Monthly Archives: October 2011

Are Vitamins Innocuous? Maybe Not!

Are Vitamins Innocuous?  Maybe Not!

Reference: http://archinte.ama-assn.org/cgi/content/short/171/18/1625

http://jama.ama-assn.org/content/306/14/1549.abstract

Competency:  Nutritional Supplements

Two reports this week about vitamins and extra risk for early mortality.  This is sort of a surprise and takes some thinking what it might mean.  First, in the very prestigious Archives of Internal Medicine is a report following 38,000 plus women in the Iowa Women’s Health Study asking them about what supplements and vitamins they took.  Of the fifteen items that were surveyed, 14 were found to be associated with higher mortality.    They women were 61 years old when the study started and upon ending 18 years later, more than half had died.  This is a big study.  Iron was found to be the strongest risk on the list.   Now, I’m a bit suspicious that 14 of 15 were found to be problematic.  That is a problem itself.  In fact, the only one thought to be beneficial was calcium, and that has been shown in other studies to be problematic and not helpful.   The study is apparently pretty well designed and regarded in its methodology except for one detail, and that is that they asked the women to remember what they had taken in the past.  No one measured blood levels and reported on personalized details.   If I have a family member with an iron deficiency anemia, I still think they should be on iron.  (Once I know why they are low on iron.)

A second study was released in JAMA about prostate cancer and Vitamin E and selenium.   Again, a pretty big study (SELECT Trial) and well designed with good placebo control.  This one seems more rigorous in design because it was randomized.  It only lasted 3 years but had 35,000 men.  That’s big.   What they found was that Vit E (400 IU) did NOT protect from prostate cancer, and in fact had about a 17% increased risk.   That translates into 16 extra cases for every 10,000 men.  400 IU a day isn’t much.  It’s the size of most E supplements in the grocery store.  Most multivitamins only carry a fifth of that amount.  But that’s a big jump and very disconcerting.

Both of these studies have the power of standardized large studies on their side, well executed and carefully thought out.  Both suffer from a couple of fallacies that should be understood.  We should more sophisticated than what they expect.  We should all be past the era when we think any one supplement taken out of context and given in high dose would be beneficial.  At no time in human evolution have we ever had isolated vitamins given to us in huge doses.  Most of my functional medicine colleagues have long since given up on pure alpha-E and are instead focusing on gamma – delta E as that is where the action seems to be moving.  We probably need the mix.  And where do we get the very best balance of that mix?  When we eat a diet rich in whole, organically raised foods.  If your grandma recognized it as a food, it probably is.  If was raised in your garden, it qualifies.

WWW. What Will Work for Me?  I don’t take Vit E any more.  I did for about 5 years back in the 90s.  I’m pretty convinced that I do better with 9 servings a day of vegetables and a few fruits for fun.  If I can find convincing evidence that our body naturally had high doses of a vitamin in it, like with D, I’ll change my mind.  But then D isn’t a vitamin, it’s a hormone, and our bodies naturally make it when we have sunshine. Which we don’t for the next six months.  So, trash the E.  Start your D.

Written by John Whitcomb, MD

Brookfield Longevity and Healthy Living Clinic  262-784-5300

Brookfield Longevity and Healthy Living Clinic

17585 W North Ave, Suite 160

262-784-5300 or www.LiveLongMD.com or info@LiveLongMD.com

Three Little D’s

Three Little D’s: We Don’t Have Enough, Linked to Many Diseases and You Really Need it if you are Fair Skinned

