depression Archives

Sep

2016

Hidden Cause Of Depression

By Ray Schilling | alcohol, depression, Mental Health, Nutrition, Vitamins and supplements

About 15.7 million Americans suffer from depression every year, but there remains a hidden cause of depression.

Not everybody responds well to antidepressant medicine. Only 30 to 50% of depressed people respond to antidepressants. There are two blood tests many physicians do not know and therefore fail to order: homocysteine blood levels and 5-methylfolate levels (5-MTHF).

Homocysteine as a hidden cause of depression

In 2004 a research group studied 924 middle-aged men. They noted that those men who fell into the highest third of homocysteine levels had a two-fold higher risk of being depressed than those who fell into the lower third of homocysteine levels. Other studies showed that SAMe, a nutrient that is required to build up mood enhancing neurotransmitters was sadly lacking in depressed people. In addition, folate levels were also found to be low in depressed people.

Having found this association between lack of nutrients and depression offered new opportunities to treat depression. Two studies examined the effect of taking 5-methylfolate on the effect of antidepressants. The result was astounding: in one study 7% of patients taking an antidepressant experienced improvement of their depression when assessed with a standard depression score. However, the same group improved their depression by 19% when 5-methylfolate was given in addition to the antidepressant.

Patients with the most severe depression on antidepressants had a 16% improvement of their depression. Adding 5-methylfolate to the antidepressant caused a 40% overall improvement in these severely depressed people, 24% more than without this simple vitamin supplement.

There is other evidence that patients with depression recover faster in the presence of 5-methylfolate. Moderately depressed patients recovered within 231 days on antidepressants alone, but in only 177 days when 5-methylfolate was present as well. The most severely depressed patients recovered within 150 days with antidepressants alone, but recovered within only 85 days on 5-methylfolate and the antidepressant.

Hidden cause of depression and Alzheimer’s disease

The story is getting more involved. Depression is related to proper balance of neurotransmitters that can be influenced by antidepressants and 5-methylfolate. But new research showed that Alzheimer’s disease (dementia) patients with cognitive decline have elevated homocysteine blood levels. A study in the New England Journal of medicine in 2002 found that after 8 years of observation more than 75% of them were diagnosed with Alzheimer’s disease. When blood homocysteine levels exceeded 14 micromole per liter the risk of Alzheimer’s had doubled compared to those with normal homocysteine levels. The researchers concluded that homocysteine is an important risk factor for the development of Alzheimer’s diseases and dementia, although it is not the only one.

Methylation pathway defects as a hidden cause of depression

40% of the population is defective in one or more genes that control the so-called methylation pathway in each of our cells (Ref. 1). This can slow down the metabolism of brain cells including the synthesis of certain neurotransmitters. At the same time it can cause the rising of homocysteine, which is then a useful marker for methylation defects. Another marker is the 5-methyl folate level, which, when low, indicates a deficiency in methyl donors including 5-methylfolate (5-MTHF).

Mental illness is an area where epigenetic factors play an important role. Depression that responds only partially or not at all to SSRI’s (antidepressants) often responds to L-methylfolate, a simple supplement from the health food store as a supplement. Similar epigenetic approaches are useful to treat psychosis, schizophrenia, bipolar disorder and Alzheimer’s disease.

Other illnesses due to methylation defects

Dr. Rozakis mentioned that 92% of migraine sufferers have a defective methylation pathway involving histamine overproduction and they can be helped with a histamine-restricted diet (Ref.2).

Autism, ADHD (hyperactivity) and learning disabilities are other diseases where methylation pathway defects are present. Physicians should check patients with autism for methylation pathway defects, and appropriate supplements and diet restrictions can help in normalizing the child’s metabolic defects. Mothers should consult with a DAN physician (“defeat autism now”) who is knowledgeable regarding all aspects of autism.

S-adenosylmethionine (SAMe) defects are another type of methylation defect, which associates with certain liver, colon and gastric cancers.

Dr. Rozakis went on to say that methylation defects lead to disbalances between T and B cells of the immune system and are important in autoimmune diseases like lupus or rheumatoid arthritis.

Methylation defects can also cause autoimmune thyroiditis and type 1 diabetes. They can also cause cardiac disease by raising homocysteine levels, which causes dysfunction of the lining of arteries and premature heart attacks.

Epigenetic factors through global methylation defects from vitamin B2, B6 and B12 deficiency can cause many different cancers. Hypomethylation is the most common DNA defect of cancer cells.

With skin diseases it has come to light that atopic dermatitis, eczema, psoriasis, scleroderma and vitiligo are related to methylation.

When we age, certain hormones are gradually missing, which leads to menopause and andropause. This leads to impaired cell function, elevated cholesterol, arthritis, constipation, depression, low sex drive, elevated blood pressure, insomnia, irritable bowel syndrome and fatigue. Replace the missing hormones with bioidentical ones, and symptoms will normalize.

Tests and treatment for hidden cause of depression

It is important for a physician to test patients for homocysteine levels once per year. As we age, we tend to lose some of the methylation pathway enzymes, which can result in an increase of homocysteine in the blood. A normal homocysteine level is less than 7 to 8 micromoles per liter. This is lower than the commonly recommended 15 micromoles per liter.

If the homocysteine level is too high, the treatment consists of methionine containing foods like dairy products and meat. Methionine, an essential amino acid, functions as a donor of methyl groups. The methyl groups normalize the methylation pathway defect and allow the homocysteine level in the blood to decrease. Research studies have been using 1000 to 5000 micrograms of 5-methyl folate daily to reduce homocysteine. Other B vitamins are necessary to reduce homocysteine, like vitamin B2, B6 and B12 in addition to 5-MTHF.

Hidden Cause Of Depression

Conclusion

Depression and several other illnesses can be related to methylation pathway defects. This can cause a lack of 5-MTHF resulting in high homocysteine blood levels. It is important that a physician checks his elderly patients for homocysteine blood levels once per year. This will prevent depression, Alzheimer’s disease, migraines and a number of other illnesses.

Once a methylation pathway defect has been identified, it is relatively easy to treat the patient. The treatment consists of a proper methionine rich diet and 5-MTHF supplements as well as other B vitamins as discussed. It can prevent a lot of disability and human suffering.

References

Ref.1: William J. Walsh, PhD: “Nutrient Power. Heal your biochemistry and heal your brain”. Skyhorse Publishing, 2014.

Ref. 2: https://www.askdrray.com/life-expectancy-is-influenced-by-lifestyle/

Oct

2015

Depression Needs Treatment

By Ray Schilling | Alzheimer’s disease, Cancer, depression, Diabetes, Medical Condition, Parkinson’s disease, Vitamins and supplements

Depression is common and depression needs treatment. 10% of all men and 20% of all women have a period of depression in their lives. In people with medical illnesses depression is more common: 20% to 40% (Ref.1).

First, the peak age for depression is usually the age of 25 to 44. There are special groups where depression is also common. In adolescents 5% are affected with depression and 13% of women tend to get depressed after delivery, a condition called postpartum depression.

Second, in any age group with depression there is a risk of suicide, but with adolescents this is particularly true.

Third, about 10% to 15% of people with general medical illness are developing depression, such as patients with Parkinson’s disease, stroke, Alzheimer’s disease, cardiac disease, HIV infection, end-stage renal failure and cancer.

Causes of depression

Officially it is not known what causes depression. That is what medical textbooks say. However, other books like Datis Kharrazian’s book “Why isn’t my brain working?” offers several scenarios that can cause depression and he has examples of cases that were cured of depression (Ref.2). He points out that deficiencies in two major brain transmitters can cause depression: serotonin and dopamine.

Serotonin

First of all, serotonin is produced in the midbrain from the amino acid tryptophan in two biochemical steps. It is important to realize that these biochemical conversions require iron, vitamin B6, vitamin B12, niacin, folic acid and magnesium as cofactors. But you also need the “large neutral amino acid transporter” (LNAA) to transport tryptophan through the blood/brain barrier into the brain.

Dopamine

Furthermore, dopamine is a neurotransmitter that is produced in the frontal lobes of the brain. Notably, it is also necessary for learning. The brain synthesizes dopamine from tyrosine, which has to be manufactured in the liver from the amino acid phenylalanine. You need to have a healthy liver to produce tyrosine, which needs to be transported through the blood/brain barrier into the brain; similar to tryptophan this requires the “large neutral amino acid transporter” (LNAA). People with hepatitis, fatty liver, insulin resistance or diabetes may have problems with the LNAA transporter, which can cause dopamine deficiency (Ref.2). But they may also have low serotonin, if tryptophan did not enter the brain because of a transportation problem. This will happen with sugar overconsumption, as insulin resistance develops and affects the LNAA transporter resulting in both low serotonin and dopamine (Ref.2).

Inflammation

Finally, in the 1990’s researchers confirmed that inflammation is also a possible factor in the causation of neurological disease including depression. Ref. 2 points out that gut issues can become brain issues as inflammatory substances can leak trough a leaky gut into the blood stream and trough a leaky blood/brain barrier into the brain. Hypothyroidism can activate brain inflammation and lead to an imbalance of the neurotransmitters. Gluten sensitivity is also an important cause of depression through the inflammatory connection, but few physicians recognize the full impact of this.

Tests for depression

There are no laboratory tests that would define depression. However, every patient should receive a blood test to check for hypothyroidism, a common cause of depression. When the tests confirm hypothyroidism, the physician can easily treat this with thyroid hormone replacement.

