& Nutrition News,
Drug Watch and More…
Thanks so much to all of you who e-mailed last month to say, “glad you’re back.” It’s good to be back, and I’m enjoying delving into research, interviewing scientists and digging for the truth, to provide you with useful information about your health each month. Questions and suggestions are always welcome!
Why Saliva Testing Works Best
One of the reader questions that has come up is how to explain to your doctor why a saliva test gives a better portrait of hormone levels than a blood test. Here on my website you’ll find some informative articles by Dr. John Lee and myself, that should answer your doctor’s questions. One in particular, “The Biochemistry of Saliva Testing,” will provide the detailed scientific information that your doctor may be looking for. You’ll also find a more simplified explanation in the article, “Why We Like Saliva Testing,” and Dr. David Zava’s take on it in Chapter 5 of Dr. John Lee’s Hormone Balance Made Simple.
DCA and CANCER
Wonder Drug or False Hope?
News about a chemical called dichloroacetic acid (DCA), an inexpensive drug that may cure cancer without side effects, is making the rounds of cyber space at warp speed. The research on DCA is being done at the University of Alberta in Canada, led by Evangelos Michelakis. Preliminary research in the test tube and on rats is very promising.
The American Cancer Society Responds
DCA has attracted so much attention that Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, was moved to write a somewhat testy essay about it on his blog. His overall take on DCA: maybe it works, maybe it doesn’t, don’t get excited about it yet. The conspiracy theorists claim that because DCA has no patent, the drug will never be widely used in cancer treatment because there are no large profits to be made.
The DCA Theory
DCA reportedly works by making cancer cells commit suicide without harming healthy cells. Very simplistically put, most cells produce their energy through tiny furnaces called mitochondria that use oxygen. In tumors, the mitochondria are shut down and the cancer cells turn to an alternate energy-producing process called glycolysis. (Glycolysis depends heavily on sugar, which is one reason why a sugar-laden diet encourages cancer growth.) The theory of DCA is that it switches the mitochondria back on, which kills the cancer cells, largely through a process called apoptosis (a-pop-toe'-sis), which causes old or damaged cells to kill themselves. One of the traits that allows a cell to become cancerous is that it doesn’t die when it’s supposed to.
Dr. Lichtenfeld claims that articles he read (he doesn’t cite them) show that DCA causes liver cancer in rats. However, in the DCA research Michelakis did with rats, there were no side effects.
Buyer Be Aware
This is most definitely an experimental cancer drug that has limited research on rats, and no published research on how it works in humans. The theory sounds good, and if it works as well Michelakis believes it does, it would be an inexpensive cancer treatment with few, if any side effects. The research is being done at a respectable university, not in someone's garage. And let’s keep in mind that conventional chemotherapy sometimes works, sometimes doesn’t, and almost always has serious side effects. That makes the use of DCA a very personal choice. There are already websites popping up that are selling DCA but there's no way to know how legitimate they are.
If you’d like to read more detailed information about DCA, here’s a link to an article, “Cheap, safe drug kills most cancers” published in New Scientist magazine.
Raise your hand if you’ve stopped taking vitamins because they upset your stomach or make you tired. If you raised your hand, you have a lot of company.
It may seem obvious that taking vitamins is good for your health, but that’s not always the case. Most studies of people taking vitamin supplements show conflicting benefits, and some have been shown to be harmful. Nearly all of the health claims that are made for vitamins and supplements are based on diet research done with foods. For example, a series of excellent studies done on vitamin E supplements and heart disease not only showed no benefit, in some cases heart disease increased. Does that mean vitamin E is bad for us? Not at all, it just depends on what form of vitamin E you’re using. Research on people whose diet is high in vitamin E shows it has numerous health benefits.
As these distressing facts have dawned on the vitamin industry over the past few years, one possible solution has come in the form of food-based supplements. I spoke to Naturopath Larry Permen from Ventura, California about these issues. Permen has had great success incorporating food-based supplements into his practice.
INTERVIEW WITH NATUROPATH LARRY PERMEN
“I distinguish between nutriceuticals, which are isolated vitamins and minerals found in potencies and forms you would never find in nature, and foodaceuticals or food-based supplements, which come much closer to how we get our nutrients from nature.
