Monthly Archives: August 2011

Got Sore Tendons! Curry Can Help

Got Sore Tendons! Curry Can Help

Reference:  Journal of Biological Chemistry 286(32):28556-28566, 2011

Competency:  Inflammation

Curry and sore tendons!  The connections here seem a little weak.  That’s what caught my eye.  How can curry help my sore thumb?  I’ve had tendonitis in it for a couple of months after straining it opening a jar.  A lot of us get tendonitis as we get older.  Pain around a joint, particularly with use, with a tender spot that hurts when you strain the joint is a pretty sure sign that you have an inflamed tendon.  Your elbow, thumb, shoulder, knee, heal, wrist may all be affected.   It can last for months and months and be rather annoying.  That limitation, not always serious, can spiral into real trouble when it causes a fall or limits your ability to react to a sudden unexpected event.  Plus it just plain hurts and keeps you from doing things you want to do.

What’s the curry connection?  Dr. Ali Mobasheri from the University of Nottingham in England took cells from tendons in tissue culture and created experimental inflammation.  That inflammation could be inhibited by curcumin.  He found that it down-regulated interleukin-1beta-induced inflammation and the gene products that mediate matrix degradation, prostanoid production, apoptosis and stimulation of cell survival .  (That’s a mouthful!)  He said “we believe that it could offer scientists an important new lead in the treatment of these painful conditions through nutrition”.   This could be the beginning of new drugs to replace NSAIDS.

Turning his language into English goes as follows.  We know that curcumin, the yellow color of curry powder and mustard, is a potent inhibitor of NFkB.  (pronounced NF kappa B)  And you should know that NFkB is the central controller for inflammation inside your cell.  NFkB has a protein fragment attached to it that is essentially it’s activation lock.  When it’s attached, it can’t turn on.  When it becomes detached through inflammation signals coming from outside the cell, NFkB then starts all the cascades in your cells that spiral into inflammation.  Curcumin puts a headlock on NFkB and keeps it silent.  No inflammation, no activation of prostanoids, of interleukin-1 beta, no matrix degradation etc.

The key idea for us to know here is that NFkB is being increasingly fingered in processes that don’t serve us well.  It’s an important controller for proper inflammation, like when you are fighting an infection. But when it turns on and doesn’t turn off, we have achy tendons for months at a time.  And curcumin keeps it from turning on.  Will this cure our current tendonitis?  Probably not right away.  It may help over a month or so.  I’m giving it a try.

WWW.  What will work for me?  I try and eat curry a couple of times a month.  And I take curcumin as a supplement.  Hasn’t cured my current tendonitis.  But I’m going to watch this story and see if curcumin doesn’t replace all those NSAIDS that tear my stomach up.  We need something new on this front.

The Cheapest Way to Reduce Your Mortality: Double Your D

The Cheapest Way to Reduce Your Mortality:  Double Your D

Reference:  William Grant, European Journal of Clinical Nutrition pub online 8/18/2011

Competency Vit D

Dr Grant present a statistical paper looking at the global risk reduction that occurs with Vit D and the risk reduction that would come to population health.  He estimates that in six Vit D deficient regions of the world, where average D levels are 22 ng, mortality could be reduced globally by about 7-13%.  The average life expectancy would be extended by about 2 years considering the current state of accomplished research, by increasing the average D level to 44 ng.   And this would all be accomplished for cheap.  The least expensive way to live longer.  Nice idea, right?

He notes in his paper that policymakers call for Randomized Placebo Controlled trials which he maintains to be nonsense.  He argues that D is a critical life giving substance, not a drug.  Drug needs RCTs.  You already have D inside you.  Arguing that you need to do an RCT with Vit D when we know you are low is sort of like arguing with a dehydrated man dying in the desert that you have to prove he needs water by an RCT.   “Only two drops until we prove it’s good for you.  Now, NO GRABBING. “   With long latency diseases, randomized trials, to meet the rigors of research, would require a group to standardize their sun exposure and then be followed for 10 to 20 years.  It’s not going to happen ever.

There is a nifty way around the policy holders.  Ignore them.  Take care of yourself.  You need to understand how D works.  It is your bodies “maturation” hormone.  It tells stem cells to mature into their intended adult form, allowing them to do their function properly.  Virtually every cell line investigated so far has found Vit D receptors in them.  Because it is a hormone, you need an optimal level.  There is pretty good evidence that optimal level is somewhere in the 60 ng range, which is what you would get if you were to go to the beach every day for 20 minutes, or were a farmer in the tropics, or a life guard, or a tanning booth user three times a week.  We all would get to 60 ng.  And many of us, after many years, would have skin cancer.   So, avoid the cancer and the sun.  Take 5000 IU every day.  Give your kids under 10 at least 1000 a day (or 5000 every 5th day)

What you also must understand it that much D gets hidden in fat tissue.   Everyone needs a loading dose.  Average sized folks need about 300,000 IU over a month or two.  Bigger folks may need much much more.  If you just start at 2000 IU a day, you will take years to get to a higher steady state, and may never exceed 30 ng.  Most literature shows that 5000 IU a day will get you 60 ng for most folks, over about 6 months.  Only a blood level can tell for sure.  No other blood level will help you live 2 extra years.

WWW.  What will work for me.  Two years longer life for a level of 44.  I can’t wait till they get to the ability to predict what benefit you have when you get to 64.  Like the Beatles, “Will you still need me, will you still….when I’m 64.”  Way ahead of their time.  If only they had all lived a few years longer.

