Author Archives: Dr John Whitcomb

About Dr John Whitcomb

Dr John Whitcomb is one of Milwaukee's premier functional medicine and Anti-Aging doctors. He is in private practice in Brookfield. He is board certified in Anti-Aging Medicine, Internal Medicine, Emergency Medicine and has a Masters Degree in Nutrition and Metabolic Medicine. He is also now developing Wellness University, an innovative course to teach the fundamentals of nutrition and self care to individuals and companies.

Restore Hashimoto’s Thyroid Function with Selenium and Myo-Inositol

Restore AutoImmune Thyroiditis with Selenium and Inositol!

 

References: Eur Rev Med Pha SciInternational Jr of EndocrinologyJr Thyroid Research,

This is quite a remarkable claim. Reversing Hashimoto’s?!! This is like finding the Holy Grail. Hashimoto’s is one of the most common autoimmune diseases in women affecting about 5% of women and 8-15 times as many women as men. There is a robust connection between wheat sensitivity and Hashimoto’s, with celiac disease being documented the most firmly. In the functional medicine world, it goes without saying that Hashimoto’s needs to be managed with the avoidance of gluten. Fasano has been the leading voice in advocating the role of gluten in making leaky gut and subsequent autoimmune disease.
This study took 168 patients with TPO or anti-thyroglobulin antibodies and a TSH between 3-6. That’s quite modest Hashimoto’s. The higher the TPO, the more damaged the thyroid gland is, and the more prolonged course has been already endured. The free T4 and free T3 levels were still “normal”. They were randomized to receive either 83 mg of selenium or 83 ng if selenium and 600 mg of myo-inositol for 6 months. The combination group had a better response and recovered their thyroid function better and felt better to boot. This isn’t the first study to prove this effect, but it is the largest.
Certainly we know the role of selenium, at least to some degree. The enzyme that catalyzes the production of free T3 has to lop off the fourth iodine of T4. It is called de-iodinase. It is based on the selenium atom. If you want to do a deep dive into de-iodinase, the ZRT blog has an excellent summary. Leave it sufficient to understand that there are three forms of de-iodinase which all help conserve iodine, balance thyroid function by maintaining the level of free T3 is a healthful range and responding to stress and starvation. There is less selenium in mid-westAmerican soil, lots in Rocky Mountain soils. Hence, selenium deficiency is common.

Myo-inositol is new player here. It actually looks like glucose, but it is structured differently. It plays a role in changing membrane signaling. It also plays a role in thyroid activation. Several studies demonstrated that myo-Inositol is the precursor of the synthesis of “phosphoinositides”, which are part of the phosphatidylinositol signal transduction pathway across the plasma membrane, via the second messenger 1,4,5-triphosphate that modulates intracellular calcium release. That means it acts as a second messenger regulating the several like insulin, follicle-stimulating hormone (FSH), and thyroid-stimulating hormone (TSH). And if you understood one word of that paragraph, you get an A.

Bottom line, this unique combination of simple supplements appears to work together to target the missing links in the thyroid dysfunction called Hashimoto’s. That might suggest that anyone might be on the edge of dysfunction, and are then tipped over by an extra stressor, gluten. If we catch you early, you can prevent that tipping and never get in trouble.
WWW.What will work for me. Well, selenium is that critical element we all appear to be a bit short of. If you are reading this in Wyoming, you are likely getting enough because your soils have it. If you are in Wisconsin, you probably need to take a supplement. I’m intrigued that Bredesen considers it a critical part of his Alzheimer’s pathway. That makes me in. Selenium is important.

 

Pop Quiz

1. Hashimoto’s is a rare Japanese thyroid problem. T or F
Answer: False. It is common the world over, with up to 5% of women affected

2. Hashimoto’s damages the thyroid gland leading to all the symptoms of low thyroid. T or F Answer: In a nutshell, yes.

3. You can remarkably improve early Hashimoto’s with selenium and a glucose analog called moo-inositol. Answer: That’s this week’s nugget.

4. The physiology of thyroid function is well understood. T or F Answer: are you kidding, we are just on the surface and continue to be amazed at its complexity and nuance.

5. Getting thyroid right, and selenium right, are critical to healthy brains: Answer: Bingo!!!

 

 

Generosity is Good for YOU

References: PsychNETHealth PsychologyCurr Dir Psychol Sci-FiScience,

Alright! We just had a huge hurricane in Texas, and another on the way in the Atlantic. The TV and radio are all calling out for help with money, time, boats, you name it. They need help. They need your generosity. And here is what is cool, you do too!

Giving, at first, feels hard. You worked hard for your dollars. You earned your good salary. But why does every religious tradition in history consider helping people one of their central tenants? Jesus, as one example, talks more about giving away your wealth than any other topic. Jewish tradition is what Jesus was referencing. They are just as generous. It’s one of the Five Pillars of Islam. Buddhism has “10 Good Deeds“. Hindu’s get to heaven giving alms.

Modern researchers are finally putting some “scientific data” around that. Why is “giving” so important for us to learn to do? What is it about generosity that makes it so compelling, despite the barriers of self interest?

