Wednesday, July 30, 2014

Wisdom Wednesday: Boswellia

This is my favorite herb for personal use – it works really well for me as an anti-inflammatory compound. Boswellia or Indian frankincense is derived from the resin of Boswellia serrata. There are no known contraindications, it is deemed safe for use in pregnancy and breast feeding. However, a few people have had mild diarrhea or skin rash as an allergic reaction. I have had one case in ten years of clinical use.

The key constituents of Boswellia serrata include the boswellic acids but the resin also includes essential oil. The typical dosage is 600 to 1200mg/day of extract standardized to contain 60% boswellic acids.

I use a complex that also includes some Celery Seed fruit, ginger, and Turmeric. This combination will target leukotriene and cytokine inflammation with some benefit in reducing prostaglandin inflammation as well. Although it works in the same pathway, it does not prevent the production of leukotrienes and cytokines like ginger. It has an effect on the Vagus nerve that stimulates the breakdown of these immune inflammatory compounds in the liver.

Boswellia is extremely effective in the treatment of asthma as well. It is thought that the effect on the Vagus nerve also has a calming effect on the goblet cells lining the respiratory tract. The result is a reduction in both bronchial inflammation and mucous production in the respiratory tree.

Monday, July 28, 2014

Female Triathletes May Face Health Problems Such as Incontinence

Women who compete in triathlons are at increased risk for pelvic floor disorders, including incontinence, and other health problems, a new study says.

“There has been a surge in popularity of high-impact sports such as triathlons, but little has been known until now about the prevalence of pelvic health and certain other issues associated with endurance training and events,” study author Dr. Colleen Fitzgerald, a physiatrist at Loyola University Health System, said in a university news release.

The term “pelvic floor” refers to the muscles that support the pelvic organs, such as the uterus, bladder, or bowel.

Researchers surveyed more than 300 female triathletes, with a median age range of 35 to 44. On average, they ran 3.7 days a week, cycled 2.9 days a week and swam 2.4 days a week.

One-third said they had pelvic floor disorder symptoms, such as urgency urinary incontinence (16%), stress urinary incontinence (37%), bowel incontinence (28%) and pelvic organ prolapsed (5%).

The survey also revealed that 29% of the women had abnormal bone density, 24% had menstrual irregularities, and 22% had disordered eating. These are components of the so-called female athlete triad. While the research shows an association between triathlon training and certain health issues, it doesn’t establish a cause-and-effect relationship.

Friday, July 25, 2014

Tylenol ‘does not ease low-back pain’

Low back pain is the main cause of disability worldwide and acetaminophen (brand name Tylenol) is currently the first port of call in terms of reducing pain and speeding recovery.

However, a large randomized trial published in The Lancer investigates the efficacy of acetaminophen for acute low back pain and finds it performs no better than a placebo.

The researchers, led by Dr. Christopher Williams from the George Institute for Global Health at the University of Sydney, Australia, say their findings bring into question the “universal endorsement” of acetaminophen as the main painkiller for low back pain.

After conducting a systematic review of previous studies assessing the effectiveness of acetaminophen for low back pain, the team found no evidence to support its use. “All seven of the included trials had substantial methodological flaws, and only one trial included more than 25 participants per group,” they write. Additionally, they say no trial has compared acetaminophen with a placebo or compared dosing.

Their study randomly assigned 1,652 participants, of an average age of 45 years, with low back pain to receive regular doses of acetaminophen (3,990 mg per day) for up to 4 weeks; a second group was given acetaminophen as needed, and the third group a placebo. Results showed that between the treatment groups, there were no differences in the number of days to recovery; the median time to recovery was 17 days for the regular dose group, 17 days for the as needed group and 16 days for the placebo group.

