Monday, March 31, 2014

The Flu Can Infect Many Without Causing Symptoms

Think you know who has the flu? Thing again: a new study finds that three-quarters of people infected with seasonal flu and swine flu in recent years showed no symptoms.
Sunday, March 16, 2014 (National Institutes of Health)

Researchers analyzed data gathered in England during the winter flu seasons between 2006 and 2011, including the 2009 H1N1 "swine flu" pandemic.

Overall, about 18 percent of unvaccinated people became infected with an influenza virus, but only 23 percent of them went on to develop flu symptoms, the researchers reported March 16 in The Lancet Respiratory Medicine.

What’s more, only about 17 percent of infected people became ill enough to see a doctor, the British study found. And compared with some the seasonal flu strains, the 2009 swine flu strain actually caused much milder symptoms.

The findings suggest that relying on data about flu-related visits to primary care doctors underestimates the extent of flu infections and illnesses, the researchers said.

Overall, the infection rate for the winter flu seasons as calculated in the study were an average of 22 times higher than the rates recorded by standard methods.

"Reported cases of influenza represent the tip of a large clinical and subclinical iceberg that is mainly invisible to national surveillance systems that only record cases seeking medical attention," study lead author Dr. Andrew Hayward, of University College London, said in a journal new release.

"Most people don’t go to the doctor when they have the flu" he added. "Even when they do consult they are often not recognized as having influenza. Surveillance based on patients who consult greatly underestimates the number of community cases, which in turn can lead to overestimates of the proportion of cases who end up in the hospital or die."

An important question that needs to be answered is whether people who have the flu but have only mild or no symptoms can still easily pass on the virus, Dr. Peter William Horby from the Oxford University Clinical research Unit in Vietnam, wrote in an accompanying editorial.

Even if only mildly infectious, a large number of these people could play a major role in spreading flu each season, he suggested.

The symptoms associated with the flu are the result of the body’s immune response rather than the presence of the virus itself. Some of the more dangerous forms of influenza, like the Spanish Flu and its descendant H1N1 can be fatal only because the immune system reacts so violently to the infection, the infiltration of WBCs (white blood cells) into the lungs literally drowns the host. That’s why these flu epidemics kill young healthy adults rather than the very young and very old who have little immune response to challenge the virus.

Autoimmune diseases, like MS, Crohn’s Disease, and Rheumatoid Arthritis, are also a result of an overactive immune system and thought to be triggered by viral infections and other foreign bodies that find their way into the blood stream. Eighty-five percent of emerging disease is autoimmune in nature. I fear that the rapid spread of viral infections in our global population, along with the high mutation rates of viral infections is the driving force behind much of autoimmune disease.

If someone around has the flu, you are probably infected as well, even if you never develop any symptoms. To protect against colds and flues, a daily dose of Echinacea is recommended. It takes two weeks for Echinacea to reach its’ full potential in the immune system. Then it acts as a modulator rather than just stimulating the immune system. It can protect against an overt over active immune response to H1N1 as well as stimulate a response to a more passive virus. Eighty percent of the Echinacea sold in the US is not Echinacea or is made from the wrong plant species or wrong plant parts. Fortunately, good Echinacea will make your tongue “tingle” within a minute or so of placing it on the tongue. That’s an easy test to see if you are taking the real thing.

Friday, March 28, 2014

Sleeping Pill Use Rises as Risky Patterns Emerge

About 3.5% of US adults, or 6 million people, reported using prescription sleeping pills in a one-month period in 2009-2010, up from 2% in 1999-2000, researchers from Harvard Medical School reported in the February issue of the journal Sleep.
March 7, 2014

The Centers for Disease control and Prevention recently found similar, though slightly higher usage rates.

One obvious reason for the increase: two decades of marketing for the latest generation of pills, including zoipidem (Ambien), the drug that got Kerry Kennedy in trouble. But experts in sleep medicine say they are less worried about how many people are using the pills than about who it taking them and how.

Of particular concern, 55% of users in the latest study were also taking other sedating drugs, and 10% were taking three or more, most often opioid painkillers and benzodiazepines. While some older sleeping pills, such as triazolam (Halcion), are themselves benzodiazepines, the category also includes anxiety medications such as Xanax, and Ativan.

The fact that so many people are mixing these medications “actually makes me nervous as someone who drives down the road,” say Harvard researcher Suzanne Bertisch. Bertisch says that the heaviest users of sleeping pills are the oldest adults. The new study found 5% of people over 80 taking the medications. “Pretty much nobody over 80 should be on these medications.” Bertisch says, given the risks for daytime drowsiness, cognitive impairment, dizziness, falls and other side effects.

