Monthly Archives: November 2014

Vitamin D Levels Predict Cognitive Decline

Vitamin D Levels Predict Cognitive Decline

Reference: Neurology Nov 2014

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It’s late November. You haven’t been out in the sun for over 2 months.   But that hardly matters, as the angle of the sun has been too low since about Oct 1 to make any effective D when you do go out. And you are older than you were last year, making your skin a bit less able to make D. With a half life of about 30 days, your D level is dropping.   And the level to which it drops will predict how well your brain is working.

You are kidding! Vitamin D and brain health? That’s what this article is about.   1927 Italian elderly were given the Mini Mental Status Exam (MMSE) and then followed for 4 years. Their mean level of D was 33 ng and 28% had levels below 20 ng. at baseline.   6% were below 10 ng. Having Vitamin D levels below 30 ng (75 nanomoles) predicted a 35% chance of showing cognitive decline below 24 points on the MMSE four years later. Click on the link above and take the exam yourself. Hopefully, you score over 24.

Why is this going on? What does Vitamin D do? There are so many studies that have recently shown the lack of effect on longevity of Vitamin D that it seems a bit passé to bring back another that shows remarkable predictive effect of mental status.

Vitamin D is fundamentally your hormone for cellular maturation. Our brains are not fixed computers, humming along and gradually losing neurons. It is a vibrant, growing, reacting and changing organ than needs to constantly be nursed along with a healthy environment around it. It grows new cells, makes new connections, develops new pathways when properly stimulated and nourished.   Vitamin D would be there to help cells mature when that is called for.

There are many other factors that appear to play a role in brain health. The predominant one, in my opinion, is the low grade persistently damaging effect of slightly higher levels of blood glucose. Our brain is not designed to run on glucose all the time. To be healthy, it needs to run on ketones some of the time.   Modern civilization provides us with glucose in a constant stream of delectable goodies. Not eating for 12 hours every day (7 p to 7 am) is one good strategy to get a period of daily ketosis. 14 hours would be better. A couple of weeks each year on the ketogenic diet would be better still. Daily exercise to drive your glucose down would be best yet. All of those are effective strategies to conserve brain health.

The authors call for prospective studies to see if this will hold up. I’m skeptical we can do them, because I believe it takes too long a period of time to show the necessary improvement, and no one is willing to do any intervention for that long. I’m also skeptical in our current scientific method of doing one isolated intervention at a time. I believe Vitamins K2 and A are partners with Vitamin D in the cellular development story. It is my belief that interventions that will succeed will necessarily combine an environment of multiple interventions, of which sufficient D is only one.

WWW. What will work for me. I’ve done this idea before. Look in my archives above under Vitamin D and there are several articles on it. What startled me was that I measured my D level two months ago and found myself at 22 when I was taking 5000 IU a day. And that was at the end of summer. I must have a lousy Vit D carrying protein, or I must digest it faster. Something is amiss. So, I’m back on 10,000 IU a day and I intend to get my D level measured.   For you, I want your D level to be comfortably over 32 ng. A good healthy margin would be 45-55 – what you get when you live in steady sunshine, all the time.


Pop Quiz

  1. Vitamin D is your brains’ most important hormone? T or F

False. It’s one of many factors, all of which carry some weight.

  1. Vitamin D deficiency occurs because we don’t get enough sunlight? T or F

Mostly true. Getting older makes for less able skin conversion of sunlight. Living indoors, wearing clothes, living far up north, having poor receptors might all be other factors of significance.

  1. Low Vitamin D below 20 ng is predictive of future cognitive decline. T or F

That’s what I want you to take with you

  1. Getting your D level checked once a year is a good health strategy. T or F

Enough for me to pay for it myself if necessary

  1. Not eating for 12 hours every day might be another good strategy for brain health.

You got it.. And less glucose containing foods while you are at it.

