Friday, August 29, 2014

Kids With Autism Have Extra Brain Connections, Study Says

Researchers report that children with autism appear to have excess synapses – cellular connections – in their brains compared with typical children.

The scientists also believe it might be possible to reduce the number of extra synapses through drug treatment.
Synapses are the points in the brain where brains cells (neurons) connect and communicate with each other. Having excess synapses may have a major impact on how the brain functions, theorized neuroscientists at Columbia University Medical Center in New York City.

“It’s the first time that anyone has looked for, and seen, a lack of pruning during development of children with autism, although lower numbers of synapses in some brain areas have been detected in brains from older patients and in mice with autistic-like behaviors,” study senior investigator, David Sulzer, a professor of neurobiology, said in a Columbia news release.

His team also found that rapamycin, an immunosuppressant that helps prevent rejection in organ transplants and coats some coronary stents, can restore normal synaptic pruning and improve autistic-like behaviors in mice. The effect was seen even when the drug was given to the mice after they developed those behaviors.

The drug causes side effects that might prevent its use in people with autism, the researchers said. However, “the fact that we can see changes in behavior suggests that autism may still be treatable after a child is diagnosed, if we can find a better drug.” Sulzer added.

For the study, he and his colleagues examined 26 brains of youngsters with autism. All of the children had died from causes other that autism. Their brains were compared to 22 brains of children without autism.

Wednesday, August 27, 2014

Wisdom Wednesday: Quasi-vitamins


Traditional vitamins were discovered during the first half of the last century. There was an initial association between diet and health status that led early researchers to identify these essential nutrients. Until identified and labeled as vitamins, these chemicals were called “unidentified growth factors”. That term is still used today.

The term “vitamin” is specific for animal species, stage of development, and/or particular conditions of the physical environment and diet. For example, most primates (other than humans) can make vitamin C, so for them, it is not a vitamin. Guinea pigs, like humans, cannot make vitamin C, which is why they became so popular in research.

Of course, some of our traditional vitamins are not really vitamins. Vitamin D is a hormone not a vitamin, and is manufactured by skin cells when exposed to sunlight.

The quasi-vitamins meet the criteria of a vitamin for only a few species or only under certain conditions, and are not accorded the full status of a vitamin. Under the heading of only a few species are choline, carnitine, and inositol.

Choline is required in the diets of young poultry for optimal growth and freedom of leg disorders. It occurs in foods in the form of phosphatidylcholine (also called lecithin). The best food sources are egg yolk, glandular meats (liver, kidney, brain), soy, wheat germ, and peanuts.

Monday, August 25, 2014

New Method Shows How Bacteria Become Dangerous Pathogens

Two new papers published this month describe a new approach that combines whole genome sequencing – an ability to analyze the genetic code of bacteria in great detail – with plylogenetic reconstruction – an ability to trace the family tree of different strains of the same organism back to a common ancestor.

In the Proceedings of the National Academy of Sciences, Prof. Gordon Dougan, from the Wellcome Trust Sanger Institute in the UK, who co-authored both papers describe how they worked out that typhoid fever emerged in humans about 450 years ago. The researchers suggest the disease may have moved from animals to humans when people began to inhabit denser environments and started living close to their livestock. They suggest the bacterium followed a similar path to whooping cough and tuberculosis – it became fixed in humans and spread around the world.

Over the centuries, typhoid fever appears to have accumulated genetic mutations – not as the result of any particular event, but through a gradual process known as genetic drift.

In the second paper, published in Nature Communications, Prof. Dougan and another set of colleagues traced the genetic development of the bacterium Streptococcus agalactiae or Group B Streptococcus (GBS), a cause of serious septicemia and shock in newborns.

Friday, August 22, 2014

Health News

I write three blogs per week. One of those, Wisdom Wednesday, comes from my clinical experience. The other two are from reviewing recently published studies on human health.

I spend some time virtually every day searching the internet for interesting research. I hope that the studies I write about have some impact and meaning for you personally. It is not always easy to find research worthy of review. Sometimes I go several days without finding a good study, then I might find two or three great reports at one sitting.

