I know, I know. You already know everything about vitamin D (mainly because you ALWAYS read this blog).
Besides, your doctor has already checked your vitamin D and (almost assuredly) told you that your levels were low and you need to take 10,000 of prescription vitamin D once a week. Or maybe he or she just told you to run to the store and buy your own and take 1,000 IUs per day.
And, since you have heard that vitamin D does everything from protect you from cancer to making your lawn greener, you dutifully ran out and complied. But was this the best course?
Here are a few things to note that your doctor might not be aware of:
- If your doctor checked your levels, you can rest assured he or she is at least a decade behind the researchers who say not to bother—everyone’s low so just supplement everyone (with very few exceptions).
- While the labs say you should be over 20 ng/dl, this is NOT optimal. Optimal is recognized by vitamin D experts as being between 60-100 ng/dl.
- The prescription forms of vitamin D (which are usually vitamin D2, NOT the D3 form) just don’t budge blood levels very much. Don’t waste your time, money or health.
- If you’ve had your gallbladder out or have had bypass surgery, there is NO way you’re going to absorb a vitamin D that’s not emulsified (and few are).
- There are many factors that go into how much vitamin D you should take, but I can almost guarantee that, if your bloodwork has been low, 1,000 or even 2,000 ain’t going to get you to optimal. Most I have come across need 4, 6 or even 10,000 per day to get up to optimal levels.
- If you are at optimal levels, you’re in a very, very small elite group. Consider yourself a 1-percenter.
Despite, all the evidence and concern floating around everywhere about vitamin D, how could a mere 1% of the population reach optimal levels?? Before you think it’s unreasonable to think the number is so low, I can count on a single hand how many times I’ve seen patient bloodwork in the optimal range.
This particular study drives this point home. In it, researchers looked at 14,641 men and women aged 42–82 years who were living in England (arguably a less-than-sunny location). They were put into 5 groups based on their initial blood levels of total 25(OH)D (less than 12, 12-20, 20-28, 20-36 and more than 36 ng/dl). Here’s the details of what they found after following them for 13 years:
- The average vitamin D levels was 23 ng/dl.
- Participants risk of dying from any cause went lower as the vitamin D levels went higher than the lowest group (16% lower in the 2nd group, 28% lower in the next level up, 29% next and 34% lower risk of dying in the group with the highest vitamin D levels.
- To put this into perspective, for every 8-ng/dl increase in 25(OH)D in the blood, there was an 8% lower risk of dying from any cause, 4% lower risk of having heart disease, 11% lower risk of being diagnosed with a respiratory disease and 11% lower risk of having a fracture.
- There was, however, no change in the risk of total cancers (although I would not be surprised, given past research, if we saw a lower risk with certain cancers if looked at individually).
- Those who had levels above 36 ng/dl where the least likely to die.
- Less than 1% of the population studied had vitamin D levels above >48 ng/dl.
I think we could run this same study anywhere in the world and get similar results with similar percentages of protection as well as similar levels of very low vitamin D levels.
It’s time to take the 6 factors noted above and take action. In our office, we offer Biotics brand emulsified vitamin D that is ridiculously inexpensive (otherwise I’d be writing this from first class…). Most patients spend around $20 PER YEAR for a top-quality vitamin D and even have to share it with their family so that it doesn’t expire before they use it all.
THAT is a good bang for your buck.
Coral calcium, Tums, dairy. The list of miracle compounds to increase bone density can be found easily on the Internet.
And if you read it on the Internet, it’s got to be true, right?
Just how many times has it been drilled into your brain that 3 servings of milk, cheese and yogurt per day will make your bones, teeth, nails and nasal hair stronger? Ok, so maybe you missed the nasal hair ad, but you get the point.
So, given all the hype (and BTW, yes the whole dairy = strong bones thing IS way more hype than reality), how can you piece together what’s good for bone health.
Luckily for you, on I’m a plane heading to dreary Chicago as I write this to teach a 12 hour class on the relationships between the gut, bone health and diabetes. So I couldn’t be more brushed-up on this topic.
