• 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...]

  • Common Chemicals Affecting your Health

    Common Chemicals Affecting your Health

    There are common chemicals affecting your health that have been known since the 1950’s. They have the name PFAS, which stands for perfluoroalkyl and polyfluoroalkyl substances. There was a review article recently in CNN describing the complexity of PFAS, the toxicity, and what you can do to improve your risk. People … [Read More...]

  • Cardiovascular Risk Markers Predict Heart Attacks and Strokes

    Cardiovascular Risk Markers Predict Heart Attacks and Strokes

    An article in The New England Journal of Medicine stated that cardiovascular risk markers predict heart attacks and strokes. A summary of this study was also published by NBC News. 30-year follow-up of the Women’s Health Study This is based on a 30-year follow-up study of the Women’s Health Study. In the beginning … [Read More...]

  • Red Meat and Processed Meat Can Become a Cause of Diabetes

    Red Meat and Processed Meat Can Become a Cause of Diabetes

    A clinical study at the end of 2023 showed that red meat and processed meat can become a cause of diabetes. The authors published the results of this study in The American Journal of Clinical Nutrition on December 2023. Results of the study Notably, the study consisted of several pooled studies. To emphasize, … [Read More...]

  • Ozempic and Wegovy can Lead to Blindness in one Eye

    Ozempic and Wegovy can Lead to Blindness in one Eye

    Shocking medical news found that Ozempic and Wegovy can lead to blindness in one eye. Ozempic was approved by the FDA for treatment of diabetes. Wegovy, which is the same drug, got FDA approval for treatment of obesity. The pharmacological name of the drug is semaglutide. Both brand names of the drug are very … [Read More...]

    May
    21
    2014

    Forty Percent Of Premature Deaths Can Be Prevented

    A new report from the CDC (Center of Disease Control) in the US has revealed that up to 40% of premature deaths could be prevented by simple lifestyle changes. As this link shows every year about 900,000 premature deaths occur in the US, which are due to 5 major diseases that in the opinion of the CDC can be prevented by 20 to 40%. Here are the diseases that kill: cancer, heart disease, COPD/emphysema, stroke and accidents/injuries. These conditions were responsible for 63% of all deaths in the US in 2010.

    Let’s discuss each of these conditions and how one could lower the risk of dying from them.

    1. Cancer:

    The Framingham Heart Study has shown that smoking and cancer are closely related. Smokers who quit can significantly reduce their risk of getting cancer. We also know that exercise and prophylactic supplements like fish oil and vitamin D3 have cancer preventative effects.

    Antioxidant supplementation that included beta-carotene, vitamin A, vitamin C, and vitamin E daily or on alternate days for 1 to 12 years, along with selenium supplementation reduced the incidence of cancer of the esophagus, colon, pancreas, stomach or the liver. Insulin resistance due to sugar and starch overconsumption is causing cancer, particularly breast cancer, colorectal cancer and endometrial cancer. I have discussed this in a recent blog.

    Pollution has been linked to increased lung cancer risks as discussed here.

    2. Heart disease:

    Heart disease can be caused by several factors in combination. Lifestyle issues are important: Smokers need to quit smoking as the Framingham Heart Study has shown more than fifty years ago that smoking causes heart attacks. Obesity and diabetes also contribute significantly to the risk of heart disease. Often these are connected to faulty nutrition, which is another lifestyle issue that comes to mind when too much sugar and starchy foods are taken in; your liver will convert these into fatty acids, triglycerides and elevated, oxidized LDL cholesterol, which gets deposited under the lining of the arteries. A lack of exercise adds to this problem as a lack of exercise lowers the protective HDL cholesterol and fat is deposited under the lining of the arteries. Start exercising and your protective HDL cholesterol will rise, your total cholesterol to HDL ratio will lower to healthier levels and your risk for hardening of the arteries and for getting a heart attack will fall. If you have diabetes, it is important that you manage your blood sugars well; this means that if you inject insulin, you want the blood sugar tests to be within the normal range and the hemoglobin A1C values to be below 5.5%. Poorly controlled diabetes is an important cause of heart attacks and strokes. High blood pressure is also an important cause of developing heart attacks and strokes. It is important to control your blood pressure by taking blood pressure lowering pills and also by exercising regularly. Exercise seems to send a signal to relax the blood vessels thus lowering the blood pressure, which in turn prevents heart attacks.

    Forty Percent Of Premature Deaths Can Be Prevented

    Forty Percent Of Premature Deaths Can Be Prevented

     

    3. COPD/emphysema:

    Chronic obstructive pulmonary disease (COPD) or emphysema is mostly caused by chronic exposure to cigarette smoke from smoking. The earlier you can quit, the better your chances that your breathing will not be the limiting factor when you age. But it is also important to avoid exposure to other noxious gases, such as from welding and from exposure to pollution. This may involve a decision to move to a less polluted area. Or it might involve a job retraining. Those who are suffering from COPD can be helped to a certain extent by a portable oxygen tank with nasal prongs.

    4. Stroke:

    As mentioned before, quitting smoking, controlling high blood pressure and controlling blood sugar, if you suffer from diabetes have been shown to stabilize your blood vessels including the ones that supply your brain. The key is to prevent hardening of the arteries by a healthy lifestyle. Exercising and keeping your weight under a body mass index of 25.0 have been shown to be effective stroke prevention. Healthy nutrition as indicated above under “heart disease” is equally important for stroke prevention. Go green (eat more vegetables, consume more green smoothies), cut down grains, sugar and starchy foods and you will live longer without strokes and heart attacks. Remember, what’s good for your heart is good for your brain!

    5. Unintentional accidents/injuries:

    Wearing helmets when bicycling, wearing seat belts when driving in a car, avoiding risky behaviors are all measures that save lives. One factor stands out in all of this: if you drink too much, you run the risk of being involved in unintentional accidents or injuries. People may not like to hear this, but your brain lacks the natural inhibitory impulses when you are under the influence of alcohol, so you become more daring and you may not pay attention for the split second that could have prevented an injury or accident. People react very differently to alcohol. Some people feel inebriated after only ½ a glass of wine or beer whereas others can drink more before they make mistakes. The best is to be sober when you drive, ski, use power tools or walk in traffic. Even climbing ladders requires a clear mind!

    Conclusion:

    As the CDC said 20 to 40% of premature deaths (deaths that occurred before the age of 80) could have been prevented, if the above-mentioned recommendations were followed. Let me rephrase this: 180,000 to 360,000 premature deaths every year in the US before the age of 80 could have been prevented! Curative medicine cannot help with these statistics as a heart attack or stroke has happened when it has struck you. Cancer and end stage lung disease are similar conditions that you are suddenly faced with when they occur and unintentional accidents just seem to happen. This is where the importance of prevention can be seen, because these little baby steps every day are adding up to something formidable, a force to be reckoned with. Be part of the solution, think prevention!

    More information on:

    1. Cancer mortality: http://nethealthbook.com/cancer-overview/overview/cancer-mortality-rate/

    2. Higher vitamin D3 intake lowers mortality from heart attacks, strokes, cancer, fractures due to osteoporosis: http://nethealthbook.com/news/higher-vitamin-d-levels-associated-lower-risk-mortality/

    Last edited Nov. 8, 2014

    May
    10
    2014

    The Full Story About Testosterone

    Much has been written about what happens when women get into menopause. This begs the question: do men experience a change of life? As a matter of fact, they do. It is called “andropause”, and they can experience problems as a result. Here is a study from the Massachusetts General Hospital in Boston, MA, which was published in the New England Journal of Medicine (Sept. 2013) describing in detail what happens when men get into andropause (the male equivalent of the menopause).

