Newsletter for 2006 by Ray Sahelian, M.D. Health Newsletter - Free Email Newsletter - Online Newsletter

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Emails from subscribers
Dr. Sahelian is always interesting to read. I always learn something new each time I read his articles. Thanks for his comments.

I received a copy of your Feb 15, 2006 newsletter about the dietary study of fats done recently (the one that cost us taxpayers 450 million or so, and got no results). I am impressed with your analysis of that study, and also with your food recommendations. I heartily agree: Stupid is the only word to describe the researchers' analyses of their results!
I have just read your latest newsletter (Vol.3, issue 13-- July 24, 06 ) and I felt compelled to let you know that I strongly agree with all that you have said here. I also wanted you to know that I read most of your newsletters and really appreciate the excellent information that you talk about. Thank you for your excellent advice and also, thank you for the kind, considerate, and respectful way that you present these things. I have a great deal of experience in having tried many of these herbs in many combinations and I know that you speak the truth on all these matters. I am well acquainted with several health problems many of which you have addressed very nicely and frequently, quite timely. I am type two diabetic, and have all the typical associated health problems that go along with diabetes. ED is one of those problems, and being 54 years of age adds to those problems. I have used herbs for several years now, and have found that they help with most of my health problems. Your kindly advice has reaffirmed what I have found to be true over the years. I hope that you will continue to pass on the rich wealth of knowledge and wisdom that you obviously have, to others who may be in need. I view you as a kind, and benevolent person. And, if you aren't already, please come and be a Christian. You have a good heart from what I can see, and it would be a real tragedy for you to miss out on becoming a member of the Christian family. Do you know the best vitamin for a Christian? B1 May God bless you.

Dr. Sahelian, I would like to first of all thank you and your associates / staff, for the incredible web site put together with much time and effort. Like a previous letter writer said, it's important to find someone who one can trust somewhat, because doctors, pharma companies, supplement companies, and celebrity spokespersons along with the advertisers they "shill" for, all have their own reasons and agenda - usually financially motivated, for endorsing products. I wish more doctors would bother to keep current with information available from sites like yours. Here in Canada, most doctors are foils for the big pharma conglomerates, because the mindset is all drug related with nary a thought to natural alternatives or treatments.

For 2005 prior issues, see Supplement Research Update 2005

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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 3, Issue 20 -- December 4, 2006
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How is it possible that hundreds of thousands of medical doctors in this country who prescribe statin drugs are misguided, while I may turn out to have made an accurate prediction? Those of you who are regular readers of my newsletter have heard me repeatedly say that, even though statin drugs such as Lipitor and Zocor reduce cholesterol levels, there is no proof that statin drugs help people live longer. A recent medical journal article appears to validate my viewpoint. Fortunately, this journal article from Archives of Internal Medicine, November 27, 2006 got picked up by the news media. The CNN.com headline said, " Study doubts benefits of universal statin drug use." The CNN article begins, "Cholesterol-regulating statin drugs slightly lower the risk of heart attack and stroke in people with no history of cardiovascular disease but may do little to reduce their risk of death."
   I have had many emails from doctors criticizing me for not endorsing the wide use of stating drugs. Well, I think they judged too soon. The medical establishment needs to apologize to the public for pushing these expensive and potentially dangerous statin drugs for so many years when there has been no proof that they help patients live longer. Would you rather have a high cholesterol level and live longer, or have a lower cholesterol level but die sooner? Never mind the decreased quality of life from repeated doctor visits for cholesterol checks, muscle aches and liver damage from the drugs, let alone the high drug expense of up to two thousand dollars a year that could be well spent on something else. The discussion follows below. In this issue I also review the benefit of lipoic acid for diabetic neuropathy and the cancer reducing potential of garlic and onion.

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1. Could Half a Million Doctors be Misguided?
Statins are currently the most widely prescribed drugs in many countries. There are hundreds of thousands of doctors in the USA, and many more in the rest of the world, who prescribe statin drugs to their patients and have been doing so for the past decade or so. Most of these doctors are well meaning and do think they are helping their patients. But, unfortunately, they have been misguided by the drug companies and by the medical journals they read and trust. These medical journals have repeatedly reinforced the notion that lowering cholesterol is a good thing. I don't dispute the fact that studies show those with high cholesterol levels have a higher rate of cardiovascular conditions. However, I do dispute the fact that lowering cholesterol with statin drugs is a good thing.
This is what the CNN article says: Statins are prescribed to lower excessive levels of artery-clogging "bad" cholesterol and to lessen inflammation in blood vessels. But the latest study casts doubt on the benefits of prescribing statins to prevent cardiovascular disease in individuals with healthy cholesterol levels. While statins lessen the risk of heart attacks and strokes in people already at risk because of heart disease or high cholesterol, routine use of such drugs by otherwise healthy adults produces such limited benefits that it may not be cost-effective. For example, an analysis of seven previous trials involving nearly 43,000 adults aged 55 to 75 found that the average adult had a nearly 6 percent chance of suffering a heart attack or stroke over a 4 1/3-year period, compared with a 4 percent risk among those who took statins. Therefore, 60 patients would need to be treated for an average of 4.3 years to prevent one major coronary event," the study's author, Dr. Paaladinesh Thavendiranathan of the University of Toronto, wrote in the article. To prevent a single stroke, 268 people would need to undergo statin treatment, and to prevent one nonfatal heart attack 61 would have to take the drugs, he added. Moreover, statin use did not improve the overall risk of dying from cardiovascular disease or from other causes.
   My comments: Most of you realize by now that doctors and the medical establishment do not know it all and are fallible. (Just to be clear, I don't claim to know it all, either, but I do my best to keep an open mind and accept the use of drugs or supplements if they work.) For decades doctors prescribed hormone replacement therapy for women in high doses and a few years ago we found out that this treatment increased breast cancer rates. It is quite possible that we may in the next few years discover that the widespread use of statin therapy was not such a good idea after all. I do not deny the possibility that there are certain patients that may be helped by statins. However, statins are overused and misused. Too many people are focusing too heavily on blood cholesterol levels as opposed to looking at the effects of these drugs on the whole body. If you have an extremely high cholesterol level, then a statin drug could lower it, but would this result in you living longer? I don't know if anyone can promise this to you in great confidence. If you have a mild to moderate cholesterol elevation, and your doctor has you on a statin drug, then it is legitimate to question your doctor. Ask your doctor to show you studies or prove to you that the use of statin drugs for mild to moderate cholesterol elevation leads to a longer lifespan. If he or she can't, then why is the statin drug being prescribed? There are a number of steps one can take to improve cardiovascular health without drugs, and I list some of them at this site. See http://www.raysahelian.com/heartdisease.html

 

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Bad Breath or Less Cancer?
Using data from a network of Italian and Swiss case-control studies, researchers analyzed the relation between frequency of onion and garlic use and cancer at several sites. They found that those who ate the most garlic and onion had a lesser risk for several cancers include cancer of the oral cavity, esophageal cancer, prostate cancer, colon cancer, and other cancers. For an abstract of the study, see http://www.raysahelian.com/allium.html


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3. Alpha Lipoic Acid and Diabetic Neuropathy
An alpha lipoic acid supplement improves nerve pain or "polyneuropathy" in patients with diabetes. Dr. Dan Ziegler from Heinrich Heine University, Duesseldorf, Germany and colleagues gave lipoic acid to patients with diabetic neuropathy. Symptom scores and stabbing and burning pain subscores were significantly reduced after 5 weeks. Symptoms improved significantly as early as 1 week with the highest alpha lipoic acid dose (1800 mg daily) and within 2 weeks with the other doses (600 mg and 1200 mg daily), and there were no significant differences among the three alpha lipoic acid groups for changes in mean total symptom score at any time point. Side effects of high dose lipoic acid were nausea, vomiting, and dizziness. Researchers say, "Whether the observed favorable short-term effect of alpha lipoic acid on nerve pain and deficits can be translated into slowing the progression of diabetic polyneuropathy in the long term is unknown."
   My comments: The authors suggest using 600 mg a day of lipoic acid for the treatment of diabetic neuropathy. I suggest using a lower amount. Most of the time when researchers are doing a study, they only have a limited time since it is expensive to do a long term study. So, they end up using a very high dose of a supplement to elicit a response. However this does not mean that the dosages they used are appropriate for long term supplementation. I suggest using 50 mg of r lipoic acid a day for 2 months and then determine the dosage to go up or down based on response and side effects. Ask your doctor to read the study abstract at http://www.raysahelian.com/diabeticneuropathy.html


