March 13, 2004 I carbo-load three days a week for biking and running, and am wondering how I should modify my diet at this point in my life.
There are various reasons to avoid carbo-loading. I think it's important as you get older in maintaining athleticism that you modify your diet. Because what can happen is that if you retain the training table habits of your teens and twenties, even with significant athleticism, you will gain weight. You will push up your cholesterol. You will develop a gut in spite of your athletic exertions and I would suggest that you continue modest carbo-loading. But cool it, because actually, studies show that athletic performance is as good or better when you get about a 30-30-40 ratio of carbs to fat to protein. Mono-unsaturated fats and the omega three oils are a good source of fuel for your athletic endeavors and they are anti-inflammatory in nature.
I know what a tremendous appetite -- especially for carbohydrates -- long bicycle riding, long runs and ferocious exertion in the gym can produce. So you can't be on a no-carbohydrate diet; that would be a mistake. But you will get better muscle definition and you will get improved cholesterol if you adopt more of a Mediterranean diet and less of a starch-based dietary approach. You don't need all of the sugar that breaks down from all of that starch. A cholesterol of 200 is not bad and I would say that you're okay, relatively, in terms of cardiovascular risk because of your high level of exertion. But don't be lulled into a complete sense of false security because Jim Fixx is a good illustration of what happens when you're athletic but, at the same time, you're not cognizant of your cardiovascular risk factors from excessive cholesterol, homocysteine, C-Reactive protein.
All those factors add up so get a complete assessment. Consider getting an ultra-fast CAT scan to see if you have the beginnings of calcification and adjust your regimen accordingly.
My wife has just had her second bout with breast cancer. She had it in 1999 and she was rediagnosed just in the past week. It's going to her hip and her bones and we were wondering about nutrition.
She had a mastectomy of the right breast and then chemotherapy.
She is taking a drug called Femera.
Femera is actually a type of progesterone therapy.
This is a great time to do something with nutrition because with the hormonal therapy, she'll probably get a response and this is a time where the cancer can be held at bay and you can apply some aggressive principles of nutritional therapy.
A great book that I recently reviewed on my program by Michael Murray about natural therapies for cancer. Just look up under Michael Murray under his latest book. It has a compendium of things that are useful and one of the concepts that I like, in addition to mentioning literally dozens and dozens of therapies, is that there's a top-eight cancer fighters that is sort of a handy-dandy guide to lay people in terms of where to start. But things that can be used to prevent transition to cancer and possibly slow the progression of cancer include resveratrol resveratrol from red wine grapes. Curcumin from curry comes from the spice turmeric. Indol-3-Carbinol is very helpful, which comes from cabbage-family vegetables. And also green tea has a good effect. Aged garlic extract is beneficial, so there's a lot of natural microbicidal nutrients. You can get these from dietary sources. You can take concentrates in supplements. There are some studies that suggest that melatonin may slow the progression of cancer. And certainly when you're facing cancer for the second time, sleep problems may arise especially with hormonal therapy being used. Melatonin can sort of kill two birds with one stone. You can help sleep and you can also slow the progression of the cancer. There are also immune activating things, things like extract of Maitake mushroom and PSK and thymic extract which helps to put the immune system back on alert. We know from studies of advanced cancer therapies they use activated killer cells to try and hone in on the cancer.
Well there are ways of activating your own natural killer cells through immune stimulating therapies to get your body fighting the cancer better. It's a matter of recognizing the cancer cells, getting the white blood cells to hunt them down and destroy them. You can boost the potential of your white blood cells with simple nutrients like C and zinc and selenium which actually have an immune enhancing effect.
So there's a whole world of natural options out there and I think it's time to employ them as you judiciously use what conventional options are out there that are helpful and not too destructive.
Another resource is www.cancerdecisions.com. This is a website which, for a fee, provides all the current research on a specific cancer. Dr. Ralph Moss, a PhD,-is a very, very competent researcher in this field. He provides you with a compendium of information about the nutrients and the alternative therapies and even some of the conventional therapies that are applicable to your particular cancer dilemma. And it's a very useful resource for people who are trying to explore alternatives.
I think we need to take a complementary approach to cancer. I'm not into discarding conventional approach. Some are unnecessarily destructive and we may forego them, but others can help to slow the progression of cancer. But we always support our patients with nutritional agents.
Can you use arginine along with vitamin C, E, calcium and magnesium to control blood pressure?
There's a plausibility that because arginine can expand the blood vessels, -- arginine is the nutrient that's behind the nitric oxide principle which is actually the way Viagra works. Viagra expands blood vessels, --there may be something to it in terms of treating high blood pressure along with antioxidants that may relax blood vessels. And that's actually been shown to be helpful too, in blood pressure problems.
You absolutely can take these supplements with a beta blocker. And the concern is, a lot of people wonder what are the interactions between the drug I'm taking and the supplement I'm taking. Usually there are not but there are enough interactions there that you may well want to ask.
The problem is, there are very few people out there who know drug-nutrient interaction. It's often you'll ask your physician and , they'll say you probably shouldn't take the supplement just to be on the safe side. And what happens then, that denies you the benefit of you taking the supplement, merely out of their ignorance.
Similarly, pharmacists are learning more and more about this but there's still a tremendous knowledge gap when it comes to drug-nutrient interaction. I actually teach doctors and pharmacists about this subject when I lecture at hospitals, medical schools and conferences. I think there really needs to be more information about this kind of thing.
There's a book that you may want to use to help you with these types of issues. It's called, Deadly Drug Interactions, by Joe and Terry Graedon. The Graedons have been my guest here on Health Talk frequently, and they do a good job in running down interactions. Interactions you may be particularly concerned about involve things like Saint John's Wort, which can actually accelerate the metabolism of drugs. There's some evidence that milk thistle, which is a great thing for liver problems -- you have to be careful with it because it actually will enhance the activity of certain medications and get in the way of metabolism of others. Even grapefruit may have an impact on certain medication. So yes, there are a lot of these interactions out there, but arginine and beta blockers, is not a problem.