Competency:  Vitamin D,  References attached in hyperlink

Neal Binkley, at the American Association of Clinical Chemistry reported this month that his research shows that only 23% of Americans have enough D, that is over 30 ng.  He notes that 40% of women and 30% of men will have an osteoporosis related fracture in their lifetimes (compression fracture of a vertebra, wrist, hip or shoulder fracture – all messy and with bad outcomes).  The current level of recommended dosing wont get most folks to levels of 30 ng.  Optimal levels are probably higher, and the human body will level off at about 60 ng given adequate sunshine.  In  Wisconsin, we are now going into a virtual tunnel of darkness for the next six months with no opportunity to make D on our own.  We do know that your will raise your blood level of D about 1 ng for every 100 IU  of D you take a day.  So, the Institute of Medicine has recommended that all folks be on at least 600 IU a day, which will raise your D level 6 ng.  1000 IU a day will raise you 10 ng.  Prior reporting in this column from Antarctica reviewed an article in which 2000 IU a day got folks to an average level of 29 ng.  That’s not 30.  To get to 45-60, the optimal range for most of us, you would need about 4000 IU a day to reliably be at that level.  Considering we have never seen any toxicity below 14,000 IU a day, 4000 should be safe.

Second little D:  Fair skinned folks, especially with freckles, are more deficient in D because they get sunburned.  Oops. We thought it would be the other way around.  Fair skin allows you to make D more efficiently.  But with the lesson of sunburn, apparently fairskinned folks get in the habit of staying out of the sun. The only way to get to adequate D all on your own, is to be in the sun for a long period of time. Considering we are now going into winter in Wisconsin, we all need to be suppmenting ourselves. (You may enjoy reading some of the articles Dr.   Gellinghas published on this topic)

Final little D:  Dr Atul Gupta has found that kids with asthma have much higher rates of serious problems in direct inverse correlation with their D levels.   The mass of smooth muscle in their lungs was shown to increase with lower D levels. That just shows they are breathing harder.  The African American community in Milwaukee has a catastrophically higher rate of asthma.  I have personally given several hundred children (their mothers) instructions on Vit D and how it might reduce their risk of future ER visits.  An ER visit costs about $ 1,000.  That would buy enough D to last a child their entire life, not to mention reducing all their lost school time, lost play time, and all the other medical complications of asthma.

WWW.  What will work for me?  Vitamin D has an important threshold of activity we don’t get to unless we take enough.  2000 IU a day is not enough.  The 600-800 IU  a day recommended by the IOM is not enough.  Only a blood level will tell you if you are high enough.  And if you have fair skin or dark skin, it doesn’t matter.  Winter is  a high risk season and we all need to be on the stuff.  It’s cheap.  I’m on 10K a day.  My level is 62.  Perfect.

 

Written by John E. Whitcomb MD

Brookfield Longevity and Healthy Living Clinic

17585 W North Ave, Suite # 160

Brookfield, WI 53045

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Managing Your Mitochondria

Managing Your Mitochondria

Competency # 4 ACTIVITY

Reference:  Nutrition Action Health Letter, December 2006

If you thought keeping a trim waistline was a bummer, then you thought it was all about eating less food and exercising more.   At the bottom of it all, that would be true.  But that may be sort of like saying the only way to fly across the Atlantic is in the Spirit of St. Louis.  Sort of slow! Takes a day and a half.  Not much room for passengers.  Navigation requires watching for cathedrals in France and aiming for the Eiffel Tower.  We can do better than that.  We can zoom across the Atlantic now in just a few hours on a supersonic jet.  Can we manage our waistlines better too?  The answer would be yes.  But you have to understand the core processes.

Mitochondria are the key.  This may take a week or two, but I’m starting a series here.  First, I’ll explain what a mitochondria is.  Then we will explore how they manage your energy supply.  Then we will go into the details of how to keep them healthy.  Finally, it will be about how to supercharge them.

Step One.  What are they?  Mitochondria are tiny little oblong “organelles” inside each and every cell.  A couple of hundred million years ago, a bacteria invaded a much bigger cell.  That tiny bacteria was really good at making energy.  It was willing to share with its bigger host.  The bigger cell liked that and sort of let the little guy hang around.  The two got along famously.  When the bigger cell divided, the little one did too.  It took up housekeeping and made many more copies of itself.  Today, mitochondria are still there.  They are tiny organelles inside all your cells.  They have taken over the job of converting sugars and fats into energy molecules.  They ship the energy molecules out to the rest of the cell.  Mitochondria have their own DNA and their own genes.

