Coverage of preventive health services is required by § 2713 of the ACA, Pub. L. No. 111-148, 124 Stat. 119 (2010) (codified as amended at 42 U.S.C. § 300gg-13 (2012)).
10,000 IU/day Vitamin D Needed for Therapeutic Benefit; Vitamin K Benefits
According to this article in the American Journal of Clinical Nutrition, pregnant women have an even greater need for Vitamin D supplements than non-pregnant women. http://www.ajcn.org/content/79/5/717.full If she were my wife, I would have her on two Vitamin D 5000 IU gel caps — one in the morning and one in the evening 12 hours later. Vitamin D works slowly.
FDA and Intravenous Vitamin C Cancer Therapy
If FDA officials actually listened to patients, they wouldn’t be trying to cut off the use of intravenous ascorbic acid (IAA) as a cancer-fighter..
Checklist of Treatments for Alzheimer’s Disease Part 1 of 3
For approximately ten years, I cared for a parent with slowly advancing Alzheimer’s disease. Contrary to all of the horror stories portrayed in the national media, I have found that the burden of caring for an Alzheimer’s sufferer is less onerous than I originally expected. The primary reason that my burden was lightened is that [...]
Eating Right for Healthy Aging
Any time there are spikes in blood glucose levels, there are abnormal reactions between sugars and proteins, which produce pro-inflammatory products that accelerate aging in the body. Everyone seeking to delay age-related diseases should adopt an anti-inflammatory eating plan for life.
Persistently high HbA1C levels even on a low glycemic index diet
Later this year I may try Carnosine, which has been shown to reduce or eliminate advanced glycation end products. But Carnosine is somewhat expensive, and it helps with cleaning up the effects of too much serum glucose, but does not actually lower the glucose levels.
The Affordable Care Act (ACA) and Periodic Preventive Health Visits
Posted by Michael A. S. Guth on May 7th, 2013
Evidence Mounting AGAINST Calcium Supplementation (to prevent Osteoporosis)
Posted by mgadmin on May 5th, 2013
From Jon Barron:
The Evidence Against Calcium Has Been Building
It has been gospel for years in both the medical and alternative health communities that consumption of calcium-rich foods and calcium supplements can help prevent the loss of bone density and osteoporosis, especially in postmenopausal women. As a result, calcium supplements are widely recommended and used to combat estrogen- and age-related declines in bone mineral density. In fact, supplemental calcium has been added to all kinds of foods that you would think have nothing to do with calcium–ranging from orange juice to SpaghettiOs. No joke: SpaghettiOs has a Plus Calcium version.1 And although there have actually been a few studies over the years that seemed to indicate that supplemental calcium might actually reduce cardiovascular disease, the opposite now appears to be true. The evidence concerning the dangers of calcium supplements has been building for years–first slowly, but now accelerating.
Although researchers are not exactly sure how it does it, ever mounting data indicates that high calcium intake does indeed increase the risk of heart attacks and death. We can probably find a clue in the fact that calcification accelerates hardening of the arteries and the likelihood of death in patients with failing kidneys and that using calcium supplements accelerates it even more.2,3 It’s not hard to extrapolate that evidence to see how increased vascular calcification as triggered by calcium supplementation, especially within coronary arteries, would be expected to increase the incidence of cardiovascular disease.
As already mentioned, there have been a number of studies over the years that have found that calcium supplementation is associated with upward trends in cardiovascular event rates, particularly in healthy postmenopausal women.4 But probably the first “major” crack in the calcium myth, at least in the medical community, was the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg) study published in 2010.5 The specific objective of the study was to “prospectively evaluate the associations of dietary calcium intake and calcium supplementation with MI [myocardial infarction, i.e. heart attacks] and stroke risk and overall CVD [cardiovascular disease] mortality.” As the study pointed out in its background statement, “It has been suggested that a higher calcium intake might favorably modify cardiovascular risk factors. However, findings of an ultimately decreased risk of cardiovascular disease (CVD) are limited. Instead, recent evidence warns that taking calcium supplements might increase myocardial infarction (MI) risk.” The specific objective of the study, then, was to “evaluate the associations of dietary calcium intake and calcium supplementation with MI and stroke risk and overall CVD mortality.”
http://www.jonbarron.org/natural-health/dangers-calcium-supplements?utm_source=iContact&utm_medium=email&utm_campaign=Jon%20Barron&utm_content=Biweekly+Newsletter+5%2F6%2F13
How to tell if your metabolism is too acidic
Posted by mgadmin on April 29th, 2013
From Jon Barron: What Makes the Body More Acidic or Alkaline
Posted by mgadmin on March 24th, 2013
Lessons from Jon Barron — What Makes The Body More Acidic or Alkaline
In this week’s excerpt from Lessons from the Miracle Doctors, Jon Barron continues his discussion of body pH by exploring what makes the body more acidic and what makes it more alkaline.
“To better understand the system our bodies have developed for maintaining pH balance, we need to take a look at what affects pH (usually making us more acidic) and how our bodies respond to that change.
- Acid-Forming Foods: When they are metabolized, carbohydrates, proteins, and fats produce various acids in our bodies. That means that all meats, fish, poultry, eggs, dairy, cooked grains, and refined sugars are acid forming in the body. Probably at the top of the list of acid-forming foods in the human diet are colas. Not only are they high in refined sugar, which is highly acid-forming in and of itself, but most cola contains a large amount of phosphoric acid, not to mention carbon dioxide (an end-product of the acid neutralization process).
- Alkaline-Forming Foods: For the most part, only fresh fruits and vegetables and superfoods such as chlorella, spirulina, barley grass, and wheatgrass are alkaline-forming and help your body maintain a proper pH. It should be noted that even though citrus fruits are highly acidic, your body treats them as alkaline so that they are, in fact, highly effective alkalinizers.
When proteins are metabolized in the body, they produce sulfuric acid and phosphoric acid; carbohydrates and fats produce acetic acid and lactic acid. Since these acids are poisonous to the body, they must be eliminated. Unfortunately, they can’t be eliminated as acids through the kidneys or large intestine as they would damage these organs. The way the body handles them is to neutralize by converting them into acid salts by combining them with the minerals sodium, calcium, potassium, and magnesium. Of these, calcium is the most important.
Now, here’s the key: your body uses a priority system if there are not enough available minerals to neutralize all of the acids present. Blood is at the top of the heap—your body will steal minerals from anywhere and everywhere before it will let your blood become too acidic. Remember, even a slight deviation in blood pH results in death.
Saliva is at the bottom of the heap. Saliva is the first place your body steals minerals from to balance the blood. That’s why pH testing of saliva provides an early warning system for when you are becoming too acidic. At optimum health, your saliva will have a pH of 7.45, the same as your blood. At a pH of 6.5–7.0, you’ll find yourself frequently succumbing to colds and sickness. At 5.5 and lower, you can pretty much count on the fact that major disease has already taken hold. Virtually, all cancer patients test strongly acidic on a saliva pH test.
Unfortunately, your saliva doesn’t contain a big reserve of minerals, so you soon run out. After extracting what it can from urine and soft tissues (creating a rich environment for the spread of cancer), your body turns to its great mineral bank—your bones. So, if your diet is too acid-forming (too much meat, dairy, simple carbohydrates, phosphoric acid, and sugars), your body will fairly quickly begin to leach calcium from your bones to balance the low pH and avoid death. In effect, your body says osteoporosis is preferable to death.”
McDougall on the Annual Physical Exam
Posted by mgadmin on March 1st, 2013
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Establishing the Doctor-Patient Relationships
To clearly understand the impact of the everyday practice of medicine, please take a moment to identify a friend or relative of yours who has been under the care of a doctor. This person, faithfully seeking a healthful life and acting responsibly, submits himself to an annual exam and regular office visits. Problems are identified and treatments are initiated. After several years of following the doctor’s advice what do you notice different about this person? NOTHING! They are still fat and sick, but now they have a medicine cabinet stuffed full of pill bottles.SOURCE: http://www.drmcdougall.com/misc/2005nl/july/050700physical.htm
Oral Chelation Therapy by Jon Barron
Posted by mgadmin on February 25th, 2013
“Oral chelation is not as quick as standard chelation therapy. Nevertheless, given a little time, it can do an extremely effective job at cleaning out the blood. Most formulas are based on EDTA. EDTA works great when administered directly into the bloodstream through standard chelation therapy, but its usefulness when taken orally is open to question. There are some studies that indicate that there may be less than 5 percent absorption when taken orally.
