Monday, October 15, 2018

Vitamin A supplements could harm bone health

Vitamin A is a vital nutrient that supports the body’s development and strengthens the immune system. Because our bodies do not naturally produce vitamin A, some choose to take supplements. However, too much vitamin A is likely to harm bone health, researchers warn.

Normally, we derive vitamin A form the food we eat, such as carrots, sweet potatoes, beef liver, salmon, and several dairy products. How much vitamin A someone needs depends on their age, as well as other factors. The National Institutes of Health (NIH) state that the ideal daily intake of vitamin A is 900 micrograms retinol activity equivalents for men and 700 mcg RAE for women aged 19-50.

Over time, supplementation of vitamin A might lead to an overload of this nutrient, which can actually increase a person’s risk of experiencing bone fractures. Researchers from the Sahlgrenska Academy at the University of Gothenburg in Sweden reported in the Journal of Endocrinology that taking too much vitamin A can make bones “thin out,” thereby putting them at risk of fracturing easy.

Dr. Ulf Lerner and team administered doses of vitamin A the equivalent of 4.5-13 times the RDA for humans – for 1, 4, or 10 weeks. The scientists saw that after only 8 days of oversupplementation, the mice’s bone thickness had started to decrease. Over 10 weeks, the rodents’ bones became increasingly fragile and prone to fracturing.

Friday, October 12, 2018

Coconut Water

Coconut water is the clear liquid found inside immature coconuts. As the coconut matures, the water is replaced by coconut meat. Coconut water is sometimes referred to as green coconut water because the immature coconuts are green in color.

Coconut water is different than coconut milk. Coconut milk is produced from an emulsion of the grated meat of a mature coconut. Coconut water is commonly used as a beverage and as a solution for treating dehydration related to diarrhea or exercise. It is also tried for high blood pressure and to improve exercise performance.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly ineffective, Likely ineffective, ineffective, and Insufficient Evidence to Rate.

Insufficient evidence to rate effectiveness for coconut water was found for diarrhea-related dehydration, dehydration caused by exercise, exercise performance, high blood pressure, or other conditions.

Coconut water is rich in carbohydrates and electrolytes such as potassium, sodium, and magnesium. Because of this electrolyte composition, there is a lot of interest in using coconut water to treat and prevent dehydration. But some experts suggest that the electrolytes composition in coconut water is not adequate to be used as a rehydration solution.

Wednesday, October 10, 2018

Wisdom Wednesday: Therapeutic Fasting Could Be an Alternative to Insulin for Some Diabetes Patients


Medically supervised fasting could eliminate the need for insulin in some patients with type 2 diabetes, according to findings in BMJ Case Reports.

Three men who'd had type 2 diabetes for 10 to 25 years — and who were taking various pharmacotherapies, including insulin — underwent nutritional training and were instructed to fast for 24 hours three times a week for several months. On fasting days, they ate just dinner. On nonfasting days, they ate lunch and dinner. Low-carbohydrate meals were advised, and participants were seen twice a month for lab testing.

Among the findings:
  • All three patients were able to discontinue insulin within 5 to 18 days. Two ultimately stopped all diabetes medications.
  • All participants saw reductions in hemoglobin A1c, and none experienced symptoms of hypoglycemia.
  • All three lost weight (10%–18% of body weight) and reduced their waist circumference.
  • Patients described feeling "terrific" and "excellent" on fasting days.
  • The researchers write, "Educating patients on the benefits of fasting ... may aid in the remission of (diabetes) and curtail the use of pharmacological interventions."


My Take:
As you know from previous blogs, I have been recommending intermittent fasting for a few of my patients. Most commonly, I recommend the 18-6 fast where you eat from noon to 6 pm and fast the rest of the day and night. In this case study they used the intermittent 24 hour fast. I typically limit this fast to two non-consecutive days a week. However, extreme health issues like chronic, insulin dependent type II diabetes often calls for extreme measures. In this scenario, fasting three days per week is warranted.

Monday, October 8, 2018

Perimenopause & the Adrenal Connection

Last weekend I attended a seminar on understanding the rise and fall of hormones during perimenopause presented by Annette Kutz Schippel, DC. She practices nutrition and chiropractic in Illinois, specializing in women’s issues and pediatrics.

This is the third seminar I have taken with her. Her style is casual and easy going but she has a wealth of knowledge. This class completes my continuing education requirements for 2018 as a diplomate in nutrition. I have the choice of attending a couple of classes each year or presenting a paper for publication. Although I enjoy the challenge of writing, especially when it has to meet the requirements of peer review, I never seem to find the time.

I’ve attended several seminars on women’s health issues, particularly on menopause. However, this is the first that focused on perimenopause and, no pun intended, it did really fill in a gap.

As women enter perimenopause, hormone levels begin to fluctuate outside the normal ovulation cycle. This transition typically begins 2-3 years prior to menopause, but can start as much as 8-10 years before true menopause. By definition, menopause officially begins after menstruation has ceased for a full year.

During this transition women often experience heavier than normal bleeding, irregularity of the cycle, insomnia, depression, mood swings, weight gain, menstrual migraines, decreased fertility, decreased libido, bladder problems, fatigue, hot flashes, vaginal dryness, and more frequent illness.

Common treatment options are oral birth control, often prescribed to be taken continuously, progestin therapy, endometrial ablation surgery, bioidentical hormone treatment, partial or complete hysterectomy and/or increased use of anti-anxiety and anti-depressant medications.

Stress plays a large role in the severity of symptoms and typically the more severe the symptoms of perimenopause, the more severe her symptoms will be during menopause. This is because the adrenal glands, your organs that respond to stress, now have the additional burden of trying to make up for declining hormone production from the ovaries.

Friday, October 5, 2018

Can some foods reduce estrogen in men?

Estrogen and testosterone are hormones that occur naturally in male and female bodies. Some research suggests that certain foods can influence the levels of these hormones.

A 2016 study reports that testosterone levels decline by 0.4-2.0% each year after the age of 30. In some men, this decline leads to depression, reduced libido, erectile dysfunction, and low energy. When a man has a low level of testosterone, a doctor may recommend testosterone injections.

Estrogen is [also] vital for men’s health. It supports the functioning of almost every area of the body, including the brain, heart, bones, muscles, and the immune system. However, if a man’s estrogen levels are too high, this can cause a number of health problems, including obesity and depression.

A handful of studies have suggested that specific foods can raise or lower estrogen levels. However, scant evidence suggests that these foods can address the health effects of high estrogen. Some research suggests that the naturally occurring estrogens in plants, for example, do not affect levels of the hormone in male bodies. The research that suggests certain foods may be able to diminish the level of estrogen is often low-quality or has involved animals rather than humans.

Soy-based products, including edamame and some meat substitutes, are especially rich in plant estrogens. These phytoestrogens are weaker than estrogens that the body produces. When plant estrogens enter the body’s cells, they push out the body’s own estrogens. In this way, consuming more phytoestrogens could lower a person’s estrogen level.

Cruciferous vegetables also contain high levels of phytoestrogens and isoflavones. Results of several studies suggest that isoflavones may prevent the body from converting testosterone to estrogen.

Wednesday, October 3, 2018

Wisdom Wednesday: Does Glucosamine Work?


Glucosamine is a naturally occurring compound that is chemically classified as an amino sugar. It serves as a building block for a variety of functional molecules in your body but is primarily recognized for developing and maintaining cartilage within your joints.

Some studies indicate that supplemental glucosamine may protect joint tissue by preventing the breakdown of cartilage. One small study in 41 cyclists found that supplementing with up to 3 grams of glucosamine daily reduce collagen degradation in the knees by 27% compared to 8% in the placebo group. Another small study found a significantly reduced ratio of collagen-breakdown to collagen-synthesis markers in articular joints of soccer players treated with 3 grams of glucosamine daily over a three-month period.

Multiple studies indicate that supplementing daily with glucosamine sulfate may offer effective, long-term treatment for osteoarthritis by providing a significant reduction in pain, maintenance of joint space and overall slowing of disease progression.

Some studies have revealed significantly reduced markers of rheumatoid arthritis (RA) in mice treated with various forms of glucosamine. Conversely, one human study didn’t show any major changes in RA progression with the use of glucosamine. However, study participants reported significantly improved symptom management.

Monday, October 1, 2018

How cannabinoid drugs affect the experience of pain

A first-of-its-kind meta-analysis of existing research has reviewed the effects of cannabinoid drugs on the experience of pain.

The Centers of Disease Control and Prevention (CDC) suggest that up to 50 million people in the United States have chronic pain. An increasing amount of people now turn to the medicinal benefits of cannabis for treating and alleviating pain. As a result, scientists are trying to keep up by studying the effects of cannabinoids on pain. So far, however, studies have produced mixed results. A recent study that spanned over 4 years found “no evidence” that cannabis alleviates chronic pain that is not associated with cancer.

New research puts forth an interesting explanation for why the current clinical evidence does not fully support the popularity of cannabis as a painkiller and people’s subjective accounts of its benefits. It may be that the “feel-good” factor in the use of cannabis and cannabinoid drugs makes pain “more tolerable” and “less unpleasant,” suggests the new study, and that the benefits of cannabinoid drugs may operate more on an affective level rather than a sensory one.

To help clarify the analgesic properties, Martin De vita, a doctoral researcher at Syracuse University and colleagues examined over 1,830 experimental studies on the effects of cannabinoids that were carried out over a 40-year period. The study was recently published in the journal JAMA Psychiatry.

The results revealed that cannabinoid drugs correlated with “modest increases in experimental pain threshold and tolerance,” and a reduction in the “perceived unpleasantness of painful stimuli.”

Friday, September 28, 2018

What are the best sources of omega-3?

