SEQ CHAPTER \h \r 1INTEGRATIVE HEALTH EDUCATION

                     A monthly review of 150 medical journals

 

                                                    Volume 9 � Number 7 � August 2008                                

                                                                    EDITOR’S NOTE 

           

You may want to read the last few blogs (“Braindroppings”) to get a more complete idea of what Big Pharma is up to this summer. While prescription drugs have their place in modern health care, their overuse is raising a lot of eyebrows.

Hugo Rodier, M.D.

A drug to treat the side effects of another drug

            Even though antidepressants work in less than 50% of people, they are widely used, with significant side effects. A very bothersome side effect is sexual dysfunction in both men and women. We just learned that Viagra may be used to counteract these problems when Prozac-like meds are used by women (JAMA 2008;300:395.)

            OK, I am not a puritan by any means. I even feel that women could take Viagra for recreational purposes, since it enhances sensation in their genitals. But, the concept of taking drugs to cover up the side effects of questionable drugs is potentially problematic. How many drugs are people taking for symptoms that may be nothing but side effects from an earlier drug? Consider older people, who may take 5-10 drugs a day. How likely is the possibility that they may have drugs working against each other?

And, what happened to the report that lowly Ginkgo not only helps with depression, but it also mitigates the sexual dysfunction seen with antidepressant therapy?

[J. Archives Physiology and Medical Rehabilitation 2000;81:668. Chin Med J. 1999;112:1093

            Gingko helps depression. It potentiates effect of antipsychotic drugs.

J. Clinical Experimental Pharmacology Physiology 1997;24:958

            Gingko works through the NOS system: it reduces inflammation in the brain.

J. Clinical Psychiatry 1998;59:199 and J. Sexual Marital therapy 2001;27:541

Gingko improves the loss of sensation in the genitals that is seen with SSRI antidepressants.]

Remember that Big Pharma will try to discredit any report on any herb or non-pharmaceutical product that may cut into their sales. They take a page from the historical records of any big business that has muscled out the competition with spurious reports that favor their own product. (Did you know that Rockefeller funded the drive that led to prohibition? He was trying to demonize alcohol, which was the preferred fuel for cars back then. Rockefeller owned Standard Oil, which fell under antitrust laws to become Chevron, Exxon, and Amoco. Henry Ford’s alcohol-fueled cars were Rockefeller’s competition, but after the constitutional amendment that criminalized alcohol in general, petroleum became the nations’ main fuel.)

Problems with antipsychotic drugs

            The recent report that there is an increased risk of death in the elderly taking antipsychotic drugs is not news; we have know about this for a while (JAMA 2008;300:379.) And, the new generation antipsychotic drugs, while more expensive, do not seem to be any better than the cheaper older ones. I have herein reproduced a report I wrote in an earlier newsletter:

            “Effectiveness of antipsychotic drugs in patients with chronic schizophrenia” (New England J. of Medicine 2005;353:1209) tells us that the newer and more expensive drugs to treat this condition are no better than the cheaper older ones. In fact, these newer drugs were marketed even though studies showed that they were no better than the older ones. “None of these drugs provided the majority of patients effective treatment that lasted the full 18 months of this study.” Only one new drug, Olanzapine was slightly better, but it was “associated with weight gain, and increases in measures of glucose and lipid metabolism.” These drugs have also been associated with an increased risk of cardiovascular events and mortality (JAMA 2005;294:1934.) The so-called atypical antipsychotic drugs must not be replaced with the conventional antipsychotic drugs, since both of them raise mortality (New England J. of Medicine 2005;353:2335.)

“Dr. Drug Rep”

      A Psychiatrist’s experience while speaking for the antidepressant Effexor was highlighted in the New York Times (NYT Magazine, November 25th, 2007, page 64.) He discovered that Effexor’s claims that it is 10% more effective than Prozac-like  SSRI drugs is inflated and that the high blood pressure elevation seen with Effexor is underreported. But, the speaking fee initially blinded him to these facts. He eventually gave up the gig, but, as he became more truthful, drug reps no longer booked him.

      As an attempt to be fair, I must report that companies marketing supplements often don’t ask me to speak for them after the initial engagement. I feel it is because I don’t hype up their products as much as they would like me to. Even though they deal with nutritional products, they are still in business.

Sweet updates

            My book “Sweet Death” may be updated this year. As you may know, I feel very strongly about our addiction to refined sugars in our country. So, I am always looking for related articles. The report that pesticides increase the risk of diabetes (Am. J. Epidemiology 2008;167:1235) may surprise some, unless you are familiar with insulin resistance caused by toxicity, as previously reported (See “TOIL” in my white paper.)

            And, why would Gout increase mortality in middle aged men? (J. Archives of Internal Medicine 2008;168:1104) Because gout is driven by insulin resistance, too, which affects our circulation.

            And, why do obese men have low-quality sperm? (Annual Meeting European Society of Human Reproduction and Embryology, Barcelona, 2008) Because of poor circulation to the testicles, insulin/glucose elevation affecting gonadal function, and decreased ability to detoxify the environmental chemicals associated with low sperm counts. Remember that obese people have “Fatty Livers,” which hinders detoxification. This is the same mechanism whereby their cholesterol goes up, since 90% of cholesterol is processed in the Liver.

            Finally, more food fights: see blog on the ongoing debate over “low carb” vs. “low fat” diets and what is not being addressed about these diets. Not knowing the problems behind the studies comparing these diets may be harmful to your health.

Got milk? Got acne?

            I know you are not going to like this report; so, I am giving it to you as verbatim as possible. Don’t shoot the messenger.