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Emails from Newsletter Subscribers
Q. I am a medical doctor who takes statin drugs for high cholesterol. I decided to stop the Lipitor and instead take 3 fish oil capsules a day. I took the fish oil for 6 weeks and saw no beneficial effect of the fish oil on my cholesterol level. I think fish oil is another example of a hyped up natural product that has not been well tested. I'm going back to my statin drug since I know for sure it lowers my cholesterol.
   A. Sometimes we tend to look at absolute numbers on lab studies rather than other important matters. For instance, fish and fish oil are full of EPA and DHA. These fatty acids get incorporated in many tissues in the body, including eye, brain, skin, various organs, heart, etc., and could lead to improved microcirculation in blood vessels and capillaries, and decreased blood viscosity. By just looking at total cholesterol level, without taking into account the fatty acid composition of your cells, and without taking into account the beneficial aspects of these fatty acids from fish oil on other parts of the body does not give us the full picture of the benefits. Doctors and drug companies make the mistake of looking at cholesterol levels as if it that is the most important thing in cardiovascular health. Who knows, maybe by taking a statin you could lower your cholesterol but then die sooner? Whereas taking fish oil may not reduce cholesterol to any significant extent, but because of all the other potential benefits that fish oils provide, you may live longer. This is all still theoretical of course, but the main point I want to make is that looking at cholesterol numbers as if that is the be all and the end all is not being holistic or scientifically comprehensive.

Q. I just wanted to let you know how well Good Night Rx works for me. It gives me sound sleep with no side effects. I take it 2 hours before bed on an empty stomach. One time I took it right after dinner and it didn't work at all.
   A. Yes, it seems just about everyone who has given us feedback has mentioned that empty stomach is working better.

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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 3, Issue 19 -- November 13, 2006
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With all the news channels focused on the elections and the post election results, an anti-aging study with a wine extract didn't get as much media attention as it would have otherwise. The title of the study done at Harvard University in Boston, was, "Resveratrol improves health and survival of mice on a high-calorie diet." Now, you can see why this would perk up everyone's attention. Based on the result of this study, should everyone be taking a resveratrol supplement, eating more red grapes, or drinking more red wine?
   Another interesting recent finding was that turmeric, which contains curcumin, was found in a rodent study to be beneficial in rheumatoid arthritis.
   I want to occasionally remind users of supplements that when trying a new product, it is preferable that you take it alone for one, two or three days so that you notice its benefits and side effects without interference from other supplements or medicines. I realize this is not always possible since many of you may need to be taking medicines on a daily basis. Just keep in mind that certain herbs and nutrients are quite potent and unexpected reactions may occur when combining supplements and medicines. If you plan to take a supplement for prolonged periods, it is a good idea to know how it influences your body and how it makes you feel.
 
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1. Resveratrol, an Anti-Aging Supplement?
I find it quite interesting that resveratrol, found in red wine, extends survival in mice. How do we make practical use of this finding?
   Harvard researchers tested the wine extract resveratrol on middle aged mice. Resveratrol supplementation shifted the physiology of middle-aged mice on a high-calorie diet towards that of mice on a standard diet and significantly increased their survival. The news media took a hold of this finding and one headline said, "Compound found in red wine and grapes extends lifespan of mice." What makes this interesting is that in previous studies over the past few years, resveratrol was found to have a similar benefit on yeast, flies and worms. This was the first evaluation of resveratrol on survival extension in mammals. One group of mice ate a normal diet. The second was fed a high-calorie diet and the third had the same high calorie diet but was given resveratrol supplements. By the time the mice were 114 weeks old, about 60 percent in the high-calorie group had died, compared to about 40 percent in the low calorie diet group and the group with the high calorie diet supplemented with resveratrol. The mice taking resveratrol had healthier heart and liver tissue, decreased blood sugar levels, better insulin sensitivity and were more active than the other rodents.
   My thoughts: Will a resveratrol supplement help you live longer? We won't know until resveratrol, in varying dosages, is given to hundreds or thousands of people for at least 10 to 20 years, and I am not aware of any large scale resveratrol human studies testing for lifespan extension that have started. Do we wait a couple of decades for more research or do we start taking a resveratrol supplement now? I don't think anyone knows for sure, and there can be a legitimate number of opinions on this topic. I can only tell you what I plan to do. I will take a 10 mg resveratrol supplement once or twice a week and drink an ounce or two of red wine some evenings with dinner. Wine has several additional beneficial polyphenolic substances with antioxidant properties. For more info on resveratrol, including the amount found in red wine, see http://www.raysahelian.com/resveratrol.html


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1. Curry. Curcumin, Turmeric for Rheumatoid Arthritis and Alzheimer's
Curry, curcumin, and turmeric may be helpful in rheumatoid arthritis and Alzheimer's disease. But first, let me explain the difference between them. Turmeric is a yellow spice which has many beneficial compounds, some of them are called curcuminoids, the best known being curcumin. Curry is mix of several spices (most often turmeric combined with coriander and fenugreek).
   Dr. Tze-Pin Ng from National University of Singapore and colleagues compared test results on mental health for three categories of regular curry consumption in 1,010 elderly Asians who did not have dementia. People who consumed curry "occasionally" and "often or very often" had significantly better scores than did those who "never or rarely" consumed curry. These results, they say, provide "the first epidemiologic evidence supporting a link between curry consumption and cognitive performance that has been suggested by a large volume of earlier experimental evidence." See http://www.raysahelian.com/curry.html for details of the study.
   In experiments with rats, scientists at the University of Arizona in Tucson found that turmeric extract was able to prevent rheumatoid arthritis-like joint inflammation and destruction in the animals. The findings, published in the journal Arthritis & Rheumatism, are the first to show that a turmeric extract like those currently sold as dietary supplements has anti-arthritis powers. Rheumatoid arthritis arises when the immune system mistakenly attacks tissue in the joints, leading to inflammation, pain and progressive joint damage. Turmeric inhibited a key protein called NF-kappa B, which controls the activity of a number of inflammatory substances harmful to the joints in RA. In fact, NF-kappa B is the target of certain drugs now under development for RA.
   My thoughts: If you have rheumatoid arthritis, should you take a curcumin and turmeric supplement? I don't see any harm in trying it as long as your doctor is aware and approves. A cautious way would be to start with one capsule of a 500 mg curcumin / turmeric combination with breakfast. So many dangerous drugs are prescribed by doctors to their patients with RA that giving a natural supplement a trial should be so much safer in comparison. After a month or so the dosage could be increased to 2 capsules and then adjusted up or down. It is impossible to predict whether curcumin and turmeric will be found to be helpful in humans with RA until actual studies are done. It is difficult to predict how this natural supplement would interact with the drugs commonly used for RA. Perhaps the dosages of the drugs could be slightly reduced? Hard to say. There are more questions than answers, therefore have a frank discussion with your rheumatologist and have him or her read the information on these web pages http://www.raysahelian.com/rheumatoidarthritis.html  and http://www.raysahelian.com/curcumin.html  then decide whether natural supplements are appropriate for your condition. For an abstract of the turmeric and rheumatoid arthritis studies, see http://www.raysahelian.com/turmeric.html


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Emails from Newsletter Subscribers
Q. I came across an article on Pycnogenol mentioned in Newsweek - Nov. 6, 2006 issue - "A French maritime pine bark extract called Pycnogenol — a mix of antioxidant and anti-inflammatory compounds — is a fast-growing supplement on the U.S. market, with sales up 25 percent this year to date. Unlike most supplements, which have very little research behind them, Pycnogenol has 36 double-blind, placebo-controlled trials. The strongest evidence relates to heart health—helping to reduce unwanted clotting, lower "bad" cholesterol and bring down mild hypertension. But the latest studies suggest benefits for diabetes, too. Diabetic patients eventually tend to develop leaky capillaries, which can lead to vision loss, leg ulcers and even amputation of toes or feet. A small study in September found that 150mg of Pycnogenol a day for four weeks helped repair blood vessels and improve capillary blood flow by 34 percent—versus 5 percent for those receiving a placebo. For general health, 25mg to 50mg a day will do. But it won't come cheap (think $30 to $50 a bottle)." Do you think it is safe to take 25 or 50 mg of Pycnogenol daily?
   A. Pycnogenol seems to have good research supporting its benefits, but then again there are hundreds or thousands of beneficial substances in various fruits, vegetables, roots, barks, herbs, etc. I just discussed the benefits of resveratrol and curcumin, and last week talked about EGCG from green tea. We certainly can't take all of these supplements every day! For the time being, I think it is safe to take Pycnogenol 25 mg or 50 one or two a week with breakfast. I prefer alternating several supplements rather than taking the same ones every day. For more info, see http://www.raysahelian.com/pycnogenol.html


