Medical Articles by Dr. Ray

Jul

2022

What Electronic Cigarettes Do to You

By Ray Schilling | e-cigarettes, heart attack, Lung Disease, Prevention

A review paper of Canadian researchers showed what electronic cigarettes do to you. They can be an effective smoking cessation aid for motivated smokers who eventually want to quit. But when people continue to inhale electronic cigarettes, their use can cause heart attacks, strokes, high blood pressure and increased heart rates. With regard to the lungs electronic cigarettes can cause vaping-associated lung disease, obstructive pulmonary disease, asthma and chronic cough. A literature review showed that e-cigarettes are less harmful to the heart and the lungs than smoking combustible cigarettes.

Increased use of e-cigarettes in younger people

In Canada the 2017 Canadian Tobacco, Alcohol, and Drugs Survey, which included all ages, found that 15.4% tried e-cigarettes. But among adolescents between 15 to 19 years old 22.8% were using e-cigarettes. For young adults aged 20 to 24 the figure of e-cigarette users was 29.3%. In addition, there was a significant increase of Canadian adolescents aged 16 to 19 from 29.3% in 2017 to 37.0% in 2018. Data from the US shows similar trends. E-cigarette use among US high school students increased from 11.7% in 2017 to 27.5% in 2019.

Some facts about e-cigarettes, cigarette smoking and smoking cessation

First, researchers noted that the smoking of e-cigarettes has a 3.62-fold risk of leading to subsequent cigarette smoking.
Second, a UK study found that when people used e-cigarettes for smoking cessation, 80% of the e-cigarette group were still smoking e-cigarettes after 1 year. In contrast, only 9% of those who used traditional nicotine replacement therapy (Nicorette etc.) to quit smoking were still using nicotine replacement after 1 year.
One study compared heart attack rates in a group of regular cigarette smokers and compared this to e-cigarette smokers. Cigarette smokers had a 2.72-fold higher heart attack rate than non-smokers, while e-cigarette smokers had a 1.79-fold heart attack rate compared to non-smokers.

Effect of e-cigarette use on heart and lung disease

Several studies looked at the relationship between e-cigarette use, heart attacks and strokes. There was a 1.4-fold higher incidence of coronary artery disease in e-cigarette smokers in comparison to non-smokers. The e-smokers had a 1.71-fold higher stroke incidence and 1.59-fold higher heart attack rates. In a large metaanalysis done with e-cigarette smokers, researchers noted the following facts: Electronic cigarette smokers were compared to non-smokers. Researchers noted a 2.27-fold increase of the heart attack rates in e-cigarette smokers. There was a 2-fold elevation of the systolic and diastolic blood pressure in e-cigarette smokers.

Switching from cigarette smoking to e-cigarettes

Patients who switched from tobacco smoking to chronic electronic cigarette use had a 7-fold reduction of their systolic blood pressure and a 3.65-fold reduction of their diastolic blood pressure. The researchers concluded that switching from cigarette smoking to e-cigarettes had some merit in terms of risk reduction for cardiovascular disease. But the final judgment on this is still pending. Certainly, quitting entirely from cigarette smoking is the best choice. I reported previously that e-cigarette smokers find it difficult to quit completely and if they smoke conventional cigarettes to stop that.

Effect of e-cigarettes on lungs

In addition to cardiovascular effects there is a direct effect from e-cigarette smoking on the bronchial tubes and the lungs. The vaped substances from e-cigarettes contain a lot of noxious gases that irritate the lining of the respiratory tract. This syndrome is called EVALI (electronic vaping associated lung illness). In 2019 and 2020 there was a rush of EVALI cases in the US with 2807 hospitalizations and 68 deaths. In Canada there were 19 cases of EVALI, 15 hospital admissions, and no deaths. Patients with EVALI have problems breathing, they cough and they have chest pain. Researchers suspect that vitamin E acetate and tetrahydrocannabinol are the major culprits that cause EVALI. But at this time there is no definite proof for that.

Poor quality of vaping fluid from the black market

These substances are not present in commercial e-cigarettes, but when you buy vaping fluid on the black market, it is often mixed in. Prolonged use of e-cigarettes can cause changes on spirometry, such as chronic obstructive pulmonary disease (COPD). Chronic use of e-cigarettes may cause premature onset of COPD.

What Electronic Cigarettes Do to You

Conclusion

E-cigarette use is increasing at an alarming rate among youths and persons who never smoked. The emerging evidence from researchers showed that there is a risk when you expose yourself to the smoke of e-cigarettes. There is an association of both heart disease and respiratory disease to e-cigarette smoking, but the risk is less than with exposure to regular cigarette smoke. Some researchers think that a switch from cigarette smoking to e-cigarettes could provide a viable harm reduction strategy for some smokers. But unfortunately, many continue to smoke e-cigarettes instead of quitting altogether. And in this case the risks for heart disease and lung disease remain!

Jul

2022

Stem Cell Therapy Is a New Way to Treat Osteoarthritis

By Ray Schilling | Arthritis, back pain, chronic pain, osteoarthritis, Pain, regenerative medicine, stem cells

Traditional treatment for osteoarthritis is not very successful, but stem cell therapy is a new way to treat osteoarthritis.

Traditional treatment of osteoarthritis

Osteoarthritis is a common degenerative type of arthritis. Wear and tear are diminishing the hyaline cartilage that coats joint bones. The lubrication of synovial fluid is diminishing as well. The end result is that the patient suffers pain from bone rubbing on bone in affected joints with swelling of the synovial membranes. The physician usually prescribes diclofenac topical solution for the affected joints and also gives anti-inflammatory drugs by mouth (diclofenac or ibuprofen). Unfortunately, the patient may develop side effects of the anti-inflammatory medication, such as kidney damage and gastritis. The end result after years of suffering is that the joints turn stiff and the joint pain becomes unbearable.

Joint replacement surgery

This is when the doctor refers the patient to an orthopedic surgeon, and an artificial hip or a knee joint replacement is the next suggestion. These surgical procedures are not without dangers. Postsurgically blood clots can develop and cause pulmonary emboli. Infection and sepsis can also develop. Often the surgery does not solve all of the problems and leaves the patient with a permanent limp.

