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.
What kind of vitamin B12 are you taking? Cyanocobalamin is the most common form, but it’s also the worst form.
This is a great way to tell if your multivitamin is a good quality product or a piece of worthless junk. If your B12 is in the cyanocobalamin form (you’ll likely have to look at the actual ingredient list) you might as well just toss it in the garbage because the forms of the all the other vitamins are likely low quality as well.
The methylcobalamin form is the preferred form of vitamin B12 for the brain and this is the form I’ve typically recommended in my blog posts. In our office, I have always recommended Biotics’ brand B12 2000 which has the hydroxycobalamin form. But I’ve never really given much thought to why Biotics uses this form instead of the methylcobalamin until my education was expanded.
Dr. Harry Eidenier from DSD International sent out a communication that detailed why Biotics uses the hydroxycobalamin form. It turns out that the methyl from the methylcobalamin form has a tendency to bind up with mercury. And this information was discovered way back in the 70s and you can read about it in this particular study.
“But I don’t suck on mercury thermometers, doc,” you think to yourself.
Got any amalgam fillings? Mercury containing fillings are constantly giving off mercury vapor which can bind to the methyl in the methylcobalamin, creating methylmercury.
Methylmercury is a much more potent and absorbable form of mercury in mammals. If you have any concerns about the health of your brain, avoiding methylmercury is a good idea.
While we’re on the topic of vitamin B12, here’s a few additional tips:
- As mentioned, if you’ve got amalgam fillings, stick with the hydroxycobalamin form.
- If you’re getting injections, the cyanocobalamin form should NOT be used. The other two forms are acceptable.
- Although the RDA is around 15 mcg, a decent dose is closer to 2,000 mcg. It can take a very high dose to bypass poor absorption. Bad absorption occurs with older age (the region of the stomach that makes intrinsic factor needed to absorb B12 wears away with age). Stress and gastric bypass also affects absorption.
- I have never recommended sublingual forms. B12 is not absorbed in the mouth so holding it under your tongue does not help absorption.
Vitamin B12 is an important part of good health. Normally we get B12 from animal products, but the bacteria in the gut also produces B12. Of course, if you’ve had antibiotics you’ve likely blown this source of B12. A good quality multivitamin is likely to have a good level of vitamin B12, but if you’ve got a problem with absorption listed in #3 above, you’re going to need to be on a B12 vitamin. The brand (Biotics) that I recommend has B12, folic acid and B6—a very good combination.
Much like breast cancer, there has been much controversy with prostate cancer “prevention” and treatment in recent years.
Mainstream medicine as well as the public health gurus all put all their bets on the PSA card when it came to prostate cancer “prevention.” (For those non-regular-readers of the Rantings, I always surrounding the word “prevention” in quotation marks because mainstream medicine does little to prevent cancers–most of what they call prevention is really early detection.)
The research over the past few years has been leading away from using PSA as an effective means of preventing prostate cancer and saving lives. Even the discoverer of the PSA test, Dr. Richard Albin, has clearly shown his opinion about the matter, stating that the test should never have been used for the early detection of prostate cancer.
The main concern with the widespread use of the PSA test to detect prostate cancer is that there are a large number of prostate cancers detected that never would progress to anything of substance. This large chunk of men diagnosed with non-aggressive prostate cancer is pushed towards surgery, radiation and chemotherapy for a cancer that would never create harm.
You can see the problem here.
One of the common treatments given to prostate cancer patients includes a drug to block the action of testosterone, referred to as androgen-deprivation therapy or ADT. The idea is, if we block the action of testosterone on prostate cells (regardless of where they may be in the body) they will not divide as rapidly and these patients should have a longer survival time.
But, like so much else in medicine, we take an idea that may sound good on the surface and run with it long before the research is done to confirm that it’s a good idea.
And sometimes this research takes a LONG time. In the case of hormone replacement therapy for women, HRT was used for almost 50 years before the research trials found out it was a bad idea. This was, of course, after the drug companies made billions of dollars on drugs like Premarin.
As a result, ADT therapy is a common drug approach used in men with prostate cancer, despite a list of side effects like weight gain, loss of sexual libido and heart disease. Which brings us to this particular study.
In it, researchers looked at
Keep in mind that this is a very large study. While no single study sets anything in stone, the fact that we have been using an unproven therapy for prostate cancers that might never have progressed that have significant side effects should make you wonder just how many other commonly used treatments in medicine are creating far more harm than good.
The concerns with opioid use are becoming legendary. Despite grave concerns, prescriptions for this class of drugs continue to rise.
The only thing I can figure is that the same group of physicians that are writing prescriptions for hydrocodone, Percocet and Vicodin are also ordering CT scans on every patient. And maybe even writing antibiotic prescriptions for clearly viral related illnesses.
