Monthly Archives: December 2018

Get to the Heart of Heart Disease with Aged Garlic

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References: Cleveland ClinicFood RevolutionCleveland ClinicReversal of Clogged ArteriesMol Nutr Food ResearchEuropean Heart JournalNatural Medicine,J Cell Mol MedJ Funct FoodsJ NutritionEuropean Jr Clinical NutritionCleveland Heart LabScience Daily,

This is hot! Published just a few weeks ago in the European Heart Journal out of the Cleveland Clinic is a real breakthrough study. We’ve known for five years that gut bacteria make TMAO from carnitine, and that is strongly associated with heart disease. Red meat, but not white meat make for more TMAO and less excretion of TMAO. And if you stop eating TMAO, it’s level returns to low levels within about a month. What fascinates me is that the connection to heart disease is through the RED MEAT and the TMAO made from it, not from the saturated fat. All the studies that frame saturated fat as the enemy neglect to note that it comes in the company of red meat. Perhaps that needs to be rethought! There may be an association with fat, it just has another wild card to parse out and fully understand. Or, there may not be.

What does TMAO do in heart disease? On reviewing all the literature, a recent survey finds that higher circulating TMAO is associated with a 23% higher risk of “cardiac events” and a 55% higher risk of all‐cause mortality. It’s worth knowing, measuring and aiming to reverse. Essentially TMAO appears to be the chemical that drives small dense LDLs into your artery wall, or plays a big role is so doing. (Or that’s about the best explanation I can find). It’s bad. You want less. 
This is where aged garlic comes in. It worksindirectly through gut bacteria to reduce your TMAO. Considering the central role that TMAO plays in heart disease, and how potent the ability of aged garlic is to reduce it, you might want to take another look at this.

The Kyolic Company from Japan is the main supplier of aged garlic, They soak it for 20 months in alcohol to rid it of its “garlic” flavor and get the favorable compounds properly developed. How much does it take? Well, one capsule doesn’t do the trick, but two to four are well tolerated and work according to the European J of Clinical Nutrition (for high blood pressure). That’s about one clove. 
Can you make your own? Sure. There are lots of videos on Youtube. Got a 20 months’ supply? It takes patience. Buy the pill.

www.What will work for me. I’m fascinated. I believe this is real and am delighted the Cleveland Clinic’s investment in functional medicine is beginning to pay off. Hereafter I’m adding AGED garlic to my regimen for every heart patient. And in my basement, I have my first jar of aging garlic in alcohol/apple cider vinegar. Two weeks down, 78 to go.

Pop Quiz

  1. What is TMAO?                                                                     Answer: A central player in heart disease. An amino acid you make more of by eating red meat.
  2. How does it make for heart disease?                                    Answer: Not sure but something to do with enabling lipids to get into the artery wall
  3. Where is TMAO made?                                                          Answer: In your gut
  4. What does aged garlic do to TMAO levels.                            Answer: much less, with less heart disease to boot.
  5. Does fresh garlic do the same thing?                                    Answer: Yes, to some degree but at a higher price: more odor.

Cancer Free? Get the “Ivy Gene” Test

Cancer Free? Get the “Ivy Gene” Test

References: Jenny Hrbacek’s Cancer FreeProceed Natl Acad Sci USA,

This might be the best test of them all, so please concentrate on this week’s cancer test: The IvyGene. The science if a bit dense, but not incomprehensible. The core function that is being measured is the patterns of signaling placed on DNA in cells. Your body attaches a carbon atom, with three hydrogens on it, called a methyl group, to DNA as a marker for something to happen. The proteins that read your DNA are designed to be able to interpret what those little nubbins of carbon and hydrogen mean when they are present, or absent.

Here is the rub. Cancer cells have a reliable pattern of methylation that differs from regular cells. If we have a sample of cancer cells in a blood test, we can measure their DNA and now find that those patterns are present, or absent, as the case may be to indicate either cancer is there, or no. And we can do that all years and years before the cancer is large enough to be detected on a CT scan or a physical exam.
Remember, go back to cancer physiology. A cancer colony that you can feel or see is often 1 cm in size, which is a billion cells. And a billion cells represents 30 doublings or generations of cancer. We want to catch those little buggers when they are at the 10 generation stage, not the 29 generation stage. And that’s what the IvyGene test does.

How accurate is it? The sensitivity is said to be 86% and the specificity is 88%. This is amazing for a medical test that is now allowing us a sneak peek years before our current testing methods.