There is an alternative, however. A tincture of cilantro and chlorella has turned out to be remarkably effective as an oral chelator. Why cilantro and chlorella? Because cilantro changes the electrical charge on intracellular deposits of heavy metals to a neutral state, which relaxes their tight bond to body tissues, freeing them up to be flushed from the body. Studies have shown that levels of mercury, lead, and aluminum in the urine increase significantly after consuming large amounts of cilantro. It’s worth noting that cilantro can cross the blood-brain barrier and, therefore, appears to be particularly effective at removing heavy metals from the central nervous system. Once the heavy metals are free, the next step is to actually facilitate their removal from the body. Chlorella possesses the capacity to absorb heavy metals.
This property has been exploited as a means for treating industrial effluent that contains heavy metals before it is discharged, and to recover the bio-available fraction of the metal in the process. In studies undertaken in Germany, high doses of chlorella have been found to be very effective in eliminating heavy metals from the body—from the brain, intestinal wall, muscles, ligaments, connective tissue, and bone.
Together, these herbs create a powerful oral chelation formula. Phase I clinicals on this formula, completed in 2005, proved that it can naturally remove an average of 87 percent of lead, 91 percent of mercury, and 74 percent of aluminum from the body within six weeks. Once cleaned out with an initial six-week cleanse, a two-week cleanse every 3–4 months should be enough to keep you relatively metal free—unless you eat a lot of high-mercury fish or have more than a few amalgam fillings, in which case a cleanse every two months is advisable.
Incidentally, you do not want to use a chelation formula every day because your body actually needs small amounts of some heavy metals. Also, chelation will remove small amounts of beneficial metals such as calcium and magnesium—these are easily replaced, though, when you take a break.”
Your Skeletal System and Disease Prevention
Posted by mgadmin on February 24th, 2013
From http://www.jonbarron.org/article/your-skeletal-system?utm_source=iContact&utm_medium=email&utm_campaign=Jon%20Barron&utm_content=Biweekly%20Newsletter%202/25/13
Basic Bone Nutrition
As I said before, I’m not a big fan of calcium supplementation for most people — either in pill form or as a component of high dairy intake. Although a necessary nutrient, it doesn’t perform as promised when taken in large amounts for bone health…and as we now know, heart health. In summary, there is an abundance of research that shows that a high consumption of calcium (supplement or diet) leads to heart disease, arthritis, disabling PMS (or PMDD as the TV ads have renamed it), and senility.
Magnesium, not calcium, is the most important major mineral needed by your body, and unfortunately, the one that is most often depleted. But it doesn’t stop there. You need vitamin K to regulate where minerals deposit in your body. You need boron to regulate the metabolism of calcium, magnesium, and phosphorus. You need vitamins D and K2 to even absorb calcium. And you need sufficient essential fatty acids to properly regulate bone metabolism.
For more on calcium and bone nutrition, check out Killer Calcium.
pH
When it comes to bone health, most factors pale in comparison to the problem of a high acid diet. This is one of the primary reasons that the incidence of osteoporosis has soared in recent years. This is the reason more and more men are now suffering from bone loss. If you have not already done so, I suggest you read the chapter on blood cleansing and pH balance in Lessons from the Miracle Doctors to better understand how a high acid diet (meat, fish, poultry, eggs, dairy, cooked grains, and refined sugars) leeches calcium from your body. But for now, the brief explanation is that when you consume a high acid forming diet, your body is forced to use calcium from your bones to buffer the increased acidity so that your blood pH remains constant and you don’t die.
When talking about body pH, many people make a fundamental mistake; they confuse the terms acid forming with acidic. They are not the same thing. When you are trying to make your body pH more alkaline, you need to reduce your consumption of acid forming foods and increase your consumption of alkaline forming foods. That is not the same thing as saying you need to eat less acidic foods. For example: sugar contains no acids, and yet it is highly acid forming in your body. Citrus juices, on the other hand, are highly acidic, but your body actually treats them as alkaline, and their consumption will raise your body pH, making it more alkaline.
Incidentally, I’m not a big fan of dairy when it comes to building bones. The problem with dairy is that it actually takes more calcium to buffer the phosphorus content then you actually receive from the dairy itself–thus the high incidence of osteoporosis in countries that consume a lot of dairy. Don’t misunderstand me. I’m not saying that dairy is the biggest culprit. Actually, most other acid forming foods are worse–particularly high-sugar colas. I just single out dairy because it’s always identified as great for building strong bones, when the opposite is true.
In general, acid forming foods include all meats, dairy, grains, some fruits, and all sugars. Alkaline foods include most vegetables, nuts, seaweeds and algae (chlorella and spirulina), and many fruits including all citrus.
Exercise
A crucial factor that is almost always forgotten when it comes to building bone density is weight bearing exercise. As we’ve already learned, our body aggressively builds bone to repair a fracture. But your body also builds bone in response to anything that stresses the bone–and that includes simple weight bearing exercise. It’s important to understand that the more stress an exercise puts on your bones, the greater the response by your body and the more density will be built into your bones. Likewise, the lower the stress, the weaker your bones. That’s why astronauts who live in zero gravity for any length of time show early signs of osteoporosis. In fact, the rate of space flight induced bone loss is 10 times faster than in those with osteoporosis.6 Long term bed rest will also greatly accelerate bone loss. When it comes to exercise then, rowing or doing multiple laps in the swimming pool may well build strength and endurance, but they will do nothing to build your bones.
Walking and jogging, on the other hand, are good since they use the weight of your body to stress your bones. Lifting weights is even better since it increases the weight/stress on your bones. Think gravity. Anything that increases the force of gravity on your bones will cause the bone to respond by building greater density–the more the better. And that means that one of the single best osteogenic (bone building) exercises you can do is rebounding. When rebounding, thanks to the acceleration as you fall and the sudden deceleration as you hit the mat, your body experiences a gravitational force of two to three times normal each time you bounce. That means that, at that moment, your bones are supporting a weight of 300 to 450 lbs (assuming an initial body weight of 150). That’s a lot of bone stress, and it stimulates a lot of bone building activity in every single bone in your body.7
And finally, for those of you who are interested, here are the major bones in your body.
- 1. “Joint Moment Arm.” Muscle Physiology. 13 Jan 2006. (Accessed 18 Feb 2013.) http://muscle.ucsd.edu/musintro/ma.shtml
- 2. Li K, Kaaks R, Linseisen J, Rohrmann S. “Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study.” Heart. 2012 Jun;98(12):920-5. http://heart.bmj.com/content/98/12/920.full
- 3. Peter R. Ebeling. “Osteoporosis in Men.” 3 April 2008. New England Journal of Medicine, 358(14): 1474-1482. http://www.nejm.org/doi/full/10.1056/NEJMcp0707217
- 4. Nilas L, Christiansen C. “Bone mass and its relationship to age and the menopause.” J Clin Endocrinol Metab. 1987 Oct;65(4):697-702. http://www.ncbi.nlm.nih.gov/pubmed/3654915
- 5. Sowers MF, Clark MK, Jannausch ML, Wallace RB. “A prospective study of bone mineral content and fracture in communities with differential fluoride exposure.” Am J Epidemiol. 1991 Apr 1;133(7):649–660. http://www.ncbi.nlm.nih.gov/pubmed/2018020
- 6. Ohshima H, Matsumoto T. “Space flight/bedrest immobilization and bone. Bone metabolism in space flight and long-duration bed rest.” Clin Calcium. 2012 Dec;22(12):1803-12. http://www.ncbi.nlm.nih.gov/pubmed/23187072
- 7. Timo Jämsä, Riikka Ahola,and Raija Korpelainen. “Measurement of Osteogenic Exercise — How to Interpret Accelerometric Data.” Front Physiol. 2011; 2: 73. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198512/
Is the Lp-PLA2 Blood Test is Experimental?
Posted by Michael A. S. Guth on February 19th, 2013
Humana claims the Lp-PLA2 blood test, also known as the PLAC test, is experimental. Humana’s contention appears in sharp contrast to a mountain of scientific evidence suggesting this blood test is an excellent marker for atherosclerosis.
The web page
http://pharmaceuticalintelligence.com/2012/10/30/cardiovascular-risk-inflammatory-marker-risk-assessment-for-coronary-heart-disease-and-ischemic-stroke-atherosclerosis/
contains the following quote:
“PLAC, the test measuring Lp-PLA2 as a novel and valuable cardiovascular risk inflammatory marker implicated in the formation of rupture-prone plaque, and is the only blood test cleared by the FDA to assess risk for coronary heart disease and ischemic stroke associated with atherosclerosis. (2003 and in 2005 received additional clearance as an aid in the assessment of risk for ischemic stroke associated with atherosclerosis.)
