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VIAGRA (CIALIS, LEVITRA, etc.) SAVES LIVES IN DIABETICS

American Diabetes Association 2015 Scientific Sessions; June 7, 2015; Boston, Massachusetts.

Researchers have found that men using phosphodiesterase type 5 (PDE5) inhibitors, like Viagra, were associated with a reduction of ALL CAUSE mortality in Type 2 diabetics, even those with a prior history of heart attacks. This makes no sense since erectile dysfunction is associated with poor circulation in the penis (and elsewhere )and should be associated with an increase in mortality. They even found that those men using both PDE5 inhibitors with testosterone also showed a decrease in death!. Testosterone has been the center of controversy for the past several years because some recent studies have questioned the safety of testosterone.

“The researchers speculate that this improved survival in patients taking a PDE5 inhibitor may be partly explained by the fact that these drugs decrease the PDE5-mediated breakdown of cyclic GMP, with the latter being cardioprotective.”

More tests need to be done, but in the future, all male diabetics may be prescribed a daily Viagra-like pill in addition to their statin and other diabetes meds.

 

NEW THOUGHTS ABOUT OBESITY

We usually think about obesity in terms of calories and exercise, but not every person who makes lifestyle changes are able to lose weight no matter what they do.

The latest thinking is that obesity is related to inflammation in the body as well as micronutrient deficiencies.

Many researchers are connecting the dots when it comes to MICROBIOME (bacteria in the gut) with inflammation and insulin resistance which can lead to increased bidy fat and weight. There are studies that are looking at the role of both prebiotics and probiotics in weight reduction.(there is also an association of heart disease and depression with abnormal bacteria in the intestines)

Also, deficiencies in Vitamin C, Zinc, Iron, Magnesium, CoQ10 and Calcium have been linked to weight gain.

So, yes, diet and exercise and even sometimes prescription medications can help you lose weight but when that doesn’t help, INFLAMMATION should be considered and treated

A NEW CURE FOR ALZHEIMERS PATIENTS????

Researchers in Australia have found that by using sound waves (non-invasive ultrasound), they could break up neurotoxic amyloid plaques in the brain. Amyloid is a protein that is thought to be associated with memory loss.

Publishing in Science Translational Medicine, the team describes the technique as using a particular type of ultrasound called a focused therapeutic ultrasound, which non-invasively beams sound waves into the brain tissue.  By oscillating super-fast, these sound waves are able to gently open up the blood-brain barrier, which is a layer that protects the brain against bacteria, and stimulate the brain’s microglial cells to move in. Microglial cells are basically waste-removal cells, so once they get past the blood-brain barrier, they’re able to clear out the toxic beta-amyloid clumps before the blood-brain barrier is restored within a few hours.

The team reports fully restoring the memories of 75 percent of the mice they tested it on, with zero damage to the surrounding brain tissue. They found that the treated mice displayed improved performance in three memory tasks – a maze, a test to get them to recognize new objects, and one to get them to remember the places they should avoid.

New trials are underway to study sheep and human studies are slated for 2017.

ANTIOXIDANTS AND ASTHMA

Am J Respir Crit Care Med. 2015;191:45-53

Asthma can occur any time in life, but new studies are looking and antioxidant deficiencies as a cause. (Antioxidants help prevent free radical damage to the cells in the body which can then lead to heart disease or cancer)

In this study, the levels of antioxidant biomarkers were determined before the onset of the trial and therefore preceded the onset of asthma. Investigators found that, compared with the control group, the adult-onset asthma subjects had significantly lower levels of alpha-tocopherol and PA ((platelet-activating factor acetylhydrolase).

Most antioxidants can be obtained by eating fruits and vegetables.

We are also able to measure total antioxidant function in the office using a simple blood test called SPECTROX. We are able to check glutathione, cysteine, Selenium, Vitamin C, Coenzyme-Q10, Vitamin E and Alpha Lipoic Acid levels in the cells (as opposed to the blood itself) in the body.

 

PHYSICIANS’ COMMITTEE FOR RESPONSIBLE MEDICINE

I recently attended a medical conference and for the first time healthy lifestyles were emphasized instead of pharmaceuticals. One of the keynote speakers was Neal Barnard, MD who spoke about “Power Foods for the Brain” Dr. Barnard is an associate professor of medicine at the George Washington School of Medicine.

The highlights of his presentation showed the association between saturated fats, total cholesterol, trans fats and diabetes and Alzheimer’s Disease. He also discussed the dangers of too much iron, copper and aluminum and their relationship to oxidative damage to the cells and blood vessels in the body. You can get too much copper simply from drinking water from your copper pipes at home! Unless you have an iron deficiency, you should never take extra iron. Too much iron can also come from cooking with cast iron pans. He also spoke about the importance of anti-oxidants-both from the diet and from supplements. For example decreasing homocysteine with B-vitamins can improve memory and may reduce heart disease. Studies have shown that eating blueberries or drinking grape juice (reduced sugar!) can also improve your memory.