Otherwise the physician diagnoses depression by doing a mental status examination, history and review of symptoms. A good start is to ask: “In the past 2 weeks how little interest or pleasure in doing things have you had?” and “Have you been feeling down, depressed, or hopeless in the past 2 weeks?” (Ref.3).

There are detailed psychometric questionnaires available such as the Beck Depression Inventory that can assist the physician to establish the diagnosis.

Myths of depression

One of the myths regarding depression is that it would be contagious. As a matter fo fact, a study on 2000 high school students showed that depression was not infective. The contrary was true: human interaction with friends who had a “healthy mood” improved depression. By the same token, when you constantly compare yourself with your Facebook friends, and you are not in the best mood, your mood may worsen and you could become depressed.

Treatment of depression

Despite advances in the treatment of depression the response rate with antidepressant therapy has a limit of 60% to 70%. According to Ref.4 inadequate dosing and misdiagnoses account for the fact that 30% to 40% of treated people with depression have treatment failures. Typically the first antidepressant involves a selective serotonin reuptake inhibitor (SSRI), but newer trials have shown that the older monoamine oxidase inhibitors (MAOIs) have a higher success rate when treating depression initially (Ref.4).

For example, a good antidepressant for mild to moderate depression is St. John’s wort, which is recommended by Ref. 5 as having less side-effects as other antidepressants.

In treating resistant depression the psychiatrist often employs other combinations of antidepressants. In addition the health professional recommends to add cognitive/behavioral therapy, which makes the overall treatment more successful. It goes without saying that complicated cases of depression belong into the hands of an experienced psychiatrist.

Suicides

Unfortunately a mental disease like depression still has a stigma attached to it. As a result many people are in deep denial about the fact that mental disease exists. Friends who do not understand depression may inadvertently say things that make the symptoms of the depressed person more severe and distance themselves at a time when they would need support from friends. The end result is that the patient feels lonely, misunderstood and that suicidal thoughts enter the mind. Men often resist seeking treatment for depression, women are better in seeking professional help and getting effective treatment.

Need for a psychiatrist to help prevent suicides

This is where a psychiatrist needs to intervene. If this does not happen, people start attempting suicide and finally commit suicide. In the US committed suicides have a gender ratio of male to female of 3:1 to 10:1. These situations become very difficult. The family needs to step in and talk to the patient. It is best to accompany the patient to the hospital for an assessment. You may want to go to the hospital in your private car or by ambulance. Don’t be shy to call 911 for an ambulance. Better to be cautious than have a major crisis that ends in completed suicide.

Alternative depression treatments

There are alternative treatments for depression.

Magnetic therapy for depression: This therapy is also called transcranial magnetic stimulation (TMS) and was approved for Canada and in 2008 by the FDA. But it is not as powerful according to Ref. 3 as unitemporal electroconvulsive therapy.

Bifrontal electroconvulsive therapy (ECT): Electroconvulsive therapy with two pedals applied to the front of the skull appears to have the best results in terms of treating depression.
Omega-3 fatty acids (EPA and DHA) are powerful anti-inflammatory agents, which will take care of the inflammatory component of depression. Both fish oil and krill oil in combination give the optimal response as outlined here.

Vitamin D3 and light box therapy

Vitamin D3 is also anti-inflammatory and will contribute to an improvement with existing depression, but it also helps prevent the development of depression when taken in regularly as a supplement.
Light box therapy: The observation of seasonal affective disorder (SADS) can develop as a result of lack of light. This has led to the discovery that light boxes are helpful for treating depression and also for prevention of depression due to seasonal affective disorder.

The patients should use a light box for 30 minutes every morning during the fall and winter months. The box should emit at least 10,000 lux. Improvement can occur within 2 to 4 days of starting light therapy, but often it takes up to 4 weeks to reach its full benefit.

Avoid alcohol and too much sugar

It is known for a long time that alcohol is a depressant; it can actually cause depression and in persons with bipolar disease it can trigger a flare-up of that disorder as well.
Finally it matters what you eat: sugar and too much starchy foods (high glycemic index carbs) lead to insulin overproduction and insulin resistance. This causes inflammation, and this will cause depression. As mentioned earlier it also lowers the two key brain transmitters, dopamine and serotonin.

The solution is an anti-inflammatory diet, the Mediterranean diet without sugar and high glycemic index carbs; only low glycemic index carbs are part of this diet. This will normalize insulin production and eliminates inflammation.

B vitamins, electroacupuncture and exercise

Vitamin supplements: Folate and vitamin B12: Up to 1/3 of depressed people have folate deficiency. Supplementation with 400 mcg to 1 mg of folic acid often helps. Vitamin B12 should also be taken to not mask a B12 deficiency (Ref.5). Folate and vitamin B12 are methyl donors for several brain neuropeptides.
The symptoms of depression often improve with electro acupuncture, as shown in many studies. This treatment ameliorates the symptoms of depression and seems to work through the release of neurotransmitters in the brain (Ref.6).
Exercise on a regular basis helps to equalize the mood and seems to exert a slight anti-depressant effect on the person who engages in regular physical activity.

Depression Needs Treatment

Conclusion

I have attempted to show the complexity of depression and what we know about its causes and treatment. Very likely there are several causes for depression and further research will hopefully bring more clarity to this. Over the years psychiatrists have developed treatment modalities, both conventional and unconventional, by trial and error. The physician and patient need to use common sense: if a treatment is working, stick to it and use it. If it does not work, move on and try something else. More complex cases should be referred to a psychiatrist who has the most experience with patients that are difficult to treat. Do not neglect life-style factors and alternative depression treatments as they can often help to stabilize depression significantly. We all must be vigilant about suicide risks in depressed patients and act by calling 911, if necessary to intervene.

More info on depression: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/depression/

References

1. Depression, Major: Fred F. Ferri M.D., F.A.C.P., Ferri’s Clinical Advisor 2016, by Elsevier, Inc.

3. Goldman-Cecil Medicine “Major depressive disorder” 2016, by Saunders, an imprint of Elsevier Inc.

Oct

2015

What Stress Does

By Ray Schilling | alcohol, Cardiovascular disease, fractures, heart attack, High Blood Pressure, Hormones, Infectious Disease, Inflammation, Insomnia, Sleeep, Stress management, Stroke, telomeres

I like to discuss what stress does. We all are stressed out at times. Some people are stressed all the time and this is called chronic stress.

Acute stress

Let’s say you were in a minor rear-ender accident. It is annoying, but at least you had no injury. But you have to deal with the insurance company, get the repair done and maybe get a car rental during the time of repair. Yes, you may have a few days where you feel that your hands are shaky and your heart pounds, or your sleep may not be restful. But when everything is done things are back to normal. This is an example of acute stress with a shorter running time. It has a limited severity, is an inconvenience, but it does not really affect your body on the long-term.

Chronic stress

Let’s assume the car accident was more severe and you received a personal injury with a broken leg. You end up in hospital and the orthopedic surgeon fixes the fracture with a surgical plate. The leg has to be in a cast for several weeks, and you have to use crutches. Every day you feel reminded of the car accident, because it is awkward to walk with crutches. After weeks you notice that you have gained weight. Your doctor is also worried about you because your blood pressure showed higher readings. You do not sleep as well, waking up frequently and having nightmares about another fictitious accident. On top of that you came down with the flu. What happened here? The stress reaction released cortisol, which weakened your immune system and may be responsible for catching the flu.

High blood pressure and increased alcohol consumption

On the long-term cortisol can also contribute to high blood pressure, but so can alcohol consumption. You may have increased your alcohol intake in the evening to relax more, but with the chronic stress and the cortisol increase this can cause high blood pressure. The weight gain that you noticed has to do with the fact that you cannot work out any more because of your healing leg fracture and you having to use crutches. Inadvertently you may also eat a bit more rich food; a lot of people do that as food can be used as comfort food.

Disbalance of melatonin and cortisol with stress

And why do you sleep less well? Chronic cortisol elevation leads to lower melatonin levels, as these two hormones are natural opponents. A high melatonin level leads to a low cortisol level and vice versa. With relaxation methods you can lower cortisol and the melatonin level increases normalizing your sleep. Chronically elevated cortisol can also lead to weight gain as sugar is converted into fatty acids that are stored as subcutaneous fat. Muscles can melt down when cortisol is high giving the appearance of spindly arms and legs.

Causes of chronic stress

Holmes and Rahe tested a stress scale in 1970, which has become the standard ever since. You get a certain amount of points for a stressful event, e.g. 100 for the death of a spouse; 45 point for retirement; 23 for trouble with the boss etc. Add up all of the points that are affect you right now; if the total score is less than 150 points there is only a minor risk of getting medical problems from the chronic stress; for 150 to 299 points the risk of illness is moderate and for 300 and more points you are at a significant risk for illness.

Physical illness and mental illness from stress

There is physical illness and mental illness that chronic stress can cause. Physical illness can be high blood pressure, hardening of the arteries. The long-term risks from this are possible heart attacks and strokes. But chronic adrenalin and noradrenalin elevation associated with chronic stress can burn part of your brain cells in the hippocampus and medial prefrontal cortex. This can lead to memory loss, spatial memory loss and aggression. Mental illness caused by chronic stress can be anxiety, depression, social isolation, panic attacks and panic disorder. Psychosomatic symptoms can include headaches, back pain, abdominal pain and difficulties concentrating.