What does it cost? Well, it has been $ 400 in the past but depending on where you get it drawn, the draw and shipping fee can add a bit to that. It has to be ordered by a physician, but to date insurance doesn’t pay for it. It should
www.What will work for me. I think this is the best test with the best science for managing the success of therapy. It has only been scientifically validated for colon, breast, liver and lung but others are on the list to become validated, so it’s worth asking about. I’ve got it in my office.

Pop Quiz:

  1. How does the IVYGENE test work?                                                  Answer: It measures unique to cancer methylation patterns on DNA.
  2. What on earth is methylation?                                                         Answer: How DNA is marked so that cells know how and when to copy genes. Cancer cells do dysfunctional growth which is visible on the methylation pattern seen on their DNA. Nifty. Gets right to the heart of the problem with cancer.
  3. How early can it be positive?                                                             Answer: We believe as much as 7 years before clinically visible cancer shows up
  4. Why is it useful?                                                                                   Answer: Two reasons. It rises and falls as a cancer grows or recedes, and it tells you if the cancer is even there. With that information you can make decisions about whether you think your therapy decisions are working or not.
  5. The IVG Gene is widely available? T or F                                         Answer: Well, you can get it anywhere you can find a doctor to order it for you. The traditional oncology system hasn’t used it widely yet.

 

 

Cancer Free? The AMAS Test

Cancer Free? The AMAS Test

References: Jenny Hrbacek’s Cancer Free?Andrew WeilCancer LettersScience DirectPeptides of Biological Fluids,

Right up front, read the standard, balanced, traditional medical world’s assessment of the AMAS test by Andrew Weil, and wonder why on earth I would write a column about it. Well, consider that Dr. Weil is ensconced in a medical school and is getting his advice from oncologists who make the vast, vast majority of their income from selling traditional chemotherapy, that you know and I know, in solid tumors doesn’t work very well. I admire Dr. Weil deeply, but I’m also skeptical of the pervasive influence of money.
I’m doing this column because I keep having clients asking for it because it makes sense to them, and as part of a basket of testing, it makes sense to me. The question is, is it valid? Does it say what it says it will do?
So, what is the AMAS test? It is a blood test, approved by Medicare, that measures for the presence of the antibody to a protein called malignin, present on most cancers. It is non-specific. It goes up and down with successful treatment. And it rises and falls with immune function. So, as the cancer overwhelms your immune system, which inevitably it does, it turns “false” negative. So a negative test may be an indicator of grave prognosis.

Its accuracy goes roughly as follows. Of 1,026 known cancer patients, 92.7% had a positive test with a mean level of 273. Normal controls have a mean level of 59 and outpatients out of a hospital without cancer are around 64. Up to 135 is considered normal.

Now, if you take known cancer patients whose level is below 135 (the so-called false negative), out of 135 patients, 90 will be dead within a year. Their immune system is being overwhelmed and they are in trouble. The cancer is winning.

This appears to me to be an interesting test. The antibody shows up when you have cancer. It can kill the cancer cell in a petri dish but inside your body, the cancer cell can hide and escape. It goes down when you are successfully treated. Where would you be helped with its use? How about when you have a positive mammogram and are skeptical that you’ve been fully evaluated? How about before you start taking estrogen therapy if you are worried about having cancer being initiated by the hormones. How about when you are losing weight and can’t find any reason for it. How about when your doctor says your cancer was successfully treated, and you want to make sure.

It’s a tool. It should be part of a basket of ideas that you know how to follow and monitor. It may not be the best, most precise, most accurate, but don’t let perfect be the enemy of good enough.

The problem is the dry ice. It has to be shipped on dry ice. That’s a bit hard to do. But where there is a will, there is a way.

WWW: What will work for me. I’m really curious about this one. It certainly appears to raise some people’s ire, but like all medical tests, it is a tool. I’m interested to see what they track record we can generate. In any case, I have the kits on order and found a source of dry ice that you can buy by the pound.

Pop Quiz

  1. What does the AMAS test test for?                                                   Answer: The presence of an antibody to a protein called malignin.
  2. What is malignin?                                                                                Answer: A protein put out by just about every cancer.
  3. When your cancer is very advanced, what happens to the test?            Answer: It starts to fall and drops off as the cancer overwhelms the immune system and races out of control.
  4. How can you tell the difference between an early cancer and one that is getting out of control?                                                                                                  Answer: You can’t. You have to get a series of tests and see what the slope of change is.
  5. Is this test useful?                                                                                 Answer: You bet, particularly when you are in a position of wanting to know early about the presence of a cancer. Example: you have had a mastectomy at age 35 and were told you were cancer free. You have just gotten married and met the man of your dreams, and you want to have a child. Is there cancer still in you. Would you be reassured?