Wednesday, July 23, 2014

Wisdom Wednesday: Ginger

Herbs are a vital aspect of my practice. When used properly, they are powerful supplements that can restore normal function quickly. My favorite herb is Ashwaganda, but my most popular herb is ginger.
Traditionally, ginger is used to treat morning sickness, nausea, motion sickness, or any digestive disturbance. It is safe for use (at recommended doses) in both pregnancy and breastfeeding.

I use ginger as an anti-inflammatory compound. Scientific research has established that ginger blocks the enzyme lipooxygenase. This enzyme is required to form leukotrienes and cytokines, common inflammatory compounds arising from the immune system. Clinically, about 40% of my new patients are producing excessive leukotrienes and/or cytokines. For a majority of them, ginger will reduce their inflammation quickly and effectively with no side effects.

Like most herbs, there are quality issues with ginger. I use a 1:2 liquid extract that is manufactured in Australia. All herbal products in Australia are produced to pharmaceutical standards by law. This is the only way I can guarantee my patients are using an effective product.

European herbal companies have similar standards that the industry has voluntarily established. In the US there are no such standards and the FDA considers herbs as food. Government food quality restricts contamination from cockroach parts and rat feces but does not address herbal quality. Therefore, in the US a product listed as ginger does not need to contain any ginger.

Monday, July 21, 2014

Bone Marrow Hormone Influences Metabolism and Health

Until recently, scientists believed bone marrow had mostly a negative effect on health, but mounting evidence supports the idea that the fat tissue inside our bones – known as bone marrow adipose tissue – may be part of the body’s endocrine system.

In the journal Cell Metabolism, researchers from the University of Michigan explain how bone marrow adipose tissue is a significant source of the hormone adiponectin, which helps to break down fat and maintain sensitivity to insulin. The hormone has also been linked to reduced risk of various obesity-related diseases, including certain cancers, cardiovascular disease and type 2 diabetes.

Previous studies of bone marrow adipose tissue have primarily linked it to negative health consequences such as reduced bone mass, and raised risk of fractures and osteoporosis.

But in this study, where they looked at the role of bone marrow adipose tissue in patients having chemotherapy, or who have anorexia, the researchers found that under conditions where calories are restricted, the fat tissue may also do some good.

Senior author Ormond MacDougald, professor of internal medicine at U-M, says the findings are important because it appears bone marrow adipose tissue “may have positive, protective roles, and influence adaptive functions outside of the bone tissue, at least during calorie restriction.

Friday, July 18, 2014

Study Provides New Insight into the Formation of the Nervous System

New research from the Karolinska Institutet in Sweden has revealed some interesting new findings about the formation of part of the nervous system.

The research team, including Igor Adameyko, of the Department of Physiology and Pharmacology, and Patrik Ernfors, of the Department of Medical Biochemistry and Biophysics, recently published their findings in the journal Science.

The nervous system consists of two parts – the central nervous system and the peripheral nervous system. The central nervous system – made up of the brain and spinal cord – is the core processing center that controls the body’s activities. The peripheral nervous system – made up of nerves leading to and form the central nervous system – connects the central nervous system to limbs and organs.

In this study, the researchers say their findings may change the current understanding of how the peripheral nervous system is formed.

Using 3D reconstructions of mouse embryos, they identified how the parasympathetic nervous system develops. This is a part of the autonomic nervous system (in the peripheral nervous system) that is responsible for conserving energy as it slows the heart rate, increases glandular and intestinal activity and relaxes sphincter muscles.
Current belief holds that in various organs, parasympathetic nerve cells first arise in early progenitor cells – early descendants of stem cells that can turn into different cell types – that travel short distances when an embryo is small.

However, the team says that this belief fails to explain why many organs that develop when an embryo is larger contain cells that create parasympathetic neurons. From close analysis of the 3D mouse embryos, they found that progenitor cells –called Schwann cell precursors - create parasympathetic neurons. These progenitor cells travel through the peripheral nerves to tissue and organs in the body.