Omega-3 fatty acids are a healthful and essential type of fat, and they offer many health benefits. Fatty fish is an excellent dietary source of omega-3. People can also meet the recommended omega-3 intake by eating plant-based foods, including omega-3 rich vegetables, nuts, and seeds.

There are three main types of omega-3 fatty acid, which are called ALA, DHA, and EPA. Plant sources rich in ALA, while fish, seaweed, and algae provide DHA and EPA fatty acids.

The following types of fish are some of the best sources of these fatty acids. The serving sizes for each is 3 ounces:
  • Mackerel – 0.59 g of DHA and 0.43 g of EPA
  • Salmon – Farm 1.24 g of DHA & 0.59 EPA Wild 1.22 g of DHA & 0.35 g of EPA
  • Seabass – 0.47 g of DHA and 0.18 g of EPA
  • Oysters – 0.14 g of ALA, 0.23 g of DHA and 0.30 g of EPA
  • Sardines – 0.74 g of DHA and 0.45 g of EPA
  • Shrimp – 0.12 g of DHA and 0.12 g of EPA
  • Trout – 0.4 g of DHA and 0.40 g of EPA


Vegetarian and vegan sources of omega-3:
Seaweed and algae – seaweed, nori, spirulina, and chlorella are different forms of algae. They are important sources of omega-3 for vegetarians because they are one of the few plant groups that contain DHA and EPA
  • Chia seeds – 5.055 g of ALA per 1-oz serving
  • Hemp seeds – 2.605 g of ALA in every 3 tablespoons
  • Flaxseeds – 6.703 g of ALA per tablespoon
  • Walnuts – 3.346 g of ALA per cup
  • Edamame – a half-cup of frozen edamame beans contains 0.28 g of ALA
  • Kidney beans – 0.10 g of ALA per half-cup
  • Soybean oil – 0.923 g of ALA per tablespoon


Omega-3 supplementation:
  • Fish oil – the most common omega-3 supplement, offering the highest available dose. Fish oil supplements include both DHA and EPA.
  • Cod liver oil – rich in DHA, EPA, vitamin A and D
  • Krill oil – rich in DHA and EPA
  • Algae oil – for vegetarians, algae oils are an excellent source of omega-3s. However, they contain a lower dose than most fish oil supplements. Some brands include only DHA.
  • ALA supplements – Flaxseed, chia seed, and hemp seed supplements contain only the plant-based omega-3 ALA, which is not sufficient on its own.

My Take:
This is a fairly comprehensive list of sources rich in omega-3 fatty acids. As noted, they are essential as the human body cannot manufacture omega-3 fatty acids. However, we can convert ALA to both DHA and EPA, if our diet is clean enough. That is fortunate for vegans and vegetarians as DHA and EPA are the forms of omega-3 fatty acids most commonly used by the body.

Bottom Line:
The article doesn’t mention a recommended daily intake. I suggest a minimum of 2 grams of omega-3 fatty acids daily with about 400 mg of DHA and EPA. You can easily meet that standard with a fresh serving of fish daily. Otherwise, I recommend a supplement daily.

Source: September 23. 2018 NIH

Wednesday, September 26, 2018

Wisdom Wednesday: What does it mean if your ESR is high?


The ESR test measures the erythrocyte sedimentation rate, which is how quickly red blood cells settle at the bottom of a blood sample. Doctors cannot use the results of the test to diagnose specific disease because many different health conditions can cause the ESR to be high or low.

Doctors call the ESR test a nonspecific test, as it only confirms the presence or absence of inflammatory activity in the body. Doctors typically use other lab tests, clinical findings, and the person’s health history alongside ESR test results to make a diagnosis.

Inflammation usually occurs in the body as a result of underlying medical conditions, such as infection, cancer, or an autoimmune disease. Doctors also use the ESR to monitor conditions like RA, temporal arteritis, polymyalgia rheumatica and systemic vasculitis are responding to treatment.

A small amount of blood is drawn and transferred to a vertical test tube in which the red blood cells will slowly settle at the bottom. This will leave a clear, yellowish fluid at the top, the plasma. The result of the ESR test is the amount of plasma remaining at the top of the test tube after 1 hour.

Red blood cells settle at a faster rate in people with inflammatory conditions. Inflammation increases the number of proteins in the blood and causes red blood cells to clump together and settle more quickly.

Monday, September 24, 2018

Breast Milk Provides Food Allergy Protection

Replicating the nourishment found in mother’s milk has been a challenge, especially since science continues to reveal its complex composition. Previous research indicates breastfed children have a lower risk of certain medical conditions, such as wheezing, infections, asthma and obesity. Identifying specific components that influence immunity is key to identifying a potential for therapeutic interventions.

A recent study hypothesized that “sensitization resulting from the composition of complex sugars in breast milk [could possibly] prevent future food allergies,” and this hypothesis was verified in 1-year-old infants (N=421). Human milk oligosaccharides (HMOs) are structurally complicated sugar molecules unique to breast milk. Classified as “the third most abundant solid component in human milk after lactose and fat,” they are indigestible, but play a key prebiotic role and help develop the infant’s gut microbiota.

This team found that the overall HMO composition appeared to play a role in food sensitization, however, “no individual HMO was as yet associated with food sensitization.”  Even though the composition of HMOs in breast milk varies depending on the lactation stage, gestational age, maternal health, ethnicity, geographic location and whether or not the mother is breastfeeding exclusively, a beneficial HMO profile was associated with a lower rate of food sensitization in children at one year.

Friday, September 21, 2018

Can eating this type of sugar prevent weight gain?

Mannose, a type of sugar, can greatly affect metabolism, weight gain, and the composition of gut bacteria in rodents. This result may lead to new treatments and prevention strategies for both obesity and weight gain.

More and more studies are unraveling the multi-layered relationship between our gut microbiome and weight gain. A few years ago, a twin study that Medical News Today reported on found that genes influence the bacteria that live in our gut, which, in turn, influence whether we gain weight or not. Another paper proposed that our diets influence our guts’ “power” to decide how much weight we gain.

Belly fat – the most harmful type of fat – in particular is known to be driven by our gut bacteria, but the food that we eat, this study suggested, plays a more important role in these weight-regulating gut processes than genes. New research brings further nuance to this latter idea. Specifically, a new study looks at how the intake of mannose, a type of sugar, affects the gut bacteria and weight gain in mice.

Hudson Freeze, Ph.D., director of the Human Genetics Program at the Sanford Burnham Prebys Medical Discovery Institute in San Diego, CA, and colleagues observed the effects of mannose on weight gain while they were studying its’ therapeutic effects on CDG (congenital glycosylation). Then the team decided to investigate the effects of mannose further.

The study revealed that mice that were fed a high-fat diet plus mannose were leaner, had less fat in their livers, were more tolerant to glucose, and had overall higher levels of fitness than mice that had the mannose-free diet.

Wednesday, September 19, 2018

Wisdom Wednesday: What allows C. difficile to survive so well in the gut?


Clostridium difficile is a particularly hardy type of bacteria, which is very difficult to treat. It often affects people during a hospital stay – especially if they have taken antibiotics. Why is it this resilient, and does knowing this lead to better treatments?

According to some experts, Clostridium difficile infections are ever on the rise and becoming increasingly difficult to treat. This means that researchers need to find new and better ways of targeting this stubborn bacterium. Among other symptoms, C. difficile can cause diarrhea, which can range from mild to extremely severe. In the most extreme cases, the infection can even lead to death.

Recently, a team from the London School of Hygiene and Tropical Medicine in the United Kingdom made a new and important discovery: C. difficile releases a special compound that allows it to gain ground over gut bacteria and to establish a strong presence in the gut environment. This findings are now published in the journal PLOS Pathogens.

C. difficile infections often appear after a person has followed a treatment with antibiotics, because these drugs work by essentially killing bacteria. Unfortunately, antibiotic do not only destroy the bacteria that cause harm.

Antibiotics also disrupt the balance of the gut microbiota, which contains many types of bacteria that are harmless and promote or sustain the health of the intestines. When this happens, C. difficile sometimes takes hold – and fighting it is often very complicated.

For the first time, researcher Lisa Dawson and team found that the release of para-cresol by C. difficile affects the growth of many microorganisms in the gut and allows it to prevail over other bacteria.

Monday, September 17, 2018

LDL More Than 160 Tied to Increased Mortality in Low-Risk Patients

Patients deemed at low-risk for cardiovascular disease (CVD) but with LDL levels above 160 face increased mortality risks over the long term, a Circulation study suggests.

Over 36,000 adults in Texas (median age, 42) with an estimated 10-year risk for atherosclerotic CVD events below 7.5% had their lipid levels measured and were followed for a median of 27 years. During that time, nearly 1100 CVD deaths and 600 coronary heart disease (CHD) deaths occurred.

After multivariable adjustment, participants with LDL levels of 160–189 mg dL had a 70% increased risk for CVD mortality and more than twice the risk for CHD mortality, relative to those with LDL below 100 mg dL. Increasing levels of non-HDL cholesterol were also associated with higher mortality risks.

The researchers note that 2013 cholesterol guidelines recommend statins for low-risk patients when LDL reaches 190 mg dL, with a class IIb recommendation for considering treatment at 160 mg dL. They say their current findings "suggest a stronger consideration of using the LDL-C greater than 160 mg dL cutoff."

My Take:
The medical norms for LDL are less than 130 mg dl. However, many labs list the medical norm as less than 100 mg dl as that is the goal of statin drug therapy. Many physicians like to drive the LDL level less than 60 mg dl, although the research indicates no additional benefit in cardiovascular risk is associated with this goal.