Job stress and cancer

Perhaps one of the best examples of job stress and cancer is a study where the amount of breast cancer was correlated to the amount of stress. I discussed this in another blog. Briefly, women with a less responsibility had the lowest rate of breast cancer, but they too had some stress as there was a higher breast cancer risk after 15 years on the job versus only 5 years on the job. The same study showed that women with high responsibility had the highest breast cancer rates.

How stress leads to higher breast cancer rates

A hormone disbalance can explain this based on high cortisol levels associated with chronic stress. If cortisol is high, the cortisol binding globulin (CBG) increases; this in turn also binds more circulating progesterone, as progesterone attaches to CBG. CBG is a transport protein for both cortisol and progesterone. The end result is that estrogenic compounds get the upper hand, a condition called estrogen dominance. I have explained under the above link that this was the real reason for the increase in breast cancer in the stressed women. Similar mechanisms are causing other cancers to occur more frequently with chronic stress.

Chronic stress and cardiovascular disease

High stress jobs were found to cause a 2.2 to 2.4-fold increase of strokes and heart attacks due to cardiovascular disease when compared to low stress jobs. This was based on a British Medical Journal study in October 2002. As I discussed above under a brief description of chronic stress cardiovascular disease is often what develops as part of chronic stress. People who are under chronic stress feel that they do not have enough time to prepare good, healthy food at home. They tend to eat out more often. Even well educated people just swallow a quick hamburger and other processed foods.

Bad fats lead to heart attacks and stroke

This increases the bad fats like trans fats and omega-6 fatty acids in their system causing inflammation of the blood vessels as explained in this blog. The LDL cholesterol and triglycerides get elevated, sugar from sugary snacks oxidizes the LDL cholesterol and your coronary arteries and brain arteries get clogged up. This sets anybody on the downward pathway, and it is now only a matter of time when the chronically stressed person will develop a heart attack or stroke.

Chronic stress extremes: PTSD and burnout in soldiers

Dr. Thierry Hertoghe gave a lecture during the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas (Dec.10 to 14, 2014). The title was: “Burnout: A multiple hormone deficiency syndrome”. Burnout is the extreme of chronic stress. He said that burnout is a common condition where several hormones are affected, with the cortisol axis being the main one, but other hormone glands being stressed as well. As a result endocrine glands age prematurely. Symptoms are fatigue, exhaustion, gastrointestinal problems, anxiety, depression and aggressiveness. The underlying hormone abnormalities are a lack of cortisol, thyroid deficiency, growth hormone deficiency, testosterone and estrogen deficiency and oxytocin deficiency. Burnout is common in teachers and there is a questionnaire that has been developed for teachers (teacher’s burnout scale) to monitor them whether they are heading this way.

Burnout or PTSD

Soldiers who return from combative situations often suffer from burnout or from PTSD. The teacher’s burnout scale already mentioned can monitor their burnout severity. In suspected cases laboratory tests that measure hormone levels give concrete answers about hormone deficiencies. Treatment protocols were discussed in detail. Multiple bioidentical hormone replacements are necessary, possibly for prolonged periods, if not life long. In addition supportive counseling sessions from a counselor or psychiatrist will help to tone down increased brain activity and help regain the internal balance. Why is this important? It is important, because hormones are necessary on a cellular level and regulate the energy metabolism of every cell in the body. Also, by recognizing what is going on and helping the affected individuals, a lot of pain and suffering can be prevented.

Accelerated aging from telomere shortening

Chronic stress has been shown to cause telomere shortening. So does a lack of sleep (insomnia), smoking and alcohol overconsumption, all conditions that can be associated with chronic stress. What can we do about this? Learn what shortens telomeres and ultimately your life. Cut out what you can and take supplements that lengthen your telomeres.

Positive thinking combats stress

Negative thoughts are draining you of energy. You want to stay optimistic within what’s reasonable. Be thankful for all the good things in your life. Minimize what’s negative, but think about positive solutions to get rid of energy draining parts in your days. Do this persistently until it becomes part of your life and you will have extra energy that you didn’t waste in negative thinking or needless, anxious anxiety. Worrying does not get us anywhere, but it depletes our energy.

Relaxation methods counter stress

Self-hypnosis is a simple way to allow your whole body to relax. However, the various forms of yoga will do the same thing for you. Meditation is another way of finding peace and tranquility. Prayer is know to help people in sickness and in health. All of these methods will re-energize you. They calm your brain, help you to cope with stress and rebalance your hormones at the same time.

Building social ties and mutually supportive relationships will also build you up. It makes you feel that you belong, you have your place in society, you help others, and they support you.

Constant overdrive has physical consequences

We need some stress to get us going, but we do not need “distress”. Dr. Hans Selye, the father of the general adaptation syndrome due to stress, gave a lecture about this topic in Hamilton, Ont. in 1977, which I attended. I vividly remember how he projected a picture of his skeleton showing bilateral hip replacements. He said that chronic stress could lead to arthritis. In his case, he said, he had developed end stage arthritis in his hips requiring total hip replacements on both sides. To illustrate further that stress leads to physical consequences, he explained that one person may develop a heart attack, another a stroke, a third could get arthritis. Constant overdrive has physical consequences.

What Stress Does

Conclusion

Stress can be deadly, particularly if it lingers on and becomes chronic. But we can reorganize our lives to minimize stress. Some people may decide to seek a less stressful occupation. Others may elect to stay at that job, but develop hobbies, learn how to relax and take relaxation classes to combat job stress. The key is to start thinking about what stress you may be under and then develop a plan to counter it so you can allow yourself to rebalance your life.

Jun

2015

Preserving Our Energy

By Ray Schilling | alcohol, andropause, Anti-aging medicine, Cancer, Fitness, Health, heart attack, Heart Disease, High Blood Pressure, Hormones, Inflammation, Insomnia, Menopause, mitochondria, Mortality, Nutrition, Obesity, Prevention, Stress management, Stroke, Vitamins and supplements

We are all aging, and as we do we are gradually losing energy until we reach our last breath. Here I like to review where our energy comes from and what we can do to preserve our energy. When we preserve our energy we are in fact also slowing down the aging process and this in essence is the approach to anti-aging.

Mitochondria are power packs of energy

Each of our body cells has many mitochondria to give us energy. Some organs are more demanding. They are the main players in our body like the brain, the heart, the liver or the kidneys. Their cells have thousands of these energy packages. Without the mitochondria there would be no energy available to these key organs to perform all the work they do. They allow us to think and produce brain hormones, to contract our heart muscle and pump the blood through our arteries. They are organs like the liver that are in charge of all of the major metabolic reactions or the kidneys that filter our blood for impurities and eliminate them in urine. Mitochondria can be likened to our power bundles that give our organs and us energy to get through life.

Get enough sleep

Sleep is an energy rebuilder. But it has to be deep enough and long enough, and there has to be enough REM sleep to give us the feeling that we had a refreshing sleep. As we age some of our hormone production slows down. One of those substances is melatonin. It is crucial for good and restful sleep. If our body is not producing enough, we can supplement with small dosages like 3 mg orally to help our body to initiate sleep. It is not an addictive substance. It is the body’s own hormone. Should you wake up later in the night, you could take another 3 mg of melatonin. There is no risk either to feel tired or “hung over” after taking melatonin.

Exercise regularly

The cheapest energy you can get is by exercising regularly. When you exercise on a treadmill, go jogging or go for a brisk walk you condition your heart, improve your lungs; in short you develop cardiovascular fitness. At the same time your muscles are strengthened with isometric exercises. You are optimizing your energy flow. In the process of exercising you create a stimulus for your mitochondria to multiply in the affected tissues. This applies as much to your muscles as it does to your heart and to your lungs. You will find that your muscle strength increases. With exercise you spend energy, but you feel more energetic from it because your body is being tuned up.

Manage stress

Self-hypnosis is a simple way to allow your whole body to relax. However, the various forms of yoga will do the same thing for you. Meditation is another way of finding peace and tranquility. All of these methods will re-energize you. They calm your brain, help you to cope with stress and rebalance your hormones at the same time.

Lifestyle

You need a lifestyle that is conducive to keeping your energies. Listed here are several factors that interfere with energy production.

Smoking: If you smoke, you burn up energy with every cigarette you consume. You interfere with the oxygen transport through your lungs, but the chemicals that poison your system also poison the mitochondria of the cells. By smoking you are destroying your power packs. Pollution damages your lungs in a similar fashion as smoking does, but it is a slower process. There are a number of big cities with severe air pollution and they may not be worthwhile visiting.
Sugar and starchy foods: Back in the 1970’s based on the Framingham Heart Study it was thought that hardening of arteries would be due to an accumulation of cholesterol from fat in the diet. Saturated fatty acids were accused to be the culprit. A low fat diet was supposed to be the solution. But the end result was the obesity and diabetes wave that we still see now. There had to be another explanation of where hardening of the arteries came from. Banning fats did not lead to better statistics. The new observation was that a low carb/medium fat diet was associated with low heart attack rates, low stroke rates, and even low cancer rates. Researchers also found the real culprit: They are sugar, starchy foods and processed foods. Sugar and starchy foods are metabolized in the liver into LDL cholesterol, triglycerides and they also oxidize LDL cholesterol. This starts a vicious process of inflammation of the lining of the arteries with fat deposits into the wall of the arteries. By eating the wrong foods we interfere with our body chemistry to the point where free radicals are produced that attack everything in us including our mitochondria. I have blogged about this many times before. You can read about it here.
Alcohol: the famous one glass of red wine for women and two glasses of red wine for men is supposedly keeping us younger for longer. This is true for the resveratrol in the red wine, which is a powerful antioxidant. But to say that alcohol itself would prolong your life is a white lie. Alcohol is a nerve and cell poison; it robs you of energy. I take the resveratrol as a supplement from the health food store to protect my system. I stay away from alcohol.

