Posted on 23. Oct, 2010 by Kerry D Friesen, M.D..
The brain explains it all!
HOW TO BALANCE YOUR BRAIN’S BIOCHEMISTRY
1. TAKE the test
2. DISCOVER your deficiency
3. SELECT the Neuro•Brand supplement that’s best for your brain!
Neurotransmitters allow brain cells to communicate with one another and everyone knows that communication is the key to a healthy relationship.
The sense of well-being that healthy people describe is just a natural consequence of the brain having an abundant supply of the building blocks required to make a steady supply of essential neurotransmitters.
While there are more than fifty “neuroactive” compounds that scientists are aware of, the four following neurochemicals determine everything from mood, motivaton to memory and learning!
Take the test; score your result and decide what neurotransmitter deficiency has been determining your destiny—you’ll be amazed.
Here are the four neurotransmitters you need to know about:
Dopamine—GABA—Acetylcholine—Serotonin
DOPAMINE
1. I have struggled with my weight for years
2. I crave sugar even though I continue to gain weight
3. I have little reserve energy and feel exhausted most days
4. I have little sex drive
5. I sleep too much
6. I have a personal history of addiction (alcohol)
7. Getting out of bed in the morning is a chore
8. My spouse complains about my lack of sexual interest
9. On occasion I am exhausted for no apparent reason
10. I have cravings for prescription stimulants (amphetamines) or cocaine or Ecstasy
GABA
1. I frequently feel anxious
2. People tell me I have cold hands
3. I suffer from frequent headaches and backaches
4. I sometimes sweat too much
5. I feel shaky inside
6. I sometimes feel dizzy
7. I feel tired even after a good nights sleep
8. I frequently overeat
9. I often feel nervous inside
10. I experience heart palpitations
ACETYLCHOLINE
1. My memory is failing
2. I often crave fatty foods
3. I seldom exercise
4. I feel as though my body is rapidly aging
5. I have less muscle tone
6. My breathing has changed
7. My ability to recall names has decreased
8. In the past, I have experimented with hallucinogenic drugs (LSD, psylocibin)
9. I suffer from insomnia
10. I am less cheerful
SEROTONIN
1. I have difficulty sleeping
2. I never feel like exercising
3. Mostly I am sad
4. I have difficulty falling asleep after I wake up
5. I am a “salt craver”
6. I have night sweats
7. I change sleep positions through the night
8. I have dificulty relaxing
9. I wake up several times through the night
10. I always wake up early in the morning
Key Code: Add up the “TRUE” responses and multiply by ten.
Anything less than 50 is considered a minor deficiency.
Between 80 and 100 is a major deficiency and immediate action is recommended.
If you score between 50 and 70, begin the supplement program and retake the quiz in one month. Consider asking your doctor for more help if you are not feeling better soon.
Call for an appointment if you are not certain what category is appropriate for you, or, if you have other medical problems.
Posted on 10. Oct, 2010 by Kerry D Friesen, M.D..
Why Neuropeptide Y?
If you’ve been to your doctor and received a “cortisone shot”, then you have experienced first hand the profound appetite increasing properties of Neuropeptide Y.
The voracious increase in appetite associated with cortisone-like medications, parallels exactly what happens when Neuropeptide Y (NPY) is released from the hypothalamus as part of the “fight or flight” or stress response.
Our brains are designed for protection and survival, (after all what’s more important than the human brain?). At the same time, we are “hard-wired” for hunger.
Consider if you will, a time in human history when food was scarce either by siege, famine, drought or natural disaster. Imagine in your mind’s eye, seeing a war-torn landscape; a plague-infested village, or the apocalyptic devastation of drought.
The very real threat (and stress) of starvation flips the survive-at-all-cost switch deep within the hypothalamus that in turn unleashes a torrent of Corticotropin Releasing Hormone (CRH). CRH then acts on the tiny but powerful anterior pituitary gland, triggering the release of an overabundance of the ultra-potent adrenal gland stimulant, ACTH (stay with me almost there).
Doing what it does best, ACTH (AdrenoCorticoTrophic Hormone), squeezes every last drop of cortisol it can from your adrenal glands, forcing your brain to flood your hypothalamus with the “I’ve got to eat right now,” Neuropeptide Y! From a pure survival perspective, what kept you alive in the above scenario, was the ability of Neuropeptide Y to decrease your energy needs, ( you’re starving remember?), stimulate appetite, (forcing you to look for food) and accelerate the storage of fat.
Great if your under siege, not so great if your living in 21st century America.
A Fatal Food Coma
Today, food is abundant—and so is stress. And nothing, increases stress like loss of control. It makes little difference whether it’s loss of financial, social, career or personal control, all have the same ultimate outcome—more stress.
Your perception of stress, however, does make a difference. It’s why jumping out of a plane, (skydiving) can be exhilarating for one person—and sheer terror for another. More on this later.
Today, psychosocial stress, combined with an abundance of never-before-seen, high fat, high sugar, over-salted foods, have pushed global obesity and Neuropeptide Y levels to an all-time high. To make matters worse, scientists have discovered that NPY exerts an anti-anxiety and hypnotic effect on the brain and in some animal studies, estrogen enhances that effect.
By using refined food as a “self-soothing” tool, we may unwittingly be hooked on the hypnotic and anxiety relieving properties of Neuropeptide Y.
Suddenly the concept of “food coma” takes on a whole new meaning. As a general rule, we are the worst barometers of our own stress levels. For the first time, the combination of chronic stress and the uninterrupted flow of Neuropeptide Y in the brain, may explain why some people are unable to sense the severity of the physical and emotional burn-out looming on the horizon.
Kicking The Chronic Stress Habit
Ironically, thanks to significant advances in science and medicine, we now live long enough to worry ourselves to death. And yet even more amazing for some, enduring the negative effects of stress is preferred to sane-living and self-care. Some worry that they may be perceived by their peers as unproductive or under-employed if they are not over-booked and near-exhaustion.
