Archive for 'Women’s Health'

Taiji: Mind-Body Medicine At It’s Best!

Posted on 01. Dec, 2009 by .

0

The Essence Of Taiji: Integrating Heaven And Earth

Taiji (pronounced”tie-jee”) is an ancient healing/martial-art form that originated in China, thousands of years ago.

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….

Continue Reading

Vitamin D: The Ultimate Antiviral?

Posted on 23. Nov, 2009 by .

0
Vitamin D: Not Just A Vitamin Anymore!

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:

  • Vitamin D is not a vitamin at all—it is a “prohormone” with a profound effect on human immunity
  • Summertime sun exposure results  in vitamin D levels that average around 50 ng/ml, however, during the winter vitamin D levels may drop to less than 20 ng/ml
  • The elderly and the obese are at increased risk for vitamin D deficiency
  • Supplementation with 400 IU per day is not adequate to prevent vitamin D insufficiency
  • In one study, 2000 IU per day for one year, failed to maintain adequate blood levels of vitamin D in 40% of post-menopausal African-American women
  • Low vitamin D levels during pregnancy have been linked to schizophrenia and depression
  • Vitamin D supplementation has been shown to decrease the risk of multiple sclerosis, rheumatoid arthritis, Type I diabetes and some cancers including, prostate cancer in men and breast cancer in women

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.

  • Ask your doctor about having your current vitamin D levels measured.
  • Add fatty fish to your diet and consider taking a vitamin D supplement.
  • A teaspoon of cod-liver oil now and then can’t hurt either.

Yes your mother does know best!

Continue Reading

Recent Study: Statin Therapy, It May Help Your Heart—Or, Give You Diabetes?

Posted on 12. Nov, 2009 by .

0

Ask your doctor about statin alternatives!

Ask your doctor about statin alternatives!

Heart Disease: It’s Not Just About LDL Anymore

The cholesterol lowering drugs known affectionately as “statins” are widely prescribed for patients with elevated cholesterol and/or diabetes.  While they may be extremely effective at lowering LDL “bad” cholesterol, they also come with a “side-order” of side-effects—some potentially fatal.

As recently as 2008, statins were being extolled for their “pleiotropic” effects, that is, the ability to treat a myriad of disorders (Alzheimer’s, cancer, osteoporosis), in addition to the only FDA approved indication—elevated LDL cholesterol in conjunction with diet and lifestyle changes!

In fact, the prescribing information  for Crestor, a leading high potency statin clearly states that,

“CRESTOR is not indicated to reduce cardiovascular morbidity and mortality”

Simply put, Crestor will not save your life or prevent the coronary artery disease that can lead to a heart attack and death.  From a medico-legal standpoint, that indication is like, “having your cake and eating it too.”  Something most diabetics understand is NOT possible.

New Findings

According to Dr. Swapnil Rajpathak , lead investigator of the controversial study reported in the October 2009 issue of Diabetes Care:

“Contrary to our expectation, we did not find any benefit of statins on diabetes risk. In fact, there is a suggestion that statins may be associated with increased risk — which needs to be explored further.”

To better understand the results of the trial, investigators researched data from five other randomized trials of statins.  More than 57,000 study participants took part in the five trials.

Four years later, more than 2000 study participants had developed diabetes—a 13% increase over what was expected. The only significance treatment difference was the addition of statin therapy.

While the researchers argue that statin therapy ultimately has more benefit than risk, it should be noted that diabetics have elevated triglycerides and low HDL rather than an elevated LDL cholesterol.

What To Do?

Here is a partial list of commonly prescribed statins:

lovastatin             (Mevacor)

pravastatin          (Pravachol)

atorvastatin         (Lipitor)

rosuvastatinn      (Crestor)

fluvastatin            (Lescol)

simvastatin           (Zocor)

If you find yourself taking one of the above statins, look carefully at the changes that can be made to eliminate the need for this family of medicines.  If you truly are benefiting from statin therapy, consider adding Ubiquinol 50-100 mg per day to offset the side-effects associated with longterm statin therapy.

If all else fails, you can ask your doctor about alternative therapies.

To your health!

Continue Reading

New Study: Lifestyle And The Mediterranean Diet Better Than Drug Therapy For Diabetes

Posted on 03. Nov, 2009 by .

1

Olive Oil. Not just Popeye's girl friend anymore!