It’s not surprising, though, that so many elderly people and people on multiple medications take sleeping pills, says Daniel Buysse, professor of psychiatry at the University Of Pittsburgh School Of Medicine. About 10-15% of the population has chronic insomnia, and people with other mental and physical health problems are disproportionately affected, he says. “Depression, anxiety, substance abuse, schizophrenia, bipolar disorder – every psychiatric disorder is associated with sleep problems,” he states. So are painful conditions such as arthritis.

The average American takes four prescription medications daily. We know very little about what most drugs do in the body. We know almost nothing about the interactions between multiple drugs. Sleeping pills only treat a symptom and often create side effects that are worse than the insomnia.

Sleep issues are probably more common than this report indicates. “How well do you sleep,” is a question I ask of every new patient. There are two basic forms of insomnia – Maintenance insomnia is when you wake up in the middle of the night. Your mind starts to work and you can not seem to shut it down. Onset insomnia is when you lie down to sleep and regardless of how tired you feel, you can not shut down the mind.

Both of these problems are related to adrenal stress. Typically, onset insomnia is the more severe adrenal issue than maintenance. High cortisol, released from the adrenals is the culprit.

Cortisol naturally increases slightly as we sleep each night. In small amounts it helps maintain blood glucose levels by stimulating release of glycogen (stored sugar) from the liver. However, excess cortisol over stimulates and once you are awake you can not get back to sleep.

As the adrenals produce more cortisol, they produce less of all the other sex hormones including estrogen, progesterone, and testosterone. Eventually, without treatment, the adrenals only produce cortisol. This is a real issue as we age, going through andropause and menopause, we require more and more production of sex hormones from the adrenals.

If you have maintenance insomnia, try eating some protein at bedtime. This will help you maintain your blood glucose and the need for increased cortisol production should diminish. The herb Chaste Tree can be very effective as well. When taken early in morning, it promotes the body’s natural production of melatonin. Melatonin activates in the dark, so make sure your room is dark when you go to sleep. If you still have difficulty sleeping, have your cortisol levels checked. Our stressful lifestyle fatigues the adrenals over many years. Often adaptogens like Ashwaganda, Rehmannia, Korean Ginseng, or Tribulus can help rebuild the adrenals.

Wednesday, March 26, 2014

Wisdom Wednesday: Inflammation – Part 2

Histamine is the fourth pathway of inflammation we will examine. Cells generally release histamine as an immune response to allergens. The sinus congestion, running nose, and itchy eyes associated with our spring bloom is an all too common example. However, some people will mount a histamine response to a musculoskeletal problem, like tendonitis of the shoulder. If you react violently to insect bites or stings, your body produces a lot of histamine.

OTC (over the counter) anti-histamines are very popular. Claritin sales top 2 billion dollars a year in the US alone. It seems we will do anything to alleviate symptoms when we don’t feel well.

Initially, like all inflammatory chemicals, histamine serves a purpose. It rushes to the site of injury, stimulating an immune response. The mucous production with sinus allergies is necessary to remove the offending allergen from the nasal passages. However, when the histamine response is excessive or prolonged, the effects can be severe, even life threatening. Everyone knows someone who carries an EpiPen to inject epinephrine in case of a bee sting.

For most of us, excess histamine is just a nuisance. So we reach for the Benadryl, Dristan, or Claritin.

The key to controlling histamine is two-fold. First, try to identify and eliminate the offender. Although it is difficult to avoid airborne allergens, most of us have underlying food sensitivities that enhance or even activate the airborne offenders. The four most common food sensitivities, in order are wheat (including gluten), dairy, soy, and corn.

These are the most commonly eaten foods today. They are consumed by most of us on a daily basis. That constant exposure eventually stimulates an immune response and histamine production is the end result. Just pick any box of food off the shelf in your pantry. Chances are it contains more than one of these foods, maybe even all four.

Gluten is only one of many proteins in wheat. However, during the 1950’s and 60’s we began to cross-bred various strains of wheat. The goal was to produce wheat that had a shorter, thicker stock, so it would not fall to the ground with a heavy rain. They also wanted a grain that was insect and drought resistant. After 10 years of cross-breeding, totally new strains of wheat evolved that contained genetic material not found in any of the preceding generations. This all occurred prior to the advent of GMO (genetic modified) food. The net effect was to increase the gluten content by 400%. Today, scientists believe that everyone has food sensitivity to gluten. Some of us just produce more histamine as a result of the stimulation to the immune system.

The second key is to modulate the histamine response. The B vitamins are very important is this regard. Vitamin B1 (thiamine), B2 (riboflavin), B3 (niacinamide), folic acid, B6, and B12 all have roles in the histamine pathways. A deficiency of any of these factors can result in an overt histamine response rather than a subtle reaction.

