Serotonin, SSRIs and Depression; The Myth Behind the Marketing

serotonin and depression

If you go into your PCP’s office and mention that you’ve been feeling down there’s a good chance you’re going to get a prescription for a SSRI.

SSRI stands for Selective Serotonin Re-uptake Inhibitor.  This is a class of drugs that slows the brain cell’s ability to pick up the hormone serotonin that your brain cell just used to send a message to the neighboring brain cell.  To put it in simpler terms, SSRIs keep serotonin in play longer, increasing the likelihood that a message is going to be relayed.

The typical concept that is used in explaining the use of SSRIs is that you have a chemical imbalance in your brain (serotonin) and this drug will fix it.

Sounds pretty straightforward and seems to make sense.  It also gives many people hope that there is a drug to fix how he or she is feeling.  There is something WRONG and it can be FIXED.

But what if this entire concept was MADE UP?

Couldn’t be possible, right?

There’s no way a concept like a drug that can fix a chemical imbalance in the brain and help with depression could become as well-founded in medicine and society as drinking water to cure thirsty.

You know where I’m going with this although this point you’re probably about as skeptical as you’ve ever been.  This information was all brought up in an editorial in the BMJ by Dr. David Healy, a professor of psychiatry in Wales.  The full text of this editorial can be found on his website by clicking here.

Let’s review some things that we already know first:

1. SSRIs have been shown to be pretty much worthless in the medical research beyond placebo (especially when ALL the studies are taken in account—not just the positive ones).
2. The placebo effect is very, very powerful and deals with the brain. Which is ironic since depression and anxiety are “brain” problems.
3. While a small few do benefit, the vast majority of patients in my office who are on this class of drugs don’t notice all that much of an improvement in mood with use beyond 3 months. Most give me a sheepish shrug and a grunt of “maybe” when I ask if they seem to help.

With these three things in mind, it’s time to clarify a few more myths and identify the timeline of SSRI development, marketing and use.

Serotonin levels and depression

Early clinical studies attempted to demonstrate that people with depression had lower levels of serotonin.  This was never able to be proved.  To make this a little bit more confusing, the SSRIs have never been shown to actually increase serotonin levels (except theoretically in the synaptic cleft between brain cells).  Contrast this with compounds like tryptophan and 5-HTP, which give the body the building blocks to make more serotonin if needed.

There has been no evidence that the strength of the SSRI’s effect on blocking serotonin reuptake was related to the better outcomes (in other words, stronger SSRIs did not have a greater effect on depression).

Just to make matters worse, the original clinical trials pitting SSRIs up against the tricylic antidepressants like Elavil and Amitriptyline had them failing miserably.

Finding a use for the SSRIs

The SSRIs were developed in the late 1980s, but originally had no indication.  In other words, the drug companies had a neat new drug but no idea what to do with it.  The original thoughts were to use it for controlling blood pressure of maybe weight loss, but these ideas were quickly scrapped.

But concern was rising with the risk of dependence from the use of tranquilizers, creating a potential market for the SSRIs.  However, the general public had been trained to expect an immediate response from their anxiety and diabetes drugs and the SSRIs didn’t fit this expectation.

So the drug companies needed to retrain the public and doctors by reframing how we thought about depression.

It’s amazing what gobs of money can accomplish.

So the drug companies created the idea of a chemical imbalance linked to serotonin levels.  Luckily, the white horse was already on its way in.

So where does that leave us?

All of this does not mean that serotonin was a worthless concept.  But it does likely mean that the use of drugs that affect serotonin reuptake are not the answer.  Don’t expect this message to be adopted anytime quick, though.  This is still one of the most successful classes of drugs on the market and there are enough prescriptions written in the Westernized world to treat every adult.  Many of these prescriptions are being used because patients could not get off of them.

The long list of side effects that are experienced with withdrawal are sometimes used to convince patients that they NEED to be on the drugs.  What a way for the drug companies to create their own market.

The real long-term answer to psychological disorders lies with brain health.  Making sure that the cells of your brain have the energy they need to function at their best.  Making sure that the cells are healthy enough so that they can communicate with each other when needed as well as NOT communicate with each other when needed.

Tools for this should include:

• Exercise
• Stress management techniques (yoga, biofeedback, meditation)
• Counseling—you NEED a good therapist on your team to help you learn long-term coping strategies
• A brain-healthy lifestyle (you can check out my Depression eBook by clicking here)
• Positive outlook—waking up each day at looking for the positives, always focusing on these rather than the negatives
• Brain-healthy supplements like vitamin D, magnesium and fish oils

I’m not saying that there is no need for drugs that affect the psychological aspects, but these drugs should be used short-term while you get the motivation and education to rise above your current mental state.

Some may still need drugs long-term, but these drugs, like any other drugs, should not be the ONLY tool in your toolbox.  Rather, they should be just one of many (like those on the list above) of the tools you use to help your brain.

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The Holy Grail of Aging: Overview of the Mitochondria

THE HOLY GRAIL OF HEALTH??

For those of you who didn’t sleep through high school biology class, you’ll probably remember the mitochondria.  The powerhouse of the cell.  The site of ATP generation.  Well, fast forward 30 years and our understanding has blossomed.  It is well researched that the beginning of ALL chronic diseases begin with dysfunction in the mitochondria and their ability to generate ATP.  So we need to protect them from harm, and support their function whenever possible.  This article is a nice review on the growing understanding of the mitochondria and health.

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Diabetes and the Secret of Erectile Dysfunction – The Answer Lies Here

Irina Karlova/Dollar Photo Club

 

Let’s face it, erectile dysfunction, or ED as it is known in the radio commercials, is not a good thing.

For us men, back in the late teens, twenties or thirties there could be few things less desirable.  For some reason, though, as we age it becomes almost acceptable for erectile dysfunction.  Maybe it’s because, along with the ED comes a lack of sexual desire, making the ED really a secondary problem.