 

 

Cancer Free? Check Your Circulating Tumor Cells

Cancer Free? Check Your Circulating Tumor Cells

References: Jenny Hrbacek Cancer FreeWikipediaTherapeutic Adv Med Onco,

Circulating tumor cells are not rare. Hang on. You may have them. Right now. Yup, everyone one of us may have circulating tumor cells that are being shed off a cancer. Your immune system may handle them and you may never get disease. Or, they may represent hidden disease that is still years away from presentation.
What they represent is that shedding and spreading of an original clone of cancer cells to distant places. The thought is that metasteses are what kill the majority of people with cancer by causing the disease to spread to so many sites that surgical control, or radiation therapy, can no longer keep up. When you hit about 1 kg of cancer total, your burden is so great your body cannot maintain itself and you succumb to the illness.
From our prior week’s newsletters, you should now understand that a visible 1 cm cancer lesion has a billion cells in it, which represent about 7-10 years worth of growth, or 30 generations of doubling. As the cancer grows, it sheds cells into the lymph system, or into the blood system and those cells float away. Generally, they don’t stick and survive. Most are filtered out and are gobbled up by your immune system. We think that the majority of them are able to successfully spread only when they travel in bunches or groups. But there they are, and that’s what will do you in. Your lung, your liver, your bones and occasionally your brain tend to be where the cells are captured and then establish a new colony. Cancers in the bowel tend to then spread to the liver, as that is the next upstream filter. Breast can go almost anywhere. Prostate is commonly in bone. On and on.

Hmmm. So, you may have circulating cancer cells floating around from a cancer that is only 13 generations into its growth, so is so tiny you can’t see it. You can’t feel it. You can’t find it to biopsy it. But with antibody technology, you can find it, bind it, measure it and know it is there. Just not exactly where. We can even find fragments of circulating DNA (ctDNA) from destroyed cancer cells that indicate something amiss; either the cancer cells dying and disintegrating from your immune attack. And all 5-7 years before it shows up clinically. At that stage, the cancer is likely to be more mature than a cancer at the 23 generation stage. Or more mature than the 27th generation stage, when it is still too small to be seen but is now even less mature and more aggressive and out of control. Earlier generations are more prone to be vulnerable to lifestyle changes: diet, supplements like curcumin, mushrooms, alkalinity, polyphenols.
And here is the kicker. What happens if you change your diet and exercise and after three months, your CTCs go down? Would you continue to eat the way you are eating with lots of vegetables and no animal protein? Would your fast mimicking diet not seem so onerous? You betcha.
The test is from Biocept in San Diego. They can also test for some specific markers of specific cancers like HER2, ER, EGFR, BRAF, ALK, PD-L1, KRAS, NRAS, PR, AR, ROS1, RET, MET, and FGFR1. And if you understood one word of that sentence, you are way ahead of the fame. The test needs to be done at least two weeks away from any prior treatment and requires a courier service to ship it. The company claims their validated biomarkers are 83-90 percent sensitive and 92-99 percent specific. Some insurance companies pay for it, and Biocept is willing to give it a try. But you can get it for around $ 700.

WWW: What will work for me. Goodness. This is a roadmap to allow folks with disease the opportunity to monitor how they are doing. It’s a bit pricey, but the data is pretty powerful. Knowing that you may be getting a 7-10 year jumpstart is pretty cool if you want to know. Would you get chemotherapy for a specific cancer before you could even see the cancer? It raises many issues, to be discussed by you and your oncologist/doctor. I’m doing it.

Pop Quiz

  1. Most people with cancer die from the size of their primary cancer? T or F         Answer: False. Most people die from the accumulated mass and disruption caused by the original cancer spreading to distant sites by cancer cells floating around and taking root in distant places. It’s still breast cancer if it started in your breast and is now mostly in bones. And it will very likely have protein markers you can measure on it.
  2. How big does a cancer have to be to show up on a physical exam?                   Answer: Usually in the range of 1 cm, which is a billion cells, which is 30 generations.
  3. What happens to circulating cancer cells when you start a lifestyle strategy change that is successful?                                                                                                                    Answer: The CTCs (circulating cancer cells) go down. Success!
  4. Which would you rather have, surgery on your lung to biopsy a cancer ($ 25,000 and 3 days in the hospital) or a blood test ($ 700 in 5 a minute blood draw)?                    Answer: Your choice
  5. The blood test for circulating cancer cells becomes? What?                               Answer: A liquid, affordable biopsy.