If you suffer from excessive histamine production, consider eliminating wheat. Give it 3 weeks, if you don’t feel better, try dairy, then soy, then corn. Although 3 weeks is often enough time to reduce antibody activity, it can take as long as 3 months to remove all the immune complexes stimulated by exposure to these foods.

Please review my Wisdom Wednesday blogs on folic acid, B6 and B12 for information on how to determine if you are deficient in these factors.

Finally, you can always consult a qualified nutritionist who will help you determine if you have food sensitivities and/or vitamin deficiencies that contribute to excess histamine production.

Monday, March 24, 2014

Insight Into The Cause Of Chronic Pain

New insights into how the human brain responds to chronic pain could eventually lead to improved treatments for patients, according to University of Adelaide researchers.
Friday, March 14, 2014

Neuroplasticity is the term used to describe the brain’s ability to change structurally and functionally with experience and use. “Neuroplasticity underlies our learning and memory, making it vital during early childhood development and important for continuous learning throughout life.” Say Dr. Ann-Maree Vallence, a postdoctoral fellow at the University of Adelaide’s Robinson Institute.

“The mechanisms responsible for the development of chronic pain are poorly understood. While most research focuses on changes in the spinal cord, this research investigates the role of brain plasticity in the development of chronic pain.”

Chronic pain is common throughout the world. More than 100 million Americans are believed to be affected by chronic pain.

The study focused on comparing motor task training on participants that suffered from chronic tension-type headaches (CTTH) from a control group with no history of chronic pain. A non-invasive brain stimulation technique was also used to obtain a measure of the participants’ neuroplasticity.

CTTH is characterized by a dull, constant feeling of pressure or tightening that usually affects both sides of the head, occurring for 15 days or more per month. Other symptoms include poor sleep, irritability, disturbed memory and concentration, depression, and anxiety.

“Typically, when individuals undertake a motor training task such as this, their performance improves over time and this is linked with a neuroplastic change in the brain,” Dr. Vallence says. “The people with no history of chronic pain got better at the task with training, and we observed an associated neuroplastic change in their brains. However, our chronic headache patients did not get better at the task and there were no associated changes in the brain, suggesting impaired neuroplasticity.

“These results provide a novel and important insight into the cause of chronic pain, and could eventually help in the development of a more targeted treatment for CTTH and other chronic pain conditions,”
she says.

This is the neurological basis for the evaluation and treatment format I use in practice – Quintessential Application (QA). I evaluate current neurological function – are reflex pathways intact? If not, then there is probably an injury reflex impairing that function. Correction is easily performed by “rebooting” the nervous system, Once the reflex pathways are restored, functional neurological testing responses are predictable and can be used to evaluate and treat the body.

More importantly, correction of injury reflexes restores neuroplasticity to the brain and spinal cord. This allows injuries to begin to heal and chronic pain patterns to resolve.

After 38 years in practice, I am convinced that the most important factor in resolving chronic low back pain is resolution of the associated injury reflexes. Sure you have to reduce inflammation and improve spinal mechanics. But if neuroplasticity is not restored, the chronic pain pattern remains and the instability will remain as well.

If you suffer from chronic pain, consider having a QA evaluation. If you Google “Quintessential Application”, you will find a web site that can direct you to a qualified practitioner.

Friday, March 21, 2014

Saturated Fat Is Not Bad For Health, Says Heart Expert

NHS guidelines which advise cutting down on high fat foods like butter, cream and chocolate may be putting the public at risk and should be urgently revised, a leading heart scientist has warned.
March 6, 2014

Diets that are low in saturated fat do not lower cholesterol, prevent heart disease or help people live longer, Dr. James DiNicolantonio insists.

He is so concerned about the misinterpretation of ‘flawed data’ that he has called for a new public health campaign to admit ‘we got it wrong’. British health experts and nutritionists backed his comments claiming that for too long ‘uncomfortable facts’ have been stifled by ‘dietary dogma’.

Saturated fat is traditionally found in butter, cheese, fatty meat, biscuits, cakes and sausages. But Dr. DiNicolantonio claims sugar and carbohydrates are the real culprits driving high cholesterol and the obesity epidemic. He suggests that the guidelines should be changed urgently. “There is no conclusive proof that a low-fat diet has a positive effect on health. Indeed the literature indicates a general lack of any effect, good or bad, from a reduction in fat intake.”

DiNicolantonio points out that the ‘vilification’ of saturated fats dates back to the 1950’s when research suggested a link between high dietary saturated fat intake and deaths from heart disease. But the study author drew his conclusions on the data form six countries, choosing to ignore the data from 16 others which did not fit with his hypothesis. Nevertheless the research stuck and since the 1970’s most public health organizations have advised people to cut down on fat.