If you listen to the commercials (which I can no longer do since I threw the radio out the window in frustration) about erectile dysfunction you will be convinced that testosterone deficiency, or low T syndrome, is the cause of ED.

Here’s the real truth.

Erectile dysfunction is cardiovascular disease.  Period.  An erection is all about controlling blood flow.  If blood flow is poor an erection is not going to happen.

This can be due to poor vascular reactivity (aka endothelial dysfunction) where the blood vessels cannot open and close when needed or it can be more advanced where the blood vessels that are supposed to fill the penis with blood are full of plaque (atherosclerosis).

This means that both the short and long term answer for ED needs to focus on the health of your blood vessels (aka vascular health).

Considering that diabetes is so incredibly bad for your blood vessels, the findings of this particular study looking at the relationship between ED and diabetes should come as no surprise.  In it, researchers looked at 220 Type 2 diabetic to see how common erectile dysfunction was and whether depression or anxiety played any additional role.

The questionnaires used were the IIEF (International Index of Erectile Function), SAS (self-rating anxiety scale) and SDS (self-rating depression scale) to assess whether and how much these situations were present.  Here’s what they found:

• 52.9% of the patients were affected by erectile dysfunction.
• In those diabetics who spent less time with their HbA1c levels below 7% (indicating that they were better controlled) over a two year period had a lower likelihood of ED. The reverse was also true.
• Patients with ED had higher levels of triglycerides and fasting insulin.
• Resistin (a hormone released by the abdominal fat that has been linked to prediabetes and diabetes) levels were higher in patients with ED.
• Free testosterone was lower in patients affected by ED (remember that this is just ONE other problem and NOT the cause of the ED).
• Depression and anxiety were not related to the risk of ED.

Over half of the diabetic patients had erectile dysfunction.  Half.

There are VERY few diabetic patients who cannot drastically improve their health with the right dietary choices, exercise program and attention to simple things like drinking out of plastic water bottles.  Many of the diabetics I come across knowingly and willingly make less-than-ideal choices.

If it was me, I would have to balance these lifestyle choices against the risk of developing ED.  Can’t say not exercising on a regular basis or eating that 2^nd serving at dinner would win out.

If you’re really interested in learning about how you can make better choices, I would strongly suggest checking out my Diabetes eBook by clicking here.

 

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High Intensity Exercise and Heart Damage

IS THERE SUCH A THING AS TOO MUCH EXERCISE?

As a martial artist for many years now, I’ve never been a big fan of long distance running.  I’d much rather go the interval route like fighting in the boxing ring.  I’ve also encouraged patients to follow more of a modified interval type training designed to increase cardiac function and resiliency.  And, quite frankly, I don’t think humans were designed for long distance aerobic activity.

Seriously–think of a single animal we would have stalked or been stalked by that would’ve taken an hour to accomplish?  Think you can outrun a tiger for an hour?  Chase an antelope for an hour?  I’m thinking not…

So this study looked at ventricular function in normally trained and endurance trained athletes after a short bouts (14, 1 minute) of all out running.  They found that, in the endurance trained athletes there was a reduction in heart function that wasn’t present in the normally trained athletes.  So why is this?  I have spoken to runner’s groups about the amount of oxidative stress generated during endurance events.  It is highly likely that these endurance athletes may be in a chronic state of oxidative stress, leading to rapid reduction in cardiac function with high levels of intense exercise.

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Anti-Seizure Medications: Are You on Too Many?

Too many seizure meds may create problems

The mainstream approach to treating seizures is to use medications.  And it pretty much stops there.

You may get some cursory advice to exercise and watch your stress levels, but the reality is that many neurologists believe that nothing you can do will be as powerful as the anti-seizure medications.

When those medications don’t work at all (which is about 30% of the time) another medication is tried.  Most of this is guesswork.  There really is no science behind who will benefit from Drug A over Drug B.  Much of this is provider experiences—they go with what they know.  And they are more likely to try the new fancy drugs over the older ones that have decades of history.

When the list of drugs doesn’t work or doesn’t give adequate seizure control, another drug is added to the mix.  At this point, we’re completely out of the realm of double-blind placebo controlled studies and into guesswork.

Every anti-epileptic drug has a list of side effects.  Some minor, some life-debilitating.  And the more drugs you add in, the longer this list of side effects becomes.  And this still does not guarantee that the seizures will be controlled.

Poor controlled seizures are called refractory.  In this interesting study, researchers took 962 patients with drug refractory epilepsy and put them in a neurology ward to see what would happen if the number of medications they were on were reduced from an average of 4.24 down to a maximum of three AEDs during their stay in the ward.

Personally, I think 3 meds still sounds like an awful lot of foreign chemicals running through the brain.  I’d wonder how many of these patients were also trying natural approaches to seizures that have been shown to be effective like exercise, omega 3 fatty acids, vitamin D and diet.

Here’s what they found after these patients were followed up 6 months later:

• After the tapering of the drugs, patients were on an average of 2.65 AEDs.
• In 82.7% patients there was either a REDUCTION in seizure frequency or no change at all.

So basically, taking these patients off of some of their drugs led to no change or an actual improvement in seizure frequency.  Clearly there is something wrong with the way these patients were managed.  For me, this makes it clear that medications are not the only answer and can actually begin to create more problems than they solve.

If you suffer from seizures and the first medication that you take does not adequately control your seizures, it is clear that you can no longer rely on medications alone to help heal your brain.

While it is beyond the scope of this post to outline things that can be done to heal your brain, feel free to check out my Migraines and Epilepsy book by clicking here.

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Childhood Obesity and Breast Cancer Links

Kokhanchikov / Dollar Photo Club

I have said that a girl developing breasts at 8 and starting her menstrual cycle by age 9 is a very scary recipe for breast cancer.

And yet this is exactly what we are seeing.  The number of Elementary school girls who can be classified as overweight or obesity has risen continually in the past decade or so.  While these numbers seem to be leveling off, it will remain a concern for many years to come.

