Is Your Body Inflamed?

February 20, 2012 By admin Leave a Comment

Inflammation is a central cause of accelerated aging and one of the most common problems we see in patients today.

If your arteries are inflamed long term you may suffer from heart attacks and strokes. An inflamed brain may lead to Alzheimer’s disease and memory loss. If your joints are inflamed you may have aches and pains and with time develop arthritis. Increased inflammation also increases your risk for cancer. Since fish oil supplements decrease inflammation, it should not surprise you that taking fish oil reduces your risk for heart attacks, strokes, and memory loss.

Both my parents have advanced arthritis, and in my late 50s, I’m aware of my own arthritis too. The good news is that my arthritis symptoms have dropped considerably since I added fish oil, curcumin, and glucosamine sulfate to my multivitamin regimen–now I take a multivitamin pack with arthritis support every day.

To clarify if you have signs of early arthritis and increased inflammation, look for:

Joint stiffness (especially in the morning)
Joint swelling, usually mild and subtle
Joint pain, especially after pounding activities

A useful blood test to measure inflammation is the high sensitivity C-reactive protein (hs-CRP) level. A normal hs-CRP level is <1.0, borderline is 1-3, and high cardiac risk is >3. Keep in mind that a recent infection causes substantial inflammation and your CRP level can jump to 10-20 after a bad infection. This value typically returns to normal within 4-6 weeks.

A recent study has shown that fish oil supplements containing long chain omega-3 oils lower CRP levels by 40% (Kamran et al, Clin Lipidol, 2011;6:723-729). Subjects took a fish oil supplement with 1,275 mg of EPA and 300 mg of DHA for 8 weeks to show a 40% drop in CRP levels.

If you aren’t sure how much fish oil you need, there are new blood test kits designed to measure omega-3 blood levels, ensuring your dosage gives you an optimal level of these critical nutrients. We have recently added these kits at the Masley Optimal Health Center.

Tips to Lower Inflammation Levels

Add fish oil daily, depending upon your health and symptoms, from 600 to 1,300 mg of EPA daily. (EPA provides the best anti-inflammatory activity of all the fish oils but you also need the DHA form as well.) To clarify high quality fish oil products, please see my article on Fish oil.
Take Curcumin, 500 to 1000 mg daily. As curcumin is poorly absorbed from Turmeric, see my article on Curcumin for details.
Avoid sugar and refined carbs, as sugar spikes prompt a jump in inflammation. Saturated fats from fatty dairy and fatty meats also increase inflammation levels.
Keep your body fat controlled, fat cells produce compounds that increase inflammation. Let us know if you need help achieving your weight and body composition goals.

Wishing you a life without pain and excess inflammation!

Steven Masley, MD, FAAFP, CNS, FACN

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Filed Under: Lifestyle and Nutrition, Osteoporosis

Five Secrets to Slow Memory Loss and Increase Brain Speed

October 29, 2011 By admin Leave a Comment

After a flight to Seattle last weekend to see my mom’s apartment in her new retirement center, I realized the importance of maintaining our brain function into our golden years if we hope to enjoy life long term. It was great to see my mom adapting to her new environment.

The brain is an incredible network of neurons and connections–giving us memory, processing capacity, and our many senses. Your brain function depends not only upon your genetic makeup, but also on how you nourish and care for it. Ironically, the memory center of the brain, called the hippocampus, is the most sensitive brain region susceptible to damage and aging.

Below are five simple secrets that will empower you to slow memory loss and enhance your brain speed and function: [Read more...]

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Filed Under: In the News, Memory Loss, Memory Loss, Mercury

Reversing Obesity, Optimizing Weight Loss

September 22, 2011 By admin Leave a Comment

While speaking to the ~ 5,000 physicians at the AAFP’s annual scientific meeting this week on obesity and weight loss, I made the point that our national obesity crisis impacts not just our health, but also our national budget, and the bottom line of every company’s medical insurance plan. Wake up America, we are losing the battle of the bulge!

While weight loss medications might provide short term weight loss and rarely cause heart attacks and strokes, and while very expensive weight loss surgeries have been shown to work long term but have significant side effects, we are not using truly effective lifestyle interventions (diet and exercise) that are shown to really work. See my Weight Loss Plan for details.

For people who fail appropriate attempts at weight loss through healthy eating and regular exercise, treatments and testing that need much more research and attention are detoxing and genetic testing.

Detox for Weight Loss

When people lose weight, they have the potential to release large quantities of stored pesticides and chemicals from their fat cells into their blood stream that adversely impact their ability to burn calories. This stops further weight loss and promotes rebound weight gain. Detoxing, to remove these chemicals as they are released during weight loss programs, may become the next critical step for successful weight loss. See my discussion on detoxing for details.

Encourage Genetic Testing for Customized Weight Loss Plans

If you aren’t succeeding with weight loss, perhaps you are trying the wrong diet. Results from recent weight loss interventions that included genetic testing show that some patients should follow a Mediterranean Diet, some a low-carb diet, and others a low-fat diet. Everyone is not created equal and it doesn’t make sense that everyone should be following the same eating plan. We have noticed excellent results using customized genetic testing (see www.Pathwayfit.com for details). I’ll discuss NutriGenomic Testing in more detail with a later post.