March 15, 2004
Government ads urge Americans to shed pounds
FDA asks for clearer labels of food, menus
By Betsy McKay and Suzanne Vranica. The Wall Street Journal. March 10, 2004
NYC mayor meets with Atkins widow
The Associated Press. March 15, 2004
Cells hold key to baldness cure
University of Pennsylvania. Dr. George Cotsarelis
FDA asks for clearer labels of food, menus
By Maggie Fox. Reuters. March 14, 2004
March 17, 2004
Are cancer-causing parabens your antiperspirant's stinky secret?
Journal of Applied Toxicology
A boost for the immune system? Magic Johnson endorses a dietary supplement
March 20, 2004
Monologue on fructose
It's an epidemic. Call it the new crack. According to a recent report in a medical journal, it's plentiful, it's cheap, it's hitting the streets and it's killing thousands, perhaps millions of Americans. What are we talking about here? Well we're not talking about Ecstasy; we're not talking about methamphetamine. We're talking about something that's quite legal to purchase and its use is being decried in the April edition of the American Journal of Clinical Nutrition. The addictive stuff is called fructose and this study takes a look at why fructose, a fruit sugar, is so dangerous for you.
What they did is they looked at statistics for weight gain across the 20th century and they noted that body weights rose only slowly for most of the early part of the 20th century. Remember the 20th century? The 20th century, the previous century that some people have little memory for. Body weights rose slowly for most of the 20th century until the late 1980s and then something happened. At that time, many countries showed a sudden uptick in the rate at which obesity has been galloping forward. And now we're hit with a problem where the majority of us are considered overweight.
According to some statistics, 65 percent of North Americans tipped the scale at higher than optimal weight. And what's that about? Well there's a science called epidemiology. That science looks at what's going on in a culture and a society to create change in the health patterns. And there's an interesting coincidence here because it was in the 1980s that a sweetener called high fructose corn syrup took off in industrial production in our food supply.
Prior to that, we used to use good, old-fashioned cane sugar or barring that, especially when we got in trouble with banana republics in Cuba, we started making our own sugar out of beets. But an even cheaper source of the sweet stuff is corn. It's so plentiful that they don't know what to do with it. They want to turn it into gasoline, turn it into fuel, give states and farmers agricultural subsidies not to grow it because there's such a surplus. But the food industry was a ready source for utilizing all of that extra corn and so they developed a highly sweet, sticky substance called high fructose corn syrup. And where did they put it, they put it mostly into soft drinks and what are called, euphemistically, fruit beverages.
Why fruit beverages? Well, technically, you're able to call something a fruit beverage if it, in some slight way, resembles fruit. Perhaps it's yellow or orange but it's sweetened not with natural fruit juice, it's jazzed up with high fructose corn syrup. That started happening in the 1970s and 1980s and it's completely coincidental with the epidemic of obesity. And this article points out one of the perils of fructose is: Yeah it's sugar, so what? So it's a different form of sugar. It's cheaper and actually fructose was touted -- I remember this, earlier in my career in medicine they said if you're diabetic, use fructose because it's good for diabetics. You don't require insulin to handle fructose and that's actually true. It's a physiological fact that the body does not require insulin to handle fructose.
But here's the rub: Fructose is real tricky for the body because it kind of gets in under the radar of the body's normal appetite defense systems. And according to this article, it says fructose, unlike regular sugar, does not even affect appetite. What an incredible product. You can drink as much fruit juice or fruit beverage as you can consume and it won't even affect your appetite. Unlike glucose, it does not affect insulin secretion. It has absolutely no affect on the feeling of satiety linked with consumption of most foods.
In other words, we know that calorically sweetened beverages may enhance caloric over-consumption by their actions in the body. That's the conservative language in this medical journal, the American Journal of Clinical Nutrition. It gets in under your hunger radar and here's something even worse: Fructose turns fairly readily into a type of fat you find in your bloodstream called triglycerides. We have an epidemic of folks with high triglycerides, they're often overweight. Some of them suffer from a liver problem called fatty liver. All that extra fat ends up getting deposited in the liver and this is a serious problem. People are guzzling soft drinks and fruit beverages and here's a statistic -- and maybe why one of the reasons why we're in trouble in this country -- traditionally, they say we don't exercise enough. We're overeating; we're super-sizing. But look at this statistic: Consumption of high fructose corn sweeteners increased more than 1,000 percent between 1970 and 1990. That far exceeds intake of any other food or food group. So hone in on one big problem that's undermining our health, think fructose.
Study:high-fructose corn sweeteners partly responsible for obesity epidemic
American Journal of Clinical Nutrition. April 2004
This is from Reuter's Health, "Healthy diets may increase bad cholesterol."
Often you hear, when you're looking at commercials for statin drugs on TV, the catch phrase is: When diet and exercise fail, take Lipitor, Zocor, Pravachol, Crestor -- they seem to be so sure that diet and exercise are going to fail. Of course, diet and exercise are going to fail. When do they ever work? You've got to take your drugs, right? Well, the problem may be not that just people are lazy bums, slobs, eat bad diets -- maybe that the right diet, the so-called healthy diet, a diet that's often advocated by the American Heart Association is the wrong diet for lowering cholesterol.
Here's what the study says, this is from Arterial Sclerosis Thrombosis and Vascular Biology -- not too scintillating. It's from this month's edition of that stimulating medical journal, but the article looks at a group of people. In particular, they find this is applicable to women. They put 37 healthy women on two different diets. Both diets were low in total unsaturated fat, so they were the traditional low-fat diets. One was actually low in vegetables. The other was high in vegetables and fruits. So two variations of the standard low-fat diet; one probably not as healthy because there weren't as many fruits and vegetables. What they discovered was that it makes sense that if you stop eating fruits and vegetables, your blood tests might get worse. The blood levels of dangerous LDL increased by 27 percent on the low-fat diet that didn't have lots of fruits and vegetables.
So what happens then, they put plenty of healthy fruits and vegetables into the low-fat diet? Well, bad news folks. LDL increased by 19 percent. LDL is the prime reason that we tell people to take statin drugs. Suggestion: Maybe some people would benefit from carbohydrate restriction and not just eat all the grains, the bread, the pasta, juice fruits, starchy vegetables, corn, potatoes that you want.