Written by

John E Whitcomb MD

Brookfield Longevity and Healthy Living Clinic

17585 W North Ave, Suite 160

Brookfield, WI 53045

Triple Negative Breast Cancer and Vitamin D

Breast Cancer Risk and Vitamin D

Competency Vitamin D

The very worst kind of breast cancer is so called “triple negative” or TN.  It has no receptors for estrogen, progesterone or the HER2 gene that make for sensitivity to endocrine manipulation.  That makes for more aggressive cancer.  The Department of Defense Breast Cancer Research Program meetings last week came up with some interesting papers on that topic.  Dr. Song Yao from the Roswell Park Cancer Institute presented a fascinating look at women with breast cancer and compared their cancers to their vitamin D levels, and TN type cancers.

Now, Vit D is essentially your “grow up and become mature” hormone that tells stem cells to become mature cells.  A mature cell does three things: it stops dividing, it does its function and it goes through natural cell death.  Each of those functions are the opposite of cancer.  Knowing that basic function, you can understand why Vitamin D has so many disparate beneficial effects.  It seems to affect every organ and body systems favorably, as it should if it made stem cells grow up in every tissue.  Even plankton in the ocean use Vit. D to initiate cell division and maturation.   A cancer cell never grows up, keeps dividing and never does its function.   Vitamin D should be, by all accounts, a cancer preventative.

So, what would you expect Dr. Yao to discover in his exploration of Vit D and breast cancer?   Well, first of all, in comparing African American women to Caucasian American women, he found lower D levels in the African Americans.  Darker skin makes for slower D production so no surprises there.  And who would you guess would have the more aggressive cancer?  You got it, the African American women.  And comparing women with cancer to those without, what would the levels of D be?  Again, those with cancer averaged a D level of 22 ng and those without had 26.  But those with the most aggressive Triple Negative cancer before menopause had D levels averaging 16 ng.   For every 10 ng rise in serum Vit D level, there was a calculated 64% reduction in Triple Negative cancer risk.

Let me say that again.  There was an inverse relationship between Vitamin D and aggressive breast cancer risk.  And Vitamin D could be the explanation for why African American women have such aggressive cancers.  The question remains, could this be just the first study to clearly demonstrate the racial disparities in health outcomes we see in the African American community?  What about premature babies and mortality? How about hypertension and diabetes?  Each of those illnesses or conditions have Vitamin D documented risk.

This isn’t hard science.  It’s observed associations.  Proof in its final form requires a randomized trial.  But explain to me the risk of raising your D level to normal when it’s just a natural substance, not a drug, with no toxicity below 100 ng.

WWW.  What will work for me.  I’m on 10 k a day of D.  My blood level is 80.  I intend to stay there.  My African American friends know that, and hopefully their blood level is up there too.  Time to treat Vit D like a life saving, inexpensive anti-cancer drug.  If you know someone who isn’t on it, please give them the gift of life, a bottle of D.   Wrap it in a pink ribbon, would ya.

Written by John Whitcomb MD

Brookfield Longevity and Healthy Living Clinic

17585 W North Ave, Suite 160


Exceptional Longevity and Lifestyle: Not as Virtuous as We thought

Exceptional Longevity and Lifestyle: Not as Virtuous as We thought

Reference:  Jr of American Geriatrics Society, August 5th, 2011, Circulation 2002, p 893-898 Vol 105

Date:  August 8, 2011

To get to be really old, you have to eat right and exercise more! Right?  Well, maybe not.  Published this week in the Journal of the American Geriatrics Society is a fascinating study looking at centenarians and comparing them to the rest of the population.   Dr Barzilai at Yeshiva University looked at 477 Askenazi Jews were living independently and were over 95 years of age.  Now, 75% of them were female so maybe the criteria ought to be changed to “To live to be 100, you better be a woman.”  These 477 study subjects were compared to 3164 matched controls from the general population.  All of them together made a pretty hefty cohort of folks who had lived into their 90s and remained quite healthy.

What they found was that the centenarians didn’t really have much different about them from the general population in terms of diet, activity, BMI or smoking.   Smokers!  Can you imagine? They found smokers in the really, really old group.  The only really difference found was that the centenarians were less likely to be obese.  (4.5% vs 16.2 % of the general population)  That was it.  But they did find some centenarians who were overweight.

They conclusion was that the populations didn’t differ by all that much, except for the obesity, and then it wasn’t a majority issue as only a small percentage of folks had it.   Hence, the authors concluded that it must be more about how the individuals interacted with their environment than their specific lifestyle factors.

What could all this mean?  Dr Barzilai correctly pointed out that the lesson from this cannot be that you can go out and smoke and eat bad foods because this study shows the futility of lifestyle changes.  The vast majority of people benefit from reducing weight, exercising and stopping smoking.  In fact, both the EPIC-Norfolk Population study from Europe and the Harvard Professional Lifestyle Factors study both showed that most of us will add 14 years to your life by stopping smoking, exercising, losing weight and “eating right”.  Adding 14 years is a good concept, provided my brain is working for those 14 years.

What this study does show is that there is likely more pieces in the puzzle to be teased out.  Reducing inflammation, taking Vitamin D, avoiding toxins are all not mentioned or measured in this study.  The fact remains, many of us are living into our 90s.  We would like to do it well.

WWW: What will work for me?  I would like to still be gardening in my 90s.  I would like to still be passionate about some hobby or vocation.  I would like to know and recognize my family and loved ones.  To do that, I’m putting my bets on exercise and eating well and avoiding diabetes.  (This morning I passed a major hurdle in my exercise program: I beat the 12 minute mile.  Whew.  Down from 16 minutes)


Written by

John E. Whitcomb, MD

Brookfield Longevity and Healthy Living Clinic