I've been scolded by several of you that my last newsletter was too horribly depressing and that you basically don't want to know about all this gloomy environmental stuff because you can't do much about it anyway. One of you suggested that I write this affirmation at the beginning of this newsletter, which may, by magical thinking and by repeating it over and over again, improve our food sources and environment, reduce harmful fracking, reduce the smog in the skies over China and clean up Fukishima safely and without incident. At any rate, what it might do is help you feel better. Have a go at it.
Everything I see, hear and feel, taste, touch and breathe promotes my physical and spiritual well-being.
Fruit: In Moderation, One of the good guys: Fruit has been getting a bad rap lately. Too high on the glycemic index, fattening, increases your risk for diabetes. But, wait a minute. Cross that last one out. Latest news from the British Medical Journal says this is not true. They utilized 3 large health studies, tracking diet and disease for about 12 years in more than 185,000 people, 12,198 developed type 2 diabetes. To cut to the chase, researchers found that some fruits strawberries, oranges, peaches, plums and apricots had no significant effect on the risk for diabetes, or in other words it didn't matter one way or the other whether you ate these 5 fruits or not.
However, eating grapes, apples and grapefruit all significantly reduced the risk of Type 2 diabetes and the big winner? Blueberries: Eating only one to three servings per month decreased the diabetes risk by 11% and having five servings a week, decreased the risk by 26%. Fruit juices continue to be awful yes, even that POM stuff - as they significantly increase the risk for diabetes.
I am not a huge proponent of eating uncontrolled amounts of fruits. In fact I suggest, depending on what I see on patients' lab work and observe as their symptoms, restricting their fructose grams to either no more than 15 or no more than 25 grams per day. There is an aging component called glycation and that happens when you add too much sugar/fructose/carbs to your diet especially when combined with proteins. Glycation occurs when sugars react with the body's lipids and/or proteins resulting in the formation of advanced glycation end products or AGE's. Picture the top of a Crème Brule? That's an image of your cells on sugar: Glycated cells can't fight disease as well and you will eventually have an impaired immune system.
Speaking of Immunity: It's that time of year when it seems that everyone around you either has the sniffles, someone's child caught something from someone else's child in school or their husband picked up something at the office and generously brought it home to the entire family. Innate immunity is our first line of defense in the war against infection, both microbial and viral.
As we get older, that vigorous immunity response goes bye-bye along with that vigorous 30 year old self, so we need to boost it a bit. Here is a list of immune boosters that you might want to take a look at and include in your winter armamentarium, and as usual, I can always test you to see which ones might be, let's say, the top three for you: Echinacea, Ginseng, Garlic, Turmeric, Astragalus, Cats Claw, Ashwaganda, Reishi, Chlorella, Camu, Probiotics, vitamin D. Then there is the oh so good and the oh so expensive Immune Tonic, a mixture of Echinacea, Gingko and Licorice. I swear a daily swig or two of that potent elixir has kept me well for the last two winters, knock on wood.
Glycation and Immune Impairment are just 2 out of the 5 most important aging issues that we have. Another one, or number 3, is inflammation now experiencing its 15 minutes of fame according to all the research I am reading and it makes sense to me. But let's see what your blood work says, especially your hs-CRP which is a fine measure of the amount of inflammation in your body. Inflammation is connected to everything from A (Alzheimer's) to Z (Herpes Zoster or shingles). Lots of things can cause inflammation including being overweight (fat cells hold inflammation), smoking, lack of exercise, and stress. There are many natural anti-inflammatories, but you can see that most of the causes are life style, so best to start there.
Oxidative Stress is number 4: This is what happens when you have unstable molecules running rampant in your body, searching for a place to land, banging into everything and damaging cells. A rusty pipe is a perfect image of oxidative stress. The best thing for this is lots of antioxidants and a diet rich in antioxidants and phytonutrients.
And number 5 is faulty methylation: To make a long story short, this means that Phase II of liver detoxification is not working as well as it could in its main job of shuttling the very toxic cells it has received from Phase I into the kidneys and bowel for safe excretion. In essence, what faulty methylation does is prevent that toxic debris from being carefully and safely excreted and instead will permit the toxins to dump directly into your bloodstream. This is sort of like having a faulty muffler in your car, which, instead of sending the toxic byproducts of petroleum breakdown into the environment (bad), sends that exhaust right into your car to affect you (even worse). These toxins will affect you where it hurts - your DNA - which is an important template for every cell in your body. So, the good news is when your liver Phase II methylation is working properly, you are healthier and you age more slowly because your DNA and your cells are not being choked by toxins. Get your homocysteine levels checked via a blood test: This is a pretty accurate marker for how your methylation is working. If it's high we can lower it very simply with 5MTHF (a powerful form of folic acid) B12 and B6.
