Mar
29
2014

Alternative Treatment Of Hyperactivity (ADHD)

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

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

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

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

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

The causes of hyperactivity (ADHD)

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

Alternative Treatment Of Hyperactivity (ADHD)

Alternative Treatment Of Hyperactivity (ADHD)

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

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

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

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

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

Treatment of ADHD

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

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

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

Conclusion

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

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

References

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

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

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

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

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

Last edited Nov. 7, 2014

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Dec
14
2013

Pollution And Soaring Lung Cancer Rates

In early 1900 lung cancer was unheard of. This was before the cigarette industry started to mass-produce and market cigarettes.

However, ever since the arrival of the industrial revolution air quality has suffered. In China poor air quality has now reached such enormous values that the specialized cancer agency of the World Health Organization, the International Agency for Research on Cancer (IARC) has labeled poor air quality as one of the causes of lung cancer.

When you rank countries by average air pollution measurements, one sees that Europe, the US and South America overall have good ratings, whereas the Middle Eastern countries, China and India have poorer ratings.

However, when the pollution index of cities where the population is much denser than in the countries at large, are tabulated a much different picture emerges: Cities in Iran, India and Pakistan stand out as particularly bad followed by cities in China, Eastern Europe, Paris, London, Berlin, cities in California (the populous State), Chicago and New York.

Pollution does not stay local, but travels through the stratosphere around the globe. The result is that now 10 to 15% of lung cancer in the US occurs in patients who never smoked. This translates into 16,000 to 24,000 deaths annually of never-smokers in the US.

In certain cities such as Beijing the lung cancer rates have doubled in 9 years between 2002 and 2011. As this article shows lung cancer in never smokers can be caused from exposure to radon, to second-hand tobacco smoke, and other indoor air pollutants can also cause such cancers. But the outdoor air quality has been a problem ever since the industrial revolution, which started around Europe in the 1800’s and first part of the1900’s. In the latter half of the 1900’s much of the industrial wave has migrated to the Middle East, to India and China. But the air quality of the whole world has suffered as the jet stream and other air currents carry pollution in the stratosphere all around the globe.

Pollution And Soaring Lung Cancer Rates

Pollution And Soaring Lung Cancer Rates

History of pollution in various regions

1. In Germany’s  Ruhr district (“Ruhrgebiet”) in North Rhine-Westphalia, a highly populated industrial area, pollution reached a peak in the late 1950’s. From 1963 onward many of the coal mines, iron ore mines and other mineral mines closed down. 50 years ago the German Chancellor, Willy Brand was concerned about the environment and promised that blue skies would return to the Ruhr district again.  A special task force was initiated and maximally allowable limits were established for industries’ pollution emissions and enforced by the German government. Government and industry were co-operating in developing anti-pollution measures, which have cleared up a lot of the pollution since. With regard to car emissions lead free gasoline was introduced and carburetors ensured more complete burning of exhaust gases. This is now common and accepted anywhere except for diesel fume exhaust, which nobody wants to address despite proven carcinogenicity.

Now Germany is one of the leaders in green technology, which is also important for tourism.

2. England has its own legacy of pollution in soil and air from the industrial revolution. The soil of moorland, which soaked up acid rain for decades, is more acidy than lemon juice and it will take a long time despite industrial complexes having closed long time ago, before the soil quality will be returned to normal.

3. Hamilton in Ontario/Canada has had a longstanding pollution problem, which I witnessed from 1976 until my departure in 1978. It is well known that Stelco, the local steel plant downtown Hamilton is sending polluting emissions into the air. In 1976 a vising professor from Australia gave an interesting talk about a study that was done at that time regarding the risk of developing bronchogenic carcinoma (a synonym for lung cancer) in the immediate surroundings of the Stelco plant. He said that this was one of the first studies to show that the distance of people’s houses from the source of pollution mattered as that determined how concentrated the air pollution was (the closer the more polluted the air). This  affected cancer rates: they were much higher in the immediate surrounding of Stelco when compared to the average rate in the rest of Hamilton. This difference was very significant within a radius of 1 kilometer (= 0.62 miles) from the Stelco plant.

Just in May of 2013 the local cancer agency of Hamilton announced that the lung cancer rate in Hamilton was higher than elsewhere in Ontario because of a combination of poor air quality and of a higher percentage of people smoking. Then in August 2013 the city of Hamilton announced a new air pollution bylaw for stricter pollution measures to improve the air quality in the downtown area. It is just a pity that Hamiltonians had to wait until 2013 before the city approved an anti-pollution bylaw that could have been passed 50 years earlier like in Germany’s Ruhr district!

4. In 2008 Pittsburg, a former steel manufacturer town like Hamilton, Ont. outdid Los Angeles with regard to small particle air pollution.

Lung cancer prevention by the authorities

As mentioned before up o15% of lung cancer is caused by environmental exposure. So, we ourselves can only prevent 85% of lung cancer by not smoking and not exposing ourselves to industrial emissions or to smoke from incense. However, in many cities around the world you will get exposed to air pollutants that are well above the safe limits, so the risk of getting lung cancer from just breathing the air there can be much higher than in rural areas where there is no industry.

Technologies to control air pollution are widely available. We need to exert pressure on politicians to show leadership around the world. Government regulations to lower emission rates need to be put into place and inspectors need to ensure the rules and regulations are adhered to. Without reducing emissions of cancer producing gases and chemicals right at the source (open burning of cuttings in orchards or burning cut trees), cutting emissions of cars, planes, ships, diesel cars, locomotives, electric generator plants etc. the air quality will not improve. Despite some costs involved industry, governments and individuals have to work together to make clean air happen.