Friday, September 14, 2018

Nutrition and Functional Neurology: Partners in Holistic Patient Care

Sweeping through models of chiropractic care, functional neurology is transitioning away from the limited concept of vertebral fixations to embracing the concept of neural tone, championed by the very originator of chiropractic – D.D. Palmer. Indeed, the updated definition of subluxation put forth by the Council for Chiropractic Practice in 2013 plainly states that subluxation is “a neurological imbalance or distortion in the body associated with adverse physiological responses and/or structural changes which may become persistent or progressive.” Following this line of reasoning, functional neurology opens the discussion to a range of causes of the neurological imbalances, including (i) inflammation, (ii) nutritional problems, (iii) hormonal imbalances, (iv) emotional stress, and (v) structural derangements that dominated earlier models of chiropractic interventions.

The positive aspect of functional neurology is its reorganization of nerve cells, making possible the restoration or bypass of connections that have become disrupted or damaged. A perfect example would be performing exercises to recover from [a] stroke. The negative aspect of functional neurology, however, is that if a neuronal pathway is not fired, synaptic connections may become inactive with the loss or inactivation of neurotransmitters and receptors, as exemplified by the risk of cognitive decline in the elderly and the undertaking of exercise to counteract that effect. Both of these transformations of nervous system activity have become known as neuroplasticity, not limited to neural injury or recovery but also including the remodeling of dendrites, synapse turnover, long-term potentiation, and neurogenesis. One striking example out of many demonstrating the phenomenon of neuroplasticity was offered by an observational study of London cab drivers, in which there was a redistribution of gray matter in their brains as they became familiar with the city’s layout.

Wednesday, September 12, 2018

Wisdom Wednesday: The Dirty Dozen


Every year, the Environmental Working Group (EWG) releases the “Dirty Dozen” – a list of the 12 non-organic fruits and vegetables highest in pesticide residues.

Pesticides are substances commonly used in agriculture to protect drops from damage caused by insects, weed pressure and diseases. To compile the Dirty Dozen list, the EWG analyzes over 38,000 samples taken by the USDA and FDA to single out the worst offenders.

While the EWG claims that this list can help consumers avoid unnecessary pesticide exposure, some experts – including food scientists – argue that the list is scaring the public away from consuming healthy foods.

Pesticides are tightly regulated by the USDA, and recent reports indicate that pesticide levels found on 99.5% of conventional produce are well below recommendations set by the EPA. The USDA Pesticide Data Program ensures that the U.S. food supply “is one of the safest in the world,” due to rigorous testing methods.

However, many experts argue that continuous exposure to pesticides – even in small doses – can build up in your body overtime and lead to chronic health conditions.

Additionally, there is concern that the safe limits set by regulatory agencies don’t take into consideration the health risks involved with consuming more than one pesticide at a time.

Monday, September 10, 2018

The Man Who Sold America On Vitamin D – And Profited in the Process

Dr. Michael Holick’s enthusiasm for vitamin D can be fairly described as extreme. The Boston University endocrinologist, who perhaps more than anyone else is responsible for creating a billion-dollar vitamin D sales and testing juggernaut, elevates his low levels of the stuff with supplements and fortified milk. When he bikes outdoors, he won’t put sunscreen on his limbs. He has written book-length odes to vitamin D, and has warned in multiple scholarly articles about a “vitamin D deficiency pandemic” that explains disease and suboptimal health across the world.

His fixation is so intense that it extends to the dinosaurs. What if the real problem with that asteroid 65 million years ago wasn’t a lack of food, but the weak bones that follow a lack of sunlight? “I sometimes wonder,” Holick has written, “did the dinosaurs die of rickets and osteomalacia?”

Holick’s role in drafting national vitamin D guidelines, and the embrace of his message by mainstream doctors and wellness gurus alike, have helped push supplement sales to $936 million in 2017. That’s a ninefold increase over the previous decade. Lab tests for vitamin D deficiency have spiked, too. Doctors ordered more than 10 million for Medicare patients in 2016, up 547% since 2007, at a cost of $365 million. About 1 in 4 adults 60 and older now take vitamin D supplements.

But few of the Americans swept up in the vitamin D craze are likely aware that the industry has sent a lot of money Holick’s way. A Kaiser Health News investigation found that he has used his prominent position in the medical community to promote practices that financially benefit corporations that have given him hundreds of thousands of dollars – including drugmakers, the indoor-tanning industry and one of the country’s largest commercial labs.

In an interview, Holick acknowledged he has worked as a consultant to Quest Diagnostics, which performs vitamin D tests since 1979. Holick, 72, said that industry funding “doesn’t influence me in terms of talking about the health benefits of vitamin D.”

Friday, September 7, 2018

“Transparency” as Mask? The EPA’s Proposed Rule on Scientific Data

The Environmental Protection Agency (EPA) recently proposed excluding from consideration in setting environmental standards any studies whose raw, individual-level data are not publicly available. This proposal was preceded by the wholesale exclusion from the EPA’s scientific advisory boards of academic scientists who receive research grants from the agency – and their replacement by industry-funded scientists. It is hard to interpret these actions as anything other than an attack on the use of hard scientific evidence to set environmental standards.

Open science has growing support, and justly so. However, studies conducted at academic institutions and involving humans, which are regulated by the Health Insurance Portability and Accountability Act (HIPPAA) and institutional review boards (IRBs), must maintain a basic regard for privacy. Great progress in understanding pollution’s effects has been made by adding exposure information to large cohort studies that were established to explore cardiovascular disease or cancer. Such studies have been used, for example, to analyze concentrations of metals in blood, urine, or toenails and to attribute air pollution exposure to people according to their residential address. Precisely because these studies include measurements of many potential confounding factors, it is difficult to make the data public without also making participants identifiable. For example, after Hurricane Katrina, a local newspaper published a map of the locations of deaths. It showed no roads, and the only geographic data included were neighborhoods. Yet researchers were able to correctly identify the residential address for most of the people who died.

It is difficult to believe that EPA leaders do not know that few human cohort studies could comply with their requirements – and therefore difficult not to conclude that the real purpose of the proposal is to eliminate a vast body of highly relevant data from consideration, resulting in a weakening of standards that are no longer supported by “sufficient scientific evidence.”

My Take:
The attacks on science in the current political climate are real and dangerous. The EPA has been under a gag order since the new administration took office. Please read my blog “Chemicals Found in Many U.S. Streams” posted on April 28, 2017. Just enter “EPA” in the search box in the upper left hand corner of my blog page. This study was completed prior to the gag order but published after the gag order with no comment from the EPA who sponsored the study.

Bottom Line:
This anti-science trend is reminiscent of my high school world history class study on the Dark Ages. I have always found it hard to believe that people could be so ignorant, even a thousand years ago. Those that ignore history are doomed to repeat it.

Source: August 30, 2018 The New England Journal of Medicine

Wednesday, September 5, 2018

Wisdom Wednesday: A Soy-based Diet Could Help Strengthen Bones


A new study has investigated the impact of dietary soy on bone strength in postmenopausal women. The authors conclude that eating more soy might in fact strengthen bones in women of all ages.

The reduction in bone density and strength that is common in postmenopausal women is of huge concern. As women age, osteoporosis, reduced activity levels, and weight gain act together to decrease bone health and negatively impact metabolism. Osteoporosis and bone weakness increases the risk of fractures, which then lead to even more inactivity and weight gain, exacerbating the issue further. As the population becomes – on average – older and heavier, bone health is an important area of medical science to study.

To investigate, researchers from the University of Missouri in Columbia utilized so-called low-capacity running rats, which have lower fitness levels.

The researchers surgically removed the ovaries of half of the rats to mimic menopause. The scientists fed half of the rats a soy-based diet and the remaining animals a corn-based diet. Both diets contained the same amount of calories. They weighed the rats every week for the duration of the 30-week trial.

Then, the team took blood samples, tested bone strength, and assessed body composition. The analysis showed that, although turnover markers were not significantly altered, the leg bones of soy-fed rats were stronger than the bones of the rats that were fed a corn-based diets.

Friday, August 31, 2018

Daily Aspirin Unwise for Most

Taking a low-dose aspirin every day has long been known to cut the chances of another heart attack, stroke or other heart problem in people who already have had one, but the risks don’t outweigh the benefits for most other folks, major new research finds.

The research was discussed Sunday at the European Society of Cardiology meeting in Munich.

A Boston-led study gave aspirin or dummy pills to 12,546 people who were thought to have a moderate risk of suffering a heart attack or stroke within a decade because of other health issues.

After five years, 4% of each group had suffered a heart problem. One percent of aspirin takers had stomach or intestinal bleeding, mostly mild – twice as many as those on dummy pills. Aspirin users also had more nosebleeds, indigestion, reflux or belly pain. Bayer sponsored the study, and many researchers consult for the aspirin maker. Results were published by the journal Lancet.

Oxford researchers randomly assigned 15,480 adults with Type 1 or 2 diabetes but otherwise in good health and with no history of heart problems to take aspirin, 1 gram of fish oil, both substances, or dummy pills daily. After 7.5 years, there were fewer heart problems among aspirin users but more cases of serious bleeding, so they largely traded one risk for another.

The same study also tested omega-3 fatty acids, good oils found in salmon, tuna and other fish. Supplement takers fared no better than those given dummy capsules: 9% of each group suffered a heart problem. “We feel very confident that there doesn’t seem to be a role for fish oil supplements for preventing heart disease,” said University of Oxford’s Dr. Louise Bowman, study leader.

Wednesday, August 29, 2018

Wisdom Wednesday: Pesticide Linked to Autism


Abstract
Objective:

Autism is a complex neurodevelopmental disorder with a largely unknown etiology. To date, few studies have investigated prenatal exposure to toxins and risk of autism by using maternal biomarkers of exposure. Persistent organic pollutants are lipophilic halogenated organic compounds and include the insecticide dichlorodiphenyltrichloroethane (DDT), as well as its metabolite p,p′-dichlorodiphenyl dichloroethylene (p,p′-DDE), and polychlorinated biphenyls (PCBs). The objective of this study was to test whether elevated maternal levels of persistent organic pollutants are associated with autism among offspring.