Of interest, at last week’s scientific assembly of the American Academy of Family Physicians (AAFP), I would estimate that these physicians (and physicians at the twenty 0ther medical meetings I have attended over the last year) have the same problems with weight control as average American men and women, with 1/3 appearing normal weight, 1/3 overweight, and 1/3 obese. Physicians need help with this crisis, too, which is a very clear sign to me that the standard weight loss recommendations that most doctors are using today don’t work.

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Filed Under: In the News, Lifestyle and Nutrition, Weight Control, Weight Control

Essential Nutrients for Bone Health: Calcium, Magnesium, Vitamin D, and Vitamin K

September 5, 2011 By admin Leave a Comment

OPTIMIZE BONE HEALTH—YOUR PLAN TO PREVENT OSTEOPOROSIS FRACTURES.

As men and women age, they lose bone density and are at increasing risk for debilitating fractures. Several preventative measures will help to maintain strong bones and prevent your risk for a fracture. The two most important factors for bone health are activity and nutrition.

Activity Builds Bone Strength

Bones need vibration to stay strong. Send a healthy fit adult to the space station in outer space, and they risk losing a lifetime of bone density in just a few months; now you know why they have a mini gym in the space lab for astronauts.

Bones need physical stress to stay strong, not surprisingly, weight bearing exercises (walking, running, elliptical machine use) and strength training (weight lifting, Pilates) are fantastic for your bones. Taking bone nutrients (calcium, vitamin D, etc) alone is not enough to maintain bone density.

Are you getting enough activity? Most experts recommend walking 10,000 steps daily (as measured on a pedometer), the equivalent of walking about 3 miles every day.

Bone Nutrition

Your bones need four primary nutrients to stay strong and prevent fractures: calcium, magnesium, vitamin D, and vitamin K (plus trace elements found in a high quality multivitamin). My favorite pill that contains all four is OsteoForce. For details on bone nutrition, keep reading:

Bone Nutrition Outline

How much Calcium do you need?
What is the best type of Calcium supplement? Are some absorbed and tolerated better than others?
Should you always take Calcium with Magnesium?
How much and what type of Magnesium do you need?
How much Vitamin D do you need?
Do you need to check a Vitamin D level?
What if you get Vitamin D, but you don’t get Vitamin K?
Why do you need vitamin K?
How much Vitamin K do you need for your bones and arteries?
What are food sources for vitamin K?

Calcium:

How much Calcium do you need? Calcium needs vary by lifestyle. If you do everything right, you do well with only 800 mg of calcium daily, but if you do most things wrong, 1,500 mg daily won’t keep you from fracturing later in life. I recommend that you select one of three choices that best matches your lifestyle:
1. You do everything right and you need 800 mg of calcium daily: meaning you get 45 minutes of weight bearing exercise 5-6 days per week, you lift weights 2-3 times per week, you don’t smoke, do not drink more than 1-2 servings of alcohol at a time, you get at least 1,000 IU of vitamin D and 500 mcg of vitamin K daily, you do not eat excessive animal protein or salt (>10 ounces meat-poultry-fish daily, >2,000 mg salt daily), and you eat at least 5 cups of fruits and vegetables every day. Sadly, this is only about 5% of Americans.
2. You do most things wrong, or, you already have osteopenia or osteoporosis and thus you need 1,500 IU of vitamin D daily: you don’t exercise; you get excessive amounts of alcohol, tobacco, animal protein, and/or salt; and you don’t get your 5 cups of fruits and vegetables every daily. This is about 20-30% of Americans today.
3. Most often, you are somewhere in between and you should get 1,000 to 1,200 mg of calcium daily.
Once you know your calcium requirements, calculate how much calcium you get from food. See the table below. To simply it, think of plain yogurt at 400 mg of calcium per cup. Milk, calcium-fortified soy milk, almond milk, & orange juice all have 300 mg of calcium per cup. Green leafy veggies (except spinach) have 100 mg per cup. Beans have 100 mg per cup. On a typical day (not a good or bad day), how much calcium do you get through your food?

Food Item Calcium content (mg)

Non-Fat Yogurt (8 ounces) 415

Non-Fat Cow’s milk (8 ounces) 300

Soy & Rice milk (Calcium fortified-8 ounces) 300

Orange juice, calcium fortified 300

Soy beans (edamame, 1 cup) 261

Sardines in tomato sauce (3.5 ounces) 240

Broccoli, cooked (1 cup) 175

Kale, and other cooked greens (1 cup) 100-150

Seaweed (dry Hijiki or Wakame) 100-160

Tofu (1/2 cup) 130

Navy beans (1 cup, cooked) 128

Garbanzo beans (1 cup) 80

Almonds (1 ounce) 75

Carrots (1 cup) 35

Brown rice (1 cup), or oatmeal cereal, (1 cup) 20

Whole wheat bread (1 slice) 20

Now that you know your calcium requirement, and your dietary intake, you can calculate how much calcium to add daily to meet your needs. If your dietary intake is lower than your requirement, either add more calcium rich foods daily, or take a supplement.