Here is the science of it. In 2013, a study of retired representing a statistical sample of America was conducted. They had to be over 50 and multiple variables were recorded over 4 years of observation. Those who volunteered more than 200 hours in the 12 months prior to the study being started showed they developed less high blood pressure (40% less). That’s about the same effect as taking a pill. They also had high scores on “well being”. This is pretty remarkable. But that’s not all.

Another study looked at elderly folks given $ 40 and told they had to dispose of it in one day. Half were to spend it on themselves. The other half had to give it away. Guess what happened! Those who had to give it away dropped their blood pressure as much as folks taking a pill to lower pressure. This reinforces other research that shows that “Happiness Runs in a Circular Motion.” There is plenty of other research showing that the closer you are involved, the stronger the emotional tie. Up front and personal matters.

I get it. Every religion says it’s good because the geniuses of history expressed their insight into human nature as rules for us to follow for daily living. It’s good for you. Plain and simple. Thank goodness there are folks around who need our help. That applies to the poorest of the poor.

WWW.What will work for me. One of my strongest childhood memories from Bisrampur church in India was the “Muthi Dhan” offering where the local farmers would bring in a “fistful of rice” to share with those more needy. These were folks living on $ 3-5 a day for their whole family. They would qualify in just about anyone’s lexicon as being poor, and needing help. But their own happiness depends on giving too. I’m intending to go to my current congregation and give a meaningfully big check towards hurricane relief. I would ask you do do that same, for your sake.

Pop Quiz

  1. Something about the way we got wired as humans gets into a good spot when we share what is important and precious to us with others? T or F
    Answer: Call it your faith, your duty, your community, but yes, isn’t that true.
  2. We can measure medical consequences of being generous. What is it?               Answer: Blood pressure lowering as much as with a pill
  3. Is this why brain health experts say to keep a healthy brain, you need to be connected? Answer: You decide. Of course!
  4. I’m too poor to give. T or F                                                                             Answer: Research shows the “poor”tend to be more generous, proportionately.
  5. Most money is given by the poor? T or F                                               Answer: actually false. 70-80% of total dollars comes from “wealthy”, but they are giving a lower percentage of their income. So, don’t trash the rich. Praise them for their generosity. It’s really important for them to be connected too.  I suspect that the mind set of “accumulating wealth” becomes a habit, then an addiction, making giving all the harder, and all the more important.  It appears it’s a habit not broken easily, hence the religious admonitions.

Copper, Another Cause of Alzheimer’s

References: Dr. WeilJ. Biological and Inorganic ChemistryFront Aging NeurosciJr Nutr Health AgingPro National Acad Sci., NeurologyEuro Biophy Jr,

We have established that iron is a problem in Alzheimer’s Disease (AD). That’s clear. But are there other links? What else has changed in Western Society? One example is clean water, delivered through sterile pipes made of………copper. That is new in the last 100 years.
Wast AD rare 100 years ago? Yes. In 1900 it wasn’t even mentioned in Osler’s compendium of medical diseases. That was at a time we had over 3 million folks over age 60, and at today’s rate of AD, there should have been 36,000 cases in the USA, enough to have been noticed and commented on by Osler. So, it’s new and it’s common.
Sparks and Schreurs published an article in 2003 looking at free inorganic copper added to rabbits drinking water at a concentration of 0.12 parts per million caused AD like pathology in their brains and damaged their memory. The EPA allows 1.3 ppm of free copper in our water. That’s allegedly safe. Singh confirmed the exact same results in a mouse model of AD in 2014.
The key here is the difference of “free” copper, loose in your blood and lightly bound to albumin and organic copper, tightly bound and regulated attached to a protein called ceruloplasmin. The free copper is a problem. Squitti showed that free copper is elevated in AD, but not in vascular dementia and its ratio of free copper to bound copper predicts the range of dysfunction. Free copper comes from copper pipes. Organic copper comes from food. Don’t confuse the two, they are different in their biological behavior. Organic copper is bound to proteins, carefully guarded and processed. Free copper is not bound and is not in the protection system of the body.

Where do we get “free” copper from. Our plumbing. 90% of American homes have copper pipes in them. The use of copper took off after WWII as did the incidence of AD. It should be noted, the Japanese were hesitant to use copper and didn’t use copper in internal plumbing. They have had MUCH less AD. When Japanese move to Hawaii, they lose that advantage and develop AD just like everyone else.
What does copper do in the brain? It appears to be part of the APP and APOe protein pathology. It certainly causes oxidative stress on brain cells. It may be simpler than that. The APOe 2 gene has 2 binding sites for copper, the APOe3 gene has 1, and the APOe 4 gene (the bad one) has no binding sites for copper.

Here is the proposed sequence for copper
1. You live in a home with copper pipings.
2. Your brain copper rises as you get too much in your water
3. Your copper removal system kicks into gear, the APP system works on copper like it does on iron.
4. You have an APOe 3 gene (lousy with only one binding site) or worse, an APOe4 with no binding sites – so you can’t get rid of it at all
5. Your brain churns and churns, trying to get rid of copper with the APP protein, and it just can’t do it because you have too much copper in relationship to your APOe risk.
6. You overwhelm your brain cells. They die. You slow down.