Today, I thought I would review a few of the rejects, studies that didn’t make the cut. All of these studies were published on Medline Today by the NIH (National Institutes of Health). It is, without question, my best source of information. I also look at WebMD, the New York Times, CBS News, and even Fox News. These are from the past week and a just a sample of the studies funded, conducted, and published on a daily basis:

  • Employees Benefit from Natural Light, Study Finds
  • Natural Lighting Brightens Nurses’ Outlook, Study Says
  • Good Neighbors are Good for Your Heart, Study Says
  • Health Tip: Practice a Well-Balanced Exercise Program- Don’t focus on just one form of activity.
  • Lunch Box Hygiene Helps Prevent Foodborne Illness, Expert Says
  • Many Seniors Get Unnecessary Cancer Tests - Screening should not be done when patients have less than a 10-year life expectancy research says.
  • Losing Weight May Help Against Osteoarthritis – Too much weight can strain joints.
  • Nearly 1 in 5 American Adults Consume at Least One Soda Per Day: CDC – Mississippi is the highest at 32%.
  • Popular Southern Fare May Harm Your Kidneys, Study Finds – Fatty, sugary foods run risk of death due to organ problems.
  • Many Shift Workers Use Drugs to Sleep, Stay Awake, Study Finds
  • Study Hints at Link Between Poor Sleep, Suicide Risk – But fails to shows a direct cause and effect relationship.
  • Forty Percent of Americans Will Develop Diabetes, CDC Predicts
I hesitated to include the last one because it is such an important issue. It’s just that the jury returned this verdict long ago. Why would the CDC make such a redundant announcement at this time? Besides, I believe the numbers are too low, it’s at least 50% of those currently alive.

There was also another study questioning the value of statin drugs. Although that is also old news, the drug industry, American Heart Association, and American Cardiologist Association have not yet shifted their position. That topic needs to be reiterated.

The Ebola viral outbreak is the most popular topic in health news over the course of the past few weeks. I wish that the interest was in the health of those living in Africa that are at high risk. However, I believe that the public is easily distracted by focusing on a health issue that won’t affect them directly rather than deal with the very real health dangers we face ourselves.

THE BOTTOM LINE:
A very small percentage of the research published on health care really advances the science. I suppose that is what gives me the drive and the material to write this blog. I will continue to try and find those pearls, both good and bad, to illuminate. I hope you continue to read along.

Wednesday, August 20, 2014

Wisdom Wednesday: Chaste Tree


This herb has been used for over 2500 years as a tonic for female hormonal issues. During the middle ages, the monks would chew the leaves to reduce their libido and “keep their thoughts on higher things.” The tree originates from the Mediterranean region but grows well in all sub-tropical climates.

I began using this herb about fifteen years ago. Like most nutritionists, I used it to treat PMS, irregular menstrual cycles, painful menstruation, etc. The herb was thought to have a direct effect on the ovaries so it was not used on men or postmenopausal women.

Within a couple of years, we began to use it to treat postmenopausal women, but only if they still had a least one ovary. It was very effective for hot flashes and mood swings.

Chaste Tree (or Monk’s Pepper) also had an antidotal use as a sleep aid. In addition, the full dose was given first thing in the morning rather than throughout the day like most supplements. The rationale for use and the application had been lost over the centuries.

New research on Chaste Tree was published ten years ago. The study focused on the traditional use as a sleep aid. They discovered that Chaste Tree does not directly influence the ovaries at all. Rather, it stimulates the pineal gland to make more melatonin. Clinically, melatonin production increases by 95% within two weeks.

Monday, August 18, 2014

Bone Drugs Don’t Lower Breast Cancer Risk

Drugs known as bisphosphonates – commonly prescribed to treat osteoporosis, don’t appear to reduce the risk of breast cancer as previously thought, new research finds.

“We found that postmenopausal women who took a biphosphanate for three or four years did not have a decreased risk in breast cancer,” said study author Trisha Hue, an epidemiologist at the University of California, San Francisco.

