Drug Treatment for Depression “Bad to the Bone?”

The understanding of the relationship between bone, the gut and diabetes has had exponential gains in the past few years.

Heck–just the fact that there IS a relationship is new news.  For pretty much forever, we have viewed bone as a static tissue that holds stuff up and a place to attach muscles to.  But every system in our body connects and has an impact on every other system; bone is no exception.

We cannot treat “systems” in a bubble and not expect to have an impact on other systems.  In this particular review, authors look at the relationship between serotonin and bone health.

Two-thirds of the body’s serotonin is produced not in the brain, but in the gut.   Higher stress (poor digestion, drugs that increase serotonin levels like the SSRIs, etc…) will actually damage bone growth.  Stress out the gut, produce more serotonin, and you’ll have less bone.

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Common Heart Treatments Increase Heart Disease??

You follow your cardiologist’s advice, thinking it will protect you in the long run.  But what if this is not the case?

It will come to no surprise for regular readers of my blog that I think that lifestyle changes are the ONLY answer for heart disease.  Unfortunately, many patients opt not to make the right changes, or worse–these changes are not even discussed with patients because of a lack of knowledge on the part of the provider.

This particular study looks at outcomes of medical treatment (i.e. drugs), coronary angioplasty (PCI) or open heart surgery (CABG) ten years later.  Here’s the disturbing findings after following 611 patients who had CABG, PCI or standard medical therapy (MT=drugs):

• 10-year rates of needing additional invasive procedures (revascularizations) were 7.4% with CABG, 41.9% with PCI, and 39.4% with MT.
• Those in the drug only group had a 235% higher risk of future cardiac events (including deaths) than in the CABG group.
• Those in the PCI group had a 185% higher risk of future cardiac events than in the CABG group.
• 10-year rates of freedom from angina were 64% with CABG, 59% with PCI, and 43% with MT (P<0.001).

The bottom line?  Medical treatment or PCI actually INCREASED the risk of the need for more stents, heart attacks and / or cardiac death.

Wow.  I know that it SOUNDS like doing procedures is a good thing and it all seems well and dandy on paper, but when translated to the patient the outcomes just don’t work out.  So it boils down to having your sternum cracked open and some blood vessels taken from another area of your body to replace the disease ones that are needed to get nutrients and oxygen to your heart.

Or…

Eat better / stress less / exercise.  Hmmm…tough decision…

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When it Comes to Vaccination, Mother Nature Always Wins

In some cases, the vaccination game is like a giant “wac-a-mole” game.  You smash down one infectious disease only to have another, more powerful bug rise up in it’s place.

The Prevnar vaccination against the Streptococcus pneumoniae bacteria was originally designed against just 6 of the types of this bacteria that can cause ear infections, pneumonia and meningitis.

Sounds great, right?

But, as I mentioned in the title, Mother Nature doesn’t appreciate us trying to best her.

In this particular article, research looked at what happened to the type 19A, a type of this bacteria that is harder to kill with antibiotics, when the Prevnar 7 vaccine was introduced.  Here’s what they found when they looked at the bacteria hiding in 948 infants given different Prevnar vaccinatin schedules (2 doses of Prevnar-7 at age 2 and and again at 4 months; 3 doses at 2, 4, and 11 months; or no vaccinating as the control group) :

• In those who received the 3-dose vaccination schedule, there was a 75% higher risk of having the more dangerous 19A present (16.2% vs 9.2% in the unvaccinated).
• In the 2-dose schedule, these infants were 43% more likely to harbor 19A (13.2% vs 9.2%).

Luckily, after this was realized, on a white horse rode Prevnar 13, which now included the 19A.  But then everyone who had been vaccinated to get vaccinated again.

Wow.  I really wish I had a financial machine like this.  Make billions on the first product that creates a bigger problem, than make MORE money fixing the problem they solved!  And everyone thinks BP Petrolum is the evil corporate giant…

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Info on Heart Failure Your Cardiologist Probably Doesn’t Know

McCarony/Dollar Photo Club

Heart disease remains the biggest killer in the Western world. This is despite billions of dollars pumped into this condition.

Billions of dollars into research, drug development, drug use and cardiology procedures. And yet, all we have to show for it is a slight reduction in deaths from heart disease, but an increasing number of people living with heart disease.