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:

  • Heart disease and stroke are 4 times higher in adults with diabetes.
  • In 2004, heart disease was noted on 68 percent of diabetes-related death certificates among people ages 65 years or older.
  • Diabetes is the leading cause of kidney failure, accounting for 44 percent of new cases in 2005.
  • In 2004, about 71,000 nontraumatic lower-limb amputations were performed in people with diabetes.
  • Periodontal, or gum, disease is more common in people with diabetes. Among young adults, those with diabetes have about twice the risk of those without diabetes.
  • Poorly controlled diabetes during the second and third trimesters of pregnancy can result in excessively large babies, posing a risk to both mother and child.
  • About 60 to 70 percent of people with diabetes have mild to severe forms of nervous system damage. The results of such damage include impaired sensation or pain in the feet or hands, slowed digestion of food in the stomach, carpal tunnel syndrome, erectile dysfunction, or other nerve problems.

Now For The Good News!

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

Consuming a Mediterranean-style diet, rich in vegetables, fruits and nuts, olive oil, and legumes, is more effective for diabetes control than a low-fat diet!

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

Continue Reading

Talk About Your Antioxidants: Astaxanthin Combats Chronic Inflammation And Much More

Posted on 31. Oct, 2009 by .

3
Astaxanthin supports heart health and blood flow!

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:

  • a healthy immune system
  • eye health
  • joint health
  • connective tissue health
  • skin health
  • cardiovascular health and blood flow
  • brain health
  • gastrointestinal health
  • muscle function
  • muscle recovery after exercise
  • cellular membrane health after exposure to UV light
  • normal oxidant:antioxidant balance

Talk about your antioxidants!  At 500 x the potency of vitamin E, astaxanthin has it all.

Shouldn’t you be taking it? I do!

Continue Reading

Finally The FDA Finds That Supplemental Vitamins—”can be useful”

Posted on 23. Oct, 2009 by .

0

Nutrigenomics_disciplinesEarlier 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.

The Right Vitamin For The Right Reason

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,

  • you adhere to a vegan or vegetarian diet
  • you are pregnant or breastfeeding
  • you are over the age of 50
  • you have a specific health condition

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!

Continue Reading

Green Tea: Several Cups A Day Keeps Depression Away

Posted on 21. Oct, 2009 by .

0

Green Tea Helps Depression

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.

They are no longer sad — but they’re not happy either.

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.

Psychological Distress

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.

Source: American Journal of Clinical NutritionTitle: Green tea consumption is associated with depressive symptoms in the elderly
Authors: K Niu, A Hozawa, S Kuriyama, S Ebihara, H Guo, N Nakaya, K Matsuda, H Takahashi, Y Masamune, M Asada, S Sasaki, H Arai, S Awata, R Nagatomi, and I Tsuji

Continue Reading

Forget Cheerios: Try Harvard Medical School’s Top 11 Cholesterol Lowering Foods!

Posted on 20. Oct, 2009 by .

2

Sushi Avocado Ginger: Truly Functional FoodsWhy Not Try These Truly Functional Foods

This recently released list of foods that lower cholesterol will come as no surprise to some people.

What is surprising is how little it really takes to make a significant difference.

For example, just 20 to 35 grams of oats per day, 2 ounces of nuts, 10 ounces of tofu or 2.5 cups of soy milk per day can lower LDL cholesterol by 5 percent.

Just 2 grams of phytosterol containing foods can lower LDL by 10 percent!

While the end result of adding these functional foods to your diet may be the same, the way they lower cholesterol can be remarkably different.

Fiber binds to cholesterol in the digestive tract while phytosterols compete for absorption of cholesterol.  Fatty fish lowers triglycerides by activating an enzyme called lipoprotein lipase in the blood stream and nuts contain PUFA (polyunsaturated fatty acids) that directly lower LDL (bad) cholesterol.

Harvard Medical School’s Top Eleven Foods

  1. Oats
  2. Barley and other whole grains
  3. Beans
  4. Eggplant and Okra
  5. Nuts
  6. Vegetable oils
  7. Apples, grapes, strawberries, and citrus fruits
  8. Foods fortified with sterols and stanols
  9. Soy
  10. Fatty fish
  11. Fiber supplements

As an added benefit, most of these foods possess natural anti-inflammatory properties that when combined with lowered cholesterol, decrease the risk for heart disease and stroke.

So why wait?  Make it your mission to include these 11 top-rated foods in your daily diet.  Better yet, add the foods and include a high-quality supplement to boost the health promoting benefits!

Continue Reading

I’ll See You In Health! Stephen Colbert Rebuts Ridiculous Crestor Claim

Posted on 19. Oct, 2009 by .

0
Not For Everyone!

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.

Continue Reading

Why I Quit Counting Cholesterol: Confessions Of A Medical Heretic

Posted on 24. Jan, 2009 by .

2

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.

Continue Reading

Heart Disease: It Doesn’t Have To Happen

Posted on 24. Jan, 2009 by .

0
Neurocardiology Comes Of Age

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”

Continue Reading