    We know from other studies that in obese men testosterone is converted into estrogen because of the enzyme aromatase that converts testosterone into estrogen resulting in erectile dysfunction and loss of sex drive. In lean men above the age of 55 there is a true testosterone reduction because the testicles produce less testosterone. This results in less sex drive, moodiness and lack of energy. But these men will do well with bioidentical testosterone replacement.

    Main findings of the Massachusetts General Hospital study:

    1. Testosterone was responsible for thigh muscle development and leg press strength, for erectile function and sexual desire.
    2. Surprisingly, estradiol (the main estrogen component in both sexes) plays a significant part in sexual desire in the male. This became particularly apparent in the post-andropause male who desired hormone replacement. When bioidentical testosterone is used to replace what’s missing there was no problem with sexual desire or erectile function as a small amount of the testosterone was aromatized into estradiol. The researchers were able to measure both testosterone and estradiol levels.
    3. Here is a surprising fact: a lack of estrogen leads to abdominal obesity. This could also be verified by hormone measurements.
    4. In the past doctors used synthetic testosterone products like methyltestosterone, danazol, oxandrolone, testosterone propionate, testosterone cypionate or testosterone enanthate. The problem with these synthetic testosterone products is that the body cannot metabolize a portion of them into estrogen that is desirable for a normal sex drive, so the testosterone compounds alone are not doing their job as well as the bioidentical testosterone that the body can aromatize.

    In obese men the problem is that there is too much estrogen in the system, which leads to a disbalance of the hormones in the male with a relative lack of testosterone. Overweight and obese men produce significant amounts of estrogen through aromatase located in the fatty tissue. Aromatase converts testosterone and other male type hormones, called androgens, into estrogen. Excessive levels of estrogen cause breast growth, muscle weakness, lead to abdominal fat accumulation, heart disease and strokes. Dr. Lee described what happens in men who enter andropause years ago as indicated under this link.

    The Full Story About Testosterone

    The Full Story About Testosterone

    Testosterone to estrogen ratio:

    Dr. Lee indicated that in his opinion saliva hormone testing is more reliable than blood tests (Ref. 1). One of the advantages of doing saliva hormone tests of estrogen and testosterone is that you can calculate directly the ratios of these two hormones. In hormonally normal younger males the testosterone to estrogen ratio is larger than 20 – 40 (Ref.2). The testosterone to estrogen ratio in obese men is typically less than 20 meaning it is too low. But lean men in andropause produce too little testosterone and their testosterone to estrogen ratio is also less than 20, because they may still have enough estrogen in their system from aromatase in the fatty tissue, but they are lacking testosterone due to a lack of its production in the testicles (Ref. 1 and 2).

    When a man in andropause is given bioidentical hormone replacement with a testosterone gel or bioidentical testosterone cream this is absorbed into the blood and body tissues and then partially metabolized into a small amount of estrogen. This can be seen when saliva hormone tests are done; a higher level of testosterone is detected and much lower estrogen level so that the testosterone to estrogen ratio is now 20 to 40 or higher and the affected person will no longer be the “grumpy old man” that had been a source of distress to his partner before.

    This New England Journal of Medicine study is important because it confirmed what anti-aging physicians had been saying for years: a small amount of estrogen is necessary for the male for bone health as estrogen receptors will regulate the bone density, it also helps for a normal sex drive. The same is true for women: a small amount of the opposite hormone (testosterone) will help a woman’s sex drive, but she needs the right mix of progesterone to estrogen (a progesterone to estrogen ratio of 200:1 using saliva tests) to feel perfectly normal as a women.

    Health and well-being of a man depend on normal testosterone levels:

    It is important to realize that testosterone is not only supporting a man’s sex drive and libido, key organs like the heart, the brain and blood vessels contain testosterone receptors as well. The body of a man was designed to respond to testosterone all along. It is when testosterone production is no longer keeping up that premature aging becomes apparent, as the target organs do no longer receive the proper signals.

    A healthy heart in a man depends on regular exercise and testosterone stimulation whether he is young, middle aged or old. The same is true for the lining of the arteries where testosterone receptors are present to help with the normal adjustment to exercise and relaxation. The brain cells have receptors for all of the sex hormones and in a man they are used to higher levels of testosterone and lower levels of progesterone and estrogen. If you take the balance away, the aging man will feel miserable and grumpy. Depression will set in. Here is a brief review how one man’s life has been changed by testosterone replacement.

    So, bioidentical hormone replacement is not just a matter of replacing one hormone, you need to pay attention to all of the hormones. Lifestyle issues enter the equation as well. I have reviewed the issue of bioidentical hormone replacement for women and men in this blog.

    Conclusion:

    When a man reaches the age of 55 or older there comes a point where a lack of testosterone and estrogen sets in. It is wise to start doing intermittent blood or saliva hormone tests before this point is reached in order to gage when bioidentical hormone replacement treatment should be given. Along with an assessment regarding the hormone status it would be wise to also assess lifestyle issues as often other factors play a role in premature aging. I have reviewed these factors systematically in a recent publication (Ref. 3). It is best to combine bioidentical hormone replacement with life style interventions to achieve optimal preservation of a man’s health.

    More information about male menopause (=andropause): http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/male-menopause/

    References:

    1. John R. Lee, MD: “Hormone Balance for men- what your doctor may not tell you about prostate health and natural hormone supplementation”. 2003 by Hormones Etc.
    2. George Gillson, MD, PhD, Tracy Marsden, BSc Pharm: “You’ve Hit Menopause. Now What?” 2004 Rocky Mountain Analytical Corp. Chapter 9: Male Hormone Balance (p.118-148).
    3. Dr.Schilling’s book, March 2014, Amazon.com:“A Survivor’s Guide To Successful Aging: With recipes for 1 week provided by Christina Schilling”.

    Last edited Nov. 8, 2014

    Apr
    30
    2014

    Overuse Of Supplements that Can Create Health Risks

    This article is about the overuse of supplements that can create health risks. The Dietary Supplement Health And Education Act of 1994 made it easier for people to acquire supplements and vitamins from health food stores. But since then there has been a proliferation of various products that merchants sell as supplements and not as drugs. It may give you the impression that all supplements are harmless, but this is not so. There are some supplements like vitamin A where you need to watch that you are not inadvertently overdosing, as toxicity is a problem; calcium supplements are also potentially toxic, if overdone. And amino acid supplements (protein supplements) can lead to an overdose of brain hormones. Here is a sample of some of the supplements that I would want you to watch.

    1.Vitamin A toxicity

    Vitamin A is essential for normal night vision, for red blood cell production in the bone marrow and for the immune system. Here is a brief review about its metabolism. But while small amounts are beneficial for the body, high doses are toxic. In the 19th century the Arctic explorer Elisha Kane reported that consumption of polar bear liver caused severe headaches, drowsiness, irritability and vomiting within a few hours of ingesting it.

    The underlying condition is due to “pseudotumor cerebri”. This is a condition that mimics a brain tumor, but coms from an acute overdose of vitamin A contained in liver (Ref. 1).