In 2007 the PLAC Test was granted a Category I CPT Code (83698) by the American Medical Association and is reimbursed by the Centers for Medicare and Medicaid Services (CMS) with a National Limitation Amount (NLA) of $47.77 in the 2011 CMS Clinical Laboratory Fee Schedule.
PLAC Test is an alternative to C- Reactive Protein Test
The PLAC® Test is a simple blood test to detect Lp-PLA2 in the bloodstream. It is used to help predict risk for coronary heart disease and ischemic stroke associated with atherosclerosis.
The PLAC Test measures Lp-PLA2
(lipoprotein-associated phospholipase A2), a vascular-specific inflammatory enzyme implicated in the formation of rupture-prone plaque. It is plaque rupture and thrombosis, not stenosis, that causes the majority of cardiac events.
· A substantial body of evidence, including over 100 studies and abstracts in peer-reviewed journals and conferences, support Lp-PLA2 as a cardiovascular risk marker that provides new information, over and above traditional risk factors.
· Consistent with ATP III and European guidelines, the PLAC Test should be used as an adjunct to traditional risk factor assessment to identify which moderate or high risk patients, as initially assessed by traditional risk factors, may actually be at higher risk.
· An elevated PLAC Test may indicate a need for more aggressive patient management.
Separately, a press release had this to say:
SOUTH SAN FRANCISCO, Calif., April 26, 2012 /PRNewswire/ The American Association of Clinical Endocrinologists (“AACE”) medical guidelines for clinical practice published in the March/April 2012 issue of Endocrine Practice today announced the inclusion of its vascular-specific inflammatory marker Lp-PLA2.
“The AACE’s guidelines are an important endorsement of the clinical utility of Lp-PLA2 measurement. Specifically, the guidelines recommend the use of multiple markers, including Lp-PLA2, to assist physicians in personalizing therapy for elevations or other abnormalities in blood lipids. These abnormalities, commonly referred to as “dyslipidemia,” are a major risk factor for coronary artery disease,” said Brian E. Ward , Ph.D., Chief Executive Officer of diaDexus. “As more health care professionals utilize Lp-PLA2 as a component of cardiovascular risk assessment, we believe that diaDexus’ PLAC Test for Lp-PLA2 should contribute to saving lives.”
The AACE is the third major association of medical professionals to underscore the value of Lp-PLA2. The new recommendations complement medical guidelines published by the American College of Cardiology Foundation/America Heart Association and the American Stroke Association, in 2010 and 2011. These two earlier guidelines support Lp-PLA2 measurement for assessment of cardiovascular risk in asymptomatic adults and for primary prevention of stroke.
The new AACE guidelines(1) recommend Lp-PLA2 measurement as part of global risk assessment for patients with dyslipidemia, and have identified elevated Lp-PLA2 levels as an important risk factor for the development of vascular disease. Dyslipidemia is a major risk factor for the development of coronary artery disease (“CAD”) and may even be a prerequisite for CAD, occurring before other major risk factors come into play. Elevated Lp-PLA2 levels are specific for inflammation in the blood vessels, and are not influenced by obesity, infections or other inflammatory conditions unrelated to atherosclerosis.
The AACE guidelines include the following statements:
Lp-PLA2 has been identified as a strong and independent predictor of cardiovascular disease events and stroke in patients with and without clinically evident CAD.
Measurement of Lp-PLA2, in some studies, has demonstrated more specificity than high sensitivity C-Reactive Protein (“hs-CRP”) when it is necessary to further stratify a patient’s cardiovascular disease risk, especially with elevated hs-CRP in the presence of other causes of inflammation (hs-CRP is an indiscriminate marker of general inflammation).
Significantly elevated Lp-LPA2 in combination with significantly elevated hs-CRP constitutes very high cardiovascular disease risk in individuals with low or moderately elevated LDL cholesterol.
(1) American Association of Clinical Endocrinologists’ Guidelines for Management of Dyslipidemia and Prevention of Atherosclerosis. PS Jellinger et al. Endocrine Practice Vol 18 (Suppl 1) March/April 2012.
Finally, http://wikipedia.org is an online encyclopedia intended to be read by members of the general public with no particular background. Wikipedia represents the common man’s level of understanding its various entries. As to the Lp-PLA2 test, Wikipedia writes:
“Clinical significance
Lp-PLA2 is involved in the development of atherosclerosis.[3] In human atherosclerotic lesions, 2 main sources of Lp-PLA2 can be identified, including that which is brought into the intima bound to LDL (from the circulation), and that which is synthesized de novo by plaque inflammatory cells (macrophages, T cells, mast cells).”
It is used as a marker for cardiac disease.[5]
A meta-analysis involving a total of 79,036 participants in 32 prospective studies found that Lp-PLA2 levels are positively correlated with increased risk of developing coronary heart disease and stroke.[6]
References
1. Tjoelker LW, Wilder C, Eberhardt C, Stafforini DM, Dietsch G, Schimpf B, Hooper S, Le Trong H, Cousens LS, Zimmerman GA (April 1995). “Anti-inflammatory properties of a platelet-activating factor acetylhydrolase”. Nature 374 (6522): 549–53. doi:10.1038/374549a0. PMID 7700381.
2. Tew DG, Southan C, Rice SQ, Lawrence MP, Li H, Boyd HF, Moores K, Gloger IS, Macphee CH (April 1996). “Purification, properties, sequencing, and cloning of a lipoprotein-associated, serine-dependent phospholipase involved in the oxidative modification of low-density lipoproteins”. Arterioscler. Thromb. Vasc. Biol. 16 (4): 591–9. doi:10.1161/01.ATV.16.4.591. PMID 8624782.
3. Zalewski A, Macphee C (May 2005). “Role of lipoprotein-associated phospholipase A2 in atherosclerosis: biology, epidemiology, and possible therapeutic target”. Arterioscler. Thromb. Vasc. Biol. 25 (5): 923–31. doi:10.1161/01.ATV.0000160551.21962.a7. PMID 15731492.
4. “Entrez Gene: PLA2G7 phospholipase A2, group VII (platelet-activating factor acetylhydrolase, plasma)” – this reference is a hyperlink to a journal article that is available on the Internet.
5. Mohler ER, Ballantyne CM, Davidson MH, Hanefeld M, Ruilope LM, Johnson JL, Zalewski A (April 2008). “The effect of darapladib on plasma lipoprotein-associated phospholipase A2 activity and cardiovascular biomarkers in patients with stable coronary heart disease or coronary heart disease risk equivalent: the results of a multicenter, randomized, double-blind, placebo-controlled study”. J. Am. Coll. Cardiol. 51 (17): 1632–41. doi:10.1016/j.jacc.2007.11.079. PMID 18436114.
6. The Lp-PLA2 Studies Collaboration (2010). “Lipoprotein-associated phospholipase A2 and risk of coronary disease, stroke, and mortality: collaborative analysis of 32 prospective studies”. The Lancet 375 (9725): 1536–1544. doi:10.1016/S0140-6736(10)60319-4. Lay summary – BBC News.”
In summary, on one side of this question we have Humana claiming that the Lp-PLA2 test is experimental and will not be covered as a medically necessary diagnostic test. On the other side of the question, we have
(1) The FDA, which has cleared the PLAC test (Lp-PLA2) test as the only approved blood test for atherosclerosis.
(2) The American Medical Association, which granted the PLAC Test Category I CPT Code (83698), and thereby approved the use of this test in clinical practice by its members.
(3) The Centers for Medicare and Medicaid Services (CMS), which has approved the PLAC test for reimbursement as a valuable medical diagnostic tool.
(4) The American Association of Clinical Endocrinologists, which has included the PLAC test in its clinical practice guidelines.
(5) The American College of Cardiology Foundation/America Heart Association, which has included the PLAC test in its clinical practice guidelines.
(6) The American Stroke Association, which has included the PLAC test in its clinical practice guidelines.
(7) Even Wikipedia, reflecting the common consensus of its informed readers, defines the PLAC test as a diagnostic test used in clinical practice for the detection of atherosclerosis.