I’ve come to recognize the symptoms of “stress addiction” in my patients. Typically, stress addicted people are unable to separate their real identity from their occupation. They confuse “who they are” with “what they do” regarding themselves as indispensable. Stress addicts seldom exercise; are constantly on the phone; consider asking for help a weakness and will continue on the same path even as their weight increases and their health declines.
While you can never entirely eliminate psychosocial stress, regulating the brain’s response to stress is the key to regulating appetite, other addictive behaviors and achieving and maintaining your optimal weight.
Here are some stress reducing tips to help normalize Neuropeptide Y levels in your brain!
Now you know the “why” of Neuropeptide Y.
Posted on 26. Sep, 2010 by Kerry D Friesen, M.D..
Supports Healthy Dopamine Levels in the Brain
GLOBAL OBESITY
“Globesity”—it’s how the World Health Organization describes the current global obesity epidemic.
Worldwide, one billion overweight people now outnumber the starving.
Here in America, with sixty-six percent of adults and thirty-percent of children overweight, scientists predict that for the first time parents may outlive their children.
ASK YOURSELF WHY
After twenty years of practicing medicine and hearing the plight of thousands of struggling overweight patients, I have often asked myself, “Why would someone continue to knowingly overeat with the threat of high blood pressure, diabetes, heart attack, stroke or cancer looming on the horizon?”
Years later I would discover that this is the hallmark of addiction.
THE BRAIN EXPLAINS IT ALL
While obesity may be a complex and confusing disease and scientists continue to look for other explanations, one factor has emerged above all others. There is a striking similarity in the use and abuse of highly refined and processed foods–sugar, fat, salt and the drugs of abuse.
For example, everyone has heard of the tendency for people to gain weight once they stop smoking or drinking. In essence, they have replaced one addiction with another. This observation has led neuroscientists to ask the question: “could it be that, food and drugs of abuse compete for the same brain pathways?”
OXYCOTTON CANDY©
As it turns out, highly processed foods, including sugar•fat•salt, trigger the same reward system of the brain as addictive drugs.
In fact, in the rat brain, table sugar is powerful enough to produce a pain-killing effect by binding to opiate receptors as a kind of “OXYCOTTON CANDY.”©
For some, just seeing certain foods can increase dopamine levels in the brain. Once the addictive food is eaten however, dopamine levels drop, leading to despair, disappointment and craving for more food.
“Dieting” only perpetuates the cycle of deprivation, desire and bingeing, all the while depleting dopamine levels and strengthening the addiction.
DOPAMINE AND THE REWARD CIRCUITRY OF THE BRAIN
Mood, motivation, memory, sleep, sexual arousal, reward, punishment and the regulation of appetite, are all the work of the brain chemical dopamine.
Dopamine is so important to proper brain health, it has it’s own eight-lane
superhighway of neural networks!
This superhighway however, now has competition.
Never before have so many high fat, high sugar, high salt foods, been so readily available.
Scientists now know from animal studies that, that bingeing on sugar every day elevates dopamine levels in the brain and ultimately leads to symptoms of withdrawal if bingeing is prohibited.
THE LEPTIN-DOPAMINE LINK
Just as a household thermostat regulates temperature, leptin, (from the Greek word leptos meaning thin), is a protein synthesized by fat cells that signals the brain when we are full. Dialing down the “appestat” turns down appetite and encourages careful eating.
But, leptin can only work if sufficient dopamine is present in the brain to communicate the sensation of fullness.
According to the most recent brain imaging studies, if you are overweight, then you are already dopamine deficient!
NEURO•MEND for a Balanced Brain and a Balanced Body
Two NEURO•MEND capsules per day, contain the essential amino acid dl-phenylalanine and the amino acid tyrosine, required to produce the brain energizing benefits of dopamine.
Siberian Rhodiola rosea is a potent neuroadaptogen, neutralizing brain stress and relieving symptoms of depression. As a mild Monoamine-Oxidase inhibitor it naturally elevates serotonin, dopamine and beta-endorphins in the brain.
L-methionine actively regenerates critical dopamine receptors, while octacosanol enhances oxygen utilization throughout the brain.
DL-Phenylalanine ……………………………….. 300 mg
L-Tyrosine …………………………………………. 200 mg
Rhodiola rosea extract …………………………… 75 mg
(standardized to contain 1% rosavins)
L-Methionine ……………………………………….. 60 mg
Octacosanol …………………………………………… 2 mg
©Many thanks to Dr. Farrago for the irreverent analogy
Posted on 01. Dec, 2009 by Kerry D Friesen, M.D..
The Essence Of Taiji: Integrating Heaven And Earth
The Chinese conceived of taiji as a way to bring heaven and earth closer together, to resolve the great “opposites” of life—light/dark, yielding/resisting, relaxing/contracting and—to integrate mind and body.
The Yin And Yang Of It All
The Chinese know it as Yin-Yang (pronounced “een” and “awng’) and while the symbol is recognized the world over, the concept is poorly understood. Far from being a “new age” idea, this ancient way of looking at life emphasizes balance in all aspects of life as the critical component of health and healing.
Long ago, the Chinese understood the importance of optimal blood flow . Centuries before the Western world, they correctly determined that blood flow is circular and that health depends on preventing stagnation and optimizing flow. More importantly, they understood that, the myriad of interrelated yet opposing forces that make up the world around us are played out within the trillion or so cells that make up our brains and the ten’s of trillions that make up our bodies—in short, balance was everything.
Self-Directed Neuroplasticity
When practiced properly, the slow, carefully coordinated movements of taiji bring about relaxation, increased blood flow, strengthening of muscle and sinew and profound healing to both body and mind.