Stem cell therapy to treat osteoarthritis

Regenerative medicine has developed an alternative to the conventional treatment of osteoarthritis. I described this new approach to osteoarthritis before here.

Stem cells are harvested from fatty tissue of the patient and injected into the affected joint. Stem cell stimulators like platelet rich plasma and low-dose laser therapy activate the stem cells that were lying dormant in the fatty tissue. These type of stem cells are mesenchymal in origin, so they go by the name of mesenchymal stem cells. When injected into a joint with osteoarthritis they can transform into any tissue that is needed to repair the damage of the joint. A defect of the hyaline cartilage is covered by stem cells transforming into cartilage cells and fixing the hyaline cartilage defect.

What stem cells do

Stem cells fix any meniscal degeneration in the knee joint by mending what is degenerated. They can form new tissue that over-bridged mini tears in the meniscus. If the synovial membranes that produce joint lubrication are damaged, the stem cells rejuvenate the old tissue and joint lubrication normalizes. The end result following stem cell treatment is that the osteoarthritic joint becomes regenerated with normal function. Stem cell treatment normalizes the osteoarthritic process in the joint, and down the road no joint replacements are necessary. This is a huge advantage in comparison to the conventional treatment of osteoarthritis.

My own experience with stem cell therapy for osteoarthritis of my left knee

I have experienced mild left knee arthritis for 5 years. It was not severe enough to treat with anti-inflammatory pills. I used higher amounts of fish oil capsules, which helped somewhat. I heard that Dr. Michael Weber from Lauenförde, Germany treats osteoarthritis with stem cell therapy.

He had treated my back successfully on several occasions in the past. I had previous stem cell treatment 4 years earlier as summarized here. Part of this was stem cell therapy for my left knee. During the Covid time I could not go to the gym for a period of time. Instead, I went for long walks on a nature trail that was bumpy and had many roots. This flared up my previous problem with my left knee. But in early June 2022 I made my way back to Dr. Weber’s clinic for more stem cell therapy.

The following summarizes how he treated my left knee with stem cells.

Liposuction to harvest stem cells for treatment

The doctor used a local anesthetic to freeze the skin and subcutaneous tissue on the right flank. Subsequently a solution of normal saline that contained adrenaline and bicarbonate was injected. This allowed Dr. Weber to withdraw fatty tissue easier 20 minutes after the normal saline injection. The generous portion of fatty tissue harvested was brought to a cell separator, which separated stem cells, fat cells and connective tissue. The stem cells were counted by a technician. They were found to be 100% viable and there was a total of 980 million stem cells.

Intravenous stem cells

Dr. Weber administered one portion of the total stem cell harvest intravenously. I was told that this ensured that stem cells would be delivered to tissues that needed renewal through stem cell therapy. There are several methods to stimulate stem cells. One of these methods is to give oxygen intravenously with a device with the name Oxyven (from Swiss Medica) . This procedure took 20 minutes. A second method to stimulate stem cells is with low-dose laser therapy. Dr. Weber used intravenous red, green, blue and yellow lasers, for 20 minutes each.

The laboratory kept the rest of the stem cells overnight at room temperature. Dr. Weber told me that it would have been a mistake to keep the stem cells in the refrigerator overnight as the cold temperature kills all of the stem cells!

Targeted stem cell therapy

The following day I received treatments with my stem cells harvested the day before. The doctor drew blood up first, which underwent centrifugation. The interface between the red blood cell portion and the plasma contains PRP (platelet rich plasma). Dr. Weber mixed PRP in with the stem cells. PRP is a powerful stimulator of stem cells.

Dr. Weber inserted a needle into my left knee and injected stem cells (and PRP) into the left knee. Following this he inserted a thin sterile fiberglass applicator. This served to introduce four laser lights into the knee, namely red, green, blue and yellow low-dose laser beams. Dr. Weber connected each for 20 minutes. He explained that the laser light activates the stem cells, similar to PRP and to oxygen (Oxyven, Swiss Media).

Lower cervical spine, upper thoracic spine and lower lumbar spine also treated

I get monthly chiropractic manipulations to my spine to stabilize it. My chiropractor told me that it would help to have stem cell therapy in the C4 to T4 area of the upper spine and in the L4 to S1 region in the lower spine. Dr. Weber concentrated his treatments on exactly these levels of my spine. He placed interstitial needles over the facet joints bilaterally in the lower cervical spine, upper thoracic spine and lower lumbar spine. Subsequently he injected the stem cell/PRP mix and followed this up with the four laser lights for 20 minutes each.

Follow up after the stem cell treatments

There was a lot of swelling in my left knee during the first two days after the stem cell treatment. I also experienced pain with walking. But on the third day the swelling disappeared completely. After 1 week the previous mild left knee pain improved significantly. After 1 month the left knee no longer ached with stairs or uneven ground. Presently I am still completely pain-free. My back pain also disappeared within 2 to 3 weeks.

Stem Cell Therapy Is a New Way to Treat Osteoarthritis

Conclusion

When it comes to the treatment for osteoarthritis, conventional medicine offers topical and oral anti-inflammatory medicine. Usually, the physician also recommends active exercises and heat applications by a physiotherapist. When anti-inflammatories no longer work and bone rubs on bone in a hip or knee joint, total hip or total knee replacement by an orthopedic surgeon is usually the next step. Unfortunately, these surgical procedures have a certain complication rate. They often do not lead to perfect end results with residual pain and possibly a limp

Stem cell therapy is usually not what a family practitioner recommends. But when the physician does stem cell therapy at an early stage, the success rate is good and as in my case you can always do another stem cell therapy to improve the knee or hip joint further. There are three procedures that help to stimulate stem cells: platelet rich plasma (PRP), intravenous oxygen (Oxyven, Swiss Media) and low-dose laser activation. In my case Dr. Weber applied all of these methods together with stem cell therapy. Improvement in my case was very rapid, and it was a delight to witness the result of stem cell therapy as a patient.

Jul

2022

Can Surgery Help with Snoring?