Method:
The investigation was derived from the Finnish Prenatal Study of Autism, a national birth cohort study based on a nested case-control design. Cases of autism among children born between 1987 and 2005 were ascertained by national registry linkages. In cases of childhood autism and matched control subjects (778 matched case-control pairs), maternal serum specimens from early pregnancy were assayed for levels of p,p′-DDE and total levels of PCBs.

Results:
The odds of autism among offspring were significantly increased with maternal p,p′-DDE levels that were in the highest 75th percentile, with adjustment for maternal age, parity, and history of psychiatric disorders (odds ratio=1.32, 95% CI=1.02, 1.71). The odds of autism with intellectual disability were increased by greater than twofold with maternal p,p′-DDE levels above this threshold (odds ratio=2.21, 95% CI=1.32, 3.69). There was no association between total levels of maternal PCBs and autism.

Conclusions:
These findings provide the first biomarker-based evidence that maternal exposure to insecticides is associated with autism among offspring. Although further research is necessary to replicate this finding, this study has implications for the prevention of autism and may provide a better understanding of its pathogenesis.

My Take:
Although DDT was banned in the United States in 1972, it still remains in our environment, along with all its’ metabolites. It is still used in many parts of the world and limited uses in the US continue under “public health exception, for emergency agricultural use.” This continued use is not well publicized.

The half-life for DDT is 2-15 years with 97% of it degraded after 5 half-lives. It stores in the fatty tissues of our bodies and has been linked with Alzheimer’s disease, MS and other chronic degenerative conditions.

Clinically, I find reflex testing for both DDT and Round Up quite often. Both of these toxic chemicals are in all of us. It appears that DDT predominates in my older patients while Round Up shows up in younger patients. The real question is do these toxins need to be removed from the body? More and more, the answer is yes, although it often is not the first priority.

Bottom Line:
Autism is multifactorial but I strongly suspect that environmental toxins are a major factor in the dramatic increase in the rate of autism worldwide.


Monday, August 27, 2018

It’s All About the Bass

Music is almost universal. Every society on earth has music blended into its culture, and music, inevitably, brings dance.
But why are we so driven to move out limbs, heads, and bodies to rhythmic sounds? A facet of music that often goes hand in hand with dancing is the heavy use of bass. Be it the beat of a drum or the pulsing sound from a subwoofer, the bass is often a driving factor in our desire to move in time with the music.

A new study set out to investigate music and the brain, and although it does not fully answer the questions above, it does give new insight into music and the human experience. The results were published this week in the journal PNAS.

The scientists – from Western Sydney University’s MARCS Institute in Australia – were particularly interested in the way that our brains process low-frequency sounds. The scientists played each participant rhythmic patterns, in either a high- or low-pitched tone, and recorded the electrical activity of the person’s brain using electroencephalography (EEG). They found that brain activity became synchronized with the frequency of the beat.

In the current study, however, they found that bass-heavy music was more successful at locking the brain into the rhythm. The lower frequencies, it seems, strong-arm the brain into synchronizing. The lower frequencies, as the authors write, boost “selective neural locking to the beat.”

The authors theorize that the synchronizing effect that bass has on the brain could be due to “a greater recruitment of brain structures involved in movement planning and control,” such as the cerebellum and basal ganglia.

Friday, August 24, 2018

A2 Milk: Breakthrough of Science or Marketing?

Shoppers in the United States are about to encounter something new in the dairy aisle. A2 milk, a substitute for conventional milk successfully launched in New Zealand two decades ago, is hoping the win over American consumers with an expansive pitch of health claims.

Advocates of A2 mild don’t just see it as the next almond or soy milk. Instead, they’re positioning it as an alternative to one of Western society’s foundational food sources, which they believe has had an outsized role in causing maladies ranging from simple indigestion to cardiovascular disease, autism, and schizophrenia.

These claims have been met in equal measure by critics who have identified A2 milk as something more conventional – a hype-driven product building a profitable foundation on limited science.

Beta-casein is the major source of protein in mild. Around 8000 year ago however, the characteristics of beta-casein began to change, with a lone mutation occurring at one of the 209 amino acids in its genetic profile. Breeding practices and random acts of history made A1-production cows the norm in Europe and, subsequently, the majority of the Western world.

The difference is potentially important because digesting A1, but not A2, beta-casein can cause the release of the opioid beta-casomorphin (BCM-7) in the small intestine. BCM-7 has been linked to impaired gastrointestinal function, such as decreased intestinal contractions and suppressed lymphocyte proliferation.

Many studies on the risks of A1 milk are from animal study data and causal associations showing higher rates of chronic disease in countries primarily reliant on A1 milk. Researchers have used both to establish a link between A1 milk consumption and an elevated risk for gastrointestinal impairment, type 1 diabetes, coronary heart disease, and perhaps further afield, autism and schizophrenia.

Many of these studies have been knocked for being funded by the A2 Milk Company, the main producer of this product. In a turnaround befitting the tit-for-tat nature of this debate, the author of a 2006 critical review that found “no convincing or even probable evidence” of A1’s harmful effects in humans was later found to have been a consultant for a New Zealand dairy company producing A1 milk.

Wednesday, August 22, 2018

Wisdom Wednesday: Homocysteine


A homocysteine test measures the amount of homocysteine in your blood. Homocysteine is a type of amino acid, a chemical your body uses to make proteins. Normally, vitamin B12, vitamin B6 and folic acid break down homocysteine and change it into other substances your body needs. There should be very little homocysteine left in the bloodstream. If you have high levels of homocysteine in your blood, it may be a sign of a vitamin deficiency, heart disease, or a rare inherited disorder.

If your health care provider thinks a vitamin deficiency is the reason for your high homocysteine levels, he of she may recommend dietary changes to address the problem. Eating a balanced diet should ensure you get the right amount of vitamins.

If your health care provider thinks your homocysteine levels put you at risk for heart disease, he or she will monitor your condition and may order more tests.

My Take:
Another “dummied down” press release from NIH. Again, the information is fairly accurate, although misleading. I write about homocysteine frequently. Please review my blog “Cardiovascular Disease: Risk Assessment with Nontraditional Risk Factors” posted on July 13, 2018. This will familiarize you with the cardiac risks associated with homocysteine.

Homocysteine is an intermediate metabolite in the sulfur amino acid pathway. We consume sulfur attached to amino acids, most commonly in cruciferous vegetables like broccoli, cauliflower, arugula, and kale. Methionine (a sulfur bearing amino acid) is converted to SAM-e, a popular nutritional supplement used to calm the brain. SAM-e is then converted to homocysteine.

Monday, August 20, 2018

After Doctors Cut Their Opioids, Patients Turn to a Risky Treatment for Back Pain

An injectable drug that the manufacturer says is too dangerous to use along the spine is growing in popularity for back pain as doctors turn away from opioids.

The anti-inflammatory drug, called Depo-Medrol and made by Pfizer, is approved for the injection into muscles and joints. Once a drug is approved, however, doctors may legally prescribe it however they see fit.

What few doctors or patients know is that Pfizer, faced with hundreds of complaints about injuries and complications related to the shots, asked the Food and Drug Administration to ban that type of treatment five years ago. The company cited the risk of blindness, stroke, paralysis and death – a request that neither the agency nor Pfizer made public.

The FDA declined to issue a ban but toughened the label warning. Other countries – among them Australia, Brazil, Canada, France, Italy, New Zealand and Switzerland – heeded Pfizer’s request.

After concerns were raised about the off-label treatments, use of the injections declined. But the opioid epidemic appears to be spurring their popularity despite risks known to public health officials and doctors.

According the FDA, back problems are the most common cause of disabling, chronic pain. Weekend classes to train physicians in the procedure are flourishing. Critics like Dr. Terri A. Lewis, a rehabilitation specialist and lecturer at the Southern Illinois University, say they are responsible for transforming pain clinics into “drill mills.”

And in June, as part of legislation to tackle the opioid crisis, the House of Representatives approved an increase in Medicare reimbursement for the procedure.

Friday, August 17, 2018

ORIVO Certification

ORIVO provides laboratory services for testing the authenticity of marine ingredients, both oil and meal. The testing technology, initially developed by the Norwegian research organization SINTEF, is based on proven species and region of origin via quality assured sampling protocols. Based in Molde, Norway, ORIVO serves the global markets independent third party verification to meet the consumer demand for non-adulterated and sustainable marine ingredients.

Biotics Research Corporation is the first supplement brand in the United States to provide certification of authenticity to their fish oil products, verified by ORIVO through an independent third-party authenticity test. They use an anchovy source from the cold waters of the South Pacific Ocean off the South American coast.

Customers now can be certain they are getting the highest quality omega-3s available. The certification also shows the fish oil is coming from sustainable sources.

My Take:
SINFEF developed this technology in response to concerns about the quality of omega-3 fatty acids products, most of which come from Norway. In the past, most supplement companies depended on the wholesale manufacturers to provide good quality fish oil.

Reputable supplement companies, like Carlson and Metagenics, would pay the manufacturer to remove any mercury from the raw material. That is how their labels claimed that their products were “mercury free”. Brands that offered low cost fish oil, like Costco, didn’t pay for mercury removal and made no such claims.

However, in 2004, 74 supplement companies were indicted by a judge in California for mercury contamination in products that claimed to be mercury free. The common source was a Norwegian manufacturer who was charging for mercury removal but skipping the high density molecular extraction process needed to remove the mercury.