"Healthy diet" may increase bad cholesterol
Arteriosclerosis, Thrombosis, and Vascular Biology. March 2004
We doctors are supposed to be role models. Dr. Michael Fleming happens to be president of the American Academy of Family Physicians -- that's a 94,000 member organization of doctors who do primary care in this country. They're the first line of medical treatment in a lot of communities. One little fact you ought to know about Dr. Fleming is that he's 6 feet tall and he weighs 265 pounds. And they quote Dr. Fleming here as saying, ýIt's a little disingenuous to say I want you to do something I don't do myself.ý He's down there in Shreveport Louisiana.
So Dr. Fleming and family practitioners who are part of his organization are going to do something about this. Fleming is spearheading an effort to get members of his medical academy to get in shape themselves. And he's actually going around the country to enlist family practitioners in healthier lifestyles. He has already lost 25 pounds. What he's done is he's urged participants in his program to get pedometers. These are little devices that you can put on your hip or pant leg and they measure the number of steps you take every day. We actually use them with some of our patients at the Hoffman Center. There's a new program, it's the 10,000 steps a day program. If you take 10,000 steps a day, you probably double the amount of circumambulation that you do, thereby burning off more calories. That may be all it takes to get you to lose weight, to reverse the calorie balance in your thermodynamic equation. If you're not burning enough calories, get a pedometer and do 10,000 steps a day. He's also cut back on carbohydrates like potatoes and bread, although he hasn't gone so far as to embrace the Atkins or South Beach diet.
So, Dr. Michael Fleming, is attempting to make doctors into appropriate role models for patients and I think it's great. Leading by example is important and you can get information about a program called Americans in Motion at the website of the American Academy of Family Practitioners. It's AAFP.ORG on the web or you can check out the President's Council program and he leads by example too. He was pretty active until his knee got a little sore. PRESIDENTSCHALLENGE.ORG outlines steps you can take to increase your physical activity and you don't have to be a marathon runner to pull this off at home.
Doctors start dieting and working out
Americans in Motion. http://www.aafp.org/x22874.xml
President's Council program: http://www.presidentschallenge.org/home_adults.aspx
Here's an item that suggests that if you're suffering from chest pain, the most effective solution may not be an operation or roto-rooter procedure.
The study was done at the University of Leipzig, which is a wonderful medieval city in what was formerly East Germany. You could not do this study in America -- no way, no how. Because immediately when someone experiences chest pain in the United States, particularly if you're close to a major university hospital, you're going to be taken to cardiologists. They will recommend an angiogram. The angiogram will lead to either a decision to perform bypass surgery or you'll get some little metal stents put in your arteries to open them up -- metal or some other material. Now, the stents are coated to keep them open longer.
But this study, they were able to do because it's in Germany. In Germany, spa medicine is popular. You can actually get a medical prescription to go to a spa to detoxify, to eat a good diet and to engage in a program of brisk gymnastics.
Eins - Zwei - Drei, we're going to do some pushups we're going to get on the exercise bicycle and we're going to work out.
Well that's what they did to these folks. Incredibly, a group of 101 men age 70 and younger, they had mild angina during exertion -- this is real heart pain, it wasn't severe or what's called unstable angina which often occurs at rest, unpredictably, that's potentially dangerous. But people have suffered from heart pain long before heart surgery and stents were available. What they decided was they took these folks, randomized them into two groups, one group got invasive angioplasty. The other group was given a daily exercise regimen program; and guess what happened. After a year, both groups reported an improved ability to exercise without chest pain. Although, get this, the exercisers could work out at a higher intensity without pain. Now, angioplasty was immediate relief, it was a quick fix, you've got to admit that, but it was also associated with more complications. In some cases it required repeat procedures. But here's the most significant and salient finding: 88 percent of the exercise group had no heart attacks or strokes. After all, that's the name of the game. We want to prevent heart attacks, strokes or death and 70 percent of the angioplasty group had no heart attacks or stroke.
So actually there were better results in the group that just did exercise. Presumably they got medical therapy, they took medicines, they didn't necessarily all just take vitamins, herbal medicine or some alternative therapy like chelation. But the study suggests that we ought to go back to simple natural methods of coping with mild to moderate heart problems and not immediately send people for invasive heart procedures. It's a study that supports bypassing bypass or bypassing stents if at all possible.
Daily exercise may relieve chest pain
By Jane E. Allen. The Los Angeles Times. March 15, 2004
I've been overeating and my liver is enlarged. My liver enzymes are elevated: AST 110; ALT 152.
A primary benefit would be to, A: Find out precisely what's causing your liver problem. You may need to go to a specific type of doctor called a hepatologist, a liver specialist, and get some tests performed to find out what's going on. But probably it is related to your problem of overeating. A lot of people think: Well, liver problems, well maybe this guy's got viral hepatitis; maybe it's alcoholic liver disease, we don't know. But the most common cause of liver problems in this country is simply overeating, and probably highly influenced by the consumption of fructose.
So get it checked out. Find the cause and then address the cause by modifying your diet. The diet you ought to be following is something along the lines of the Salad and Salmon diet.
The Salad and Salmon is a good diet for combating liver overload due to excessive toxicity. You know the French have a word for this. In French, they call it du foie. A lot of Americans know the word foie because we buy pate de foie gras, that means -- pate is liver and it's made from the livers of geese who are cruelly, deliberately overfed. They put a funnel in their mouths and they put all kinds of grease and fat and starch in their intestinal tracts and their livers react by enlarging, which makes for a good culinary item. But it's not good when you become a Strasbourg goose yourself by overeating and so you need to turn that around.
It's likely that the cause of this problem is dietary. What constitutes a healthy diet is really subject to some controversy these days, especially with the vote of confidence to high protein diets by some studies in the wake of Dr. Atkins pioneering efforts.
What can you do when you have been diagnosed with H. pylori and have been prescribed Prevpac.