By Ray Schilling | Insomnia, sleep, Sleep apnea

Snoring is a common problem in people, and so the question is: can surgery help with snoring? About 25% of adults snore regularly, 45% snore occasionally. You are more likely to snore when you are overweight. Other factors are being a middle-aged or older male or a postmenopausal woman. Over the last decades various surgical procedures were in development in an attempt to cure snoring.

Obstructive sleep apnea

A person with obstructive sleep apnea has a problem of a relaxed rooftop in the mouth, where the uvula drops down. At the same time the tongue is falling backwards and together with the relaxed rooftop this leads to intermittent obstruction of the airway. The end result is loud snoring, which can lead to intermittent cessation of breathing. A positive pressure device is a common remedy for this condition, which keeps the airway open during your sleep. It is called continuous positive airway pressure (CPAP). However, this system is somewhat noisy, and about 50% of patients find it disturbing and cannot tolerate it. Many patients prefer a surgical, permanent solution.

Classification of snoring

Most snorers have primary snoring. Among these patients there is a minority who stop breathing periodically, which lowers the blood oxygen content. The patient awakes from this and tightens the muscles in the palatine-pharyngeal area and then breathes normally again for a while. These patients have obstructive sleep apnea (OSA). However, when deeper sleep is reached in OSA patients the cycle repeats itself. A clinical test how to distinguish between primary snoring and OAS is a polysomnography study, which also goes by the name of a sleep study.

Uvulopalatopharyngoplasty

This sounds like a tongue twister! In lay terms it is a surgical procedure which removes the uvula and the adjacent tissues of the palate and throat walls. There are side effects like swallowing problems, throat changes and the permanent feeling of a foreign body in the throat. Since the original design several modifications were introduced, which reduce the side effects of this procedure, but do not entirely eliminate them.

Somnoplasty or radiofrequency ablation

For patients with primary snoring, who do not have OSA a new procedure utilizes low levels of radiofrequency heat energy to create finely controlled localized burns in the lining of the soft tissues of the palate. This tightens the palate tissue and avoids the vibrations that cause snoring. The procedure can be done in the office setting under local anesthetic. It takes only about 30 minutes. When researchers compared pre-treatment scores with scores after three years following two ablation radiofrequency treatments there was a significant reduction of the snoring activity. Somnoplasty is another name for the FDA approved ablation radiofrequency treatment. This treatment works well for patients with primary snoring, but is not so successful for patients with OSA.

Maxillomandibular advancement (MMA)

The physician orders this fairly invasive surgery for patients with OSA who cannot tolerate continuous positive airway pressure. The goal of the surgery is to remove the two obstruction points where the patient chokes at night. This occurs most often behind the palate and behind the tongue. MMA was introduced more than 35 years ago. On the plus side, the success rate is about 90%. The minus side is the fact that it is major invasive surgery where the surgeon moves both the upper and lower jaws forward opening up the two choke points in the back. The surgery lasts about 6 hours and it takes approximately 6 weeks for it to heal.

Hypoglossal nerve stimulation

An alternative for patients with moderate to severe OSA is the use of hypoglossal nerve stimulation. Patients with OSA have a weakness in the muscle tone of the muscles that push the tongue forward. When they fall asleep the tongue tends to fall backwards obstructing the airways. This can be remedied with the use of hypoglossal nerve stimulation that stimulates the muscles that push the tongue forward.

Results with hypoglossal nerve stimulation devices were encouraging, as more than 80% of patients with OAS who had this device inserted had a successful treatment outcome. 4 years later, in the same patients there was still effectiveness of the hypoglossal nerve stimulator and the improvement in quality of life remained the same.

Can Surgery Help with Snoring?

Conclusion

There are several procedures that can help patients with primary snoring or patients with an obstructive sleep apnea (OSA). For patients with primary snoring, who do not have OSA a new procedure utilizes low levels of radiofrequency heat energy to create finely controlled localized burns in the lining of the soft tissues of the palate. This tightens the palate tissue and avoids the vibrations that cause snoring. In patients with obstructive sleep apnea a continuous positive airway pressure device (CPAP) is a common remedy for this condition, which keeps the airway open during their sleep. But only about 50% of patients tolerate this procedure.

More surgical procedures

The uvulopalatopharyngoplasty can help a certain number of patients. Here the ear/nose/throat surgeon removes the uvula and the adjacent tissues of the palate and throat walls. The surgeon does this under general anaesthesia, and patients will take about two weeks to fully recover. Another more invasive procedure is the maxillomandibular advancement (MMA). The goal of the surgery is to remove the two obstruction points where the patient chokes at night. This occurs most often behind the palate and behind the tongue. The surgical procedure is in use for more than 35 years and the success rate is about 90%. However the surgery will take several hours, and recovery of the patient will take about 6 weeks.

Jun

2022

Tick Bites Can Render You Allergic to Red Meat

By Ray Schilling | Allergies, anaphylactic reaction, immune system, red meat

Tick bites can render you allergic to red meat. This comes from the alpha-gal syndrome, which is a type of food allergy. It is a tick with the name of Lone Star tick that transmits this syndrome in the southeastern United States.

Deer carries the Lone Star tick into other parts of the US. The bite of the tick transfers a sugar molecule called alpha-gal into the person’s body. Subsequently the person develops a sensitivity to red meat, like beef, pork and lamb. Red meat membranes are rich in the sugar alpha-gal. The allergy can also be directed against other mammal-related products like milk protein. Often the person is unaware of this type of allergy, alpha-gal syndrome. In this case people continue to get exposed to red meat and mammal products, and the immune reactions become more severe over time. Anaphylactic reactions that are not due to food allergies have a high probability to be due to alpha-gal syndrome.

More details about the alpha-gal syndrome

Alpha-gal is the abbreviation for Galactose-alpha-1,3-galactose, which is a carbohydrate. It is part of most mammalian cell membranes, except for primates. The immune system in humans recognizes it as a foreign body and produces anti-alpha-gal antibodies. It is the bite of the lone star tick in North America or the castor bean tick in Sweden that can start the allergy to alpha-gal. If a person has frequent anaphylactic reactions, the physician should think of alpha-gal syndrome, which could be the underlying cause.