Any person of intelligence is going to side with these seven sources, including the FDA and AMA, over Humana. Atherosclerosis and the metabolic syndrome are my primary research focuses. If there were a better blood test to check for atherosclerosis than the PLAC test, then I would have ordered that other test by now.
In order for Humana to maintain its position that this blood test is experimental, it will have to prove that other medical conditions, besides atherosclerosis, can cause elevated Lp-PLA2 levels, and thus the test is unreliable. I seriously doubt Humana will be able to identify even one other condition that raises Lp-PLA2.
Chemotherapy Concerns from HSIonline.com
Posted by mgadmin on February 19th, 2013
“Dear Reader,
From my own experience, I can tell you there are all kinds of ways a cancer patient might be misled about chemotherapy. Usually, it’s unintentional. But it can still lead to unrealistic treatment choices. And those choices can be disastrous.
A recent WebMD article contains information that might create false expectations about chemo. Ironically, it appears in a report about patients who have false expectations about chemo. Is it any wonder why patients are misinformed?
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No comfort from chemo
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In a new study, researchers surveyed patients who had advanced cancers that had spread to other locations. Doctors considered all these patients terminal. And yet, nearly three out of four believed their chemo regimen would probably cure them. How could so many patients end up so deeply misinformed?
The WebMD report shows how easy it is to mislead. The article states that in terminal cancer patients, “chemotherapy can alleviate pain and extend life by weeks or even months.” Chemo can alleviate pain? Seriously. That’s a stretch! In some cases, chemo shrinks tumors. That might relieve pain. But there’s another, more common source of cancer pain relief. Painkillers.
Dr. Spreen told me that virtually all advanced cancers cause pain. That’s why doctors almost always give powerful painkillers in these cases. Meanwhile, chemo invariably compromises quality of life. And pain is usually a key part of that equation. Here are just three potential side effects of a new colon cancer drug I told you about last year…
* Serious bleeding in the stomach or brain — sometimes fatal
* Kidney problems — sometimes fatal
* Vision disturbances — including blindness
WebMD’s second claim — that chemo might extend life for months — is off the mark. Yes, some patients may get a few more weeks or months. But the opposite is true in many cases.
Previously, I told you about a review of 600 cases in which cancer patients died within 30 days of receiving chemo. In 40% of these cases, patients experienced “significant poisoning.” Treatment actually accelerated or caused about one-in-four deaths. And finally, some chemo drugs won’t work at all.
A few years ago, an oncologist examined the medical records of almost 8,000 cancer patients. In cases where patients received chemo in the final six months of life, ONE-THIRD had cancers that are unresponsive to chemotherapy. Chemotherapy is enormously complicated. Every cancer is different. Every chemo regimen is different. There are many ways misconceptions can creep in. So if you ever have to discuss chemo options with a doctor, go on high alert. That might be difficult if you’re sick. So bring someone with you. Record the conversation if you can. Ask as many questions as you can think of. Take notes. And don’t be afraid to call your doctor the next day with follow up questions.
Likewise, if a friend or family member gets a cancer diagnosis, offer to go along for the doctor’s meeting. In fact, insist that they don’t go alone. The more you know, the better you’ll be able to protect yourself (or a loved one) from misconceptions.
Sources:
“Many With Incurable Cancer Think They Can Be Cured” Denise Mann, WebMD, 10/24/12, webmd.com
“Patients’ Expectations about Effects of Chemotherapy for Advanced Cancer” New England Journal of Medicine, Vol. 367, No. 17, 10/25/12, nejm.org”
NOTE ADDED 2/19/2013
Dear Reader,
You might not think that a cancer patient would need to worry about protecting his brain. He shouldn’t even have to think about it.
But if he doesn’t, his doctor probably won’t either.
Yesterday, I told you about a little-known chemo side effect. It’s called “chemobrain.” This cognitive impairment includes poor memory, slow thinking, and attention deficit.
And the kicker… If you survive cancer, and if you survive chemo, the chemobrain effect may last for decades. That’s right. “Decades.” Plural.
So how can you protect your precious brain?
The answer may be very simple. Conventional doctors will howl. But it’s not THEIR brain. It’s yours.
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A clear win-win
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Chemotherapy creates a severe free radical environment in your body. Medical mainstreamers believe this harsh approach is necessary for chemo to be effective. They claim that antioxidants subvert chemo’s mission.
Sorry guys. That’s just not so.
More than 10 years ago, cancer researcher Ralph W. Moss, Ph.D., made the case… “The overwhelming mass of data accumulated so far supports the concurrent use of chemotherapy with dietary antioxidants.”
And here’s what that mass of data shows. Antioxidants minimize chemo side effects. They also ENHANCE the effectiveness of chemo.
You can’t get much more win-win than that. And that double win may include reduced risk of chemobrain.
Antioxidant-rich nutrient therapies are often given to cancer patients via IV. And one of the ingredients commonly included in these therapies is N-acetyl cysteine (NAC).
A few years ago, researchers tested NAC in rats given chemotherapy. Rats that received only chemo had lower memory scores compared to rats in the chemo-plus-NAC group.
The choice of NAC was not random. This amino acid stimulates production of glutathione, a powerful antioxidant. Researchers call glutathione “the great protector” for its immune system support. Studies show that it also helps reduce fatigue, muscle aches, and…brain fog.
Aging depletes our natural stores of glutathione. Stress, caffeine, alcohol, and some drugs accelerate that process. So keeping levels high is important under the best conditions.
Under the worst conditions — when the body is under attack by chemotherapy — glutathione support is essential.
Your brain will thank you later.
You can find glutathione easily online. And you can locate doctors in your area who provide NAC and other nutritional therapies via IV. Just check the Find a Doc feature here on our HSI website.
Sources:
“Antioxidants may Prevent ‘Chemo-Brain’” Natural Standard, 9/12/08, blog.naturalstandard.com
“Scientists Find ‘Chemo Brain’ No Figment Of The Imagination” Science Daily, 10/8/06, sciencedaily.com
“‘Chemo brain’ linked to neurobiological mechanism” HemOnc Today, 5/10/12, healio.com
10,000 IU/day Vitamin D Needed for Therapeutic Benefit; Vitamin K Benefits
Posted by Michael A. S. Guth on February 18th, 2013
Do you think my expecting wife can take 5000 Vit D?
Vitamin D has little or no side effects. However, for your own peace of mind, you should ask her doctor before starting her on this supplement. One caveat, if she has a doctor who makes the statement “People don’t need to take any dietary supplements or vitamins; they just end up in the person’s urine….” then the doctor should be fired on the spot! Americans absolutely have dietary deficiencies — these are well-known and published in articles by national news services about once every two weeks.
Keep in mind that Vitamin D is actually a prohormone and not a “vitamin.” Because she is pregnant, she may be producing excess estrogen or have a small imbalance in her hormone levels.
According to this article in the American Journal of Clinical Nutrition, pregnant women have an even greater need for Vitamin D supplements than non-pregnant women. http://www.ajcn.org/content/79/5/717.full
If she were my wife, I would have her on two Vitamin D 5000 IU gel caps — one in the morning and one in the evening 12 hours later. Vitamin D works slowly. It takes 2 months of prolonged use at high enough doses to boost the immune system and the skeletal structure. Also, high serum Vitamin D levels of 50 nG/ml or higher are correlated with a lower incidence of colon cancer, which is the 3rd most prevalent form of cancer in the USA.
“By some estimates, 90 percent of the population is D deficient. But evidence shows you can move yourself closer to the fortunate 10 percent by following one simple habit. Cleveland Clinic researchers asked a group of 17 subjects to take D supplements with their largest meal of the day. Results: Over three months, absorption of the vitamin was improved and blood levels of D increased, on average, by more than 55 percent! And that held true for nearly all subjects, whether their intake was just 1,000 IU daily, or 10,000. So simple, but given the enormous importance of vitamin D in fighting cancer, improving heart health, and preventing type 2 diabetes, depression, and cognitive decline, this little study may prove to be a very big deal.” hsionline.com
Sources:
“New daily recommendation for vitamin D is off by THOUSANDS” Jonathan V. Wright, M.D., Nutrition & Healing, 2/25/11, wrightnewsletter.com
“Vitamin D Supplement Doses and Serum 25-Hydroxyvitamin D in the Range Associated with Cancer Prevention” Anticancer Research, Vol. 31, No. 2, 2011, iiar- anticancer.org
“Taking Vitamin D with the Largest Meal Improves Absorption and Results in Higher Serum Levels of 25-Hydroxyvitamin D” Journal of Bone and Mineral Research, Published online ahead of print 2/8/10, jbmr.org
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Note added February 25, 2012:
Vitamin D is one of the areas I have researched in some detail. I teach a course, Health Economics, for a college of nursing, and in Week 2 or 3 of that course we critique the National Institute of Medicine’s study concluding Vitamin D supplements have no benefit on health. It is very easy for my undergraduate (nursing) students to point out all the faults in that study, and it perplexes me how doctors who are members of the National Academy of Sciences could not understand their own shortcomings in their methodology and conclusions.
