Tuesday, October 22, 2013

Vitamin D Supplements Do Not Improve Bone Health?

According to a new study published in the The Lancet, adults taking vitamin D supplements did not improve their overall bone mineral density, reports Medical News Today. Researchers from the University of Auckland in New Zealand analyzed data from 23 studies involving 4,082 healthy adults with an average age of 59. They found that adults who took supplements of vitamin D for an average of two years did not see any improvements in their bone health, apart from a small increase in bone density around their femoral neck. “Most healthy adults do not need vitamin D supplements,” said lead author Ian Reid from the University of Auckland.

MY TAKE:
First and foremost, bone density does not measure bone health. Dense bone is often old, brittle bone as exemplified by all the hip fractures caused by taking biophosphonates, like Boniva and Fosamax. These drugs preserve bone density by keeping the body from removing bone as it ages and preventing the body from forming new bone. Is this any way to treat osteoporosis?

Second, vitamin D has many, many functions in the body. It really is not a vitamin but a hormone. It is necessary for the absorption of calcium from the digestive tract, the first step to incorporating calcium into bone. However, there are many additional factors involved in calcium metabolism. Besides, bone is just a repository for calcium, which is exchanged continually with the blood stream to act as a buffer to control the pH of the blood. The real strength of bone comes from collagen, the protein matrix of bone that holds the calcium.

Third, vitamin D deficiency is epidemic, even in South Florida, where I practice, and the daily sun stimulates production of vitamin D in the skin. In the northern half of the United States, every winter a majority of the population is deficient from lack of adequate sunshine and poor diet. In my practice, it is the most common factor associated with an impaired immune system.

The nutrition board allows practitioners to recommend up to 4000IU per day of vitamin D, without any lab work to identify any deficiency. For supplementation above that level, laboratory testing is recommended.

Finally, the use of the prescription strength 50,000IU dose taken once a week is a dramatic overdose to the body. Unfortunately, many physicians have prescribed this dangerous dosage under the guise of “evidence based medicine”. They fail to understand that the study used a high, weekly dose only to monitor the test subjects. That is, in order to know that they were taking the supplement, they watched them swallow it every week. Daily monitoring just is not logistically feasible. In really, double blind, placebo controlled, crossover studies comprise only 1/3 of an evidence based practice, like mine. Another third is the practitioner’s clinical experience, and the final third (and most important) is patient preference.

THE BOTTOM LINE:
Have your vitamin D level checked. The medical norms are 30-100, but I prefer levels above 40. If you are unwilling to test, then just supplement 2,000IU per day. That may not be enough, but it could very well prevent a chronic, life threatening illness.

Friday, October 18, 2013

The Blue Man Group

Paul Karasas, the “blue man”, infamous for his appearance on Oprah in 2010, recently died at the age of 62. He had a medical condition called argyria, caused by deposition of silver into the tissues that turns the skin blue. The controversy is the claim that the condition was caused by drinking colloidal silver and applying it to his skin. Silver has been used as a medical treatment for infection for literally thousands of years. Today silver is used in topical creams for infection, in several medications, and is required by law as an application to newborn infants eyes in most states.

MY TAKE:
Silver is a heavy metal and can be toxic. It is found is many forms, chemically bonded to acids such as silver nitrate (used on newborns) and silver chloride (used in film). Colloidal silver is made by passing a low electric current through silver electrodes in distilled water. This creates a microscopic suspension of solid silver molecules in the water that varies from about 5 to 10 parts of silver per million parts of water. I have successfully used colloidal silver in my practice for the past 20 years. Eye infections, outer ear infections (swimmer’s ear), sore throats, sinus infections, intestinal flu, and even vaginal infections respond well to direct application. I particularly like to use it in a Netti Pot for sinus infections. Personally, I keep a bottle on hand at all times. If I wake up in the middle of the night with a little sore throat, a simple 30 second gargle and swallow, and the sore throat is gone. I also recommend colloidal silver when patients have symptoms of both viral and bacterial infection, or maybe even a fungal element as well. The classic example is a “head cold that moves into the chest”. Often there are at least two different infective agents involved. Colloidal silver has anti-viral, anti-biotic, and even anti-fungal activity. There have been 4 recent studies showing colloidal silver to be effective against MRSA.