Prevpac is a combo of antibiotics plus an acid-blocker that is used to treat H. pylori. H. pylori is a bacteria that's thought to be implicated in ulcers -- that's pretty much been well substantiated -- and in gastritis, but probably only to some degree in GERD, a reflux disease. And in non-specific stomach problems like you have, there's less of a payoff of using Prevpac. There's a high prevalence of H. pylori worldwide. A lot of people feel fine. Probably in this country 30, 40 percent, out of this country 60, 70 percent, people are not dropping like flies and it doesn't pose a danger unless it creates an ulcer or gastritis.
During the time you take the Prevpac, make sure you take probiotics. You've got to take acidophilus which you can get if you're not intolerant to dairy. You can get it from fresh yogurt, preferably the health food store kind that has live cultures in it. Or you can take the supplements of lactobacillus. Other supplements, probiotics, include bifida bacteria that can also help irritable bowel. There are many factors involved with this.
Definitely check out food allergies. Make sure you're eating the right foods. If you're gluten sensitive, avoid that.
With irritable bowel if you're eating the right food and if you've gotten on the right diet and you've treated pathogens like parasites or H. pylori or candida, and you still have problems, the problem may be all in your head. I'm not saying that you're a head case, a nutty person, but there are a lot of nerves in your intestinal tract. And some people just have nervous stomachs, nervous digestion, and it's all hooked up to stress.
I am holding in my hands a copy of a paper that I think has important implications for a lot of people suffering from irritable bowel. This study done in England proves something that we have known for a long time which is that hypnotherapy can be beneficial for irritable bowel syndrome. And this is not a parlor trick. This is not something where they turn you into a quacking duck in front of a nightclub audience for entertainment purposes. This is a medical treatment. 71 percent of patients with irritable bowel syndrome responded well to therapy and that's a very high percentage, suggesting you can get yourself to a place where they offer a good program of relaxation biofeedback or hypnotherapy, once you've taken that Prevpac and you've resolved the H. pylori, you might even get greater improvements.
What causes premature ventricular contractions?
PVCs are due to a couple of factors. One is you may have a little bit of a loose wire in the electrical system of your heart. Normally, there are conduction systems, really they're nerves, tiny and invisible within the heart wall itself and sometimes those wires get frayed. And another thing that promotes PVCs is fluctuations in your level of adrenaline and some people have poor regulation of their adrenaline system. They have a lot of spurts of adrenaline that may affect their body in many ways. It may speed up their heart rate it may cause skipped beats. It may cause transient sensations of nervousness or disruption and this is the regulation of what's called the autonomic nervous system which is automatic and not so much subject to voluntary control. So that's what's going on with you.
Magnesium levels have an impact. We even think that the intake of certain essential fatty acids may have an impact on that because omega-3 fatty acids may help coat the nerve cells. They may fatten the nerve sheaths in the proper way to insulate them so that you don't get that frayed wire effect. So there are some things that you can do nutritionally. Keeping blood sugar stable is very important because ups and downs of blood sugars will give you a power surge, will cause you to skip beats.
Sometimes food intolerances can do this. Some people regularly have PVCs when they eat certain types of foods. Alcohol will do it, caffeine will do it. Certain types of medication like decongestants are murder for people who have PVCs because they actually have a speed-like effect. Asthma medication will do this. They have to be careful in a variety of settings.
What should we do about abnormal fasting glucose ?
Well, here's the problem. First of all, if you have a fasting glucose of 110 or more, that's trouble. It's not actually diabetes but it's called IFG, which is impaired fasting glucose. Impaired fasting glucose doesn't necessarily mean diabetes but it does mean you're likely to have what's called Syndrome X insulin resistance, and that's trouble in the making. And that's actually a new designation by the powers that be that set parameters for optimal health in this country. They are actually recognizing the fact that -- they used to say, don't worry unless your blood sugar is over 120, or -30 or -40 on a fasting test. They missed a lot of people that way. But 96 is quite well within the limits.
But if you want to find out exactly what's going on, have your wife get a simple test called a glucose tolerance test with insulin levels. It's important to measure the insulin because even if the glucose is normal, you can actually have an overproduction of insulin that reflects a tendency to move towards diabetes and Syndrome X. That's a test that we do fairly routinely in some of our patients and even in young, thin, healthy appearing patients we sometimes see departures from normal and we can head those off at the pass and deal with it dietarily, exercise and with nutrients like chromium, vanadium, alpha-lipoic acid, fish oil, magnesium, vitamin E; all of these things help restore insulin sensitivity to the body.
Another indication is gestational diabetes or abnormal blood sugar, two hour glucose tolerance tests that a lot of OBGYNs do when women are pregnant. That's often an indication that there's trouble down the line for women as they get to be 40 or 50 or 60. If they've had big babies, or if they've had impaired glucose tolerance during pregnancy, that's a sign of trouble brewing on the horizon.
What do you suggest for recurring fever blisters?
Fever blisters are often related to viruses. And if you're taking even a very conservative prenatal supplement -- because, usually prenatal supplements are pretty weak because they don't want to give you mega doses of anything that might be harmful to the fetus -- that might just give you enough immune boosting to help your body combat the effects of the virus. So really, what you ought to do since you're not pregnant is focus in on the nutrients that have anti-viral effects. The key ones are zinc, selenium, vitamin C, perhaps some vitamin A -- but don't overdo it on vitamin A because it can be toxic. And consider other things that are less common, things that support the immune system, things like echinacea. Now they have a supplement called My Defense, which is endorsed by Magic Johnson made by Natrol which contains Larch extract. Larch is an immune enhancer that -- we're not saying it's so powerful that it blows away the AIDS virus but it has an anti-viral effect, an immune enhancing effect. And also consider food allergies because intake of certain foods may promote the growth of Herpes viruses. We put people on low arginine diets and add lysine. That usually consists of avoidance of foods like nuts but taking supplements of Lysine to give you an anti-viral effect.
How would you treat a five months old baby who developed eczema after her mother stopped nursing her and gave her formula whose father has eczema?