What this tells me is that we are getting better at keeping people alive who have had a heart attack, but we still suck at doing anything to keep people from getting there in the first place.  Most cardiologists and primary care doctors would point to the statin class of drugs as the singlemost important discovery in cardiologist ever.

Which pretty much explains why we’re in the mess we’re in because statins pretty much suck at preventing heart disease. Period. (in case you think this isn’t true, I’d invite you to read through my 100+ page eBook on cholesterol and we can talk after that…)

One thing we HAVE discovered from all the billions of dollars that have gone into cardiovascular research is that heart disease is almost 100% preventable.

Yup.

Seems hard to reconcile that the #1 killer in the Western world is almost entirely preventable. All we need to do is exercise more and eat better.

Except that it’s not quite that simple.

At the surface, yes, healthy dietary choices, not smoking and exercising regularly will eliminate a huge chunk of heart disease in this country. Then there’s the specifics, things like:

1. Short burst aerobic exercise instead of merely walking 30 minutes a day
2. More healthy fats (monounsaturated, omega-3) instead of trans and omega-6 fats
3. Managing stress
4. Avoiding refined carbohydrates and eat more whole grains
5. Avoiding toxic environmental chemical exposure like BPA

But sometimes the answers are far more complex. And way beyond the realm of the average cardiologist.

You see, the human body has never respected the artificial boundaries of medical specialties that we have created. The examples of neurology crossing into gastroenterology, endocrinology crossing into cardiology and obstetrics crossing into psychology are all over the place.

This particular article is no different. In it, researchers looked at 60 stable patients with mild CHF (half with NYHA functional class I to II) and moderate to severe CHF (half with NYHA functional class III to IV) and evaluated the composition of the inhabitants of the gut. Here’s what they found when these heart failure patients were compared to normal patients:

• The entire heart failure population had massive quantities of pathogenic bacteria and Candida.

You can bet these findings will be the key topic of discussion at the next joint Cardiovascular / Gastroenterology convention.

(Yeah, don’t hold your breath waiting for the invite to this event…)

But seriously, these are some VERY striking differences between the heart failure patients and the normal participants. The question is whether the changes in the gut were the cause or the result of the chronic heart failure.

As with everything, the answer likely lies somewhere in between. We already have strong evidence that the bacteria in the gut contribute to obesity and diabetes. It would not be a big stretch to link bad bacteria balance in the gut with the later development of heart disease.

Personally, I’ll keep an eye on the research as it comes out over the next few years linking the gut bacteria and heart disease. In the meantime, I would do everything possible to make sure I’m living a lifestyle that is consistent with a healthy bacterial flora in the gut as well as avoiding antibiotics in all but the most life-threatening situations.

Your heart will must likely thank you for it.

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Should All Patients with a Migraine See a Chiropractor?

Ok..given my bias everyone probably knows my answer here.

It never ceases to amaze me when a patient has had headaches for years or even decades that have never been to a chiropractor.  Given the evidence, it really should be considered malpractice (lack of informed consent) for a neurologist to NOT refer to a doctor of chiropractic for an evaluation of any headache patient.

And yet the referral to a chiropractor who specializes in soft tissue treatment of the neck almost never happens.  It is the migraine sufferer that loses out.

Just how common is neck pain in migraine headache sufferers?  This particular article looks at this question in 113 migraineurs, who had headache frequencies ranging from episodic to chronic migraine.  These headaches sufferers were examined by headache medicine specialists to confirm the diagnosis of migraine and rule out both cervicogenic headache and fibromyalgia.

For each attack over the next few months, sufferers recorded the whether nausea was present as well as the intensity of headache and neck pain (graded as none, mild, moderate, or severe).  Here’s what they found:

• There were 2411 headache days, 786 of which were migraines.
• The majority of migraines were in the moderate pain stage.
• Regardless of the intensity of headache pain, neck pain was a more frequently present than was nausea.
• Those diagnosed with chronic daily headache were more likely to have neck pain.

So what does this mean?  From a standard migraine approach, this means that, although the presence of nausea is a characteristic of a migraine headache, neck pain (which is not a characteristic) is actually more common.