    In the US where people eat enough meat, fish and dairy products, there is no overt vitamin A deficiency. Read this link to avoid overdosing with vitamin A in multiple supplements.

    Overuse Of Supplements Can Create Health Risks

    Overuse Of Supplements Can Create Health Risks

     

    2. Vitamin C

    Vitamin C is an important antioxidant vitamin. It plays a role as a cofactor for many metabolic reactions. It is participating in the production of collagen and connective tissues, helps with fatty acid transport and is necessary for the synthesis of neurotransmitters in the brain (Ref.2). The lack of vitamin C has the name scurvy; symptoms include bleeding gums from fragile capillaries, delay in wound healing and impaired bone metabolism. In the earlier research the hope was that vitamin C would prevent colds and cure cancer. More recent re-evaluations found that vitamin C does not prevent you from getting colds. Instead it accelerates the recovery from colds by cutting down the recovery time by as much as 25 to 30%. It also has some cancer protective effects (Ref.2).

    1500 mg of vitamin C per day the upper limit

    Higher doses seem to be more beneficial, but 1500 mg per day seems to now be the consensus of a reasonable upper dose limit per day. What about kidney stones? Several studies in the past have warned that vitamin C may in some people experience a breakdown into calcium oxalate kidney stones. Here is a brief review of the literature with regard to kidney stone formation. A study regarding the DASH diet, which is used for people with high blood pressure, showed that the incidence of kidney stones is almost half for both men and women compared to controls on a normal North American diet.

    Kidney stones from vitamin C a myth

    There has been a concern among the medical community that vitamin C as a supplement would increase kidney stones (oxalate stones). However, a 2014 study showed that when both vitamin C and vitamin E are taken as supplements, the kidney stone formation goes down.

    Many inhabitants of industrialized countries including the population in the US and other countries are magnesium deficient and this can be a major factor for forming calcium oxalate stones. But it has been known for decades that those who develop kidney stones excrete more oxalates in their urine (so-called “oxalate excreters”). Here is a 1996 study that measured this in detail.

    Green smoothies contain a lot of vitamin C

    If you are taking in a lot of green smoothies from green leafy vegetables (spinach, kale, Swiss chard) that are high in water-soluble vitamins, you may not require any vitamin C supplements. In other words, think about what else you do and eat and add it up, so you do not exceed a total of 1500 mg to 2000 mg of vitamin C per day.

    3. Calcium supplements

    Calcium is a key mineral in the body, important not only for healthy bone structure, but also to balance the electrolytes within the blood, in the extra cellular fluid space and within our cells. If calcium is low, the brain is more prone to seizures and the heart can produce dangerously irregular heart beats. We definitely need a balance of calcium! Because calcium is so central to our wellbeing, several factors work together to keep our calcium levels stable: the kidneys, the thyroid, the parathyroid glands, the adrenal glands, the bone as a reservoir of calcium, the gastrointestinal tract for absorption and a good, balanced nutrition. The chapter on “Vitamins and Minerals” of Ref.3 points out that 4000 mg of calcium per day definitely causes toxicity (hypercalcemia and milk-alkali syndrome).

    Absorption of calcium

    Absorption of calcium depends on the dose you take meaning that only 500mg of calcium carbonate crosses the gut/blood barrier at a time. Vitamin D3 deficiency leads to reduced calcium absorption. But with high doses of vitamin D3, which is now often recommended, more calcium is absorbed, so it is important not to take too many calcium supplements. They can also interfere with iron and zinc absorption and when more than 2600 mg of calcium is taken magnesium absorption is inhibited as well. Calcium can interfere with thyroid hormone supplements (take 4 hours apart) and may reduce the effect of calcium channel blockers, drugs used for angina or high blood pressure.

    99% of body calcium stored in bone

    There is a balance between calcium stored in bone (99% of total body calcium) and the circulating portion of 1% of calcium in the blood. The parathyroid hormone and calcitonin are also involved in this balance. Hypercalcemia is the condition when calcium is too high. Common causes are the improper use of diuretics (thiazide diuretics), overuse of calcium carbonate supplementation (often for osteoporosis) and overuse of vitamin D3, which increases the absorption of calcium (Ref.3). See your family doctor for blood tests and advice what to do in your case.

    4. High protein diets and protein (amino acid) supplements

    Many protein supplements are available through health food stores and vitamin stores. The advertisers often state that our food would be substandard and these supplements would help “to regain strength”.  Athletes hope to get stronger muscles from amino acid supplements because they are the building block for protein that builds up muscles. Fact is that no supplements are needed when you eat balanced meals containing meat and fish and you exercise regularly. The protein in your food will be broken down into amino acids and your body metabolizes this into your own protein. Here is a website that reviews the subject of supplementation with amino acids.

    Protein supplements or not?

    It is clear from this that this is a rather complex problem. Vegetarians may require these supplements to replace protein for the missing meat intake. But the rest of us have to guard ourselves against overdosing with too much meat, amino acids supplements or protein supplements.

    High protein diets (Atkins diet and others) have been glorified as being helpful for weight loss. But the long-term effect of such diets lead to chronic kidney damage in those with diabetes and high blood pressure as evidenced by protein leakage in the urine (called ”microalbuminuria”, Ref.4).

    Reference range for protein requirement

    According to this reference the average protein requirement is 0.6 g of protein/kg body weight/day. This text comments that this would be compatible with the World Health Organization (WHO) recommendation for protein intake. For a person weighing 140 lbs. this translates into about 50 grams of protein per day. Here is a website that explains the upper limit of meat intake with the example of an 8-ounce portion of top sirloin steak.

    Protein supplements have become very popular, but you need to be careful when you supplement with this that you do not get an overdose of amino acids. Amino acid profiling has been useful for physicians and naturopaths to examine deficiencies in children or adults checking for essential amino acids in the blood.

    Overuse of meat from food and protein supplements

    In industrialized countries like the US, Canada and others the larger concern is now the overuse of meat. Atkins-like diets and protein supplements are also a source of extra amino acids. The same amino acid screening tests will find several of the ingredients (amino acids) in these protein supplements to be too high. In this case it is imperative to stop the protein supplements to prevent amino acid toxicity.

    This study warns that not enough is known how performance-enhancing supplements affect the metabolism of the body. There are discussions that perhaps upper limits for amino acid supplements need to be established.

    5. Creatine supplementation

    Creatine supplementation in the sports-minded and in athletes who want to build up muscle mass is of concern. The liver synthesizes creatine from amino acids, which derive from fish and meat. The body breaks this down into the amino acids arginine, glycine and methionine. There is no shortage of these amino acids, but athletes and sports minded people want to push the envelope. They consume additional creatine for their energy metabolism (ATP production) in the muscles to increase their performance (Ref. 5). Creatine is vital for the brain, the heart, the kidneys and the eyes (retina). It is a buffer for lactic acid during anaerobic exercise. Some of the side effects are muscle cramps, diarrhea, fluid retention and kidney failure. Exposure to high heat and dehydration aggravates this. There are no long-term studies of the use of creatine supplements, yet many athletes take them all the time.