Q. I am a graduate student at MIT. I have been assigned to write about a recent Mayo Clinic study that suggests the popular antiaging supplement DHEA has no beneficial effects. The two-year study appeared in the October 19, 2006 issue of New England Journal of Medicine. I was wondering if you think elderly people should stop taking DHEA in light of the findings? Do you think more research is necessary to evaluate the potential long-term health risks associated with DHEA?
   A. Two years is not long enough to determine if a supplement has anti-aging benefits. I am not a big proponent of DHEA. In my opinion, hormone supplementation is very risky. DHEA side effects could occur with high dose use. These include hair loss and potential tumor formation. DHEA may be appropriate in some people who have very low DHEA or testosterone levels. Low dosages of 1 to 5 mg, with a week off each month, may be appropriate for some people who may notice an increase in vitality and libido. The whole topic of hormone supplement use is very controversial and there is a variety of opinions among physicians and scientists. For more info, see http://www.raysahelian.com/dhea.html



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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 3, Issue 18 -- October 26, 2006
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EGCG - In the future you're going to see these initials quite often. EGCG (epigallocatechin gallate) is a potent antioxidant found in green tea, which has shown promise as a cancer fighter and to speed up metabolism, hence its potential popularity as a weight loss supplement. Many laboratory studies in cultured cells, and some rodent studies have shown that EGCG prevents fat formation. The Coca Cola company has come out with a green tea product with the promise that consumers will lose weight. So, does green tea lead to weight loss? I will discuss this matter, along with some disturbing news that drugs used to control agitation in Alzheimer's disease may actually be causing more harm than good. Are there better alternatives? Also, would you really benefit from a lycopene supplement?

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1. Green Tea for Weight Loss?
"Enviga increases calorie burning. It represents the perfect partnership of science and nature," says Dr. Rhona Applebaum, chief scientist, The Coca- Cola Company. "Enviga contains the optimum blend of green tea extracts (EGCG), caffeine and naturally active plant micronutrients designed to work with your body to increase calorie burning, thus creating a negative calorie effect." The press release continues: "The accumulated body of scientific research shows the ability of green tea's powerful antioxidant EGCG to speed up metabolism and increase energy use, especially when combined with caffeine," adds Nestle researcher Dr. Hilary Green. Nestle is cooperating with Coca-Cola Company to promote this product.
   Enviga will be available to the consumer in a few weeks. However, in many newspaper articles that followed the press release, health experts dismissed claims that Enviga would burn calories by speeding up the drinker's metabolic rate, and cast doubt on the chances it would help people lose weight.
    My thoughts: Now that one of the largest companies in the US is heavily promoting green tea and EGCG, it is time to seriously evaluate the potential benefit and harm of overconsumption of green tea. I think it is premature to make the claim that ingesting Enviga leads to weight loss. The Coca Cola Company has not provided any direct research that indicates drinking several cans of this green tea and caffeine product is safe and effective, yet their press release makes quite promising statements. I am concerned about the overstimulation of heart muscle when so much green tea and caffeine are ingested, and the potential for irritability, anxiety, and insomnia. It is possible that many people will continue drinking their coffee throughout the day while ingesting one or more cans of Enviga, hence potentially increasing their blood pressure and causing heart problems. EGCG, one of the beneficial substances in green tea, shows a lot of promise. In lab studies, the potential health benefits ascribed to green tea and EGCG include antioxidant effects, cancer chemoprevention, improving cardiovascular health, preventing fat formation, protecting the skin from the damage caused by ionizing radiation, and others. The compound EGCG has been shown to regulate dozens of disease-specific molecular targets. However, at this time, it is too early to say whether consuming large amounts of EGCG will provide more benefit than harm. There are countless beneficial substances in herbs and plant products that have been shown to have similar benefits. For instance, lycopene from tomatoes, curcumin from turmeric, resveratrol from grapes, genistein from soy, etc. How do we know whether taking a very high dose of a single substance is safe in the long run? Logic tells us that ingesting smaller amounts of many substances is healthier than taking a large dose of just one. Oranges are a healthy fruit. But, does it make sense to only eat several oranges a day and no other fruits? One would think that eating a variety of fruits would be a healthier option. Same with green tea and EGCG. I would recommend you avoid the temptation of taking too much of this beneficial substance until we have long term studies to indicate its safety. You may be better off just drinking an old fashioned cup of regular green tea or taking a green tea extract capsule.
For more info on EGCG and green tea, see http://www.raysahelian.com/greentea.html

For suggestions on weight loss, see  http://www.raysahelian.com/weightloss.html

 

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2. Safer Alternatives to Alzheimer's Disease Drugs
"Alzheimer’s Drugs Offer No Help, Study Finds" was an article in the October 12 issue of New York Times written by Benedict Carey. According to this interesting article, the medicines most commonly prescribed for agitation and delusions in Alzheimer’s disease are no more effective than placebos, and put them at risk of serious side effects, including confusion, sleepiness and Parkinson’s disease-like symptoms. The drugs tested in the study — Zyprexa from Eli Lilly; Seroquel from AstraZeneca; and Risperdal from Janssen Pharmaceutical — belong to a class of medications known as atypical antipsychotics. These drugs are used to treat schizophrenia and other psychoses, and are commonly prescribed for elderly patients in long-term care facilities. About a third of the estimated 2.5 million Medicare beneficiaries in nursing homes in the United States have taken the medications. Within the past two weeks, two new studies became available that show the untapped potential of natural supplements in the prevention or treatment of AD. In the first study, 200 patients with AD were given DHA and EPA, the fatty acids found in fish oils, for a period of 6 months. Improvement was noted in patients who had a mild case of AD. A study by researchers at the David Geffen School of Medicine at UCLA and the VA Greater Los Angeles Health Care System show that curcumin, a compound occurring in the spice turmeric, assists the immune system in the clearance of amyloid beta in the brain. Amyloid beta is a substance that accumulates in the brains of Alzheimer's patients to form the plaques that are characteristic of the disease.
   My thoughts: So much time and money has been spent on finding drugs that treat Alzheimer's disease, but as of now the anticholinesterase drugs and the antipsychotics have been quite disappointing. What if all these years, rather than having wasted all this effort on drugs, the focus had been on finding natural ways to prevent or reduce the occurrence of this disturbing condition? For research info on natural options to address Alzheimer's Disease, see http://www.raysahelian.com/alzheimer.html

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3. Do You Need More Lycopene?
Lycopene, found in many fruits and vegetables -- especially tomatoes and watermelon -- may play an important role in reducing risks of many diseases, including prostate cancer and breast cancer. Some epidemiological studies indicate that high consumption of lycopene may lower the risk of heart disease, atherosclerosis, and macular degeneration. However, would you benefit from taking a lycopene supplement? It is difficult to say. I think tomatoes and tomato based products are consumed by Americans in a disproportionate basis compared to other fruits and vegetables. In other words, we may be consuming enough lycopene in our diet but perhaps not enough of other healthy substances found in a number of fruits and vegetables that are eaten infrequently. Therefore, I am not yet convinced that taking a lycopene supplement will provide benefits to most people, unless their diet is low on tomato based products. Perhaps those who consume adequate or large amounts of tomato based products may be better off taking other types of supplements such as those found in acai, goji, noni, pomegranate, curcumin, soy extracts, artichoke, asparagus, barley grass, etc. The point is, if you plan to take supplements, it may be better to take those that you don't normally consume in your diet as opposed to something like lycopene where it may already be abundant in your diet.
For more information on lycopene, see http://www.raysahelian.com/lycopene.html


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Emails from Newsletter Subscribers
Q. I was skeptical about trying Good Night Rx, and my first night that I took it it did not seem to work well. So I emailed Physician Formulas and they asked if I had taken it with a meal or on an empty stomach. I had actually taken it right after dinner. So the next night I took it an hour before bed and about 2 to 3 hours after dinner. It worked so well. Within a half hour I could tell feeling relaxed and shortly thereafter I yawned. I did not have any side effects except maybe a slightly more vivid dream, and woke up quite refreshed and in a good mood.
   A. The effectiveness of certain supplements has a lot to do whether they are taken with food or on an empty stomach. Each supplement is different on how it should be taken, but, as a general rule, if you wish to feel a mental or physical effect from a supplement, take it on an empty stomach. If you are just taking a supplement for health reasons, such as an antioxidant, for instance curcumin or vitamin E, take it with food. We have had good feedback with Good Night Rx. Most people really like the sleep inducing effect, but we do suggest to just using it 2 or 3 times a week. People who seem not to notice the sleep inducing effects as much, at least initially, are those who happen to be addicted or habituated to potent pharmaceutical sleep drugs.