But how does taiji help the mind?
By building a better brain!
Until recently, scientists assumed that once damaged, the brain was beyond healing.
Nothing could be further from the truth.
We now know, that neurogenesis (the birth of new neurons) occurs in various areas of the brain over an entire lifetime. This is an especially promising scientific finding for anyone that has suffered a stroke or severe head trauma. In essence, where the brain leads—the body will follow.
In the case of taiji, the consistent practice of carefully coordinated body movements, stimulates neurons to grow and ultimately connect with tens of thousands of other neurons. This process is known as self-directed neuroplasticity—the ancient neuroscientific secret of taiji!
Seated Taiji
Take a careful look at the video featured above.
†Dr. Zibin Gou, a University of Connecticut and Harvard-trained medical anthropologist, illustrates the power of the seated taiji program he created for the 2008 Paralympic Games in Beijing China. Seated taiji is ideal for stroke patients or patients with spinal chord injuries where standing is not possible.
Elderly patients, or patients with limited mobility due to arthritis would also benefit from the improved muscle coordination that comes with practicing seated taiji.
Follow this link for more information about the power of seated taiji.
Help is just one carefully coordinated movement away….
Posted on 30. Nov, 2009 by Kerry D Friesen, M.D..
Cataract Surgery: A Last Resort
The Two Faces Of Vitamin C
L-ascorbic acid or “vitamin C” is an essential nutrient and potent anti-oxidant.
Vitamin C has a long history dating back to 1795 when the British Navy introduced lime juice to prevent the scourge of scurvy.
More recently, mega-doses of vitamin C have been used for everything from the common cold to cancer.
While generally recognized as safe, experimental animal studies have suggested a link between high-dose vitamin C ( > 1000 mgs/day ) and age-related cataracts.
A cataract is a cloudy area in the otherwise crystal-clear lens of the eye. Smoking, diabetes, UV radiation, cortisone, trauma and inflammatory diseases, all accelerate cataract formation.
As a potent anti-oxidant, vitamin C would ordinarily be expected to counter-act the cellular “oxidative-stress” associated with the medical disorders mentioned. Now a recent study of 24,593 Swedish women aged between 49 and 83, conducted over a eight-year period, suggests vitamin C may have a more sinister side.
Information about vitamin C supplementation, cortisone, hormone-replacement therapy and other lifestyle factors was collected from 1997 to 2005.
More than 2,400 cataract surgeries were performed on the study participants over the same eight-year period.
Conclusion?
Among women over 65 who consistently took greater than 1000 milligrams of vitamin C per day, the risk of cataract formation increased by 38%.
For women on hormone-replacement therapy, the risk increased by 56%.
According to the researchers the “results indicate that the use of vitamin C supplements may be associated with higher risk of age-related cataract among women.”
What To Do?
If you are currently taking more than 1000 milligrams of vitamin C per day and fall into one of the above higher risk categories, start by reducing your daily intake to only 500 milligrams per day. Although there are anecdotal reports of “rebound scurvy”, no scientific proof for this supposed condition exists.
Aim for 250 milligrams of vitamin C per day and consider taking a different anti-oxidant. Polyphenols or plant phytochemicals are extremely effective antioxidants and have not been shown to increase oxidative-stress or function as “pro”-oxidants.
Moreover, do not smoke, wear UV-blocking sunglasses and avoid cortisone therapy if you can. If you are a diabetic, adopt the Mediterranean diet and exercise more for better blood-sugar control.
Source: American Journal of Clinical Nutrition
Published online ahead of print, doi:10.3945/ajcn.2009.28528
“Vitamin C supplements and the risk of age-related cataract: a population-based prospective cohort study in women”
Authors: S. Rautiainen, B. Ejdervik Lindblad, R. Morgenstern, A. Wolk
Posted on 23. Nov, 2009 by Kerry D Friesen, M.D..
Vitamin D: Not Just A Vitamin Anymore!
Remember cod-liver oil?
Well a great idea, just got better!
While cod-liver oil is a good source of vitamin D, it contains far too much vitamin A and a only a fraction of the omega 3 fatty-acids recommended.
We now know that vitamin D is the “active ingredient” in cod-liver oil and responsible for most of the benefit.
Here are some little-known facts about vitamin D metabolism:
Practically Speaking
It has been my practice to measure vitamin D levels in my patients for the last ten years. During that time, fewer than five out of hundreds of patients had normal vitamin D levels. Conclusion? Most people are vitamin D deficient and unaware.
The “normal range” for vitamin D set by the Food and Nutrition Board is currently considered to be 30-90 ng/ml. Keep in mind, many, many experts consider this level inadequate for the prevention of most vitamin D deficiency related disorders.
This recommended blood level translates into a daily intake of 5000 IU for men and 6-10,000 IU of vitamin D per day for women. It is nearly impossible to maintain healthy levels of vitamin D through diet or sun exposure alone. Supplementation is almost always required.
Vitamin D, immunity and the flu
Based on multiple recent studies and our new understanding of vitamin D metabolism, it is no coincidence that the “flu” peaks in the winter when vitamin D levels are at their lowest. Vitamin D is required for immune system regulation and has a direct effect on our ability to fight viral and bacterial infections.
As the author of one study asks, “where is the virus between epidemics?” From other scientific studies we know that the virus is in fact present in the population year-round, yet has an “explosive” effect only during winter months. The same author goes on to ask another impossible to answer question without invoking the role of vitamin D and immunity, ” why does experimental inoculation of humans (without previous exposure to a virus), fail to cause illness in all the volunteers?”
What to do?
In order for vitamin D to effectively support the immune system, adequate stores must be present. Stored vitamin D is drawn on specifically during viral infections and without daily supplementation of 5-10,000 IU per day, is rapidly exhausted.
Yes your mother does know best!