I have written continually about how situations that occur in childhood will affect that child decades later as an adult.  Obesity cuts across so many of future health conditions in so many ways, with conditions such as heart disease, diabetes and cancer having roots in childhood health conditions.

In this particular study, researchers looked at how the bodies of obese adolescent girls break down estrogen.  In general, estrogens can get broken down into one of 3 pathways—the 16 and 4 pathways, which are known to damage DNA and cause cancer, and the 2 pathway, which is generally considered protective and lowers the risk of cancer.

In this small study, researchers looked at 12 lean and 23 obese pre-pubertal girls (Tanner Stage I breast and pubic hair) and compared body weight to estrogen breakdown products.  Here’s what they found:

• Estradiol concentrations were 6.9 times higher in obese versus lean girls (3.45 pg/ml vs 0.5).
• Concentrations of 16α-OH-E1 were 14.34 times higher in the obese girls (7.17 vs 0.5).
• The protective 2-MeO-E2 levels were lower in the obese group.

In other words, even at a very young age, these girls were priming their risk for breast cancer.  Obviously, maintaining an ideal body weight is a top priority.  It is also very important for society to understand that being overweight as a child is not a temporary thing or something to brush aside as aesthetic but not health-damaging.

In the meantime, cruciferous vegetables (broccoli, cauliflower, cabbage, radishes, Brussel sprouts…) are known to help our bodies break down estrogens in a protective, non-cancerous way.

Another very important factor that is hardly ever addressed is our exposure to environmental estrogens.  Plastics, Styrofoam, phthlates and flame retardants can all have estrogen-like activity in the human body. Identifying and eliminating (or at least reducing) these chemicals in yours and you children’s lives needs to be a consistent habit.

Lastly, constipation can actually increase the estrogen levels in the body.  The body eliminates estrogens through a process called conjugation that occurs in the liver.  The conjugated estrogen is then put into bile and is supposed to be eliminated in the feces.  But, if you’re constipated, that estrogen never makes it out—rather it is broken down by bacteria in the gut and thrown back into the bloodstream, free to wreak havoc on estrogen sensitive tissues like the breast and endometrial lining.

Of course, living an anti-cancer lifestyle in general will also help protect the estrogen levels from obesity from damaging the breast tissue, but this is all just going to be a band-aid until the weight is better managed.

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The Mammography Debate Continues; Are You a Victim?

 

Monkey Business / Dollar Photo Club

Society and medicine are very slow to adapt and change.  This may be fine in some situations, but when it comes to mammography and breast cancer, the consequences are extreme.

The story needs to start with what exactly constitutes “breast cancer.”  The two most common types are lobular and ductal carcinomas.    Both of these have invasive and is-situ versions.  There is no doubt that the invasive forms of both are scary situations.  With the in-situ types, the abnormal cells have not penetrated beyond the surface of the cells.

You’ll notice I did NOT call this cancer.

In-situ is a precancerous state.  It is NOT cancer, although it does indicate that your current state of health is in jeopardy and that the risk of developing invasive cancer in the future is high.  Overall, though, only a small percentage of women with DCIS will progress to invasive ductal carcinoma.  Some 15% of women have DCIS found at autopsy; meaning that these women died WITH DCIS not FROM DCIS.

But what happens when you get diagnosed with DCIS?  All the scary things that you think about—the worry, the discussions with family, the surgery, the chemo, the radiation and the lifelong damage that you carry from this pattern of treatment.

Let’s put this in perspective.

• You have an abnormal PAP screen. Your doctor immediately gets you in for a surgical removal of your uterus and ovaries, followed by chemo and radiation.
• Your dermatologist removes a small lesion on your skin by burning it off, just to be safe. But, just to be REAL safe, you undergo PET scans and biopsies to make sure nothing has spread followed by chemo and radiation.
• You come out of your colonoscopy and your GI doc said they took out a small polyp. He then immediately schedules you for a colon resection with follow up chemo and radiation.

Of course these 3 scenarios sound like massive overkill a ridiculous approach to treatment.  But they are NO different then what we do with ductal carcinoma in situ.  When women are told that this is cancer (which it is NOT, it is precancerous) the entire psychological impact of the “C” word comes into play.

Every statistic related to DCIS will tell you that it accounts for about 20% of breast cancer cases and that the incidence of DCIS has been increasing over the past few decades.  This increase mirrors the increase in the public health recommendations to increase mammogram screenings.

Here’s the rub.  Despite this increase in DCIS and the increased number of women undergoing breast cancer treatment, the overall mortality rate from breast cancer has not changed.  Should raise some questions, don’t you think?

Should we be aggressively treating DCIS that, in most cases, will never create a problem?

Some women would prefer the aggressive treatment just on the off-chance that the aggressive treatment will save them in the future.  Think Angelina Jolie.

Just in case you are in this camp of taking the aggressive treatment, this particular article really helps put everything in perspective.  In it, researchers looked at the substantial harms associated with overdiagnosis associated with mammography and the medical and societal costs from this overdiagnosis.

The researchers looked at the cost data from a major healthcare insurance carrier covering some 700,000 women 40 to 59 years old, who had undergone routine mammograms from 2011 to 2013.  Here’s what they found:

• 11% of the routine screening mammograms resulted in false positives.
• The translates to 3.2 million receiving false positive mammograms each year, at a cost of $2.8 billion annually (yes—with a “B”).
• Of the true cancers detected, with an accepted overdiagnosis rate of 22% (based on previous studies), 20,116 women would be overdiagnosed with invasive breast cancer, at a cost of $1 billion each year.
• For DCIS, the rate of overdiagnosis is a shocking 86%. With these numbers for DCIS the estimated the cost of DCIS overdiagnosis nationwide to be $243 million.
• Put together, they estimated costs of $1.2 billion in overdiagnoses for both invasive breast cancer and DCIS and another $2.8 billion for the workup and treatment costs associated with false positives.