You can’t change your genes. You can change your water. Brewer studied several hundred American homes for copper levels. He found that about a third had copper levels above 0.1 (damages rabbits and mice), about a third had levels below 0.01 and a third were in-between.. Your pipes are killing your brain.

www.What Will Work for me. I’ve been startled by checking zinc and copper levels for the last year. I have had two or three couples whom I have seen who have normal zinc and copper ratios. To a person, they have all had normal zinc copper ratios. (Remember, zinc and copper work like a teeter-totter. As copper goes up, zinc goes down and vice versa.) Healthy brains have more zinc than copper. Everyone else has low zinc and very high copper. When I went to Burma last spring and asked about AD at a nursing home we visited, I was met with curiosity and confusion. They had never heard of it. Thirty residents over 70 should have had some dementia. Their water source: a single iron pipe, outside in the courtyard. Hmmm. For now, I’m taking zinc every day. I’m thinking about how to get my water checked.

Pop Quiz

  1. Copper works on the same channels in your brain as iron causing formation of amyloid protein plaques? T or F                                                                                 Answer: That, my friend, is true.
  2. Copper is tightly regulated by nature with a protein called ceruloplasmin where it is safely sheltered. T or F                                                                                               Answer: That’s what we measure and presume.

 

  1. Alzheimer’s patients have high levels of “free copper” relative to bound ceruloplasmin copper. T or F                                                                                                    Answer: See the pattern we are building?     True

 

  1. What percent of American homes have copper pipes, and what percent have levels of copper enough to create plaques in brains (in rabbits – 0.1 ppm)?                        Answer: 90% and 30%

 

  1. Zinc levels balance copper, so one strategy to soften copper’s damage is to take zinc. T or F Answer: True. Get your serum zinc higher than your copper

 

The Trouble with Iron: Part IV The Nitty Gritty of What Happens in Your Brain!


References: The MindSpan Diet, Nature Communications, Front Aging Neurosci, Maynard: Jr Biological Chem, Annual Review of Neurosci,

Bear with me. I need to know the details of just what happens in your brain that makes iron so destructive. So here goes. You can get a wonderful synopsis by reading the MindSpan Diet book, or if you want a deep dive, I’ve got links here to some of the most meaningful literature.

For starters, what is the role of the APOe -4 gene? Having one copy doubles your risk of Alzheimer’s (AD), but two copies is a 10 times risk. Only 2% of Americans have two copies, but they are 15% of AD. Just two years ago, the AD Neuroimaging Initiative published a very strong paper showing that the APOe gene drives iron into the brain, and the level of iron in the brain, (as measured by cerebrospinal fluid ferritin) correlated with cognitive decline.

Along comes gene number 2, the APP gene. It was found in Down’s folks, who inevitably get dementia, and who have 3 copies of the APP gene. (It’s on chromosome 21 which Down’s folks have 3 copies of instead of two.)

Now, here is the key. We have 20,000 genes. Only 20 of them are responsive to levels of iron in our environment. It’s called the Iron-Response Element. It gets turned on when there is more iron, turning on the production of the APP protein. APP protein has the job of exporting the extra iron out of the brain.

The importance and centrality of the IRE system and the APP gene comes from population research in Iceland. There, a small and homogenous population allows genetic research to flourish. There are Icelandic folks who have a genetic variation of the APP gene, and they get about 10 years of brain protection out of it. Or, they have a 7.5 times less likely to get AD at age 85 than the rest of Icelanders. Lucky devils. It completely negates the danger of the APOe-4 gene. That really fingers the APP system as being in the forefront of causing AD. There it is.

So, let’s just simplify the sequence.

1.   You have too much iron, either because you ate too much red meat, took too many iron pills, or had two copies of the APO-e 4 gene. (Bad luck or bad environment.)

2.  The IRE system turns on, like your sprinkler system in your building in response to a fire.

3.   The production of APP protein turns on. (The sprinklers are blasting water everywhere, trying to douse the flame of too much iron.)

4.  The brain equivalent of Servrpro comes along to clean up the mess and ends up clipping a piece off the APP protein that gets left behind. That piece ends up accumulating in plaques, called beta-amyloid.

5.   As amyloid pieces accumulate, the clean up crew has to work overtime, using up its ability to duplicate  (the cells can only duplicate themselves so many times, each time shortening their telomeres and finally being unable to clean up at all).  Clean up slows.

6.  AD accelerates and the brain falls apart.  You slow.

Well, you can’t control your genes. You got what you got. You also can’t control the other elements of the breakdown process. But you can control your iron. That’s what is in your power.

WWW.What will work for me. It’s all about lowering your ferritin. What we haven’t talked about yet is the roll of copper. That may be as bad as iron, and that is coming next week. For now, I’m thinking about how to get rid of my iron. I’ve got too much and I now have the supplies in my office to do “phlebotomy” – cleaning and carefully draining blood out of you. If you can’t give it to the blood donation center. Please, please, please, do that first. Remember – you are aiming for a ferritin of 40. Give yourself a year to get there. Each time you give blood, your ferritin will drop about 20-40 points.

