AND YOU THOUGHT THE HEART PROBLEM WAS BAD NEWS

The problem with the way the body works and the way medicine is set up is that our bodies do not respect these artificial barriers of specialties.  That means that, when we treat ourselves badly, it is not just one organ (i.e the heart) that is affected.  It is not just diabetes that occurs.  It is not just weak bones that occur.  It is not just cancer.

The sad fact is that the risks for all of these track together.  If you have one, you’ve got them ALL, just not always to the point of getting a named disease or condition.

In this particular study (and it’s not the first one along the exact same lines), researchers looked at patients who were found to have colorectal masses on colonoscopy.  As if this isn’t bad enough news, in those patients who had mass, they had a much higher risk of also having heart blockages.  The reverse was also tru–those having cardiac procedures (in this case angioplasty) had a much, much greater risk of having colorectal masses.

Herein lies the problem with using medications designed to treat a single disease.  They are designed to address only ONE condition (and usually do a pretty poor job of even that).  Lifestyle changes, on the other hand, cut across every disease state we know of.

 

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The Cost of Medical Research; It’s Not What You Think

Kenishirotie/Dollar Photo Club

The drug companies use the cost of drug development as a rationale for charging massive amounts for new drugs when they get brought to market under a patent.

The reality is that many of these drugs are priced far above what it cost to bring it to market and definitely beyond what it costs to produce.  In other words, it has nothing to do with what the drug company’s costs were or are; it instead has to do with how much the market will bear the costs.  This leads to massive profits.

But this is NOT were the true cost of these drugs lie for society.

The true cost lies with the fact that many of these drugs are a complete waste of money.  (This of course does not begin to account for the damage done from drugs that are later taken off the market or given black box warnings for safety reasons discovered after the drug was launched)

Sound a little extremist?

Before you judge me, you need to understand the concept of SURROGATE END MARKERS, which I have discussed many times before.  A surrogate end marker is used in drug research studies to basically save money and time.

The ultimate classic example is cholesterol lowering drugs.  Lipotor was initially approved and based on its ability to lower cholesterol levels.  What I usually point out is that no one really gives a hoot about his or her cholesterol levels, it’s just that no one wants to have a heart attack or stroke.  Using cholesterol as the surrogate end marker for heart attacks, the Pfizer did not need to run years-longer, more expensive studies to see if Lipitor actually lowered rates of heart attacks.

And that’s what happened.  It took YEARS before the studies on statins were done and published to see if cholesterol lowering drugs actually lowered rates of heart attacks.  When the dust finally settled on the topic, the results were less-than-stunning.  About a 1% absolute reduction in the rates of heart attacks.

The amount of money wasted (and continuing to be wasted) on this class of drugs is beyond most of our comprehension.

If this was an isolated example everything would be maybe OK, but it’s not.

Blood pressure medications for stage 1 hypertension (systolic <160 or diastolic <100) do not lower the risk of heart attack, stroke or death.  What the heck are we wasted BILLIONS of dollars on them then???  (I’d love an answer, but I fear the question is largely rhetorical)

Fancy new cancer drugs that improve “disease free survival” do not actually help cancer patients live longer but cost tens of thousands of dollars more per patient.

But we can’t leave diabetes medications out of the mix.  About a decade ago, there began a massive shift in research dollars towards a gut hormone called GLP-1 that happened after researchers found that a compound in Gila monster spit could act the same in our bodies.

Since that time, published research on this hormone and the class of drugs that could slow down our body’s own breakdown of GLP-1 (normally only last about 1-2 minutes in our own body) has dominated the diabetes medical journal landscape.  These two types of drugs (GLP-1 like drugs and drugs that slow down our body’s breakdown of this same hormone) hit the diabetes drug market at a full-on sprint with names like Byetta, Vicotoza, Januvia and Onglyza.