Air Pollution and Your Brain

Air Pollution and Your Brain

References: Levesque Jr Neurochemistry, Calderon BioMed Research 2013,

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You know that black stuff that comes out of the back of big trucks or busses? All those fumes. You thought it was benign?   Well, we are beginning to understand the danger it provides. As more and more humans crowd into big, polluted cities we have the opportunity to study what happens to them in response to that.   Big cities have lots of chemicals like ozone and carbon monoxide, but they also have lots of tiny particles – 2.5 to 10 micrometers come from wood fires, construction and tire erosion. Smaller than 2.5 mcms comes from tail pipe emissions and power-plants and LPS particles (these are lipopolysaccharides or the proteins off of bacteria – polite term for sewer sludge). These little guys can get deep down into your lungs and kick off all sorts of immune reactions to your delicate lung lining. Then, there are the teeny, tiny < 0.1 mcm particles made by incinerators, engines, power plants. These little devils can penetrate anything. When accidents happen and children are tragically killed, autopies on them give us a window into these chemical effects.

Most importantly, when you breath, these particles can penetrate the nerve cells in your nose which whisks them up into your brain. I’m kidding, right? No, I’m dead serious. The tiny size particle can make it up into your brain. In cities, it is pretty common to have levels of 50 mcg per cubic meter of these particles. By big roads you can get levels as high as 110 mcg per cubic meter. In fact, the closer you live to a big, busy road, the more you can measure these effects.

Ok, so just what happens when this stuff gets into your brain? As a general rule, bad stuff. There have been many linking type studies to autism, MS, schizophrenia, sudden death, asthma, diabetes, ….want more? There is even research showing that babies are affected in their brains in the last three months of pregnancy, with impacts on their life long ability to make decisions, socialize fight inflammation.

The process that happens is that those micro-particles activate the microglia in the brain (they are the main immune cell in the brain).   This activation sets off intense immunoexcitotoxicity which is part and parcel of every neurodegenerative disease.

In Levesque’s article above from Mexico City, he showed that 58% of kids have the same lesions in their frontal cortex that you find in Alzheimer’s.   If they had the APOE4 genotype, 100% of the kids had lesions – as kids! Kids living in low pollution areas had a 0% rate of those findings.

When researchers look for what part of the brain is the most involved, they find the heaviest inflammatory burden in the part of the brain associated with Parkinson’s called the substantia nigra.   The second most involved area was the frontal cortex, the part associated with Alzheimer’s. There you have it.

WWW. What will work for me. Well, none of this does. I don’t want any of it. I live in pretty clean suburbs. I’ve stopped burning oil lamps in my home. The gunk on our windows bothered me. I bet it got in my lungs and brain too. I no longer follow big semi’s on the highway. I don’t burn my leaves in fall. I chop them.   I change the filters on my furnace every 3 months. And I’m paying attention to air, water and sewage pollution politics.


Pop Quiz

  1. Air pollution has particles in it from different sources, of which the smallest ones can penetrate into my brain through my nose. T or F

Yuck. True

  1. In your brain, your immune system clears the stuff out through the glymph system, neutralizing it. T or F

Where do you get that?   It does clear it, but now without intense activation of the immune system.

  1. The parts of the brain that are most effected by this inflammation are the same parts that are involved in Parkinson’s and Alzheimer’s. T or F


  1. The closer you live to a busy, heavily trafficked road, the worse it gets. T or F


  1. This problem can start before birth. T or F

Ouch, true.