Posted on 16. Nov, 2009 by Kerry D Friesen, M.D..
More Muscle Means Less Diabetes!
Some Fast Facts:
Men with diabetes have lower testosterone levels than healthy men
Testosterone replacement therapy is readily available and seldom utilized
Testosterone is critical for mental, physical and sexual health in both men and women
Low testosterone is linked to diabetes, obesity, heart disease, erectile dysfunction, depression and high blood pressure
Simple cost effective screening tests are available to help diagnose low testosterone (eg. the *ADAM questionnaire—Androgen Deficiency in Aging Male)
For Men Only (Ok ladies can peek)
- Do you have a decrease in libido (sex drive)?
- Do you have a lack of energy?
- Do you have a decrease in strength and/or endurance?
- Have you lost height?
- Have you noticed a decreased “enjoyment of life”?
- Are you sad and/or grumpy?
- Are your erections less strong?
- Have you noted a recent deterioration in your ability to play sports?
- Are you falling asleep after dinner?
- Has there been a recent deterioration in your work performance?
If you answered “Yes” to any 3 questions OR “YES” to question 1 or 7, consider talking to your doctor about a blood test to measure serum tesosterone levels. Better yet, take this questionnaire to your doctor and get the answers you’re looking for.
The Health In Men Study: Low “Normal” Testosterone = Insulin Resistance And Diabetes
According to a recent study published in the †European Journal of Endocrinology, even low “normal” levels of testosterone are associated with an increase in insulin levels and Type 2 diabetes.
Elevated insulin levels promote weight gain specifically around the waist.
So-called “truncal” obesity signals insulin levels to rise even higher making our cells increasingly resistant to the all important glucose lowering function of insulin. In addition, chronically elevated insulin levels suppress the body’s natural production of testosterone and so on and on the cycle goes!
In the study noted above, as insulin levels rose, serum testosterone levels were driven lower with the lowest levels of testosterone observed in men with the most severe insulin resistance.
How Do I Know If I Have Insulin Resistance Syndrome?
Insulin resistance occurs when our cells no longer recognize insulin’s ability to transport glucose (blood sugar) out of the blood stream to inside the cell where metabolism and energy production takes place.
Here are some indicators that insulin resistance is present:
What To Do?
If you think you might be insulin resistant, ask your doctor to order the following tests in addition to the check list mentioned above:
Consider starting a simple exercise program with the primary goal of toning and building lean muscle. Forget crunches for now. Truncal obesity means the excess weight is packed deep around internal organs and cannot be eliminated by liposuction or abdominal exercises.
Adopt the Mediterranean diet with a special emphasis on low glycemic index foods. Consider adding a supplement to enhance glucose transport and decrease circulating insulin levels.
Finally remember, “more muscle means less diabetes!”
*ADAM questionnaire the brainchild of : Morley JE et al. Validation of a screening questionnaire for
androgen deficiency in aging males. Metabolism. 2000;49:1239-1242.
† European Journal Of Endocrinology, 2009 Oct;161(4):591-8. Epub 2009 Aug 6.
Posted on 03. Nov, 2009 by Kerry D Friesen, M.D..
Olive Oil. Not just Popeye's girl friend anymore!
Diabetes: A Modern Day Plague Of Biblical Proportions
Twenty-four million people in America have diabetes. That’s a staggering 8 percent of the population.
Men and women in the 60 and over age group have the highest incidence with an equally incomprehensible 23 percent currently diagnosed with diabetes!
This modern day metabolic plague will continue to spread as increasingly younger populations combined with a rapidly aging population in turn develop diabetes.
It’s Complicated
According to the National Institutes Of Health:
In a recent study reported in the Annals Of Internal Medicine, 215 overweight people with newly diagnosed type-2 diabetes were randomly assigned to a Mediterranean diet, (with less than 50 percent of all daily calories from carbohydrates), or a low-fat diet (with less than 30 per cent of all daily calories coming from fat).
Conclusion
In fact, the Mediterranean diet was so effective that the need for drug therapy in this overweight diabetic population at risk for heart disease was delayed in 44 percent of the study participants. More than 70 percent of those in the placebo group required prescription drug therapy to normalize blood sugar and HbA1c levels.
According to the research scientists:
“the findings reinforce the message that benefits of lifestyle interventions should not be overlooked despite the drug-intensive style of medicine fueled by the current medical literature”
Honorable Mention:
“Participants assigned to the Mediterranean-style diet lost more weight and experienced greater improvements in some glycemic control and coronary risk measures than did those assigned to the low-fat diet.”
Summary
Only the Mediteranean diet, rich in cereals, wine, fruits, nuts, legumes and whole grains, fish and olive oil, and low in dairy, meat, junk food and fat , has been linked to longer life, less heart disease, and protection against cancer.
It should come as no surprise that the Mediterranean diet is rich in carotenoids, polyphenols, antioxidants and monounsaturated fats.
Monounsaturated fatty acids are especially important in Type 2 diabetes where insulin resistance is thought to be the underlying metabolic disturbance. Monounsaturated fats such as olive oil are effective at reducing insulin resistance and improving glucose function, therefore decreasing the need for drug therapy.
Why not start today and introduce the essential components of the Mediterranean diet into your daily routine?
Olive oil is the best source of monounsaturated fat, colorful foods are rich in polyphenols, carotenoids and antioxidants. Don’t forget fish, red wine (resveratrol) and whole grains.
I’ll see you in the produce section of your local grocery store!
Source: Annals of Internal Medicine
Volume 151, Pages 306-314
“Effects of a Mediterranean-Style Diet on the Need for Antihyperglycemic Drug Therapy in Patients With Newly Diagnosed Type 2 Diabetes – A Randomized Trial”
Authors: K. Esposito, M.I. Maiorino, M. Ciotola, C. Di Palo, P. Scognamiglio, M. Gicchino, M. Petrizzo, F. Saccomanno, F. Beneduce, A. Ceriello, D. Giugliano
Posted on 31. Oct, 2009 by Kerry D Friesen, M.D..