These are serious numbers.  This may help you understand why so many groups were against the recommendations to stop routine screening women under age 50.  There’s a LOT of money to be lost.  These groups continue to shout from the mountaintops that routine screening should be done and the mounting evidence demonstrating significant harm from routine mammography is all hogwash.

No one seems to be taking you, the female patient, into consideration.

The best discussion between you and your doctor would be one that discusses the very real and very likely chance that you will be diagnosed with a condition that will never harm you.  This should take into account your family history, lifestyle factors and age.  This discussion should then naturally steer towards what lifestyle choices you should choose to dramatically lower your personal risk of breast cancer.

If this is NOT the discussion you are having with your primary care physician, then maybe it’s time to find a new one.

 

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Are You Giving Your Kids this Vitamin?

 

Vitamin D as a child affects life as an adult

You take your vitamins religiously. You exercise and watch what you eat.  But your kids?  You send them to school with a Twinkie and fruit juice and don’t think twice about vitamins for them.

It’s not that you don’t care about your kids, it’s just that we don’t really think of them as having the problem.  We think of kids being more resilient and the choices that they make not having a long term impact.  But we just now that this isn’t true.  There is a long list of things that happen to children that have effects decades later as an adult.  These can include:

• Childhood maltreatment (physical, emotional, nutritional, sexual)
• Exposure to parents who smoke
• Antibiotic exposure as an infant

The point is that things that happen in childhood DO matter.  These things can play a huge role in the health challenges your child will or will not have to deal with as an adult.

That’s a pretty strong responsibility as a parent.

Luckily some things are easier to implement.  Which brings us to this particular study looking at the relationship to vitamin D levels in children and the health of their blood vessels 27 years later (as measured by carotid artery intima media thickness, or IMT).  Here’s what they found:

• Children with the lowest levels of 25-OH vitamin D (<40 nmol/L or 16 ng/ml–a very low number) were 70% more likely to have high-risk IMT.
• These same low-level vitamin D kids were 80% more likely  to have risk factors for heart disease as an adult.

This is a very simple addition to your child’s routine.  With Keegan (9 years old), he gets 6,000 IU of vitamin D per week.  That’s only 3 drops per week of the Biotics Bio-D-mulsion Forte formula that I recommend here in the office.  I will usually add another drop of Biotics Bio-Ae-mulsion Forte as well (vitamin A 12,500 IU) to help support immune function.

This combination has seemed to keep his immune system humming at top efficiency and according to this study, may be protecting his blood vessels at this very moment…

 

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Enhance Your Wellness Along with a Lifecare Chiropractic care In Mesa AZ

The body is actually a development that still frustrates lots of viewers, specifically when that pertains to caring for this. That is actually a bypast determination that bad medical care and also outdoors impacts are going to provide greatly to its own wear and tear. There are actually several physicians which concentrate on particular regions of the body system. Meanwhile, when this concerns the spinal column as well as the technique this impacts our company the most effective medication is actually a chiropractic doctor. Higher anxiety can easily have a significant cost on your body system. The effects may vary coming from clinical depression as well as anxiousness to blood stream stress problems. Although a back rub could offer a tiny amount of alleviation, chiropractic specialist deals with prompt as well as lasting wellness problems.

A Very early Beginning.

Our team possess all listened to the notices, boost your stance, or even you will certainly be actually perambulating along with a hunchback. Some notices regarding pose advise that your development might be influenced. As a moms and dad selecting lifecare chiropractic Mesa AZ might be the most intelligent selection you ever before created. Actually, the earlier you receive all of them begun, the far better their position will definitely be actually. Research studies present that a correctly lined up vertebrae functions miracles on the growth and also features of the human brain. Aside from an enhanced stance, the open thoughts of a little one indicates that is actually simpler to find out brand-new points.

No person Likes  Discomfort.

People that possess no encounter along with a chiropractic specialist typically create pictures of a great massage therapy. When a chiropractic physician has your situation, there is actually a whole lot much more at post, like a more powerful body immune system. The client is actually specific to experience muscular tissue as well as shared comfort, and also higher versatility. People along with nerves concerns could be delighted to learn that a couple of sees to the chiropractic physician might transform points around within all of them. That must likewise be actually born in mind that back placement can boost hypertension. Prior to eating more tablets, why certainly not find just what our chiropractic physicians may do within you.

Regrettably lousy position may likewise convert in to severe pain in the back. Several grownups produce the journey to their health care physician to aid conceal the signs. A check out to chiropractic and massage in mesa az might handle several of your problems. That ought to be actually born in mind that the chiropractic doctor will definitely pay attention to the large photo and also certainly not the local ache. Chiropractic doctors have actually assisted a lot of people cope with agonizing problems, featuring migraine headaches. The neck and throat and also pain in the back are actually likewise high up on the listing of success. The very best updates is actually that the client will not jeopardize a chemical addiction with prescribed medicine, which merely hides the signs anyhow.
Perform This Within Your Wellness.

Chronic Migraine Headaches, Inflammation and Your Belly

Naeblys/Dollar Photo Club

There ARE answers to eliminating or reducing your chronic migraine headaches, but the solution is not likely going to come in a pill.

Having been active on several of the larger Facebook migraine groups, the attitudes seem to be split.  There are those who are seeking answers because they know that there is an answer someone out there.  The others are there for support because they do not ultimately feel like there is a solution for their chronic headaches.  This group does not like to see the word “cure” anywhere near chronic migraine headaches because they do not believe that there is such a thing.

It’s very easy to see where these patients get this “there is no cure” mentality.  From their doctors.  If the only tools your doctor has in his toolbox are medications, then he or she will quickly run out of treatment options.  Then, since your doctor could not “cure” the headaches, he or she proclaims that there are no cures.

While I have definitely come across a small handful of patients who have, despite doing everything right, could not cure their chronic headaches, these patients are in the minority.  The vast majority of migraine sufferers can indeed find an answer.

But, as I mentioned, this answer is not going to be found in a single pill.  Nor will it be found in a single exercise or single supplement or a single perfectly executed chiropractic adjustment.  Rather, conquering true migraines requires a comprehensive approach that includes stress reduction, exercise, diet, chiropractic care, supplements, stress management and attention to the chemicals you are exposed to.