Wednesday, July 16, 2014

Wisdom Wednesday: Black Current Seed Oil

Black current seed oil is an omega 6 fatty acid. Just like the omega 3 fatty acids, omega 6s are essential. Humans can not create the double bond at the 3rd carbon or the 6th carbon from the terminal end of the fatty acid. So both must be in the diet.

Unlike omega 3 fatty acids, there are plenty of sources of omega 6 fatty acids in our diet. Olive, corn, soy, sunflower, and safflower oils are all rich in omega 6s. Unfortunately, most of these oils also contain saturated fats that are not so healthy.

In addition, many of us can not convert the linoleic acid (omega 6) into gamma linolenic acid (GLA) to be used by the body. Alcohol, saturated fats, trans-fats, deficiencies of vitamin B3, B6 or zinc, some chemicals and some viral infections can block the chemical pathway for conversion. As we age, as stress increases, or when any of the factors of metabolic syndrome appear, this process becomes less efficient. GLA can also be diverted into the arachidonic acid pathway by these same factors, increasing inflammation body wide. (Please review my blog on Sesame Seed Oil)

The abundance in the diet, poor conversion to GLA, and tendency to be pro-inflammatory in nature has led most nutritionist to recommend against supplementation of omega 6 fatty acids. However, I disagree with their reasoning and often recommend black current seed oil. I believe you need to correct the metabolic errors rather than deny an essential nutrient to the body.

Monday, July 14, 2014

One Third of Total Knee Replacements in US are ‘Inappropriate’

Figures from the Agency for Healthcare Research and Quality show that more than 600,000 knee replacements are performed each year in the US.

This surgery has become increasingly more common over the past 15 years, with studies showing a 162% annual volume increase in Medicare-covered knee replacement surgeries during 1991-2010.

Experts are divided on the reasons for this growth, with some maintaining it demonstrates that the procedure is effective, others argue the surgery is being overused. One concern of the critics is that the procedure “is highly reliant on subjective criteria.”

Researchers from Virginia Commonwealth University in Richmond examined the criteria that is used to determine appropriateness for total knee arthroplasties (TKA). They found that one third of TKA in the US are “inappropriate” when applied to a Spanish patient classification system, according to their study published in Arthritis & Rheumatology.

Friday, July 11, 2014

Could Antihistamines Help Fight Cancer?

Antihistamines are medications used to prevent or relieve symptoms of allergies, including hay fever, atopic eczema, and reactions from insect bites and hives.

The drugs work by stopping the release of histamine – a substance produced by the body that causes watery eyes, itching, sneezing, runny nose and breathing problems.

A research team, including Daniel H. Conrad, PhD, of the Department of Microbiology and Immunology at Virginia Commonwealth University, recently published their findings in The Journal of Leukocyte Biology. They found that as antihistamines do their job, they also interfere with the function of myeloid-derived suppressor cells – a type of cell known to hinder the body’s ability to combat tumors – meaning a new cancer drug candidate may be in the cards.

The research team analyzed two groups of mice. In one group, they triggered a strong allergic response by infecting them with a rodent intestinal helminth, while the other group of mice had tumors.

The allergic mice were then injected with myeloid-derived suppressor cells and treated with one of two antihistamines – cetirizine or cimetidine. The mice with the tumors were also injected with the cells but were only treated with the antihistamine cimetidine.

Wednesday, July 9, 2014

Wisdom Wednesday: Flax Seed Oil

The oil extract from flax seed is comprised of both omega 3 and omega 6 fatty acids. Alpha-linoleic acid (ALA) is the primary omega 3 fatty acid in flax seed oil. As noted in previous blogs, the omega fatty acids are essential as we can not manufacture these oils from any other chemicals. We can however convert ALA to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the primary omega 3 fatty acids found in fish oil. ALA, EPA, and DHA all have health benefits, but most of the research on essential fatty acids has focused on EPA and DHA.

Conversion of ALA to EPA and/or DHA is often impaired in the human body. The chemical process is blocked by alcohol, saturated fats, trans fats, deficiencies of vitamins B3, B6 or zinc, some chemicals, and some viruses. The process is less effective as we age, under high stress, and in metabolic syndrome, especially diabetes.