Q. Generally speaking, is it safe to give supplements to children?
A. There have been few studies with children and supplements, and, as a rule, except for low dose multivitamins, whole vegetable and fruit extract, and fish oils or cod liver oil, it may be best to be cautious in giving supplements to children for prolonged periods except when necessary to treat a medical condition. I rather have children get their nutritional needs from whole foods.


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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 3, Issue 17 -- October 5, 2006
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"Millions use alternative medicine for sleep," was a CNN headline last week Most respondents who used herbal therapies or relaxation techniques found these methods helpful for managing their insomnia. Some of the reasons for the high rate of sleeping problems in this country include physical inactivity (desk work), psychological stress, lack of adequate sunlight exposure, and bright light exposure late into the night. Below I discuss the common herbs and nutrients used for sleep and a summary of their benefits and shortcomings.

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1. Using Alternative Medicine for Sleep
An estimated 1.6 million people, are using complementary and alternative medicine to help themselves sleep better. People with anxiety, depression, congestive heart failure, hypertension and obesity are more likely to have problems sleeping. Keep in mind that taking high doses of certain herbs and supplements can lead to alertness at bedtime and cause shallow sleep.
   Prescription sleep drugs are often effective, but have many side effects including memory loss, decrease in sexual desire, and morning grogginess leading to car accidents. The advantage of herbs and supplements is that they are safer than sleep drugs. The disadvantage of the supplements is that they are not as consistently effective and are not as potent as the pharmaceutical sleep medicines. But, a combination of herbs and nutrients can provide good results in most people. It is best not to use drugs or supplements every night, but at most 3 nights a week. Tolerance and dependence may develop if used nightly. I don't have any objections to the occasional use of a prescription sleep medicine. Which herbs and nutrients are effective for sleep? Below are the most commonly used supplements in alphabetical order. Please note that dosage and timing can vary significantly among people.

5-HTP or 5-hydroxytryptophan is a nutrient that converts into serotonin. Serotonin is involved in relaxation. At night, serotonin is converted in the pineal gland to melatonin, the sleep hormone. 5-HTP is not consistent in its sleep effects, but sometimes a smaller amount than the usual 50 mg capsule can be effective when taken on an empty stomach about an hour or two before bed. The capsule can be easily opened and perhaps half or 2/3 used. Higher amounts can cause nightmares.

Chamomile may help you relax, but I have not found it to be very effective for sleep. The effects from chamomile are quite mild.

Good Night Rx is a combination of 5-HTP, melatonin, GABA, taurine, kava, valerian, hops, chamomile, and several other herbs. I am actually quite proud of this formula -- which took me years of trial and error to develop -- and thus far our feedback has been quite positive. One capsule is taken half an hour to 3 hours before bed on an empty stomach. Good Night Rx, when taken with or after a meal, will not work as well. Wait at least half an hour after taking Good Night Rx if you plan to have a late night snack. Some people say that they notice the sleep inducing effects even better the second or third night of use. Good Night Rx, in my opinion, is more effective than any individual herb or nutrient. Our feedback thus far has an 80 percent satisfaction rate which is quite high for an herbal product.

 

Hops is the herb that beer is made from. Hops is a good herb to induce sleep but it is not as good in maintaining sleep throughout the night. Many people find hops to have a sedating nature. A dosage of 300 to 600 mg of hops is one option an hour or two before bed.

Kava, a plant from the South Pacific, is better known for relaxation as opposed to sleep although some formulations or extracts can have more sedative activity than others. A dose of 300 mg of a 30 percent extract can be used an hour to 3 hours before bed on an empty stomach.

Melatonin is the sleep hormone made by the pineal gland at night. Melatonin is perhaps the most consistently effective natural supplement for sleep, although at least a third or half of users may still not find it helpful. The dosage varies between a quarter of a milligram to 3 mg. Higher dosages can cause nightmares and morning grogginess. I suggest using a third or half
of a mg at first, taken 1 to 3 hours before bed on an empty stomach. The sustained release form is a good option.

Passion Flower is useful for relaxation, but I have not found it very potent as a sleep aid.

Tryptophan is an amino acid that converts into 5-HTP which then converts into serotonin, and then into melatonin. I have been asked which of the 3 supplements is best for sleep: 5-HTP, melatonin, or tryptophan. I think it is a matter of personal preference. It is difficult to predict which one you will find best suited for you until you try them. The dose of tryptophan is 500 mg one to 3 hours before bed on an empty stomach. At least half of users notice a good sleep inducing effect from tryptophan.

Valerian is perhaps the best known sleep inducing herb. I find that about half of users like it, while the rest don't feel that it does much for them as a sleep aid. A dose of 300 mg may be tried one to three hours before bed

 

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2. Colostrum Helpful for Athletes
Colostrum is the early milk produced for a few days after delivery. In cows, it's called bovine colostrum. Athletes may have more energy when taking a bovine colostrum supplement. A study published in the British Journal of Sports Medicine, reports that bovine colostrum helped male cyclists have more energy during a bout of intense training. Cecelia Shing of the
   University of Queensland in Australia followed 29 male distance cyclists. After taking baseline measurements of the men's performance on a 40-kilometer time trial, the researchers randomly assigned them to drink either a supplement containing 10 grams of bovine colostrum protein or a whey protein supplement every day for eight weeks. During week eight, the men underwent five consecutive days of high-intensity training; their performance was tested before and after the training bout. There were no clear differences between the two groups during normal training. However, volunteers who used bovine colostrum performed at a higher level, with fewer signs of fatigue, during tests taken after the five-day run of intense training. See http://www.raysahelian.com/colostrum.html

   My comments: I think there are certain foods that I would consider superfoods in that they have a high concentration of beneficial substances useful for wellbeing and overall health. I believe colostrum falls into this category. You can find bovine colostrum in the dairy section of a health food store, and it is also available as a supplement in capsules. Every few weeks I will choose a superfood as a discussion topic.

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Emails from Newsletter Subscribers
Q. I was watching home shopping network and they were selling CoQ10 in capsule form as opposed to softgel with oil. CoQ10 is fat soluble, isn't oil necessary in the softgel for the CoQ10 to be absorbed and won't the CoQ10 in a capsule not be as effective?
   A. I really don't see a problem with the capsule. Since CoQ10 is taken with breakfast, there's always some form of fat or oil in one's breakfast and I think the CoQ10 will be absorbed whether taken as a softgel or a capsule. Some people, in my opinion, are taking too high a dose of CoQ10, so even if there is a slight reduced absorption (which I doubt), perhaps that's for the better.

Q. Should krill oil be refrigerated?...and how long can it be stored in the refrigerator?
   A. Yes, it is better for krill oil and fish oils to be refrigerated, and hopefully to be used within a few months, preferably a few weeks, of opening the bottle.

Q. There's been a lot of talk about EGCG lately, the extract from green tea. I see supplements of EGCG being sold in high dosages. Are these safe to take?
   A. Green tea is hot these days (no pun intended). Consumers are switching from regular tea to green tea and other herbal teas. I am not a big fan of taking large doses of isolated substances from herbs, such as a high amount of EGCG, preferring to take the whole powder or a less concentrated extract. Many people think the higher the dose of a substance they supplement, the healthier they will be, but that may not always be the case, and often is not the case. So, for the time being, I don't see the need to take a high dose of EGCG unless perhaps under medically supervised treatment for a health condition.

Q. Within 3 days of stopping Lipitor, the pain in my legs went away. I had been on Lipitor for 18 months, and the pains started a few months ago. My doctor did not tell me that the Lipitor could cause muscle aches. I had not been taking walks for the past few months because of aches in muscles and joints and I thought it was due to possible onset of arthritis. Now I'm able to walk around the neighborhood and get some exercise.
   A. We've had quite a few people email a similar response, that their muscle aches stopped soon after stopping a statin drug for cholesterol. We did have one person who emailed and said he had been taking Lipitor for ten years without problems.