    Conclusion

    We are tempted by various merchants and infomercials to take in more and more vitamins and supplements. This includes protein and amino acid supplements. But when you eat well-balanced meals, preferably organic food, you already have enough nutrients. This includes protein, nutrients, calcium, vitamin C and vitamin A in your food. So you may be inadvertently putting a strain on your kidneys. They have to eliminate whatever it is that is too much for your body to take. Your liver may also be quietly working overtime as well.

    Limits of your organs

    Your brain gets overactive by the surplus of amino acids that are utilized by the brain to make brain hormones. Your system can only take so much; at one point a surplus of supplements will make you sick! So, be vigilant and think about what your regular food intake already provides. Do you really need that supplement or do you already get enough from your food intake? Are you falling for some marketing scheme? Remember, you are the steward of your own health!

    References

    1.Shannon: Chapter 69: The Vitamins. Haddad and Winchester’s Clinical Management of Poisoning and Drug Overdose, 4th ed.© 2007 Saunders

    2. Mandell: “Water-Soluble Vitamins”. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 7th ed. © 2009 Churchill Livingstone

    3. Rakel: Chapter “Disturbances in Calcium and Phosphate” and chapter entitled “Vitamins and Minerals”. Textbook of Family Medicine, 8th ed. © 2011 Saunders

    4. “High Dietary Protein Intake” in “Taal: Brenner and Rector’s The Kidney”, 9th ed. © 2011 Saunders

    5. DeLee: DeLee and Drez’s Orthopaedic Sports Medicine, 3rd ed. © 2009 Saunders

    Apr
    19
    2014

    Measuring Your Heart Function

    Recently I came across a book by Dr. Steven Masley, cardiologist (fellow of the American Heart Association, see Ref.1). The heart’s function is to pump your blood reliably all your life. It is a complicated organ, but it works well, if we treat it well. Western medicine has taught us that with complicated machinery and tests we can assess how the heart is doing. But until recently there was no reliable easier way to assess our cardiac health function. The purpose of this blog is to summarize a three-pronged approach to measure your heart and blood vessel health. It is described in detail in Ref.1, but I doubt that many people have yet read this important reference book. It is also important to FIRST see your doctor whether you are able to do the Bruce protocol (treadmill test, the third component below). If you neglect to be cleared by your doctor you run the risk of possibly getting angina pains or getting a heart attack.

    1. Carotid IMT or carotid intimal-medial thickness test: You measure the degree to which there is hardening of the coronary arteries indirectly by measuring the thickness of the lining of the carotid arteries (carotid IMT or carotid intimal-medial thickness test). Dr. Masley has showed over a period of 10 years and more in many patients at his Health Center that there is a close correlation between the degree of coronary artery hardening and the degree of hardening of the carotid arteries. He stated that his research has shown that “90% of the time, the carotid arteries, the coronary arteries, and even the arteries of your legs all grow plaque at the same time”. The gold standard for checking the condition of your coronary arteries is a heart catheterization as Dr. Masley explains (page 58). But he adds: “IMT testing should be the new gold standard for cardiovascular plaque testing. However, this is not yet the case. Despite its usefulness, 95% of doctors are not ordering this screening test for their patients. You can rest assured that this is a situation I am to change“.

    Measuring Your Heart Function

    Measuring Your Heart Function

    2. A detailed lipid analysis called the VAP test: A detailed laboratory test analyzing your lipid fractions (LDL, HDL, total cholesterol and VAP test). The buoyant HDL fraction, called HDL2 is the key to having a low risk for hardening of the arteries. HDL2 is large, fluffy and is designed to remove garbage from within the lining of the arteries. Also, the cholesterol ratio is another measurement for a low risk for hardening of the arteries when it is less than 3.0. The first two tests assess how much hardening of the arteries there is present and when they are normal, there is a relative reassurance that nothing drastic (like a heart attack or stroke) should happen within the next 10 years provided you keep up a regular exercise program and healthy food intake.

    3. Bruce protocol (Treadmill test): The Bruce protocol (treadmill test) is often done by a cardiologists, but can also be done through many gyms, where a trainer with experience in exercise physiology will do it. This functional test measuring cardiac output has been developed many decades back and has withstood the test of time. Here is an overview what this is. As the slope of a treadmill and the speed of the belt are increased, the heart needs to do more work to maintain blood flow to your extremities and vital organs. The trainer or exercise physiologist measures the response of the heart activity in relation to the increase of the exercise load. A complicated formula allows calculating how much your maximal cardiac output is. This test has several variations and can be complicated to understand. Essentially, the higher the numbers you can create, the better. Here is a table with various results of the VaO2max from Bruce protocols and how they are interpreted.

    4. Treating abnormalities found with the three basic tests: These are the necessary tools that tell you where you are in regard to your heart function. People with heart failure should not do this third test, because their heart muscle is too weak to sustain this and they would get heart failure meaning that blood gets backed up into the lungs and there could be severe breathing problems leading to a lack of oxygen (anoxia) in the heart tissue, which in turn can cause irregular heart beats (fibrillation of the heart muscle) and a heart attack. Assume that the first two tests were within the normal limit for your age, then the Bruce protocol would give you the maximum heart output at the peak level of your treadmill test. At this point you are measuring directly the cardiac output (in other words what your heart is capable of pumping for you in a certain time unit). This measurement is what physicians call the VaO2 max  or maximal oxygen consumption. This is the best index for maximal heart capacity. If your levels are higher than normal, you have extra reserves with respect to your heart as a pump for times when you need it. If this latter tolerance test shows poor results, it usually means that you were inactive and you would benefit from an exercise program. If the first test shows hardening of the arteries more than is appropriate for your age, you would need to look at your eating habits. At the same time often the VAT values and the cholesterol ratio is off meaning that you are eating the wrong foods and it shows in your blood test results.

    5. Advise regarding diet, exercise and relaxation: Dr. Masley’s book has several sections that explain what needs to be done when things are not normal. For instance, the author does not mince words when it comes to eating the right fats and cutting out sugar and starchy foods. For instance on page 199 there is a neat table that lists the fiber content of different foods. We need more fiber to slow down the absorption of sugary substances, which will minimize the insulin response following a meal. Dr. Masley also mentions that omega-3-fatty acids from fish and good seafood choices will balance the omega-6-fatty acids that would lead towards the arachidonic acid pathway, which causes arthritis, inflammation and cancer. There are many more dietary recommendations, too numerous to repeat them all here. Suffice it to say that molecularly distilled omega-3 fish oil, vitamin D 1,500 to 3000 Units daily, and magnesium supplements are all good for you heart. Vitamin K2 gets calcium out of your blood vessels and into the bone (100 micrograms per day). Other worthwhile supplements mentioned in the book are CoQ-10 (50 to 200 mg twice per day), but it would be wise to have blood levels drawn, which should be above 2.5mcg/ml to which the CoQ-10 intake could be titrated. Curcumin and Resveratrol are also recommended. Most of all, it seems that regular physical exercise such as a balanced gym program is the single most effective way to reverse hardening of the arteries as measured by the carotid IMT testing.

    Conclusion: Times have changed. It used to be thought that our lives were following a one-way street downwards. During periods of malnutrition, lack of exercise, being sessile and abusing alcohol and drugs this may well be the case. However, we now know that this is reversible. Change to healthier food, start smoothies with organic vegetables in a mixer, get going and walk. Jog or use a gym to get regular exercise. Physical exercise reverses the fat deposits inside the lining of the arteries. The HDL-2 fraction rises and helps counteract the elevated LDL cholesterol. Even the mood of the person who exercises regularly becomes more stabilized. Using these simpler three tests the physicians will not need the more complicated Thallium heart scans, heart catheterization etc. These three tests described above are well worth being done every two years, so that you can monitor what’s going on with your heart and blood vessels in general. What questions do you have? You could ask them below.