In this case, the father is carrying a gene that makes the kid susceptible to allergies. And I've actually talked about this, the whole concept of allergy-proofing your child if one or the other or both parents have allergies. An important concept is that you want to withhold the introduction of the following five or six foods at least prior to six months and preferably longer. And these foods are cow's milk, wheat, corn, tomatoes, eggs and unfortunately, soy is often on that list because these are among the most allergenic foods. I probably should throw peanuts in there. It suggests that there's nothing left but there's actually a pretty good complement of foods that are available that circumvent those restrictions.
Surprisingly, breast feeding, while it seems wholesome, is not entirely protective because it appears that, according to dictum, you are what you eat. In this case, you are what you eat eats. And when baby eats mother's milk, and mother eats some of the offending foods, the baby can actually get introduced to some of the food allergens.
A small amount of Culturelle could also help to get rid of potential yeast overgrowth or overgrowth of harmful bacteria which may stimulate eczema. And also recently a study that looks at primrose oil or borage oil, GLA is the active ingredient. There's a study that's disappointing, suggesting that GLA could not prevent eczema. We used to think of GLA as an anti-eczema agent. I don't think the word is out on that yet. But there's probably stronger evidence for the use of fish oil as an anti-inflammatory in eczema. So fish oil in the diet of mom if mom is breast feeding, a little bit of added fish oil to the formula and now formulas are containing DHA and EPA. It's been a long, upward battle but the FDA has finally okayýd infant formulas containing these useful fatty acids and they actually help to reduce inflammation in the body.
The only lingering thing I have over the last couple weeks of finishing chemo is that my finger nails are extremely painful. And I can't figure out why.
Cancer chemotherapy attacks rapidly growing cells and the most rapidly growing cells in the body are cells in the hair and nails and that's why a lot of patients develop alopecia or baldness or nail abnormalities. And the suggestion is that if you didn't at all develop those abnormalities, you might not have had chemotherapy that's worth its salt. If I were to suggest things that prevent hair from falling out or keep nails completely in tact, I'm not sure I wouldn't be doing a complete disservice to the administration of the chemo, maybe getting in the way of its efficacy. But I can suggest that now that you're done, you may want to make use of some of the nutrients that help nails grow better. And one key nutrient is biotin. It's a B vitamin. It's kind of a forgotten stepchild of the B vitamin family. But biotin is especially important in the growth of hair and nails. And you're going to need fairly high doses of Biotin at least 3,000 to 5,000 micrograms or 3 milligrams to get that effect. Actually, the discoverer of these effects of biotin was a fellow by the name of Hoffman. It wasn't me, it was a guy in Switzerland. Consider that, also consider a full range of the supplements that help tissue growth, the B vitamins, the rest of the B vitamin family, vitamin C and zinc. Make sure that you get adequate protein, especially protein containing the amino acids cysteine and proline, those are the things that essentially you can get by taking gelatin. You might even try a little Knox Gelatin because that supplements part of your amino acid profile that's more for nail growth. Knox Gelatin, not good as a general protein supplement but after all, since it's made from hooves, it will help your hooves grow better.
I have a question. In December, my husband was diagnosed with atrial fibrillation. And they have no idea why. He has no coronary heart disease
DR. HOFFMAN: They usually don't know why, it just kind of develops.
CALLER: Can you tell me if major trauma or stress can cause that?
DR. HOFFMAN: Yes. You know heartache is definitely very real.
CALLER: And what about physical stress?
DR. HOFFMAN: Well potentially, although, I guess there are instances of people who exert themselves in the gym or in a marathon or who have the physical stress of a very restrictive diet. That's a form of stress too, you know somebody who fasts or does something like that. They can occasionally come up with cardiac arrhythmia. The type of stress that often precipitates atrial fibrillation -- excessive consumption of caffeine or certain drugs like decongestants which have a speed-like effect. Even ephedra, which has been banned in many states, actually can cause many types of arrhythmia to come to the fore. Nutritional deficiency may damage the heart by depleting you of certain crucial minerals like magnesium or potassium, certain drugs will do that. Diuretics will do that. But sometimes atrial fibrillation comes on its own. One other form of stress is a condition of hyperthyroidism which sometimes develops unnoticed until it puts somebody into a cardiac arrhythmia. So rather than ask the question why, let's deal with the question what to do. What is he doing?
CALLER: He's on Toprol. And he's also on Coumadin but a large dose because his body seems to eat it up. He's on 20 milligrams one day and 10 milligrams the other day. My concern is actually he's kind of an athlete. Not overdoes it, but he's an avid cyclist. And I'm very, very concerned with the season coming up now of him riding while he's on so much Coumadin.
DR. HOFFMAN: Yes, I guess the concern is if he cracks up and he's on a blood thinner that the results may be more calamitous shall we say. This can happen if you have a sprain instead of being simply an aching joint you could have some bleeding into the joint. If you fall off the bike and get a laceration, the bleeding would be harder to stop. But that should not preclude him from being active and perhaps a little bit more cautious, a little bit less over the top. And unfortunately, it's important to be on a blood thinner if you have episodes of atrial fibrillation because the alternative is to throw a blood clot up towards the brain and cause a stroke.
There is no substitute, unfortunately, for this drug and there's no 100 percent guarantee that he's not going to flip in and out of atrial fibrillation. So the blood thinner is important. I urge him to remain physically active because I think it's important for his overall health and well-being and for his morale and mental status. But it just argues for just a little bit more caution and I would suggest -- and I always suggest this -- for cycling, make sure he's fitted for a good quality helmet. So if there's a head injury, might just be a bump on the head, there's not more serious bleeding that could actually cause bigger problems.