Keep the arteries open

We need healthy arteries to pump blood through all of the branches and deliver oxygen and nutrients to the body cells. Unfortunately, as we age our arteries tend to get deposits that make them more narrow, and this could also raise our blood pressure. The end result is that less nutrients and oxygen will reach our body cells. We perceive that something is wrong by not feeling as energetic as usual. Simple lifestyle changes as mentioned below can improve our circulation and lower our blood pressure. Chelation therapy has also been shown as helpful in the TACT study.

Get rid of inflammation

Dr. Paul Ridker found that approximately 50% of patients with heart attacks had a normal cholesterol level. He was looking for a more meaningful screening test and found it in the C-reactive protein. If the test result was higher than 3 there was a high probability that there was inflammation somewhere in the body, but a test result of less than 1 was normal. In the meantime scientists have learnt that the C-reactive protein is a very sensitive tool to measure inflammation in the body, but it is not specific for heart attacks. It is also positive in people with arthritis, cancer, and autoimmune diseases. Chronic inflammation is also destroying immune cells: this explains the development of cancer as the end stage of chronic inflammation.

Chronic inflammation robs you of energy. We can do a lot with natural anti-inflammatory supplements to quench inflammation.

Preserve your immune system

We can strengthen our immune system by exercise, taking vitamin C regularly and by taking vitamin D3 supplements to just name a few. DHEA, the precursor hormone from the adrenal gland also helps stimulate the immune system.

Balance your hormones

As we age we loose hormones one by one. With melatonin this starts happening after the age of 20, with DHEA and growth hormone after you are in your mid thirties. Women start to get into menopause at the age of 45 to 55, but this can occur earlier or later. Men are going through their hormone change (andropause) at the age of 55 to 60. Both, women and men know when they are entering their hormone change because of a lack of energy and a few other unpleasant symptoms. Women get hot flashes. Men get grumpy, have erectile dysfunction, a lack of sex drive, week muscles and slower thinking. If you feel those symptoms, seek the help of a naturopath who is knowledgeable on bioidentical hormone replacement. Chances are that your regular doctor will want to prescribe synthetic hormones unless you can find an anti-aging physician. If your blood tests show deficiencies in the sex hormones, you will need to get a bioidentical hormone prescription. They are usually dispensed as creams, which you apply to your chest wall or non-hairy forearms in the morning. After 4 weeks your energy will be back, and your body will function normally again. All the body functions that you thought were gone forever just needed that extra stimulus from the missing bioidentical hormones.

Organic, GMO free food

I was tempted to just write “good food”. But this may be confusing to people. It is difficult anywhere in the world to get good food. Often insecticides and pesticides contaminate fruit and vegetables, which function as xenoestrogens blocking hormonal receptors. These residues are toxic for your body, and they are destructive to your energy. Organic food with the USDA certification or any independent certification is the best way to ensure that you get a good food product. I take this seriously and pay the extra dollar. We do not need plates heaped with foods. Small helpings of good quality foods are more important for our well-being.

Treat depression and mental disease

People who are depressed will complain of a lack of energy. Their brain circuits are constantly in overdrive being busy with negative thinking. Cognitive therapy can help depressed patients to face their negative emotions. It is a learning process of thinking step by step to distinguish what is real and what is magic thinking. It is important to seek qualified help. Depressed patients distort the way they think, but cognitive therapy sets their thinking straight (Ref.1). When the thinking is normalizing, the drained energy returns, people sleep better again and they can use the energy to move forward.

Positive thinking

Negative thoughts are draining you of energy. You want to stay optimistic within what’s reasonable. Be thankful for all the good things in your life. Minimize what’s negative, but think about positive solutions to get rid of energy draining parts in your days. Do this persistently until it becomes part of your life and you will have extra energy that you didn’t waste in negative thinking or by getting caught up in needless anxiety. Worrying does not get us anywhere, but it depletes our energy.

Preserving Our Energy

What can we do to prevent aging?

It follows from all that I said that anything that preserves energy would also prevent premature aging.

As mentioned, it is important to exercise regularly (gym, swimming, dancing, fast walking, jogging etc.). Have good, balanced nutrition, preferably organic food. Some supplements are also helpful: resveratrol, Co-Q-10; pages 100 to 103 of my book contain more vitamins and supplements (Ref.2). Here is a link to my website NetHealthBook, which also addresses vitamins and supplements (scroll down to table). Avoid sugar and starchy foods to avoid oxidizing LDL cholesterol. Use bioidentical hormones to replace what is missing. Get your 7 to 8 hours of sleep and don’t forget relaxation. Detoxify to get rid of toxins that would slow you down. Infrared saunas are one way to detoxify. It is helpful to consider chelation treatments. Last but not least have a positive outlook on life.

Conclusion

Our energy that we feel tells us whether we are staying healthy or whether we are at the verge of getting sick. It is best to maintain your energy at all times by doing a combination of things outlined above. You will retain youthful energy; you prevent cardiovascular disease, Alzheimer’s and even cancer. Most of all you have the energy to do the things you want and love to do.

I prefer to work on staying well and in the process I have the energy to do the things I want to do. Part of it is blogging, part of it is writing books, and part of it is dancing. The key is that I like what I am doing. I invite you to do what will keep you energized. Listen to your body.

References:

1. David D. Burns, MD: “feeling good – the new mood therapy” 1999, Harper Collins.

2. Dr. Schilling’s book, March 2014, Amazon.com:“A Survivor’s Guide To Successful Aging: With recipes for 1 week provided by Christina Schilling”

May

2014

The Full Story About Testosterone

By Ray Schilling | Heart Disease, Hormones, Men's Health, Obesity, Osteoporosis, Prevention, Stroke

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:

Testosterone was responsible for thigh muscle development and leg press strength, for erectile function and sexual desire.
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.
Here is a surprising fact: a lack of estrogen leads to abdominal obesity. This could also be verified by hormone measurements.
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

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:

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.
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).
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

Feb

2014

Every Patient Is Unique

By Ray Schilling | Anti-aging medicine, Heart Disease, Hormones, Mental Health, Osteoporosis, Vitamins and supplements, Women’s Diseases

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

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

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every patient is unique

Feb

2014

Early Alcohol Use Will Result In Memory Loss Later In Life

By Ray Schilling | Cancer, Health, Heart Disease, High Blood Pressure, Prevention, Substance abuse, Vitamins and supplements

Researchers found that heavy alcohol use in males during midlife paves the way to memory loss from dementia later in life.

I thought that this would be a good topic to review the effect of alcohol in general. Alcohol is a known cell poison, yet cardiologists keep on referring to the beneficial effects of that 1 glass of wine per day that will prolong your life. I will attempt to explain these diverse effects, where small amounts are supposed to be good for you while high amounts can be very damaging.

Review of the effects of alcohol

50% of the world population drinks alcohol, 10% to 20% have chronic alcoholism (Ref.1). Just recently a Guardian news study was released showing that an astounding 25% of Russian men die before reaching the age of 55, compared to only 7% of men in the United kingdom and less than 1% of men in the US. The study looked at the effects of consuming large amounts of vodka. There are about 10 million chronic alcoholics in the US. Chronic alcohol consumption leads to 100,000 deaths every year in the US. More than 50% of these deaths are from traffic accidents, the rest from medical problems caused by alcohol (Ref.1). Most of the alcohol gets detoxified through the liver cells and is metabolized into acetaldehyde. This involves the cytochrome P-450 system. That means that when a person also takes narcotics, sedatives or psychoactive drugs that are also metabolized through this liver enzyme system drugs and alcohol are taking much longer to be metabolized. This can lead to lethal overdoses that we hear about on TV all the time, hence the warning that you must not mix alcohol with drugs.