And they weren’t cheap (lots of variables, but on average $300+ / month)

But no one could argue that they did a better job of control blood sugar (if you can ignore those pesky side effects like acute pancreatitis and pancreatic cancer).  But one COULD argue that the lesson from the past about using surrogate end markers almost always ends up to be a bad plan.

You see, most diabetics die of heart-related complications.  This means that any drug used to treat diabetes really has to have an impact on heart disease if it’s going to be worth squat.

I’m betting you can see where I’m going with this….

In this particular study, researchers evaluated any published studies done on the benefit of DPP-4 inhibitors (the drugs that block the enzyme that breaks down GLP-2 so quickly) and major adverse cardiovascular events (MACE).  Here’s what they found when they looked over 69 different trials with almost 68,000 patients:

• Luckily, when compared to another class of diabetes drugs called sulfonylureas, DPP-4 inhibitors were associated with a 42% lower risk of MACE.
• But when the DPP-4 inhibitors were compared to the newest class of drug for diabetes (SGLT2 inhibitors, which allow sugar to be lost through the kidneys) they were linked to a 89% higher risk of MACE.
• When compared to placebo the expensive, heavily used, new class of drugs that mess with the GLP-1 pathway, there was no benefit on major cardiovascular events.

To sum this up, an entire new class of drugs designed to help diabetics manage blood sugar are pretty much worthless at preventing the major complication in diabetics.

With this in mind, it doesn’t matter squat what it cost to develop or what it costs to manufacture because the drug doesn’t really help diabetics in the long run.  This means that cost to society is equal to pretty much every dime spent by the healthcare system on this class of drugs PLUS the medical costs associated with the sometimes dangerous and fatal side effects from the drugs.

Good thing more people have access to drugs through the Affordable Care Act.

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My Biggest Frustration with Migraines

Chronic migraines as a progressive brain disorder

I have dedicated a significant amount of time to migraines.  From treatment in my office to hundreds of review articles of medical studies to publishing a book on Migraines And Epilepsy, I consider myself quite educated on the topic.

While there have been a few exceptions in my office (literally less than a handful over the past 18+ years), if patients are willing to make the changes I recommend, they get better.  My recommendations range from a course of treatment in the office to exercise to managing stress to major lifestyle overhauls.  If patients are willing to make these changes, I can almost guarantee that migraines will be history.

Why?  How can patients get better with my recommendations versus the neurologist that they’ve been seeing for years and practice out of a very well-known hospital system?

Because the “why” is far more important to me than suppressing the symptoms of a migraine.  It is VERY rare that I have a chronic migraine patients come into my office that has been educated on the underlying cause of his or her migraine headaches.

But before I get into the secret of migraine headaches I need to make a very important distinction.

By the time patients make it into my office they have accumulated multiple types of headaches.  The two biggest classifications are structural and migrainous.  And I can say, with a high degree of confidence, that every migraine patient has aspects of both.

The structural headaches are related to the soft tissues (ligaments, tendons, muscles and fascia) and joints.  While my opinion is strongly biased, these types of headaches HAVE to be addressed by a chiropractor that understands and treats the soft tissues.  Adjusting alone, exercises alone, Botox alone (and yes-if someone responds to Botox it is because they have been improperly diagnosed with migraines instead of a structural headache) or soft tissue work alone is not going to completely fix the problem.

But, as I mentioned, it’s my bias based on almost 20 years of treatment migraine patients who have not responded elsewhere.

The true migraine headaches, however, do not respond well to good structural care.  This is because the true cause is not one that can be addressed from outside the body.

If you experience chronic migraine headaches and you really, really want to get rid of your headaches, you’re going to have to address the health of your blood vessels.

Period.

Anything less will not guarantee a fix for your headaches.  And medications?  Not a damn one of them will fix your blood vessels.  Some will actually make it worse.  And even if medications control your headaches, they have not fixed the problem.

Poor blood vessel health, endothelial dysfunction, vascular dysfunction.  It goes by different names depending upon who you are speaking to, but they all mean the same thing.