 

Cancer Free? Check your Metabolic Profile

Cancer Free? Check your Metabolic Profile

References: Cancer Free HrbacekWikipediaCancer ResearchBr J CancerOncotargetWorld Jr Biol ChemJournal of Cancer,

When cancers start they tend to become “less mature” in an increasing fashion. It shouldn’t be surprising that cancers have immature fetal proteins in them. Humans start as immature fetuses. Your first marker of being pregnant as a woman is having HCG (human chorionic gonadotropin) in your urine. That’s the little line that shows up on the pregnancy test you bought at Walgreen’s. It logically follows that the immature cells of cancers might make HCG, a fetal protein. Indeed, some unique cancers that start in the placenta skyrocket their HCG levels, but a lot of cancers have a little bit of HCG. By itself, that little bit might merit a shrug. The core idea of the American Metabolic Profile is to combine all the markers that show up in small amounts in various cancers into a panel of tests. Each one of them is not so remarkable. However, all of them put together combine to make a uniquely sensitive test. This may not tell you what you have, but it’s quantity may be useful in expressing how much you are progressing or regressing.

Here are the separate markers in the test.
1. HCG. As mentioned, the pregnancy test. Normal is less than 1 mIU/ml. 1-3 is a gray zone. Anything above 3 is something to be concerned about and monitor. This can show up as early as 10 years before an x-ray or physical exam will find the cancer. How does it relate to pregnancy? Less than 5 is “not pregnant” and greater than 25 is “pregnant”. It doubles every couple of days in pregnancy. Cancer is a different beast. A level of 2.2 might not merit a fire alarm. When it changes to 2.6 in this profile, it does!
2. PHI, Phosphohexose isomerase. Funny little protein that helps glucose shift back and forth with fructose. No big deal. But somehow it also ends up playing a role in helping cancers spread, metastasize. That’s exactly what you want to know. Normal is under 34 and the gray zone is 34-40. But any change is meaningful.

3. CEA: Carcinoembryonic Antigen. This has been found to be present in many folks with cancer, and rises and falls with the amount of the cancer. It shows up early. It is another of those embryonic ones we mentioned. Normal is under 3 and gray is 3.1-5 ng/ml.

4. GGTP: Gamma-glutamyltranspeptidase. This enzyme is bound to membranes in the liver and reflects damage to the liver. Its action is to break down glutathione into its individual amino acids. We like glutathione. Losing it is bad. Why cancer does this might be in part because cancers don’t like glutathione. So they try to make more GGTP to get rid of it. So let’s measure it and see how much you have. It’s part of that early detection thing.

5. TSH. Thyroid stimulating hormone. Go figure! For whatever reason, many folks with cancer have high TSH because their thyroid just poops out. Again, not dramatic, but combined with the others, makes for a red flag. Could this be why some folks advocate for more iodine to lower cancer risk?

6. DHEA-S. Dehydroepiandrosterone. It’s sort of thought of as the anti-stress hormone but curiously, again, it’s oddly low in many folks with cancer. You don’t want to be low. It’s a predictor of trouble. By itself, not certain, but nevertheless, a yellow caution sign. Normal ranges are: Females 35.0 – 430.0 µg/dL, Males 80.0 – 560.0 µg/dL.
That’s the list. Not remarkable in itself with its individual test, but combined has a close to 90% predictive accuracy. Its changes with therapy are useful. It is not specific to what type of cancer, but it helps to tell if you if your diet is helping you, your supplements, your IV Vitamin C etc.

WWW: What will work for me. I’m going to get this one on myself. I’ve just ordered a bunch of tests for my office. It’s going to be on the list of tests I offer my new clients who want to get a screening test just to know. Its cost of $ 549 is a slightly sobering fact.

Pop Quiz

  1. A high TSH means you have cancer. T or F                                      Answer: Heck no. It means your thyroid is struggling and not keeping up. But combined with the other tests in this screen, it may indicate you are at some risk. Consider taking some iodine just on general principles. Go for about 1 mg a day. Sea weed in any form. (Hurray, Sushi tonight!)
  2. Taking DHEA as a supplement will help prevent cancer. T or F Answer: We don’t know that. We do know that folks with cancer almost always have a low DHEA. Taking a supplement? Well, I do and I prescribe it to virtually all my clients. Evidence of rock solid proof is thin.
  3. Which one of these is the enzyme that encourages cancers to spread?            Answer: PHI
  4. Cancers all tend to be pretty mature cells? T or F                         Answer; Oops. Backwards. Pretty immature. Which is why CEA or carcino-EMBRYONIC-antigen is an indicator of a very immature cell.
  5. The validity of this test comes from what?                                     Answer: No individual one but the combination of all of them and their mutually supporting snap shot. To be used to measure the success of your efforts to bring the wicked disease to heal.