Astaxanthin supports heart health and blood flow!
Chronic inflammation underlies most diet and lifestyle related diseases, including high-blood pressure, heart disease, diabetes, obesity and even Alzheimer’s and Parkinson’s disease.
Antioxidants play a pivotal role in combating chronic inflammation and premature aging by reducing the oxidative damage that occurs when cells are stressed beyond their capacity. When left unchecked for months and years, cellular damage leads to tissue damage and ultimately overt disease.
When combined with a suboptimal diet and low levels of antioxidants the entire process is accelerated and people appear to age prematurely. Fine lines, wrinkles and sun-damaged skin belie the real problem—mitochondrial dysfunction, DNA disrepair and accelerated aging.
Ultimately, our arteries suffer leading to atherosclerosis, coronary artery disease, stroke and heart attack. When blood vessel walls are involved, high blood pressure develops. If the brain is involved, cognitive impairment, Alzheimer’s and Parkinson’s disease may evolve.
Astaxanthin (pronounced—”asta-zanthin”), a naturally occurring, fat soluble antioxidant that imparts the pink color to wild salmon, is 500 times as potent as the quintessential antioxidant vitamin E!
More importantly, astaxanthin has a natural affinity for cell membranes and mitochondria, the power-houses that keep our cells alive.
While LDL cholesterol may not be the sole cause of coronary artery disease, a chemical reaction known as peroxidation turns them into extremely reactive and damaging molecules. LDL is then deposited within blood vessel walls ultimately leading to heart disease and stroke.
Astaxanthin possesses unique anti-inflammatory properties that prevents the oxidation of LDL particles and thus reduces the risk for heart disease and atherosclerosis.
Recent studies suggest that astaxanthin may also help support:
Talk about your antioxidants! At 500 x the potency of vitamin E, astaxanthin has it all.
Shouldn’t you be taking it? I do!
Posted on 23. Oct, 2009 by Kerry D Friesen, M.D..
Earlier this month the Food And Drug Administration released a consumer advisory regarding the use of supplemental vitamins. To everyone’s surprise the advisory admitted that vitamins “can be useful” and that “there are many good reasons” to consider taking them! As a physician that practices “preventing” medicine, I couldn’t agree more.Vitamins are and always will be, vital for life. We cannot in fact live without them.
Both vitamins and minerals are essential cofactors responsible for the myriad of chemical reactions that we refer to as “life.”
Nutrigenomics is a new discipline that seeks to understand diet-related disease by tracing the signaling pathways that occur within a cell when triggered by specific nutrients that in turn, activate our genes that then code for the proteins that keep us alive.
As the chart illustrates, nutrition, genetics and molecular biology figure prominently in understanding how vitamins prevent or at the very least ameliorate disease.
According to Barbara Schneeman, PhD, the director of FDA’s Office of Nutritional Products, Labeling, and Dietary Supplements, “Supplements can be useful when they fulfill a specific identified nutrient need that can’t be met by food or is not being met through normal food intake.”
Here are some of the recommendations in the FDA’s Fortify Your Knowledge About Vitamins advisory:
You should consider taking a vitamin supplement if,
Admittedly, choosing the right supplement can be difficult.
However, certain supplements including B12, Vitamin D3 and polyphenols (the “active” ingredient in medicinal foods) can be generally recommended.
Consider your diet, lifestyle and age when making a decision. Or you might even consider asking your doctor.
If you have a specific supplement-related question, leave a comment and I will be happy to help!
Posted on 21. Oct, 2009 by Kerry D Friesen, M.D..
Green Tea Helps Depression
Depression can be difficult to treat.
Even with the most effective medications, a sixty percent response rate is considered exceptional. Worse yet for most people, continued treatment revolves around minimizing side-effects rather than aggressively addressing the circumstances that allowed the depression to develop in the first place.
Even more confusing are recent clinical studies that suggest new-generation anti-depressant medications may function primarily as placebos for everyone but the most severely depressed.
Like most physicians, I have watched select patients benefit from SSRI and dopaminergic-type medications and marveled at their relatively rapid onset and ease of use. And, like most physicians, I’ve watched as patients gain weight, develop sexual side-effects and after prolonged drug therapy become less engaged and more dispassionate about life in general.
Clearly, a “pharmaceutical answer only” is not the best approach.
A recent study published in the American Journal of Clinical Nutrition, investigated the relationship between green tea consumption and depressive symptoms in 1,058 elderly Japanese over the age of 70 with mild to severe depression.
In Japan, as in the United States, depression is common among the elderly and frequently misdiagnosed or ignored altogether.
Moreover, it is now well known that depression increases the risk of other medical disorders such as heart disease and diabetes. In addition, the World Health Organization (WHO) forecasts that within 20 years more people will be affected by depression than any other health problem.
Depressive symptoms were 44 percent lower for study participants that drank four or more cups of green tea per day even after adjusting for additional risk factors such as sex, age, BMI, alchohol consumption, smoking and diet!
Of course other factors associated with tea drinking may be involved and a larger population based study would reveal any potential confounding variables.
However, in the meanwhile here is what is known.
A previous study by the same author, found that drinking five cups of green tea per day reduced the incidence of psychological distress by 20 per cent.
Anti-anxiety/ Anti-stress Benefits
In addition to its well-known role as an antioxidant, green tea contains L-theanine. L-theanine, (N-ethyl-L-glutamine) is a major amino acid uniquely found in green tea.
In animals, l-theanine increases serotonin, dopamine and GABA levels in the brain promoting relaxation. L-theanine also has neuroprotective properties by virtue of its ability to antagonize the excitiotoxicity of glutamic acid (think monosodium glutamate).