Pop Quiz

  1.   The APP protein is responsible to get extra iron out of your brain? T or F              Answer: True

2.     The Iron Responsive Element is one of 20 proteins in our genome that turns on in response to too much iron, and it turns on the production of more APP? T or F                             Answer: In a nutshell, you got it

3.   Your iron level in your spinal fluid reflects what’s in your brain. T or F                      Answer: Right again. True

4.   Blood donation will lower your ferritin. T or F                                                                 Answer; True. Isn’t that just too easy?

5.   We have tried our best to make sure people have enough iron. That is good for…..?                   Answer: Young menstruating women. Not so good for those of us over age 50.

The Trouble with Iron Part III Diabetes

The Trouble with Iron Part III Diabetes

References: Cell MetabolismJ of Diabetes Research,

You were trained to think of iron as absolutely necessary to help fatigue. “Build up your blood!” and other such phrases are deep in our subconscious. We see blood and know it is the red of iron. Iron is critical for life, because it’s the key to carrying oxygen to the tissue so that we can make energy. No doubt, iron is important. But carrying oxygen is no mean feat, as it is such a reactive chemical, it needs the strong chemical bond of iron in heme to transport it. What happens when you get too much iron?

Two conditions of too much iron are thalassemia and hemochromatosis. Guess what happens to those folks? Hemochromatosis is also known as bronze diabetes. They fill up the islet cells of their pancreas with iron, and their insulin producing capacity fails. This can be reversed with removal of the iron.

And what happens to normal folks? Well, here again we find that the tendency to being diabetic goes along with the tendency to be iron overloaded. And the devil is in the details. It’s not just the total load of iron that causes damage. It’s not just the accumulation of iron in the islets of your pancreas. It’s the whole ecosystem effect of iron. Iron plays a role in every tissue that mediates energy metabolism, particularly the fat cell. There is a whole host of signaling that occurs when iron is present with intracellular and extracellular messaging. The nuance of it is still not anywhere close to being understood, but you can get a sense for its complexity by the review in Cell Metabolism.
And what have we done, with all of our good intentions, in America. We have devised guidelines for iron supplementation that serve young, pregnant women, well. We add iron to all our grains. It is the fortification you see on the label of every kind of flour product. When you eat most breakfast cereals, particularly the ones that claim to have you supplemented with great vitamins and minerals, you will find 18 mg of iron added to each serving. But it will also be in the flour of your bagel, your hotdog bun, your Danish, your french toast. And it interferes with your metabolism of carbs, immediately. On the spot.

This raises a fascinating conjecture. Is it the iron added to carbs that makes them so problematic for weight gain, insulin resistance and diabetes? Hmmm. There is enough evidence around iron to make it a perfectly reasonable hypothesis. That also explains a few conundrums that the pure carbohydrate hypothesis doesn’t solve. For example, why is red meat so insulogenic? You eat a large bloody red steak, dripping with heme, and you get a huge spike in insulin. And it may not be just the red meat per se, because we see a stronger effect with processed meats. The evidence seems to lean towards more complicated and nuanced reasons, like the amount of AGE’s and ALEs. (If you knew what those were before you read this: you are a star. AGE’s are Advanced Glycation End Products – made by roasting meat with sugared sauces and ALEs are Advanced Lipo-oxidation Products, that occur with food preparation of meats with protein and high fat content.) However it occurs, iron is in the middle of it.
Here are some tests this hypothesis. First, one must look for high ferritin in folks who have high cholesterol, moderate blood glucose and elevated insulin: all the people we thought were overindulging in carbs. So far, I’m three for three. The last one had a ferritin over 600. Another test…..why can’t women lost weight after menopause? Answer: They stop losing iron with menses after menopause, accumulate iron and have their insulin go up. That makes them gain weight. Hmmm. Ever seen that happen? They go carb free and eat more meat, and don’t lose weight. Hmmm. I’m about 400 for 400 on that one.

WWW: What Will Work for Me. I’ve paid a lot of attention to this topic in my own life. Right now I’m reading labels and finding secret iron everywhere. At the picnic last night, I avoided the hamburger offering and had two olive oil salads instead. I had just read that the iron in spinach is tightly bound by oxalates. And what about Vitamin C? It increases iron absorption 400%. Complex, isn’t it?

Pop Quiz

  1. Too much iron in you can cause you to become insulin resistant, thereby leading to diabetes risk and obesity? T or F                                                                              Answer: Bingo. True
  2. The mechanism for this cause is well known. T or F                            Answer: Well, it’s well known now but the mechanism is still murky. Too complex. The phenomenon has been observed. And ferritin is deposited into insulin cells in the pancreas, but the cellular mechanism is much more nuanced, probably because iron is so tightly regulated and bound.
  3. You should know your iron level and it should be?                              Answer:  Ferritin of 40 or so.
  4. If your ferritin is too high, you can reduce it by?                                   Answer: giving blood to the Red Cross. Come on in and we will phlebotomize for you if the Blood Donor Center won’t or can’t do it.  (Leaches.  Blood letting.  Hand to hand combat.)
  5. This iron topic is a whole new way of interpreting the problem with carbohydrates, because………..?                                                                                           Answer: we added iron to virtually all carbs in Western societies. It may be the iron, and not the carbs.  This is conjecture for now, but it sure fits.