Wednesday, August 15, 2018

Wisdom Wednesday: C- Reactive Protein (CRP) Test


A C-reactive protein test measures the level of C-reactive protein (CRP) in your blood. CRP is a protein made by your liver. It’s sent into your blood stream in response to inflammation. Inflammation is your body’s way of protecting your tissues if you’ve been injured or have an infection. It can cause pain, redness, and swelling in the injured or affected area. Some autoimmune disorders and chronic diseases can also cause inflammation. Normally, you have low levels of c-reactive protein in your blood. High levels may be [a] sign of a serious infection or other disorder.

If you’ve already been diagnosed with an infection or have a chronic disease, this test may be used to monitor your treatment. CRP levels rise and fall depending on how much inflammation you have. If your CRP levels go down, it’s a sign that your treatment for inflammation is working.

The CRP test is sometimes confused with a high-sensitivity-(hs) CRP test. Although they both measure CRP, they are used to diagnose different conditions. An hs-CRP test measures much lower levels of CRP. It is used to check for risk of heart disease.

My Take:
This is the kind of “dummied-down” information currently being released by NIH (National Institutes of Health) rather than reporting on cutting edge research.

Although the information presented is fairly accurate, it is also misleading. The hs-CRP also measures inflammation but it is specific for vascular inflammation. As such, it can be an indicator of cardiac risk. When elevated, the hs-CRP stimulates LDL cholesterol to bind with homocysteine and create plaque in an inflamed artery wall. At low levels this is a form of repair, protecting the damaged artery from rupture. However, when excessive, artery occlusion or clots can occur resulting in a CVA, stroke or pulmonary embolism.

Monday, August 13, 2018

Salt Restrictions for Some May Be Better Than for All

Restricting sodium intake seems best suited to communities with the highest consumption levels, according to an 18-country study in The Lancet.

Researchers used urine samples from nearly 100,000 adults to estimate sodium and potassium intakes. Blood pressure was also measured, and cardiovascular events were tracked.

Mean sodium intake was 4.8 g per day, with Chinese communities having higher intakes (5.6 g). During a median follow-up of 8 years, a mean increase of 2.86 mm Hg in systolic pressure was noted for every 1-g increase in sodium intake above the overall average. There was a positive association between sodium intake and stroke, but only in communities with the highest sodium intake. Of note, the frequency of cardiovascular events showed an inverse association with sodium intakes in communities with the lowest intakes.

Higher potassium intakes were associated with lower rates of all cardiovascular events.

The authors suggest that targeting restrictions to communities with sodium intakes above 5 g/day would bring the most benefit. Commentators call the findings "exceedingly provocative."

My Take:
WHO recommends that populations consume less than 2 g/day sodium as a preventive measure against cardiovascular disease, but this target has not been achieved in any country. This recommendation is primarily based on individual-level data from short-term trials of blood pressure (BP) without data relating low sodium intake to reduced cardiovascular events from randomized trials or observational studies. Now a new well-designed study questions the wisdoms of this recommendation.

Friday, August 10, 2018

Saunas Linked to Numerous Health Benefits

A stint in a sauna is not only pleasant and relaxing but may also improve health, according to the authors of a new, comprehensive literature review. Among the benefits they identified were a reduced risk for cardiovascular, neurocognitive, and pulmonary illnesses such as asthma and influenza; amelioration of pain conditions such as rheumatic diseases and headache; decreased risk for mortality; and an improved quality of life.

Overall, “the physiological responses produced by an ordinary sauna bath correspond to those produced by moderate or high intensity physical activity such as walking,” Jari A. Laukkanen, MD, PhD, from the Faculty of Sport and Health Sciences, University of Jyvaskyla, Finland, and colleagues write in an article published online July 31 in Mayo Clinic Proceedings. In fact, the advantages of sauna bathing plus physical activity may be additive, they write.

The findings build on earlier research by the same authors linking sauna use to a decreased risk for stroke. In that study, there was an inverse relationship between frequency of weekly sauna visits and stroke rates per 1000 person-years for follow-up. The authors listed a variety of positive effects associated with sauna baths that might account for that finding, including lower blood pressure and improvements in lipid profiles, arterial stiffness, carotid intima-media thickness, and peripheral vascular resistance, as well as a reduced risk for hypertension, dementia, and cardiovascular and all-cause mortality.

They confined the analysis to traditional Finnish sauna baths, as those have been the most widely studied to date. In a Finnish sauna, temperatures range from 176-212 degrees Fahrenheit, with 10-20% relative humidity. A bather will usually spend 5 t0 20 minutes in the sauna and follow it with a swim, a shower, or just a cooling-off period at room temperature, the authors explain. Finnish people typically have “a sauna bath at least once per week, with the average habitual frequency being 2 to 3 times a week.”

Wednesday, August 8, 2018

Wisdom Wednesday: Clinicians Rarely Ask for Patients’ Input, Often Interrupt


During consultations, clinicians rarely ask patients to explain the reasons for their visit, a recent study published online July 2 in the Journal of General Internal Medicine has shown.

“The patient’s agenda was elicited in 36% of the clinical encounters,” writes Naykky Singh Ospina, MD, from the University of Florida, and colleagues. And, “among those in which the agenda was elicited, patients were interrupted seven out of ten times, with a median time to interruption of 11 seconds.”

According to the authors, patient-centered decision-making is a key feature of quality healthcare. In particular, identifying and understanding the patient’s agenda for the visit both improves and facilitates patient-clinician communication, they emphasize.

My Take:
The remainder of the article was devoted to a statistical analysis of the methods used to analyze these videotaped clinician-patient encounters.

I was taught, and still believe, that 80% of a good diagnosis is a detailed history. I often tell my patients who are not forthcoming during consult that without hearing their story I might as well be a vet. Of note, this article was written by Dr. Nicola M Parry, a veterinarian.

In theory, the consult guides your examination and combination of these two elements leads to confirmatory testing. Unfortunately, modern medicine works in reverse. They run a lot of tests and hope to find a diagnosis. Studies indicate that 80% of medical costs incurred by a patient are for diagnostic testing rather than treatment.

Monday, August 6, 2018

99% of Doctors Need Diagnostic Help

Medical errors have become an accepted if unfortunate part of medical care, but physicians may greatly underestimate how much they contribute to the problem.

“The average clinician is making a lot of mistakes that they are unaware of,” says Dr. Art Papier, a dermatologist and medical informatics specialist. How many doctors fall into this category? All but the “master diagnosticians,” who represent less than 1% of practicing clinicians, he says. That would mean that 99% of doctors regularly make errors that they never realize they make.

Papier points to analyses of malpractice claims that show diagnostic errors are the largest cause of lawsuits, not bad outcomes of surgeries or baby deliveries as many people believe. And many of the missed diagnoses that lead to lawsuits are for common diseases such as cancer.
Fortunately, new decision support tools are available that can help streamline the diagnostic process and help clinicians more reliably get to the right answer. Some of these tools employ artificial intelligence (AI), which are techniques that enable computers to mimic human behavior, or they use machine learning, a subset of AI that uses statistical methods to enable machines to improve as they solve more problems.

The FDA has approved three AI-based tools this year for use in the clinic. The LVO Stroke Platform flags signs of stroke on computed tomography scans. The IDx-Dr device can be used by primary care clinicians to screen for diabetic retinopathy. The third device, OsteoDetect, is used to diagnose wrist fractures in adults.

Friday, August 3, 2018

When Patients Come In Quoting ‘The Dr. Oz Show’

If you’re a clinician, you know about the Dr. Oz phenomenon – when a patient comes in asking questions about something that was hear on The Dr. Oz Show. “Should I take that berry to lose weight?” “Will that root extract boost my immunity?” “Can this supplement really prevent cancer?”

Sometimes you know right away that the answer is no. Other times you may not be so sure. My colleagues and I decided to look into the claims being made on two shows: The Dr. Oz Show and The Doctors. Overall, we found that the recommendations made on these shows were only occasionally based on high –quality, evidence-based data. Often, we couldn’t find any literature or medical studies to confirm or refute the claims made on the show. Moreover, the costs and harms of the suggested treatments were often overlooked.

We also discovered that the hosts of the shows frequently discussed products made by companies that advertise on the shows. How did we discover this? We enlisted a group of medical students to tape and view all episodes of The Doctors and The Dr. Oz Show for a full month. The students logged all health recommendations made on these shows, whether harms or cost were discussed, and whether a source or reference was mentioned. They noted the advertisements that were aired during the show and tracked whether the advertisements were related to the show’s content to see if there were any conflicts of interest.

We counted more than 300 health recommendations, with an average of about 6.9 per day on the Dr. Oz Show and 9.5 on The Doctors. Discussion of potential harms or risks was noted in only about 8.6% of Dr. Oz’s recommendations and about 13% of The Doctor’s recommendations. The costs and interventions were mentioned about 23% of the time on the The Dr. OZ Show and only 3% on the time on The Doctors. Statements on The Dr. Oz Show agreed with evidence-based medical guidelines 22.7% of the time. For The Doctors, it was about 20%.

Wednesday, August 1, 2018

Wisdom Wednesday: Mercury in Retrograde


On Thursday, July 26, Mercury entered what's known as apparent retrograde motion, a phrase often shortened to "Mercury in retrograde" or simply "Mercury retrograde."

This phenomenon occurs when the super-speedy planet appears to be moving across the sky in a different direction than it normally does.

It's an optical illusion created when Mercury catches up to and then passes Earth in its orbit around the sun. It's all about perspective.

Since Mercury moves so quickly, a "year" on that planet (the time it takes to complete its orbit around the sun) takes approximately 88 Earth-days. So Mercury's apparent retrograde motion relative to Earth happens three or four times a year, and tends to last approximately three weeks each time. This time, it will last until August 19.

As NASA and countless astronomers have pointed out, there's absolutely no evidence that astrology can tell you anything about the future, how you should behave, or what your personality is based on the position of Earth relative to the stars when you were born.