Consumption of as little as 50 mg of l-theanine is associated with alpha brain wave activity observed in states of profound relaxation.
The final message? Don’t despair—help may be as close at hand as your next “cup of tea”. If all else fails, try l-theanine 50 mg, 2 -3 times per day for a more relaxed brain.
Posted on 19. Oct, 2009 by Kerry D Friesen, M.D..
Not For Everyone!
OZ: THE LAND OF INFINITE MEDICAL ANSWERS
(THAT DOESN’T EXIST)
What does it mean when Comedy Central becomes the voice of reason in all things medical?
Only that when you get to the Emerald City and pull back the curtain and discover the Wizard of Oz is really the Wizard of Biz and incapable of solving all of your problems (but more than willing to take your money), you have finally reached the realm of medical realism rather than some pharmaceutical fantasy land.
Despite all the media hype and medical experts claiming otherwise, the so-called pleiotropic effects of statins are not sufficient to cure cancer, Alzheimer’s disease, osteoporosis, multiple sclerosis, rheumatoid arthritis, lupus, aortic stenosis, cardiac myocyte hypertrophy or any other “trophy” for that matter.
Off-label applications excluded, all HMG-CoA reductase inhibitors, in other words, “statins” are effective at lowering LDL cholesterol and raising HDL cholesterol (minimally)—but that’s it.
PHARMACEUTICAL FAIRY TALES
The AstraZeneca claims for Crestor however have to do with the inherent anti-inflammatory property of some statins.
Both vascular and neuro-inflammation are in fact critical risk-factors for cardiovascular and neurodegenerative disease. However, to suggest that everyone would benefit from taking Crestor is bad science and crass commerce.
There are better ways to reduce vascular inflammation. Taking a prescription medicine would be last on my list. A diet rich in polyphenols supplemented with multiple natural anti-inflammatory agents, including astaxanthin would be my preference.
In a Wall Street Journal interview, AstraZeneca CEO David Brennan downplayed the commercial impact of the Jupiter study while simultaneously suggesting that analyst’s forecasts were “pretty bullish”.
Given our current economy, where will the estimated 10 billion additional health care dollars come from that it would take to implement the plan, enforce compliance and manage the inevitable adverse drug reactions?
And what if the expected health benefits are never realized?
OUR DIRECT-TO-CONSUMER ADVERTISING IDIOCRACY
Pharmaceutical companies spent an estimated $2.5 billion in 2000 on direct to consumer advertising and more than $4 billion in 2005.
In one year, prescriptions written for the 50 most heavily prescribed drugs increased by a whopping 25 percent compared to just 4 percent for all other drugs combined!
While direct-to-consumer advertising is illegal in Canada,it is nearly impossible to enforce.
Meanwhile here in America, pharmaceutical DTC advertising thrives in a virtually unregulated environment, emboldened by PhRMA, the lobbying group of the US drug industry.
THE PAL PROJECT AND THE “BITTER PILL” AWARDS
It has been left to watchdog groups (see PAL—the Prescription Access Litigation Project), to reign in the ridiculous.
For example, in 2006 both AstraZeneca’s Crestor and Pfizer’s Lipitor, received the coveted “Got Cholesterol?” award, given for “overpromoting expensive brand name statins,”.
A total of 5 of the country’s best selling drugs received “Bitter Pill” awards in 2006 for overly agressive and misleading DTC advertising.
That same year, AstraZeneca received a disciplinary letter from the FDA for a DTC advertising campaign claiming Crestor was more effective than other statins.
STEPHEN COLBERT AND THE COLBERT NATION: IS THE DOCTOR OF FINE ARTS IN?
Forget the Mayo brothers, if you need a sound dose of medical realism and a cheap second opinion, head straight to the office of Dr. Stephen T. Colbert DFA.
He may not have the bedside manner of a country doctor, but he at least has his medical facts right.
And except for Prescott Pharmaceuticals, Big Pharma doesn’t own him.
Posted on 25. Jan, 2009 by Kerry D Friesen, M.D..
Remember you heard it here first.
There now exists a formidable body of literature linking cardiovascular disease and neurodegenerative disorders. More than ten years ago I found myself lecturing my patients on the not-so- subtle connection between abdominal obesity; insulin resistance; syndrome-X and endothelial-cell dysfunction. With abdominal obesity, fat is progressively packed around internal organs until it literally takes on a life of it’s own. Adipocyte (fat cell) signalling becomes so strong that it becomes the dominant “endocrine” or hormone secreting organ in the body. In the vernacular, all hormonal “hell” breaks loose.
IT’S ALL ABOUT BALANCE
Resistance is futile. You have become one with your fat cells. The delicate yin and yang balance between your immune system and other major organ systems is lost. The cytotoxic and neurotoxic effects of inflammatory mediators like TNF-alpha; peroxynitrite and IL-6 to name a few, reign supreme. Over time, free-radical formation and the subsequent oxidative damage result in irreversible mitochondrial DNA decay and cell death. If the affected cells reside in your brain, then any one of a multitude of neurodegenerative diseases is possible. If they happen to line the vascular endothelium in your heart, then you are well on you way to your first heart attack.
Most people reading this blog will find themselves in between the two extremes. In this “no-mans land” of disease, doctors euphemistlcally tell patients they have a “touch of sugar” (you have frank diabetes) or their blood pressure is a “little elevated” (you’ve been diagnosed with high blood pressure) or your “good cholesterol” (HDL) is a little low (you are at high-risk for heart disease and diabetes). I could go on…
INTERLEUKIN-6 FYI: FOR YOUR INFLAMMATION
As it turns out, the common denominator in the above scenario is inflammation overload. Nothing, not even the micro-circulation of the brain escapes the damaging effects of IL-6 and tumor-necrosis factor-alpha. Atherosclerosis “hardening of the arteries”, impairs blood flow to the already hypermetabolic brain tissue, as a result underperfused neurons respond with ß-amyloid plaque deposition, acetylcholine signaling defects, oxidative stress and more inflammation.