In any event, to derive a therapeutic effect on the immune system from Vitamin D, people need to strive for serum Vitamin D levels of about 50 ng/mL. I get very little sun, aside from the summer months, so I was taking 10,000 IU of Vitamin D daily. That dose was very safe and posed no side effects. My serum Vitamin D level rose to 75 ng/pL. I subsequently cutback to 7,000 IU/day, and my serum Vitamin D levels fell to 49 ng/mL. Now I am back on 10,000 IU/day, and I would expect my serum Vitamin D levels to again be close to 75 ng/mL the next time I check them.
Vitamin D takes several months to accumulate in the body. I would not advise anyone to test his or her serum Vitamin D levels until he or she has been taking at least 5,000 IU of Vitamin D for at least 3 months. Taking between 2,000 and 3,000 IU of Vitamin D left me at serum levels of about 25 ng/mL. I would be surprised if a low dose like 2,000 IU of Vitamin D would be enough to boost anyone into the therapeutic range of 50 ng/mL.
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Note added April 25, 2012
from HSIonline.com
Really? They can’t come up with anything new?
If I hear this ridiculous argument one more time, my head might explode. I’m sure you’ve heard it too…
“The only sure thing about dietary supplements is they give you expensive urine.”
That oh-so-clever little quip always reveals a lot about the person who speaks it. It’s a very lazy thing to say. They’re just parroting what they’ve heard from someone else. And they haven’t bothered to do their homework.
Over the past 20 years, we’ve seen many studies proving supplements work. Just today, I found a great example showing the health benefits you get from vitamin D.
You know, along with all that “expensive urine.”
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Remarkable protection
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Vitamin D studies? Oh, we’re waist deep in them.
In just the past couple of years, we’ve seen that vitamin D supplements help diabetics control blood sugar. In other studies, D reduced risk of flu among schoolchildren, and even reduced muscle pain caused by statin drug use.
In the newest D research, it did exactly what drug makers WISH statin drugs could do.
The study included nearly 10,900 subjects. The average age was 58, and 70 percent of them were vitamin D deficient.
Over more than five years, the research team linked D deficiency to an increased risk of diabetes and heart disease. In this group, overall mortality was almost 165% higher compared to subjects with good D levels.
Researchers also found that vitamin D supplements reduced heart and diabetes risk, and “conferred substantial survival benefit.”
Researchers noted that the Institute of Medicine RDA for vitamin D is 600 IU. Based on their study, they believe this is too low. They say 1,000 to 2,000 IU daily is more appropriate.
Agreed – 600 IU is much too low.
But 2,000 is still not quite enough.
Keep in mind that your body produces at least 10,000 IU of vitamin D in just 30 minutes of full exposure to sunlight. That’s why Dr. Jonathan Wright recommends a minimum of 5,000 IU daily. And that’s just for starters. Dr. Wright believes that double that amount is necessary to cut risk of cancer and other diseases.
The Kansas team didn’t discuss supplement specifics. But as I’ve said before, you should only supplement with a good quality vitamin D3. That’s the same form of the vitamin your body produces after sunlight exposure.
D3 usually doesn’t cost a lot, so I can’t promise how “expensive” your urine will be.
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July 2, 2012
“Vitamin D & Calcium… The saga continues.
Last week, I told you about a new recommendation for seniors. The U.S. Preventive Services Task Force determined that RDA doses of D and calcium are too low to prevent fractures in the elderly.
So if you up the dosage, is the problem solved?
Not so, says the task force. Higher calcium intake produces a slight increase in the risk of kidney stones.
Not so, says Dr. Spreen. Not only is the correlation very weak, but add a magnesium supplement and it becomes even weaker.
But wait… We’re not done yet.
Dr. Spreen sent me details of a new study from Denmark. Researchers looked at eight studies. Each study included about 1,000 elderly men and women. Subjects were given D supplements, calcium supplements, D and calcium combined, or placebo.
Over an average of three years, those who took calcium and D together had a lower risk of dying.
You’ve got to like THAT trend.
Stay tuned. I’m sure there are more chapters to come in the D and calcium story. ”
hsionline.com
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Note added Aug. 6, 2012
“It’s almost as if NOTHING works right without this stuff.”
That comment comes from Dr. Spreen. And the “stuff” he refers to is vitamin D.
And I could add, “Yes. Once again.” Because the rave reviews never stop with this indispensible nutrient.
Dr. Spreen sent his comment with information about a new study. Swiss researchers who specialize in aging issues, reviewed a dozen placebo-controlled studies. Each trial tested vitamin D supplements as a fracture preventive.
The 12 studies involved more than 31,000 subjects, all over the age of 65.
Results linked the highest D intake to a significant reduction of hip fracture risk. Risk of other fractures was reduced as well.
Now… How high is “highest intake?”
As usual, not high enough.
The average high intake for the 12 trials was 800 IU daily. Some subjects received as much as 2000 IU.
And yet, 2000 IU really just gets you started.
Keep in mind that your body produces at least 10,000 IU of vitamin D in just 30 minutes of full exposure to sunlight. That’s why Dr. Jonathan Wright recommends a minimum of 5,000 IU daily. And Dr. Wright believes that double that amount is necessary to effectively cut risk of cancer and other diseases.
For those who take a calcium supplement for bone health, I want to share a comment from one of the Swiss researchers… “Calcium supplements without vitamin D have been reported to increase the risk of hip fracture.”
And that brings us back to Dr. Spreen’s comment… “It’s almost as if NOTHING works right without this stuff.”
hsionline.com
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Note added 10/24/2012
I take 10,000 IU Vitamin D daily and recommend all adults in North America get at least 5,000 IU daily, but preferably 10,000 IU. As to evidence refuting the claimed risks of therapeutic doses (10,000 IU/day of Vitamin D), I would recommend the interested reader click on these links: (1) http://www.lef.org/magazine/mag2010/sep2010_Michael-Holick-The-Pioneer-of-Vitamin-D-Research_01.htm?source=search&key=vitamin%20D
(2) http://www.lef.org/magazine/mag2012/aug2012_In-The-News.htm?source=search&key=%22vitamin%20D%22
(3) http://www.lef.org/magazine/mag2007/sep2007_report_vitamind_01.htm?source=search&key=%22vitamin%20D%22
(4) http://www.lef.org/magazine/mag2006/mar2006_report_vitamind_01.htm?source=search&key=%22vitamin%20D%22
These articles are easy to read and each one contains over two dozen citations to medical articles referenced therein. Depending on whether anyone is still debating the beneficial impact of high (therapeutic) doses of Vitamin D, I can reprint citations to the medical literature — like 20 articles at a time.
Vitamin D is one of my research areas. I would advise anyone who has a primary care doctor who denies the benefit of therapeutic doses of Vitamin D to find a new and better doctor!
Finally, I also take a therapeutic dose of Vitamin K. I take about 2,200 mg Vitamin K1 and K2 daily. Together Vitamin K and Vitamin D have a synergistic effect and enhance the bone mineralization of the skeletal structure.
NOTE ADDED 10/26/2012
I personally take artificial Vitamin D3, and it has boosted my serum 25-hydroxy Vitamin D levels into the optimal range. My level is currently 68 ng/mL. I must repeat that I STRONGLY recommend everyone boost his or her immune system, reduce the risk of certain cancers, and improve bone mineralization by taking therapeutic doses (at least 5,000 IU/day and probably 10,000 IU/day is required) of Vitamin D3 as a supplement.
Without exception, each of the more than two dozen articles that I have read claiming health benefits for Vitamin D consumption involved HUMANS, not mice, and not petrie dish cultures. You can find any number of Yahoos claiming basic scientific evidence is wrong, but who cares about their ignorant opinions. A fact is a fact.
Let me take this one step further. In America, people with health insurance now have a wellness visit benefit in which the office visit plus any associated blood work is provided at no cost to the insured: the insurance company pays for the wellness visit. During these periodic preventive health visits, I strongly recommend everyone ask his or her doctor to order the serum 25-hydroxy Vitamin D test. I reprint here the justification that I provided my insurance company in order to get them to pay for that particular lab test.