“Women who get bisphosphonates have a low bone mass density,” she said. “If you have low bone mass density, you probably have low estrogen.” This is because the hormone, which is depleted after menopause, helps regulate bone mass and strength. Many types of breast cancer need estrogen to grow, she said.

Previous studies that found the fringe benefit of reduced breast cancer risk were observational, meaning people taking the drugs happened to have lower breast cancer risk. But the research didn’t establish a direct cause-and effect relationship.

The new study, published in JAMA Internal Medicine looks at two randomized clinical trials that compared two popular osteoporosis drugs, Fosamax and Reclast, to see if the women taking the drugs were less likely to get breast cancer than women given a placebo. After nearly three years of follow-up, less than 1% of the women in each group developed breast cancer.

Friday, August 15, 2014

Experts Issue Guidelines for Treating Irritable Bowel Syndrome

Newly released guidelines for the treatment of irritable bowel syndrome and a type of constipation known as chronic idiopathic constipation reveal a number of proven treatments for those two common conditions.

“There’s a greater variety of approaches which reflect a greater understanding of the disorders,” said guidelines co-author Dr. Eamonn Quigley, chief of the division of gastroenterology and hepatology at Houston Methodist Hospital.


“We now have a better opportunity to improve the lives of our patients,” Quigley said.

The guidelines are published in the August issue of the American Journal of Gastroenterology.

An estimated 5 to 15% of the world’s population has irritable bowel syndrome, a condition that can cause symptoms such as abdominal pain, diarrhea or constipation, cramping and bloating, and gas. It can affect people at any age but is especially common when people are in their 20s and 30s, Quigley said.

The condition can be difficult to diagnose because other conditions share the same symptoms. Unlike other conditions, however, there’s no specific diagnostic test for irritable bowel syndrome, he noted. Physicians must rely purely on symptoms to make the diagnosis.

The new guidelines, released this week by the American College of Gastroenterology, say there’s evidence to support the following treatments for irritable bowel syndrome:
• Fiber (psyllium especially when compared to bran)
• Probiotics
• An antibiotic called rifaximin (Rifagut)
• Medications known as linaciotide (Linzess) and lubiprostone (Amitiza)

The irritable bowel syndrome guidelines also say that research has boosted the case for using antidepressant medications and psychological therapy.

Wednesday, August 13, 2014

Wisdom Wednesday: The B Vitamins


I’m not covering all the B vitamins today, just the first three – vitamin B1, B2, and B3.

Thiamine (B1) was first vitamin discovered in 1912 as the unseen substance in rice and wheat that cured beriberi. It was just called “vitamin B”. Soon scientists realized there were many more water soluble substances and the list of B vitamins began to grow. Riboflavin (B2) was discovered in milk in 1926. Although it did not cure any known disease, it was found to be essential for growth. Vitamin B3, niacin was isolated as the cause of pellagra in 1935.

Thiamine (B1) is stimulatory in nature. When the body is lethargic, the heart rate and blood pressure are low, thiamine can be very effective. However, it is commonly a trigger for tachycardia and atrial fibrillation. I believe that “fortified foods” like breakfast cereals, where the natural thiamine is first stripped out, then replaced with synthetic vitamins is a significant factor in the onset of atrial fibrillation. Thiamine is also used to treat neuropathy and is especially effective in treating Bell’s palsy.

Riboflavin (B2) and niacin (B3) both have a calming effect. Early in the history of vitamins, they were lumped together as “vitamin G”. There are still a few supplement companies that use that designation. They counterbalance the stimulatory effects of thiamine in the B complex.

The ratio of these B vitamins is critical. In most foods, that ratio is 3:1 with riboflavin and niacin being three times as abundant as thiamin. Unfortunately, most supplement companies have ignored this ratio. A “B50” or “B100” supplement will contain 50 mg or 100 mg of each of the B vitamins without any regard as to how they are normal combined in nature.