Let’s get one thing out of the way first. Healthy bones are not about talking calcium supplements. This couldn’t be further from the whole story. Rather, you need to view this in the context of “bone health,” understanding that bone is not an inert tissue that we happen to attach our bones, tendons and ligaments to. Rather, bone tissue is an incredibly active tissue being affected by the health of your GI tract and, in turn, affecting your risk of diabetes. It also plays a critical role in producing immune cells, platelets and red blood cells. Do you really think calcium alone can handle this enormous task?
The list of things playing a positive or negative role in bone health are quite long, but the short list includes:
- Optimal levels of vitamin D
- Eating a plant-based diet loaded with natural calcium sources like green leafies
- Weight bearing exercise
- Avoiding drugs that affect serotonin levels (like SSRIs)
- Avoiding drugs that block acid production in the stomach (like Nexium)
The long list is enough to take up an entire eBook (which is in the development stages).
So what does all this have to do with this particular article? In it, researchers looked at the ability of a high dose of resveratrol (the protective compound found in red wine from the skin of the grapes as well as from peanut skins) to have an impact on bone density. They specifically looked at 74 middle-aged obese men who were pre-diabetic (Metabolic syndrome, or MetS) because being pre-diabetic is bad for your bones.
Here’s the details of the study:
- They were given either 1,000 mg or 150 mg of resveratrol a day or a placebo daily for 16 weeks.
- Bone alkaline phosphatase (BAP) was measured to look for how fast bone was being remodeled (higher = more bone turnover).
- BAP increased the most with the highest dose (around 4%).
- The volume of the bone in the lumbar spine increased 2.6% in the high dose group.
Before you go digging around in your “Principles of Bone Density” textbook you’ve right by your side, I can tell you can a 2.6% increase in bone volume in just 4 short months is pretty amazing. And all without breaking a single drop of sweat or drinking liquid from a cow’s udder meant to raise its young to an independent heifer.
Not quite in that same breath I can also tell you that 1,000 mg of resveratrol is a pretty high dose. It’s not that you’d have GI upset or grow a third limb; it’s just that this would be a pricey proposition to increase your bone density. This much resveratrol, from a good quality source, is likely going to run around $100 / month or more.
Of course, when compared to the cost of drugs used to treat bone density, it’s still a very cheap bet. As way of comparison, the newest drug used to treat osteoporosis, Denosumab (Xgeva), runs about $2,000 per monthly injection. Makes the resveratrol look like quite a bargain.
I don’t mean to beat a dead horse, but merely managing your chronic migraine headaches with meds is not the answer.
I am not saying that it’s not the short-term goal. If you’ve ever spent time on some of the social networking sites that relate to migraine headaches, you’ll realize just how devastating and life-shattering migraine headaches can be. Jobs, relationships and lives in general can be restricted to living like a hermit in constant pain.
I understand that controlling the pain of the headaches is the first priority for a migraine sufferer. But not everyone gets relief from medications. This group spends their lives in a constant search for relief. Medication after medication after medication. When they’re lucky enough to find a medication to help, sometimes the side effects are just as debilitating.
The other group includes the ones who do find relief from medications. But then they stop there, blissfully unaware that this is just the first step.
I have written over and over that the headaches are the symptom of a much bigger problem. The headache is NOT a problem in the head. Rather, it is the brain that is the most sensitive organ to the unbalanced state of health, with the critical dysfunction coming from blood vessel health (also referred to as “vascular health”).
Poor vascular health is at the root of migraines. It is not always the only answer, but in most it is the principle problem. If you can address vascular health and improve the health of your blood vessels, it is highly likely that you’ll find that your migraines improve as your blood vessels do.
Just in case you think I’m crazy for suggesting this merely because your neurologist has never suggested it, I would like to present as evidence this particular study.
In it, researchers looked at the relationship between the development of Parkinson’s disease in migraine sufferers in the AGES-Reykjavik study. And the news isn’t good.
The Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-Reykjavik) is a study that began in 2002 and is designed to look at the relationship between risk factors, including genetic susceptibility and gene/environment interaction, in relation to disease and disability in old age.
Between 2002 and 2006, 5,764 participants from this study were reexamined to look for symptoms of parkinsonism, Parkinson disease, a family history of Parkinsons and Restless Leg Syndrome. Here’s what they found:
- People who experienced midlife migraine (especially migraine with aura) were 360% more likely to report parkinsonian symptoms.
- They were also 250% more likely to be diagnosed with Parkinsons.
- Women who had migraines with aura were 226% more likely to have a parent or 178% more likely to have a sibling who were diagnosed with Parkinsons.
- All of those who experienced headaches were more likely to experience Restless Leg Syndrome.
Parkinson’s disease has been strongly linked to prediabetes and diabetes. The damage to the blood vessels that occurs in the diabetic process is pretty bad, leading to actual brain damage and dying brain cells. I don’t know about you, but I’m hoping to keep all my brain cells intact as long as possible.
While no single study or research finding is enough to set anything in stone, the links between poor vascular health and migraines is quite extensive. Extensive enough to warrant finding a new neurologist if this has never been discussed with you.
It is equally clear that vascular problems LEAD to migraine headaches, NOT the reverse. This means that all the bang for your buck is in improving the health of your blood vessels to help your migraine headaches, not improving blood vessel health by controlling your migraines. There is not a single medication used to control headaches that does anything to improve blood vessel health.
There are quite a few ways to improve the health of your blood vessels. While it is beyond the scope of this article (you can read all about it in my Migraines and Epilepsy eBook by clicking here) here are a few short tips:
- Short-burst exercise is a must
- Cocao products like dark chocolate and cocoa, are very good for the blood vessels
- Wild caught fish
- Not smoking (smoking DESTROYS the blood vessels)
While this is the short list, it should be enough to get you started.
There is a time and a place for everything in medicine. Even, I would (very) begrudgingly admit, statins. But too often we are using meds without a full understand of the dark side of medicine.
And that dark side can be as devastating to your health as any diseases we’re trying to conquer with drugs. Antibiotics are on this list.
When you would ask the average doctor what the principle danger of antibiotics is, it is almost assured that you will get antibiotic resistance as the answer. And antibiotic resistance is a community issue. As the prescribing physician, it’s easy to think that the risk of antibiotic resistance has little to do with the patient standing in front of you with an upper respiratory infection. After all, antibiotic resistance is a community” thing, not an “individual” thing.
In other words, if there is little harm of antibiotic resistance from unneeded antibiotic use to the patient staring you in the face, the potential benefit, however small, is worth the risk. So that prescription will be given on the off chance that it may help the upper respiratory infection.
The first peer reviewed published article on probiotics was published in 1908. Now, 106 years later (as of the writing of this article) very few doctors grasp even the basics of the relationship between us and the bacteria in our gut. This is despite literally thousands of studies documented the benefits of probiotics.
But even this concept is reversed.
It’s not about the benefits of probiotics. Rather, it’s about the devastating health consequences of destroying the beneficial bacteria seeking refuge in your body:
- Disrupted immune balance, leaving you susceptible to allergies, asthma and autoimmune conditions
- Inability to fight off infections from disease-causing bacteria, viruses and parasites
- Inability to detoxify toxic chemicals from the environment
- Alteration of the hormone balance in the body, leading to depression, obesity and anxiety
The list is far longer, but I think you get the idea.
The group who does NOT get the idea, however, is the one continuing to write prescriptions for antibiotics in all but the most severe cases. Ear infections. H. pylori in the stomach. Upper respiratory tract infections. Pharyngitis (sore throat). Before dental work. After every surgery. Sinus infections. As a preventative just in case a bacterial infection MIGHT happen during a viral illness. The list is quite long. And all of this in spite of mounds of research screaming to NOT use antibiotics.
Until prescribing providers truly, deeply and passionately understand just how important it is to have a normal bacterial flora living and thriving within us, our society will be plagued with chronic diseases.