    More information on heart disease: http://nethealthbook.com/cardiovascular-disease/heart-disease/

    References: 1. Dr. Steven Masley, MD: “The 30-day Heart Tune-Up – A Breakthrough Medical Plan to Prevent and Reverse Heart Disease”, Center Street, A Division of Hachette Book Group Inc. New York, Boston, Nashville, USA © 2014.

    Last edited Nov. 8, 2014

    Apr
    12
    2014

    Lead Still Poisoning Us

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

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

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

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

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

    1.History of lipsticks:

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

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

    Lead Still Poisoning Us

    Lead Still Poisoning Us

    2. Evidence of considerable absorption of lead:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    5. Treatment and prevention:

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

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

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

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

    Conclusion:

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

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

    References:

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

    Last edited Nov. 7, 2014

    Apr
    05
    2014

    Yes, There Are Healthy Sugar Substitutes

    It is true that sweets are not good for you because they lead to fat accumulation and to diabetes. I explain how this works later in this blog. But who says you cannot sweeten your life with healthy ingredients? Not all sugar substitutes are the same; some are awful, some are in between and one is good (see below).

    General information why sweets and starches are bad for you:

    There is a triple whammy from sweets that you don’t really want:

    a) First, sugar gets absorbed really fast through the gut wall and arrives in your blood stream within 15 to 20 minutes. Starches can be just as powerful in terms of blood sugar surges, but it takes perhaps 30 to 40 minutes for the peak of blood sugar to occur. The end result is the same: whether you load up with a pizza, a doughnut or drink a large, sugar-loaded soda drink, your pancreas reacts the same way. It produces a lot of extra insulin to bring the blood sugar level down. When you do this day after day your pancreas gets used to overproducing insulin and you develop insulin resistance meaning that your insulin receptors that are on every cell surface get tired and become less sensitive to insulin. Due to insulin resistance the muscle cells and the liver cells do not take up sugar (in the form of glucose) as easily as before.

    b) Second, because excess sugar cannot be stored as glycogen (the storage form of glucose in the liver and the muscles), the liver converts excess glucose into triglycerides and oxidized fatty acids get taken up by white blood cells called macrophages. These attach to the inner lining of the arteries and lead to atheromatous plaques, the first stage of hardening of the arteries.

    c) Third, glucose is an oxidizing agent that will oxidize LDL cholesterol. This makes the LDL particles much denser and forms the so-called very dense LDL lipoprotein fraction (VDLDL) that can be detected in special blood tests (Ref.1).

    Not surprisingly people who consume sugar, sweets, soft drinks and starches on a regular basis will have very dense LDL particles (=VDLDL, also called “pattern B-LDL”). The treatment for this is to quit sugar and starchy foods.

    I have explained in more detail what sugar does in this blog.

    Yes, There Are Healthy Sugar Substitutes

    Yes, There Are Healthy Sugar Substitutes

    The food industry’s answer to low carb diet drinks and low sugar foods:

    Many years back the food industry decided to offer alternative diet drinks that would not contain sugar, but instead have aspartame in it.

    Dr. Blaylock has researched excitotoxins like MSG and aspartame (NutraSweet) and urges you in this link to abandon both. I agree with him. But while we are at it, don’t take other artificial sweeteners like sodium cyclamate in Canada (Sweet’N Low). Are you thinking of taking sucralose (Splenda) instead? Think again. What the industry seems to have forgotten is that it was originally developed as an insecticide. This website states that sucralose was actually discovered while trying to create a new insecticide. A researcher tasted it and found it exceedingly sweet. I have done the experiment myself in Hawaii where small ants are ubiquitous. I thought I take a package of Splenda from a coffee shop and do the experiment: In the beginning the ants were reluctant to eat it, but after a few hours they came and took it in. One day later there were only shrivelled up dead ants left in the area where Splenda had been sprinkled. Proof enough for me that Splenda was developed as an insecticide!

    In the Splenda marketing scheme they decided to first introduce Splenda gradually into diabetic foods as a sweetener, then later sell it to the public at large. Don’t fall for it. It was a side product of insecticide research, and insecticides have the undesirable quality of being xenoestrogens, which block estrogen receptors in women. As a result of that estrogen can no longer access the body cells, including the heart. The final consequence for a woman is a higher risk for cardio-vascular disease. This can cause heart attacks, strokes and cancer. In men estrogen-blocking xenoestrogens can cause breast growth and cause erectile dysfunction.

    The natural sweeteners:

    One wonders why the food industry did not choose healthy sweeteners like stevia that has been used for decades in Japan and South America.

    Other sweeteners like xylitol, sorbitol, maltitol, mannitol, glycerol, and lactitol are sugar alcohols. Contrary to what many believe they have calories, but much less than sugar, so they are perceived as “safe” as a dietary supplement for weight loss. These alcoholic sugar compounds still produce partial LDL oxidization; interfere with weight loss and still lead to a certain insulin response.  Stevia, a natural sweetener from a leaf of South America is safer and without any calories.

    The key is that stevia will not oxidize your LDL cholesterol and will not cause a hyperinsulinism response following a meal. It is metabolically neutral. It is the ideal sweetener for people who desire to lose some weight. It is also safe as it is no excitotoxin. The FDA has recognized stevia as “generally recognized as safe” (GRAS).

    What about fructose, agave syrup, honey, brown rice malt syrup, fruit juice concentrates, refined fructose, maple syrup?

    The problem is that they are all sugars, which cause a full insulin response leading to obesity, diabetes and hardening of the arteries. This causes heart attacks and strokes. These natural sugar products also oxidize LDL cholesterol, which initiates plaque formation as discussed above; this is the first step leading to hardening of the arteries. It took the medical profession 30 years of observing that a low fat/high carb diet makes us fat and causes heart attacks, leads to strokes and causes diabetes. Let’s not make the mistake of trusting the food industry and mindlessly swallow so-called natural other sugars and sugar substitutes like xylitol, sorbitol, maltitol, mannitol, glycerol, and lactitol. You may want to chew the odd gum with xylitol, as this will prevent cavities in your teeth. But otherwise it is much safer to just stick to Stevia to sweeten your tea, coffee or food. There are brands that are less bitter than regular stevia products, like stevia from New Roots in Canada and stevia from KAL in the US (no, this is not a commercial, it is based on my own observations).

    Conclusion:

    Sugar is an emotional topic that can get people caught up in heated discussions. The sugar industry and the sugar substitute industry have also powerful lobby groups that provide the Internet and the popular press with conflicting stories to convince you to buy their product. This blog was meant as a no-nonsense guide to get you removed from the high-risk group of candidates for heart attacks, strokes or diabetes. Let’s not forget the metabolism behind the various sugars and starchy foods described above, which I have explained in more detail in my recently published book (Ref.2). Forget the emotions of severing yourself from your favorite fix and stick to a tiny amount of stevia that can replace the familiar sweet taste that you have become accustomed to from childhood onward. At least this is what I do. The only alternative would be to take the plunge and cut out any sweet substance altogether, which I am not prepared to do. If you can do it, by all means go ahead.