I never said it was going to be easy.

Sometimes, the answers IS easy and all it takes is the right advice or treatment from someone who can view migraines from a unique perspective.  Other times, the changes needed require a much more committed attack on your part.  Some of these may include:

1. Identification and management of sleep apnea
2. Quitting smoking
3. Getting stress out of your life
4. Achieving and maintaining an optimal body weight

These items can’t just be done with the flip of an internal switch.  I don’t really remember ever telling a patient that he or she needs to stress less. quit smoking or  lose weight and he or she got a surprised look saying that he or she never thought of that before and will start right away on making positive changes.  Nope.  These things require a complete turning around or your interior thought process and a solid commitment to making the right choices for your brain.

And yet they have to be done.  A smoker who is having migraines cannot expect a “cure” until he or she quits smoking.  The same with the other 3 on the list.  Oftentimes, when someone says there is no cure, what they really mean is that there is no medicine or supplement or manual treatment that is going to overcome the damage that these 4 factors are doing to your brain.  Period.

Just to emphasize this point, I’d like to present this particular article.  In it, researchers looked at a small group of migraine sufferers to evaluate the levels of abdominal fat-derived hormones (called adipokines–you can read a prior blog article where I covered this topic more in detail by clicking here) and how these related to the severity of the headaches as well as the response to treatment.  Here’s what they found:

• Initial pain severity was higher as the number and ratios of adipokines increased (HMW:T-ADP ratio and resistin levels).
• In those who responded to the use of sumatriptan/naproxen to control the pain of the headaches, certain fat-derived hormone levels dropped within 2 hours of being given the treatment (T-ADP and resistin levels).
• In addition, in those who responded to treatment, other adipokine ratios improved (HMW:T-ADP ratio decreased and LMW:T-ADP ratio).

So what do the authors conclude?  That we need to look at these adipokines as a new route to treating migraine headaches.  In other words, we need to find a drug that can control adipokines and thereby better control headache pain.

It is this attitude that has kept migraine sufferers from thinking that there is no cure.  The real take home message from this study is that hormones that come from unhealthy fat in your gut play a very large role in chronic migraine headaches.  This means that achieving and maintaining an ideal body weight is an absolute necessity when it comes to migraine treatment.  Without this on the treatment plan, your abdominal fat is actually rising up against your brain, creating inflammation in the short term and damaging the blood vessels that provide all-important nutrients to your brain cells in the long run.

 

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Vitamin D And Cognitive Decline

CAN THIS SIMPLE ACT PROTECT AGAINST LOSING YOUR MIND?

Again beating a dead horse here…the benefits of Vit D are truly too many to count.  This particular study looked at the risk of cognitive decline and Vit D levels in the blood in those older than 65 yoa and found that those with < 25 nmol / L had a 60% greater risk of “substantive cognitive decline.”  Talk about a simple approach.  And considering that these researchers used a cutoff of 25 nmol / L (“optimal” levels are >60 nmol / L) the benefits at optimal serum levels are likely to be much greater.  One of the reasons I think that Vit D has taken so long to catch on is that this would require the national “health” powers that be to put their collective feet in their mouths.  For so long it has been drilled into us to avoid the sun at all costs.  Turns out this info is as destructive to our collective health as the USDA food guide pyramid.  I always advocate reasonable sun exposure coupled with Vit D supplementation.

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Are You a Smoking Parent? Shocking Info You Need to Know

OOZ / Dollar Photo Club

I grew up in a household with two smoking parents. I was the one hanging my head out the car window with the dog.

I can’t go back and change the fact that my parents smoked.  Luckily, their smoking did not influence me to begin my own life-draining habit.  So I escaped the damage.

Or so I thought.

I’m pretty sure the days of parents blowing smoke directly into their children’s faces for laughs are pretty much over.  These days, this same act would almost certainly be accompanied by a visit from child protective services.  But even the most conscientious of smokers can’t protect their children from damage.  This is because few smokers seem to be aware of the concept of third-hand smoke.  Sure, we all know about secondary smoke and passive smoking.  And if you do your best to not smoke around your kids and not smoke in the car you’re going to fully insulate your kids from your bad habits.

Not true.

Cotinine is a compound that shows up in the blood of those who have been exposed to cigarette smoke.  This includes both smokers and the children of smokers.  The higher to cotinine levels, the higher the exposure.  With that in mind, if you are a smoker and you care about your child or children’s health (which I’m sure you do), then you need to pay attention to this particular study.

In it, researchers looked at the carotid arteries of adults who had been exposed to cigarette smoke TWENTY-SIX YEARS earlier.  Here’s what they found:

• The percentage of children without any cotinine in their blood levels was highest in non-smoking households (84%), followed by one smoking parent (62%) and households where both parents smoked (43%).
• Two and a half decades later, the adults who were raised in a smoking household were 70% more likely to have hardening of their carotid arteries.

This is not good news.  This means that the damage to the blood vessels begin as a child as a result of this early exposure to indirect smoke.  And, in all likelihood, it is an ongoing process.  The hardening of the arteries does not happen as a child, but rather is the end result of a decades-long progression of the damage that started way back when.

But it gets worse:

• Even in those households were parents were conscientious about not exposing their children (referred to as good “smoking hygiene”) and whose children had no detectable blood levels of cotinine there was still a 60% higher risk of hardening of the arteries.
• For those children who parents really didn’t focus on protecting their children (poor smoking hygiene–the children had detectable blood cotinine levels) there was a whopping 400% increased risk of hardening of the arteries in the carotid arteries of the neck.

400%.

If you are a parent who smokes, you need to take a hard look at just how much of an effect this is going to have on your kids.  And it’s not an IF, it’s a HOW MUCH.  And we can see that, even it you do not directly expose your kids to cigarette smoke, they are suffering the damage of your lifestyle choices.

Period.