This particular article drives this home. Even further, most of this entire Journal of Clinical Investigation is devoted to the topic of just how integrated bacterial populations are integrated into every part of our health.
The authors highlight the emerging viewpoint that we need to view ourselves and the bacteria within us as an ecological community. One where wanton destruction of its inhabitants have long-term damaging consequences to our health.
It takes no convincing for society to look with horror on the killing of Siberian tigers for the pelts, elephants for their tusks, the overfishing of certain fish populations to near extinction or the loss of the rainforests killing the abundant life that lives within.
It is through this lens that we need to view the bacteria within us. We need to focus our efforts on supporting solid growth and diversity in our newborns and infants through vaginal birth, breastfeeding and NO antibiotics in the first few years of life. As we age we need to focus on diets that support the growth of bacteria rich in soluble fibers and without processed junk. We need to do everything in our power to avoid drugs that block acid production in the stomach (unless a bleeding ulcer is present). And we need to change the way we raise livestock in an antibiotic soup.
Until we can make these changes, both in understanding and in behaviors, the modern, antiseptic life is going to rob us of health.
Weight loss. Your doctor pronounces the goal like it’s as easy as changing socks. But it’s the rare physician that can put you on the path to that goal.
The (much) less informed physicians will recommend drink mixes to lose weight with names like Medifast or Slim Fast. Maybe the DASH diet or the American Heart Association Step 1 diet. Maybe they’ll hand you a sheet with some do’s and don’ts.
Weight loss, however, is never that easy and the opinions are all over the place. But there are some very clear concepts that play out again and again. And while there are many ways to lose weight, some of these methods are a very bad idea.
How can losing weight be a bad idea? I mean beyond cancer cachexia, intestinal parasites and amputation, of course. Let’s put it into a question…When you lose weight, would you rather lose fat or muscle?
Pretty simple question. I can see all hands being raised for the desire to lose fat. Except for the group in the back studying to become sumo wrestlers…
It has been clear for some time that, when we make the wrong decisions to lose weight, we lose muscle mass instead of fat. On the outside, you may lose weight. But when you take a peek inside using techniques such as bio-impedance analysis (BIA), you may find that the weight loss actually came from muscle mass NOT fat. Not a good thing.
In this particular study, we see just how glaring this can be. In it, researchers looked at 30 women with polycystic ovarian syndrome (PCOS) to see what happened when they were put on either a restricted calorie low carbohydrate diet or a standard restricted calorie diet. Specifically, the low carb diet had 41% of calories from carbs versus 55% of calories from carbs in the standard diet.
These women followed each diet for 8 weeks and body composition was monitored by DXA for body composition and CT scans for fat mass.
Here’s what they found:
- The women lost an average of 3.7% of total fat on the low carb diet versus 2.2% fat loss on the standard diet.
- The low-carb diet led to a decrease in fat in the subcutaneous-abdominal, intra-abdominal, and thigh-intermuscular areas (− 7.1%, − 4.6%, and − 11.5%, respspectively).
- The standard diet, on the other hand, led to a LOSS of lean body mass.
This is a perfect example of what happens when we make the wrong choices for weight loss. This is also why our office’s weight loss program focuses on a low-calorie, low-carb diet to make sure you lose weight the RIGHT way.
Considering that PCOS is essentially a prediabetic condition, this gives more weight to the idea that controlling carbohydrate intake is of critical importance for managing and avoiding both prediabetes and diabetes.
This means that, without a doubt, most “meal-replacement” shakes are off the list. Most are loaded with carbs (that way they are low-fat…) and if not, they have artificial sweeteners, also linked to weight gain.
Avoid them like the plague (or, if you prefer to be timely, Ebola…).
I’ve been reviewing research related to seizure control and brain health for many years now through the lens of natural medicine.
I still remember being in a consult with an epileptic patient with a very well-known neurologist to discuss natural methods to help control seizures. Despite this particular neurologist’s association with one of the top healing physicians in the world, his did not feel that there was really much to be done for seizure control beyond medications.