Monday, August 11, 2014

New Drug Could Treat Low Testosterone with Fewer Side Effects

A new drug, enclomiphene citrate, may prove to be more effective in treating men with low testosterone than the testosterone gels and injections currently prescribed.

A similar drug has been used in fertility treatment to help women ovulate. Enclomiphene citrate is a derivative of clomiphene citrate, which is marketed under the name Clomid as a female infertility treatment. Researchers from Repros Therapeutics in The Woodlands, Texas, and from Baylor College of Medicine in Houston treated 73 men with “secondary hypogonadism.”

Researchers say the drug increased levels of testosterone produced by the testes, as well as levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) produced by the pituitary gland. The study will appear in an upcoming issue of the journal Fertility and Sterility.

One side effect of current “low T” therapy is that testosterone gels and injections actually lower sperm count. This is because the influx of exogenous testosterone causes the brain to tell the testicles to produce less testosterone, which compromises sperm production. Many primary care physicians do not know about this effect, however, and they readily prescribe testosterone to male patients who have low testosterone and also wish to have a child, said Dr. Lawrence Ross, a urologist and professor emeritus at the University of Illinois at Chicago. He wrote an editorial accompanying the new study. A survey by the American Urological Association found that 25% of urologists said they would use testosterone to treat infertile men pursuing pregnancy.

Friday, August 8, 2014

Nutrition and Spirituality Podcast

Today’s blog is a departure from the usual format. This podcast, “Speak Your Truth Radio”, is hosted by Kristen Bomas. You can learn more at KristenBomas.com. In today’s blog she and I explore some of the common ground between mental, emotional, and physical health.

Wednesday, August 6, 2014

Wisdom Wednesday: Molybdenum


Molybdenum is a trace mineral in the body. Scientists have long known it is essential for health but little was known about what functions it serves. Over the course of the last few years we have begun to work out the mystery surrounding molybdenum.

Researchers studying the benefits of cruciferous vegetables on liver function stumbled across molybdenum. Cruciferous vegetables are very high in sulfur bearing amino acids. Sulfur, another mineral used in the body, enters the body attached to certain amino acids in protein, rather than as a free mineral like calcium or magnesium. In order to use the sulfur, it must be stripped from amino acids like methionine and cysteine. This requires vitamin B6, B12, folic acid, and molybdenum.

Molybdenum actually catalyses the last step in this process that releases sulfur as an electrolyte. Sulfur is required for five of the ten pathways in phase II liver detoxification. Please review my first Wisdom Wednesday Blog: Vitamin B6, posted on March 14, 2014.

As noted in that blog, the sulfur is used to make ground substance to repair all connective tissues of the body: muscle, ligament, tendon, bone, disc, and cartilage. Sulfur also controls Candida growth in the bowel.


Monday, August 4, 2014

Effects of Extended-Release Niacin with Laropiprant in High-Risk Patients

BACKROUND – Patients with evidence of vascular disease are at increased risk for subsequent vascular events despite effective use of statins to lower the low-density lipoprotein (LDL) cholesterol level. Niacin lowers the LDL cholesterol and raises the high-density lipoprotein (HDL) cholesterol level, but its clinical efficacy and safety are uncertain.

METHODS – After a prerandomization run-in phase to standardize the background statin-based LDL cholesterol-lowering therapy and to establish participants’ ability to take extended-release niacin without clinically significant adverse effects, we randomly assigned 25,673 adults with vascular disease to receive 2 g of extended-release niacin and 40 mg of laropiprant or a matching placebo daily. The primary outcome was the first major vascular event (nonfatal myocardial infarction, death from coronary causes, stroke, or arterial revascularization).

RESULTS – During a median follow-up period of 3.9 years, participants who were assigned to extended-release niacin-laropiprant had an LDL cholesterol level that was an average of 10 mg per deciliter lower and an HDL cholesterol level that was an average of 6 mg per deciliter higher than the levels in those assigned to placebo. Assignment to the niacin-laropiprant, as compared with assignment to the placebo, had no significant effect on the incidence of major vascular events. Niacin-laropiprant was associated with an increased incidence of disturbances in diabetes control that were considered to be serious, as well as increases in serious adverse events associated with the gastrointestinal system, skin, and unexpectedly, infection and bleeding.