             “Diet Gains Legitimacy as Potential Factor in Acne,” J. Skin and Allergy News, May 2008, page 9. Report on Annual Hawaii Dermatology Seminar, Waikoloa, 2008

·        Milk, high sugar, high fat diets the culprit

·        6,096 girls ages 9-15 drinking more milk had more acne. And 4,273 teen boys had more acne with milk consumption, J. Am Acad Derm 2008 [doi:10.1016/j.jaad.2007.08.049]

·        Milk has progesterone, dihydrotestosterone precursors, somatostatin, prolactin, insulin growth factor-releasing hormone, insulin-like growth factors1 and 2, and other substances that could stimulate pilosebaceous activity, J. Am Acad Dermatol 2005;52:360

·        No acne in natives in Paraguay and Papua New Guinea, because they don’t eat refined foods

·        A low glycemic diet lowers insulin resistance and improves acne, J. Am Acad Derm 2007;57:247

·        Low glycemic diet has 30 % more fiber than average diets and substantially more poly unsaturated fats, both of which decrease androgen levels that worsen acne, J. Am Acad Derm 2007;57:1092

I hope your dermatologist reads this report, and the following one…

The Oregon grape, “Mahonia,” J. Skin and Allergy News, May 2008, page 30

  • Mahonia aquifolium, the Oregon grape root belongs to the berberidaceae or barberry family. This is an evergreen shrub, native to the American Northwest, used mostly to treat chronic skin eruptions and pustules that come from fatty foods, J. Dermatology Therapy 2003;16:106
  • Berberine, an alkaloid, is the most active ingredient, is a powerful antioxidant, anti inflammatory (J. Bioorg Med Chem 2004;12:4709) and antimutagenic molecule whose primary mode of action is the inhibition of lipid peroxidation, J. Planta Medica 1994;60:421.
  • Berberine inhibits cell growth, J. Planta Medica 1995;61:74. It induces apoptosis in promyelocytic leukemia, J. Arch Pharmacol 1996;93:193
  • It relieves neonatal jaundice, J. Comp. Med. East West 1977;5:161
  • It has anti pyretic activity, and it is used as an anti inflammatory for lumbago and rheumatism, J. Life Science 2002;72:645
  • Anti acne effect, (J. Skin Pharmacology 1993;6:56) and helpful in psoriasis (J. Pharmazie 1996;51:58.) Berberine was 84% effective in psoriasis and 64% of patients rated it as effective as the standard calcipotriene Rx (Am J. Therapy 2005;12:398.)
  • Antifungal effect, J. Phytotherapy Res 2003;17:834
  • Antimicrobial activity against Staph, J. Phytotherapy Res 2004;18:67

“Leaky brain” and coffee

            Coffee has been shown to protect the Blood Brain Barrier, BBB from cholesterol-induced leakage (J. of Neuro-Inflammation, April 2008.) This means that coffee, which is high in antioxidants, keeps the blood vessels in the brain from “leaking.” Since cholesterol is a very important molecule in the repair of cell membranes or lining of arteries, its levels and function need to be optimal to prevent leaking. Let’s review this important concept.

            Everyone is familiar with “leaky gut.” Once we get it that a TOILing intestinal lining may lead to mucosal permeability, we may easily see that the same process may occur anywhere in the body. It turns out that poor glucose processing also makes the brain more “leaky,” which allows toxins to enter the brain easier. The “Blood Brain Barrier” (BBB) is weakened by age and insulin resistance, which accelerates the rate at which the brain’s blood vessels become leaky from cell membrane TOILing (J. Neurology Neurosurgery & Psychiatry 2003;74:70)

             It is not surprising that the BBB is impaired in Alzheimer’s Disease (J. Neurology 2007;68:1809.) Glucose at high levels is itself toxic to the Central Nervous System (J. Proceeding of the National Academy of Science, Feb 1st, 2003.)  Environmental toxins may not get inside the brain to trigger TOILing of neurons, unless the BBB is itself leaky from TOILing (J. Nature Neuroscience, April 2008.) For example, Formaldehyde may pose a risk for ALS or Lou Gehrig’s Disease (60th Annual Meeting Am Acad of neurology, Chicago, 2008, J. Neurotoxicology 2007;28:532.) In other words, we are all exposed to toxins, like pesticides. But, our nutrigenomic factors make it so that each of us is affected differently.

             A leaky BBB is more likely when we lower our cholesterol too much. Remember that cell membranes are made up mostly of phospholipids. The most important phospholipid in the cell membranes of brain neurons is cerebrosterol (J. Lipids 2007;42:5.) When we insist on lowering cholesterol too much, we mess with cerebrosterol, and we increase our chances of Parkinson’s disease (J. Neurology News, January 2007, page 4,) and dementia (J. Archives of Neurology 2007;64:103.) This is why we would do well to eat a lot of nuts, so we don’t go nuts (British J. Nutrition 2006;96:Supp#2.) No, nuts don’t make you gain weight (AJCN 2003;78:647.)

              Not surprisingly, a leaky BBB has been linked to high blood pressure (JAMA 2007;297:2339,) which as you now know, is a function of insulin resistance. High blood pressure itself is going to increase brain cell aging, and dysfunction.

              So, fixing the TOILing that leads to “leaky brain” helps with practically all neurological problems. This is why coffee, which is high in antioxidants and thus reduces insulin resistance, has been shown to protect the BBB from cholesterol-induced leakage (J. of Neuro-Inflammation, April 2008.) Not surprisingly, Green tea reduces the risk of learning deficits in rats deprived of oxygen, because of a reduction of TOILing, or oxidative stress (American J. of Respiratory and Critical Care Medicine, May 15th, 2008) and 2,000 U of vitamin E reduce the risk of dying by 26% in Alzheimer’s, without side effects (J. Family Practice News, May 15th, 2008, page 38.)