“25-hydroxy Vitamin D – serum Vitamin D levels are closely tied with cardiovascular disease (one of the risks explicitly authorized for screening by the Affordable Care Act during wellness visits) as well as the overall health of the immune system. See, e.g., (1) Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc. 2006 Mar;81(3):353-73. (2) Scragg R, Jackson R, Holdaway IM, Lim T, Beaglehole R. Myocardial infarction is inversely associated with plasma 25-hydroxyvitamin D3 levels: a community-based study. Int J Epidemiol. 1990 Sep; 19(3): 559-63. (3) Lind L, Hanni A, Lithell H, et al. Vitamin D is related to blood pressure and other cardiovascular risk factors in middle-aged men. Am J Hypertens. 1995 Sep;8(9):894-901. (4) Zittermann A. Vitamin D and disease prevention with special reference to cardiovascular disease. Prog Biophys Mol Biol. 2006 Sep;92(1):39-48. (5) Achinger SG, Ayus JC. The role of vitamin D in left ventricular hypertrophy and cardiac function. Kidney Int Suppl. 2005 Jun;(95):S37-S42. (6) Zittermann A, Schleithoff SS, Tenderich G, Berthold HK, Korfer R, Stehle P. Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure? J Am Coll Cardiol. 2003 Jan 1;41(1):105–12. (7) Martins D, Wolf M, Pan D, et al. Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin d in the United States: data from the third national health and nutrition examination survey. Arch Intern Med. 2007 Jun 11;167(11):1159-65.”
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From: Hillel Mazansky, M.D. [mailto:drhm@gianinc.com]
Sent: Saturday, November 10, 2012 6:47 PM
To: Dr. Michael A. S. Guth, Ph.D., J.D.
Subject: Re: Need your comment
My Dear Dr./Lawyer.
How did you become so erudite? I bet it’s because you take Vitamin D3.
HIllel
Hillel Mazansky, M.D. M.prax.Med (S.A.) M.R.C.G.P.(London)
La Jolla Corporate Center,
3252 Holiday Court, Suite 101,
La Jolla, CA. 92037
Tel. (858) 320-0021
Website: http://www.gianinc.com
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Watch our Youtube Video: http://youtube.com/MrGianinc
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On Nov 4, 2012, at 4:16 PM, Dr. Michael A. S. Guth, Ph.D., J.D. wrote:
Dear Hillel Mazansky, M.D.
As an attorney, I would like to prosecute doctors for malpractice who tell patients that Vitamin D at therapeutic doses has no benefits to them. Unfortunately, malpractice is not determined by reasonable person conduct. It is governed by the standard of care for a given state. That gives all doctors powerful incentives never to try anything new or recommend any substance other than FDA-approved drugs or write off-label prescriptions, because the large herd of physicians practicing in the state don’t do those things. That herd mentality makes it difficult for doctors like you to get your message out above the din of “eat healthy and get exercise and you’ll be fine” allopathic medical advice given out daily.
I wish the President of the United States would go on national TV and say that he personally takes 10,000 IU/day of Vitamin D and believes it has boosted his immune system and lowered his risks of cancers and other diseases. Then we would see hundreds of millions of Americans wanting to do the same thing as the president. Unfortunately, we have not had any president who knows anything about age management medicine or even simpler life extension health strategies.
Mike Guth
From: Hillel Mazansky [mailto:drhm@gianinc.com]
Sent: Sunday, November 04, 2012 6:42 PM
To: Dr. Michael A. S. Guth, Ph.D., J.D.
Subject: Re: Need your comment
Forgot to mention in a recent study, I think it was in the Annals of Medicine, not sure, read so many articles, study proves the higher the dose of Vit D3 ,the lower the chance of a MS recurrence. If you are really interested there is another article on this very subject in PUBMED where researcher’s prove that a level of 100 ng/mL of sreum 25-hydroxy Vitamin D was used to prevent reassurance, sans any toxicity. What do allopathic physicians know about vit. D ? “It’s toxic”. That’s all they know and when I prescribe 5,000 to non-cancer patients and 10,000 to those suffering, the MD’s standard response , that’s toxic!
Please get your “A” over here , we would have a great time together Mr. Dr. Attorney!
LOL
Hillel Mazansky, M.D. M.prax.Med (S.A.) M.R.C.G.P.(London)
La Jolla Corporate Center,
3252 Holiday Court, Suite 101,
La Jolla, CA. 92037
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Note added 11/12/2012
Thank you for your recent correspondence.
We understand your concern. The author of the post you provided us with discussed that instead of relying on the sun to obtain adequate amounts of vitamin D, individuals may need to supplement with vitamin D from dietary sources such as mushrooms.
As individuals age, they convert less vitamin D in their skin from sunlight, therefore it becomes necessary for individuals to obtain vitamin D from their diet and from supplementation. There have been studies showing that UVB-exposed mushrooms may be beneficial. In fact, a study demonstrated that the ergocalciferol (vitamin D2) in lyophilized (freeze-dried) and homogenized wild mushrooms increased serum 25-hydroxyvitamin D concentrations as effectively as the ergocalciferol supplement. The following is a link to the study, discussing this association in detail:
http://www.ncbi.nlm.nih.gov/pubmed/9925129
While this study is promising in the fact that UVB-exposed mushrooms are just as effective as the ergocalciferol supplement in raising serum 25-hydroxyvitamin D levels, there are some limitations to it. This study used one species of mushroom, and used freeze-dried and homogenized wild mushrooms. The bioavailability of vitamin D from fresh, nonlyophilized mushrooms was not evaluated. Additionally, natural variations in products are going to produce variations in the amount of vitamin D that the mushroom may contain. It would be easier for an individual to maintain a consistent dose of vitamin D in a supplement form, than it would be for an individual who is consuming the mushrooms.
Keep in mind, these mushrooms contain vitamin D2. Vitamin D2 is very well absorbed, and is ideal for vegetarians. However, recent research shows that vitamin D3 may be the preferred form of vitamin D.
Due to the variables with this study, and lack of consistency with the dosage of vitamin D contained in mushrooms, it may be easier for individuals to obtain optimal vitamin D levels through supplementation. We believe that most people require a daily dose of 5000 IU of supplemental vitamin D, obtained from all of their supplements, to achieve optimal blood level status of 25-hydroxyvitamin D. We suggest maintaining a level of 50-80ng/mL. Keep in mind, that this is a general suggestion; some individuals may need a higher daily intake (7000 IU for example) while others may need a lower amount to achieve optimal vitamin D levels.
If you have any additional questions, please e-mail us or call the advisor helpline at (800) 226-2370; international customers dial 001-954-202-7660. We will be glad to assist you.
Visit Life Extension on the web: www.lef.org
Please make sure Case:[2131035] is in the subject line of all correspondence.
For Longer Life,
Life Extension
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Please note: It is the purpose of Life Extension to provide relevant and useful information from our research and review of scientific and clinical studies to our customers and their health care providers. It is our intention to serve as an information resource upon which customers and their health care providers can draw beneficial and relevant information. There is no patient-physician relationship established as a result of your discussions with Life Extension. Life Extension customers do not receive physical exams and Life Extension does not intend to supplant the judgment of a patient’s treating physician or substitute Life Extension information for a physician’s diagnosis and treatment. It is further recommended that the reader of this correspondence review the actual text of any above cited research and exercise their own personal and/or medical judgment. THIS INFORMATION (AND ANY ACCOMPANYING MATERIAL) IS NOT INTENDED TO REPLACE THE ATTENTION OR ADVICE OF A PHYSICIAN OR OTHER HEALTH CARE PROFESSIONAL. ANYONE WHO WISHES TO EMBARK ON ANY DIETARY, DRUG, EXERCISE, OR OTHER LIFESTYLE CHANGE INTENDED TO PREVENT OR TREAT A SPECIFIC DISEASE OR CONDITION SHOULD FIRST CONSULT WITH AND SEEK CLEARANCE FROM A QUALIFIED HEALTH CARE PROFESSIONAL.