CONCLUSIONS – Among participants with atherosclerotic vascular disease, the addition of extended-release niacin-laropiprant to statin-based LDL cholesterol-lowering therapy did not significantly reduce the risk of major vascular events but did increase the risk of serious adverse events.

MY TAKE:
Please reread the first sentence – Patients with vascular disease are at increased risk of for subsequent vascular events despite the use of statins. The slight benefit from statins comes from reducing inflammation, not from lowering LDL cholesterol.

What this summary doesn’t disclose is that Merck also added another drug to the niacin-statin combination to prevent flushing. Niacin, even in small doses can cause a flushing of the skin accompanied by itching. In previous studies about 25% of participants discontinued niacin therapy due to these side effects. The researchers admit that they don’t know if the negative side effects were related to the niacin or the third drug.

Clinically, I use the niacin without the statins and it works great. I use a much lower dose, up to 500 mg rather than the 2 g used in the study. Yes, my patients “flush” but I have long believed that the flush is important to the biochemical metabolism of niacin. Recent research indicates that the flush comes from the epithelial cells of the body using cholesterol in the formation of prostaglandin inflammation. This chemical process would lower LDL and raise HDL levels through normal biochemical pathways in the body.

Any nutrient – vitamin, mineral, phytochemical – can act like a drug if the dosage is too high. This is a constant concern in daily practice. Nutrients facilitate biochemistry while drugs mandate. I’ll admit that I occasionally cross that line. When I do, it is for short term therapy and I monitor my patient closely.
Drug-nutrient interactions are common place. I have textbooks and internet web sites dedicated to this subject. I am not surprised at the results of this study. I think the study should have been reversed – test niacin and a placebo against niacin and a statin in a double blind study.

Finally, the premise is all wrong. Manipulating the LDL and HDL levels with drugs, vitamins, or even combinations of drugs and vitamins is not the answer. When a patient has high cholesterol, you need to ask why it is high rather than just force it down. Is it diet and lifestyle? Do they have hypothyroidism? Do they suffer from dysbiosis? Commonly, the answer is more than one of these issues is at fault. Correct the metabolism and the serum lipids will come into balance. High cholesterol is a test result, not a disease.

THE BOTTOM LINE:
If you want to reduce cholesterol levels, lower LDL and raise HDL, niacin can be an excellent tool. Work with a nutritionist who will view your serum lipids as a reflection of the health of the body rather than a disease process.

Source: New England Journal of Medicine -July 17, 2014

Friday, August 1, 2014

Study Finds Many Flu Patients Not Treated Appropriately

Antiviral drugs aren’t prescribed often enough for patients at high risk for flu complications, while too many of them receive unneeded antibiotics, a new study says.

The findings show that doctors require more training about the proper use of antiviral and antibiotic drugs in treating flu patients, the researchers said. Unnecessary use of antibiotics contributes to the development of antibiotic resistance.

“Our results suggest that during 2012-13, antiviral medications were under prescribed and antibiotics may have been inappropriately prescribed to a large proportion of the outpatients with influenza,” wrote Dr. Fiona Havers and colleagues from the U.S. Centers for Disease Control Prevention and several other institutions.

The researchers analyzed data from about 6,800 patients with flu symptoms seen at five outpatient care centers in Michigan, Pennsylvania, Texas, Wisconsin and Washington State during the 2012-13 flu season. The team focused on prescription records for two antiviral drugs for flu – oseltamivir (Tamiflu) and zanamivir (Relenza) – and three widely used antibiotics (amoxicillin-clavulanate, amoxicillin, and azithromycin).

Antiviral drugs were prescribed to only 19% of patients who were at high risk for flu complications and saw a primary care provider within two days of their flu symptoms emerging. And only 16% of patients with laboratory-confirmed flu got oseltamivir or zanamivir.