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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 3, Issue 16 -- Sept 20, 2006
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Will drinking green tea help you live longer? Maybe, maybe not. An epidemiological study done in Japan showed those who drank the most cups of green tea lived longer than those who drank fewer cups. An epidemiological study is a study on a human population which attempts to find a connection between a cause (exposure to a specific chemical, herb, medicine dietary choice, etc.) to a health effect (for example longevity, heart disease, cancer, etc.).
I think we can get some good information from epidemiological studies, but there are so many factors involved in trying to weed out all other factors that influence longevity that it is difficult to know for sure whether drinking more green tea was the factor that made these Japanese live longer. And even if it did, would this apply to those consuming a western diet? See my thoughts below.

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1. Does Diet Influence Uterine Fibroids?
A study published in the American Journal of Clinical Medicine hints at the possibility that diet may have an influence on fibroid tumor growth. Uterine fibroids are hormonally responsive; estrogen and progesterone stimulate their growth. Lignans can act as weak estrogens or antiestrogens. Researchers found that women who excreted a higher amount of lignans in their urine (meaning their diets included foods with a high lignan content) were less likely to have fibroid tumors. See http://www.raysahelian.com/lignan.html  for a list of foods with high lignan content.
   My thoughts: Have you considered adding flax seeds to your soups?


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2. Vitamin D and Pancreatic Cancer
Taking a Vitamin D supplement may reduce your risk for fatal pancreatic cancer. Vitamin D has shown strong potential for preventing and treating several types of cancer. Regions with greater sunlight exposure have lower incidence and mortality for prostate, breast, and colon cancers. Harvard University researchers examined data from two large, long-term health surveys involving 46,771 men between 40 and 75 years old and 75,427 women between 38 and 65. They found that people who took Vitamin D, 400 IU a day had a 40 percent lower risk of pancreatic cancer. Those who took doses of less than 150 IU per day had a 22 percent reduced risk of cancer. Taking more than 400 IU a day did not reduce the risk further.
   My thoughts: Most multivitamins include vitamin D usually at 100 to 400 units. You could consider getting more sun exposure or taking an additional vitamin D supplement. A supplement of 200 to 400 units a day is sufficient for most people. For additional info, see http://www.raysahelian.com/vitamind.html


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Fish OIls better than Cardiac Defibrillators?
Fish oils could potentially save more lives than cardiac defibrillators. Many studies have already established a link between consumption of EPA and DHA fatty acids found in oily fish to a lower risk of fatal heart rhythm abnormalities. This latest study tried to estimate the potential public health impact of raising omega-3 levels with fish oil supplements. Using a computer-simulated community of 100,000 Americans and data from past medical studies, the researchers estimated that raising omega-3 levels would save 58 lives each year. This amounts to a 6 percent total death reduction -- mostly by preventing sudden cardiac death, according to the study authors, led by Dr. Thomas E. Kottke of the Heart Center at Regions Hospital in St. Paul, Minnesota. Even if automated external defibrillators (AEDs) were available in every home and public area, the devices would lower a community's annual death rate by less than 1 percent. Based on this analysis, it appears that communities where people eat more fish or supplement with fish oil would have more widespread benefits than either AEDs or implanted defibrillators. American Journal of Preventive Medicine, October 2006.
   My thoughts: I think most people can benefit from taking one, two or three fish oil capsules a day unless they consume fish at least 2 times a week. For fish oil info, see http://www.raysahelian.com/fishoils.html


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Drink Green Tea so you can live longer to drink more green tea
According to a study done with Japanese adults, those who consumed the most green tea were less likely to die from cardiovascular disease or any other cause, except cancer, than were the less-frequent green tea drinkers. Dr. Kuriyama and colleagues analyzed information on 40,530 Japanese adults, 40 to 79 years old, who participated in the Ohsaki National Health Insurance Cohort Study. The subjects, who were followed an 11 year period from 1995 to 2005, were from a northeastern region of the country where most of the adults drink green tea three or more times per day. Adults who drank the most green tea were the least likely to die from cardiovascular disease. Men who consumed at least five cups of green tea each day were 12 percent less likely to die from any cause. Whereas, women who drank five or more cups of green tea each day were 23 percent less likely to die from any cause and 31 percent less likely to die from cardiovascular disease. For more details, see http://www.raysahelian.com/greentea.html
My thoughts: For the time being, if you don't drink green tea, it may be a good idea to have a cup a day or a few times a week. If you already drink green tea on a daily basis, you could perhaps add another dup a day. It's also possible that drinking a variety of teas may provide more benefit than just drinking additional green tea. Who's to say other herbal teas (and there are so many to choose from) are not as healthy as green tea? Another option is to take a green tea extract supplement a few times a week. Avoid the use of the tea or the supplement after mid afternoon since the caffeine and stimulants may interfere with sleep. One factor to consider is that this study was done in Japan. Americans have a different diet and lifestyle. Will green tea have similar benefits in those on a Western diet? Probably, but we can't say for sure.
   I know many people who like the taste of green tea, but it is not my favorite, but I drink a cup a few times a week anyway, particularly when I visit a Japanese restaurant to have wild Alaskan salmon teriyaki. Sometimes I bring a small bottle of stevia to the restaurant and add a couple drops of clear stevia liquid to sweeten the green tea.

Email from Newsletter Subscriber
Q. Is there any evidence that the use of statins for cholesterol reduction prolongs life?
A. Statins do lower cholesterol levels, but I have not come across convincing evidence yet that the use of statin drugs prolongs lifespan.

Q. From Lou Mancano, M.D. (a doctor friend) - I read your September 5 Newsletter today regarding the atorvastatin (Lipitor) and stroke study. You might comment in a future edition on the Number Needed to Treat (NNT) analysis. The NNT is the number of patients who need to be treated in order to prevent one additional bad outcome. It is the inverse of the Absolute Risk Reduction (ARR). How to Calculate NNTs.

NNT = 1/ARR
ARR = [CER - EER]
where
CER = control group event rate
EER = experimental group event rate

In the statin and stroke article, the CER was 13% and the EER was 11%. Therefore the ARR is 2%. One divided by 0.02 = 50. Therefore, one needs to treat 50 patients to avoid one stroke, meaning 49 out of 50 patients derive no benefit.
Number Needed to Treat is a quick method I use for determining how many patients I need to treat in order to (probably) benefit one. However, it doesn't account for how many people will develop side effects that are not included in the outcomes statistics. It's interesting to me that NNT calculations show us that many pharmaceutical treatments don't benefit most patients who take the medicines. Drug companies often report Relative Risk Reductions which can easily fool doctors and the public. They find the statistical method that best suits their purposes.

   A. Thanks, Dr. Mancano. If that is the case that only one person out of 50 may have a reduced chance of stroke from this expensive and potentially harmful medicine, I think the editors of The New England Journal of Medicine should have mentioned this to the public and the news media. I also had another thought. The study went on for about 4 to 7 years. What if the study continues and we find out that the side effects from Lipitor actually caused premature death after a more extended period of Lipitor use? It is a possibility to consider.


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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.

Vol. 3, Issue 15 -- Sept 1, 2006
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I'm now convinced more than ever that The New England Journal of Medicine, which at one time was a respected medical journal, cannot be entirely trusted. It is my sad conclusion that The NEJM, in many cases, is basically a marketing extension of the pharmaceutical industry. What was it that finally made me accept this sad fact? It began two weeks ago when I came across a headline on MSNBC website that said, "Statin Use Lowers Stroke Risk." "That's interesting," I though to myself. I started reading the article and what I found is quite disturbing. More details below.
In this issue I will discuss age related macular degeneration, a leading cause of vision loss and the use of chromium supplements for diabetes;

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1. Macular Degeneration
Macular degeneration is a condition in which there is progressive deterioration of the central area of the retina of the eye, resulting in gradual sight loss in the center of the field of vision. There are several carotenoids in the eye, the predominant ones being lutein and zeaxanthin. In a study of healthy women younger than 75 years, whose diets were rich in lutein and zeaxzanthin had a lower rate of age-related macular degeneration.
Lutein and zeaxanthin are found in green leafy vegetables, corn, and squash. Zeazanthin is also found in Goji berries.
My thoughts: Many people limit their vegetable intake to a few of their favorites, such as carrots, tomatoes, lettuce, etc. It's important to have a wide variety in order to obtain various types of carotenoids. I had not eaten corn for quite some time, and recently I ate 2 ears at one time,. About 10 to 16 hours later I noticed my vision was clearer and colors were brighter. Corn has a lot of lutein. I am not sure whether my vision improvement was due to the corn, but if anyone else notices this effect, do email us. Over many years of experimenting with different herbs and foods, I have become quite sensitive in noticing minor changes in my body.
   As to using a lutein supplement, most of the capsules come in 20 mg dosage. I don't think this dosage is necessary to take on a daily basis. Taking a 20 mg lutein capsule 2 or 3 times a week should be fine. Fish oils could also be helpful at 1 to 3 capsules a day, especially for those who don't eat much fish. See www.raysahelian.com/maculardegeneration.html  for additional suggestions. Before you resort to supplements, make sure your diet is the best that it can be. Supplements are just that, supplemental.