    More information on carbohydrates: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/carbohydrates/

     

    Reference:

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

    2. Dr. Ray Schilling: “A Survivor’s Guide to Successful Aging“, Amazon.com, 2014

    Last edited Nov. 7, 2014

    Mar
    29
    2014

    Alternative Treatment Of Hyperactivity (ADHD)

    Attention Deficit Hyperactivity Disorder (ADHD or ADD, attention deficit disorder) has been in the spotlight on and off over the years. It affects 8% to 10% of school-aged children, and about 2% to 5% of adults who still have this condition.

    Typically a parent receives a note from school that they must come to a teacher/parent meeting and it is discussed that the child is disruptive in class, not paying attention, interrupting the teacher inappropriately and forgetting to do their homework. The teacher suggests that this may be a sign of hyperactivity. The school nurse is also of this opinion and they suggest getting a prescription for Ritalin or Adderall (amphetamine type medications), drugs that have been shown in other kids to be fairly effective in treating the symptoms.

    Next the child is seen by the doctor who confirms the diagnosis and Ritalin (methylphenidate) is prescribed.

    In an attempt to quickly control the situation, the side effects of Ritalin are often not discussed in detail: agitation, insomnia, nervousness, anxiety, nausea, vomiting and loss of appetite, palpitations, dizziness, headaches, an increase in the heart rate, blood pressure elevation, and even psychosis (Ref.1).

    It is easy to just write a prescription for Ritalin and hope that all is well. Had the parents heard of all the possible side effects, they may have asked whether there were alternative treatments available.

    The causes of hyperactivity (ADHD)

    The exact cause of ADHD remains unknown, but there is a clustering of this condition in some families, so there seems to be a clear genetic component (Ref.2). It appears that several genes are involved, namely those associated with serotonin and glutamate transporters, but also those affecting dopamine metabolism. Males are affected with ADHD more often than females (in children 3:1, in adults 1:1).

    Alternative Treatment Of Hyperactivity (ADHD)

    Alternative Treatment Of Hyperactivity (ADHD)

    Some remarks regarding brain development are in order: Dr. Kharrazian describes that the grey matter of the brain develops before the age of 9 and the development of the white matter is completed by the age of 19 (Ref. 3, p.3). In ADHD patients the frontal brain is underdeveloped resulting in an inability to suppress unacceptable behavior, immediate desires and impulses. Prescription drugs may alter the behavior on the surface, but the frontal brain development is still lagging behind. The only thing that can influence this is behavioral/cognitive therapy and extra tutoring while the symptoms are controlled. The window of opportunity is closed by the time the ADHD patient has reached the age of 19. After that a juvenile ADHD turns into a permanent adult ADHD. The cases that had only childhood ADHD and outgrew it were the ones where the frontal lobe abnormalities had corrected themselves before the age of 19.

    This review article has noted that there is an association between a Western style diet (sugar and fat rich) and ADHD.

    Interestingly both Ref. 1 and 2, which I would categorize as having originated from mainstream conventional medicine circles, deny such an association. But the link also noted that a healthy diet with fiber, folate, and omega-3 fatty acids as well as supplementation with iron and zinc when these minerals are found to be low in the blood, do make a significant difference in ADHD patients towards normalization of their symptoms.

    One of the under diagnosed causes of ADHD is gluten sensitivity as Dr. Perlmutter described in his book (Ref. 4, pages 150-158). This can spare the child or teenager the toxic side effects of anxiolytics, antidepressants or antipsychotics that may be inappropriately prescribed by their physicians, and a gluten free diet would allow the brain to recover very quickly in such cases. A food sensitivity history and some simple gluten sensitivity blood screening tests will diagnose this condition or rule it out.

    To complicate matters even more, Dr. Amen has mentioned in several books that there are at least 7 different subcategories of ADHD that he has found in ADHD patients when studying thousands of single-photon emission computed tomography brain scans (SPECT brain scans). Dr. Amen mentions that the 7 subcategories of ADHD are the combined type ADD, the primarily inattentive ADD subtype, overfocused ADD, temporal lobe ADD, limbic ADD, ring of fire ADD and trauma induced ADD. Dr. Amen explains that each of these types needs to be treated differently and some of the treatment failures are explained by the fact that the wrong type of ADD was treated (Ref.5).

    Treatment of ADHD

    In the following I mention 5 steps that are useful for treating ADHD patients.

    1. A first step toward normalization of the metabolic changes in the brain metabolism of the affected child or adult is to adopt a diet that has been linked with low risk for ADHD: avoid food additives, cut out refined sugar, avoid known food allergies like gluten sensitivity and others. You may need to test the patient for food allergies using an elimination diet. Add a good amount of molecularly distilled omega-3 fatty acids (the pure form of omega-3 without mercury, lead or PCBs) as this has shown beneficial effects in ADHD patients.
    2. Involve a behavioral psychologist for behavioral/cognitive therapy treatments. This is particularly effective in the 9 to 19 year old category where the frontal region of the brain is still developing.
    3. Work together with the schoolteacher and get supplemental teaching in areas of academic weakness to reduce the frustrations in the classroom setting.
    4. In adolescent girls who just started their period, a relative lack of progesterone (estrogen dominance) may be a contributory factor. A small dose (20mg to 30 mg) of bioidentical progesterone from day 6 to 16 of the menstrual cycle may help significantly in alleviating the symptoms of ADHD. You may need to consult a naturopathic doctor or anti-aging physician to get a prescription for that.
    5. If all of this helps only marginally, then a smaller amount of Ritalin may be helpful; however, blood tests should be drawn from time to time to monitor for drug toxicity as the rate of absorption and elimination of the drug varies significantly from patient to patient.

    It is interesting that studies have shown that a combination of Ritalin or Adderall with alternative treatment methods had a better outcome than either method alone.

    Conclusion

    It is important to think about the various possible causes of ADHD and not just get caught up in the knee-jerk reflex of treating ADHD with Ritalin (note that this was only step 5 above, if all the other things failed). In co-operation with the school system and using alternative ways at home first (change of diet, possible addition of low dose bioidentical progesterone cream in girls) and additional tutoring in weak school subjects the need for Ritalin may be avoided. If all else fails, the conservative approach is still available, but I suggest that drug monitoring (blood levels that should be done from time to time to avoid toxicity) is important.

    More information about ADHD: http://nethealthbook.com/mental-illness-mental-disorders/developmental-disorders/attention-deficithyperactivity-disorder/

    References

    1. Ferri: Ferri’s Clinical Advisor 2014, 1st ed., © 2013 Mosby.

    2. Jacobson: Psychiatric Secrets, 2nd ed., © 2001 Hanley and Belfus

    3. Dr. Datis Kharrazian: “Why Isn’t My Brain Working?” © 2013, Elephant Press, Carlsbad, CA 92011

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

    5. Daniel G. Amen: “Use Your Brain To Change Your Age” © 2012, Harmony Books, An imprint of Crown Publishing.

    Last edited Nov. 7, 2014

    Mar
    15
    2014

    Mold Allergies Often Overlooked

    In a recent news story extensive mold infestation was found in a house that had oriented strand boards (OSB) instead of plywood walls. The house also was tightly sealed trapping moisture, which contributed to the extensive mold problem.