The residents of those countries that have low pollution values will not benefit, if pollution continues to occur in other parts of the world as it just travels in the stratosphere around the globe until it arrives right here at home! We need an international pollution police. Satellites can be used to monitor where pollution occurs and this can be followed up through the local regulatory bodies with penalties and remedial actions.

What can I do personally to prevent lung cancer?

1.The most obvious step is to quit smoking and ask smokers who come to your place to smoke outside (not in your home).

2.Consider moving away from the city, if the air quality is unacceptable to a place where there is low air pollution.

3.Vitamin D3 has been shown to prevent colorectal cancer, but as there are vitamin D receptors found on the surface of various cells in tissue around the body including the lungs, many researchers feel that this vitamin in higher doses (2000 IU to 5000 IU) has probably a wider applicability in preventing cancers, even lung cancer.

4.Cutting out sugar and adopting a Mediterranean type diet is a prudent thing to do; also cutting down your calories to the maintenance you need (mildly ketogenic diet). If you bought body composition scales, it would display what your daily calorie consumption is and you should not exceed this, or else you’ll gain weight. An aging man who is overweight will experience hormone changes as fat is being metabolized and the enzyme aromatase contained in fatty tissue will turn male hormones (testosterone, DHT, androstenedione) into estrogen. Estrogen (particularly estradiol) is a known carcinogen that has been proven to cause breast cancer in women and prostate cancer in men. However lung cancer is also being promoted in women by estrogen as discussed in this link. In men one needs to remember that lung cells have estrogen receptors and there is concern in aging men with higher estradiol levels that this can promote cell divisions in existing lung cancer. So, it is important to maintain a normal body mass index between 21 and 24 (well below 25.0 and well above 18.5, which are the official accepted limits). This way there is no problem with insulin resistance (too high an insulin level), and other metabolic substances (cytokines, growth hormone like factors and tumor necrosis factor-alpha from body fat) that are cancer promoting.

5. If testosterone deficiency is present, which is common in older men, testosterone will have to be replaced with bioidentical hormones. It is a myth that testosterone would cause prostate cancer. Testosterone in males is necessary to maintain a normal metabolism including the immune system, which then can fight lung cancer and any other cancers.

6. Exercise and reducing beef consumption are also often mentioned in terms of preventing lung cancer.

7. Here are several recommendations from the LifeExtension Foundation that I found very useful in terms of lung cancer prevention. This link shows that antioxidant vitamins such as vitamin C, alpha tocopherol, the minerals selenium and zinc are also helping to reduce the lung cancer rate. Drinking green tea has also been shown to be effective in a dose-response curve manner (more tea protecting more from lung cancer). Vitamin B12 and folate have been shown to reduce abnormal bronchial cell growth in smokers as shown by repeat bronchoscopy studies.

8. Those who have been smokers in the past and those who have been around heavy smokers for more than 10 years in the past should consider having a preventative bronchoscopy done by a lung specialist (also called respirologist or pulmonologists). This way any suspicious areas with precancerous lesions can be biopsied during the procedure and attended to.

Hopeful research for new lung cancer treatments

Lung cancer is a disease that is best prevented. Once a person gets lung cancer, the prognosis is still very poor. However, cancer researchers are getting close to newer treatments involving genetically modified T-cells (killer cells) as was recently achieved for leukemia. Similar research is going on regarding ovarian cancer, melanoma, lung cancer and pancreatic cancer.

More information about lung cancer: http://nethealthbook.com/cancer-overview/lung-cancer/

Conclusion

It is not acceptable to let pollution take its course , the way politicians around the globe have handled this in the past 6 decades with a few notable exceptions mentioned. We all suffer a higher risk of getting lung cancer, even if we have been life-long non-smokers. Right now up to 15% of lung cancer in most populations are of this type. However, in Beijing this number is already much higher. The technology is available; Germany has led the way in the Ruhr district in the 1960’s and beyond. In my opinion the G8 meetings should have this high on their agendas and send technological aid to all the regions that have higher than the average world pollution index under the mandate of a special UN commission. This should be supported by the major industrial players with the knowledge that they will prevent the death of millions of potential consumers down the road, which will on the long-term pay off the relatively minor investment of installing pollution controls, before lung cancer levels rise even more.

Last edited Nov. 7, 2014

Feb
01
2006

Macular Degeneration Risk Less With Vitamins

Age related macular degeneration (AMD) is one of the more frequent reasons for loss of vision in the ageing population. The disease is also the most prevalent reason for blindness in developed countries.
A group of researchers from the Netherlands made it their mandate to investigate, in which proportion antioxidants were useful in the prevention of AMD. Supplementation with vitamins C, D and E was used and also beta-carotene and zinc. The observations were made using questionnaires from the Rotterdam Study (1990-1993).

The group on which the research concentrated consisted of inhabitants 55 years of age or older living in a middle class suburb of Rotterdam. Of 5836 at the baseline with a risk of AMD 4765 had reliable data of their dietary habits. At the end of the study 4170 participated in the follow up.
Dietary intake of vitamin E and zinc was inversely associated with the development of AMD: the group with an intake of vitamin E and zinc had less macular degeneration than those whose diet was deficient. A higher than median intake of all the four nutrients, vitamin E, zinc, vitamin C and beta-carotene showed even more benefit. The risk to develop macular degeneration was reduced by an impressive 31 %.

Macular Degeneration Risk Less With Vitamins

Macular Degeneration Risk Less With Vitamins

These results are of importance to the ageing population and the elderly. A high dietary intake of the four nutrients is important in the risk reduction of age related eye diseases like AMD.

Reference: JAMA. 2005; 294:3101-3107; Vol. 294, No. 24, December 28, 2005

Last edited December 6, 2012