“It seemingly led us down the wrong ‘dietary road’ for decades to follow”, said Dr. DiNicolantonio, of Ithaca College, New York, writing in the BMJ journal Open Heart. “This stemmed from the belief that since saturated fats increase total cholesterol (a flawed theory to begin with) they must increase the risk of heart disease.”

Dr. DiNicolantonio believes the switch away from fat towards carbohydrates has harmed public health. He suggests the rise in high-carb diet is responsible for the increase in diabetes and obesity epidemic in the US.

The best diet to boost and maintain heart health is one low in refined carbohydrates, sugars and processed foods, he recommended.

What Dr. DiNicolantonio is saying is nothing new. It is common knowledge in the world of nutrition that the studies on cholesterol were flawed. What is new is that someone in the field of cardiology is finally admitting what most of science and health care has known for 30 years. He is a very brave man to buck the establishment and should be applauded.

After thirty years of low fat diets the rate of heart attacks should be dropping in this country, not skyrocketing. In truth, more than 50% of people suffering their first heart attack have normal or even low cholesterol.

The cholesterol myth is all about statin drugs, the most commonly written prescription in the world. Currently 49% of Americans over the age of 60 take statin drugs. With the new guidelines that number is estimated to become 49% of Americans over the age of 45. The American Heart Association (AHA) and the American Cardiology Association (ACA) have both advocated adding statin drugs to our drinking water. That is the level of dogma that Dr. DiNicolantonio references.

Fats are essential to health. Feel free to eat butter, eggs, cheese, and animal fats as part of a balanced, healthy diet. Just remember to have two servings of fruit and five servings of vegetables in the mix. Quit obsessing over your cholesterol readings and take a look at your waistline. Reduce those refined carbohydrates and processed foods.

Wednesday, March 19, 2014

Wisdom Wednesday: Inflammation – Part 1

Regardless of what symptoms you have, inflammation is the key component. I frequently tell my patients, “if I had a magic wand and waved it to get rid of your inflammation, 80% of your symptoms would be gone.” There are several known chemical pathways for inflammation in the body. I will review the first three in this blog and cover the remainder in subsequent posts of Wisdom Wednesday.

The most common form of inflammation in the human body comes from prostaglandin production. At the site of injury, prostaglandins are released from damaged cells. The liver responds to this and releases large amounts of prostaglandins that promote systemic inflammation. That is why you often will “hurt all over” after a localized injury.

Typically musculoskeletal injuries, whether chronic or acute, will follow this prostaglandin pathway. NSAIDS (non-steroidal anti-inflammatory drugs) like Advil, Aleve, and aspirin block the prostaglandin pathways, reducing inflammation, and often providing relief. Unfortunately, they also block the prostaglandin anti-inflammatory pathways that omega 3 and omega 6 fatty acids follow. When taken for more than three days, these drugs interfere with cell membrane production and repair. With chronic use, GI bleeds, liver failure and heart attacks can occur. Several studies have documented that a minimum of 16,500 people in the US die each year from taking NSAIDS. Less than a third have any warning signals.

Omega 3 fatty acids often will block prostaglandin inflammation. I believe that the rampant inflammation seen in this country is due, in part, to omega 3 fatty acid deficiency. It is rated as the most common deficiency in America. Sometimes, omega 6 fatty acids are also necessary to block prostaglandin inflammation. However, if you have any of the attributes of metabolic syndrome (see earlier blogs), your body often will shunt the healthy omega 6 fatty acids from the anti-inflammatory pathway to make even more inflammatory prostaglandins.

A slightly less common inflammatory pathway is governed by leukotrienes and cytokines. When these chemicals are released from injury sites, they stimulate the immune system rather than the liver. The immune system then releases large amounts of leukotrienes and/or cytokines to promote systemic inflammation. This is a common occurrence in auto-immune diseases like rheumatoid arthritis, psoriasis, and Crohn’s Disease. NSAIDS have no effect on these inflammatory compounds. In fact, when NSAIDS block prostaglandins and the injury is not resolved, the body often defaults into the leukotriene/cytokine pathway. That is why NSAIDS often stop providing relief with continued use. Fortunately, leukotrienes and cytokines often will be reduced by two common herbs – ginger and boswellia.

Approximately 1500 herbs are used medicinally world wide. Of these, only 80 have had really good research. Both boswellia and ginger are part of those elite 80.

Ginger works by denaturing an enzyme called lipoxygenase. Lipoxygenase is required to form both leukotrienes and cytokines. Boswellia has an effect of the vagus nerve that results in reduced leukotrienes and cytokines. It is also often very effective in relieving asthma. In my office I prefer the ginger as it is inexpensive and easier to administer. Boswellia is quite expensive and must be taken with fat to be properly absorbed.