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2. Chromium Picolinate and Diabetes
The mineral chromium picolinate may help people with type 2 diabetes better control their blood sugar. Chromium supplements are marketed as a way to improve the body's use of insulin. Previous research has provided conflicting results on chromium's insulin and blood sugar effects. Researchers tested whether chromium picolinate supplements were useful in combination with a sulfonylurea medication -- an older class of diabetes drugs that often promote weight gain. Diabetic adults took either the medication plus 1,000 micrograms of chromium picolinate per day or the drug plus a placebo. After 6 months, those who took the chromium picolinate supplement showed greater improvements in insulin sensitivity and long-term blood sugar control. They also gained less weight and body fat than those on the medication alone. For more info, see  www.raysahelian.com/chromium.html

   My thoughts: This is encouraging news. I prefer a lower dosage of chromium picolinate to be used if a diabetic plans to take this supplement for prolonged periods. Rather than 1,000 mcg, perhaps a 200 mcg pill with breakfast and lunch might be appropriate.

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Statins and Stroke - Don't Let the Medical Establishment and Drug Pushers Mislead You
Would you pay 150 dollars a month for a pill that would not help you live longer, and may cause you to have muscle aches, liver damage and possibly hurt your body in other ways? That's what the medical establishment wants you to do. If you have had a stroke, they want you to take high dose Lipitor because it may slightly reduce your risk for stroke. But, you're not going to live longer, so what's the point?
Let's look at how the news media promoted a recent study in the August 10, 2006 issue of The New England Journal of Medicine.

HealthDay News -- A new study supports the use of cholesterol-lowering statin medications after stroke -- even for patients without a prior history of heart disease. Patients who took a statin drug -- which include Lipitor, Pravachol and Zocor -- reduced their risk of a second stroke by 16 percent over the next five years. "Doctors now have very clear clinical trial results to help guide therapy," said co-researcher Dr. Larry B. Goldstein, director of the Center for Cerebrovascular Disease and the Stroke Center at Duke University in Durham, N.C. "These results will have a major effect on how people are treated after a stroke," he added. The study was funded by drug maker Pfizer, which makes Lipitor.

Reuters Health - Statins helps prevent repeat strokes
Treatment with high doses of Lipitor (also called atorvastatin) reduces the overall risk of stroke and cardiovascular events in patients who have experienced a recent stroke or "mini-stroke," new research shows. While Lipitor was associated with a reduced risk of ischemic strokes -- the type caused by a blood clot -- it was also associated with an increased risk of hemorrhagic strokes -- the type caused by bleeding in the brain. After 4 to 7 years of follow-up, the stroke rate in the Lipitor group was 11 percent compared with 13 percent in the control group, a risk reduction of 16 percent. Lipitor use did not affect overall mortality: 216 patients died in the Lipitor group versus 211 in the placebo group.

My thoughts: Can you believe this? An expensive drug -- Lipitor -- is given at a cost of 150 dollars a month, and after 4 or more years more people died who took the drug than those who didn't. Yet, the people at The NEJM want patients with a history of stroke to take this drug and the news media emphasizes the meager 16 percent reduction in stroke but does not headline the fact that those who took the drug did not live longer. This kind of drug promotion by a medical journal borders on outright deception. It is misleading, unethical, and irresponsible. The headlines should have been, "Statin use after stroke found not to influence mortality." Shame on the news media, and shame on the doctors who wrote the abstract in a manner that emphasizes the meager benefitsl.
Am I misinterpreting this study or is the news media and The NEJM misinterpreting it? I called my dear friend and colleague from residency days, Dr. Louis Mancano, from Reading, PA whose honest opinion I respect. After reading the abstract, he came to the same conclusion I did.
   Is it possible that just taking a simply fiber such as psyllium -- a teaspoon with a glass of water twice daily with a meal -- could decrease cholesterol levels and have a similar effect to taking the expensive and dangerous drug, Lipitor? What about eating more omega-3 oils? Increasing overal vegetable and fiber intake? Learning relaxation and meditation techniques? There are many natural, simple, and cheap steps that can be taken to reduce stroke risk than going the dangerous statin direction. For info on natural ways to prevent stroke, see www.raysahelian.com/stroke.html On this web page you will find the full abstract of the study. Notice that several people involved in the study actually work for the drug company Pfizer, maker of Lipitor.


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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 3, Issue 14 -- August 10, 2006
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If you are taking statin drugs (such as Lipitor, Zocor, and others) to lower your cholesterol level, or you know anyone else who is taking a statin drug, you must be aware about potential serious side effects. I recently saw an ad on TV for Lipitor. The promoter of this drug was Dr. Robert Jarvik, the inventor of the first successful permanent artificial heart. I was surprised that he would be promoting this drug when it is becoming clear that it can have serious side effects.
The American Diabetes Association has specified a diet to lower cholesterol and blood sugar. Is there another diet that works better? For a full discussion, see below.

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1. Statins May Reveal Underlying Neuromuscular Conditions
It has been known for quite a few years that one of the side effects of statin drugs is damage to muscle tissue. I think this side effect is more prevalent that patients and doctors realize. In the June 2005 newsletter, I mentioned that even my mother had muscle aches when on Lipitor. The muscle aches stopped when she got off the drug. Now, it appears that patients with a predisposition to a neuromuscular disorders (that they may not yet be aware of), could have their condition precipitated by statin use. Greek doctors from the University of Athens Medical School report four such cases.

Case 1 was a 46-year-old man with a history of hypertension and diabetes mellitus who was prescribed Pravachol for hypercholesterolemia. Three months later he mentioned to his doctor that he had fatigue, muscle pain and stiffness. Genetic testing revealed myotonic dystrophy.

Case 2 was a 62-year-old man with a history of heart attack and diabetes. His high cholesterol was treated with Zocor. Blood creatine kinase levels (an indicator of muscle damage) became persistently elevated and did not return to normal after drug discontinuation. He was diagnosed with McArdle disease.

Case 3 was a 51-year-old man with hypertension and high cholesterol who was hospitalized with acute rhabdomyolytis (muscle tissue breakdown) after taking Lipitor for 18 months. He was diagnosed with mitochondrial myopathy.

The last case was a 58-year-old man who began treatment with Pravachol. Shortly after a dose increase, he developed muscle twitching, muscle cramps and difficulty walking. He was diagnosed with Kennedy disease.

My thoughts: There's always a tradeoff regarding benefits versus risks when using a drug or a supplement. Without question there are patients who have very high levels of cholesterol and have benefited from statin drug therapy. However, doctors are placing individuals who have mild cholesterol elevations on these drugs as if they are perfectly safe. My intention is not to scare everyone from totally abstaining from the use of statin drugs. I just want to let people (and their doctors) know that they should be much more cautious about the use of these medicines, to use the lowest dosages that work, to perhaps take occasional breaks; and to evaluate thoroughly the need for these drugs before taking them. Also, natural methods should first be explored before using these medications. Statin drugs are known to lower CoQ10 levels in the blood. CoQ10 is a nutrient involved in the formation of energy within mitochondria. I am not sure if the muscle tissue damage is due to a decrease in CoQ10 levels or other factors.
 