The Trouble with Iron – Part II – Your Brain on Iron

The Trouble with Iron – Part II Iron and Your Brain

References: The MindSpan DietNeuromolecular Medicine, Nature CommunicationsJournal Biol ChemUCLA Newsroom,

Ok you got it. You know the “AP” rule, antagonistic pleiotropy, from last week: what’s good for you at one age isn’t so good later. Young women need lots of iron to have babies. Young men need iron for their brains to develop. Young. As we get older, that changes and becomes “ANTAGONISTIC”.

What’s the trouble with iron? First of all, epidemiology. Men accumulate iron faster than women, and get Alzheimer’s younger than women. Women who have hysterectomies start accumulating iron sooner, and get dementia sooner.

Then there is pathology. All major brain diseases (Parkinson’sALSAlzheimer’s) are shown to accumulate iron in their region of damage. Iron is very reactive. With oxygen it’s a deadly combo. On our cars, we call it rust. In our brains, it wreaks havoc.
There are many mechanisms now being understood wherein iron is a problem in the brain. In essence, beta amyloid accumulates as a net effect of excess iron. And chelating that iron, in animal models, reduces the damage.

What do we see in human populations who have very little Alzheimer’s disease and who live to be 100 with healthy brains? First, they eat foods low in iron and live in parts of the world where there aren’t “fortified” grains (added iron). Their average serum ferritin is 20. In America, we call that deficient. More and more research is showing that ferritin in spinal fluid and blood predicts risk for AD. This is the perfect example of Estep’s “AP” rule. The iron we needed in youth to make babies isn’t so good for us as we age. Those, whose scales are tipped to eating more iron by intention or serendipity, are at greater risk.

The question arises, how do I get rid of excess iron? Rule #1: when in a deep hole, the first thing you do is stop digging. Stop eating iron rich foods. That included fortified wheat products. Cereals like Total contain 18 mg of iron per serving. Don’t. Steak. Don’t. Find flour that is not fortified. Find bread that is not fortified. Consider taking supplements that deplete iron. Wheat grass juice is uniquely good. Go to the Blood Center and give a pint. Often. Let them have double red cells. Get your serum ferritin to 20. AKA: KNOW YOUR FERRITIN.

www.What Will Work for Me. I’m changing my meat eating. I’m looking for unenriched flour. I just measured my ferritin and I’m over 100. Hmmm. I just might give some blood away. I threw out our red colored ibuprofen (iron coating).

 

Pop Quiz

 

  1. Iron is good for your brain. True or false                                    Answer: Ha, Trick question. It appears to be important for you when you are young, but too much is a deadly toxin as you get old. That is the AP Rule: Antagonistic Pleiotropy.

 

  1. We have added iron to many of our foods on the belief that it is good for us. T or F        Answer: True.

 

  1. People around the world who have the best functioning brains, the longest, have much lower blood iron in the form of ferritin than we have thought was safe. T or F                  Answer: Yup. Average ferritin of 20

 

  1. Beta amyloid in the brain might be accumulating as a side effect of our brain’s attempt to get rid of extra iron. T or F                                                        Answer: Again. Yup

 

  1. Getting rid of excess iron might be the only way to reduce our risk for the dangers of iron. The easiest way to do that is……?                                 Answer: Donate blood.

 

 

 

The Trouble with Iron

The Trouble with Iron

References: The Mindspan DietEndocrine Society MeetingHow Much Iron in My CerealJr of Nutrition,