___________________________________
Note added 11/26/2012
There are multiple factors causing the majority of Americans to not absorb/utilize vitamin D. We stay indoors a lot. Those of us with darker pigmentation do not absorb the rays of the sun as effectively. And those who live above the equator cannot depend on getting sufficient sunshine. Most people also use sunscreen liberally now, and many of those are actually blocking the good UV rays that help us to make vitamin D. I also think our SAD (standard American diets) contribute to the problem. I don’t think we can totally get away from supplementation if we desire good health. There will always be those who go overboard on everything. That is one reason why I strongly recommend that we check vitamin D 25 OH levels and monitor how the patient is doing. That is also why I do not understand why the insurance companies stopped paying for levels to be done when they know that at this time, over 90% of patients are deficient. I am sure other insurance companies will be following their lead very soon.
Sharon A. Collins, MD, FAAP
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Michael Platt, M.D.: “As you may be aware, vitamin D is not a fat soluble vitamin but a prohormone. Why this is important to know is that some preparations of Vitamin D are in gelcaps with oil.
The oil actually impedes absorbtion to some extent; get the capsules with powder.
You should also be aware that it appears that we have lost the ability to convert sunlight into vitamin D, as evidenced by studies done in Hawaii and Costa Rica and by my own personal observations on patients in southern California. In the last 10 years, I have never had a patient with a vitamin D level above 30 who was not taking the vitamin.
I personally suggest doses of 10,000 to 15,000 IU’s per day of vitamin D3, given with vitamin K2 (MK7) to help prevent calcification of blood vessels from the vitamin D. In the old days, 15 minutes of sunshine was equivalent to 15,000 IU of vitamin D.
If women took this kind of dose of vitamin D, they could prevent breast cancer and be able to throw away their meaningless pink ribbons that has been started by a drug company that does chemotherapy for breast cancer.”
Dr. Dean Raffelock, D.C.: “Actually D3 is a true genomic hormone because it turns on and off DNA programs. The genomic hormones are the most powerful chemicals in the body which include the adrenal cortex hormones (DHEA, cortisone, cortisol etc.) and most of their active metabolites, all the major reproductive hormones and most of their metabolites, the major thyroid hormones, D3 and vitamin A. Drops that are put directly onto the tongue seem to absorb best in my experience but any form of D3 that effectively raise 25-OH D3 into the upper quartile on a blood test is good. Totally agree with balancing D3 with K2.”
What is the optimal balance one should see on a lab test for K2 and D3, or how did you mean “balancing” them?
Dr. Dean Raffelock: What I meant by “balancing” is that both should be supplemented to appropriate levels when indicated. The test I use for K is Undercarboxylated Osteocalcin (ucOC). Here is Metametrix labs explanation for this test:
Elevated ucOC is a functional marker of vitamin K deficiency. Vitamin K is required for the carboxylation of osteocalcin (OC) in order to bind calcium. OC is a product of mature, active osteoblasts that delivers calcium to form bone matrix. When Vitamin K is low, ucOC increases. By similarly affecting other calcium-binding proteins, insufficient vitamin K may lead to longer clotting times and has been associated with increased risk of vascular calcification.
So we don’t want the ucOC test to be elevated or in the higher quartile because it is an indicator of low or borderline low vitamin K.”
Does this test differentiate K1 from K2? I don’t see that in the lab’s explanation.
COMMENT BY MIKE GUTH: I take, and recommend others take, 10,000 IU/day of Vitamin D3. That dose has boosted my serum 25-hyroxy Vitamin D levels to 65 ng/mL. A consensus is building that people need levels above 50 ng/mL to derive the full therapeutic benefits of Vitamin D. I also take Life Extension’s Super K = 2.1 g every other day Vitamin K1 (as phytonadione) 1000 mcg, Vitamin K2 (as menaquinone-4) 1000 mcg, Vitamin K2 (as menaquinone-7) 100 mcg. The doctors at Life Extension recommended that I take Super K every day, but I found that taking Vitamin K every day made it too difficult to draw blood from me. I have had two episodes in which the phlebotomist had to insert the needle into 3 or 4 different veins, because the first vein was no longer filling up her vials. You might think I was dehydrated, but I was drinking lots of liquids prior to and even during the blood draw.
In any event, one of my current research interests is the extent to which Vitamin D, but especially Vitamin K, can remove arterial calcification and get those calcium deposits back into the skeletal structure where they belong. There is a large literature showing that people with atherosclerosis generally have low Vitamin K levels (and possibly low Vitamin D levels to boot). But that raises an interesting question of whether the converse is true: will Vitamin K in sufficiently high doses prevent or remove arterial calcification and atherosclerotic plaques in patients with some degree of atherosclerosis?
Finally, I was wondering what should be the optimal level of Vitamin K as measured by some blood test. Can the (ucOC) test serve that purpose? If so, what are the optimal levels that patients should target?
COMMENT from Dr. Dean Raffelock: The ucOC test is reflective of bone loss so no it doesn’t differentiate between K1, K2 or K3.
Michael- I too take 5000IU of D3 per day (and Life Extension’s Super K) but we need to be careful recommending that everyone take the same dosage of D3 because not everyone is the same and an excess can cause calcium deposition in soft tissues and cause problems like kidney stones. Much better to test and retest D3 levels to insure healthy ranges. People who get a good amount of sun exposure on skin tend to need less though some don’t seem to make more D3 with sun exposure. The ucOC test should ideally be in the lower quartile because at higher levels it is indicative of bone loss reflective of a loss of hydroxyappatite. A somewhat simplistic way of seeing the relationship of D3 to K2 when speaking of atherosclerosis is that they are somewhat opposite in that D3 makes calcium enter the bloodstream with an excess of D3 potentially allowing calcium to be stored in soft tissue including the vascular system and K2 specifically drives calcium into bone. Hence the need for “balance.” There is some evidence that K2 can drive atherosclerotic calcium back into bone but as you know that doesn’t mean that very high dosages are therapeutic. I use nattokinase and serrapeptase as enzymes to dissolve arterial plaque in my patients. Optimizing testosterone levels is also a powerful multifaceted way to prevent and treat atherosclerosis. Here’s am interesting short article on K2: http://www.jlgh.org/JLGH/media/Journal-LGH-Media-Library/Past%20Issues/Volume%203%20-%20Issue%203/JLGH_V3n3_p112-113.pdf
COMMENT by Christopher K. Nagy, MD: A deeper understanding of some of this information can be found in the book, Vitamin K2 and the Calcium Paradox. Great info. The fat soluble vitamins work as a team and should all be included as part of a regimen. Nothing works well in isolation.
COMMENT BY Dean Raffelock, D.C.: I think perhaps going no higher than 200 IUs of mixed tocopherols (heavier in the gamma with perhaps tocotrienols included) is probably a better bet. There is some research pointing to adverse prostate outcomes in higher E dosages. Metametrix does offer an antioxidant profile that includes vitamin E, vitamin A, betacarotene, Co Q10 etc. that might prove useful in dialing in dosages because each one of us has different needs based upon our metabolic individuality. I have not seen thus far any problem with anyone taking A and D3 together as far as one limiting the absorption of the other. I do only use lingual drops of A and D so perhaps that makes a absorptive difference. Nor have I seen any problem with taking A&E based upon the ucOC but I will start paying more attention to this specific issue. Also the “Super K” product that Life Extension offers has 10x the K2 you are consuming. I take 2 of those a day. My father had massive atherosclerosis and died of an ischemic stroke at 67. His father died of the same at 72. I am 61 with no plaque burden based upon heart EBCT testing and carotid doppler testing. Perhaps my vitamin K and serrapeptase/nattokinase program is working along with better life style choices in general. I do keep my testosterone levels very robust. Adequate testosterone initiates the liver to make hepatic lipase and scavenger receptor B1 both causing the liver to up-regulate excretion of LDL cholesterol. Oftimes this is a better strategy than statin drugs (for many reasons) because testosterones basic message to DNA is “repair, restore, maintain” normal function. Overdosing statins causes all kinds of hormonal issues.
Michael-Thanks for you kind comments. I never could understand why DCs who go through the same 4590 hours in the basic sciences as medical school wind up only manipulating the spine. Why study endocrinology, immunology etc. and pay large tuitions if you don’t want to function as a doctor? Perhaps there should be some kind of trade school for those kind of practitioners. I graduated chiropractic school in 1976 ( where I was taught clinical nutrition by naturopaths and had to perform minor surgical procedures, GYN exams and deliver 2 babies to graduate) and have earned board certifications in acupuncture, clinical nutrition, integrative medical and applied kinesiology. I function as a primary for many people including quite a few MDs. I teach at conferences mostly about either male hormone issues or the interdependence of genomic hormones and neurotransmitters. I own a nutrient company, formulate nutriceuticals for other nutrient companies and my book A Natural Guide to Pregnancy and Postpartum Health-Avery 2003 is in its 3rd printing. The only reason I cannot prescribe certain hormones and medications is that the “straight” chiropractors were up in arms about this and flew in their political representatives to grip to the Colorado legislature. The Colorado Medical Association and the pharmaceutical companies were all for multi-board certified docs like me having full prescriptive rights (except for opioids, etc) providing we took a 40 hour refresher coarse in pharmacology. Crazy right? Oh well. I enjoy very good relations with many physicians here in Boulder and can usually facilitate my patients receiving whatever they need that I cannot prescribe myself.