He also spoke about the many benefits of a plant based diet. Although this is a great way to go, it is probably too difficult for most people.

To get more information, I would recommend checking out www.pcrm.org.

 

NEW TRENDS IN OSTEOPOROSIS: BONE DENSITY (DXA)SCANS DO NOT MEASURE BONE STRENGTH

There are new guidelines in screening and treating osteoporosis. It is recommended to screen all women over 65 and all men over 70 (of course, there are no codes for men, so insurance probably will not pay). Women who are 50 and are at risk for osteoporosis should also be screened. This would include women who smoke, use alcohol excessively, have rheumatoid arthritis or have a history of chronic or recurrent steroid use or have unexplained fractures. Not everyone with decreased bone mass (osteopenia) needs to be treated. If your bone density shows decreased bone mass, it has been suggested to be rechecked in 5 years. Women with normal bone density scans can wait 15 years before being tested again. The big question is what exactly does a bone density scan measure? It appears to have limitations as it does not tell us anything about BONE STRENGTH-which is what we try to achieve when treating. Even those taking medications may not show improvement although fracture risk is diminished! Supplements like calcium and vitamin D have no EFFECTS of bone integrity after menopause! (Supplements should only be used if you have a deficiency. Also, both Magnesium and vitamin K2 are necessary to drive calcium into the bones).

Another interesting finding is that only 40% of women with hip fractures ever regain 100% strength and function back.

And now, even the benefits of weight bearing exercise is being debated.

The only way I know of to build muscle and bone strength and be able to measure it is with the bioDENSITY machine we use in our office (www.bioDensity.com). It is the only exercise program ever to be analyzed and accepted for publication in an osteoporosis journal. And the great thing about it is that it is safe, easy and only requires 5-10 minutes of your time/week.

 

 

DRUGS AND DEMENTIA

Researchers have found a connection between common anticholinergic drugs and dementia. Examples of anticholinergic medications include common anti-histamines like Benadryl which are used to aid in sleep (Tylenol PM) as well as chlorpheniramine, a common sedating OTC medication for allergies. Medications used for overactive bladders like oxybutynin and tricyclic antidepressants like Elavil, which are often used for migraines and chronic pain have been linked to memory problems even at low doses.

There are many annoying side effects of these type of drugs, like dry mouth, constipation and urinary retention but when these medications are used long term-it doesn’t matter how low the dose is-the risk of dementia rose.

It should be noted that the newer non-sedating allergy medications (Allegra) do not affect memory. All tricyclic medications should be used with caution in older patients, especially with heart disease and one bladder medicine, Myrbetriq probably does not affect memory. It should also be noted that it is considered a DUI if you have an accident while under the influence of Benadryl-even if you took it the night before!

 

UPDATE ON TESTOSTERONE

New England Journal of Medicine

There have been 2 major controversies about testosterone replacement concerning the risks of heart disease and prostate cancer. I have written several blogs recently that looked at heart disease and saw no proof of a connection. Now we have a study of over 1000 men that actually showed a lower incidence of prostate cancer than those who were not taking testosterone. The researchers found an incidence of 30-50 cancers/ 10,000 men. The overall incidence of prostate cancer in the general population was 100/10,000 men.

This study only lasted 5 years. This is also not an excuse not to be screened for prostate cancer if you are taking testosterone.

New cure for diabetes?

It is known that diabetes causes an overproduction of a protein called TXNIP which can damage the pancreas. Researchers have found that an old high blood pressure pilled called VERAPAMIL could reverse diabetes in the lab by decreasing TXNIP levels.

All that’s left now is to perform human trials, and if successful will revolutionize the way we treat diabetes in the future.

The importance of triglycerides and diet in diabetes

Cardiovascular Diabetology, 10/17/2014 

This study looked at the relationship between high triglycerides and all-cause mortality in type 2 diabetics. It is obvious that the higher the triglycerides, the more likely you are to have heart disease. These findings were independent of LDL, HDL, HgA1C, weight/obesity, fasting blood sugar and treatment for both diabetes and hypertension.

We know that high intake of sugars and starches can raise triglyceride levels in most people. Years ago Dr. Atkins (Atkins’  Diet fame) stated that ideal triglycerides should be less than 3 times higher than HDL (good cholesterol. This is obviously very hard to do. If your HDL is 40, for example, than triglycerides should be no more than 120!  This is almost impossible for the average person since triglycerides in my practice average around 200 or more. As a matter of fact, triglycerides greater than 500 greatly increases the risk of acute pancreatitis (which is very painful and will land you in the hospital)

We also know that all medications, whether prescription or  OTC fish oil/krill oil may lower triglyceride levels but have never been shown to decrease death rates.

The only thing that does help is DIET and EXERCISE! This will naturally decrease triglycerides and increase HDL. So, unfortunately, there is no easy way out.

 

 

 

 

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