March 22, 2004
PowerBar found Maxwell collapses, dies at 51
New studies cast doubt on artery-opening operations
by Gina Kolata. The New York Times. March 21, 2004
Of drunken elephants, tipsy fish and scotch with a twist
by Carol Kaesuk Yoon. The New York Times. March 22, 2004
To improve prostate-cancer detection, doctors approach to testing
by Tara Parker Pope. The Wall Street Journal. March 22, 2004
Big families mean big waistlines for mom and dad
Journal of Women's Health. January/February, 2004
March 24, 2004
Low B-12 levels linked to increased rate of bone loss
J Clin Endocrinol Metab. 2004;89: 1217-1221
March 25, 2004
Ascorbic acid arrests or improves symptoms of Charcot-Marie-Tooth Disease in mice
Nat Med
Food additives may trigger stuffy noses in some
Allergy, February 2004
Vitamins could help 2 billion kids
Cutberto Garza. UNICEF
Walking 15 minutes a day won't prevent obesity
American Journal of Public Health, March 2004
Skin care products may contain food allergens
Dr. Kelly Newhall of Children's memorial Hospital, Chicago
March 27, 2004
Traffic reduction may lead to fewer stuffy noses
Occupational and Environmental Medicine, March 2004
Here's a study from Great Britain that suggests that another form of congestion can lead to congestion and that congestion is traffic congestion. They studied a small town in North Wales and they found that after construction of a bypass that took traffic around the residential district of the town, that there was a considerable reduction in runny nose, sneezing and itchy, watery eyes. I guess that's not too surprising but it's often an overlooked cause of congestion symptoms.
A study showed that individuals who consume foods laced with preservatives who suffer from sneezing, nasal congestion, and symptoms of allergy, that a certain percentage of them can eliminate these symptoms by avoiding such preservatives as sodium benzoate.
I was cruising around the market yesterday, looking at foods. And a high percentage of foods, like pickles and various types of sauces, contain sodium benzoate preservative. And elimination of the sodium benzoate can relieve symptoms in a percentage of people.
Acupuncture treats chronic headache
British Medial Journal, March 14, 2004
Here's a study on headaches and acupuncture.
You know, a lot of people believe that acupuncture is going to help their headaches. In fact, some of the oldest anthropological evidence when they dig up the bones of prehistoric man suggests that ancient doctors actually administered very, very complex forms of cranial surgery on parties, presumably with prehistoric forms of headache. Maybe that was the origin of acupuncture. They actually see skull evidence that, perhaps they were trying to let the evil spirits out of the heads of people suffering from chronic headaches.
But acupuncture commonly used for headache -- does it really work? Big study in the British Medical Journal March 14, 2004. Acupuncture is, according to study, a useful cost-effective treatment for patients who suffer from chronic headaches or migraine. Patients receiving acupuncture had 22 fewer days of headaches per year. They used 15 percent less medication and made 25 percent fewer visits to their family doctors and took fewer days off sick than the other group. There weren't many side effects. The treatment was cost-effective. In other words, it doesn't make sense if there's an alternative to taking an Excedrin and going for a $50 acupuncture treatment.
Diet can affect non-Hodgkin's lymphoma risk:study
American Journal of Epidemiology, March 1, 2004
This is a study that looks at the relationship between diet and a certain type of cancer.
A preliminary study in the American journal of Epidemiology, finds that there may be a downside to massive amounts of animal protein and saturated fat. This study compared women who had the lowest levels of animal protein and saturated fat in their diet with those who have the highest levels and they found that high levels of protein and saturated fat were associated with a high risk of non-Hodgkin's lymphoma. This is a serious medical problem. We're beginning to have better treatments for this condition but there's still no quick fix. The increase was 70 percent for high levels of animal fat and 90 percent for saturated fat and they discovered that there was a 40 percent reduced risk for those who had high levels of polyunsaturated fat in their diet. Polyunsaturated fats would include fats from vegetable oil and from omega-3 fatty acid sources.
Also looking at the relationship between mono-unsaturated fat, olive oil, Mediterranean diet -- there was no real association. High levels of vegetable protein were neither protective nor were they contributory to high levels of non-Hodgkin's lymphoma.
It's a correlation; it doesn't mean it's the fat or the protein that cause the cancer. It may be that people who take in lots and lots of animal protein may take in other undesirable environmental chemicals that are locked within the fat of animals. That's where a lot of harmful environmental chemicals -- hormones may be sequestered in animal tissue. And it may be that if the same study were done with organic or range-fed animal protein that there would not be such a correlation because we've seen in the past that lymphomas are related to chemical exposure. The study suggests that larding on the lard may not be beneficial in at least one type of cancer.
Pumping iron improves insulin effects in diabetics
Diabetes, February 2004
According to an article in the most recent addition of the medical journal, Diabetes, strength training is very helpful for diabetics.
This study from Diabetes shows that the effects of insulin are increased with just six weeks of strength training, three times weekl. In addition to increasing muscle mass insulin appeared to be more effective. So whether it's your own insulin or whether it's insulin you take because of a medical need or diabetes, strength training can be beneficial. It also slows the loss, the inevitable loss of muscle mass that occurs at about the rate of 10 percent with each decade of life after the age of 40. After the age of 40, you go into what's called catabolic phase, where you actually lose muscle mass. And you can reverse that particular effect of ageing by a routine exercising program.
But here's a caveat before you start pumping iron, you get overzealous. First, get a doctor's checkup to make sure that you don't have a medical condition such as poorly controlled hypertension or heart problems or brain aneurism, which could make excessive strength training problematic for you.
School junk food
www.feingold.org
Here's a press release that suggests that reducing school junk food reaps unexpected benefits -- students behave and focus better. The Center of Disease Control and Prevention have just announced that unhealthful diets and physical activity will soon become the leading cause of preventable deaths, surpassing smoking, because the resulting obesity epidemic continues to sink our economy, bankrupt social security and Medicare. A lot of these problems start in childhood.
In response, the nonprofit Feingold Association has launched a new website -- I recommend that you go there, it's www.school-lunch.org -- on how and why to improve school food.
According to spokesperson Jane Hersey, she says we've found that the cutting out of unhealthy foods has the added benefit helping children focus and behave better. I've seen this too in my practice as we treat a lot of kids with autism, attention deficits, with difficulty focusing and performing in school. Evidence to support that, is that school test scores rose dramatically in New York City between 1979 and 1983 when sodas and foods with artificial colors and flavors were eliminated from schools.
The website www.school-lunch.org also describes the experience of several British schools that had remarkable success with additive-free school food programs. There was one in which they found that additives cause one in four children to have tantrums. After a two-week trial banning 27 additives, the staff noted a marked improvement in student's behavior and concentration levels and decided to ban all synthetic additives from all school meals.