If you suffer from inflammation, and I know you do, try supplementing omega 3 fatty acids. Chances are you are deficient anyway – it’s not in your diet anymore. If you have any factors associated with metabolic syndrome – central obesity, high blood pressure, high serum lipids, low thyroid function, or insulin resistance – limit your omega 6 fatty acid intake. Consider adding sesame seed oil to your diet. That will help block the conversion of healthy omega 6 fatty acids to inflammatory prostaglandins.

Monday, March 17, 2014

Glucosamine Fails to Prevent Deterioration of Knee Cartilage or Decrease Pain

A short-term study found that oral glucosamine supplementation is not associated with a lessening of knee cartilage deterioration among individuals with chronic knee pain.
Tuesday, March 11, 2014

Findings published in Arthritis & Rheumatology, a journal of the American College of Rheumatology (ACR) journal, indicate that glucosamine does not decrease pain or improve knee bone marrow lesions – more commonly known as bone bruises and thought to be a source of pain in those with osteoarthritis (QA).

According to the ACR, 27 million Americans over 25 years of age are diagnosed with OA – the most common form of arthritis and the primary cause of disability in the elderly. Patients may seek alternative therapies to treat joint pain and arthritis, with prior research showing glucosamine as the second most commonly used natural product. In fact, a 2007 Gallup poll reports that 10% of individuals in the US over the age of 18 use glucosamine, with more than $2 billion in global sales of the supplement.

For this double-blind, placebo-controlled trial, Dr. C. Kent Kwoh from the University of Arizona in Tucson, enrolled 201 participants with mild to moderate pain in one or both knees. Participants were randomized and treat daily with 1500mg of glucosamine hydrochloride in a 16-ounce bottle of diet lemonade or placebo for 24 weeks. Magnetic resonance imaging (MRI) was used to assess cartilage damage.

Trial results show no decrease in cartilage damage in participants in the glucosamine group compared to the placebo group. Researchers report no change in bone marrow lesions in 70% of knees, 18% of knees worsened and 10% improved. The control group had greater improvement in bone marrow lesions compared to treated participants, with neither group displaying a worsening of the bone marrow lesions. Dr. Kwoh concludes, “Our study found no evidence that drinking a glucosamine supplement reduced knee cartilage damage, relieved pain, or improved function in individuals with chronic knee pain.”

Glucosamine Sulfate was the first supplement I recommended to patients 38 years ago. Clinically, 80% of my patients with chronic low back pain experienced reduction in symptoms within 30 days. I quickly realized that about half of the patients that did not respond favorably were diabetic.

Today, we have uncovered the chemistry behind glucosamine sulfate. Basically, it requires good glucose metabolism and good sulfur metabolism to function. That explains why my diabetic patients failed to respond. Sulfur metabolism depends on the ability of the body to strip sulfur from sulfur bearing amino acids.

Please read my recent Wisdom Wednesday: Vitamin B6 blog post for information on this process.

The first flaw in this study is the use of glucosamine hydrochloride, not glucosamine sulfate. Without adequate sulfur, the chemistry just doesn’t work. They also failed to identify participants that may have impaired glucose metabolism. As I have frequently written, insulin resistance is epidemic in this country. Finally, glucosamine sulfate, MSM, and chondrotin sulfate all help form ground substance which is necessary to repair connective tissue. None of these chemical are inherently anti-inflammatory in nature. If you do not reduce inflammation first, healing can not occur.

I still use glucosamine sulfate in my practice today. However, I first address inflammation, sulfur amino acid metabolism, and glucose metabolism prior to supplementation. Most of the time, correcting these three chemical pathways solves the problem and direct supplementation of sulfur and glucose in not necessary or desired.

If you want to take one of these supplements, at least take one that contains both glucose and sulfur. Better yet, have your glucose and sulfur metabolism evaluated. A simple blood test, the glycohemoglobin A1c will assess your metabolism of sugar for the past two months. If eating cruciferous vegetables, like broccoli, cauliflower, or cabbage, gives you gas, then your sulfur amino acid metabolism is suspect.

Friday, March 14, 2014

Serious Diarrheal Infection in Kids Linked to Antibiotics

A new study by the US Centers for Disease Control and Prevention (CDC) published in the journal Pediatrics finds that most cases of the severe – and potentially fatal – diarrhea illness in children caused by Clostridium difficile infection were picked up outside the hospital and occur among those who have recently taken prescribed antibiotics.
Monday, March 10, 2014

The CDC urges doctors to improve antibiotic prescribing to protect the health of American children. “When antibiotics are prescribed incorrectly, our children are needlessly put at risk for health problems including C. difficile infection and dangerous antibiotic resistant infections.

The human gut is home to over a thousand species of microbe. Kept in the right balance, these microorganisms do no harm and the “friendly” ones even help with processes like digestion and protecting the gut.