The blood vessels of a true migraine patient have lost the ability to respond appropriate to changes in demand for blood supply.  This system—where the blood vessels open and constrict based on how much oxygen the tissues need—is an incredibly dynamic process, with changes occurring by the second.  If your blood vessel is no longer able to respond to needs of your brain cells your brain cells are not going to be happy with you and can trigger a migraine.

THIS is the key to understanding your migraines.  THIS is the key to lifestyle changes that will help your chronic migraine headaches.

I have certainly spent time on migraine message boards and there are a lot of headache patients who get pissed off at my suggestion that headaches can be fixed.  These patients, however, have not achieved ideal body weight.  They are stressing too much.  They are not eating the right foods (even if he or she thinks his or her diet is ideal).  They are not exercising.  They are smokers.

I would suggest that, as much as it may be offensive to some, patients with true migraine headaches have not made the correct choices for his or her blood vessels and brain.

The details of these changes are beyond the scope of this article, but are outlined very readily in my book Migraines and Epilepsy that can be purchased by clicking here.

While many migraine sufferers care about getting rid of or controlling headaches, there is a bigger problem looming.  Poor blood vessel health has everything to do with risk of heart attack or stroke in the future.  This is absolutely, unquestionable solidly demonstrated in medical research study after research study.

Most of these research studies, however, have focused on migraine with aura.  Most of the studies that have linked future risk of heart disease or stroke have been on migraine with aura.  This particular study is yet another one in the long list of studies linking heart disease risk and migraines, except this one covered ALL migraines, not just those with aura.  Here’s the details on this large study of 17,531 women with migraines who were followed up for 20 years:

• Migraine was associated with a 50% higher risk for major cardiovascular disease.
• They had a 39% higher risk of a heart attack.
• There was a 62% higher risk of having suffered a stroke.’
• Sufferers had a 74% higher risk of having chest pain or having had a coronary angiogram.
• Furthermore, migraines were linked to a 37% higher risk of dying from heart disease.

The relationship is so strong that, in a linked editorial, the suggestion is that migraine should be viewed as a risk factor for heart disease just like high blood pressure and cholesterol.  This is a strong statement and one that is not entertained by the average treating neurologist or primary care doctor.

It also reinforces my concern that the vast majority of true migraine patients are not getting the education needed to understand and improve the condition.  Chronic migraine sufferers HAVE to address the underlying dysfunction of the blood vessels through lifestyle changes geared towards protecting the heart.  This include diet, stress management, exercise and focus on reducing exposure to environmental chemicals that damage the heart and blood vessels.

Anything less is only a band-aid.

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Low T Symptoms and Fertility; Barking up the Wrong Tree?

vladimirfloyd / Adobe Stock

I could not be more against testosterone supplementation. Sure, patients feel better and have more energy, but people on cocaine have more energy, too. Doesn’t mean it’s a good idea.

Several years ago, very aggressive marketing by the manufacturers of testosterone supplementation put “low T” on the map, leading to a huge uptake of lab testing for testosterone levels. And guess what? Just like the vitamin D phenomenon, it seems like everyone (males and females alike) came back low.

And low testosterone became linked to everything from fatigue, low libido, belly fat and erectile dysfunction. And you can’t talk about testosterone without talking about fertility.

This is because male fertility is the ultimate expression of testosterone (it’s not, but that’s how society would have us view it). For this reason, you can bet your right testicle on the fact that any fertility consult with a “fertility specialist” will include a testosterone check.

But there are many other factors that play a role in fertility that are indirectly related to testosterone. Environmental chemical exposure to BPA and phthalates are well known to affect fertility rates in both men and women.

Low testosterone, much like low cholesterol or high blood sugar or high blood pressure, is merely the symptom of a bigger problem. Fixing high cholesterol with statins, lowering blood sugar with insulin or lowering blood pressure with medications does not, in any way, shape or form. None of those medications fix the actual underlying “broken thing” that is causing the cholesterol, blood sugar or blood pressure.