I guess he could never really look beyond the deficiencies and brainwashing of his traditional medical, drug-oriented training to evaluate the power of natural approaches to seizures.
That was really sad for this particular patient. And every other epileptic patient saddled to a neurologist (or epileptologist, for that matter) who believe antiepileptic drugs are the only answer. They will spend their lives chasing one drug after another to find one that helps your seizures and has acceptable side effects.
But, if you’ve been lucky enough to partner up with someone who actually reads medical literature, you will find that there is a long list of approaches that have been documented in the medical literature that can help you better manage or even eliminate your seizures.
It is all about healing your brain. If you experience seizures (or migraines or both) your brain is not functioning the way it is supposed to. Messages are getting into cells that are not supposed to be. Other messages that are supposed to be delivered to the cell don’t make it. Your very brain cells are starved for energy so they can work the way it was intended.
Natural approaches to seizures take this into account. I’ve covered many of them over the years, from vitamin D to exercise to fish oils. Some are simple. Others require an upheaval of your lifestyle.
But I have never covered the approach outlined in this particular study.
I guess, had I thought about it, sleep apea would have a strong association with seizures. It’s a stress on the body and brain. It’s linked to prediabetes (prediabetes leads to sleep apnea and sleep apnea worsens prediabetes) and prediabetes is really bad for the brain. It starves brain cells of the oxygen it so desperately needs. And, it occurs at night when the seizure threshold is lower.
Researchers looked at a group of 132 adults with epilepsy to evaluate them for sleep apnea to see whether the use of a CPAP had an effect on the number of seizures over the course of a year. Here’s what they found:
- Seventy-six (57.6%) of the group had obstructive sleep apnea (this is pretty darn high).
- 73.9% of those in the PAP-treated group had more than a 50% seizure reduction in seizures (versus only 14.3% in the untreated sleep apnea patients—HUGE difference).
- Overall, the PAP-treated group experienced a 58.5% reduction in seizures (versus 17.0% in the untreated sleep apnea group—again a HUGE difference).
- 83.7% of those who had PAP-treated sleep apnea had a ≥ 50% seizure reduction or became seizure-free (versus 53.6% in those who did not have sleep apnea and 39.4% in those who had sleep apnea but did not use a PAP).
- To put this in perspective, in those PAP-using sleep apnea adults, they were 9.9 times more likely to have a good outcome than those with untreated sleep apnea and 3.91 times those who did not have sleep apnea.
- When measured in terms of seizure reduction, the group with PAP-treated sleep apnea were 32.3 times more likely to experience a ≥ 50% seizure reduction compared with the group with untreated sleep apnea and 6.13 times compared with the group with no sleep apnea.
These are some pretty serious numbers. To flip everything around, it can be said that sleep apnea is very, very bad for the brain when left untreated. If any of these fits you (whether or not you have seizures), it’s time you got checked out:
- Chronic loud snoring
- Witnessed apneic episodes or breathing pauses during sleep
- Excessive daytime sleepiness
- BMI > or equal to 28
- Small jaw / small airway
- Large neck size (at least 17” male, 15.5 female)
- Family history of sleep apnea
In addition, your risk for sleep apnea is increased if you have high blood pressure, Type 2 diabetes or untreated hypothyroidism.
If any of the above fits you AND you are epileptic, given how much of a difference it made in this study, you need to get checked out for sleep apnea and get treatment (i.e. CPAP) if you have sleep apnea.
There are many causes of adult and childhood obesity, but some rise to the top.
Today’s poor quality diets consisting of liquid calories (regardless of whether it’s milk, soda or Gatorade, we should NEVER drink our calories) and phytonutrient-poor food choices combined with the culling out of physical activity at home and school.
Digging a little deeper you can find that chemical exposures like BPA in plastics, phthalates in vinyl, Teflon in cooking pans and flame retardants in mattresses, furniture and clothing all contribute to weight gain, obesity and diabetes.
Pulling out the shovel to dig even further and you will find that childhood neglect also contributes to childhood obesity. This can be nutritional, emotional or physical abuse.