Early Alcohol Use Will Result In Memory Loss Later In Life

Alcohol is a cell and nerve poison. The most vulnerable organs in the body are the liver, brain, heart, pancreas, bone marrow and stomach. So, here are a number of conditions caused by drinking alcohol:

a) Anemia: When a person drinks heavily and regularly anemia shows up in a blood test. Alcohol has a toxic effect on the bone marrow, which interferes with the production of red blood cells. But certain vitamins required by the bone marrow to manufacture red blood cells are often also missing in the diet of an alcoholic, which contributes to anemia as well.

b) Cirrhosis of the liver develops in 10% to 20% of heavy drinkers. With cirrhosis part of the liver cells get replaced by fibrotic tissue and in advanced cases this can lead to a hepatic coma and death. Others are developing alcoholic hepatitis. This is an inflammation of the liver with fever and jaundice where the skin and eyeballs turn yellow. It is associated with severe abdominal pain.

c) Gastritis: Alcoholic gastritis is common, but often undetected. The affected individual may just have stomach pains for a few days, or vomit food and/or blood in addition. With continued use of alcohol it may turn chronic. Alcoholic gastritis can turn into gastric ulcers with massive bleeding that often lead to death.

d) Pancreatitis: The pancreas is a particularly vulnerable glandular tissue, which gets damaged by regular alcohol intake and with chronic alcohol intake gets partially replaced by fibrotic tissue causing the feared and painful chronic pancreatitis. This is a condition with vomiting and severe abdominal pains that can be unrelenting.

e) High blood pressure, seizures, dementia, depression, heart irregularities and nerve damage:

You may ask yourself how all of these conditions would be reasonably under one heading. The heading for this is “nerve damage”. Let me explain: The sympathetic nerve is very sensitive to alcohol toxicity and when the sympathetic nerve fibers are damaged, you will develop high blood pressure. You see your physician, get blood pressure medication, but the pressure is difficult to control, if you continue to drink alcoholic beverages. It does not make sense to just add blood pressure pills and hope that this will cure your problem. Seizures are due to direct nerve damage in the more sensitive parts of the brain, which will cause these areas to produce extra electrical activities, which we call seizures. Again, just treating with anti-seizure medications is not the solution. Avoidance of alcohol is the other part of the treatment schedule. Dementia from heavy alcohol use is due to direct nerve atrophy in the brain. Our brain shrinks normally 1.9% to 2.8% per decade, depending on which research papers you read. But in the presence of heavy drinking the frontal lobe of the brain is particularly vulnerable to brain shrinkage.

As this publication shows, mild and moderate drinkers did not suffer more frontal lobe shrinkage than abstainers, but heavy drinkers had a 1.8-fold higher risk of frontal lobe shrinkage on average when compared to abstainers. It was calculated that alcohol had contributed 11.3% to that frontal lobe shrinkage.

The rest of the toxic effect on the nerve tissue explains why depression would develop. The frontal brain contains most of the serotonin producing nerve cells. When serotonin-producing nerve fibers get damaged, the body does not produce enough serotonin to prevent depression from setting in; GABA producing cells often also get damaged, which causes anxiety. It’s not good enough to just prescribe anxiolytic drugs to which the patient will get addicted. The whole person needs to be treated, and abstinence from alcohol has to be part of the program.

Heart irregularities (atrial fibrillation, ventricular fibrillation) can be life-threatening complications due to the toxic effect of alcohol on the nerve fibers within the heart muscle. Emergency physicians are aware of the connection of these conditions to alcohol consumption. Some people’s hearts are more sensitive to the effects of alcohol than others. The most common cause of temporary atrial fibrillation is excessive alcohol intake (holiday heart) according to Ref. 2.

Finally there is the effect of alcohol on nerves in the body. This explains that heavy alcohol consumers can come down with painful pins-and-needles sensations in their hands and feet or with numbness or loss of muscle strength. When the parasympathetic nervous system is affected embarrassing incontinence or constipation can result. Erectile dysfunction in men is also very common. Viagra and continuing to drink is not the solution.

f) Gout: This painful formation of uric acid crystals in joints can be precipitated in sensitive individuals by consuming alcohol in combination with eating large helpings of beef. There may be a history of gout in the family. Treatment for this is to refrain from alcohol and avoid foods that are leading to uric acid production when ingested.

g) Cancer: When the body detoxifies alcohol in the liver, the breakdown product is acetaldehyde, which is a known cancer producing substance. A whole array of cancers are known, which come from heavy, chronic alcohol consumption: cancers in the mouth, larynx, esophagus, stomach, pancreas, liver and colorectal cancer have all been linked to excessive alcohol intake.

h) Cardiovascular disease: heart attacks and strokes can be caused particularly by binging; it is thought that binging makes platelets from the blood more sticky so they clump together and cause blood clots, which in turn leads to heart attacks and strokes.

i) Infections: Alcohol weakens the immune system, which is another effect on the bone marrow similar to causing anemia, except that this is the toxic effect on the white blood cells and lymphocytes. Heavy alcohol consumers are more prone to pneumonia, to HIV, sexually transmitted diseases, and tuberculosis.

Cardiology view of preventative alcohol

Despite all of these hair raising toxic effects cardiologists have painted the rosy picture that 1 glass of wine for women and 2 glasses of wine for men per day will prevent heart disease. What is the true story here?

Ref.2 points out that there are about 100 prospective studies that confirm that there is an inverse relationship between mild to moderate alcohol consumption and “heart attack, ischemic stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes”. It describes further that the reduction of risk in these various studies was persistent and consisted of a 20% to 45% risk reduction. Using blood tests investigators have found that this is because of an increase of HDL cholesterol, reducing blood clotting, making platelets less sticky and reducing inflammation as evidenced by a reduction of the C-reactive protein. Further research has pinpointed that it is the phenols and resveratrol that are contained in alcoholic beverages that are responsible for the beneficial effects. The bad news is that three glasses of wine or more do the opposite, so does binge drinking. Unless you are extremely disciplined and never increase your allowed limit (1 drink for women, 2 drinks for men) you will CAUSE heart disease rather than PREVENT it (Ref.2). Some people have a family history of breast cancer or colon cancer and they should avoid alcohol altogether; also people coming from alcoholic families should avoid alcohol.

Conclusion

Where does this leave us with regard to prevention of heart attacks, strokes and hardening of the arteries in the legs (peripheral vascular disease)? If you are disciplined and stick to the limits, you could prevent 20% to 45% of cardiovascular risk. The brain study mentioned in the beginning of the blog would also confirm that there was no difference between dementia or brain shrinkage when mild to moderate drinkers were compared to abstainers over 10 years. What is not told by the wine industry is that the same effects that prevent cardiovascular disease in mild to moderate drinkers can also be achieved by natural means: exercising regularly will raise your protective HDL cholesterol; taking ginkgo biloba, flax seed and omega-3 fatty acids thins your blood and the platelets are getting less sticky; omega-3 reduces inflammation and resveratrol elongates telomeres making you live longer. At the A4M conference in Las Vegas in December 2011 there were three speakers who pointed out that even small amounts of alcohol will poison mitochondria of your cells and interfere with normal hormone action. This was enough to make me join those who abstain alcohol completely. One thing has not yet been investigated in long-term studies, namely how small effects of alcohol may affect the body over several decades and over an entire lifetime. Despite all the promises of interest groups that red wine is a trendy drink for those interested in heart health, the fundamental long-term studies are missing. What does a guy do with a healthy heart and a brain that is not functioning too well? I just do not want to be the guinea pig in that worldwide study.

More information on alcoholism: http://nethealthbook.com/drug-addiction/alcoholism/

References:

Kumar: Robbins and Cotran: Pathologic Basis of Disease, Professional Edition, 8th ed. © 2009 Saunders
Bonow: Braunwald’s Heart Disease – A Textbook of Cardiovascular Medicine, 9th ed. © 2011 Saunders

Last edited Nov. 7, 2014

Dec

2013

Slow Down Aging And Prevent Disabilities

By Ray Schilling | Alzheimer’s disease, Anti-aging medicine, Arthritis, Cancer, Diabetes, Fitness, Health, Heart Disease, Hormones, Nutrition, Obesity, Other neurological conditions, Prevention, Stress management, Weight loss

You have seen it many times before: a man or a woman retires at age 65; for a while you see them around at social functions; then they are not seen any more and they return in a wheel chair only to die prematurely. You ask yourself: what can I do better to avoid this death trap?

There are several aspects to this equation: first, we would like to slow down the aging process. Part of this is to retain our physical functioning. In the following I am discussing the ingredients that are necessary to achieve the goal of aging in dignity, but avoiding disability.

It starts with a healthy mind set

You need to be optimistic and have a mindset of believing in yourself that you can do it. With a negative attitude, you will manage to find something to complain about, no matter how perfect the day has been. Negative thinking is rampant, and depression tends to be higher in the older population. If you suffer from depression or you had negative events such as accidents or abuse in the past, it is important to do some house cleaning. Do not be hesitant seeking professional help and counseling from a health professional to help you build up your self-esteem.

Regular exercise is important

A regular exercise program helps you to get your day organized. If you think that you are too busy to find the time to exercise, you are sacrificing your wellness and in fact you sabotage your health. It’s time to rethink your lifestyle! The reason you need exercise is to set the automatic pilot on staying healthy and active. If you are accustomed to sitting down in front of the computer or television set for hours, your muscles do not get the exercise they need. Fast-forward several decades and you will be one of those who rely on walkers, wheel chairs and assisted living establishments. Without training your muscles you are more prone to falls and injuries. Your balance organ is not getting the impulses it needs on an ongoing basis to prevent you from falls later in life. People in their 80’s are often stable up to the point where they trip and fall. I have seen many patients like this arrive in an ambulance where I was doing my shift as the emergency physician in a community hospital. When I summarize the fate of all of the people in their 80’s who had falls and broke their hips over the years, 50% of them made it through the surgery and went back home (often with a walker or in a wheel chair) or ended up in a nursing home; the other 50% died from complications of the surgery, often from heart attacks during the surgery or from clots in their pelvic veins or in the leg veins that dislodged and turned into pulmonary emboli. A fracture and in particular a hip fracture in your 80’s is a serious, potentially deadly accident. So, you need strong muscles and joints and you need strong bones. All of this comes free to you from years of regular exercise in your 60’s and 70’s.

Slow Down Aging And Prevent Disabilities

You guessed right: good nutrition is important!