My Take:
Last week was a real anomaly in my office. The previous week I had three new patients with seemingly simple, but very chronic back issues. Their symptoms dated back years. During consult and examination, I wondered why these three simple cases had not resolved on their own. (Cases of acute low back pain resolve much more quickly with spinal manipulation, but they will eventually resolve without treatment as well) I had the nagging feeling I was missing some factor is each case.

Monday, July 30, 2018

Study Offers Clues for Improving Seasonal Flu Vaccine

The 2017-2018 flu season was rougher than most. During peak flu activity in February, more than 10% of deaths in the U.S. were attributed to the flu or pneumonia, according to the Centers for Disease Control and Prevention.

To help combat the flu, NIH-supported researchers are exploring how to improve vaccines. Current influenza vaccines mainly target the influenza surface protein hemagglutinin (HA) but can sometimes offer varying or limited protection.

Recent studies indicate that seasonal flu vaccines might provide better protection if they were optimized to include an additional target, a different flu surface protein called neuraminidase (NA).

The study is supported by the National Institute of Allergy and Infectious Diseases. This study and related efforts are part of NIH’s larger plan to develop a universal vaccine – one that can durably protect all age groups against multiple strains of the flu.
Remember to get your seasonal flu shot every year to help protect yourself and your loved ones.

My Take:
There are several problems with our current vaccination process. The concepts are over 100 years old and the technology is quite dated as well.

Friday, July 27, 2018

The Trouble with Ingredients in Sunscreens

Sunscreen is a unique body care product: consumers are directed to apply a thick coat over large areas of the body and reapply frequently. Thus, ingredients in sunscreen should not be irritating or cause skin allergies, and should be able to withstand powerful UV radiation without losing their effectiveness or forming potentially harmful breakdown products. People can potentially inhale ingredients in sunscreen sprays and ingest some of the ingredients they apply to their lips, so ingredients must not be harmful to lungs or internal organs. Further, sunscreens commonly include ingredients that act as “penetration enhancers” and help the product adhere to skin. As a result, many sunscreen chemicals are absorbed into the body and can be measured in blood, breast milk and urine samples.

Active ingredients in sunscreens come in two forms, mineral and chemical filters. Each uses a different mechanism for protecting skin and maintain stability in sunlight. The most common sunscreens on the market contain chemical filters. These products typically include a combination of two to 6 of the following active ingredients: oxybenzone, avobenzone, octisalate, octocrylene, homosulfate and octinoxate. Mineral sunscreens use zinc oxide and/or titanium dioxide. A handful of products combine zinc oxide with chemical filters.

Laboratory studies indicate that some chemical UV filters may mimic hormones, and physicians report sunscreen-related skin allergies, which raises important questions about unintended human health consequences from frequent sunscreen application.

The Food and Drug Administration has not reviewed evidence of potential hazards of sunscreen filters – instead it grandfathered in ingredients used in the late 1970s when it began to consider sunscreen safety. The Danish EPA recently reviewed the safety of active ingredients in sunscreen and concluded that most ingredients lacked information to ensure their safety (Danish EPA 2015). Sixteen of the 19 ingredients studied had no information about their potential to cause cancer. And while the published studies suggest that several chemical filters interact with human sex or thyroid hormones, none of the ingredients had sufficient information to determine the potential risks to humans from hormone disruption.

EWG has reviewed the existing data about human exposure and toxicity for the nine most commonly used sunscreen chemicals. The most worrisome is oxybenzone, which was added to nearly 65 percent of the non-mineral sunscreens in EWG’s 2018 sunscreen database. The Centers for Disease Control and Prevention routinely detects oxybenzone in more than 96% of the American population. In a recent evaluation of CDC-collected exposure data for American children, researchers found that adolescent boys with higher oxybenzone measurements had significantly lower total testosterone levels. Three other studies reported statistically significant associations between oxybenzone exposure during pregnancy and birth outcomes.

Wednesday, July 25, 2018

Wisdom Wednesday: Rheumatoid Arthritis or Osteoarthritis?


Rheumatoid Arthritis is an autoimmune disease, a result of the immune system attacking the tissues that line the body’s joints. This causes pain, swelling, and stiffness in the joints and the pain is often symmetrical. It is more common in women and those who are middle aged, but it can happen to anyone.

Osteoarthritis happens over time. It is the most common form of arthritis, and it usually occurs in older people. The protective cartilage on the ends of your bones wear down as you age, making it difficult to move. It usually affects one side of the body. Osteoarthritis can damage any joint in your body, though it most commonly affects joints in your hands, knees, hips and spine.

My Take:
This article is fairly accurate but is an example of the type of health care reporting that has replaced reporting on new research.

Rheumatoid Arthritis (RA) effects women nine times more often than men. It tends to be bilateral and symmetrical. If you left elbow is affected, sooner or later, so will the right, but maybe not with the same intensity. It is typically diagnosed in a woman’s mid-to-late 30’s. But has been going on for years. I don’t consider that middle age but maybe that’s because I’m in my sixties.

There are reliable blood tests for RA including the ANA (antinuclear antibodies), RA factor, and SED rate. However, the diagnosis is based as much on symptoms as lab work. On occasion, the diagnosis is based on x-ray findings but by the time you see the damage on x-ray, the disease is quite advanced.

Osteoarthritis (OA) is the result of wear and tear on a joint over time. So, the joints that get the most use typically show the most damage. The base of the thumb on your dominant hand is the most likely joint for osteoarthritis.

The current theory on the mechanism of osteoarthritis is more complex that just a wearing down of the protective cartilage over time. It is thought that micro trauma (or a single severe traumatic injury) damages the blood supply to the end of the bone. The gradual loss of blood supply causes the cartilage to erode.

Monday, July 23, 2018

Is Melatonin Safe for Kids?

It’s estimated that up to 75% of school-aged children don’t get enough sleep. Unfortunately, poor sleep can affect a child’s mood and ability to pay attention and learn. It has also been linked to health issues such as childhood obesity. This is why some parents consider giving their children melatonin, a hormone and popular sleep aid.

Melatonin levels rise in the evening, which lets your body know it’s time to head to bed. Conversely, melatonin levels start to fall a few hours before it’s time to wake up. It also helps regulate your blood pressure, body temperature, cortisol levels and immune function.

In the US, melatonin is available over-the-counter at many drug and health food stores. However, in other parts of the world, including Australia, New Zealand and many European countries, melatonin is only available with a prescription.

An analysis of 35 studies in children with autism found that melatonin supplements helped them fall asleep faster and a stay asleep longer. Similarly, an analysis of 13 studies found that children with a neurological condition fell asleep 29 minutes faster and slept 48 minutes longer on average when taking melatonin.

Similar effects have been observed in healthy kids and teenagers who struggle to fall asleep. However, sleep problems are complex and can be caused by a variety of factors.

For instance, using light-emitting devices late at night can suppress melatonin production. If this is the case, simply limiting technology use before bed can help treat sleep issues.

Most studies show that short-term melatonin use is safe for kids with little or no side effects. However, some children may experience symptoms such as nausea, headaches, bed wetting excessive sweating, dizziness, morning grogginess, stomach pains and more.

Friday, July 20, 2018

Low Dose Aspirin May Not Be Effective in Heavier Patients

Low-dose aspirin may not be effective in preventing cardiovascular events in people weight 70 kg (154 pounds) or more, a Lancet study suggests.

Researchers analyzed 10 trials that evaluated aspirin versus controls for primary prevention of cardiovascular events in 120,000 people.

Daily, low-dose aspirin (75-100 mg) was associated with reduced risk for cardiovascular events among those weighting less than 70 kg (odds ratio, 0.77), but there was no significant effect for heavier patients – roughly 80% of men in the study and nearly half of women weighted 70 kg or more. In the heavier group, low-dose aspirin may be even less effective in smokers and in those who take enteric-coated aspirin.

High-dose aspirin (300-325 or 500 mg), meanwhile, appeared to be effective in reducing primary cardiovascular events only [in] patients weight 70 kg or more.

Commentators said that people with more body mass may have more esterases, which clear aspirin and would reduce the bioavailability of the drug.

The authors conclude: “A one-dose-fits-all approach to aspirin is unlikely to be optimal, and a more tailored strategy is required.

Wednesday, July 18, 2018

Wisdom Wednesday: Health Research Dissemination


I’ve been blogging for the past five years trying to inform you about new developments in health and health care. The National Institutes of Health (NIH) has been a constant source of information for those blogs.

PubMed, the official publication of NIH, posts peer reviewed research and research papers presented at conferences all over the world. As you might imagine, that’s a lot of data and unless you know what you are looking for, new information is difficult to find.

Research is arranged by the number of citations in other research, so the new stuff is often buried behind older research. To remedy this issue, a team of writers glom through the web site, pulling out new research of interest to health care professionals and the general public.

At least, that is the way it used to work. Starting in 2018, Medical News Today, the official newsletter of NIH, contains “headlines from the past week.” The weekly publication begins with advertisement for various drugs. This week the ads are for “Relapsed Multiple Myeloma – Updated Treatment Option Info,” “Psoriasis Treatment,” and “Osteoporosis Information.”

Current research is scant. Instead, general health tips are provided in article format. Here is a smattering of this week’s selections: “Causes of shortness of breath during pregnancy,” Chinese restaurant syndrome: What you need to know,” “How men can improve their sexual performance,” “The riddle of human nipple sizes,” “What to know about anal herpes,” “Is having vaginal pressure during pregnancy normal,” “Does nipple stimulation help to induce labor,” “What causes chest pain and vomiting,” “What causes bellybutton pain during pregnancy,” “Why does it hurt when I swallow, “Are Epsom salt baths safe during pregnancy,” “What causes a nosebleed at night,” and “How to fix peeling nails.”