You get them only from your mother, so we can trace your maternal lineage very accurately.  They mutate very slowly, but at a steady regular rate.  The more mutations we find, the further apart human populations are.  It’s following and tracing the genetic differences in mitochondria that allows us to confidently say that we humans all descended from one lovely young lady living somewhere in Sudan or Ethiopia some 75,000 years ago.  Those of us who ended up in the Yucatan have one set of mutations.  Those of us who found our way to Fiji, another set, India, yet another and Finland, another still.  Milwaukee has them all.  All mixed up.

Our hardest working cells have some 2,000 mitochondria in each of them occupying a little more than 50% of the cell.  Heart cells, for example are almost 60% mitochondria and only 30% muscle fibers.  That’s because heart cells never stop working.  Then there is brain, muscle, liver, kidney and you get the drift.  Mitochondria are our power grid.  Without them, we couldn’t efficiently burn energy.  And burning energy is what each cell has to do.    Burn baby, burn.

WWW:  What Will Work for me.  I need to learn about mitochondria.  My first key takeaway lesson is that it’s not just energy in = energy out.  Of course that’s true.  I want to make sure my energy grid is up and working.  With the high price of oil, I mean fat, it’s time I burn my own energy efficiently.  I want to be jet powered.

Exercise Increases the Number of Mitochondria in your Brain

Exercise Increases the Number of Mitochondria in your Brain

Reference:  American Jr Physiology, Sept 2011

Competency:  Brain Health

Mitochondria are your energy factories.  Muscle cells have about 200 of them each while heart cells have as many as 5000.   Some larger brain cells have than many too.  Without the production of energy, we couldn’t think, move or function.   It’s been an established fact for years now that regular exercise will increase the number of mitochondria in your muscles.  That’s part of the secret to exercise helping you lose weight.  Mitochondria can’t turn on and off. They constantly hum along at a low level, even when you aren’t exercising much.  When you exercise and induce a few more to form, you increase the rate of “background burn”.

What about your brain?  Your brain doesn’t pump iron.  What happens to your brain when you exercise?  Does it reap a benefit?  Well, that experiment has never been done until now.  (And now, only in mice.  It’s hard to get most humans to give a sample of their brain for an experiment.  Teenagers might, for the right inducement).  This experiment, just published, took two groups of mice.  One was given regular exercise by running on a treadmill for an hour a day. The others had the same handling but no exercise.  After 8 weeks they took “samples” of muscle and brain tissue to look for mitochondrial changes.  They found multiple markers of mitochondrial stimulation that correlate with the total number of mitochondria . (It’s extraordinarily difficult to count the mitochondria in brain cells as they are such thin, filamentous things and don’t separate out into nice round packages.)  Some of those markers have names like PPAR (peroxisome proliferator-activated receptor), silent information regulator T1 and citrate synthase.  When the mice were tested by how far they could run, the exercised ones had increased their running ability to about 50% over the sedentary.   74 to 126 minutes.

This experiment tells us something is going on with exercise that affects your brain in a very beneficial way.  There must be some net effect of exercise that is circulating in your blood and signals messages into your brain, across the blood brain barrier and into the mitochondria to start proliferating and multiplying.  Pretty cool, huh?  We haven’t specifically found that circulating humor specifically yet, but it is likely to be a multifactorial mix.   It’s could, for example, be something to do with osteocalcin, (would be my guess) as that has been found to be stimulated by exercise with a hugely beneficial effect on your blood sugar.

WWW. What will work for me?  This is a big boost to my mental task of convincing myself to exercise.  I can just count off the mitochondria in my brain as I pant and puff up that hill.  I’m finding that I can run, every day, but the task is mostly mental.  I need to constantly feed my thoughts and my focus with positive images of benefit and good outcomes.  The thought that my mitochondria are all cheering me on gives me some comfort.  If only it was light at 6 in the morning.

Written by John E. Whitcomb MD

Brookfield Longevity and Healthy Living Clinic

17585 W North Ave, Suite # 160

Brookfield, WI 53045