Rock Calcium vs. Food Calcium
One of the best examples is calcium. Calcium nutriceuticals are literally made from rock—they’re essentially chalk. But in its raw rock form, calcium isn’t acidic enough to be absorbed well—estimates are that only 5 percent of it is absorbed. So if you take 1500 mg of rock calcium, at best you’re actually getting about 75 mg. Over the years the vitamin industry has added various acidifying substances to calcium to make it more absorbable. For example, calcium citrate is calcium plus citric acid, calcium gluconate is calcium plus gluconic acid and calcium lactate is calcium with lactic acid added. But even acidified, you still only absorb 30 to 37 percent of rock calcium.
If you take a food-based calcium, which is readily absorbed, you only need about 100 mg to absorb 75 mg.
People are designed by nature to acquire their minerals through food, not from rocks. Plants do know how to absorb an inorganic mineral like rock calcium and convert it into a living, organic mineral. Then a human can eat the plant—or the animal that’s eaten the plant— and digest and metabolize the organic mineral, which is easily absorbed and excreted.
High Potency Vitamins can Drain Your Energy
But absorbability isn’t the only issue with the nutriceuticals. What you don’t absorb well, you don’t excrete well either. Rock calcium for example can stick to the arteries, form stones and spurs, and be a building block for fibroids and cysts. These highly potent substances can be hard on the digestion and on the liver. If you’re taking supplements on an empty stomach, you haven’t had a chance to start the digestive process, you haven’t broken it down with your teeth and saliva. Even when you take them with food, if you have any kind of digestive challenge at all, which most people over the age of 35 do, supplements can take an enormous amount of energy to process and you can feel really tired after you take them. Then the liver has to process them and that can also make you tired. When people see me for the first time, they often arrive with a couple bags of supplements. In most cases I immediately take them off 95 percent of them. They return a week or two later and their energy is way up, just because they stopped taking all those supplements!
With food-based supplements, you can take a lot less, you absorb them much more readily, and you excrete them more effectively. With the synthetic supplements, you have to take high dosages because your body isn’t using them efficiently.
Ascorbic Acid by Itself can Suppress the Immune System
Let’s take vitamin C as another example. Ascorbic acid, typically known as vitamin C today, is really one form of vitamin C, made famous by Dr. Linus Pauling. Ascorbic acid is a good example of being on the right track but on the wrong train. Ascorbic acid is typically made from high fructose corn syrup or some kind of sugar, and acetone. Ascorbic acid in its natural form does have an acidic nature, but its acetone form is much worse. So what science has done to make ascorbic acid less acidic is buffer it with some type of rock like calcium carbonate. Ascorbic acid plus calcium carbonate is the idea behind Ester C. Now we have a chemical buffered by a rock to make something that’s not as detrimental to the body. The problem is that it’s still just one isolated form of vitamin C. A lot of people take vitamin C as ascorbic acid for their colds or flu, which can actually suppress immune function and make them feel worse. It’s the bioflavanoids, the rosehips—which are food—in the supplement that can actually help the immune system. Even better, if you eat an orange, you’re going to get many forms of vitamin C packaged with hundreds or thous ands of other beneficial phytochemicals.
The vitamin industry hasn’t embraced food-based supplements more enthusiastically for a couple of reasons. First, they’re more expensive to make and rocks are incredibly cheap—the typical markup on a rock mineral supplement is 1000 percent, and it can be as high as 2000 percent. Second, the American public is convinced that more must be better, so if you see a 1500 mg calcium supplement for $10, and a 100 mg calcium supplement for $15, which are you going to choose? Unless you’re a very sophisticated shopper, you’re going to choose the cheaper, higher potency calcium.
Less can Be More
High potency can often be equated with potential toxicity. If you think about it, we have evolved over millenia as a species eating simple foods with relatively small amounts of nutrients per serving. We aren’t equipped to process highly potent chemicals every day, even if they are essential vitamins and minerals. Ideally you want to aim for getting the most results from the least amount of supplement, because the less energy you expend on digesting and processing a nutrient, the more energy you can spend on repair and regeneration. Research has shown that in cultures with a low incidence of osteoporosis, people typically consume about 300 mg of calcium daily from vegetables.