Eat right and your body will function right. This is where a lot of people are sent on the wrong path due to clever advertising from the Agro Industry, Big Pharma, the American Dietetic Association and the United States Department Of Agriculture. So they preach that wheat and wheat products are good for you, but the lab tests show that it induces hyperinsulinemia and leads to diabetes. The genetic changes of wheat (“accomplished” through forced chemical hybridization in the 1970’s) are responsible for the metabolically very active wheat belly (accumulation of visceral fat) that Ref. 1 has described in detail. But others have researched this topic as well. Ref. 2 for instance confirms that gliadin, the glue in wheat, which allows dough to stick and makes it easy to create bread, bagels and pasta, is responsible for neurological issues like numbness of fingers and feet (peripheral neuropathy), balance problems and cognitive decline all the way to Alzheimer’s disease. If you continue to eat wheat and wheat products (all contained in conveniently packaged “processed” foods), you may very well find that your balance and muscle control will deteriorate by the time you are in your eighties. This condition is not new: one of the lecturers I listened to at McMaster University in Hamilton, Ontario in 1977 referred to those unfortunate individuals who were severely disabled as the “tea and toasters”. The tea in this case was probably the lesser evil, but the wheat induced malabsorption and malnutrition was a reality already in the mid and late 1970’s.

However, if you start eating organic foods to avoid the chemicals and estrogen-like xenoestrogens from pesticides, and you cut out sugar, high-density carbs and wheat products, you will no longer have problems with weight control and you will maintain your muscle, brain and nerve function. This is not what you learn from the regular agencies mentioned at the beginning of this paragraph, but Ref. 1 and 2 will fill you in on the details. Essentially, I follow a Mediterranean diet without sugar, starchy foods and wheat or wheat products. Ref. 2 stressed the importance of enough saturated and healthy fat (omega-3 fatty acid rich oils) in a balanced diet consisting of 20% protein and low carbs. No specific numbers were given regarding the %-age of fat. I would say that a limit of about 25 to 35% for fat would be reasonable except for the Inuit who are used to a fat content in their diet of 80%. The new thinking is that healthy fats are good for your brain and heart. Healthy fats are omega-3 fatty acids (EPA and DHA) derived from fish oil as they are very protective (anti-inflammatory) oils, so is olive oil and coconut oil. These latter two are anti-inflammatory monounsaturated fatty acids. Keep in mind that you want to change the ratio of omega-3 to omega-6 fatty acids (the ratio in this link is cited as omega-6 to omega-3) more in the direction of omega-3 fatty acids, so that the ratio will be between 1:1 and 1:3. Most Americans are exposed to ratios of 1:8 to 1:16 (too many omega-6 fatty acids in fast food and processed foods), which leads to inflammation of the arteries as well. Omega-6 fatty acids, found in safflower oil, sun flower oil, grape seed oil and canola oil are bad for you when not balanced by enough omega-3’s (flax seed oil and fish oil) as they lead to inflammation through the arachidonic acid system in the body. It may be a surprise to you that saturated fats are OK: animal fat like butter, lard, cream, ghee (clarified butter), and other animal fats provided they come from clean (not antibiotic or bovine growth hormone treated) animals. Buy organic and buy organic meats as well such as grass fed beef and bison, chicken and turkey.

Here is an example of what a day would look like nutritionally in terms of a breakfast, lunch and dinner (recipes by Christina Schilling):

Breakfast: Great Greens Omelet

(2 servings)

1 tablespoon olive oil or coconut oil

3 chopped green onions

3 cups spinach leaves or a mix of greens: kale, spinach, Swiss chard

1 red pepper cut into strips

3 eggs and 3 egg whites

2 tablespoons grated Parmigiano

In non-stick pan sauté green onion, greens and pepper strips in oil, stir eggs and egg whites and pour over the vegetables, sprinkle with Parmigiano. Cook on medium heat, till the egg mixture has started to set. Turn over and briefly let cook. Remove from pan, divide into two portions and sprinkle with a bit of salt (optional). Serve with salsa and guacamole.

Lunch: Oriental Salad

(2 portions)

1 small Sui choy cabbage (Napa cabbage)

2 cups mung bean sprouts

1 small daikon radish, shredded to yield 1 cup

1 red pepper, cut into thin slices

3 green onions, chopped

1 medium sized carrot, cut into matchstick size pieces

1 can sliced water chestnuts, rinsed.

Dressing: 2 tablespoons sesame oil,

2 tablespoons rice vinegar,(light balsamic vinegar works too)

1-tablespoon tamari soy sauce

1 tablespoon Thai sweet chilli sauce

1-teaspoon fresh grated ginger

3 tablespoons chopped fresh cilantro

Prepare all vegetables and put into salad bowl. Stir all dressing ingredients together and pour over vegetable mix. Stir gently, cover and refrigerate. This salad can be consumed immediately or kept refrigerted for a day. To complete the salad with a protein portion add your choice of 6 oz. cooked shrimp or the same quantity of cubed or sliced grilled chicken.

Dinner: Florentine Chicken

(2 servings)

1 large boneless chicken breast

1 tablespoon of chopped fresh basil-alternatively use 1 teaspoon dried basil.

1 tablespoon grated Parmigiano

4 thin slices prosciutto

1 tablespoon olive oil

2 tomatoes- cut into halves

3 chopped green onions

2 cups baby spinach leaves

pinch of salt

Spread chicken breast flat and top it with the basil, Parmigiano and prosciutto slices. Fold into half an hold the stuffed chicken breast together at the edges with a toothpick or two. Heat olive oil in frying pan, add onion and tomato slices and put the chicken breast on top. Put lid on the pan, and cook at medium heat till the chicken is cooked through. If you test with a fork, the juices will be clear. Remove vegetables and chicken from pan, put on serving plate and keep warm. Remove toothpicks from meat, and cut chicken breast into two portions. Put spinach into pan and let the leaves wilt at medium heat (cover with lid). Put spinach on the side of the chicken and tomatoes, and sprinkle with a bit of salt.

Dessert after dinner: Berry Sorbet

(2 servings)

2 cups of deep frozen berries (strawberries, blueberries or a berry mix, no sugar added)

¾ cup of organic yogourt or goat’s milk yogurt

a few drops of liquid stevia or small amount of powdered stevia-to taste.

Put into blender and process till smooth. You will have to open the blender jar to stir the contents in between. Serve with a dollop of whipped cream, if desired.

What about the “slow down” of menopause and andropause?

It is a fact that as we age, our hormone glands do not produce as much hormones as when we were in our 20’s and 30’s. But if you find a health care provider who is interested in anti-aging medicine (there are about 26,000 physicians, chiropractors and naturopaths who are members in the A4M), your hormones can be measured accurately from saliva and blood tests. This will tell whether you are hypothyroid, deficient in sex hormones and whether you should be supplemented with the missing hormones in adequate doses through bio-identical hormones. For instance, women are often deficient in progesterone in menopause and men deficient in testosterone. Treatment needs persistence and patience, as it often takes months for the patient to feel better and up to 2 years, to find the exact balance for you where the hormones are re-balanced and your symptoms of tiredness, insomnia, hot flushes etc. disappear. All our body cells have hormone receptors that require stimulation for the cells to function normally. Your health professional needs to pay attention to this and not just treat your symptoms symptomatically. When your hormones are in balance and you take a few supplements, your bones will be strong (no osteoporosis), your brain will be clear, your hearing perfect, and your balance great. You will be much less likely in your eighties to fall and break a bone and your mind will be clear and sharp.

Stress management

As the baby boomers age, they need to be aware of the stress in their lives. You may have been accustomed to having lots of energy when you were in your child rearing years or in your active professional career. Often we do not even notice that there may be stress in our lives. But your adrenal glands know. This is really a subpart of what I said of hormones: they need to be in balance. But cortisol, which is produced in your adrenal glands, is different from the menopause/andropause hormones. Corticotrophin-releasing hormone (CRH) from the hypothalamus and adrenocorticotrophin hormone (ACTH) from the pituitary gland are the rulers of the adrenal glands. And it is how you handle stress when you are in your 40’s, 50’s and 60’s which will determine whether you come down with adrenal fatigue, various degrees of adrenal insufficiency or not. Ref. 3 is a whole book that deals with this topic. Here I like to mention only that the best test to diagnose adrenal problems is a four-point saliva hormone test for cortisol. You connect the four points and get a curve where the cortisol level is expressed as a function of time. If this curve is below the lower normal range, which the laboratory provides for you, you need to be managed by a knowledgeable health care professional in order to build up the reserves of your adrenal glands. Yoga, meditation, deep prayer, self-hypnosis and enough regular sleep are all proven methods to overcome any stress related issues. Sometimes more effort is needed to rebuild the adrenals by specific herbs or porcine adrenal gland cortex extracts. Your health care provider can tell you more regarding this.

Useful supplements

1. On March 17, 2013 I wrote in a blog about prevention of osteoporosis the following summary:

“The best combination is 1000 mg (or 1200 mg as per National Osteoporosis Foundation recommendation) of calcium per day together with 400 to 800 IU of vitamin D3 (for cancer prevention you may want to take 4000 IU to 5000 IU of vitamin D3 per day instead monitored by a 25-hydroxyvitamin D blood level test through your physician) and 100 micrograms of vitamin K2 (also called MK-7). In the age group above 50 missing hormones such as bioidentical testosterone in men and bioidentical progesterone/estrogen combinations in women should be given as well. This works best, if you also watch your weight, cut down your alcohol consumption to a minimum (or better cut alcohol out altogether), exercise regularly (this builds up bone and muscle strength) and stick to a balanced diet resembling a Mediterranean or zone type diet (low-glycemic, low fat, wheat free and no sugar).” I would add in view of Ref. 1 and 2 that “low fat” should now be replaced by “balanced fat diet”. With this I mean that nuts, almonds, olive oil, unsalted butter are allowed within reason. Lately there have been new insights that some cholesterol is needed for normal hormone production. What needs to be cut out are omega-6 fats and trans fats.