Sensitization of the human host

When the lone star tick bites mice, rabbits or deer it takes up alpha-gal sugar. Subsequently, when the tick bites a human, the alpha-gal sugar is injected into the human host together with its saliva. This alarms the immune system and antibodies are produced. When the human host later consumes meals with red meat, the body reacts to the previous sensitization to alpha-gal sugar by the tick bite. The antibody response to alpha-gal sugar from further red meat meals becomes even stronger than before. The only relief for human host from immune reactions is to switch to a diet that is free of red meat.

Allergic symptoms

The alpha-gal allergy can manifest itself by skin rashes, welts, skin itchiness, swelling, shortness of breath, headaches, belly aches, diarrhea and vomiting. In serious cases an anaphylactic reaction can occur, which in some cases can be lethal.

Protein allergies versus carbohydrate allergies

Until 2009 medical science believed that allergies would only be due to proteins. One such example are allergic reactions to peanuts. It is the peanut protein that can cause allergies. Subsequently, the alpha-gal allergy became known, which involves the sugar galactose-alpha-1,3-galactose. This was the first sugar molecule that researchers could demonstrate to mount an allergic reaction, from which the human host could turn sick.

Tick Bites Can Render You Allergic to Red Meat

Conclusion

The Lone Star tick in the southeastern US carries the sugar galactose-alpha-1,3-galactose (for short alpha-gal) which originates from bites of mammals that are not primates (cattle, pigs and lambs). When the tick bites a human, the immune system produces antibodies against alpha-gal. This can produce skin rashes, welts, skin itchiness, swelling, shortness of breath, headaches, belly aches, diarrhea and vomiting. But when the person recovers from the tick bite, a lifelong sensitivity against reed meats remains. Every time a sensitized person consumes a red meat meal the same symptoms, as originally experienced from the tick bite, return.

Abstinence from red meat

The only remedy for the alpha-gal syndrome is to abstain from red meat. The cell membranes of the muscle of red meat contain the sugar alpha-gal. Seafood, chicken, eggs and turkey meats are OK for consumption. But the patient has to be diligent about not making any dietary mistakes. If intermittent red meat exposure continues, a more severe allergy can develop. These have the name of “anaphylactic reactions”, where the patient is in danger of suffocating or even die from it.

Jun

2022

Erectile Dysfunction Drugs Pose a Risk to Eyes

By Ray Schilling | erectile dysfunction, Eye Diseases

A new study from the University of British Columbia, Vancouver, BC showed that erectile dysfunction drugs pose a risk to eyes. UBC researchers studied 213,000 insurance claims of serous retinal detachment, retinal vascular occlusion, and ischemic optic neuropathy. They found that there was a close association with these eye conditions and the use of drugs like Viagra, Cialis, Levitra, and Stendra that these men used for erectile dysfunction (ED). In the year before these men started to take ED drugs none of them had any of these three eye conditions. Once they started taking these drugs there was an 85% increase in occurrence of one of these eye conditions.

Explanation of eye conditions

Serous retinal detachment

Serous retinal detachment can occur when you develop a tear of the retina. In this case the vitreous fluid from the center of the eye can leak underneath the retina and lead to retinal detachment. If you develop spots or floaters or flashes of light, or if you develop weak vision, this is a sign that you should seek immediate help from an eye-specialist.

Retinal vascular occlusion

When a blood clot occurs in either a vein or artery that supplies the retina with blood there can be a sudden loss of vision. This is an emergency and requires a trip to an eye specialist in the hospital.

Ischemic optic neuropathy

The optic nerve collects all the signals from the retina and transports this to the brain for further processing. When the blood supply to the optic nerve gets interrupted, there can be a sudden loss of vision. This is an emergency. An eye specialist has to immediately assess the patient in the hospital.

Eye professor warns to take eye conditions seriously

Professor Dr. Mahyar Etminan from UBC said: “These are rare conditions, and the risk of developing one remains very low for any individual user. However, the sheer number of prescriptions dispensed each month in the U.S. – about 20 million – means that a significant number of people could be impacted.” He went on to say: “Regular users of these drugs who find any changes in their vision should take it seriously and seek medical attention.”

Causation versus statistical association

The study showed a strong statistical association between the ED drug use and these three eye conditions. Patients on the ED drugs were 1.85-fold more likely to develop one of the eye conditions. This was in comparison to controls who were not on ED drugs. Professor Etminan said: “These medications address erectile dysfunction by improving blood flow, but we know that they can also hinder blood flow in other parts of the body”. And he continued: “So although our study doesn’t prove cause and effect, there is a mechanism by which these medications could conceivably lead to these problems. The totality of the evidence points toward a strong link.”

Erectile Dysfunction Drugs Pose a Risk to Eyes

Conclusion

When men age, they often develop erectile dysfunction (ED). ED drugs were developed that can overcome this problem. But like any drug these can have side effects too. One of the rare side effects are three serious eye conditions. The have the name serous retinal detachment, retinal vascular occlusion, and ischemic optic neuropathy. As these men were older, they likely already had some arteriosclerosis of the blood vessels. This means they were at a higher baseline risk to develop one of these eye conditions. A study showed that they were 1.85-fold more likely to develop one of the eye conditions. This was in comparison to controls who were not on ED drugs. At this point the researchers at UBC Vancouver, BC say that they found the following. There was a strong association between ED drugs and these serious eye conditions. They commented that at the present time, however, they cannot say that ED drugs would have caused them.

May

2022

What Works for Permanent Weight Control

By Ray Schilling | diet, exercise, fasting mimicking diet, stem cells, Weight loss

A recent publication examined what works for permanent weight control and what not. The study came from the Queen’s University in Kingston, Ont., AdventHealth, Fla. and the University of Alabama, Birmingham, Ala.

320 sedentary adults who were overweight or had obesity were treated by monitoring alone or by doing “small change approaches”. Both groups were observed for 3 years. The “small change approach” consisted of increasing their activity by 2000 steps per day and by limiting their food intake by 100 kcal per day. The researchers measured the weight, waist circumference and cardiorespiratory fitness of all the subjects.

The results at 3, 6, 12 and 15 months from the start showed significant reductions in weight. However, by 24 and 36 months the subjects had regained body weight.