For info on natural ways to deal with cholesterol, see www.raysahelian.com/cholesterol.html

For info on statin drugs, see www.raysahelian.com/statins.html

For info on the above neuromuscular diseases, see www.raysahelian.com/neuromuscular.html


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2. Vegan Diet better than ADA diet?
According to a report in Diabetes Care, a journal published by the American Diabetes Association, those who eat a low-fat vegan diet lower their blood sugar more, have lower cholesterol levels, and lose more weight than people on a standard American Diabetes Association diet. The vegan diet does not have animal products such as meat, fish and dairy and is low in fat and sugar. Researchers tested 99 people with type 2 diabetes, assigning them randomly to either a low-fat, low-sugar vegan diet (without meat, fish, or dairy) or the standard American Diabetes Association diet. After 22 weeks on the diet, 43 percent of those on the vegan diet and 26 percent of those on the standard diet were either able to stop taking some of their drugs such as insulin or glucose-control medications, or lowered the doses. The vegan dieters lost 14 pounds on average while the diabetes association dieters lost 7 pounds. An important level of glucose control called hemoglobin a1c fell by 1.2 points in the vegan group and by 0.38 in the group on the standard diet. In the dieters who did not change whatever cholesterol drugs they were on during the study, LDL or "bad" cholesterol fell by 21 percent in the vegan group and 10 percent in the standard diet group. Participants said the vegan diet was easier to follow because they did not have to measure portions or count calories.
   My thoughts: I give credit to the ADA for admitting that another type of diet works better than their diet. I appreciate honesty. There is no doubt that diet has much more to do with blood sugar and cholesterol control than most doctors realize. However, vegans and vegetarians need to make sure they are getting adequate amounts of nutrients that could be lacking in their diet. These include B12, carnitine, the omega3 fatty acids EPA and DHA, creatine, CoQ10, etc. For more info, see  www.raysahelian.com/vegetarian.html


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Email from Newsletter Subscriber
Q. I have used Passion Rx every other day for a year and half with good results. In the last 6 weeks it has been less effective. Actually last week I took it several days in a row to try to increase the effect but it didn't happen. Any thoughts?
   A. Tolerance can develop to certain sexual herbs or combinations of herbs. We prefer people using Passion Rx or any sex herbs to take at least one full week off a month. In your case it may be a good idea to take at least a month or two completely off from sexual herbs since you have been using this product regularly for a long time. Sometimes the body may get used to a particular herb or herbal combination and another herb or product may provide better results since it could work with a different mechanism of action. But, the most important factor is to take frequent breaks to allow the body to readjust hormones and neurotransmitters.
   I have been using Passion Rx two days a week with a complete week off a month for nearly 3 years and it still works great for me. In my case Passion Rx with yohimbe works quicker, but we have feedback that different people have different preferences. Some people prefer to take individual herbs as opposed to combinations.


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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 3, Issue 13 -- July 24, 2006
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You may have heard the news that some products touted on the Internet for sexual enhancement illegally contain the same active ingredients as Viagra or the other prescription impotence medicines. Recently the FDA sent a press release warning consumers not to use certain herbal sexual products. FDA tested many products advertised on the internet and determined these seven to be laced with the drugs: They are Zimaxx, Nasutra, Libidus, Neophase, Vigor-25, Actra-Rx and 4Everon. People who take nitrates or other heart medicines may have not realized they were being exposed to these drugs. Also, those who have impotence or erectile dysfunction should have a medical evaluation since in many cases this could be an indication of heart disease. Just as the arteries in the heart can get atherosclerosis, so can the arteries to the genital organs. I'll share more thoughts about herbal sexual enhancement later.
   For many years I have been trying to formulate a product that provides a deeper sleep, not cause morning drowsiness, and not cause nightmares. Melatonin and 5-HTP can help with sleep, but they can also induce nightmares. I personally have difficulty sleeping at times since I have an active mind late into the night and can't always shut it off at bedtime. I have trouble sleeping also if I have not exercised that day. After many years of trial and error, I think I have finally developed a good sleep enhancer. For more than a decade I have experimented with combinations of several herbs and nutrients such as valerian, hops, chamomile, sleep inducing Chinese herbs such as jujube and bupleurium, lemon balm, kava, gaba, 5-HTP and melatonin, etc I have finally found a combination that seems to be quite helpful. Good Night Rx does not have the knockout punch as do some pharmaceutical sleep meds such as Ambien or Lunesta, but it seems to be quite helpful for those who sometimes are tense in the evening, have occasional sleepless nights, and need something to help them relax and provide a deeper sleep than normal. This is a new product, and so far almost everyone who has tried it has noticed a benefit. As with many herbal products, or even pharmaceutical drugs, Good Night Rx will not work in everyone. Sometimes the benefits are noticed on subsequent nights. The capsule is best absorbed on an empty stomach, generally anywhere between half an hour to 3 hours before bed. My research staff and I found that taking it after a meal was not as effective. We suggest not using it more than 3 nights a week, and it is a good idea to take a week off from it each month. As with any pill, it is impossible to have one dosage that works for everyone. Some may find 2/3 of a capsule works better for them whereas others may find taking more than one capsule works better. Those over the age of 70 may wish to use less than a full capsule the first night just to see how their body reacts to it. Discuss with your doctor before use if you have any medical conditions or are taking medicines.

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1. A Few Thoughts about Sexual Herbs
I have been frustrated for quite a while formulating Passion Rx and Passion Rx with yohimbe. I had heard that there were products on the market that gave results in one hour, and it bugged me that I could not formulate Passion Rx to be effective as quickly. I thought to myself, how are a few of the other products working so fast? Do the formulators know something I don't know? I was relieved to hear that the reason these products worked so quickly was because of the laced drugs, not because the formulators were so advanced in their herbal knowledge.


For those who wish to have a quick erectile response in an hour or two, the pharmaceutical drugs are an option. However, Viagra and its cousins do little to enhance libido, sensation, or overall sexual pleasure, and they really are not meant for women. These drugs may, in rare cases, have serious side effects such as blindness. Herbs don't work as quickly as the drugs (although Passion Rx with yohimbe sometimes works within hours or even within an hour or two), but once the effects begin, normally within a day to four days, the overall sexual enhancement with herbs is more holistic. Yohimbe can work very quickly at a high dose, in less than an hour, but the side effects are quite unpleasant, hence the amount of yohimbe in the Passion Rx with yohimbe version is a rather small amount in order to minimize some of the side effects such as rapid heart beat, anxiety, and sweating.
 

If you are not in a rush, the sexual herbs and their combinations are preferable, providing increased arousal, sexual drive, pleasurable sensation of genital organs, better blood flow, and more stamina. Sex herbs are not totally free of side effects. The side effects are dose dependent. That is, the higher the dose, the more likely you will notice overstimulation, increased body temperature, rapid heart beat, alertness, irritability, and insomnia. If you have erectile dysfunction, have a medical evaluation to make sure you don't also have heart disease. Most sex herbs should not be used by those with heart disease and extreme care should be taken if you are currently taking antidepressants, stimulants, or other medicines. If you have a medical condition, always discuss with your doctor before using potent herbs or supplements.

 

I prefer using lower dosages of sex herbs (even if it involves taking a portion of a capsule) over several days with a day or two off in between rather than to take a high dose at one time. I remember a few years ago speaking with an elderly Chinese doctor familiar with herbal medicine. I asked him if he was aware of Chinese sex herbs that worked very quickly. He responded that Chinese medicine doctors prefer to enhance sexuality gradually over several days than shock the system with a high dose of an herb. Us westerners are quite impatient and want results rather quickly. We can get quick results with Viagra, but we also pay the price with potential serious side effects.


It is nearly impossible to develop a pill that provides a satisfactory sexual enhancement to every user. Viagra and its cousins improve erectile function at best in about 60 to 70 percent of users, and the feedback that I have over the years from users of sexual herbs is that, with patience, these herbs have a higher rate of providing sexual enhancement, maybe close to 70 to 75 percent. It is impossible to predict which herbal product or individual sex herb (tongkat ali powder, tribulus, horny goat weed, maca, ashwagandha, catuaba, mucuna pruriens, or combination, etc) will work in any particular person. Sometimes it may take trial and error over several days or weeks until the right herb or combination is found. Taking breaks from the use of these herbs actually helps them work better than taking them every day. Sometimes you may not notice an effect the first day or two, but then surprisingly a few days later you may notice a significant sexual arousal, even if you have been off the herbs for a day or two. Many of these herbs have a delayed effect.