2. Omega-3-fatty acid supplements from molecularly distilled fish oil at a good dosage (3 to 6 capsules a day) will prevent chronic inflammation that often causes arthritis. Chicken cartilage (UC-II) from the health food store will desensitize your system in case you have rheumatoid arthritis or osteoarthritis. This will prevent crippling arthritic disease down the road.

3. Mitochondrial aging (the mitochondria are the energy packages in each body cell) is slowed down by the two supplements ubiquinol (=Co-Q-10, take 400 mg per day) and 20 mg of PQQ (=Pyrroloquinoline quinone). Co-Q-10 repairs DNA damage to your mitochondria and PQQ stimulates your healthy mitochondria to multiply. Between the two supplements you will have more energy.

4. Vitamin C 1000 to 2000 mg per day and a multivitamin supplement help to support the rest of your metabolism. Some may want to add PS (Phosphatylserine) 100 to 200 mg per day, which works together with vitamin D3 for Alzheimer’s prevention.

Conclusion

By now you noticed that nothing comes from ignoring the fact that we are aging. We need to pay attention to our body functions and think about what we can do to make us stronger. In the end we are our own caregivers. When we are in our eighties, we should still be active and our brains should function with a lot more experience than in our past. Our bones will be strong and our balance should prevent us from falling. I do not want to use assisted living and I do not like the confinement of a wheel chair. In the meantime I am going to carry on dancing.

More information on:

1. Fitness: http://nethealthbook.com/health-nutrition-and-fitness/fitness/

2. Nutrition: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/

3. Vitamins, minerals and supplements: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/vitamins-minerals-supplements/

References

1. William Davis, MD: “Wheat Belly. Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2011.

2. 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.

3. James L. Wilson, ND, DC, PhD: “Adrenal Fatigue, the 21sty Century Stress Syndrome – what is it and how you can recover”; Second printing 2002 by Smart Publications, Petaluma, Ca, USA

Last edited Nov. 7, 2014

Oct

2013

Being SAD in Fall (Seasonal Affective Disorders)

By Ray Schilling | Abdominal Pain, Hormones, Insomnia, Mental Health, Pain, Prevention, Stress management, Vitamins and supplements

Any general practitioner knows that fall and winter are the time when patients come in with a variety of complaints like a lack of energy, problems sleeping, inability to cope with stress, but often there may be non-specific pains like muscle spasm in the back, the shoulders, or indigestion. These symptoms can all be part of seasonal affective disorders (SAD) like depression, the winter blues, often coupled with anxiety.

Emotional health does not fit easily into our health care model. The receptionist will warn the doctor that this is going to be a “difficult” patient. If the doctor has only time for a 5 or 10-minute visit, where only one or two problems can be dealt with, then this does not fit when a patient with SAD has a problem concentrating, falling asleep, and presents with a long list of other complaints. Even 20 minutes or 30 minutes may not be enough to deal with this patient adequately. It is easier to send the patient for tests and to prescribe an antidepressant and a sleeping pill and reschedule for a follow-up appointment. But this likely will result in normal blood tests and investigations, added health care costs, but no solution to the patient’s problem when he or she simply states “doctor, I feel so sick”.

I thought it would be interesting to review how our emotions can get out of balance and review an integrative approach to SAD.

Definition of SAD

Seasonal depression (also called seasonal affective disorder) occurs during fall (autumn) and winter, but this alternates with no depressive episodes during spring and summer. A person defined to suffer from SAD would have suffered from two major depressive episodes during the past 2 years with no depressive episodes in the intervening seasons of spring and summer (Ref.1). Alternative names for SAD are winter depression and wintertime blues. Typically SAD lasts about 5 months.

Brain hormone disbalance

Around 2002 it was detected that in mice there was a second light sensitive pathway from ganglion cells in the retina that were responsible for circadian hormone rhythms. This was later confirmed to be true also in humans, where photosensitive retinal ganglion cells buried deep in the retina and containing the pigment melanopsin absorb blue light in the visible light spectrum. The electrical signals are sent along the retinohypothalamic tract, so that light from the retina regulates the hormone circadian rhythm (daily hormone fluctuations including the sleep/wake cycle) in the hypothalamus. The hypothalamus is one of the major hormone centers in the center of the brain. As this publication shows there are minor genetic sequence changes for the retinal photopigment, melanopsin in patients with SAD. This affects about 1 to 2% of the American population. Many more have probably partial defects in the function of this pigment.

Being SAD in Fall (Seasonal Affective Disorders)

Many hormones in our brain experience a circadian rhythm.

When the sun goes down, melatonin is produced making us sleepy. In the morning serotonin production goes up and stays up all day, which normally prevents depression. There are other hormones that cycle during the course of the day. Cortisol is highest in the morning and low in the evening and at night. Growth hormone and prolactin are highest during sleep.

There is a lack of serotonin in the brains of patients with SAD and depression.

Symptoms of SAD

A person affected by SAD or any other patient with ordinary depression will present with symptoms of lack of energy, with tearfulness, negative thought patterns, sleep disturbances, lack of appetite and weight loss and possible suicidal thoughts. On the other hand symptoms may be more atypical presenting with irritability and overindulging in food with weight gain. Some patients somaticize as already mentioned in the beginning of this review experiencing a multitude of functional symptoms without any demonstrable underlying disease. It is estimated that up to 30 to 40% of patients attending a general practitioner’s office have some form of depression and in the fall and winter season a large percentage of them are due to SAD.

Treatment approaches to SAD

There are several natural approaches to SAD. However, before deciding to go this route, a psychiatrist should assess the patient to determine the risk for suicide. When a patient is not suicidal, light therapy can be utilized.

1. Light therapy: According to Ref. 2 a light box from Sun Box or Northern Light Technologies should be used for 30 minutes every morning during the fall and winter months. The box should emit at least 10,000 lux. Improvement can occur within 2 to 4 days of starting light therapy, but often takes up to 4 weeks to reach its full benefit (Ref.2).

2. Exercise reduces the amount of depression. The more exercise is done the less depression remains. A regular gym workout, dancing, walking, aerobics and involvement in sports are all useful.

3. Folate and vitamin B12: Up to 1/3 of depressed people have folate deficiency. Supplementation with 400 mcg to 1 mg of folic acid is recommended. Vitamin B12 should also be taken to not mask a B12 deficiency (Ref.3). Folate and vitamin B12 are methyl donors for several brain neuropeptides.

4. Vitamin D3 supplementation: A large Dutch study showed that a high percentage of depressed patients above the age of 65 were deficient for vitamin D3. Supplementation with vitamin D3 is recommended. (Ref.3). Take 3000 to 4000 IU per day, particularly during the winter time.

5. St. John’s Wort (Hypericum perforatum) has been found useful for minor to moderate depression. It is superior in terms of having fewer side effects than standard antidepressant therapy (Ref.3).

6. Standard antidepressants (bupropion, fluoxetine, sertraline and paroxetine) are the treatment of choice by psychiatrists and treating physicians when a faster onset of the antidepressant effect is needed (Ref.3).

7. Electro acupuncture has been shown in many studies to be effective in ameliorating the symptoms of depression and seems to work through the release of neurotransmitters in the brain (Ref.4).

8. A balanced nutrition (Mediterranean type diet) including multiple vitamins and supplements (particularly the vitamin B group and omega-3 fatty acids) also stabilize a person’s mood (Ref.3). Pay particular attention to hidden sugar intake, as sugar consumption is responsible for a lot of depression found in the general population.

9. Restore sleep deprivation by adding melatonin 3 to 6 mg at bedtime. This helps also to restore the circadian hormone rhythm.

Conclusion

Seasonal affective disorder is triggered by a lack of light exposure in a sensitive subpopulation. An integrative approach as described can reduce the amount of antidepressants that would have been used in the past in treating this condition. This will reduce the amount of side effects. The use of a light box can reduce the symptoms of this type of depression within a few days. But the addition of electro acupuncture and St. John’s Wort may be all that is required for treatment of many SAD cases. Regular exercise and a balanced nutrition (with no sugar) and including vitamin supplements complete this treatment. If the depression gets worse, seek the advice of a psychiatrist and make sure your doctor has ordered thyroid tests and hormone tests to rule out other causes where depression is merely a secondary symptom.

More information on depression: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/depression/

References

George A. Ulett, M.D., Ph.D. and SongPing Han, B.M., Ph.D.: “The Biology of Acupuncture”, copyright 2002, Warren H. Green Inc., Saint Louis, Missouri, 63132 USA

Last edited Nov. 7, 2014

Aug

2013

Postpartum Depression

By Ray Schilling | Mental Health, Prevention, Women’s Diseases

Recently there has been a lot of publicity around the topic of postpartum depression (PPD). Typically the reports originate from a case where depression led to catastrophic consequences. It is sad that it often takes a tragedy before a problem like this is publicly more acknowledged. But sadly reports are often one-sided and are missing vital information about pre-existing risk factors. The family doctor often misses the diagnosis of postpartum depression. There is often denial on behalf of the mother and family. The mother is getting no support from support groups, even though there are such groups.