If you happen to have any excavating equipment, you will find that exposures in the womb can prime the as-yet-unborn child for chronic diseases like obesity, heart disease and diabetes. High levels of maternal stress, chemical exposures and poor dietary choices by mom have all linked to later chronic diseases.
Which brings us to this particular study. In it, researchers looked at the links between antibiotic use in childhood and later obesity. The relationship between the bacteria in our gut and obesity has been in the spotlight for the past few years.
Rather than any single bacteria that plays a role in protecting or producing obesity, it has more to do with the patterns of bacteria present within the gut. Following this concept, it would make sense that antibiotics, which completely decimate the bacteria in the gut, will have some of role to play in obesity.
Broad spectrum antibiotics, which indiscriminately destroy the good bacteria in the gut, would have stronger effects.
Here’s the surprising details:
The bottom line? Think really, really, really hard when your infant is given a prescription for antibiotics. Question the pediatrician about the long-term side effects. If he or she seems unaware besides antibiotic resistance, this is your first sign that your doctor hasn’t cracked a medical journal in QUITE a while. Time to run.
Personally, I usually steer my patients towards family practice. In general, providers in a family practice seem far more in tune with the research and less inclined to follow dogma and write a prescription for every stuffy nose.
Quitting smoking, limit alcohol use, exercise, more fruits and veggies. We all know these risk factors for breast cancer.
Or at least I hope you know these factors and more. If you need a little refresher, feel free to check out prior blog posts on breast cancer prevention by clicking here.
Some risk factors are a little less obvious. Exposure to toxic chemicals like BPA in plastic water bottles, cooking in Teflon and phthalates from vinyls all increase your risk of breast cancer. Stress plays a role. Vitamin D plays a role.
But the gut?
Or, more specifically, the bacteria in your gut.
To understand the relationship of the bacteria in your gut to breast cancer risk, you have to better understand the way the human body breaks down estrogen. The 3 main estrogens in the body are estriol, estradiol and estrone.
Estrogens in the human body are broken down through several mechanisms. The breakdown occurs through several pathways which can be either safe or damaging and this pathway is called hyrodylation. Hydroxylation can occur down several pathways that produce different end-products. The 2 pathway is generally considered the friendly pathway. On the other hand, the 16-alpha pathway creates an estrogen that damages DNA and increases the risk of hormone related cancers like breast and uterine.
Dietary choices like broccoli and cauliflower will help your body breakdown estrogen into the safer 2 pathway. That’s why you should eat more cruciferous vegetables to lower your risk of breast cancer (never saw a poster proclaiming this during any of the Susan Komen 3-days).
But there’s another really important factor that helps to determine what pathway your body will take when breaking down estrogens, which brings us back to the gut.
The bacteria in your gut play a very large role in how estrogens get broken down. And since most of the estrogens that your body is trying to get rid of are dumped into the bile and then into the gastrointestinal and out the body from there. This means that the estrogens have a very heavy exposure to the bacteria in the gut.
In this particular study, researchers looked at how much the bacteria in the gut played a role in the breakdown of estrogens. Specifically, they looked at estrone and estradiol levels (called the parent estrogens) and compared them to the hydroxylated estrogens.
Without going into details of the study, the take home message is that the more diversity there was in the bacteria of the gut, the better the ratio between the parent estrogens and the estrogen byproducts.
So what does this mean? Anything that destroys bacterial diversity in the gut is likely to increase your risk of breast cancer.
Highest on the list for destroying the good bacteria in your gut? Antibiotics. And not just in the past week. As in EVER.
Even 2 years after a course of antibiotics bacterial diversity still has not recovered. There really hasn’t been any studies looking at how long it takes to recover diversity, but I would guess it takes decades when left alone.
You can probably shorten this time by using probiotics and eating foods that support the growth of bacteria in the gut. This includes foods like beans, whole grains and fruits. These foods contain soluble fiber that the bacteria feeds on.
Remember this info the next time your primary care or urgent care offers you a prescription for your upper respiratory viral infection.