Results of the study

Results from both groups, the non-intervention group and the small change group, were stacked against each other. There was no significant difference in terms of weight loss between 24 and 36 months into the trial. The researchers concluded that the approach of small change interventions failed.

Another approach to permanent weight loss

Valter Longo, a professor at UCLA, California has established that the fasting mimicking diet can help people to lose the last pounds that are difficult to lose. Patients do a 5 day semi-fast for 5 consecutive days, once per month. They eat three meals per day, but the total daily calorie consumption is only 500 to 800 calories. The calorie deficit leads to a reduction in body mass index between 0.3 and 0.9 for every monthly fasting mimicking diet. I have followed Dr. Longo’s fasting mimicking diet since December 2017. This allows me to keep my body mass index between 21.0 and 22.0.

Conditions that respond to the FMD

The following list shows some of the conditions that respond favorably to the FMD.

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

The above was previously published here.

Discussion

The 3-year study that I mentioned at the beginning of this article showed that for the group that made “small changes” for 2 years there was a slight weight loss with a reduction of 100 calories per day. However, the patients got tired of dieting and regained their lost weight between 2 and 3 years. In contrast, the fasting mimicking diet requires a 1200 to 1500 calorie reduction for 5 days of each month. After a few months the patient becomes highly aware what leads to weight gain and what not. I use electronic body composition scales daily where I can determine weight, fat percentage and muscle percentage. It also records calories consumed and the body mass index (BMI).

Watching your fat percentage and BMI

I record all this data in a little booklet. Once per month I see that the fasting mimicking diet lowers my body mass index by 0.3 to 0.9 points. There is the negative experience of eating ice cream or a New York cheesecake that within one day shows as an increase in fat and the BMI. On the other hand, it is encouraging to see your elevated BMI melt away in only a few days every month. This motivates you over the years to cut out the big diet offenders and to keep your eating portions smaller. Also, you value the neutral effect of berries and vegetables.

What Works for Permanent Weight Control

Conclusion

An interesting diet study of 3-year duration showed that small caloric reductions of 100 calories per day are ineffective over a longer period of time. In this study the effect of small caloric reductions wore off after two to three years. On the other hand, I experienced the effects of the fasting mimicking diet (FMD) of Dr. Longo for more than 4 years. This helps me to keep my body mass index (BMI) in the 21.0 to 22.0 range. Without the FMD I would slowly slip into the overweight category. Following the FMD every month and recording the body composition scale values daily keeps me motivated to watch what I eat resulting in persistently low BMI values. Knowing that this is also a key to health keeps should keep anybody motivated.

May

2022

The Dirty Dozen and the Clean Fifteen

By Ray Schilling | Cancer, food, organic food

This article describes the dirty dozen and the clean fifteen.

The environmental working group (EWG) defined the “dirty dozen” as crops, which farmers pollute by repetitive spraying. Notably, this is a list of the 12 most insecticide-sprayed crops like strawberries, spinach, tomatoes and others. It is important to realize that in the last few years, the EWG added the 15 clean crops. For this reason, if you want to avoid toxins on your food you exchange the 12 dirty dozen for organically grown crops. Specifically, you can also rest assured that the pollution levels in your food is of no concern, when you add the “clean fifteen” since these crops are relatively non-polluted. By all means, I have used this shopping guide for over 10 years and always look for the yearly updates.

The dirty dozen

Here is the dirty dozen:

Strawberries
Spinach
Kale, collard & mustard greens
Nectarines
Apples
Grapes
Bells and hot peppers
Cherries
Peaches
Pears
Celery
Tomatoes

It is important to realize that certain agricultural methods lead to the insecticide contamination of the dirty dozen. It may come as a surprise that not only spinach, strawberries and cherries, but also apples, grapes, celery and tomatoes are very contaminated. I buy only organic equivalent versions of the dirty dozen.

The list of the clean fifteen

Here is the list of the clean fifteen:

Avocados
Sweet corn
Pineapple
Onions
Papaya
Sweet peas (frozen)
Asparagus
Honeydew melon
Kiwi
Cabbage
Mushrooms
Cantaloupe
Mangoes
Watermelon
Sweet potatoes

These are crops that you can buy and eat, because they are not contaminated with insecticide spray. There is a yearly update on the website, which informs you of any changes of the contaminated crops. So far little has changed over several years.

According to the CNN article cited in the beginning of this article 70% of the clean fifteen list have no detectable residues of pesticides. Just under 5% of this list had two or more pesticide residues. For this reason I would label those as relatively non- polluted.

Why pesticides are dangerous

Toxicity of pesticides depends on the chemical configuration. Some are more toxic than others. But in combination pesticides are much more toxic than each one of them alone. Some pesticides irritate the skin, others the eyes. Other chemicals are toxic to the nervous system and the hormone system. And on the long-term pesticides can cause cancer.

Specific toxins

DCPA http://extoxnet.orst.edu/pips/DCPA.htm is a general herbicide that farmers spray on several vegetable crops. It was banned by the European Union in 2009.
Nut and fruit tree farms use Chlorpyrifos, a pesticide, which farmers also spray on broccoli and cauliflower. The EPA banned this substance in February 2022. Chlorpyrifos contains an enzyme that causes neurotoxicity in children. It also causes neurodevelopmental effects in children.
Organophosphates block acetylcholinesterase, an enzyme that inactivates acetylcholine. Toxicity of organophosphates comes from poisoning with acetylcholine, which overstimulates muscles. https://en.wikipedia.org/wiki/Organophosphate_poisoning#Pathophysiology The brains of babies and children are very sensitive to the toxic effect of organophosphates.
A number of pesticides are endocrine-disrupting chemicals. This can have permanent or long-lasting effects on the reproductive development. https://cfpub.epa.gov/si/si_public_record_report.cfm?Lab=NHEERL&dirEntryId=212273

Complaints of the industry about the EWG

The industry has repeatedly complained about the EWG that the publication of the dirty dozen would harm the sales of crops. But studies done by the EWG showed that only 1 in 6 consumers are buying less vegetables and fruit. Alexis Temkin, a toxicologist at the EWG with expertise in toxic chemicals and pesticides said: “The study actually shows that just over half of people surveyed said the ‘Dirty Dozen’ list made them more likely to buy fruits and vegetables.”