 

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Slash Breast Cancer Risk with this Supplement

CAN THIS SUPPLEMENT SLASH BREAST CANCER RISK??

Hate to beat a dead horse, but I’m going to anyway.  Most types of cancer are repeatedly shown to be lowered through lifestyle factors.  Exercise, Vit D levels, stress, diet, chemical exposure.  The list is endless and puts almost all the power for prevention back in the hands of the patient at risk.

This particular study was a little different, and actually looked at supplement use instead of dietary intake.  The authors found that fish oil supplements may potentially lower the risk by up to 32%.  While they stress that this is not a recommendation to prevent breast cancer (yet), it again points to the power of lifestyle in the ability to prevent breast cancer.

Do NOT EVER rely on early detection (i.e. mammography, self exams, GYN app’ts) to prevent breast cancer.  These are designed to detect problems already present and should NOT be mistaken for “prevention.”

Read More 

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Iron Supplements and Your Health: Good or Bad? 3 Tips to Know

concept w / Dollar Photo Club

Iron plays a tricky role in your health.  On the deficiency side, anemia creates all sorts of problems.  But the other end has a dark side as well.

Iron’s principle role in the body is to form the anchor to which oxygen binds in the hemoglobin molecule inside of your red blood cells.  It also serves much the same function in the myoglobin molecule within skeletal muscle.  Lastly, iron plays a role in certain enzymes that help with energy production and detoxification (namely the cytochrome family of enzymes).  When iron functions the way it is supposed to all is good.

However, there is a dark side to iron.  Iron is a strong oxidizing agent when it is set free in your body.  After head trauma, for instance, the damaged tissue leaks blood into the surrounding brain cells, releasing free iron in the process.  Being an oxidizing agent, the iron goes on to do what iron does–oxidize and damage the uninjured tissue surrounding the damaged tissue.  This sets up the process of oxidative stress, jeopardizing the ability of brain cells to safely generate the energy they need to function properly.  Fast-forward 5, 10 or even 20 years later and seizures can develop.  This is one of the reasons why head trauma can be a later risk factor for seizures–because of the free iron.

Another little tidbit about iron–it can cause bacteria to reproduce like wildfire.  This is one of the reasons why iron is protected and held on to tightly by your body–so that invading bacteria cannot use the iron to reproduce and do nasty things like kill you.  When it’s not doing its work inside of cytochrome enzymes or hemoglobin, extra iron sits idly by inside of your cells in a storage protein called ferritin.  When your body decides it needs to move iron around from one place to another it uses a different protein called transferrin.  All this means is that iron is not supposed to be running around wild wreaking havoc on your long term health.

But this is iron that is working properly inside of your body, kept away from the mean, bad bacteria wishing to rise up and conquer your immune system.  What about the iron in your gut that is present before it is absorbed?

Turns out this may be a problem.

This particular study looks at the use of two different formulas in two different studies (one study with a formula containing a maize porridge with and without 2.5 mg of iron as NaFeEDTA and the other with the same porridge with and without 12.5 mg iron as ferrous fumurate) in a group of 115 six-month-old Kenyan infants followed for 4 months.  Here’s what happened:

• At the beginning of the study, a large chunk (63%) of the bacteria present were Bifidobacteriaceae.
• Iron increased the class of bacteria called enterobacteria, which included the dangerous E. coli strains and Shigella while decrease the amount of friendly bifidobacteria.
• Iron also increased the inflammation in the gut (as measured by fecal calprotectin).
• During the trial, 27.3% of the infants who got the 12.5 mg of iron required treatment for diarrhea versus 8.3% in the group that didn’t get the iron.

We are still learning more about the microbiome every single day.  I have recently begun to believe that, while probiotic supplementation is a good idea, it is rarely the only thing needed to combat the ills that come with a bad bunch of bacteria in your microbiome.  Avoidance of antibiotics (unless TRULY life-threatening) and attention to diet are critical.  Stress management.  Strong soluble and insoluble fiber intake.

And, as we begin to find out other aspects of what affects the bacterial balance in your gut, using these new findings to your advantage.  In this case avoiding iron supplementation unless you are sure that it is needed.  A few tips when it comes to iron:

1. The best way to get iron is from foods (organic, grass-fed beef, organic chicken, lentils, beans, chickpeas, green leafies)
2. The ferrous form of iron is a much better absorbed form.  If you absorb the iron, it can’t help feed the growth of undesirables lower in the gut.
3. Adding vitamin C to your iron can help you absorb the iron better.

Follow these tips and you are adding another positive piece to the puzzle that is the bacterial microbiome in your gut.

 

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The Diabetic Breakfast; Why You Should Avoid Oatmeal

mariiya / Dollar Photo Club

This is not the first time I’ve debunked the idea that oatmeal and Cheerios are good breakfast options, despite the frequent recommendation.

Breakfast is, without a doubt, one of the most important health decisions you’ll make in a given day.  And that decision starts with actually having breakfast.  The decision to skip breakfast is one of the most common problems I find in patients.  Sometimes patients say they just aren’t hungry, don’t have time or are nauseous when they first wake up.

If you’re not hungry first thing in the morning, all it takes is a little amount of fuel to begin your day properly.  A handful of raw almonds or a tablespoon of real peanut butter can be enough to jump start your system.  Here’s the deal:  Your brain needs fuel in the morning whether you feed it or not.  If you choose to skip breakfast, your body will break down precious muscle to fuel your brain.

If you’re looking for the “less muscle, more fat” look, then by all means continue to skip breakfast.  If, however, this isn’t the look you are deliberately going for, then breakfast has to be on the menu, hungry or not.  Eventually, your body will get used to getting fed early and will let you know it’s ready for fuel from outside the body by stimulating hunger.

The time excuse is not a good one, either.  I’ve had patients use the time excuse but will run through the drive-thru of McDonalds to buy an Egg McMuffin, which arguably takes time as well.  Compare that to warming up an Amy’s breakfast burrito for 1 and a half minutes in the microwave (with the added bonus of being less expensive).  The same goes for the aforementioned handful of almonds or bit of real peanut butter.