From my standpoint of almost 20 years of treating migraine patients, we have totally, absolutely missed the ball.  Since most headache specialist do not touch the patient and wouldn’t even know how to treat problems in the neck is he or she found them, these patients are mis-diagnosed.

I can’t tell you how many times I’ve had patients come in with a diagnosis of “migraine” only to have the headaches go away with soft tissue treatment of the neck structures combined with manipulation.  These were NOT migraines.  Migraines generally do not respond as well to manual therapies, but most often need a lifestyle overhaul to manage the headaches.

The bottom line?  Neck pain is strongly associated with headaches.  If you have headaches, it is absolutely essential for you to find a chiropractor competent in soft tissue treatment to see if this will help.

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Does Your Cardiologist Perform this Invasive Procedure?

If you have any interactions with a cardiologist, this is a must read.  And read VERY carefully.

Percutaneous coronary intervention (PCI) is the procedure where a stent is (almost always) placed into a coronary artery.  Most know this as coronary angioplasty.  This procedure largely did not even exist a decade ago (it began to blossom in the late 80’s, but it seems to me like the past decade has seen major increases).   It has created an entire field within cardiology called interventional cardiology.

It has been established that coronary angioplasty for non-emergency chest pain really does nothing but makes the patient feel better temporarily, until they actually have a heart attack sometime in the near future.  To make this a little more problematic, this is NOT a cheap procedure (runs around $35K) and has its list of side effects, including death.

But does your cardiologist know this?  In this particular study, researchers asked this very same question of a group of 27 cardiologists (10 interventional and 17 referring).  Here’s what they found:

• 63% of cardiologists surveyed agreed that PCI is ONLY good for symptom relief.  Symptom relief only.
• Almost 3/4 of patients felt that, without the PCI, they would definitely suffer a heart attack in the next 5 years
• 88% of patients, however, mistakenly believed this procedure would prevent a future heart .  Talk about a disconnect!
• The real deeper problem here, however, is that, despite the fact that this procedure would only manage symptoms and not really fix anything, 43% of cardiologists would STILL PERFORM THE PROCEDURE!!

Yes–almost half of the cardiologist would still perform a $35,000 procdure with death as a potential side effect that does little other than help with chest pain.

And your insurance will gladly pay for it.  No wonder our system is so screwed up!

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Are Your Cooking Pans Damaging Your Child’s Health?

You know those wonderful, non-stick pans that you love so well?  I hope you realize that many of today’s “conveniences” like non-stick cookware come with a price beyond the initial purchase.

The wonderful Teflon that keeps all your foods from sticking to the pan is no exception.  The chemical compounds typically found in non-stick cookware include 25 cent words like perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS).  Toxic compounds like these have been found to affect thyroid function, cancer risk and heart disease.

In this particular study, researchers looked at the relationship between PFOA and PFOS levels and cholesterol levels in 12,476 children.  Here’s what they found:

• PFOA was linked to higher total cholesterol and LDL-C
• PFOS was linked to higher total cholesterol, HDL-C, and LDL-C

Even if these compounds were not linked to heart-disease-friendly changes in blood lipids, do we really want something called “perfluorooctanoic acid” in our children’s blood anyway when the word is too long to even fit on a Scrabble board??

Toss your non-stick cookware and buy stainless steel.

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Have I Mentioned that Prediabetes is Bad for the Heart?

I have said before that, from my standpoint, diabetes and heart disease are the same thing.

Seventy percent of diabetics die of cardiovascular causes.   Almost all heart disease sufferers have some trace of diabetes or prediabetes.  The lifestyle changes that impact one impact the other, both negative and protective.

In the medical research over the past few years, there has been a very strong push towards using a compound called brain natriuretic peptide (BNP) to estimate risk for heart attacks and strokes.

In this particular study, research found that the more prediabetic factors someone had, the higher his or her levels of BNP.

You can rest assured that this is because a drug to control BNP levels would then be a brand new blockbuster drug worth untold billions of dollars.  In the end, this would really just create another drug to dance around the problem of insulin and the cell not playing well together and not actually fix anything but a number found on bloodwork.

Just like blood pressure meds, diabetic drugs and statins for cholesterol.

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