Here is what the consumer can do

Rinse fruit and vegetables before you serve it; this removes surface toxins
Buy food from a local farmer; you can enquire about his farming practices.
Buy produce in season; if you buy organic crops they are most reasonable are that time, and you can prepare or freeze the fruit and vegetables for future use.

The Dirty Dozen and the Clean Fifteen

Conclusion

The environmental working group (EWG) developed the concept of the 12 dirty dozen and the clean fifteen crops. The consumer needs to know the 12 dirty dozen, as he/she has to buy organic crops as a replacement for this. On the other hand, you can buy the 15 clean crops, but you first need to know what is on the list. Knowledge is power, and knowing about these crops ensures that you keep insecticides, fungicides and herbicides out of your body. This information is not only important for adults and youth, but particularly important for babies and small children. Chlorpyrifos, which was banned in February of 2022 in the US causes neurotoxicity in children. But it also causes neurodevelopmental effects in children. The cleaner the crops are that we eat, the healthier our bodies are.

Apr

2022

Immune System Responses against Covid-19 or anti-Covid Vaccination

By Ray Schilling | immune system, Infectious Disease, Prevention, vaccinations

This article is about immune responses against Covid-19 or anti-Covid vaccination.

Investigations of the immune system showed that people who had Covid-19 and subsequently were vaccinated had an immune response that lasted for at least one year. In the following a discussion follows about the details why this is so.

The WHO confirmed more than 430 million cases of Covid-19 since the pandemic started. 4.9 billion people or 63.9% of the world population received at least one vaccination as of late February 2022.

How vaccination against Covid-19 works

The vaccine attacks the spike protein of the Covid-19 virus (SARS-CoV-2). The body produces antibodies through B cell activation. These are lymphocytes that originated from the bone marrow (hence B cells). They are capable of producing large amounts of antibodies that target the spike protein of the virus. It takes at least two vaccinations with the Pfizer vaccine to get a good antibody response. A booster vaccine brings the antibody titer even higher.

Cell-mediated response by killer T cells

When the virus enters a cell, the antibodies are no longer effective. Here the T killer cell comes into play. T killer cells are lymphocytes that were thymus processed (hence the name T cells) and activated by the vaccine. T killer cells function as a second line of defence. These immune cells specialize in detecting virus-infected cells. They immediately destroy these cells before the virus has a chance to replicate and shed more virus copies into the blood stream. It is the T cell response that prevents hospitalizations and deaths. Media coverage misled the public to believe that the bulk of the immune response would be from antibody production. However, the truth is that the T cell response is what is responsible for recognizing Covid-19 variants and why people survive Covid-19 with very little complications.

Long term immunity

When people had a Covid-19 infection the activated B cells that produced antibodies and the T killer cells get converted into memory cells. With a re-infection the memory cells can reactivate themselves to turn again into active B cells producing antibodies and T killer cells. The key for immunity with multiple vaccinations is also the memory cell pool. Those with two Pfizer vaccinations and a booster vaccine are much more immune to Covid-19 than those who only received one or two vaccinations.

Waning immunity

Following an infection with Covid-19 the immunity comes to a peak at 3 months after the start of the infection. The CDC said that people who are 90 days post-infection do not require a quarantine when they meet someone with an active Covid infection. By about 6 months immunity is declining. This is also true for people after double vaccination and a booster vaccine.

Hybrid immunity

The immune response after either a natural infection with Covid or following vaccinations with anti-Covid vaccines lasts only about 6 months. On the other hand, scientists observed that people recovering from Covid infections who subsequently received an anti-Covid vaccine just once had a very strong immune response that lasts for over a year. This is called hybrid immunity. This type of immune response triggers a very strong antibody response that is lasting longer. Immunologists are now researching whether the hybrid immunity is achievable with an improvement to vaccines. Results of this will not be available for several years.

Immune System Responses against Covid-19 or anti-Covid Vaccination

Conclusion

The immune response to Covid lasts for about 6 months; the same is true for the immune response after a vaccination. But when a person comes down with Covid and he or she receives a vaccination one month later, the immune response lasts for over one year. Scientists call this hybrid immunity. At this point experts recommend to have a booster vaccine every 6 months. But immunologists are researching for ways to incorporate the mechanisms of hybrid immunity into vaccines, which likely will not be available for several years.

Avoid deliberate exposure to Covid-19

Some persons who read about the response after a Covid infection and a vaccination misinterpreted this. They took this as an “invitation” to expose themselves to the virus in the hope to boost their immunity. However, a Covid infection remains an illness with potentially serious consequences. There is no way to predict whether the course of an infection will be mild or extremely severe. In addition, a significant number of patients come down with “long covid” and struggle with breathing problems, lack of energy and more. Covid is still here, and our best protection remains the full vaccination including boosters and hygienic measures. This involves masks, frequent hand-washing and disinfection of surfaces in daily life.

Mar

2022

Adolescents’ Lifestyles Are Linked to Faster Aging in Adulthood

By Ray Schilling | diet, fasting mimicking diet, Mental Health, mitochondria, Mortality, Obesity, Smoking, Vitamins and supplements

A longitudinal study found that adolescents’ lifestyles are linked to faster aging in adulthood. The study started with a baseline examination in a group of adolescents around the age of 15. 30 years later doctors examined the same individuals again. The researchers found that smokers, obese people and people with untreated emotional problems were aging faster than controls who did not have these problems. CNN discussed this study as well. A fourth condition, asthma was also included in the study. Indeed, adolescents who suffered from asthma in their mid-teens were not more biologically aged at age 45 when compared to controls who never had asthma. The authors concluded that treated asthma did not prematurely age a person. However, lifestyle habits like smoking, excessive weight and untreated mental illness contributed to accelerated aging.

Does having a healthy lifestyle lower your risk of developing medical conditions and diseases?

It must be remembered that anti-aging medicine is watching out for new treatments that can prolong life. However, this is not just one “breakthrough”, but rather a number of factors that in combination lead to longevity.

Resveratrol

Resveratrol, the supplement from red grape skin can stimulate your mitochondria metabolism. Exercise more and regularly as this will also stimulate your mitochondria to multiply similar to the effects of PQQ, a supplement. I take 500 mg of resveratrol concentrate once daily.

