system (CYP2C19). But this enzyme system interfering with the drug elimination process may also eliminate other drugs taken by the patient. The end results can be toxic drug levels of PPIs. It can potentiate the side effects and become responsible for the 25% increased risk of death when the patient takes PPI drugs chronically. Even though PPIs are the newer medication, newer does not always mean better.

Jul

2017

Some Drink Milk, Others Are Lactose Intolerant

By Ray Schilling | Abdominal Pain, autoimmune disease, breast cancer, diet, exercise, heart attack, Hormones, milk

Some drink milk, others are lactose intolerant; this is the fact about drinking milk.

For a long time the dairy marketing board advertised with the slogan: “Got milk?”. But dairy milk consumption has declined over the past decades.

Why this is has been reviewed in this article. I like to review the problem of lactose intolerance, milk as a source of calcium to prevent osteoporosis and offer alternatives to milk consumption.

Lactose intolerance

Milk cows have been around in Europe for about 6000 years. But not everybody can tolerate milk products. Most of the Europeans, North Americans and Australians have adjusted the digestive enzymes in their duodenum to produce enzymes, called lactase that digest milk sugar (lactose) into glucose and galactose. But up to 75% of the world population (Africa, South America, Asia) is lactase deficient; they cannot tolerate dairy products. They get abdominal cramping, intestinal gas, bloating, diarrhea, nausea and vomiting from drinking a glass of dairy milk. This link explains why goat milk is better than cow’s milk for those who cannot tolerate cow’s milk.

It is also interesting that many people who are lactase deficient can tolerate cheeses, yogurt and other fermented milk products as the fermenting bacteria have digested the lactose.

Milk as a source of calcium

One key advertising slogan of the dairy industry used to be that milk would be such a good source of calcium, which would prevent osteoporosis. But milk also has a lot of animal protein in it, which acidifies blood. This means that the kidneys use calcium to neutralize acidic blood and excrete calcium. The net result is that there is more calcium leaving the body. Some of the calcium from the bone serves to keep the balance between acidity and alkalinity neutral.

This 12 year long Harvard Nurses’ Health Study involving 77, 761 women between the ages of 34 to 59 showed that a higher consumption of milk did not protect against hip and wrist fractures.

The myth that full fat milk causes heart attacks and strokes

There is another myth floating around, namely that full fat milk would be bad for the heart because of increased saturated fatty acids. But an Australian study showed that full fat milk is healthier for you than milk with less fat.

After 14.4 years of follow-up the group that consumed the most milk compared to the lowest fat intake group had a 69% lower death rate from cardiovascular disease!

A 2016 study showed that consumption of plain yogurt was associated with better health outcomes on the long term. Be more concerned about the sugar content than the fat content of yogurt!

Prevention of osteoporosis

For years numerous sources have indoctrinated us to accept a false concept. It is the concept of increasing milk consumption (“Got milk?”) for increased calcium intake and possible osteoporosis prevention. The sales mantra went like this: Milk-calcium-osteoporosis prevention. Now we know the real truth. Milk provides protein and calcium. But absorption of calcium is poor and the acidified blood is alkalinized through calcium from milk and from the bone leaking calcium into the blood and into the urine. The end result is a net loss of calcium from the bone, as it is more important to the body to keep the blood’s acid/base stable than to increase the calcium level in the bone. Sadly all the high consumers of milk from the Harvard Nurses’ Health Study ended up having fractures from osteoporotic bones.

Prevention of osteoporosis requires intake of vitamin D3, vitamin K2 and calcium (supplement or diet) as I have reviewed in this blog. In addition regular exercise is also very beneficial as is bioidentical sex-hormone replacement. It is interesting that a large clinical trial that I mentioned in this blog showed after 7 years that there were 35% to 38% less fractures of the hip than in the placebo group. Vitamin K2 is essential to keep calcium in the bones and to keep calcium out of the blood vessel walls. Vitamin D3 is important for calcium absorption through the gut wall and to deposit calcium into bone. Without all of these ingredients it is not possible to prevent osteoporosis.

Alternatives to cow’s milk consumption

One obvious step is to replace cow’s milk by goat milk. As you can see from this link, there are many advantages to goat milk. What I find important is the fact that those with lactase deficiency often can tolerate goat milk while they would otherwise react to cow’s milk. There are also many goat milk products like cheese and yogurt, all of which are very healthy. They do not contain any antibiotics or bovine growth hormone (bST), the use of which is confined to cows. Goat milk products are also an excellent source of protein.
You can eat a more vegetable-based diet. A lot of vegetables and fruit have calcium and protein in them.
You can consume almond milk instead of cow’s milk. The downside to know is the fact that almond milk is not a significant source of protein. It has the advantage of being slightly alkaline; this will ensure that the calcium absorbed in the gut will reach the bones as long as you also supplement with vitamin D3 and vitamin K2. The many “fake milk” products such as rice milk, coconut milk and hemp milk are also poor protein sources. The only product higher in protein is soymilk. But soy has its own problems: over 90 % of the crop in North America is genetically engineered, and soy is a known allergen. As of recent, another product based on pea protein is available, and the protein content is excellent, so it is worth looking for it (It is called “Ripple”).

Some Drink Milk, Others Are Lactose Intolerant

Conclusion

Drinking milk as a source of protein and calcium has become an obsession a few decades back. In the meantime it turned out that drinking milk tips the acid-base balance in the direction of acidity. This causes osteoporosis, as the kidneys excrete all of the calcium from milk that is absorbed. On top of that even more calcium is taken out from bones to recalibrate the acid-base balance.

Up to 75% of the world population is lactose intolerant. They get sick from drinking cow’s milk. But they usually tolerate goat milk quite well. Considering the fact that antibiotics are used in cow milk production and recombinant bovine growth hormone as well, I have joined the crowd that prefers goat milk instead of cow’s milk. I take the supplements I mentioned for bone maintenance (vitamin D3 and K2) and I get lots of calcium also from vegetables and salads. I have no lactose intolerance, but that’s my take on milk.