I’m not saying that the nutriceuticals have no benefit, they certainly do have their place. For example, it’s hard to get L-carnitine and CoQ10 from food, but both can be very useful nutrients for building and supporting good health.
The Sensible Approach to Good Nutrition
The best way to approach good nutrition is to first eat high quality foods that are pesticide free, hormone free, ripe, and organic if possible. That’s number one. Then you want to avoid the poisons—sugars, highly processed foods, white bread, pasta, things from a can, a package or a box. Next you want to make sure you’re digesting what you’re eating. In my practice I primarily use plant enzymes to support digestion, and then use food-based supplements if needed.
Larry Permen is a board certified Naturopath and president of Broadmoore Labs in Ventura, CA. He can be reached at 800-822-3712.
Catapano AL, “Antioxidant effect of flavanoids,” Angiology 1997;48(1):39-44.
Cronquist A, Plantae. In Synopsis and Classification of Living Organisms. Vol 1. Mcgraw-Hill. 1982:57.
Ensminger AH, Ensminger ME et al, Food & Nutrition Encyclopedia 2 nd ed. CRC Press. New York 1993.
New SA et al, “Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health,” Am J Clin Nutr. 2000;71(1):142-151.
Spindler A, “Bone mineral density in a native population of Argintina with low calcium intake,” J Rheumatol, 1995;22(11):21-48-2151.
Thiel RJ, “The truth about vitamins in supplements,” ANMA Monitor. 2003;6(2):6-14.
We’ve known for decades that certain medications can contribute to bone loss. They include steroids such as prednisone, and calcium-channel blocking drugs for hypertension such as Procardia and Norvasc. Now we can add two other drugs to the list: acid-suppressing drugs used for heartburn, such as Prilosec, Prevacid and Nexium; and selective serotonin reuptake inhibitor (SSRI) antidepressants such as Celexa, Zoloft, Prozac and Paxil.
Heartburn or Hip Fracture?
The heartburn drug study examined the medical records of 13,000 people who had suffered a hip fracture, and compared them with 135,000 similar people who had never had a hip fracture.
Those who had used the family of heartburn drugs known as proton pump inhibitors (PPIs) for more than a year had a whopping 44 percent higher risk of hip fracture. Those taking the drugs at the highest doses for the longest period of time had the highest risk of hip fracture. Critics of the study point out that so-called “retrospective” research looking back at medical records tends to be less accurate, but even if the PPI users had a 22 percent risk instead of 44 percent risk, it would still be a very high number.
It’s theorized that the PPIs probably cause bone loss that leads to hip fracture by interfering with the absorption of nutrients that build bone, such as calcium and other minerals.
The PPIs can be a very useful short-term solution for stopping heartburn, but it’s important to make the lifestyle changes that can prevent heartburn and get off the drugs. For more information on preventing heartburn, here’s an article by Dr. John Lee and myself: What Your Doctor May Not Tell You about Heartburn.
The research on SSRIs and bone loss is smaller but still important. This was a Canadian study done at McGill University that began with a pool of 5,008 randomly selected people over 50 and followed them for five years. Of that group, 137 were taking SSRIs, and they were found to have 2.1 times the risk of bone fractures. Although this was a relatively small group taking the SSRIs, the researchers took into account many other risk factors for bone fractures and still got the same result. Some critics argue that people who are depressed fall more often, but the study showed that the SSRI users had “fragility” fractures, meaning broken bones caused by relatively minor incidents like falling out of bed—in other words, it didn’t take much for their bones to break.
The Prescription Drug Triple Bone Whammy
It’s not uncommon at all to find senior citizens on multiple prescription drugs. Some of the most common include prednisone, calcium channel blockers and proton-pump inhibitors—all now linked to bone fractures. There are many reasons to avoid prescription drugs in general, and now we can add bone loss to the list. Prescription Alternatives, a book I wrote with Dr. Earl Mindell, gives many alternatives to prescription drugs, as well as detailed descriptions of common drug side effects and interactions.
Yang YX, Lewis JD et al, “Long-term proton pump inhibitor therapy and risk of hip fracture,” JAMA. 2006 Dec 27;296(24):2947-53. University of Pennsylvania School of Medicine.