Another study showed this involving twins, which is interesting. You take twins -- you figure well, genetically they're the same. So you take one twin and put him on a food-additive-free diet and leave the other twin on a normal diet. They found that there was an adverse effect of preservatives on children's concentration and IQs. The Feingold Association has persuaded Fairfax County, Virginia, which has one of the largest school systems in the United States, to remove harmful additives from school food. The food additives in question include synthetic food dyes, artificial flavorings and the preservatives BHA, BHT and TBHQ as well as MSG.
So you can get information and guidelines and support in your efforts to make an impact on your child's school district with regard to these, what I consider very harmful and brain addling substances. We don't really need them in kidsý foods, why are we feeding kids chemicals?
PETADOLEX:Butterbur root (Petasites hybridus extract) in the treatment of asthma-an open trial
Alternative Medicine Review. Vol. 9, No. 1. 2004. pp.54-62
A new herb is showing benefits in the treatment of asthma. We're always looking for new agents to help us with asthmatic problems. Magnesium, fish oil, vitamin C, all of these are part of our armentarium, our natural armentarium against problems of lung inflammation and lung spasm and allergy.
But a couple of new studies look at the effects of an herb called common Butterbur in dealing with asthma, and the studies have appeared simultaneously in a couple of medical journals. Butterbur is used quite a lot in Europe to treat both migraines and chronic nasal congestion. The product that is frequently used in Switzerland, Austria and Germany is Petadolex. Petadolex has actually been shown to be approximately as effective as common non-sedating antihistamines like formerly used Seldane, which is now replaced by other antihistamines. But in a study done in Europe, it worked about as well in the treatment of seasonal allergic rhinitis.
Some good studies in migraines. We use Petadolex sometimes when Feverfew is not effective in migraine patients but it makes sense to look at Petadolex or Butterbur extract in asthma because it's effective for chronic nasal congestion, perhaps it has an affect on asthma.
A big study in Alternative Medicine Review suggests that 40 percent of patients using asthma medications reduced their intake of these medications by the end of the study when they were given Butterbur extract. The product is Petadolex and another study in a medical journal called Clinical Experimental Allergy shows changes in a lot of measures of the severity of asthma. I'm not going to bore you with the technical details, but there are ways to measure the severity of inflammation levels of eosinophils which are allergic cells in the blood. These are high-tech methods for determining the severity of asthma.
Well, after treatment with Butterbur, and these patients were using asthma medications at the same time, they got an added benefit when they were taking Butterbur. So the suggestion in these studies is that Butterbur is not a magic quick-fix that will completely eliminate the need for medications. But it can reduce the need for medications and improve the status of chronic asthma patients. The product, Petadolex. 800 456-9384
We've been talking about an ultra-potent extraction of green tea called EGCG. It's epigallocatechin gallate, is a major compound found in green tea and we've extolled the benefits of it. It's helpful for cardiovascular protection. It has anti-cancer effects. It has anti-inflammatory effects and it will also help to promote thermogenesis -- which is fat burning -- and it will also bring you the afternoon paper when you come home. No, it doesn't do that. But it's amazing how versatile this nutrient is.
Here's another study that shows it has an additional unanticipated benefit. The study is from Japan where they do a lot of green tea research. They found that EGCG, when combined with standard antibiotics which are used to treat H.pylori -- that's the bacteria that's thought to be responsible for ulcers, gastritis, many stomach problems, even gastrointestinal lymphoma -- that EGCG enhances the effects of the antibiotics, creates a higher killing rate for the H.pylori harmful bacteria.
So the conclusion is that EGCG may be a valuable therapeutic agent against H Pylori infection. The good news keeps rolling along.
There's an article in this month's edition of Alternative Medicine Review on erectile dysfunction. And you think, well this is a magazine about herbs, vitamins, supplements, and they're and they're going to come in with some ringing endorsements for all the natural products that make men more potent. And they review things like Yohimbe, and they review Ginseng and maca and ginkgo biloba and DHEA and tribulus terrestris, these are all things that are purported to be beneficial for producing erections.
And what they say is that these things may have mild effects but in general, the studies that are used to support their use are from foreign countries -- sometimes foreign countries which are not particularly well regarded for scientific voracity. And there's a commercial interest they support and so it's easy to sometimes buy a study. A poor researcher in Bulgaria will write you a study for a few hundred bucks. Just to give you an example of the flavor of their review: They say several studies of questionable worth are used to support the pro-erectile effects of tribulus. Due to the absence of quality research on DHEA and tribulus, there's minimal information regarding the long-term safety or effectiveness of these agents when used to treat erectile dysfunction. And what they're saying here is that Viagra offers the first, orally-effective symptomatic treatment of erectile dysfunction, and it works.
But other things, L-arginine included, may in some way, at least theoretically benefit the process underlying erectile dysfunction. But they say these substances are far from providing a magic bullet, and I'm quoting here: "or cure for ED. Practitioners and consumers should not be fooled by unsubstantiated claims made by the manufacturers of natural agents to treat erectile dysfunction." And I commend this journal, Alternative Medicine Review, because it's an unbiased and dispassionate look at this field, which is unfortunately ridden with fraud and exaggerated claims.
Caller: I had talked to you before and you said I should check with my doctor, which I did. I'm on niacin, fish oil, and also I've been taking plant sterols to lower my cholesterol. I couldn't handle statins, they were just throwing me for a loop.
DrH: Just for our listening audience, what were your symptoms you experienced with the statins?
I was just very weak. I was having leg cramps, I'm a runner and a weightlifter, not like Arnold Schwarzenegger. You're not a sickly guy. You're not like an elderly bed-bound patient with kidney and liver failure, yet the statins knocked you for a loop anyway?
Well they did. I felt like I had the flu all the time. I really gave them a try but I just couldn't handle them. So I called you up and you said check with your doctor, which I did, and I'm able to handle the niacin and the fish oil and the sterols and it seems to help quite a bit.
How much has it lowered your cholesterol?
Well, I also took your suggestion about the salmon diet and that helped a lot too. I went down from an average of probably and 240, 250 and I'm down to 173 now.
That's great, you're just doing fabulous.