    Mold problems have been around for centuries, but only in the past few decades allergists  have pointed out to their patients how important it is to prevent this from happening.

    In the following I will review a few typical scenarios that can lead to mold accumulation.

    1. Mold from airtight house construction

    The homeowner described in the link above is not the only case in the world that has a mold problem. Energy efficient homes are popular because they save energy costs; homeowners often also respond to gas companies, electric utility companies and government incentives to convert to airtight home construction.

    In the 1980’s the construction industry introduced the cheaper OSB products to replace the more expensive plywood for wall construction. This is often the problem with newer house construction. However, older homes are not immune to mold development.

    2. Roof leaks in older homes

    Older homes that were built in the 1970’s may have plywood walls and have a bit of airflow from poorer wall construction, which would prevent mold formation. But roofs are older and do not always get replaced right away when a leak is detected. It may even take some time in areas where there is less precipitation before it is picked up during a particularly heavy rainstorm. Water that enters from a leaky roof can form a puddle on top of the ceiling where mold softens the drywall material until a leak in the ceiling causes water to drip down onto the floor. The mold spores multiply particularly well in wall-to-wall carpeting, but OSB material is also a good growth opportunity for molds due to the mini air spaces between the glued wood pieces. Plywood with its several tight layers is much more resistant to water penetration and mold growth.

    Mold Allergies Often Overlooked

    Mold Allergies Often Overlooked

    3. Mold growth after hurricanes

    After hurricane Sandy images of “black mold” were frequently shown in the media. The problem is that after 48 hours anything that was in contact with water produces mold. However, often with disasters like hurricanes there are evacuation orders and you cannot return to your home for several days. There may be further delay because there is a waiting period for insurers to assess the amount of damage, before you can clean all surfaces affected by mold.

    The end is result often that expensive mold sanitation is needed or the person ends up moving away and the house is levelled before a new house can be built.

    4. Effects of molds

    People with preexisting allergies and asthma are more susceptible to the effects of molds. It leads to itchy eyes, wheezing, coughing, and exacerbation of asthma.

    Here is a brief overview what the CDC is stating about mold. This site also explains that you can recognize a mold problem because of a musty smell or foul stench in the air and because of the appearance (discoloration of ceilings or walls, water damage).

    You can clean hard surfaces with bleach water. Bleach kills molds, but it may have to be cleaned several times within a few days to get rid of the last spores. Whatever cannot be sanitized in this way must be removed or replaced.

    5. Health concerns regarding molds

    Ref. 1 reviewed the public concern about the toxic effects of molds. It noted that with the Internet and the popular press having exaggerated some of the connections of symptoms with mold allergies, the term “mold madness” has been coined (Ref.2). Despite the paranoia in the general public about toxins from molds, there is only a small percentage of the population that is sensitive to molds where IgE antibodies and IgG antibodies against molds can be determined through blood tests. These individuals often are also allergic to other environmental allergens like grass pollen and dust mites. The asthmatic reactions in sensitive people are not as severe as what peanut traces would do to peanut sensitive patients, but skin testing and blood test screening for specific IgE and IgG antibodies do often confirm that sensitive people indeed can have specific mold allergies. In the vast majority of people these tests are negative and correlations between mold infestations and allergic reactions could not be verified (Ref.1).

    6. Fixing mold damage and dealing with allergies

    It follows from this that you should remove any visible molds and fix whatever the cause was for its appearance. Carefully disinfect the areas with diluted bleach water (the CDC recommends 1 cup of bleach per 1 gallon of water) several times. Make sure the areas are dry and not musty otherwise you  have  work on improving ventilation. If you are not one of these hypersensitive persons, there is nothing to worry further. However, if you are hypersensitive an allergist should examine you. Common indoor molds that cause the so-called “immediate type hyper reactivity” are due to the mold species Aspergillum and Penicillium. Most outdoor molds that can cause problems for sensitive people are due to Alternaria and Cladosporium species. The latter would be the ones found in carpets after a leaky roof has caused problems. When the allergist has found specific allergies to one or several of the mold species, allergy shots may be prescribed that would have to be given weekly to the sensitive person who was found to have environmentally induced asthma. Often it takes several years for these desensitization shots to stop the affected person from reacting  to molds. In some cases patients need to stay on these shots life-long.

    Conclusion

    The key with regard to mold allergies is to prevent mold growth by being vigilant about detecting early problems with leaky roofs, walls and cleaning up water damage right away. When there is a musty tell- tale smell, investigate right away and remedy the problem. For most people this is the end of the story. However, a small percentage of very sensitive people need to consult with an allergist who should investigate whether or not these people would benefit from allergy injections.

    In some rare cases the affected person may have to relocate to another house that is free from molds.

    More information about asthma: http://nethealthbook.com/lung-disease/asthma-introduction/

    References

    1.Shannon: Haddad and Winchester’s Clinical Management of Poisoning and Drug Overdose, 4th ed. Copyright 2007 Saunders

    2. Zacharisen MC, Fink JN: “Is indoor “mold madness” upon us?” Ann. Allergy Asthma Immun. 2005; 94:12-13.

    Last edited Nov. 7, 2014

    Mar
    08
    2014

    Protecting Yourself From Environmental Toxins

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

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

    The youngest and most vulnerable

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

    Function of liver and kidneys

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

    Diabetes from environmental toxins

    Environmental toxins can cause insulin resistance and type 2 diabetes.

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

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

    Inorganic arsenic

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

    Protecting Yourself From Environmental Toxins

    Protecting Yourself From Environmental Toxins

    Other toxins around the house

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

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

    Fumes of chemicals can cause lung cancer

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

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

    Lead and mercury poisoning, and radioactive pollutants

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

    Mercury contamination of the environment

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

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

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

    Monomethylmercury poisoning

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

    Other marine pollution

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

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

    Protecting yourself from toxins

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

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

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

    Detoxification

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

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

    Remove toxins from your home

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

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

    Exposure to radioactive substances

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

    Conclusion

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

    Accountability of quality of food and beverages

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

    References

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

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

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

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

    Last edited March 8, 2014

    Feb
    19
    2014

    Every Patient Is Unique

    Modern Western Medicine tends to see the disease of a patient as a unique entity. Conventional medicine behaves as if a disease is associated with characteristic symptoms, findings and lab test results, which are then treated in a standard fashion by treating the symptoms of the disease.

    The reality though is different: The same disease can present in various patients with different symptoms.

    Naturopathic physicians, integrative physicians and anti-aging physicians see patients as unique individuals with characteristic personality traits and slightly varied presentations, which may be shared in a disease entity, but differ substantially from person to person.

    It is important to be aware of this uniqueness, if the caregiver wants to achieve the optimal treatment result.

    Big Pharma does not like this approach as they would like you to think that the conventional medicine system is superior. A certain disease is treated a certain way, preferably with the most expensive drugs.

    I thought that in this blog it would be good to shed some light on this important topic.

    Menopausal women with symptoms

    Let us consider an example of a 55-year old woman who has hot flashes, dry skin, a loss of hair from the outer aspect of her eyebrows, does not sleep well and has lost her sex drive. She also has put on 20 pounds in the last year despite no change in her diet.