As for the nausea, this boils back down to your body looking inside for fuel.  The sympathetic / adrenal pathway gets activated and this shuts down digestion, potentially leaving you feeling nauseous.  Again, within a short period of time your body will adapt to being fed and you’ll find yourself being hungry instead of nauseous at breakfast time.

Which brings us back to the all-important “what” for breakfast.  This has remained an avenue of very poor recommendations for a long time now.  Yogurt, with very few exceptions, is not a good option.  If you’re going to do yogurt, make sure you’re doing plain Greek yogurt with a higher protein content and lower calories (you’ll have to read the labels and compare…consider brands like Fage that can be found at Costco) only with a serving of fresh or frozen fruit added in.

Oatmeal, again with a few exceptions, is not a good option.  Certainly the instant Quaker-type oatmeals are absolutely off the list.  I’m usually ok with the steel cut, slow cooked oatmeal with some high quality protein source mixed in (real peanut butter, nuts, granola).  But the vast majority of the oatmeal that people seem to choose for breakfast doesn’t cut it.

In general, the anti-diabetic breakfast (which we should all be eating) should be protein-based or very high fiber (8 grams or more).  Good recommendations include:

• Eggs, either scrambled in olive oil or hard-boiled
• High fiber, unprocessed breakfast cereal in something other than cow’s milk (Nature’s Path, Cascadian Farms, etc…)
• Real peanut or other nut butter (no added oils) in celery or on true whole-grain bread
• Granola (just be careful of the calories!)
• Steel cut, slow-cooked oatmeal with a high quality protein mixed in
• Juicing (the blending type with the pulp included) so long as you add in some type of high quality protein like powered peanut butter, high quality whey or pea protein or high protein Greek yogurt.

Just how important are these breakfast decisions for fighting off or controlling diabetes?  This particular study gives us some insight.  In it, researchers looked at the effect of glycemic index (a score for how fast sugar shows up in the bloodstream after eating a meal, the lower the better) of 4 different meals on certain markers of diabetes in a small group of Type 2 diabetics.  Here’s what they found:

• There was more glucose in the bloodstream in the high glycemic index diet with low fiber.
• The amount of insulin after patients consumed the high glycemic index, low fiber diet was 13% higher than the low glycemic index, high fiber diet.
• When consuming a low glycemic diet, the diet with high fiber led to 12% lower insulin levels after a meal.
• Ghrelin (a hormone that helps increase hunger) dropped ONLY after the low glycemic index diets (both with high and low fiber).

Overall, it is very clear that your breakfast choices will have a clear effect on how well your body does or does NOT respond after the meal.  Choosing the options listed above will lead to a much stronger anti-diabetic effect and protect every other aspect of your health.

And you’ll notice that Cheerios, the go-to breakfast to lower your cholesterol (which is probably because you’re prediabetic…), in no way, shape or form fits these recommendations.  And you will also notice that fruit, by itself, is NOT on the list.  Nor is orange juice (all calories, little value).  These items have way too much carb content without the needed protein or fiber to balance it out.

 

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Childhood Obesity Stats: Run if the Pediatrician Gives This

 

Dmitry Naumov / Dollar Photo Club

While the incidence of childhood obesity seems to have leveled off, it remains one of the biggest concerns for the future health of our population.

Every pediatric journal I read continues to highlight the concern and the aspects that are contributing to the increasing waistlines of our children.  Almost immediately the need to have our children be more active was hoisted to the top of the interventions to be promoted.  From Michelle Obama decrees, statewide Healthy Children initiatives and McDonald’s commercials, the push has been towards getting our kids moving more.

If only it was  simple.

When that didn’t seem to be doing the trick, the focus has started to (rightfully so) shift to cutting back on calories and avoiding sugary snacks and drinks.  And pediatricians have been leading the charge for getting our kids healthier.

But what if pediatricians are playing a major role in childhood obesity??

Regular readers of this blog will know where this is going.  It is now crystal clear that the bacteria in our collective guts play a massive role in all aspects of our health, with obesity and autoimmune conditions topping the list.

I frequently say that mainstream medicine remains decades behind the medical research, but in few instances is this problem as glaring as the intertwined issue of gut bacteria, probiotics and antibiotics.  It has only been recently that I have been reading in authors in medical journals discussing the overuse of antibiotics on the destruction of the normal bacteria in the gut.

The problem with antibiotic overuse has always been highlighted as antibiotic resistance.  But while this IS a concern, it is dwarfed by the fact that antibiotics decimate the diversity of the bacteria in the gut.  In this manner, antibiotics may greatly increase the risk of obesity, devastating autoimmune conditions and psychological disorders.

While we don’t know everything yet (and probably never will) about how the hundreds of different bacterial species in your gut interact with your health, current research is pointing to diversity as being very important.  With this in mind, in this particular study, researchers looked at the links between antibiotic use in a group of 6114 boys and 5948 girls and the later development of obesity.

The results are a little scary:

• Children who were exposed to antibiotics in the first 2 years of life were, on average, heavier than kids who did not get antibiotics.
• The effect was strongest in those exposed in the first 6 months to macrolides (broad spectrum antibiotics–think Azithromycin, Chlarithromycin and Erythromycin).  Specifically, boys were 72% more likely to be heavier and give 77% more likely to be heavier than the un-antibioticized children.
• In addition, those children who had more than one exposure to antibiotics were 80% more likely (boys) and 87% more likely (girls) to be overweight.

These are significant numbers.  And it wouldn’t be so scary if antibiotics were used for life-threatening diseases instead of being used in conditions like low grade fevers, coughs and ear infections.  It is rare for a child to escape the prescription pad in his or her first two years of life.

So, the next time your child’s pediatrician wants to write a prescription for an antibiotic, first find out if your pediatrician thinks that antibiotics could contribute to obesity in children.  If your doctor gives you a strange look, it is absolutely time to find one that has cracked a medical journal in the past decade.