Ready to blow your mind with a whole new set of ideas? Want to live a lot longer and have your brain survive with you? Want to have an organizing principle that explains much of the trouble with modern nutrition, that is a complete curve ball from anything you have ever heard before? Here goes. Please read the next couple of weeks of The News with great attention to the details in this column.
Dr Person Estep is not am MD, he’s the smart kind, a PhD at Harvard Medical School, in Genetics and Health Science. HIs research is into those populations of people whose brain survives into their later years, and why. I’ve just devoured his book, and if you want to preserve your brain, you should too. This is a must read.
Let me start with a few core principles and ideas that he presents. First, the concept of MIND SPAN. I want my brain to survive longer than my body. My LIFE span makes me nervous, if it’s longer than my brain span. That’s Alzheimer’s (AD). Get that? Of course your do. We all do, and right now 50% of are getting it if we have the “good fortune” of living to 85. That’s idea #1.
Concept #2 for us to all know is the idea of Antagonistic Pleitropy. (Wow, if you get this, you can skip medical school.) It’s actually a simple idea. What it means is that your bodies needs change as you age. What was good for you once, becomes bad for you later. Biology works by natural selection, and reproduction is the driving force. If you can’t pass on your genes, they can’t change. So, natural selection works only until you stop reproducing. Nature is not interested in you once the pressure of natural selection is over. Get it? What is good for you before passing on your genes, may be bad for you later. Women have to give iron to their babies. The human body needs iron for it’s blood making. And through most of human history, our guts were filled with tiny worms that made us lose iron. In this mix, men have to make sperm. Trillions of them. But sperm doesn’t involve the losing of iron. Making babies does. Lots of iron. The human species has resulted in a model that generally, in both genders, accumulates iron easily. That’s good for women, while they are making babies. And its good for all of us when we keep losing iron from intestinal parasites. What happens to us after we stop reproducing? Well, nature has no way of repairing or changing that tendency to accumulate iron after our reproductive years. What happens if we keep accumulating iron? What happens when we get good plumbing and sanitation and stop getting pin worm? Our iron leak stops.
What happens, if we decide that our society is across the board iron deficient and we add iron to all of our grains? (Look at your breakfast cereal and see how much iron you are getting. Look at your “fortified bread” and see how much iron you are getting. Consider that the USDA says that we need 18 mg of iron a day, and good science shows that actually you probably need much less, like 4 mg a day, once you hit 50. What’s happened is that in America, we have added abundant iron to our diet, to our baby formula, to our grains, our breakfast cerealsour rice, to our whole food chain. And that may be a big problem.
What if I told you that accumulating ferritin in your pancreas pushes you into diabetes? What if I told you that amyloid plaque in your brain may be a side effect of a desperate attempt to get that toxic iron out of your brain. We’ll get to that in the coming weeks.
For now, think about these two core ideas and please, look at your “fortified” flour on your shelf and read the labels for your source of iron. Think about how red meat provides you lots of iron. And next week, we’ll have more details.

WWW.What will work for me. My mind is being totally turned upside down. I can’t wait to tell you the rest. This is a whole new way of exploring the metabolic problems we face with aging. But for now, stop taking any iron in your diet. STOP. Trust me. Stop. Stop your vitamin pill with iron. Stop your fortified cereal. Get skeptical about red meat. I’ll prove it to you. Or else buy the book. Next week.

 

Pop Quiz

  1. The human body accumulates iron easily, too easily. When is that good, and when is it bad?                                                                        Answer: It’s good if you are a young female, having lots of babies and with lots of intestinal parasites – like humans were until 100 years ago when we cleaned up our toilets, our guts and stopped having so many babies. It’s bad when you are male, have a clean gut, live longer than 35 years.
  2. What is this effect called?                                     Answer: Antagonistic Pleiotropy. (Go straight to your third year in medical school.) What’s good for you at one age or circumstance, becomes bad for you later.
  3. We decided, as a society, that every one should have how many milligrams of iron a day?                                                                             Answer: 18
  4. How many milligrams do mature adults, past the age of child bearing need? Answer: Probably around 4.   Certainly no more than 8.
  5. Should I worry about the red color of my ibuprofen pill?                              Answer: Yes, that is actually oxidized iron. Buy another brand. The ibuprofen is good for your brain. The Iron is not.

Nine Risks for Cognitive Decline

Nine Risks for Cognitive Decline

References: The Lancet, July 2017BBC News

This week, in London, the Alzheimer’s Association International Congress, just met. One of their presentations was a publication in the Lancet detailing the current best evidence of risk factors for developing cognitive decline. The over arching principle is that the brain does show changes with time that eventually lead to withdrawal and loss of cognitive function. It shows up as short term memory loss, but starts with other risks. Prevention should be focused on building a “cognitive reserve” earlier in life. If there is to be an inevitable downward slope, change the grade of the slope.
Your brain is constantly tasked with decided what to keep and what to throw away. It is not a hoarder. It repeatedly questions what memories to discard, what are important, and which are less important. The stop sign you passed on the way to work may not be all that important to remember. It gets tossed. Where you put your keys is important, only in the short term, but can be forgotten. Your spouses birthday, now, that is important. Your brain has to sort those out. Routine and repetition can lead to letting go.

In order to do all that sorting, your brain needs data. It needs to be exercised, flexed, challenged, used. Knowing that, the list presented at the meeting makes sense. They estimated that approximately one third of dementia was amenable to prevention by early intervention. That starts with mid life hearing loss. This is the first paper that I have seen with a meta- analysis of multiple high quality studies of hearing loss as a risk for cognitive decline. It accounted for 9% of the risk. Following that was lack of a completed high school eduction (8% risk), smoking (5% risk), failure to seek early treatment for depression, (4%), physical inactivity, 3%, social isolation (2%), high blood pressure (2%), obesity (1%), Type II diabetes (1%). These all add up to the 35% percent of modifiable risk factors.
Continuing life long learning keeps your brain working with new data. Doing something “hard” every day, keeps your brain solving problems. Staying socially engaged with humans keeps all your filters of human interaction functioning. These factors appear to be important, and make sense. They flatten the slope of decline.
What is quite new in this examination is the consideration that diabetes accounts for only 1% of risk, obesity 1%, smoking 5% and physical inactivity 3%. These are far lower than prior estimates and suggest that there was no attempt or discussion about reduction and change of lifestyle risk factors. That is likely because the prior model of weight loss is all about low fat, which doesn’t work. Hence, no one has been able to succeed with weight loss, diabetes reversal, high blood pressure reversal etc. With the proper use of low carb for weight loss, modifiable risks for cognitive decline will appear to be more meaningful and effective.
WWW.what will work for me. I’m paying attention to the hearing loss concern. This is the first study that shows it to be so high on the list. It’s never been so high in any prior study. I’m going to find a time to get myself checked. I haven’t seen any other study like this, so this could be a statistical blip, but it sure catches my eye. Pay attention.

