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Letter from Dr. Janson
DHEA (and More) for Menopause
Vitamins Help Alzheimer's
Disease
Lung Function and Mortality
In the Health News
Recipe of the Month: Tangy
Sauce for Veggies
Dear Friends,
I just returned from the Scientific Conference
of the American College for Advancement in Medicine
(ACAM), and it was a great meeting attended
by more than 350 doctors interested in cutting
edge medicine. About 150 exhibitors also attended,
not only to show their products to the physicians,
but also to learn from the scientific sessions.
One of the researchers, John Classen, MD, reported
on the higher incidence of type I diabetes (insulin
dependent diabetes mellitus, or IDDM) in people
who have been vaccinated for various childhood
diseases and tuberculosis (the BCG vaccine,
more common in Europe than in the US). The risk
stems from immunizations given after the first
eight weeks of life. IDDM is an autoimmune disease,
resulting from destruction of the pancreas cells
that produce insulin. Immunization against whooping
cough (pertussis, the “P” in DPT), is strongly
associated with increased diabetes. The same
is also true for other immunizations, but is
reversed if immunization is done during the
first eight weeks.
What is especially interesting is the way the
manufacturers and government agencies are able
to deny the association. They simply cite studies
that show the difference, but that are too small
to be statistically significant, so they can
point to “no difference” between the two groups.
This erroneous conclusion is comparable to those
from other manipulated data designed to show
what the sponsors of the studies want to show.
For example, the recent study on St. John’s
wort that I reported in the last edition had
problems beyond those that I mentioned.
Dr. Joseph Glenmullen, author of Prozac Backlash
(his website is www.prozacbacklash.com), revealed
that this study on major depression was too
short for studies of St. John’s wort, which
takes longer than drugs to work, and it did
show a difference between the two groups in
favor of St. John’s wort, but the difference
was not “statistically significant.” One of
the details not reported was that the researchers
used a scale of depression that can show improvement
(for example a drop in score from 24 to 12),
but they did not count anyone whose score did
not show “cure” (a drop in score all the way
to 6).
Another feature of Dr. Glenmullen’s presentation
was the report of side effects from anti-depressant
drugs. Interestingly, the frequency of side
effects in reports from the manufacturers of
various drugs is different from that shown in
studies done by their competitors (at least
their financial interest may play to our benefit).
He also went into the many other valuable treatments
for depression and anxiety, including exercise,
caffeine and alcohol avoidance, kava kava, valerian,
and more.
The information on the value of alternatives
to drugs and even surgery continues to impress
me. I’ll continue to bring you reports from
these important biannual ACAM meetings.
I have previously reported on the value of the
hormone dehydroepiandrosterone, or DHEA. It
is an adrenal hormone precursor, or “mother
hormone,” as well as a free-radical inhibitor,
but DHEA production declines with age, making
it worthwhile to consider supplements.
DHEA reduces platelet aggregation, protects
blood vessels from atherosclerosis, restores
depressed immune function, and it reduces the
damage from burns if administered after thermal
injury. In addition, it reduces insulin resistance
in obese patients, thereby improving their sugar
regulation.
Some patients and colleagues have wondered
if DHEA might increase the growth of some cancers,
as it is converted to both estrogen and testosterone,
but this appears not to be the case. DHEA provides
protection against cancer by inhibiting the
proliferation of cancer cells. It has been shown
in animals to prevent and arrest the growth
of malignant liver tumors, and the immune support
it provides should help the body cope with cancer.
Men with prostate cancer tend to have lower
DHEA levels than those without cancer, so it
is unlikely that any connection exists between
DHEA supplements and prostate cancer. Although
some reports express concern about increased
risk of other cancers, partly depending on levels
of estrogen already present, the weight of the
evidence suggests the opposite. It only slightly
increases the level of estrogen, even with supplements
of 50 mg daily.
In menopausal women, the normal levels of adrenal-derived
testosterone drop, and DHEA supplements increase
those levels and help to increase sexual interest
and satisfaction, as well as energy, mood, and
bone density.
The opinions on the right dose vary quite a
bit, from 5 to 50 mg for women and 10 to 100
mg for men, and without a check of blood levels
I would recommend staying with the lower doses
for people over 50. This would mean taking 5
to 25 mg for women, and 10 to 50 mg daily for
men. If you have your blood level checked (DHEA-sulfate
is the appropriate test), it is then best to
take the amount that brings your level into
the normal range for a younger person.
Many other health habits help to reduce
menopausal symptoms and reverse some of the
effects of aging for anyone. One of these is
regular exercise, including aerobic, stretching,
and resistance training for maintaining muscles
and bone density as we age, increasing physical
capacity, controlling weight, increasing flexibility
and suppleness, and reducing depression. This
is an impressive array of benefits for something
that is free, fun, playful, and can be implemented
at any age.
Diet also helps if you avoid the junk and fast
food that is so prevalent in the Western diet,
and spend a little time with food preparation.
Eat lots of fresh vegetables and fruits, plus
some whole grains and legumes, and to that add
some fish, seeds, and nuts, and perhaps some
organic eggs and low-fat yogurt. Keep sugary
foods and beverages to a minimum, as these contribute
to bone loss and depression. (Notice that I
do not recommend meat or chicken.) The ads for
milk that promote it for bones are misleading!
In countries with the highest milk intake, they
have the highest rates of fractures from osteoporosis.
Finally, if you have specific menopausal symptoms
you could take supplements of black cohosh (80
to 160 mg a day), agnus castus (400 mg), or
dong quai (400 to 600 mg), gamma-linolenic acid
(240 mg), and magnesium (500 to 1000 mg), as
well as vitamin E (400 to 800 IU) and bioflavonoids
(1000 to 2000 mg) for hot flashes.