Monday, July 16, 2018

Vitamin D Toxicity: A 16-Year Retrospective Study

Interest in vitamin D has increased during the past 2 decades, with a corresponding increase in laboratory testing of 25-hydroxyvitamin D [25(OH)D]. The vast majority of specimens tested display normal or deficient levels of 25(OH)D; concentrations rarely fall in the potentially toxic range.

We performed a retrospective investigation of elevated 25(OH)D levels during a 16-year period at the University of Iowa Hospitals and Clinics, a 734-bed medical center. Detailed medical-record review was performed for patients with serum/plasma 25(OH)D concentrations higher than 120 ng per mL.

A total of 127,932 serum/plasma 25(OH)D measurements were performed on 73,779 unique patients. Of these patients, 780 (1.05%) had results that exceeded 80 ng per mL and 89 patients (0.12%) had results that exceeded 120 ng per mL. Only 4 patients showed symptoms of vitamin D toxicity. Three of these cases involved inadvertent misdosing of liquid formulations.

Symptomatic vitamin D toxicity is uncommon, and elevated levels of 25(OH)D do not strongly correlate with clinical symptoms or total serum/plasma calcium levels. Our study highlights the potential risks of the liquid formulation of vitamin D.

My Take:
Vitamin D is one of the most common supplements I recommend in my practice. I do use the liquid formulation in which one drop contains 2,000 IU of vitamin D3. I typically recommend two drops daily (4,000 IU) but have recommended higher doses up to 5 drops daily (10,000 IU). Honestly, I have never had an issue with inadvertent overdosing of the supplement.

Friday, July 13, 2018

Cardiovascular Disease: Risk Assessment with Nontraditional Risk Factors

Cardiovascular disease is the most common cause of death among adults in the United States. Treatment to prevent CVD events by modifying risk factors is currently informed by the Framingham Risk Score, the Pooled Cohort Equations, or similar CVD risk assessment models. If current CVD risk assessment models could be improved by adding more risk factors, treatment might be better targeted, thereby maximizing the benefits and minimizing the harms.

Detection - The USPSTF found adequate evidence that adding the ABI, hsCRP level and CAC score to existing CVD risk assessment models may improve calibration, discrimination and reclassification. The USPSTF chose to review these 3 nontraditional risk factor because prior evidence reviews identified them as the most promising to improve on existing CVD risk assessment tools.

Benefits - The USPSTF found inadequate evidence to assess whether treatment decisions guided by ABI, hsCRP level, or CAC score test results, when added to existing CVD risk assessment models, lead to reduced incidence of CVD events or mortality.

Potential Harms – Testing for hsCRP level and the ABI is noninvasive, and there is little direct harm from the tests. Harms of testing for CAC score include exposure to radiation and incidental findings on computed tomography of the chest, such as pulmonary nodules, that may lead to further invasive testing and procedures. Abnormal test results may lead to further testing, procedures, and lifelong medication use without proof of benefits but with expense and potential adverse effects for the patient. Psychological harms may results from reclassification into a higher-risk category for CVD events.

Wednesday, July 11, 2018

Wisdom Wednesday: Lifelong CMV Infection Improves Immune Defense in Old Mice


Epidemiological studies have shown a correlation between CMV infection and immune system aging, especially in elderly populations. It remains unclear whether CMV infection is a key driver of, or simply a factor associated with, aging of the immune system. In this study, we show that CMV infection improves T cell immunity in old animals by broadening the immune response to a different pathogen. Animals that have aged with CMV are able to recruit novel T cells into these immune responses that are present in, but not utilized in, animals aging without CMV. This data squarely challenges the premise that CMV is solely detrimental to the aging of the adaptive immune system.

My Take:
The abstract was very technical so I didn’t repeat it here. However, these researchers basically exposed old mice with a history of CMV and a control group to Listeria monocytogenes then looked at the immune response. They postulate that we share coevolution with CMV that may include potentially positive impacts on adaptive heterologous immunity in late life.

In younger patient populations, CMV and EBV (Epstein - Barr virus) are documented factors in at least a third of all autoimmune cases. So this study showing an immune stimulation by CMV in older patients is not surprising.

In immune compromised patients, like HIV/AIDS, CMV can cause life threatening disease.

The real question is CMV a positive or negative factor in health? In my opinion, it has the potential for both. If your immune system is balanced, then CMV probably plays a positive role. However, if your immune system is compromised or overstimulated (autoimmune disease) then the effects are negative.

As we age, our immune systems tend to decline, so the immune stimulation from a chronic CMV infection may very well provide a boost to immune function. Again, as long as the immune system is healthy to begin with.

Monday, July 9, 2018

Vitamin N Deficiency

For the first time in history, the majority of the world’s population now live in urban setting rather than rural settings. This trending switch has taken us away from nature, which has taken a collective toll on our health.

With urbanization on the rise, people are less engaged with nature. No longer do we have the need to interact with nature for survival. Instead our relationship with the natural world is primarily based on recreation and enjoyment, and it’s minimal at best. As a result, many people suffer from what American writer, Richard Louv, calls “nature deficit disorder,” defined as a “diminished ability to find meaning in the life that surrounds us.”

In Louv’s book, Last Child in the Woods, he explains that nature affects “everything from a positive effect on the attention span, to stress reduction to cognitive development and a sense of wonder and connection to the earth.” With incidences of heart disease, diabetes and cancer continuing to rise, as well as escalating mental health issues, research is linking artificial stimulation to exhaustion and a loss of health and vitality. Simultaneously, mounting scientific evidence points to the positive effects that interacting with nature has on a person’s physical and mental well-being.

Even though the amount and type of nature accessible to people is varied, our desire to connect with it somehow seems to be universally embedded in our DNA. As humans, our cells expect and thrive on natural sunlight, fresh water and air. Not having such a connection is, no pun intended, “unnatural”. Spending days in windowless rooms with artificial light and glowing screens from televisions, computers and smartphones denies us the necessary symbiotic relationship we need with the natural world to thrive. Our bodies haven’t evolved to keep pace with what is now a disconnect from nature. At our core, we’re still hunters and gatherers. In other words, our bodies need what nature give us, and that may always be the case.

The pendulum seems to be swinging back and we are seeing a shift back to nature. From fast food to more “slow” organic foods, a rise in popularity of dietary lifestyles rooted in hunting and foraging ancestral patterns and a resurgence of planned parks amidst urban sprawl, we are seeking a reconnection with nature. “Grounding” or “earthing”, a practice that involves walking barefoot on the earth’s surface, is also gaining popularity. Research has shown “earthing” can reduce inflammation promote wound healing, strengthen the immune system, and prevent or even help to alleviate chronic diseases, including autoimmune diseases.

Even in hospital settings, people are planting trees and gardens. Studies have shown that connecting to nature can speed recovery from surgery just being around plants or images of nature helped to heal the body faster and more efficiently. Patients with garden access on hospital grounds demonstrated positive health outcomes, such as less stress and anxiety, a positive outlook and faster healing.

Friday, July 6, 2018

Water Quality Reports

I just received the 2017 Annual Drinking Water Quality Report from the City of Deerfield Beach. The city has a longstanding reputation for providing high-quality drinking water. Their monitoring program tests over 90 regulated and unregulated compounds, with some tested regularly, following the standards required by the Environmental Protection Agency (EPA) and the Florida Department of Health in Broward County.

The source of water for the City of Deerfield Beach is ground water pumped from two aquifers: the Biscayne and the Floridian aquifers. The Biscayne aquifer is an underground geologic formation made up of highly permeable limestone and less permeable sandstone located under a portion of South Florida. The Biscayne is the shallower of the two aquifers, extending to depths of approximately 240 feet along the coast of South Florida and is the major source of ground water for Miami-Dade, Broward and Palm Beach counties. The Florida aquifer is deeper than the Biscayne and extends to depths of about 3,000 feet and has much higher mineral content, thus making the treatment process considerably more expensive. The raw water pumped from these aquifers is treated by three distinct processes: Lime Softening, Nanofiltration, and Reverse Osmosis.

Lime softening reduces the hardness of water from the Biscayne aquifer with quicklime. Then the water passes through high rate granular media filters to reduce turbidity. Disinfection is then achieved by choramination, combining chlorine and ammonia. Low levels of fluoride are also added to help with the prevention of tooth decay.

Nanofiltration of water, also from the Biscayne aquifer runs in a parallel path to lime softening and is then mixed with the softened water prior to disinfection.

Reverse osmosis is reserved for the deeper Florida aquifer water. The source water is treated under high pressures and sent through semipermeable membranes to remove salt and other inorganic minerals to produce drinking water. Again, the waters are blended with those produced from Lime Softening and Nanofiltration prior to disinfection.

The water quality test results include microbiological contaminants like E. coli from human and animal fecal waste. Radium, from erosion of natural deposits is the most common radioactive contaminant measured. Several inorganic contaminates are also monitored. A few examples are: Antimony from petroleum refineries, fire retardants, ceramics, electronics and solder. Arsenic runoff from orchards. Barium from drilling waste water. Fluoride discharged from fertilizer and aluminum factories and as a water additive. Copper and lead come from the corrosion of household plumbing systems and leaching from wood preservatives.

Monday, July 2, 2018

Detoxification


Toxicity is a ubiquitous health issue. I frequently have new patients fill out a symptom survey. It groups symptoms by organ systems. Over 95% of patients will show liver toxicity as their number one source of symptoms. The other 5% generally show a tie between liver and some other organ.

Many nutritionists start their patients with a detox program. However, I don’t believe detox is the place to start. In the QA (Quintessential Applications) protocol, liver detoxification is step 19 of 32. Inflammation is where treatment must begin, followed by immune system, general metabolism and endocrine function. Then, and only then can liver detoxification truly be effective. Digestion is a wild card and may have to be addressed before or after any of these other systems.