But if the balance of these microbe populations is upset – by taking antibiotics, for example – there is a risk of losing vital protection from the beneficial bacteria. This allows C. difficile to grow out of control and release toxins that attack and inflame the lining of the gut, causing colitis.

Although rare compared to other gut bacteria, C. difficile, is one of the biggest causes of infectious diarrhea in the US. According to the CDC, the bacterium causes at least 250,000 infections in hospitalized patients and 14,000 deaths every year. Levels of infection have never been higher than they are at present.

Investigators found that 73% of the children who acquired C. difficile had been taking antibiotics prescribed in an outpatient setting, like a doctor’s office, in the 12 weeks preceding the infection. Most of these children were prescribed antibiotics to treat ear, sinus and upper respiratory infections.

The CDC says research shows at least half of all antibiotics prescribed in doctors’ offices to treat children are for respiratory infections, most of which no not require antibiotics. Dr. Lauri Hicks, director of the CDC’s Get Smart: Know When Antibiotics Work program, says: “As both a doctor and a mom, I know how difficult it is to see your child suffer with something like an ear infection. Antibiotics aren’t always the answer. I urge parents to work with their child’s doctor to find the best treatment for the illness, which may just be providing symptom relief.”

Indiscriminate antibiotic use has threatened the health of this nation. It is encouraging to see the CDC acknowledge this chronic issue. C. difficile is just one example of a bigger problem. MRSA (Methicillin resistant Staphylococcus aureus) is another antibiotic resistant infection that is common place in the US today.

The cure for C. difficile is a rectal implant of healthy bacteria from a closely related family member that lives with you. They must be eating the food you eat and have lived where you live so they have similar bacterial makeup. When done properly, the cure takes less than 24 hours.

Just imagine how powerful and important our gut flora must be to be able to create and cure fatal diseases in such a short period of time. In my office, I estimate 75% of my patients have some form of dysbiosis (altered gut flora) driving their symptoms. Two-thirds of them list digestive problems as their chief complaint. However, the other third have little or no digestive issues. They complain of joint pain, general malaise, impaired immune system, or any number of other, seemingly unrelated heath issues.

Ninety percent of upper respiratory infections are viral. They do not respond to antibiotic therapy. If you seek medical care for yourself or your children for an apparent cold or flu, ask for a throat culture and a CBC (complete blood count) before taking an antibiotic. The throat culture takes three days, but the CBC results only take a couple of hours. A high WBC (white blood cell) count or increase in the neutrophils is indicative of a bacterial infection that might respond to antibiotics. If the CBC warrants a broad spectrum antibiotic and it fails, then the throat culture should direct the physician to a drug for which the infection is susceptible.

Wednesday, March 12, 2014

Wisdom Wednesday: Vitamin B6

Vitamin B6 is part of the vitamin B complex. It is found in flesh foods, starchy vegetables, and many fruits. Like folic acid, it is involved in more than 100 chemical pathways in the body as an enzyme. Enzymes catalyze (facilitate) chemical reactions in living systems.

B6 often works with folic acid and vitamin B12 in those pathways. For example, sulfur bearing amino acids found in cruciferous vegetables (like broccoli, cauliflower, and cabbage) are stripped of their sulfur for use throughout the body. Vitamin B12 and folic acid initially create homocysteine then B6 takes over and through several steps, the sulfur is freed.

High levels of homocysteine in the blood stream increase plague formation and it is associated with an increased risk of heart disease. I routinely test homocysteine to access coronary risk, but more basically to gauge sulfur amino acid metabolism and vitamin B6 status.

The freed sulfur is used to make glucosamine sulfate, chondrotin sulfate, and MSM; all necessary to repair connective tissue in the body. These popular supplements are dependent on vitamin B6 metabolism.

The sulfur is also used in phase II liver detoxification. Phase II detox is where all the man made chemicals, drugs, exogenous hormones, and other pollutants in the body are eliminated. There are 10 potential pathways and sulfur is required for 5 of them to function. In earlier times, alcohol and our own hormones were the only chemicals cleared from the body through these pathways.

Additionally, sulfur is used in the bowel to control Candida and other potential parasites.
Although vitamin B6 is abundant in food, the body can not use the food form. Like folic acid, it must be converted in the lining of the small intestine to its bio-available form pyridoxine 5-phosphate. Again, just like folic acid, 8% of the population is genetically impaired and can not make that conversion while 25% have the genetic impairment from just one parent.

Frank deficiency of vitamin B6 will create cracks in the corners of the mouth and on the tongue. Because it is involved in so many chemical pathways in the body, small deficiencies can create a myriad of symptoms.