Exercise regularly

The first thing to remember is that regular exercise will prevent about 50% of chronic diseases (diabetes, heart failure, arthritis). Consequently, this prolongs life: Lack of exercise is a major cause of chronic diseases.

Replacing missing hormones with bioidentical hormones

When you enter menopause or andropause replace missing hormones with bioidentical hormones. This will add 10–15 years of good life. This information comes from the anti-aging medicine circles and European studies of women on bioidentical hormone replacement. Here is a more conservative opinion from a US review: Counseling Postmenopausal Women about Bioidentical Hormones: Ten Discussion Points for Practicing Physicians.

Abandon sugar, starchy foods

Starchy foods (potatoes, pasta, rice, pastries and bread) and processed food accelerate aging. Avoid these foods for a healthier heart – Harvard Health. Many studies have confirmed that a Mediterranean diet is anti-inflammatory and prevents premature aging.

Are you deficient in human growth hormone?

Find out whether you are deficient in human growth hormone or not by taking an IGF-1 blood test. Dr. Hertoghe, an endocrinologist from Belgium said at various anti-aging conferences that HGH by itself prolongs life by about 15 to 20 years or more. I am deficient in HGH and I am injecting HGH myself regularly. My anti-aging physician orders my IGF-1 level three to four times per year to monitor the right dosage of HGH replacement. But it is crucial that the physician supervise the patient. This involves giving the patient only minimal amounts of HGH, which keeps IGF-1 levels in the high normal range. This is also re-emphasized in this review: Growth Hormone and Aging: Updated Review. When you overdose HGH, you lose all of the beneficial effects that HGH replacement brings.

Fasting mimicking diet (FMD)

Fasting for Longevity: 9 Questions for Dr. Valter D. Longo. When you consume only 500 to 600 calories daily for 5 days out of every month you are stimulating your telomeres (the caps on your chromosomes) to grow a little bit longer. Longer telomeres translate into longer life expectancy. In addition, your stem cells anywhere in your body also undergo stimulation. Here is more information: fasting mimicking diet for 5 days every month.

Lifestyle factors

It is best not to smoke. Keep your body mass index in the 21.0 to 22.0 range. Get enough sleep (7–8 hours every night). Use a form of relaxing exercise (yoga, self-hypnosis, meditation, Tai-Chi). This will keep the stress hormone cortisol under control; if it is constantly high from ongoing stress, it leads to premature deaths. The Science of STRESS – SLMA

Take key vitamins and minerals

When you take key vitamins and minerals every day you can add another 5 to 10 years of disease-free life to your life expectancy. Ray Schilling’s answer to Is taking vitamin supplements helpful or quackery?

All of these factors taken together help you to not age prematurely. A healthy lifestyle elongates your telomeres, which prolongs your life without diseases. It also prevents heart attacks and strokes, which again prolongs your life. And a healthy lifestyle prevents Alzheimer’s disease, so you can turn old and not have to worry about memory loss. I cannot overemphasize how important a healthy lifestyle is!

Conclusion

As summarized above, a recent study going on for about 30 years showed that premature biological aging occurs in adolescents who smoked, were obese or had untreated mental illness. On the other hand, treated asthmatics did not show this biological aging effect. I summarized what factors contribute to slowing down aging. It is a combination of proper diet, regular exercise, hormone replacement as you age and taking some supplements. One key to slower aging is to be aware of how important a healthy lifestyle is for you.

The section about having a healthy lifestyle was published previously here: Ray Schilling’s answer to What are the most exciting breakthroughs in longevity research?

Mar

2022

T-Cell Immunotherapy Cures Chronic Lymphocytic Leukemia

By Ray Schilling | Cancer, genetic marker, immune system, leukemia

T-cell immunotherapy cures chronic lymphocytic leukemia after 10 years. Researchers were able to use the blood of leukemia patients and modify immune cells to attack their cancer cells. Specifically, they introduced a chimeric antigen receptor into immune cells from patients in the lab. Subsequently they transfused the modified immune cells back into the leukemia patients. After 10 years researchers detected the same active cytotoxic T lymphocytes in both chronic lymphocytic leukemia patients, which contained the chimeric antigen receptor marker. This means that active cytotoxic lymphocytes, that also have the name of killer T cells, continued to eliminate any pathological cells from the lymphocytic leukemia patients.

The immune system explained

The immune system can respond with two major responses. The B lymphocytes originate from the bone marrow and turn into antibody producing plasma cells. With viruses this system works very well as it inactivates viruses that the immune system recognizes don’t belong into the body. The other branch of the immune system are the thymus-processed T cells. These are important to eradicate cancer cells. They are also called CD4 cells or cytotoxic T lymphocytes. Often tumor cells produce specific proteins that suppress the immune cells. But the researchers of these two chronic lymphocytic leukemia patients managed to introduce a chimeric antigen receptor into the CD4 cells that specifically targeted the leukemia cells. The immune system in these patients was working optimally and remained active for 10 years.

Some statistics regarding chronic lymphocytic leukemia

Here are some statistics of chronic lymphocytic leukemia (CLL). There were about 61,090 new cases of leukemia and 23,660 deaths from leukemia in 2021 in the US. Among these were 21,250 new cases of chronic lymphocytic leukemia (CLL). There were about 4,320 deaths from CLL. The average lifetime risk of getting CLL is 1 in 175 people or 0.5% of the population. The risk of getting CLL is slightly higher for men than women. CLL is a leukemia of older people, the average age at the time of diagnosis is 70 years. CLL is rare under the age of 40 and extremely rare in children.

Potential serious side effects of T-cell immunotherapy

Dr. David Porter, one of the authors of the study published in Nature said that this type of immunotherapy can have serious side effects. He added that therapies have become safer over the years. Oncologists are giving immunotherapies like the one which I described to hundreds and thousands of patients.

Here are the more common side effects.