In my practice I find patients who have a relatively clean diet, especially my vegetarians, often test for flax seed oil rather than fish oil. They don’t require the fish to make the conversion from ALA because they are quite capable of the chemical conversion themselves. Some patients will vacillate back and forth between the two sources as their health varies. A patient that moves from needing fish oil to flax seed oil is a sign of general improving health and/or a marked improvement in diet.

Monday, July 7, 2014

Injection Treatment No Help for Hamstring Injuries

An expensive and unusual treatment that relies on components from a patient’s own blood doesn’t appear to speed recovery from hamstring muscle injuries, according to new research.

The treatment is favored by top athletes, but the study found no benefit from platelet-rich plasma injections, at lease when administered in a certain way.

A physician who relies on the largely untested therapy says the new research misses the mark. But the study’s lead author stands by the findings, published in the June 26 issues of The New England Journal of Medicine.

“We found no benefit of platelet-rich plasma injections compared to placebo injections” in terms of the time athletes needed to return to playing sports and their risk of getting injured again, said study lead author Dr. Gustaaf Reurink, a sports medicine specialist with the Erasmus Medical Center in Rotterdam, the Netherlands.

Hamstrings are muscles at the back of the thigh and crucial to flexing the hip and knee, said Dr. Lewis Maharam, a sports medicine specialist in New York City.

In the past, pro football players with torn hamstrings might need to be kept off the field for 8-12 weeks to recover through rest and physical therapy, Maharam said, but he said platelet-rich plasma injections have made a big difference.

Friday, July 4, 2014

American Children ‘Consuming Too Many Vitamins and Minerals’

A new report from the Environmental Working Group (EWG) in the US says we should be concerned that American children may be consuming too many vitamins and minerals.

One reason the report gives is that the explosion in fortified foods, paired with inadequate government policies, means that many children in the US are now consuming too many vitamins and minerals.

Vitamins and minerals are essential for good health, and for many children, exceeding the required amount is unlikely to cause harm. But for some, there is a narrow band between an optimum level that benefits health and an excessive level that can cause harm. Unlike adults, whose bodies are much larger, children are more vulnerable to overdosing.

Citing several government and academic sources, the EWG report summarizes how millions of American children under the age of 8 are getting too much vitamin A, zinc, and niacin from fortified foods and supplements.

An excess of zinc can stop the body absorbing copper properly and result in anemia, changes in red and white blood cells and impaired immune function, while too much niacin (vitamin B3) can cause rashes and other skin reactions, nausea and liver toxicity.

The EWG report shows that breakfast cereals and snack bars are often fortified with vitamin A, zinc and niacin in amounts that exceed children’s daily needs. In some cases, the amounts exceed the limit that the Institute of Medicine (IOM) – a branch of the National Academy of Sciences – considers safe for children.

Wednesday, July 2, 2014

Wisdom Wednesday: Sesame Seed Oil

Now that I have finished my review of the QA (Quintessential Applications), I will return to describing some of my favorite supplements on Wednesday Wisdom.

In the omega 6 fatty acid pathway, long chain molecules are first converted to GLA (gamma linolenic acid). This process is often impaired by poor diet, viral infections, age, alcohol use, and various B vitamin deficiencies. You can support omega 6 fatty acid metabolism by supplementing black current seed oil, borage oil, or evening primrose oil. All three of these supplements are high in GLA. My personal preference is black current seed oil.

Once your body has acquired GLA, vitamin B6 acts as a catalyst to convert it to DGLA. At this point a highly significant crossroad is reached. In a healthy state, the body then converts DGLA into anti-inflammatory prostaglandins (PG1). However, when insulin resistance, hypothyroidism, hyperlipidemia, or any aspect of metabolic syndrome is present, the DGLA is converted to pro-inflammatory PG2.