COMMENT: Dr. Guth, thank you for your comments and appreciation. You seem to have a LOT of enthusiasm and passion for knowledge.
Yes, I know vitamin K is the “koagulation” vitamin. I would appreciate knowing if I was informed correctly that it is K1 that is responsible for coagulation and not its other forms.
In the case of vitamin D, I take 10,000 IU routinely. That got me into the 50-75 ng/dl range in my blood test. I think it matters a great deal what part of the world and the time of year one is in when supplementing. Most of North America is under clouds at the present time of year and will be until Spring. Obviously we need more D now than in the sunny season. It seems to me appropriate to test people twice a year in order to assess their actual needs.
Following the recommendation of Dr. Julian Whitaker, when I got a flu last year, I took 150,000-200,000 IU of D for three days. He says it can stop the flu, and in my case, it did. I am trying it again right now.
Thank you for checking up on vitamin K and getting back. So, essentially, K1 is used to make coagulants but is not itself a coagulant. So, for example, if someone were taking an anti-coagulant drug, the downstream products (coagulants) of vitamin K1 would be reduced by the drug, but the presence of the coagulants would upset the effect or dosage outcome of the anti-coagulant drug? Essentially, the two would conflict.
Are coagulants related to the number of platelets? I have reduced the number of my platelets and notice I bruise easily and when I bleed my blood is noticeably more runny (thin). This happened when I took a number of herbs, specifically, ginseng, ginger, ginkgo (3Gs). When I stopped one of the G’s, I did not bruise as easily. All three of these G’s help with circulation (among other effects), so it occurs to me they increase circulation by reducing platelets, which amount to lowering resistance to blood flow.
COMMENT: Dr. Raffelock, thanks for your detailed reply. I live in Canada. We cannot get Life Extension’s high-dose K in Canada. Doses higher than 100 mcg of K2 are illegal. Nattokinase became illegal recently. L-carnitine was illegal until a couple of years ago. Health Canada (our version of your FDA) is endangering the entire natural health products (in your terms, health foods) industry. It is a long story I don’t want to go into here.
I want to ask you about testosterone and estrogen. I am using Life Extension’s “optimal” range concept for evaluating my hormone range and their input as to the balance or ratio between T and E (and other hormones). As you probably know, their concept is to help people get into the hormone range of a healthy 29-41 year old. Said otherwise, high outside age-normal range on conventional blood tests. The ratio of T to E to shoot for was given as T=4 and E=1. In other words, in a man, free testosterone should be 4 times higher than the value of estrogen, and T should be in the optimal range of the ideal 29-41 year old. Would you agree with that?
Second on this subject, a male 71 and apparently healthy but showing signs of a little belly fat, on a healthy diet, also showing occasional access problems with his memory, took topical bio-identical testosterone (10%, 1/4 tsp/day). He developed hair where he never had it before and lost hair where he always had it! His concentration improved slightly. His belly fat remains. His T is in normal range for his age, but his E is out of range high. He cut back somewhat on his topical testosterone to maybe lower E, and has been trying to bring his E down using chrysin (up to 4000 mg/day) and DIM (108 mg/day). The result has been that E did come down but not into age-normal range and certainly not in the 1:4 ratio considered optimal by Life Extension. His fat endures. The worry is about future, more serious problems to do with cancer, heart disease and dementia from out of control E and low T. Short of drugs with strong side effects, what might he do?
On A, E, gamma-E and K, I had read consistently that 400-800IU/day is therapeutic dose for d-alpha E. What is the research that says lower doses of d-alpha and higher d-gamma? I know there was a study of d-alpha that said it was not effective at all but they used synthetic or dl-alpha, the usual problem. How much A and of what kind and why? I can check Metametrix, but may have a problem getting it into Canada.
I understand your lament about scope of practice limitations. I am surprised the Medical Association and pharmaceutical companies were in favor of doctors of chiropractic having prescription rights. I can understand how that would sell more drugs and the drug companies would love that. But the medical association? Up here in British Columbia (I don’t know why I say “up”!), chiropractors have never had prescription rights and have been targeted for removal from our Medical Services Plan (government health insurance plan) for over 16 years. The group doing the targeting is the British Columbia Medical Association, backed by the College of Physicians and Surgeons of BC. I actually did an investigative news reportage on their initiative in the year 2000. It was only sometime in the 1970s that DCs got to call themselves “doctors”. Even now, there is an MD in Quebec who has been on a long campaign to prove chiropractic cervical adjustments cause strokes. He is involved or is inspiration for a class action law suit against chiropractors accused or suspected of instigating strokes. One famous news story on the front page of the National Post (Canada) had huge headlines: “Neurologist Identifies Chiropractic Menace!”. Someone left a chiropractor’s office and had a stroke. What was later discovered, if I was told accurately, was that the coroner had actually LIED about some crucial evidence! Cloak-and-dagger stuff.
COMMENT BY MICHAEL PLATT, MD: If you do not mind my interjecting, chrysin is not usually terribly effective in controlling estradiol levels. Zinc, 50 mg per day can be used because it is an aromatase inhibitor, DIM and indole-3-carbinol in a dosage of 300 mg/day may be helpful as well. However, the most effective means is probably anastrozole (Arimidex). A compounding pharmacy can make up a preparation of 50 mcg/capsules that can be used M-W-F. This is a lot lower dose than the usual 1 mg (1,000mcg) daily dose given to women to prevent recurrence of breast cancer. It can also be used just to elevate testosterone levels.
Another thing, I have given my male patients a protocol advising them to use testosterone cream on the testicular sac – the most physiologic area to put it. The testosterone goes into the pelvic circulation, does its job, and then the testosterone goes into the inferior vena cava and straight to the heart where you have the most testosterone receptor sites and is able to provide the most important benefit for men in the andropause.
Using the cream in that area usually results in the ability to cut the dose in half, best regulated by morning erections rather than blood tests. I have the men apply progesterone cream to the sac before the testosterone, because it also acts as an aromatase inhibitor, as well as an alpha-reductase inhibitor.. The hair follicles in that area do not have alpha-reductase inhibitors around them anyway, so the concern is not as much for an increase in DHT.
Needless to say, my unique methods for using hormone therapy are outlined in my manual for healthcare practitioners.
NOTE ADDED 2/19/2013
…and another thing
“It’s almost as if NOTHING works right without this stuff.”
That comment comes from Dr. Spreen. And the “stuff” he refers to is vitamin D.
And I could add, “Yes. Once again.” Because the rave reviews never stop with this indispensible nutrient.
Dr. Spreen sent his comment with information about a new study. Swiss researchers who specialize in aging issues, reviewed a dozen placebo-controlled studies. Each trial tested vitamin D supplements as a fracture preventive.
The 12 studies involved more than 31,000 subjects, all over the age of 65.
Results linked the highest D intake to a significant reduction of hip fracture risk. Risk of other fractures was reduced as well.
Now… How high is “highest intake?”
As usual, not high enough.
The average high intake for the 12 trials was 800 IU daily. Some subjects received as much as 2000 IU.
And yet, 2000 IU really just gets you started.
As I’ve mentioned before, your body produces at least 10,000 IU of vitamin D in just 30 minutes of full exposure to sunlight. That’s why Dr. Jonathan Wright recommends a minimum of 5,000 IU daily. And Dr. Wright believes that double that amount is necessary to cut risk of cancer and other diseases.
For those who take a calcium supplement for bone health, I want to share a comment from one of the Swiss researchers… “Calcium supplements without vitamin D have been reported to increase the risk of hip fracture.”
And that brings us back to Dr. Spreen’s comment… “It’s almost as if NOTHING works right without this stuff.”
Good stuff!
To Your Good Health,
Jenny Thompson
“High Vitamin D Doses Lower Fracture Risk for Most Vulnerable” Diedtra Henderson, Medscape, 7/4/12, medscape.com