Richards JB, Papaioannou A et al, “Effect of selective serotonin reuptake inhibitors on the risk of fracture,” Arch Intern Med. 2007 Jan 22;167(2):188-94. Division of Endocrinology and Metabolism, Department of Medicine, McGill University, Montreal, Quebec, Canada.
“My grandfather’s mind was never the same after his heart surgery.” Most of us have probably heard similar observations about older friends or relatives who undergo surgery. Mental decline after surgery is so commonplace that it even has a medical name—postoperative cognitive dysfunction (POCD). Some people recover in hours, days or weeks, and others never recover. The older you are, the greater the risk of POCD and the greater the risk that the damage will be permanent.
The risk of POCD varies greatly depending on the type and length of surgery. Following are the rates of “delirium” for various surgeries:
– Cataract surgery 1-3 %
– General surgery 10 %
– Major orthopedic surgery 28-61%
– Cardiac surgery up to 47%
While it’s been known for decades that mental decline can occur after surgery, there’s always been a debate over whether it is caused by the surgery itself or by the anesthetic. Long surgeries, deep sedation and low blood pressure during surgery can all contribute to POCD, but recent research with animals and in test tubes is pointing a finger at the anesthetic itself. Some types of anesthetic cause the same type of clumping of beta amyloid proteins found in Alzheimer’s disease.
Here’s What Increases the Risk of POCD
Patients who take a lot of prescription drugs, abuse alcohol, are depressed or already show mental decline are the most susceptible to POCD. The prescription drugs most likely to increase POCD are anticholinergics and benzodiazepines.
Anticholinergics are a family of drugs used to decrease certain types of muscle spasms and may be prescribed for menstrual cramps, allergies (Benadryl), motion sickness (Dramamine), colds, ulcers, Parkinson’s and cerebral palsy. Many antidepressants have anticholinergic properties and some anesthetic agents have anticholinergic properties.
The benzodiazepines belong to the family of drugs, most often prescribed for anxiety, that includes valium, ativan, alprazolam and diazepam. Both the anticholinergics and the benzodiazepines are commonly given before surgery to relax the patient.
The Good News
The good news is that recent research shows that the adult brain makes new neurons well into old age, and even an elderly brain can repair itself if given support in the form of good nutrition, avoidance of toxins and exercise—both physical and mental. Then the question remains, how can someone going into surgery and general anesthesia protect themselves from POCD.
Get Off Prescription Drugs if You Can
One of the basic steps to good health as we age is to avoid prescription and over-the-counter drugs as much as possible. Virtually all drugs put stress on the liver and/or kidneys, have negative side effects, and as soon as you take more than one you’re dealing with drug interactions that often create new side effects. The book I co-authored with Dr. Earl Mindell, Prescription Alternatives, is a wonderful guide to creating and maintaining optimal health without drugs. Most of the solutions given for common health issues involve nutritional supplements, herbs and lifestyle changes. The book also details the side effects and drug interactions of hundreds of prescription drugs.
Minimize Stress and Take Good Care
People experiencing chronic stress or recent physical or emotional trauma tend to have high levels of stress hormones such as cortisol and norepinephrine. High cortisol levels can suppress the immune system, and norepinephrine can contribute to inflammation.
Use the weeks before surgery wisely; get plenty of sleep, eat wholesome foods and if possible, get some exercise.
Some of the “super foods” that promote healing, reduce inflammation and encourage good digestion include live culture yogurt (without sugar), sauerkraut, eggs (no, they won’t raise cholesterol levels), dark colored vegetables such as beets and spinach, cruciferous vegetables such as broccoli and cauliflower, sprouted grain breads, wild salmon, nuts and seeds, and vegetable juices.
Hospital food is notoriously nutrition-free and unappetizing. If possible, get a high quality protein powder before surgery and have a friend bring protein powder shakes blended with yogurt and fruit. (Of course, check with the doctor first.) If you’re on a liquid diet ask friends to bring freshly made, sugar-free fruit and vegetables juices instead of flowers!
Use a Few Supplements to Help the Healing Process
If you take handfuls of nutritional supplements before and after surgery, you’re as likely to stress your body as heal it, but a few carefully chosen nutrients can really help the healing process. As long as you’re in a hospital, be sure to clear it with the doctor before using any supplements.