The Circadian T3 Method (CT3M) for Adrenal Fatigue

The Circadian T3 Method (CT3M) for Adrenal Fatigue

Reference: Recovering with T3 by Paul Robinson

This is a very simple idea, wrapped up in some complex physiology. To date, we have defined “adrenal fatigue” as someone who is exhausted when they wake up, can’t get out of bed, need three cups of coffee to do anything and don’t feel rested all day long. When you measure their salivary cortisols four times in a day, you see low morning and/or noon cortisol levels. To date, in traditional Internal Medicine, we have said there is nothing particularly wrong with that, and tell you to go to bed on a regular basis and see an endocrine doctor who says, “There is no such thing as adrenal fatigue!%$&!”. Ok, ok. But in traditional anti-aging medicine, we have stated that you have to deal with your adrenals first BEFORE you start to replace thyroid hormone. We acknowledge adrenal fatigue and have lots of relatively slow acting responses to it, mostly using self care methods like extra sleep, laughter, friendship, hobbies and time off from your stressor. A few Chinese herbs and supposedly, you get better. Both thyroid hormone and cortisol affect energy – thyroid sets the idle on your engine, cortisol goes out and mobilizes the fuel to be burned. Both are needed to have good energy.

Cortisol is clearly secreted in circadian fashion, with multiple small bursts of ACTH in the early morning hours – an hour or so before awakening.   ACTH is made by your pituitary and stimulates your adrenals to make cortisol. The CT3M method that Paul Robinson supports is based on the premise that you can’t make cortisol in your adrenals if you don’t have the free T3 hormone that your body needs at the right time of day. If you are just taking T4 (traditional Synthroid) you are taking the pro-hormone that your body has to alter by lopping off one iodine and turning it into the active hormone called T3.   The enzyme that does that, de-iodinase, is based on selenium. If you don’t have enough selenium, you might not be able to activate thyroid hormones. For that, and many other reasons, you may end up with insufficient T3 hormone to satisfy your adrenal glands. Particularly, by taking T4 (or Synthroid) at one time of day, your effective T3 in the early morning when you are making ACTH may be too low to be effective. So, it’s actually low T3 at a critical time of day that leads to the low cortisol. (That’s the hypothesis.) Without sufficient T3 at the right time of day, your adrenal glands make no cortisol because they just don’t have enough “umph” to get off the couch and do their job.

What’s the method? Consider taking pure T3 (or natural dessicated thyroid with T3 in it) one and one half hours prior to your wake up time. If that’s 6 am, do it at 4:30.   If it’s 8, do it at 6:30. We want you to have another full 90 minute sleep cycle after that dose. You have to prepare carefully and lay out the dose on your bedside table with a sip of water, not waking up too much. The usual starting dose is at least 5 mcg of T3, maybe 10. The theory is that taking the free T3 at that time will provide the critical metabolic hormone to your adrenals and pituitary just at the point in time when they are producing pulsatile ACTH, and subsequent pulsatile cortisol. They key is that you don’t use sustained release. thyroid If you feel a wee bit better and have more energy upon awakening, that may be attributable to the T3 itself, but also to the fact that your cortisol is responding nicely. Prove it by taking another saliva series and see if your lab confirms your improvement in symptoms.

WWW. What Will Work for Me.   I have so many clients with exhaustion and early morning fatigue for whom our traditional methods of help have been slow or ineffective.   T3 is a touchy hormone.   There are reasonable concerns about too much causing heart rhythm disorders and bone loss so it needs careful supervision and monitoring. But when I hear credible clients say they weaned off their morning cortisol for the first time in years, I’m paying attention. This may be the opening of a door we hadn’t looked behind before. Time to look a little further.


Pop Quiz

  1. You make most of your cortisol in the late afternoon to match your activity level. T or F   False. You make it in the morning, and that matches your activity level. That’s why most of us feel most energy and creativity first thing in the morning.
  2. Cortisol is made in your adrenal glands in response to ACTH secreted by your pituitary, in response to CRH secreted by your hypothalamus. T or FTrue
    1. It doesn’t matter what time of day you take your thyroid hormone. T or F

    That’s what we have typically said

    1. Too much thyroid can cause fatigue too. T or F

    True. Many elderly have fatigue when over the top limit of normal thyroid range.

    1. T3 is needed for your adrenals to make adequate Coritisol – T or F.

    True, maybe. But maybe not as much as this method suggests. A very interesting idea for research.