Testosterone replacement therapy is absolutely no different.

So, while you feel better in your own little plastic bubble of T replacement therapy, there is something very wrong with your physiology that is absolutely increasing your risk of all kinds of really nasty things like Alzheimer’s, cancer, heart disease and stroke.

I have certainly written on this topic before, but just in case you think I’m really off base on this one, I’d like to present this particular study.

In it, researchers looked at the levels of pesticide exposure from fruits and vegetables and how this related to sperm quality in a group of 189 men age 18-22. The fruits and veggies were categorized as having high [Pesticide Residue Burden Score (PRBS) ≥4] or low-to-moderate (PRBS <4) pesticide residues on the basis of data from the USDA Pesticide Data Program.

Here’s what they found:

• Higher intakes of fruits and veggies, in general, did not affect sperm quality.
• However, men eating fruits and vegetable intake with the lowest pesticides (≥2.8 servings/d) had a 169% sperm count and a 173% higher sperm concentration.
• The intake of fruit and vegetables, regardless of pesticide-residue status, was not associated with reproductive hormone concentrations.

So what does this mean? It means that, while eating more fruits and veggies is important for your health, but it is really important to pay attention to whether or not you are eating organic foods that are well-known to be higher in pesticide levels.

The Environmental Working Group’s Guide to Pesticide Exposure in Produce is the best guide you can find to get this information.

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Why Blockbuster Drugs are Never a Good Thing

Avandia has been in use for over 15 years.  It was launched around the same time that another drug in the same class (PPAR-agonists…Rezulin) was pulled from the market due to liver failure.

Over time, this rapidly-adopted “blockbuster drug” began to accumulate evidence that Avandia greatly increases the risk of heart disease.  Given that 70% of diabetics already die from heart disease, one would think this would be a concern.

The bottom line is that, while this class of drugs makes your blood sugar numbers look better, it creates many more problems than it solves.

Lifestyle changes remain the only answer that doesn’t kill you first.

 

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Can a Simple Mineral Beat Statins for the Heart?

There are times when it seems like the only answer in medicine is another drug.  For heart stuff this is unquestionably statins.

Have high cholesterol?  Take Lipitor.  Have a family history of heart disease?  Take Crestor.  Your dog’s litter mates’ cousins’ owner had a heart attack?  Take atorvastatin.

You get the idea.

But when it comes to natural approaches which are JUST as powerful without a long list of potentially fatal side effects, it seems like “we just need more research.”

In this particular study, we see a simple approach…those with the highest levels of magnesium in their bloodstream had a 40% reduced risk of suffering sudden cardiac death.

At a cost that is just a fraction of even a generic statin and no side effects when taken orally.

 

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MORE EVIDENCE TO SIMPLY LOWER BREAST CANCER RATES

I just have to ask…if you’re not supplementing with Vitamin D yet, why not?

The research is very strong and the bottom line is that we were designed for heavy amounts of sunlight.  Our paleolithic ancestors didn’t have sunscreen.  Didn’t have the option of staying inside and playing Xbox instead of hunting for food.  Granted, my Irish ancestors weren’t hanging out in the Sahara, but they still were getting lots of sunlight at their latitude.

There is also something in today’s society leading to lowered blood levels of D.  Sunscreen, obesity, spending much time indoors, sunlight coming through glass, showering at night and particulate matter in the atmosphere are all likely playing a role in too low of levels in the blood.  Good thing supplementation is so darn cheap (in our office, $20 for about a YEAR for the highest quality vitamin D).

In this particular study, researchers found that, in those women with the highest vitamin D levels, there was a 27% lower risk of developing breast cancer.  However, for women under 53 years of age, this protection jumped to 40%.

Pretty good numbers for such an inexpensive and safe supplements.

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