Dosage is the big issue. Colloidal silver is for occasional, intermittent use only. Paul Karasas admittedly drank 10 ounces of silver per day for 15 years. Some critics claim he used silver chloride, not colloidal silver. We may never know the truth about the “blue man”, but my entire family doesn’t use 10 ounces in a year.

THE BOTTOM LINE:
Colloidal silver is safe, and very effective for treating a variety of infections. Like niacin, and omega 3 fatty acids, and most things, a little bit is good, too much can be an issue.

Friday, October 11, 2013

Tom Hanks Could Reverse His Diabetes

Type II diabetes is simply caused by a poor diet. In Tom’s defense, his dramatic weight fluctuations to meet the various roles he has played required terrible dietary practices. In gaining, or losing 30 pounds or more over relatively short spans of time, he has highlighted an exaggerated form of SAD (the Standard American Diet).

Americans just eat too much, too much of everything – protein, carbohydrate, and fat. Obesity rates, currently at 37 % nationally, are skyrocketing. Type II diabetes is also at epidemic levels and scientists predict about half the adult population of the United States will be diabetic by 2050, unless our eating habits change. Only one diet has been shown to increase longevity – reduced caloric intake. So Tom, you and the rest of the country have to start eating less.

Now let’s talk about food quality. It is estimated that early man, the hunter-gatherer, ate a bushel basket of fruits and vegetables per day. That seems like a lot of food, but it was not a lot of calories. These foods were high in fiber and much of the material passed through as undigested bulk. Today, the bulk of our diet is refined carbohydrates, devoid of insoluble fiber, and loaded with calories. These simple sugars rush into our blood stream and tax our pancreas and liver, dismantling our ability to manage blood glucose levels.


The solution is quite simple – I recommend 5 servings of vegetables each day, 2 fruit servings, and 3 servings of protein. If Tom (and the rest of the nation) would just meet these simple goals daily, there is little room for the refined foods and they drop away from the diet. Unfortunately, when I review food journals in my practice, I often find diets that average less than one serving of fruits or vegetables per day. The protein intake is usually adequate, unless the patient is trying to lose weight, then they typically will restrict the protein intake as well, piling on more refined carbohydrates. Then they wonder why they can’t lose weight.

Early detection of diabetes is where you need to start. It is not enough to test your fasting glucose. That just shows how well your body manages glucose without the stress of adding any calories from eating. Everyone should have a glycohemoglobin A1c performed yearly. This test measures what percentage of your RBCs (red blood cells) are saturated with sugar. The A1c tells us what your blood sugar has averaged over the course of the past two months. Tom Hanks A1c has been elevated for years prior to his diagnosis of Type II Diabetes. Yours may be elevated as well. Every week I see young adults with early signs of diabetes, all undetected, all unaware of the devastating disease they are creating by eating SAD.

Wednesday, October 9, 2013

Vitamin B12 – Are You Deficient?

In a word, YES, you may very likely be deficient in vitamin B12. The most common food source is red meat. So if you are a vegetarian, or limit your animal foods to fish and chicken, you need to supplement. But even if you are an “all American red meat eater”, a real carnivore, the odds are pretty high that you are still deficient.

Much has been written about how hard it is to absorb B12. You need adequate HCl (depleted by Prilosec and all the other protein pump inhibitors). You need intrinsic factor and healthy epithelial lining in the small intestine. While these are significant issues, the real issue is conversion.

The food form of vitamin B12 is cyanocobalamin. If all the factors listed above are working and B12 is absorbed into the lining of the small intestine, it must be converted to one of the bio-available forms to be used by the body. Methylcobalamin and adenocobalamin are the two bio-available forms that are produced by those small intestine cells. Once converted, both forms are released into the blood stream and go to work. Vitamin B12, folic acid, and vitamin B6 are involved in many, many chemical pathways in the body.