The only known genetic risk factor for Alzheimer’s disease not surprisingly, is a gene that codes for Apolipoprotein E4. Apolipoprotein E in one of its three isoforms, is responsible for the transport of triglyceride, phospholipid, cholesteryl esters, and cholesterol into cells.
Of the three main isoforms of the apo E allele, apoE3 is most common, followed by apoE4 and lastly apoE2. The lifetime risk for Alzheimer’s disease in someone with apoE3 is about 9%. The lifetime risk for Alzheimer’s in someone with the apoE4 allele is a whopping 29%. If you happen to be homozygous for apoE4 (both alleles on paired chromosomes are apoE4) the lifetime risk for Alzheimer’s sky-rockets to 91% by age 80. Apparently the apoE4 allele is so inefficient at cholesterol metabolism within the brain that sulphated galactocerebroside (sulphatide) levels drop. Sulfatide has everything to do with neuronal plasticity, cell growth and repair in addition to normal signal transduction.
How do you know if you possess the apoE4 allele? While various labs offer this test Berkley Heart Lab is consistently the most reliable.
In addition, the one-time Apo E test will help decide whether or not diet will have an effect on elevated cholesterol levels. If you possess the apoE4 isoform without question diet therapy can have dramatic effect on your LDL-C (bad cholesterol) levels. If you have seen your doctor and were told you had elevated LDL-C and have altered your diet without success, then this test is for you.
Here are the five easy steps I recommend for my patients. In this case, I personally take a double dose of my own medicine.
1. Consider Apolipoprotein E testing (ask your doctor)
2. Adopt the Mediterranean diet
3. Increase Omega-3-FA consumption
4. Decrease Omega-6-FA intake (PUFA in the form of vegetable oil)
5. Dramatically increase your intake of dietary polyphenols† (see list below)
PASS THE POLYPHENOLS PLEASE
To put it another way, make a concerted effort to bathe your body’s biochemical milieu daily in a rich blend of phytochemicals. This is the essence of the “French Paradox”, that is, while the French consume much more saturated fat than their North American counterparts, they also consume far less omega-6-FA’s and far more polyphenols (in the form of red wine primarily), and have much less heart disease to show for it. It is precisely when science flies in the face of convention that you know you’re “gettin’ warm”.
†Food sources rich in polyphenols include onion, apple, green-tea, red wine, red grapes, grape juice, strawberries, raspberries, blueberries, cranberries and walnuts to name a few.
Polyphenols can be classified as non-flavonoids and flavonoids. The flavonoids quercetin and catechins are currently the most extensively studied polyphenols.
Posted on 24. Jan, 2009 by Kerry D Friesen, M.D..
Kerry D. Friesen, M.D.
The great tragedy of science — the slaying of a beautiful hypothesis by an ugly fact.
–Thomas Henry Huxley
At one time or another we have all held certain beliefs that later turn out to be not true at all. Most are innocent lies like the tooth fairy or Easter bunny and ultimately no major mental paradigm shift is required to adjust to the “new reality”. ?
You can imagine my surprise to discover while still a D.I.T. (doctor-in-training) that I was being fed a daily diet of less-than scientific—-even downright dangerous information.
Apparently magical-mythical thinking was alive and well, even in the halls of academia.
I discovered this by constantly asking the question “why”?”
“Why give blood products– worse yet—–contaminated blood products to hospitalized patients simply because than their blood count is less than 10 mg/dl”
“Why risk life-threatening anaphylactic reactions by giving platelet transfusions to patients with no clinical or laboratory risk for bleeding”
“Why perform bypass surgery for a known metabolic disease (atherosclerosis), i.e. coronary artery bypass surgery, rather than treat the real cause.
I soon realized that medical science was in fact filled to overflowing, with medical myths.
Another often repeated myth is that bed rest speeds the healing process.
It sounds factual enough.
It even appeals to our “sense-of-the-common” (common sense).
Yet an independent review of 39 different studies confirmed that for many medical conditions strict bed rest was at best not helpful and in many cases harmful.
For that reason I jokingly tell all my elderly patients to “get out of bed”. Then with as somber a face as I can muster I proclaim, “It is a statistical fact that more people die in bed than out of it”. Therefore “get out of bed!”
We’ll come back to the intentional use and abuse of “statistical facts” later.
This next one may surprise you.
Almost everyone, doctors included, believe that the following tests have all been shown to improve survival in otherwise healthy people:
Chest X-rays in smokers
Liver function tests
Kidney function tests
Blood glucose levels
Total cholesterol levels
Mammography in women over 40
Ultrasound examination of the ovaries
Bone density in women
Resting EKG
Ultrasound examination of the aorta in men over 55
PSA in men over 50
The truth is there are absolutely no convincing scientific studies that justify the widespread use of these tests in patients without symptoms.
These tests are neither sensitive enough nor specific enough to detect disease and improve survival in healthy people.
In other words, they are just not that accurate.
That doesn’t keep doctors from ordering these tests inappropriately or patients from requesting a multitude of tests to “see if there is cancer anywhere in me”.
Like the song says
Still, a man hears what he wants to hear, and disregards the rest.
–Simon & Garfunkle, The Boxer
Remember while medical science may lessen uncertainty, it can never fully remove it since life, by its very nature is fraught with frailty and uncertainty.
Correlation-Causation Confusion
While “mini-myths” such as the ones above are easily dispelled, the myth of major monolithic proportions that concerns this book has now gone global.