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Tylenol for Your Pain; Surprising Finding on How Well it Works

Radosław Brzozo / Dollar Photo Club

Society would never consider going without over the counter pain meds. Doesn’t matter what’s it’s for; headaches, knee pain, shoulder pain, back pain.   We don’t seem to care where the pain is; that magical little pill hones in with radar precision to zap the pain and give you relief.

Or at least this is what the advertising messages would have you believe.

For starters, there is no magical honing; all drugs reach all areas of the body.  This is one of the reasons why so many side effects occur in organ systems that have nothing to do with the reason for taking a drug in the first place.

Personally, I haven’t taken any over the counter or prescriptive medications for at least 20 years (it may have been longer—I just can’t actually remember…) despite my share of martial arts injuries over the years.  But I certainly have my share of patients who take them on a regular basis.  We’ve become somewhat immune to the idea that every drug has a risk / benefit ratio.  There is not a drug out there that does not have side effects; since every single drug interferes with the way your body functions to some degree or another this is inevitable.

Paracetamol, the active ingredient found in Tylenol and generic acetaminophen, has a long list of side effects.  Just some of these include:

• Liver damage (overdosing, intentional or accidental, can kill by shutting down the liver)
• Kidney damage
• Behavioral problems in children when used during pregnancy
• Asthma (either worsening existing cases or creating new ones)
• Blood cancers

But, as mentioned, sometimes the side effects are worth the risk (although anyone on the liver or kidney transplant waiting lists may disagree…) so long as there are benefits.

But what if what you’ve been taking your Tylenol for really doesn’t work?  I can tell you that it certainly seems like many of my patients who are in pain and take many of the OTC pain medications aren’t jumping up and down for joy over how well they work (because, after all, they are in a chiropractor’s office looking for additional pain relief.

At the most, they seem to help “take the edge off” or help for a few hours at the most.  This particular study seems to agree with what I’ve experienced in my office.  In it, researchers looked across 13 different clinical trials looking at the use of paracetamol for back pain, knee or hip arthritis pain.  In the review, the researchers looked for the quality of the studies to see what the outcomes were.  Here’s what they found:

• High quality results from the studies found that paracetamol is ineffective for reducing pain intensity and disability or improving quality of life in the short term in people with low back pain.
• High quality results from the studies found that paracetamol used for hip or knee osteoarthritis for that any short-term improvement on pain and disability was not clinically important.
• High quality results showed that those taking paracetamol were nearly four times more likely to have abnormal liver function tests.

When it comes to research, there are no absolutes and no single study can determine whether something works or not. To make it a little more complicated, there are good quality and bad quality studies.  But when you have multiple high quality studies pointing to the same outcome, you can be far more confident that the results from that study may apply to you.

That’s what we have here.  Could you be one of the few for whom Tylenol is going to work for back, knee or hip pain?  Possibly.  But it should not be your first choice given that there is a long list of side effects associated with the use of Tylenol and this review strongly suggests that it is not going to work.

Of course, being somewhat biased towards chiropractic care for these conditions, I would strongly suggest that chiropractic care should be your first choice for treatment of these conditions.

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Knee Osteoarthritis Symptoms: To Use Steroid Injections or Not?

Knee arthritis and steroid injections

Somewhere along the line steroid injections became the knee-jerk (pun intended) reaction for pain anywhere.

Shoulder pain?  Shoot it with some steroids.  Elbow pain?  Wrist pain?  Knee pain?  Scoot right on up and we’ll stick some corticosteroids directly into the joint.  Low back pain?  Despite the fact that there is very little evidence to support it, let’s go ahead and inject steroids into the sanctity of the spinal canal and see what happens.

When given orally, most would shudder at the random use of steroids given the risks of bone damage, obesity, diabetes and brain damage.  But given that it’s just a local injection it doesn’t affect the rest of the body.

At least, that’s what most people (doctor’s included) think.  Then why, in a prior blog article I did several years ago, did researchers find that it didn’t matter whether the injection was given directly into the shoulder or whether it was given in the buttock?  Because it does not matter.  Steroids, whether given orally, inhaled or injected anywhere, have an effect everywhere else in the body.

Because of this, we need to be darned sure that every use of steroids is going to have a positive effect on whatever condition it is being used for.  This definitely includes steroids being used for pain.  Which is why I bring you this particular article.

In it, researchers looked at whether the use of a cortisone injection for knee pain 2 weeks prior to a 12 week supervised exercise program helped in the long run or not.  All participants had arthritis of the knee on X-ray, clinical signs of localized inflammation in the knee as well as knee pain during walking (score >4 on a scale of 0 to 10).

The participants were evaluated using the Pain subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire (range, 0-100, where higher scores indicate greater improvement).  Half of 100 knee pain patients ended up in the steroid injection group and the other half in the placebo-injection group.  Here’s what they found:

• After 14 weeks, those in the steroid group had a change of 13.6 on the KOOS score and those in the placebo group changed by 14.8 points.

Basically, the use of steroids led to a difference of 1.2 points (out of 100).  In addition, there were no differences in physical function, markers of inflammation or additional KOOS pain scores.

In other words, there were increased costs and increased risk of systemic damage from the steroids but no actual benefit.  Just to thrown a further wrench into the use of steroid injections for knee pain, it is entirely possible that the injection itself may have some benefits by disrupting blood vessels and bringing new nutrients and blood flow to the joint.  In other words, the benefits of the steroids may be even less (or worse-creating WORSE outcomes) because the injection portion of both treatments may have therapeutic benefits.

In case this STILL isn’t enough for you, it is very clear that any anti-inflammatory treatment damages the joint surface itself, preventing the cells from healing from future damage.  This means that, not only does the use of steroid injections for knee osteoarthritis symptoms not actually help, but you are damaging your knees for the future.

If you are wondering what else you can do to help your knee pain, feel free to check out my Knee Pain eBook on Amazon by clicking here.

 

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