Regardless, there does not seem to be a clear end in sight to the overuse of opioids. Sometime in 2010 the number of deaths associated with prescription pain killers (principally opioids) surpassed deaths from illegal drugs like heroin and cocaine. Interesting when you consider the fact that the illegal drugs are obtained illegally with no type of gatekeeper (and so should be easier to get with the right connections) and the prescription drugs have to go through a gatekeeper that is supposed to restrict access to only those that need the drug.
Of course, the illegal drugs are purchased with cash that is paid for by the users while the prescription drugs are largely paid for by the insurance companies. Kind of a sick system if you really think about it.
Despite all this, the uproar that accompanies medical marijuana legislation is quite loud. Those who oppose legislation say it’s a bad idea and will cost society. Ironically, this same group does not seem to have a problem with handing out opioids like Halloween candy to everyone who visits the ER or urgent care with so much as a sprained pinky. And this overuse is actually supported by the insurance companies. Crazy.
Considering that some people use medical marijuana for pain control, it would be interesting to see what happens to opioid overdosages in those states that have passed medical marijuana laws. Conveniently enough, this particular article addresses just that question.
(Disclaimer: Those who know me could easily confirm that I am NOT and have never used marijuana. Not even an inhale. So the opinion expressed in this article is in no way tied to my personal attachments or lack thereof for marijuana.)
In the study, researchers looked at opioid overdose deaths across all 50 states from 1999-2010 and compared the states with medical cannibis legislation. Here’s what they found:
- Three states (California, Oregon, and Washington) had medical cannabis laws effective prior to 1999.
- Ten states (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) enacted medical cannabis laws between 1999 and 2010.
- States with medical cannabis laws had a 24.8% lower rate of opioid overdose deaths.
- In general, the longer the laws had been in effect, the lower that state’s risk of opioid overdose deaths.
Makes for kind of a hard argument supporting the use of medical marijuana for chronic pain control instead of opioids. This protection (which can only come from a shift to marijuana away from opioids) is despite the fact that insurance covers prescription drugs and marijuana users are paying cash. Talk about a windfall for the insurance companies. You’d think they’d be lining up to get laws passed in all 50 states just to save money (opioid costs are a large chunk of chronic pain expenditures).
I think I’ll file this one under ‘natural pain relief.”
No one becomes morbidly obese by overdosing on avocados or olive oil, yet fat has been demonized in the weight loss circles since the 90’s.
I won’t go into the whole USDA food guide pyramid mistake in this article, but if you’d like to read why it was such a bad idea you can do this in a previous article which can be read by clicking here.
That being said, this does not mean that you can ignore the higher calorie content found in fats. Nuts are very good for you (raw, NO added oils) but if you eat two pounds a day there will be a price to pay in weight gain. Same thing with olive oil. But this doesn’t mean that you should avoid these foods altogether. That is throwing out the baby with the bath water (and really….did anyone ACTUALLY ever throw a baby out when dumping the bath??).
This low-fat craze, however, was a huge push over the past 3 decades. And look where it’s gotten us as a society; more obesity, more diabetes, more heart disease and more cancer. Part of the problem with the low-fat diets is that we replaced the fats with bad carbohydrates like high fructose corn syrup and enriched wheat flour, two items that are the worst thing you can do for your weight and your health.
You can still see the remnants of the low-fat craze just by looking at the front of food package. Some products proudly proclaim themselves to be “low fat” and use healthy in the same sentence. This is despite the fact that a seasoned biochemist couldn’t pronounce half the ingredients on the label.
Leaving “low fat” out of the battle for weight loss, the carb story has been just as confusing. Carbs became demonized as a group of macronutrients without thought to whether the carbohydrates came from broccoli or Wonder bread.
With all of that being said, keeping your carb intake lower is probably a good idea. This particular study reinforces that point by comparing a low-fat diet to a low-carb diet. In it, researchers compared 148 men and women put on either a low-carbohydrate diet (<40 grams per day) or a low-fat diet (<30% of daily energy intake from total fat with less than 7% coming from saturated fat]). Here’s what they found after a year’s time:
- The low-carb diet group lost more weight (7.7 pounds more).
- The low-carb group lost more fat (1.5% more fat loss).
- The low-carb group had a better improvement in HDL levels, the ratio of total cholesterol to HDL as well as triglyceride levels.
None of these results are Earth-shattering, but it does become clear that paying attention to your carb count has better payouts on health then does focusing on fat content of your diet. Just to help you along, here are some tips for lowering your carb intake:
- Try mashed cauliflower with spices and olive oil instead of potatoes.
- Try jicama tortillas instead of corn or four tortillas, or try romaine lettuce to wrap your fish tacos.
- Ditch the sodas and juices – try organic teas or get a SodaStream Crystal and make your own sparkling water with essences.
- Ditch sauces and use spices instead (spices with no sugars added, of course).
- If you’re going for pasta, try to make it a smaller part of the dish rather than the dominant food group.
So what creative ways have you come up with to lower your carb intake?