Eating more cold water fish, perhaps taking fish oil capsules, trying to minimize stress, getting a good night's sleep, doing mild to moderate physical activity, eating a healthy diet with lots of fresh produce, being exposed to erotic or sensual stimuli, all help improve sexual desire and enjoyment.
See www.raysahelian.com/libido.html


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2. Do Supplements Help Prevent Cancer?
As long as I remember there has been has been controversy in the medical and scientific community regarding the role of supplements and cancer prevention. There have been dozens of studies looking into this matter. I'm not going to bore you with the statistical details of each of the studies. Moreover, different scientists looking at the same data can come to different conclusions based on their bias. I just want to give you my overall impression as a doctor who has been following this topic for many years. My impression is that it is very difficult to do a study long enough to determine for certain and conclusively that supplements prevent cancer. Plus, when scientists do research on this topic, they usually pick a couple of well-known vitamins, such as vitamin E or beta carotene, sometimes give them in illogically high doses, and base their conclusions regarding the whole supplement topic on whether these couple of supplements, given for an inadequate period of time to a group of people, made a difference in cancer occurrence. It takes many, many years or decades for certain cancers to form and be detected, and it is quite difficult to expect research subjects to take their supplements on a daily basis for such a long time. Plus, some people in the placebo group may take other supplements on the side, without informing the researchers, that would confuse the matter.
   Bottom line: I think it is very difficult to say whether supplements prevent cancer. My impression is that the right combination of herbs and nutrients, at the right dose (not too high) can make a difference, but it is very difficult to know what this combination is, and what the right dosage would be. Plus, since each one of us has a completely different biochemistry and dietary habits, what works for one may not work for another. My advice: just don't worry about this topic until scientists figure out how to do reliable studies for a long period of time. Do your best to live a healthy lifestyle with the best diet that you can manage. Exercise, sleep deep, lead a low stress life if possible, have a positive attitude, and take your supplements if they make you feel better or are effective in treating a particular condition that you have. For more info, see www.raysahelian.com/cancer.html  which discusses some supplements tested in cancer. No firm answers are yet available.

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SUPPLEMENT RESEARCH UPDATE - by Ray Sahelian, M.D.
Vol. 3, Issue 12 -- July 6, 2006
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We're going through a major heat wave in Los Angeles. I read an article that the earth has been warmer this year than at any time in the past few hundred years. I tend to think global warning is for real, but I am not an expert in this field to know for sure. Recently I had several friends who saw the Al Gore documentary "An Inconvenient Truth" and had great things to say about it. I haven't had a chance to see it yet, but it's on my list. The movie that touched my heart the most in the past year was "March of the Penguins." I wonder how these penguins will fare as the Antarctic ice begins to thaw.
   If global warning is really happening, then chances are in the future we are going to drink more fluids to keep hydrated. This brings me to the topic of fluid intake. In the previous issues I mentioned my concern regarding drinking sodas sweetened with artificial sweeteners such as aspartame. Besides water, what other options do we have? I thought it would be a great idea to list a number of different healthy drinks with little or no sugar. You may realize you have more options that you imagined.
   In this issue I will also give my thoughts on the possible dangers from bisphosphonate drugs heavily pushed by the pharmaceutical industry for the treatment of osteoporosis; the possible prostate benefits of pomegranate; and a review of huperzine A, a compound isolated from Chinese club moss that is being evaluated for it's role in treating Alzheimer's disease.

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1. Go Natural with Osteoporosis Prevention
Bisphosphonates are a class of drugs that inhibit the resorption or breakdown of bone tissue. Bisphosphanates are used for the prevention and treatment of osteoporosis, multiple myeloma and other conditions that involve bone fragility. In the last 10 years, millions of patients have taken biphosphanates for the prevention of osteoporosis and bone thinning from cancer. Bisphosphantes once seemed safe, but lately concerns have been raised. Bisphosphante use is now believed to be associated with osteonecrosis (dead bone) of the jaw. Osteonecrosis of the jaw is an uncommon complication, but it is estimated that among the 500,000 American cancer patients who take the drugs because their disease is affecting their bones, up to 10 percent may develop the problem. Some dentists are refusing to treat patients taking the drugs, fearful that the dental work will induce a case of osteonecrosis, and lawyers are lining up to sue the drugs' makers, saying they failed to give patients adequate warning. Cancer patients, mostly those with multiple myeloma and breast cancer whose disease has spread to their bones, generally take one of two bisphosphonates, Zometa or the older Aredia, intravenously. Osteoporosis patients usually take bisphosphonates as oral pills, in lower doses that patients with cancer. These bisphosphanate drugs include Fosamax, Actonel and Boniva.
   My thoughts: It may be too early to know for certain how prevalent and serious are the risks from bisphophanates, including osteonecrosis, but if you are taking them, ask your doctor if you really need them and whether the potential risks are worth the potential benefits. In previous issues I mentioned that calcium supplements and vitamin D are beneficial; and, of course, exercise and weight lifting are the most helpful.

2. Healthy Fluids as the Globe Warms
I used to drink bottled water until I bought a high end water purifier. Now, I just drink this purified water and rarely drink bottled water unless I am traveling. I hope more people try this method rather than spending so much money on bottled water. With the price of fuel going higher, the transport of bottled water will raise prices and also contribute to pollution from fuel use and the dumping of these bottles in the trash. Besides water, have you considered what fluids you normally consume? Here are some suggestions for healthy fluid alternatives to soft drinks:
 
Fruit juice - there are so many to choose from. Why limit yourself to orange or apple? Try mango, guava, cherry, prune, grape, pomegranate, berries, watermelon, mixed juices, and others. Make sure the juice you buy is 100% fruit rather than a sugared version. Consider diluting the fruit juices in water. For extra antioxidants, you could open a capsule or two of acai, goji, mangosteen, pomegranate, and other fruit extracts to mix with your fruit juice.
 

Vegetable juice - you can drink tomato juice in a bottle or can, and also the mixed vegetable juices such as V8. If you are ambitious, you can make your own juice adding carrot, beet, parsley, spinach, ginger, etc. If you live near a health food store, you can get fresh carrot juice, greens, and other fresh, mixed vegetable juices. Offer your children vegetables juices rather than sugared drinks and sodas.

Herbal teas - there are countless herbal teas you can choose from, and make sure the tea you buy is the actual herb rather than artificially flavored regular tea. Have you ever tried licorice tea? It is so sweet. You can buy licorice root from a health food store and soak it in water and then filter it. You can add ice and make it a delicious cool summer drink. I have at least a dozen different teas on my kitchen counter and I alternate them. Some of them can be made into cool summer drinks. You can sweeten iced tea with stevia.

Lemonade sweetened - you can have delicious lemonade, sugar and calorie free. Squeeze your own lemons or buy lemon juice from the store, add water and stevia. Health food stores now carry organic lemon and lime juice. Stevia goes very well with lemon juice. Once you get used to lemonade with stevia, you won't miss the sugar. I prefer the clear liquid stevia.
Soy milk, almond milk, rice milk - these are good alternatives to milk. I am not against milk consumption, I just think many people drink too much. One glass a day of milk is plenty. Substitute these other drinks instead. Most of the soy milk in stores has added sugar. You can buy the unsweetened soy milk and add stevia. Or, sometimes I buy the sweetened ones and use a small amount of this sweetened soy milk mixed with a larger amount of the unsweetened.

Coffee - I suggest not more than 2 cups of caffeinated coffee a day, and preferably in the early part of the day. At times, when I am having breakfast at at restaurant, I ask them to pour half the cup with regular coffee, and the other half with decaf. Regular coffee may have more antioxidants, but the caffeine is not that helpful if used in excess.

Sports Drinks - Most of the sports drinks, energy drinks and enriched drinks on the market are laden with sugar. I am not against the use of these sports drinks or soft drinks when used infrequently.

Other types of fluids introduced in recent years include water with added vitamins and minerals. I really don't think these are necessarily, it is just a marketing gimmick to charge more for the water. There is no scientific evidence to support that drinking "super oxygenated" water enhances athletic performance or wellbeing. So-called super oxygenated water -- water in which the oxygen content is increased significantly -- are marketed by various companies as a way to improve athletic performance by feeding extra oxygen to the muscles through the blood stream.

3. Pomegranate for Prostate
A study funded by a pomegranate juice maker found men who drank the fruit juice took longer to double their blood levels of PSA -- a protein that indicates the presence of prostate cancer. The quicker PSA doubles means the quicker the prostate cancer is growing. When the men started drinking eight ounces of pomegranate juice a day, the time until PSA doubling after treatment extended to 54 months on average while before drinking the juice, PSA doubled in an average of 15 months. No major side effects were reported from drinking the juice. The findings were published in the peer-reviewed journal Clinical Cancer Research and funded by a trust established by the owners of Pom Wonderful, a brand of pomegranate juice.
My comments: There are many herbs and fruit extracts that have shown promise to help reduce prostate cancer. For those who do not wish to ingest pomegranate juice either because of the taste or because of added calories or fructose (particularly diabetics), a pomegranate extract capsule is a good option. Eight ounces of pomegranate juice is a lot of calories and a lot of fructose. For more information on pomegranate  http://www.raysahelian.com/pomegranate.html