Pop Quiz

  1. The current article suggests that as much as 35% of dementia can be prevented. T or F                                              Answer: That’s there data from statistical analysis. I think the number can be much high.
  2. Mid life hearing loss can be postponed until you are on Medicare. T or F                Answer: False. It leads to social isolation.
  3. Cognitive decline is a natural process. T or F                                     Answer: Sadly true if you live long enough. Age is the strongest risk factor. What is not discussed here but is quite intriguing is that dementia may be the result of a protective or natural process going awry.
  4. Hearing loss may be far more important a risk factor than we care to acknowledge. T or F Answer: Yup
  5. The combination of diabetes, high blood pressure, obesity are all one parcel of common problems best reversed with a low fat American Heart Diet. T or F Answer: It’s true they are all one parcel, it’s false that the AHA diet will help you.

 

Don’t Eat Mac and Cheese

The Poison in your Mac and Cheese

References: KleanUpKraft.org, New York Times, CNN,

It was all over CNN, BBC, New York Times this week. “What Chemicals are in your Mac and Cheese?” Mac and Cheese. My kids were raised on it. It’s one of America’s iconic foods. The pinnacle of American comfort food. Here’s the rub. Ten years ago, we banned phthalates because they were found to be “endocrine disruptors” in children and exposure resulted in behavioral and neurodevelopmental issues. All the big retailers withdrew their children’s toys that had phthalates. Kids chewing on their rubber ducky were getting phthalates that soaked out of them.

Phthalates make kids toys soft and pliable. But phthalates are plastic chemicals that have a lot of beneficial applications. Your electrical wiring in your house is coated with phthalate plastics. Your vinyl flooring is resilient and pliable because of phthalates. And now we find in in your kids food. How did it get there? It’s not added to the food, it leaches out of the plastic tubing that is pliable and long lasting because it is made with phthalates. In manufacturing Mac and Cheese, there is plastic tubing that is made with phthalates. Voila. There you have it. The packaged Mac and Cheese had four times the level of regular cheeses, even the processed stuff in slices that comes between two layers of plastic.

What did this study show? Of thirty brands of Mac and Cheese, 29 had at least one phthalate, and some had six. The most common one, DHEP, is the one most commonly found and is the one most widely restricted. Kraft Foods made 9 of the 30 samples tested. There are 2 million packages of it sold every day in America. Hmm. So your kids are still getting it.

Your first response may be, “Give me a break. You can’t get that much out of the tubing from making the stuff.” Wrong, wrong. You get parts per billion. That doesn’t sound like much but it’s as much as four times the level of your own hormones. Therein lies the rub. Phalalates have been particularly linked to the suppression of testosterone.

The good news is that once you stop eating or ingesting them, they flush out pretty quickly.

www.What will work for me. It’s so easy to make your own mac and cheese. Just get some nice sharp cheddar and gorgonzola and make your own. Just don’t squirt it through plastic tubing. In the meantime, I’m not even buying Mac and Cheese any more when I stop at the grocery for food pantry donations. It you want to change the system, let your purchasing habits drive the market. If you want to change your testosterone, don’t buy packaged mac and cheese.

 

Pop Quiz

  1.  Processed foods that come in boxes are made in large, industrial sized factories, where high pressure, high heat manufacturing methods leach phthalates out of plastic tubing, enough to have detectable phthalates in the food being made. T or F Answer: If you followed all that, you got it.
  2. The concentration of phthalates in processed food is not meaningful. T or F Answer: It’s in parts per billion, some four times what your own active hormones are.
  3. Phthalates are known to suppress estrogen. T or F                       Answer: well yes, but the real damage appears to be to testosterone, needed by both men and women.
  4. If I buy organic Mac and Cheese, I can get away from phthalate contamination? T or F                                                            Answer: Nice try. False.
  5. Our kids are particularly susceptible to phthalates, which is why we banned them from kiddie toys. Makes sense to ban it from their food.                          Answer: Not if your food lobby pays your members of Congress enough to keep quiet. But we should. (Pay attention to the language – “We are going to reduce regulations that are job killing.” Might be code for not paying attention to food contamination.)