If you have some associated depression and
anxiety, you could take some St. John’s wort
(300 mg three times a day–divided doses appear
to minimize the sun sensitivity that is sometimes
seen), or some kava kava (250 to 500 mg). Valerian
(200 to 400 mg) also helps with anxiety. All
of my herbal recommendations and doses refer
to standardized extracts.
In addition to DHEA, other natural hormone
replacement helps for menopause and aging. Natural
estrogens from compounding pharmacies mimic
the human estrogen balance, unlike Premarin,
which is derived from horse urine and has a
different composition. Natural progesterone
is not the same compound as Provera, which is
chemically modified and has a range of side
effects. (For aging men, natural testosterone
from a compounding pharmacist may be beneficial.)
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A recent study showed that low levels
of both vitamin B12 and folate (folic acid),
when considered together, are associated with
twice the risk of developing Alzheimer’s disease.
Even low amounts that are not usually considered
“deficiency” levels were significant, and related
to atrophy of the cerebral cortex. The association
was even greater among those patients whose
brain function was considered to be higher at
the start of the study.
Vitamin B12 and folate are commonly low in
elderly people, making this finding even more
significant. Supplements of B12 and folic acid
are simple to take and relatively inexpensive.
I recommend a sublingual tablet of B12 for better
absorption, usually 2500 mcg per day. Folic
acid is usually available up to 800 mcg per
day, but I often recommend up to 5000 mcg (5
mg) for patients. This new evidence shows further
benefits from these nutrients.
In addition to B12 and folate, you can help
yourself preserve brain function with other
health practices. Other recent studies have
shown that maintaining intellectual activity,
physical activity, and practicing stress management
can all contribute to prevention of brain deterioration.
Community and family support contribute to maintenance
of good intellectual function.
Try as much as possible to avoid toxic metals,
such as lead and mercury, which may damage brain
tissue. Mercury is a preservative used in contact
lens solution and mercurochrome topical antiseptic,
and it is also found in many vaccines. As I
mentioned an earlier issue, it is also found
in fish. Workers exposed to lead (from lead
batteries, for example) have an increased risk
of Alzheimer’s disease.
Supplements of vitamin E and ginkgo biloba
both help maintain brain function, and ginkgo
can apparently provide some reversal of decline
for elderly patients who have already begun
to lose cognitive ability. In one study the
placebo group showed a decline over six months
in all parameters that were studied, and the
ginkgo group improved in most assessments. The
dose of ginkgo that the researchers used was
120 mg daily of standardized extract.
Good lung function is an important predictor
of health and longevity, although this is not
as well known as other risk factors for heart
disease or cancer. The Buffalo Health Study
followed 1200 people for 29 years. A greater
ability to expel air from the lungs is related
to lower mortality from all causes, and particularly
to fewer heart disease deaths. This was independent
of obesity, blood pressure, smoking, and other
known risk factors.
This is especially important in light of another
recent study showing that antioxidants can protect
lung function. Vitamins C, E, and A, and carotenoids
(beta-cryptoxanthin, lutein/zeaxanthin, and
beta-carotene) were beneficial, independent
of smoking, weight, and other variables. The
strongest associations were with vitamin E,
beta-cryptoxanthin, and vitamin A. Yet further
reasons to eat a healthy diet, exercise for
better lung function, and take your supplements.
•Lead is a nervous system poison, and
children are particularly susceptible to the
damage. Levels formerly thought to be “safe”
are actually associated with decreased cognitive
function (Lanphear BP, et al., Cognitive deficits
associated with blood lead... Public Health
Rep 2000 Nov-Dec;115(6):521-9). Although 10
mcg per dL is officially considered acceptable,
in children 6 to 16 years old, for every 1 mcg/dL
increase in blood lead level there is a significant
reduction in arithmetic scores, reading scores,
and nonverbal reasoning, and a 0.5-point drop
in mean scores on a measure of short-term memory.
The associations even held true for levels below
5 mcg. It appears that no amount of lead can
be considered safe. Supplements of vitamin C
and zinc can help remove lead, as can EDTA chelation
therapy or DMSA treatment.
•A report from the FDA on herbs suggests
that they harbor bacteria and fungi. But the
conclusion that they might therefore be dangerous
is misleading, because these products are foods,
and our foods are also not sterile. Reliable
manufacturers test raw materials to make sure
their herbal capsules do not harbor pathogenic
organisms. (Reuters Health, American Society
for Microbiology Meeting, May 23, 2001)
•A diet high in apples and tomatoes can protect
lung function, according to a report from the
annual meeting of the American Thoracic Society
(Reuters Health, May 22, 2001). British researchers
tested the FEV1 (the volume of air you can expel
in one second), and found that over a 10 year
period regular consumption of apples and tomatoes,
both rich in antioxidants, was directly related
to preservation of pulmonary function. They
also found that eating apples, tomatoes, and
bananas was associated with less wheezing, a
symptom of asthma.
Tangy Sauce for Veggies
Often I just do not have time to prepare an
elaborate meal, so I’ll just steam some vegetables
and make an easy, tasty sauce to put over them.
Usually I’ll just rinse and trim some broccoli
or cauliflower, or I might add potatoes or butternut
squash if I want to have more variety (start
the potatoes and squash first as they take longer
to steam). Then I blend some crushed garlic
with sesame tahini (crushed sesame seeds, try
health food stores for organic brands), fresh
lemon juice diluted with water to taste, ground
pepper, thyme, fresh or dried basil, a dash
of cumin and cayenne, and other herbs. If I
do make an elaborate dinner, I can serve these
vegetables with lemon-tahini sauce as a side
dish. Experiment on your own with different
herbs and spices. |