Have your homocysteine measured as part of your yearly lab work. If you develop a lot of gas when eating cruciferous vegetables, your sulfur amino acid pathways are not functioning well and you may have a B6, folic acid, or B12 deficiency. If you take glucosamine sulfate, MSM, and/or chondrotin sulfate without apparent benefit you are either insulin resistant or have impaired sulfur amino acid pathways.

Monday, March 10, 2014

Lowering Blood Sugar Could Help Prevent Cognitive Declines

People with higher blood sugar levels are more likely to have memory problems, according to new research that suggests reducing levels of blood sugar could help to protect against cognitive disease.
October 24, 2013

Published in the journal Neurology, the research team investigated whether raised blood glucose and glycosylated hemoglobin (HbA1c) levels have an impact on cognitive functions including memory performance and hippocampal volume and microstructure in a group of healthy, older, non-diabetic people without dementia.

Led by Dr. Agnes Floel, of Charite University Medicine in Berlin, Germany, the team found that people with lower blood sugar levels were more likely to have better scores on the memory tests.

“These results suggest that even for people within the normal range of blood sugar, lowering their blood sugar levels could be a promising strategy for preventing memory problems and cognitive decline as they age,” said Floel.

The study involved 141 people with an average age of 63 who did not have diabetes or pre-diabetes, which is also called impaired glucose tolerance. People who were overweight, drank more than three-and-a-half servings of alcohol per day, and those who had memory and thinking impairment were not included in the study.

The participants’ memory skills were tested, along with their blood glucose levels. They also had brain scans to measure the size of the hippocampus area of the brain, which plays an important role in memory.

For example, the participant’s ability to recall words was lower when blood sugar levels were higher. In addition, an increase in the hemoglobin A1c (a long term measure of glucose) of 7 points was also associated with diminished memory skills. People with higher blood sugar levels also had smaller volume in the hippocampus.

Insulin resistance is strongly associated with metabolic syndrome. The other factors, obesity, high blood pressure, high serum lipids, and low thyroid function go hand-in-hand with poor sugar control to create most if not all chronic illness in our nation. Dementia is no exception. I have long advocated running the hemoglobin A1c yearly as a preventative lab test. By the time the fasting glucose is consistently elevated, significant damage has been done as evidenced by this study.

Have your hemoglobin A1c checked yearly. The medical norm is below 5.7. Don’t wait until you are 6.5, diagnosed as diabetic, and placed on medication. Diet modification and exercise can quickly reduce the A1c back within medical norms. However, it is much more difficult and often impossible to reverse the damage to the kidneys, nervous system, eyes, and legs caused by glucose intolerance.

Friday, March 7, 2014

Higher Risk of Suicide and Autism in Children Born to Older Dads

A new study from researchers at Indiana University in Bloomington, published in the journal JAMA Psychiatry, suggests that the children of older fathers may be more at risk of developing psychiatric problems than children of younger fathers.

Previous studies have indicated that “advancing paternal age” (APA) at childbearing is associated with increased risk of autism spectrum disorders (ASDs), schizophrenia and bipolar disorder, as well as academic and intellectual problems.

More recent genetic studies have claimed that the age of the father at conception is linked to the likelihood of “de novo mutations” developing in their children. De novo mutations are when a gene becomes present in a family for the first time as the result of a mutation in the egg or sperm from one of the parents.

The new study compared siblings born in Sweden over a 28-year period. They found that children born to fathers 45 years or older were at higher risk of developing all of these problems, compared with their siblings who were born when their fathers were between 20 and 24 years old.

Sperm mutation rates have been steadily rising over the past sixty years. Sperm health is measured by three parameters – mobility (are they good swimmers?), morphology (how are they shaped?) and DNA fragmentation (if the DNA is fragmented, then the sperm is damaged).

When Watson and Crick unraveled the structure of DNA in 1953, sperm were used in the studies. It contained half the genetic material of other cells and was therefore easier to work with. DNA fragmentation levels were at 50% in healthy males. Today, a male is considered healthy if only 96% of his sperm have fragmented DNA. This leaves less than four percent to produce a healthy offspring! This dramatic drop in healthy sperm took only 60 years of environmental pollution and it is ongoing. The healthy number was 95% just a few years ago.

As we age, the toll from environmental factors builds. Exposure to radiation, especially from plane travel is thought to be a major factor in the decline of healthy sperm. The accumulation of toxins from pesticides and exogenous hormones has also been implicated in this problem.

Men, if you are considering fathering children, have a sperm count performed. If your DNA fragmentation rates are high, seek the help of a qualified nutritionist. There are several herbal supplements that have shown to reduce DNA fragmentation in as little as three months.

Wednesday, March 5, 2014

Folic Acid

This is the first in a series of blogs about vital aspects of nutrition, not necessarily making headlines in the news.