Handling these potential problem areas of aging, just five things glycation, immune impairment, inflammation, oxidation and methylation can help us to slow our aging process. Yeah, the Big Dirt Nap will catch up to us at some point, but how about trying to slow it down a bit? That's my plan.
Should I get the Shingles Vaccination?
I know. The whole concept of getting shingles is a nasty idea. I have seen enough patients with the painful aftermath of shingles to know that I never, ever want to get shingles. One of my patients even had it on her face, totally enveloping her left eye and that was a real medical emergency. But being woman of a certain age, every year I live, my chances of getting the shingles are ever increasing. I have been seriously thinking of acting like a normal person and begging Kaiser for the shingles vaccination called Zostavax. That is, until I read this article in Dr. Craig Reese's November newsletter which he got from this website of Dr. Brownstein's. If you are interested, the website address is blog.drbrownstein.com/should-you-get-a-shingles-vaccine/ but I will be quoting verbatim from his article. The stats are astounding yet the whole shingles vaccination thing is not cut and dried.
"Original article: Prevention of Herpes Zoster in Older Adults by Jared Kocher, published on November 1, 2013. The author wanted to answer the question, In older adults, is vaccination against herpes zoster effective and safe?"
There is a Big However in what seems to be a successful vaccination picture and here it is, hidden in the Practice Pointers section of the Cochrane Review. In this section, the author states that, over a median surveillance period of 3.12 years, with over 52,000 participants, there was a 51% relative risk reduction in confirmed cases of herpes zoster in those that received the vaccine. Furthermore, the author stated that among those aged 60-69, the number needed to treat to prevent one case of shingles was 50. Among those 70 years and older, the number needed to treat was 100.
These numbers show that, in those aged 60-69, the shingles vaccine was ineffective 98% (49 out of 50) of those studied. For those aged 70 or older, the vaccine was 99% ineffective, since 99 out of 100 received no benefit.
It is incredulous that anyone looking at this data could proclaim that the shingles vaccine was effective. In fact, it wasn't. According to this data, the shingles vaccine was a 98-99% failure. Assuming the cost of the vaccine is, what $200, we would have to vaccinate 50 subjects aged 60-69 to prevent 2 cases of shingles at the cost of $10,000 per case. For those over 70, 100 patients would need to be vaccinated to prevent one case of shingles at a cost of $20,000. Clearly this vaccine is not cost effective for us guinea pigs, but it definitely is for the manufacturer, Merck.
Finally the author summarized the adverse effect risk of the shingles vaccine. The number needed to harm from the vaccine was 2.8. This means that for every 2.8 vaccines given, one patient was harmed. Furthermore, for every 100 subjects vaccinated, one had a severe adverse reaction such as rash, fever or hospitalization."
On the other hand, even though the vaccination may not be very good at preventing shingles, my further research tells me that perhaps it will prevent, to some degree the lingering pain, called Post-Herpetic Neuralgia that some unlucky people get. That pain, I understand, can be life-altering and earth-shattering. "One of the things that is really unique about this vaccine is that it prevents the after pain." Dr. Rafael Harpaz, a CDC epidemiologist who has worked on shingles for nearly a decade.
"Age affects the risk for post-herpetic neuralgia, (Dr. Anne Oaklander, A Mass General Hospital neuropathologist and researcher.) because the older you are the worse it seems to be." It has been statistically analyzed that that perhaps 75-80% of the time, the vaccine can prevent the PHN of a shingles episode, but only prevents getting the shingles 51% of the time.
Bottom Line: It's your call, of course, but it seems that the shingles vaccine is not very good at preventing the shingles, but pretty good at preventing the pain of the aftermath of shingles if you do happen to get the shingles.
(The vaccination has neomycin in it which is a penicillin derivative, so be careful if you are allergic to penicillin. It also has gelatin in it, in case you are allergic to that. And it's also a live vaccine which means that you are being shot full of little shingles bugs. An easier way to get your immunity is to seek out kids with the chicken pox and go play with them for a day or two.)
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