    This is how conventional medicine would handle this patient

    The doctor examines the woman and does a Pap test as well. A conventional doctor would likely order standard blood tests consisting of a complete blood count, thyroid tests (T4, TSH) and FSH and LH levels. The conventional physician would find that the thyroid hormones are low with a high TSH (thyroid stimulating hormone) and would treat the woman with Synthroid (a synthetic thyroid hormone drug). The LH and FSH were found to be high indicating to the conventional physician that the woman is in menopause. He would offer the standard PREMPRO (a synthetic hormone preparation containing a mare estrogen combination with a progestin) with the warning that he will give her the lowest estrogen combination and only up to 5 years because of the negative findings of the Women’s Health Initiative.

    Every Patient Is Unique

    Every Patient Is Unique

    Here is an example how a naturopathic or anti-aging physician’s would investigate and treat the patient

    A naturopathic physician or an anti-aging physician would likely add a female saliva hormone panel to the other blood tests mentioned above and also do a T3 hormone level as part of the thyroid blood tests. The doctor will explain to the patient that she was found to be menopausal and also hypothyroid. With respect to the hypothyroidism the physician will explain that apart from thyroxin (T4) there is a second hormone, triiodothyronine (T3) that is also necessary in order to replace all of the thyroid hormones that humans have. Drug companies assume that T4 (Synthroid) will reverse automatically into whatever amount of T3 the body needs, so they have convinced most conventional doctors to prescribe T4 drugs only (like Synthroid). The problem is that as the body ages, the enzymes necessary to convert T4 into T3 do not work as well as in a younger age.This can be verified by testing T3 and T4 levels simultaneously.

    The end result is that the patient who only gets T4 replaced may still have some of the symptoms like lack of energy and depression even when T4 has been replaced. Not so with the patient treated by the naturopath or the anti-aging physician who put our patient on Armour (porcine-derived thyroid hormone replacement containing both T4 and T3).

    With regard to the blood tests and the saliva hormone tests the second patient was told that the blood tests confirmed menopause (high LH and FSH) and that the saliva female hormone panel showed what was going on. In this particular patient the female saliva hormone tests showed that the progesterone level was low, the testosterone level was low and estrogen was normal. Another hormone, DHEA-S (which is DHEA sulfate, the storage form of DHEA) was also on the low side. Cortisol that had also been tested was normal. The physician explained that the woman’s adrenal glands showed a slight weakness not producing enough DHEA, which is a precursor to testosterone. The low testosterone level was responsible for her lack of sex drive. Progesterone, which needs to be high enough to counterbalance estrogen, was missing, which was likely the cause of her hot flashes and the lack of energy together with the missing thyroid hormones. The physician explained that the woman needed a small amount of DHEA tablets by mouth, a full replacement of progesterone (through the use of a bioidentical hormone cream) and also a small amount of bioidentical testosterone cream to normalize her hormones.

    A reassessment of the patients 2 months later showed that the first woman still had some depression and lack of energy, while the second woman felt her normal self again. Both women had regrown their eyebrows from replacing the missing thyroid hormones and have lost several pounds since the beginning of their treatments, but obviously there were quite different clinical results. The first woman was treated in a “standard conventional medicine” fashion, which will lead to breast cancer as unnecessary estrogen was given. She also will be at risk of getting cardiovascular disease as she was replaced with Progestin, a synthetic drug thought by conventional physicians to represent “progesterone”. The Women’s Health Initiative has proven that this was the outcome with PREMPRO and yet this drug is still on the market!

    The second woman received an individualized and personalized holistic treatment protocol. The low progesterone from missing her ovulations after menopause was being replaced and her body very quickly responded favorably by making her feel normal again. The missing adrenal gland hormones and testosterone were replaced and this normalized her sex drive. Both, progesterone and thyroid hormones (T3 and T4) are anabolic hormones and they gave her back her energy and restored her sleep pattern. With normal hormone levels she also lost her depression symptoms.

    Two men with depression

    If you thought that the difference of these two clinical approaches were just coincidental, think again. The next examples are two men in their early 50’s who see their physicians because they felt depressed and had a lack of energy. Both were normal weight.

    Here is the conventional medicine approach

    The physician took a history, during which a lack of sex drive was also noted. He examined the patient and came to the conclusion that physically nothing was wrong with the man, but a diagnosis of depression was made. This would account for the tearfulness, sleep problems and loss of sex drive. The doctor prescribed one of the standard antidepressants (in this case sertraline, brand name Zoloft). Three weeks later the patient returned and as he was better, a repeat prescription for the antidepressant was given. After a further two months the patient was reassessed. When the symptoms were reviewed, it became apparent that a lack of sex drive was still present, if anything the patient felt the antidepressant had made this worse. Some of the depressive symptoms have improved on the conventional antidepressant. The doctor discussed that the antidepressant could be increased by one tablet per day. The doctor also discussed the option of using Viagra for the decreased sex drive and difficulty having an orgasm.

    This would be the  naturopathic or anti-aging physician’s approach. Again similar to before a history was taken and a physical examination was done. The physician noted that the patient was in the age where a lack of sex drive could indicate an early andropause (the male equivalent of menopause, often difficult to spot with the first presentation). A depression questionnaire indicated that the man was moderately depressed. The patient was sent for blood tests and for saliva hormone tests (a male hormone panel). The physician stated that he would like to arrange for cognitive therapy treatment to sort out the various factors of his depression, but also help his mood by trying to start him on St. John’s wort, an herb that has been proven to be effective for mild to moderate depression. The blood work came back as normal. However, the hormone tests showed that testosterone was in the lower third of the normal range. DHEA-S, cortisol and estrogen were normal. So a few weeks later when the tests had come back the patient was called in.  The doctor explained to him that the low testosterone level would explain why his sex drive had deteriorated along with his symptoms of depression. Bioidentical testosterone cream was added to the antidepressant herbal treatment. The result was that within one month this patient’s sex drive was back to normal. Together with the cognitive therapy treatments and the herbal antidepressant the depression was also resolved. After a further three months of counseling he was able to stop the St. John’s wort. Due to the counseling sessions he felt stronger than ever before and his mood remained stable even when the counseling sessions were terminated. He continued to use the bioidentical testosterone cream regularly.

    These are examples of two different approaches in two identical men in their early 50’s. It appears to me that the conventional approach did a disservice to the sick person, only treated symptoms, but did nothing to solve this patient’s real problems. The second case’s depression was treated properly and the physician luckily also did not miss the underlying early andropause with low testosterone levels. Repeat testosterone levels showed a high normal testosterone level, which was now in the upper 1/3 of the normal range.

    The conventional approach missed the early testosterone deficiency, which  would cause heart disease, should the testosterone levels become even lower. Viagra certainly would not be the answer as this has a number of potentially serious side effects. The antidepressants at even higher doses would cause more erectile dysfunction, which was what he hoped to have treated.

    Conclusion

    People often have several conditions at the same time. It takes intuition, readiness to do testing, repeat close observation and repeat examination on the part of the physician. This needs to be coupled with good listening skills to sort out a patient. On behalf of the patient it is important to tell the physician all of your symptoms and observations. Be patient and never give up. A good patient/physician relationship will go a long way in sorting out complex medical problems. Every patient is unique. Not every symptom means the same thing in two different patients.

    More information on:

    1. Menopause: http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/menopause/

    2. Depression: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/depression/

    Last edited Nov. 7, 2014