 

 

Sufficient Vitamin D Improves Vascular Health

Sufficient Vitamin D Improves Vascular Health

References: Indian Jr Endo MetabAmerican Journal of Cardiology,

I was excited last year when it was reported that Vitamin D helped folks with congestive heart failure. When 233 patients with congestive heart failure were randomly given Vitamin D, their 6 minute walk time didn’t improve, but their ejection fraction increased 23% relatively, or 6% absolutely. The dose was 4000 IU a day, with no loading dose. Note, half of us will die of congestive heart failure, so this is a big deal for older folks, particularly those with congestive failure. You may not be able to walk further, but you are still walking. Most folks with an ejection fraction (the percent of blood your heart can pump out with each stroke, where normal is 65 and dead is 18) in the low 20s die within a year or less. So, being around fora year to finish a study is cool. I added Vitamin D to my Congestive Heart Failure protocol.

I’ve been watching for mechanisms of just how it works. Here it is! In this study, 103 folks with Vitamin D deficiency (below 20 ng) were given 60,000 IU a week for 8 weeks. Measurements were taken of vascular function like carotid-femoral pulse wave velocity, brachial-ankle pulse wave velocity, arterial stiffness index and oxidative stress markers like serum malondialdehyde levels and total antioxidant status. They demonstrated about a 10% reduction in pulse wave velocity, (996 cm.sec to 899 cm/sec) and systolic blood pressure from 115 to 106. All were statistically significant. Lowering blood pressure (996 cm.sec to 899 cm/sec) and systolic blood pressure from 115 to 106. All were statistically significant. Lowering blood pressure even 2 points reduces risk for vascular disease 4-6%.
[Now, there are any number of studies that are referenced in this article where Vitamin D didn’t help heart disease. Many of these have been highlighted in the popular press to suggest that vitamin D supplementation doesn’t work.

Cardiologists like to quote them to justify having a cath instead of taking D. Hmmm. Just about every one of those studies gave lower doses of D, in the 2000 iu range, for 6-8 weeks at a time. This is a good example of the utter stupidity of most studies that essentially don’t understand the physiology of Vitamin D. Your bodies fat tissue soaks up D and stores it. It is fat soluble. You are a big tank. If you are overweight, you are a bigger tank. When you start a new dose, it will take your body a full year before a new homeostasis is achieved. In the long run, a dose of 3-4,000 IU a day is sufficient in most folks to get to a level of 50 ng, my definition for replete.

This study effectively gives a loading dose. 60,000 IU a week gets to threshold.   I give 100,000 IU because that has been proven to raise your D level 14 ng a day. If someone is low, < 20 ng, you can give two doses in a row. They will add 14 ng a day and in two days will be at 45-50. Finally, Vitamin D works as your stem cell hormone, telling stems cells to wake up and start maturing into mature cells. Mature cells can do their function. It takes months for a mature cell to grow and start doing its function. If your D level is rising so slowly that you don’t have enough for a year, a study lasting 12 weeks, with an inadequate dose of D will never show an effect.

The final point to make about D is the clear need for it to be accompanied by K2. Weston Price highlighted this in the 1920s because that is what he observed when he documented the lifestyles and diets of “primitive” people. Like every pioneer, Weston Price didn’t get everything right, and his foundation has a few tangents that are off base, but by and large, he opened the door on omega fats, K2 and D, something we didn’t appreciate for another 70 years. When you look at D in isolation, you will often likely miss the beneficial effect if you don’t control for Vitamin K input. Increasing recognition of the complexity of our metabolism can be seen in the interplay of D and K2. They are really part of a biological partnership. Both are fat soluble.

www.What will work for me. I’m getting a better understanding of how D and K work together. Seeing a study where adequate doses of D make an impact when similar inadequately dosed folks didn’t get an impact is an important distinction. The self righteous deniers of this effect can’t explain that. Once they are ensconced in nay-saying, they keep nay-saying. As for me, I cheerfully take my D, 3500 IU a day in the form of 100,000 once a month. And I wear a hat and sun screen. Just one more skin cancer to take off my back.

Pop Quiz

  1. Vitamin D works by……….? Activating many genes, (10% of the human genome) which stimulates stem cells to become mature cells.
  2. It takes Vitamin D how long to change your blood level? Answer: If you don’t take enough, you will never get to an adequate blood level but generally you reach a new homeostasis in about a year after starting a new dose.
  3. To get to an adequate blood level Vitamin D, you need a loading dose of …..? Answer: 100,000 IU for every 14 ng you are deficient. If you want to get to a level of 50, and your level is 8, you need ………….? Answer: 3 doses of 100,000 IU, one day apart each.
  4. Your arterial blood velocity will drop when you take Vitamin D, which means your arteries have gotten stretchier and your blood pressure has dropped. T or F
    Bingo.
  5. To prove that Vitamin D works on heart disease, you likely need to do what in terms of designing a study? Answer: It has to run longer than a year, have a loading dose, and take sufficient D to get to a level of 50. This has never been done. Any study with less, shorter, and no loading dose, no monitoring of blood level and no randomization will not show scientifically meaningful results. Meanwhile, the physiology of benefit sits right here, in this study.