Folic acid or folate is one of the B vitamins. As the name implies, it is found in foliage. It is probably best known as the main ingredient in prenatal vitamins where its use early in pregnancy prevents neural tube defects. These are severe birth defects associated with underdevelopment of the brain and spinal cord. Folic acid is vital for cell reproduction. It needs to be present in large quantities as the fetus grows to ensure that the spinal cord develops properly.

In adults, cell reproduction rates vary dramatically. The liver replaces every cell once in seven years. However, the epithelial lining of the digestive tract is replaced, in total, every 24 to 48 hours. Again, this process requires a lot of folic acid. If folic acid is deficient, the lining of the gut quickly breaks down allowing bacteria and undigested food into the blood stream. This, in turn, creates and immune response and ultimately an autoimmune response as well.

Burn victims frequently suffer from this process. When large portions of the skin are burned the need for folic acid skyrockets as the body attempts to replace the burned tissue. Folic acid is quickly depleted and the gut lining breaks down with 1 to 2 days. As the bacteria enter the blood stream from the digestive tract, life threatening infections often occur in distant locations like the lungs. For years, hospitals tried various antibiotics only to find that they just could not control the number of potential infections. Today, burn centers utilize folic acid and L-glutamine to support repair of the digestive tract.

Folic acid and folate are not used by the body in their food form. Instead, they are absorbed into the lining of the digestive tract and converted to 5-methyltetrahydrofolate, the bio-available form, before being released into the blood stream. Think about that loop for a moment – the lining of the digestive tract needs folic acid to reproduce but the body needs the lining to make the folic acid bio-available. You can see how fragile the system is to folic acid deficiency.

Genetic defects in folic acid conversion are quite common. Eight percent of the population can not covert folic acid into 5-methyltetrahydrofolate. These people are always anemic as folic acid is essential in the production of red blood cells. Twenty-five percent of the population carries a genetic impairment from just one parent. At times they can convert folic acid, but when the body is under stress, they often are unable to convert to the bio-available form efficiently. That is one out of every four patients that walks into my office! Fortunately, 5-methyltetrahydrofolate is available as a supplement. Adding it to the diet of someone with a genetic defect can be life changing.

Folic acid, vitamin B6, and vitamin B12 work together in many chemical pathways in the body. A deficiency of one can impair the function of another. All three have to be converted in the gut to their bio-available forms and all have the same genetic defect issues.

If you have digestive issues, fatigue, or a history of anemia look at the lab report for your CBC (complete blood count). Find the MCV (mean corpuscular volume). If that number is 93 or higher, you are deficient in folic acid and/or vitamin B12.

Monday, March 3, 2014

Average Obese Woman Gets 1 Hour of Exercise a Year

A new study suggests that obese women get just one hour of vigorous exercise a year, while obese men don’t do much better at fewer than four hours.
February 20, 2014

The findings startled the researchers, whose main focus was finding better ways to measure how much exercise people get.

“They’re living their lives from one chair to another,” said Edward Archer, a research fellow with the Nutrition Obesity Research Center at the University of Alabama at Birmingham. “We didn’t realize we were that sedentary. There are some people who are vigorously active, but it’s offset by the huge number of individuals who are inactive.”

According to the U.S. Centers for Disease Control and Prevention, more than one in three people in the United States is obese, a step above overweight. Obesity increases the risk of cardiovascular disease, diabetes, stoke, and some cancers.

The study, published recently in the Mayo Clinic Proceedings, examined the results of a 2005-2006 government survey of adults age 20 to 74. Among other things, the survey tracked the weight, diet and sleep patterns of nearly 2,500 adults. Accelerometer devices were used to track their movements, providing insight into how much they exercised.

What kind of lives are the most inactive people living? “I think they’re living the typical life. They drive their children to school; they sit at a desk all day long. They may play some video games and then they go to sleep.” Archer said.

As shocking as this study seems, just walk through any airport terminal and you will see the reality. We are no longer the ugly Americans, we are the fat Americans.

Recently, on CBS national news, an MD spoke at length on the diminishing returns of exercising more than an hour a day. When asked which was better for your health, being a marathon runner or a couch potato. He said he could not really compare the two, but added that we were not made for running. The truth is we absolutely are designed to run. We are not designed to sit in chairs all day. The focus should be on increasing our exercise habits, not limiting them.

Regular exercise increases endorphins and enkelphins. These brain chemicals elevate mood and reduce pain. Just think about how much better you feel after that run on the beach or spinning class, even if you dreaded going beforehand.

Get off the couch and exercise. Find an activity that you enjoy, one that is engaging. I use a mix of running, biking and swimming, but tennis the sport that really engages me. If you are starting from square one, most communities offer a “Couch to 5K” class that will train you to run a 5K (3.1 miles) in 8 to 10 weeks.