The ability to convert vitamin B12 is controlled by our genetics and unfortunately many of us have a genetic impairment that limits or prevents us from converting B12. Eight percent of the population have inherited a defective gene from both parents and will never make the conversion. These patients are easy to identify as they are always be anemic (have a low red blood cell count, low hemoglobin, or low hematocrit) because B12 is necessary to make red blood cells. The more common issue is the person who inherited a defective gene from just one parent. Sometimes they can convert B12, sometimes not. If they are under stress from illness, poor diet, lack of exercise, long work hours, etc., they may not convert B12. Twenty-five percent of the population is afflicted with this genetic defect. That’s one of every four people!

So, looking at all the issues with vitamin B12, it’s a pretty good guess that you are deficient. Not quite 50/50, but close. Fortunately, the solution is quite easy. The bio-available forms of B12 – methylcobalamin and adenocobalamin are readily available in supplement form. You can also take a sublingual form that is absorbed without passing through the digestive tract. Clinically, I find that that supplementing the patient with partial impairment for 30 days will often restore normal conversion, eliminating the need to supplement.

Let’s discuss B12 shots briefly. Most of the injections contain cyanocobalamin, the food quality form. When you inject the food quality form into the tissues of the body, where does the conversion occur? The vitamin never has an opportunity to be converted by the cells of the small intestine. All injections of B12 should be either methyl or adenocobalamin, not cyanocobalamin.

If you look at your last blood test, the lab probably ran a CBC (complete blood count). It’s a common lab test. If the RBC count, hemoglobin, or hematocrit are low, you might need more vitamin B12. If the MCV (mean corpuscular volume) is above 92, you are probably deficient in B12 and/or folic acid.

Saturday, October 5, 2013

100 Glasses of Wine on the Wall, 100 Glasses of Wine

Everyday we all read about new studies in health and what they might mean. Much of the information is conflicting and often creates more confusion than insight into health and human body. So I’ve decided to start blogging to bring some order to the chaos. So I invite you to read along, comment, criticize, and question. Health is a journey, not a destination, so let’s start shall we?

Resveratrol and exercise is no country for old men, research claims.
July 22, 2013
A new research study by scientists at the University of Copenhagen published today shows that resveratrol reduces the cardiovascular benefits of exercise in men over 65 years of age. This conclusion is based on a eight week study of 27 healthy, physically inactive men around age 65. During the eight weeks all the men performed high-intensity exercise. Half the men took 250mg of resveratrol daily; the other half took a placebo.

The study was double blind so neither the participants or the researchers knew which received the resveratrol or placebo. The researchers concluded that exercise training was highly effective in improving cardiovascular health parameters, but the resveratrol attenuated the positive effects of training on several parameters including blood pressure, plasma lipid concentrations, and maximum oxygen uptake.

They theorized that the lack of anti-oxidant activity as a result of taking resveratrol might reduce triggers for tissue repair and improvement.


MY TAKE:
Double blind placebo studies are, in general, valid. Adding cross-over (reversing the placebo with the resveratrol for another eight weeks) would have increased validity. However, I see two major flaws in this study. First, a glass of wine contains about 2.5mg of resveratrol. So, 250mg is the equivalent of 100 glasses of wine daily! Obviously, there was no alcohol involved but how could anyone possibly achieve those kinds of levels in their daily diet? This is a common theme in health care – If a little bit is good, a lot will be a lot better. Vitamin B3 – Niacin is very effective at reducing serum lipids and especially the L(p)a marker genetically linked with coronary risk factors. That is, if the dosage is between 100 and 500mg daily. However, prescription strength niacin (2500mg) had to be pulled from the market as it was causing, not preventing heart attacks. When you take any nutrient at an extremely high levels, it can act much like a drug, forcing profound chemical changes in the body, with unfavorable or even life threatening results.

Second, all chemical reaction in the body is oxidation. The chemical term is Redox Reaction. One chemical, like vitamin C, gives up an electron to another molecule, like vitamin E. The vitamin E is “reduced” and vitamin C is oxidized to a “free radical”. This allows the vitamin E to act as an anti-oxidant and now donate and electron to reduce another free radical. A lack of anti-oxidant activity is death to the body.

THE BOTTOM LINE:
Resveratrol is an important phytonutrient, have some. Have a glass of red wine with dinner on occasion. Maybe take a supplement that contains a little resveratrol, like grape seed extract.

Thursday, October 3, 2013