Thanks to the ultra-effective “know your number” ad campaign implemented by the National Cholesterol Education Program and coordinated by the United States National Institutes of Health (NIH), the entire industrialized world is now counting their cholesterol.
But to what end?
While numerous studies have confirmed the close correlation between high cholesterol and heart disease, an even greater number now substantiate the more important role of multiple non-traditional risk factors.
To assume that cholesterol is the cause of coronary artery disease simply because people with heart disease happen to have elevated cholesterol is just one more example of correlation-causation confusion!
Scientists, statisticians, and now even the creators of a popular animated sit-com recognize that just because event A occurs before outcome B, event A did not necessarily cause outcome B.
A conversation between Homer and Lisa in season seven of the Simpson’s illustrates just how easily we are deceived by this apparent cause-and-effect relationship.
Here is how it played out——a single bear sighting prompted the worried residents of Springfield to spend millions on a “Bear Patrol”
Homer: Not a bear in sight. The “Bear Patrol” is working like a charm!
Lisa: That’s specious reasoning, Dad.
Homer: [uncomprehendingly] Thanks honey.
Lisa: By your logic, I could claim that this rock keeps tigers away.
Homer: Hmm. How does it work?
Lisa: It doesn’t work. (Pause) It’s just a stupid rock!
Homer: Uh-huh.
Lisa: But I don’t see any tigers around, do you?
Homer: (pause) Lisa, I want to buy your rock.
Pharmaceutical Fairy Tales
Besides correlation-causation confusion, errors in deductive reasoning abound. You may not know what to call it, but you will certainly recognize it when you “see” it.
For example, cholesterol drug ads claim a 25% reduction in heart attack risk.
But before you fill your prescription, always ask yourself,
25% of what?
A 25% reduction means nothing unless you know your personal odds of a heart attack!
Here is another way of looking at it. Utilizing the Framingham Risk calculator you discover you have a 2% chance of having a heart attack in the next ten years.
The 25% reduction from drug therapy will decrease your risk by
0.25 x 0.02 = 0.005 ———> 2% – 0.5% = 1.5%
A whopping one-half of one percent.
Not much to get excited about.
Keep in mind that a one-half of one-percent reduction in risk comes at the expense of taking that medicine with all its potential for harm for the rest of your life.
Thanks to a never-ending prime-time stream of pharmaceutical fairy tales, you may “Know Your Number” but do you know your vascular biology?
Measuring blood markers of inflammation and calculating oxidative stress levels is every bit as important as knowing your blood pressure and bank account number.
If you still think that the skin is the largest organ in the body, get ready for a database update.
The vascular endothelium—the trillions of cells that line our blood vessels is without question the largest organ in our bodies. Turn to Chapter __ It’s a Vascular Adventure for how we managed to miss the obvious!
While the quantity of cholesterol present in our bodies may be helpful—quality is clearly more important.
By now almost everyone has heard of so-called ‘good’ (HDL) and ‘bad’ (LDL) cholesterol.
But did you know that there are seven different sub-types of LDL and five different sub-types of HDL?
Only two of the five sub-types of HDL cholesterol are actually “good” and three of the seven sub-types of LDL cholesterol are so damaging to our endothelial cells (see Chapter 7 Pssst! What’s Your Particle Size?) that our risk for heart disease increases more three-fold!
In reality, new studies exploring the real cause of atherosclerosis and heart disease , reveal a complex, sub-cellular environment of lipid (fat) particles, non-fat metabolic trash (such as homocysteine) and chemical messengers such as nitric oxide, inflammatory mediators, antioxidants and free radicals—-all involved in the delicate balance of maintaining vascular health.
While traditional risk-factors such as cigarette smoking, hypertension, diabetes, and obesity remain important, new data emphasize how chronic low-grade inflammation compounded by a genetic predisposition to premature heart disease contribute to the pathogenesis (cause) of atherosclerosis (hardening of the arteries).
In addition, risk rises exponentially as traditional risk factors are combined with newer risks.
Sometimes it takes turning everything completely upside down in order to get it right.
While so much attention has been focused on the problem, (read LDL cholesterol and the medical-pharmaceutical-industrial complex) a token amount of research has been directed toward the solution—HDL.
Helping you understand HDL and how it reverses heart disease is one of the focal points of this blog.
Posted on 24. Jan, 2009 by Kerry D Friesen, M.D..
Neurocardiology Comes Of Age
YOU SAY YOU WANT A REVOLUTION?
Once in a great while new scientific information arises that revolutionizes a field of medicine.
THE FRAMINGHAM HEART STUDY
In 1948 in Framingham Massachusetts, 5127 men and women were enrolled in a study that has continued on to the present day. More recently, under the direction of William Castelli, M.D. , Medical Director from 1979 until 1995, careful analysis of the scientific information obtained confirmed the relationship between elevated cholesterol levels and coronary artery (heart) disease.
Since that time, numerous studies have reaffirmed that relationship.
That data, while invaluable, tells only part of a more complex story.
Almost daily, new studies into the cause of atherosclerosis , reveal a complex, sub-cellular environment of fat particles, metabolic” trash” and inflammatory mediators—-all capable of disrupting the delicate balance required to maintain vascular health. While traditional risk-factors such as cigarette smoking, hypertension, diabetes and obesity remain important, new data emphasizes the role of inflammation, genetic make-up, low HDL-cholesterol and small-dense LDL cholesterol.
In addition, risk rises as traditional risk factors are combined with newer risks and all of this is just the beginning.
Every 32 seconds someone in North America suffers a heart-attack and despite all that modern medicine has to offer, one-third of those will still die.
Women, by the way, are no exception.
In fact, more women than men die of heart attacks every day.
A better understanding of non-traditional risk factors can change that.
This blog is can help you do it!
To borrow a quote,
“May you live long and prosper”
© 2008 Kerry D Friesen, M.D.. All Rights Reserved.