And LDLs are down to 101 from way, way up there around 185. Something like that.
The good part of this is that you reduced only the bad cholesterol and you maintained and maybe even increased the good cholesterol. So your profile has just done a 180, it's fabulous, without those ubiquitous statin drugs.
Yes, sir. And I was just wondering if you thought that maybe -- I'm at the -- 500 of niacin, is recommended. I was just wondering if you thought that if I increased it a little more, I could even improve more.
The question is whether you need to improve more. Chances are, unless you have had a heart attack or needed a stent, or if you have signs of severe blockage or diabetes, these are circumstances where we're going to play the cholesterol limbo, which is, how low can you go.
Lower and lower levels of cholesterol seem to be beneficial for people who have advanced plaque formation in their arteries but with you it sounds like you're on a preventive regimen. You want to prevent problems from developing. You've got your cholesterol down to 175, that's quite a good level for prevention. Your LDL is at 101. I wouldn't get overzealous here. If you're curious as to whether you have plaque, a test that might reveal that is something called the ultra-fast CT scan. I ask many of my patients in situations comparable to yours to do that because it kind of gives us the heads up because if you have a lot of plaque unbeknownst to us, we may have to be more aggressive.
But if you have minimal or zero plaque, what you've done is quite adequate to assure prevention going forward. And you're doing well with minimal amounts of niacin. 500 milligrams, I think is sort of a starting run for effective niacin dosing to lower cholesterol. And that probably isn't going to cause too much in the way of side effects, flushing or potential for liver problems.
Caller: I have a question for my son, 24, Allport's Disease since he was born. Basically he was biopsied, he's been on dialysis in some form for about a year now. The problem is that the diet that this team recommended is just like to me, it's hard to understand. They're pushing things with a lot of sugar with no concern for nutrition and I'm just wondering if there's anything supplemental or dietary that you can recommend.
DrH: What is recommended for someone on dialysis is a low protein diet because, obviously, eating lots of protein will create waste products in his bloodstream that his failed kidneys can't handle and then will require him to have more frequent dialysis. And in the intervals between dialysis, he may experience some difficulties with the toxic effects of the protein waste products.
So the low protein diet, there's no question that's a better way to go when you're on dialysis. The only problem is when you encourage poor quality or junky carbs as an alternative to protein. That's not good either. And you may want to go to a little bit more of a, perhaps a more holistic nutritionist. He's not going to say, "Eat the Atkins diet." That wouldn't be good. But he would suggest higher quality complex carbs in the diet.
Now, the problem with certain types of carbohydrates on this diet is that certain carbohydrates are laden with potassium and magnesium and these are ordinarily good for most people. But again, that's a problem on dialysis. It is a problem that's the most difficult and challenging assignment for nutritionists to come up with a diet that is nutritional and healthy, but is not harmful when your kidneys are not properly filtering.
I'll give you suggestions for a couple of nutrients that are very helpful when you're on dialysis. Generally, dialysis patients run very high homocystine levels. Get your son's homocystine levels checked. Make sure he gets adequate B12 folic acid and B6 to lower those homocystine levels to less than ten and also encourage the use of Coenzyme Q10. And we often use carnitine in patients who are on dialysis because their carnitine levels are low and they feel crummy -- they feel tired because there's not enough CoQ10 in carnitine for energy metabolism in the body's cells.
Caller: I'm going through perimenopause and I'm losing my hair, nerves, and I went to --
DrH: You're losing your hair and your nerves at the same time.
Yes, at the same time.
Your nerves are falling out by the handfuls --
I went to the doctor yesterday, endocrinologist, and she was going to test my hormones and their fluctuation and the reason for the hair loss. And she explained to me that basically they can't tell if you're going through menopause through your blood test.
That's correct. If you're just simply in perimenopause, what happens is you're kind of on a hormone roller coaster. You may actually have, on certain days, very normal levels; on other days, no hormones; on other days, a massive outpouring of hormones. And that's why it's such a tumultuous period. It's not just like turning off a light when a woman goes through menopause or even using a dimmer switch. It's kind of like you're in a period of instability, and that's what affects you mood-wise, weight-wise, appetite-wise. It's a tumultuous period. It creates a lot of speed bumps for women. Whatever your potential Achilles heel is, health-wise, you may experience a worsening of that during perimenopause.
Anyway, so what else did she say?
I was asking her about the bio-identical hormones, once they find out if my hormone levels are abnormal, and she wasn't up to date on that. Do you know anything about that?
Yes, absolutely. We've been using bio-identical hormones for at least 15 years. Bio-identical hormones are hormones that really attempt to mimic the hormone profile that men and women have before their hormones change, before menopause or andropause. And generally, when you're using hormone replacement, you get better results and they probably are safer.
But you have to go with a certain amount of the scientific rationality here, because if there are studies that show that artificial hormones have adverse effects when you continue them after menopause, you can't just suppose that natural bio-identical hormones aren't going to have those potential cancer enhancing effects. They probably are safer. It's probably better to use an estrogen that mimics a woman's natural estrogen than to use an estrogen that's derived from a horse that's synthetically modified. But if possible, you'll want to go through menopause without the use of hormone replacement therapy.
If you're suffering, obviously from the tortures of the dammed, really bad symptoms of menopause that don't respond to Black Cohosh, to diet modification, getting your blood sugar stabilized -- there's Chaste Berry, that's helpful for some women with menopausal symptoms. There's natural progesterone, which can be applied topically to the skin. There's vitamin E and GLA from borage oil that are often helpful for menopausal symptoms -- magnesium is a benefit.
There's a lot of things that can be done. And if you don't respond to some of these natural things then you may require a look at hormone replacement therapy. And if you did, it would be with the bio-identical hormones. That's what I would prefer.
A good book by Jonathan Wright, called, I think it's called Natural Hormone Replacement Therapy. And you probably can get it through -- if you can't find it through a local book store, you can probably order it through AMAZON.COM, BARNESANDNOBLE.COM. It's a book that's still in print and it gives you a lot of information on natural hormones. Natural hormones again, you have to be careful because hormones are hormones whether they're natural or synthetic.
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