The first category is enzymes, which help the body break down the food you eat and help clear the debris left from injury and inflammation. Wobenzym is a good product that contains a mix of protein-digesting enzymes that can help reduce inflammation and fluid buildup and support good digestion.
Support the Liver
The liver takes a big hit after any surgery, and yet its job is never more important than after physical trauma and exposure to toxins such as an anesthetic. You can support it before surgery by avoiding excess alcohol, minimizing drugs and avoiding acetaminophen (e.g. Tylenol), which is very hard on the liver. The practice of prescribing acetaminophen after surgery for pain management has got to be one of the most misguided practices in Western medicine.
N-aceytl cysteine supports the liver and the brain. If I were going to take one supplement after surgery, this would be it. It’s an amino acid and antioxidant that’s a precursor to glutathione, one of the most important substances produced in the liver for clearing toxins and the major antioxidant in the brain. (Glutathione is too unstable to be put in a supplement.) Recent research is showing that n-acetyl cysteine encourages the brain to build and repair neurons. Like alpha lipoic acid, it’s used in emergency rooms to treat poisoning by liver-damaging substances such as mushrooms or acetaminophen. There have been reports that intravenous n-acetyl cysteine can produce an allergic reaction, but none I know of in response to taking it in capsule form. The most often recommended dose is 500 mg once or twice daily.
Alpha lipoic acid is used in emergency rooms to treat patients who have eaten poisonous mushrooms or other liver-damaging substances (e.g. acetaminophen) because it supports the liver in clearing toxins. It’s also a powerful antioxidant and can help balance insulin. The typical dose is 500-600 mg daily.
Milk thistle is a plant medicine that supports the liver, and there are no known interactions with drugs so it can be taken shortly before and shortly after surgery (if you’re on a liquid diet there are non-alcohol liquid extracts of milk thistle available). Herb Pharm and Gaia make high quality herbal medicines. Follow the instructions on the bottle.
Soft Cheeses and Colostrum
According to Sam Queen of the Institute for Health Realities in Colorado Springs, one of the side effects of some anesthetics is to break down iron and leave it circulating in a “free” state, which can cause toxicity, make us more susceptible to infection, and cause cancer. Prior to surgery, Queen recommends eating soft cheeses such as havarti and muenster, which contain lactoferrin and lactoglobulin, substances that bind iron and make it safer. You get even more of these iron-binding substances in colostrum supplements. Queen recommends taking 2-3 capsules daily in the few days before and after surgery.
If you’re particularly concerned about the effects that surgery and anesthesia might have on you or a loved one, another option is to have a special blood test done prior to surgery that can target specific areas of your personal biochemistry to support before, during and after surgery. This can be done through the Institute for Health Realities, but ideally needs to be started six weeks before surgery so you can get the blood test, the consultation, and start on the program. Although they are located in Colorado Springs, testing and consultation and be done by phone. They can be reached at www.healthrealities.org or by calling (800) 414-3438.
Crosby G, Culley DJ, “Anesthesia, the aging brain, and the surgical patient,” Can J Anesth 2003; 50:R1-R5.
Fodale et al, “Alzheimer's disease and anaesthesia: implications for the central cholinergic system,” BJ Anaesth 2006; 97: 445-452.
Phillips, Helen, “Alzheimer’s alert over anaesthetics,” New Scientist 2006 Oct 28.
Xie Z, Tanzi RE, “Alzheimer’s disease and post-operative cognitive dysfunction,” Exp Gerontol 2006 Apr;41(4):346-59.
Banaclocha MM, “Therapeutic potential of N-acetylcysteine in age-related mitochondrial neurodegenerative diseases,” Med Hypotheses 2001 Apr; 56(4):472-7.
Kanwar SS, Nehru B., “Modulatory effects of N-acetylcysteine on cerebral cortex and cerebellum regions of ageing rat brain,” Nutr Hosp. 2007 Jan-Feb;22(1):95-100.
HEALTH WATCH Q & A – Thanks for Asking
Here's where I respond to reader questions from the most recent back issues of the newsletter. Your questions may be answered here!