Toxins can contribute to fatigue, difficulty sleeping, indigestion, food cravings and weight gain, reduced metal clarity, low libido, skin issues and joint discomfort.

There are currently 80,000 synthetic chemicals registered for use in the United States. Over 800 million pounds of herbicides are used each year on our crops. Current research shows 167 industrial chemicals are found in adults with no employment-related exposure.

There are three phases of detoxification, the first two occur in the liver:

Phase 1 – The body transforms fat-soluble toxins to an “unlocked” state that is more water-soluble, and in many cases, more toxic than its original form. For almost all natural substances however, phase 1 is all that is need prior to transport to the bowel or kidneys. Caffeine, for example, only has to go through phase 1 detox.

Phase 2 – The highly toxic substances produced in Phase 1 convert to non-toxic molecules and become even more water-soluble. Up until about 100 years ago, phase 2 liver detox was reserved for hormone and alcohol detoxification. And those hormones were produced by you (endogenous) as no exogenous hormones existed. Estrogen, becomes dehydroxyestrogen in phase 1, some forms of which are carcinogenic. In phase 2 estrogen becomes a harmless, water-soluble compound excreted in the bowel and urine.

Phase 3 – Elimination of water-soluble toxins via the bowel and kidneys.

Most detox programs ramp up phase 1 detox. When phase 2 detox lags behind the result is an increase in highly toxic substances produced in phase 1 and the patient experiences “detox symptoms.”

The key is to support phase 2 detox first, then phase 3 and finally phase 1. We accomplish that by addressing steps 1-18 in the QA protocol prior to attempting liver detoxification.

The Bottom Line:
Detoxification is a significant issue for anyone living in the twenty-first century. However, you must improve general health and specific systems prior to a successful detox program.

Friday, June 29, 2018

16:8 Fasting Diet Actually Works

A form of intermittent fasting known as the 16:8 diet helps obese individuals to lose weight and lower their blood pressure, according to a new study.

More and more people now turn to intermittent fasting as a fast and effective way to lose weight. There are different forms of this diet, depending on the time intervals of “fasting” and “feasting.” The so-called 5:2 diet, for instance, consists of eating normally for 5 days every week and fasting for 2 days. In the fasting days, the dieter restricts their calorie intake to 500 or 600 per day. In the daily fasting, or the 16:8 diet, people eat whatever they like for 8 hours and fast for the remaining 16.

A new study evaluates the benefits of this 16:8 pattern for obese individuals and finds that not only does the diet work, but also that it helps to lower blood pressure.

As many as 93.3 million adults have obesity in the United States, according to the latest data from the Centers for Disease Control and Prevention (CDC). That’s almost 40% of the country’s entire population.

This research was led by corresponding author Krista Varady, an associate professor of kinesiology and nutrition at the University of Illinois at Chicago, and the findings were published in the journal Nutrition and Healthy Aging.

Varady and colleagues recruited 23 obese study participants who were aged 45 years, on average, with the average body mass index (BMI) of 35. Between 10 a.m. and 6 p.m., the participants could eat whatever and however much they liked, but they were only allowed to drink water and calorie-free drinks for the remaining 16 hours.

Wednesday, June 27, 2018

Wisdom Wednesday: Fish Oil Consumption Does Not Increase Bleeding Risk


Fish oil is rich in omega-3 fatty acids EPA and DHA. Increased intake of EPA and DHA is beneficial for cardiovascular health, cognitive function, mental health, maternal and child health, immunity and inflammation. EPA and DHA supplements are becoming more and more popular across a wide diversity of people, from healthy individuals to vulnerable population with impaired health.

Higher omega-3 concentrations may compete with fatty acids such as arachidonic acid for metabolizing enzymes. The interaction results in a decreased production of compounds that induce platelet aggregation and an increased production of compounds with anti-platelet properties, hence the anticoagulation benefits of omega-3. However, for patients who are under antithrombotic therapy (either with platelet aggregation inhibitors such as aspirin or anticoagulant drugs such as warfarin), the potential risk of bleeding due to the concurrent use of omega-3 fatty acids has been a concern by many clinicians, particularly surgeons.

Multiple clinical studies have been conducted to investigate whether omega-3 fatty acids pose a clinically significant bleeding risk. So far, the findings have been consistent:

A 2004 Cochrane review of 48 randomized controlled trials and 41 epidemiological analyses concludes that 0.4-7 g/day omega-3 fatty acids do not result in any change in clinical bleeding manifestations.

A 2007 review of 19 clinical studies involving nearly 4400 surgical patients concludes that the risk for clinically significant bleeding was virtually nonexistent with the use of 1.4-21 g/day of omega-3 fatty acid supplements, even with the concurrent use of antiplatelet or antithrombotic medications.

A 2013 systematic review of 10 randomized trails involving nearly 1000 adults 60 years or older concludes that there is no difference in total adverse event rates between daily use of placebo or 0.03-1.86 g EPA and/or DHA for 6-52 weeks.

A 2014 review of 7 randomized controlled trails and 3 epidemiological studies concludes that omega-3 fatty acid treatment has no effect on the risk of clinically significant bleeding and there is no support for discontinuing the use of omega-3 fatty acids before invasive procedures.

A 2017 systematic review based on 32 publications on healthy subjects and 20 publications on patients undergoing surgery finds that fish oil supplements reduce platelet aggregation in healthy subjects and do not increase intra- or post-operative bleedings in patients, and concludes that discontinuation of fish oil supplements prior to surgery is not recommended.

Monday, June 25, 2018

Florida Red Tide

A red tide, or harmful algal bloom, is a higher-than-normal concentration of microscopic alga. In Florida and the Gulf of Mexico, the species that causes most red tides is Karenia brevis.

At high enough concentrations, Florida red tide can discolor water a red or brown hue. Other algal species can appear red, brown, green or even purple. At lower concentration, the water color appears normal during a bloom.

Red tides were documented in the southern Gulf of Mexico as far back as the 1700s and along Florida’s Gulf coast in the 1840s. Fish kills near Tampa Bay were even mentioned in the records of Spanish explorers.

The duration of a bloom can be as little as a few weeks or longer than a year. In nearshore Florida waters, it depends on sunlight, nutrients and salinity. The speed and direction of the wind a water currents are also factors.

K. brevis cannot tolerate low-salinity waters for very long, so blooms usually remain in salty coastal waters and do not penetrate upper reaches of estuaries. However, other harmful algae, including cyanobacteria (blue-green algae), typically bloom in freshwater lakes and rivers.

Many red tides produce toxic chemicals that can affect both marine organism and humans. The Florida red tide organism, K. brevis, produces brevotoxins that can affect the central nervous system of fish and other vertebrates, causing these animals to die. Wave action can break open K. brevis cells and release these toxins into the air, leading to respiratory irritation. The red tide toxins can also accumulate in molluscan filter-feeders such as oysters and clams, which can lead to Neurotoxic Shellfish Poisoning in people who consume contaminated shellfish.

Wednesday, June 20, 2018

Wisdom Wednesday: Vitamin D May Decrease Breast Cancer Risk


The merits of vitamin D when it comes to cancer prevention have long been at the heart of medical debates. Where some studies have revealed that overall cancer risk is lower in people with higher levels of this vitamin, others have suggested that vitamin D has no impact on a person’s vulnerability to the disease.

Still, the case for ensuring that you get enough vitamin D is fairly strong, as low blood levels of this nutrient have been associated with raised risk of bladder cancer and, in a study that was published earlier this year, an elevated risk of bowel cancer. Previous research has also suggested a link between high vitamin D levels and better survival rates in people going through breast cancer treatment.

In a pooled analysis of a prospective cohort study and two randomized clinical trials, researchers at the University of California, San Diego School of Medicine have now investigated whether and to what extent high levels of vitamin D in the blood were associated with a lower risk of developing breast cancer.

Their analysis – which was conducted in collaboration with specialists from Creighton University in Omaha, ND, the Medical University of South Carolina in Columbia, and the nonprofit organization GrassrootsHealth in Encinitas, CA – suggests that certain levels of vitamin D correlate with a “markedly lower” risk of breast cancer. These results are now published in the journal PLOS ONE.

“We found that participants with blood levels of 25(OH)D that were above 60 nanograms per milliliter (ng/ml) had one-fifth the risk of breast cancer compared to those with less than 20 ng/ml.” – Cedric F. Garland.

Monday, June 18, 2018

Parkinson’s: Vitamin B-3 May Stop Brain Cell Death

Vitamin B-3 may help to stop the death of nerve cells that occurs in Parkinson’s disease, according to a recent German-led study that may lead to new treatments for the brain-wasting disease.

The researchers’ paper is now published in the journal Cell Reports. In it, they report how a form of vitamin B-3 called nicotinamide riboside helped to preserve nerve cells by boosting their mitochondria, or energy-producing centers.

“This substance,” explains senior study author Dr. Michela Deleidi, who leads brain research projects at the University of Tubingen and the Helmholtz Association – both in Germany – “stimulates the faulty energy metabolism in the affected nerve cells and protests them from dying off.” In the case of Parkinson’s disease, studies have shown that the dopamine cells that die off have damaged mitochondria.

Dr. Deleidi and her colleagues wondered whether faulty mitochondria are a cause or whether they are “merely a side effect” of the disease. First, they took skin cells from individuals with Parkinson’s disease who carried versions of the GBA gene that are known to increase risk for the disease.

They got the skin cells to regress into immature stem cells, and they then coaxed the stem cells to become nerve cells. These nerve cells show similar mitochondrial dysfunction as that found in the brain cells in Parkinson’s disease.

The team then fed the cells with a form of vitamin B-3 called nicotinamide riboside, which is a precursor of the coenzyme. This caused NAD levels to rise in the cells and resulted in new mitochondria and increased energy production.