    Cortisol is made in your adrenal glands in response to ACTH secreted by your pituitary, in response to CRH secreted by your hypothalamus. T or F


Tomatoes and High Blood Pressure

Tomatoes for High Blood Pressure

Reference: Fuhrman Antiox Redox Sigal, Armoza J Hypertension, Kim Atherosclerosis

Tomatoes contain lycopene. Lycopene is the bright red color in tomatoes (an watermelon and beans and other veges) that is part of the pathway to making Vitamin A, or β-carotene. It has 11 double bonds in it – which are it’s source of strong antioxidant activity. The color is pretty intense, so it doesn’t take all that much lycopene to make a tomato pretty red.   And eating a tomato raw doesn’t get as much lycopene as cooking it.

But now, along comes a constellation of research articles that really give us a better “flavor” for how useful lycopene can be. Hypertension is dangerous. The higher it is, the more mortality we have from cardiovascular disease.   The third hyperlink up above (KIM) is a powerpoint you can download that is a little lecture about hypertension and the benefits of lycopene.

The key to understanding of high blood pressure is changing our thinking about its cause. Most of us think that high blood pressure is caused by eating too much salt and that it happens to us naturally as we get older. Well, that’s just not true. In those shrinking parts of the world that don’t eat sugar and white flour, eat tons of vegetables and get abundant exercise, folks blood pressure drops with aging. In America, as many as 70% of us have high blood pressure by the time we are 70, making it one of the cardinal contributors to our epidemic of cardiovascular disease.

Ok. Explain what is the real cause of high blood pressure.   The real cause is the whole constellation of effects that cause “endothelial dysfunction”. That is a fancy term for the lining of your blood vessels getting all irritated.   And that is caused because we keep flooding our systems with oxidizing foods – most notably sugar and high glycemic foods (otherwise known as bread, cookies, donuts, bagels, milkshakes etc). Sugar, (15% of America’s calories) is 50% fructose. Fructose is a particularly wicked animal because it exhausts your liver, raises your uric acid, depletes your Nitric Oxide. Nitric oxide is the messenger in your arteries that tells them to relax.

There are other influences that make for inflammation in our bodies. Just being overweight raises the ante. Biopsies of your fat will show increasing white blood cells with increasing waist size, and increasing inflammatory markers flooding out of your fat.

Just what does the tomato extract lycopene do for me? It is a supercharged molecule of double bonds that eagerly suck up “oxidants”. Any chemical that is floating around in your blood, waiting to cause irritation by way of oxidation gets soaked up by lycopene. That stops the whole cascade at the beginning.

Can I get enough lycopene by eating tomatoes? Probably. But you need to eat a lot. Cooked is better. If I already have high blood pressure, will it help. Yup. 30 mg a day will lower your blood pressure as much as any blood pressure pill. And it’s just food.   Is it widely available? Well, that’s the kicker. Right now, not easily.

WWW. What will work foe me. This might be the most effective food extract that we have found to date to battle high blood pressure.   Step one has to be weight loss to reduce the inflammation coming from fat tissue. Step two needs to be cutting the sugar and white stuff – and then add a shake of exercise and pinch of stress reduction, and watch your blood pressure drop like a rock. Your arteries will thank you


Pop Quiz


  1. Lycopene is the red color it tomatoes and watermelon? T or F


  1. Lycopene is a champion antioxidant because it can soak up those chemicals that cause “oxidation” in my arteries. T or F

That’s it in a nutshell

  1. I can’t lower my blood pressure without getting a pill from my doctor. T or F

Wrong. Your doctor’s pill is likely only 25% as effective as your taking the matter into your own hands, losing weight, walking and then take some lycopene.

  1. I should eat more cooked tomato and tomato paste products.   Y or N

Sounds like a good plan

  1. And all the watermelon I want? T or F

Ouch. Watermelon has way too much sugar in it. Have a taste.