Swift treatment often not given

And swift treatment that would be available is often not given. The results are finally making headlines. Once a mother is desperate and deeply depressed (“psychotic depression”) she is capable of killing the baby, herself and others who are close. PPD affects 15% of mothers (Ref.1); a small percentage of them may have postpartum psychosis, which is the most severe form of PPD.

Risk factors for postpartum depression

Ref. 1 reviews several risk factors that can lead to postpartum depression. For instance, a history of a major depressive episode or anxiety attack during the pregnancy predisposes a young mother to develop PPD. However, there may also have been a history of dysphoria (intense feeling of discontent) before her periods in the past; stressful events during the pregnancy or right after birth. Often there is poor social support or a marital conflict. Other factors are low income, young maternal age or immigrant status with deprivation. A lack of support from the partner can also be a major factor.

Up to 85% of women experience postpartum blues within the first 10 days after the delivery of the baby. Symptoms such as mood swings, fatigue, confusion, tearfulness, mild elation and irritability are common during these initial days following her delivery.

Progesterone levels decreased up to 3 months

Researchers found a decrease in progesterone levels following delivery for at least one month, sometimes up to 3 months. This leads to sleep problems (insomnia), which coupled with the baby crying in the middle of the night causes more sleep disruption. Electroencephalography studies documented abnormal brain wave patterns in women following the birth of a child.

Only 1 in 500 mothers after birth develop what physicians call “postpartum psychosis”, which is a recognized psychiatric emergency. The symptoms here are extreme mood swings with confusion, poor judgment, disordered thoughts (“delusions”), paranoia (where they think that someone is after them or it is the baby’s fault that they feel that way).

Erratic behavior and impaired functioning

Erratic behavior and impaired functioning are also part of this symptom complex. It is this state that needs to be monitored in a psychiatric unit as it is associated with a high suicide and homicide rate. A psychiatrist with experience in treating PPD needs to treat the patient.

Urbanization leads to a lack of support, which is particularly devastating to new mothers who need all the support they can get. This is reflected in a higher percentage of PPD in urban areas versus the percentage of PPD in more rural areas where there is more family support.

Postpartum Depression

Hormone changes with postpartum depression

Some people do not understand why a woman who just had a baby would not be happy and content. Most women are. However, the stress from the pregnancy and from childbearing can be too much on her system. There can be a point where the hormones no longer are in balance and the young mother loses her coping mechanisms.

Serotonin concentrations in the brain of women during pregnancy are at a higher level due to higher estrogen levels that slow down the degradation of serotonin. Serotonin is the brain hormone that makes you feel good. Estrogens and progesterone are very high during the pregnancy, but this changes right after the baby’s delivery and during the time of recovery in the first few days and weeks. Studies showed that there was a 15% higher thyroid autoantibody rate in postpartum depression patients in comparison to controls without depression.

Patients with higher thyroid autoantibody rates respond to thyroid

Patients with thyroid autoantibodies associated weakly with postpartum depression and responded favorably to thyroid replacement therapy. Progesterone levels were much lower in patients with depression and in patients without depression following delivery. The reason for this likely is the fact that with the delivery the placental source of natural progesterone disappeared. Researchers replaced progesterone in a group of patients, but they die not observe any significant improvement of PPD. However, they did not explain whether the progesterone replacement involved bioidentical hormones or synthetic hormones.

Dr. Michael Platt described a case of a postpartum woman who was hypothyroid as well (Ref.2). She responded to hormone replacement with thyroid hormones and progesterone by shedding 60 pounds (she always had a weight problem) over 10 months changing from a size 20 to a size 4. She was able to wean herself off the anti-depressants.

Breast feeding women on bioidentical progesterone

In breast feeding women this could be a significant difference as women on bioidentical progesterone can breast feed and will positively influence their breast-fed child’s brain development (brain cells have a lot of progesterone receptors, which are stimulated by progesterone).

A recent Canadian study involving pregnant women and women after delivery of their babies showed that there was a significant drop of progesterone levels in saliva samples for several weeks, particularly with breast feeding. The authors explained that the lack of ovulation with a lack of progesterone synthesis in the ovaries was responsible for this. It takes several weeks for most women to regain regular menstrual cycles. It would follow from this that there is room for bioidentical progesterone replacement in the first few months of the postpartum period until the ovaries have resumed their normal cyclical hormone activity.

Conventional treatment for postpartum depression

With baby blues the symptoms are much less severe (in comparison to PPD) and are starting 2 to 3 days after childbirth, resolving spontaneously within 10 days after delivery. PPD occurs within 3 months following delivery and responds to treatment with antidepressants and psychotherapy such as cognitive behavioral therapy. Breast feeding needs to be stopped, as it is known that metabolites of the antidepressants end up in breast milk. Typically, a less toxic antidepressant is used like paroxetine (Paxil), otherwise citalopram (Celexa), and fluoxetine (Prozac). In the rare cases where PPD is so severe that psychotic symptoms are present (postpartum psychosis) hospitalization is mandatory (Ref.3). Some of these cases may require electroconvulsive therapy (ECT) and/or lithium treatment for mood stabilization. Thyroid hormone therapy has also shown a beneficial effect in treating antidepressant-resistant cases of PPD (Ref.4).

Alternative treatment of postpartum depression

Although review texts of the treatment of PPD mention that estrogen replacement in postnatal women with PPD was beneficial, there is a warning that this could cause blood clots and anticoagulant measures would have to be combined with this to prevent deep vein thrombosis. Researchers suggested progesterone replacement, which is a treatment modality where blood clots are no danger. However, there are no formal trials yet, so most medical professionals ignore this suggestion. Here is forum of women who have taken postpartum progesterone with positive effects.

Dr. Katherina Dalton published a trial involving 30 PPD patients with a positive response rate of 95% when treated with natural progesterone.

Bioidentical progesterone treatment reduces symptoms of postpartum depression

Before treatment patients were suffering from an average of 7.57 symptoms, after the treatment only 2.1 symptoms remained. (Figures with details regarding this study under the above link).

There are many descriptive observations without controls like this where natural progesterone creams are part of a holistic approach to treating PPD. Dr. Mercola describes here how useful natural progesterone therapy can be. He also cautions that the woman should take bioidentical progesterone cyclically to mimic nature’s biorhythm to allow progesterone receptors to recover in between treatments.

There are many websites that have useful information about natural progesterone cream treatment for PPD, such as this.

Conclusion

It is common sense that a woman may need natural progesterone following a delivery. She just gave birth to her placenta, which was a virtual progesterone factory. It protected her body and the baby’s brain all throughout the pregnancy. If women decided to use natural progesterone for 3 to 6 months, this would make a big difference. The majority of women would not experience the baby blues or PPD. Eventually regular menstrual cycles return, the patient’s own ovarian progesterone production resumes and there no longer is a need for progesterone cream until after the birth of the next child or at the arrival of menopause. Medicine is full of examples where common sense was applied for effective treatment options despite missing randomized studies.

Natural progesterone treatment of PPD

Natural progesterone treatment of PPD is one such example. Physicians used bioidentical progesterone intuitively, but it worked in many patients. The progesterone receptors do not distinguish whether or not researchers did a clinical trial. But they do not like the synthetic versions of progesterone, as they block the receptors leading to progesterone deficiency. The physician can combine natural progesterone treatment with traditional treatments of PPD.

More information on postpartum depression: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/postpartum-depression/

References

1.Teri Pearlstein, MD, Margaret Howard, PhD, Amy Salisbury, PhD and Caron Zlotnick, PhD: “Postpartum depression” : American Journal of Obstetrics and Gynecology – Volume 200, Issue 4 (April 2009)

Homocysteine as a hidden cause of depression

Hidden cause of depression and Alzheimer’s disease

Methylation pathway defects as a hidden cause of depression

Other illnesses due to methylation defects

Tests and treatment for hidden cause of depression

Conclusion

Causes of depression

Serotonin

Dopamine

Inflammation

Tests for depression

Myths of depression

Treatment of depression

Suicides

Need for a psychiatrist to help prevent suicides

Alternative depression treatments

Vitamin D3 and light box therapy

Avoid alcohol and too much sugar

B vitamins, electroacupuncture and exercise

Conclusion

References

Acute stress

Chronic stress

High blood pressure and increased alcohol consumption

Disbalance of melatonin and cortisol with stress

Causes of chronic stress

Physical illness and mental illness from stress

Job stress and cancer

How stress leads to higher breast cancer rates

Chronic stress and cardiovascular disease

Bad fats lead to heart attacks and stroke

Chronic stress extremes: PTSD and burnout in soldiers

Burnout or PTSD

Accelerated aging from telomere shortening

Positive thinking combats stress

Relaxation methods counter stress

Constant overdrive has physical consequences

Conclusion

Incoming search terms:

Swift treatment often not given

Risk factors for postpartum depression

Progesterone levels decreased up to 3 months

Erratic behavior and impaired functioning

Hormone changes with postpartum depression

Patients with higher thyroid autoantibody rates respond to thyroid

Breast feeding women on bioidentical progesterone

Conventional treatment for postpartum depression

Alternative treatment of postpartum depression

Bioidentical progesterone treatment reduces symptoms of postpartum depression

Conclusion

Natural progesterone treatment of PPD

References

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