The tumor lysis syndrome: when the tumor cells are all attacked at the same time, there is a lot of tumor cell destruction and the contents of the cells end up in the blood. This makes the patient rather sick for a few days. There can be serious electrolyte abnormalities that have to be countered with intravenous fluids. The toxins can also cause kidney damage, which physicians monitor closely.
Cytokine release syndrome: With this syndrome people develop a high fever, nausea, vomiting, much like a severe flu. They also develop muscle aches and joint pains. Patients can develop extremely low blood pressure. This occurs because fluid leaks into the lungs, which also causes problems breathing.
Neurologic toxicity: There can be a loss of speech and thought disturbances. Seizures can develop and the patients may turn comatose. Nevertheless most patients recover from this spontaneously.

Details of one case of CLL with successful treatment

Doug Olson was one of the patients who was studied in the publication in Nature. His original diagnosis was chronic lymphocytic leukemia when he was 49 years old. For 6 years he did not need much treatment. But then his leukemia flared up and chemotherapy got his CLL into remission for 5 years. Generally, leukemia behaves this way that treatment gets it into remission (meaning the leukemia is controlled). But on another occasion, it gets into a relapse, which means the leukemia flares up again. 11 years after the original diagnosis of the CLL there was a rapid decline due to another relapse. In a bone marrow biopsy 50% of the white blood cells were CLL and 50% were normal.

Infusion of CAR-T cells

He received his first infusion of CAR-T cells in September of 2010. Following this he became very sick and the oncologist hospitalized him for three days. One week later the oncologist could not find any more cancer cells in his body. But the cancer specialists were very reluctant to call it a cure at that time. Fast forward 10 years. And now there are still no cancer cells in Doug’s body. The blood analysis showed that active CAR-T cells are in Doug’s blood monitoring for him that no CLL cells reoccur. Now, 21 years after the initial diagnosis of his CLL the oncologists are convinced that the T-Cell Immunotherapy was what cured Doug.

Discussion

CLL is a special form of blood cancer. Chemotherapy has been successful in increasing survivor rates over the years. But the end of the patient with CLL comes from a final relapse of this leukemia form, which eventually no longer responds to chemotherapy. The researchers in this publication used a novel immunotherapy approach, where they introduced a chimeric antigen receptor into immune cells of patients in the lab. Subsequently they transfused this back into the leukemia patients.

T-cell Immunotherapy used surveillance T cells successfully

These modified immune cells became the “surveillance team” that eradicated new CLL cells and destroyed them on an ongoing basis. This immune therapy is getting rid of the last CLL tumor cell. The two cases described in this paper and investigated thoroughly after 10 years of immunotherapy intervention were completely free of CLL cells in their bone marrow biopsies. Two cases are not enough data, but it is a powerful result for a pilot study. Oncologists have to produce much larger clinical trials with more patients. This establishes that this new immunotherapy is superior to conventional chemotherapy and indeed prolongs survival compared to chemotherapy alone.

T-Cell Immunotherapy Cures Chronic Lymphocytic Leukemia

Conclusion

This pilot study showed that the immune system can be stimulated to suppress and eradicate leukemia (CLL) cancer cells. The authors introduced a chimeric antigen receptor into immune cells that were taken from patients. The researchers obtained blood samples. Then they introduced a chimeric antigen receptor into immune cells in the lab. Subsequently they injected these CAR-T cells back into the CLL patients. In these patients the CAR-T cells behaved like surveillance cells, which eradicated leukemia cancer cells on an ongoing basis. After 10 years of follow-up in two patients in this pilot study the clinicians could not find any CLL cancer cells in their bone marrows, but the CAR-T cells were still present. This type of study is encouraging as it is a model for immunotherapy of other cancers. It is a promising start, but obviously researchers need to do more studies to fine-tune cancer immunotherapy.

Increased use of e-cigarettes in younger people

Some facts about e-cigarettes, cigarette smoking and smoking cessation

Effect of e-cigarette use on heart and lung disease

Switching from cigarette smoking to e-cigarettes

Effect of e-cigarettes on lungs

Poor quality of vaping fluid from the black market

Conclusion

Traditional treatment of osteoarthritis

Joint replacement surgery

Stem cell therapy to treat osteoarthritis

What stem cells do

My own experience with stem cell therapy for osteoarthritis of my left knee

Liposuction to harvest stem cells for treatment

Intravenous stem cells

Targeted stem cell therapy

Lower cervical spine, upper thoracic spine and lower lumbar spine also treated

Follow up after the stem cell treatments

Conclusion

Obstructive sleep apnea

Classification of snoring

Uvulopalatopharyngoplasty

Somnoplasty or radiofrequency ablation

Maxillomandibular advancement (MMA)

Hypoglossal nerve stimulation

Conclusion

More surgical procedures

More details about the alpha-gal syndrome

Sensitization of the human host

Allergic symptoms

Protein allergies versus carbohydrate allergies

Conclusion

Abstinence from red meat

Explanation of eye conditions

Serous retinal detachment

Retinal vascular occlusion

Ischemic optic neuropathy

Eye professor warns to take eye conditions seriously

Causation versus statistical association

Conclusion

Results of the study

Another approach to permanent weight loss

Conditions that respond to the FMD

Discussion

Watching your fat percentage and BMI

Conclusion

The dirty dozen

The list of the clean fifteen

Why pesticides are dangerous

Specific toxins

Complaints of the industry about the EWG

Here is what the consumer can do

Conclusion

How vaccination against Covid-19 works

Cell-mediated response by killer T cells

Long term immunity

Waning immunity

Hybrid immunity

Conclusion

Avoid deliberate exposure to Covid-19

Does having a healthy lifestyle lower your risk of developing medical conditions and diseases?

Resveratrol

Exercise regularly

Replacing missing hormones with bioidentical hormones

Abandon sugar, starchy foods

Are you deficient in human growth hormone?

Fasting mimicking diet (FMD)

Lifestyle factors

Take key vitamins and minerals

Conclusion

The immune system explained

Some statistics regarding chronic lymphocytic leukemia

Potential serious side effects of T-cell immunotherapy

Details of one case of CLL with successful treatment

Infusion of CAR-T cells

Discussion

T-cell Immunotherapy used surveillance T cells successfully

Conclusion

A Survivor’s Guide to Successful Aging

Prostate Cancer Unmasked

Healing Gone Wrong – Healing Done Right