What is the best type of Calcium Supplement?

Protein-bound calcium or a calcium chelate (e.g. calcium malate chelate or calcium glycinate chelate) are by far the best absorbed and cause little to no gastrointestinal symptoms.
Calcium carbonate is the worst type of calcium as it may contain lead, must be consumed with food and even then has limited absorption, and causes constipation.
Calcium citrate is normally lead-free, but has limited absorption and can cause constipation.

Should you always take Calcium with Magnesium?

Absolutely. Please keep three facts in mind:

Most people are magnesium deficient
Taking calcium blocks magnesium absorption
Magnesium is critical for hundreds of health issues, in particular blood pressure and blood sugar control, preventing constipation & muscle cramps, plus preventing fatal cardiac arrhythmias.

So yes, if you take calcium, you should take it with magnesium. Many high quality calcium supplements come with calcium and magnesium in a 2:1 to 3:1 ratio, which is an excellent choice.

My favorite form of calcium and magnesium is OsteoForce, with a nice protein-bound form of calcium & magnesium, plus extra vitamin D and vitamin K, too. If you already get your vitamin D and vitamin K from other sources, then try our Calcium Malate Chelate and Magnesium Malate Chelate aiming for a 2:1 ratio.

Magnesium.

How much Magnesium do you need? Most people need about 400 mg daily. If you aim for 800 mg of calcium daily, then 300-400 mg of magnesium should be enough for you. If you aim for 1500 mg calcium daily, then 500-750 mg of magnesium is needed.
Does the type of Magnesium matter? Absolutely! There are many different types of magnesium, and the most common is magnesium oxide, which is a cheap form that often causes gastrointestinal distress (typically this is the type used to clean out your bowel before surgery or a colonoscopy). The best absorbed and best tolerated would be a protein bound form of magnesium, or the second best choice would be magnesium citrate.

Vitamin D.

Vitamin D is essential for calcium absorption and bone mineralization.

Vitamin D also impacts many critical aspects of health and proper intake is associated with reducing the risk of cancer, auto-immune disease, heart disease, and many other health issues.

How much vitamin D do you need? (See Get Your Vitamin D for details)

Most people need at least 1000 IU of vitamin D3 (cholecalciferol) daily. As we age, or if we have other health issues (bone density loss, auto-immune disease, cancer risk) then some people may need 2000 to 3000 IU daily. Talk to your medical provider before taking more than 2000 IU daily long term, although if your level is low, typically people take 5,000 IU daily for 2-3 months to bring their levels back to normal before continuing on 2,000 IU daily long term.

Vitamin D facilitates the absorption of calcium, helping to support healthy and strong bones. It also promotes bone mineralization. Get regular sun exposure (about 20-30 minutes a day is adequate), and take 2,000 IU of vitamin D per day – look for supplements that provide D3 (cholecalciferol) rather than D2 (ergocalciferol).

Should you check your Vitamin D level with a blood test?

If you have complicated medical problems, such as gastrointestinal problems, osteopenia or osteoporosis, auto-immune disease, cancer, then yes I suggest you check a level to ensure you are between 40-70.
Healthy people getting the dosages recommended above do not require this, although I check this at least once in all my patients to ensure they are at optimal levels. Absorption rates vary substantially and at times I am surprised how low some of my patient’s levels are.

Do you need to take Vitamin K with Vitamin D?

There are theoretical concerns that by adding vitamin D, which helps calcium absorption, in a vitamin K deficient person, this will increase arterial calcification. As there is a great deal of scientific merit behind this concern, I think it is critical to meet your vitamin K needs if you take vitamin D.

Vitamin K.

Why do you need Vitamin K?

Vitamin K was first identified to be essential for normal clotting, otherwise one might bleed to death after a minor cut.
Over time, we now realize that vitamin K is also essential for bone and artery health. Without vitamin K, bones lose calcium and arterials become stiff and hard as they cannot get rid of calcium from their arterial walls.

How much Vitamin K do you need for your bones and arteries?

The minimum for proper clotting is around 100 mcg per day (90mcg for women, and 120 mcg for men).
Yet for your bones and arteries, they function much better with at least 250 mcg of Vitamin K daily, and most experts in this field suggest that for optimum function you get 1,000 mcg daily. If you eat 1 cup of cooked greens, that provides ~1000 mcg of Vitamin K daily, while 1 cup of broccoli, onions, or beets provides about 250 mcg of Vitamin K.

Ten Years Younger options for Vitamin K:

-OsteoForce: 250 mcg Vit K/tablet
-Multivitamin with joint or arthritis support: 775 mcg Vit K/pack once daily
-Multivitamin with bone support: 1000 mcg with 1 pack taken twice daily
-Vitamin D 2000 IU daily with 200 mcg Vit K

Vitamin K Content in Food:

Food Content	Measure	mcg of K1
Kale, cooked, drained	1 cup	1,062
Collards, cooked drained	1 cup	1,059
Spinach, cooked(or ~7 cups raw)	1 cup	889
Beets, cooked	1 cup	697
Broccoli, cooked	1 cup	220
Brussels sprouts, cooked	1 cup	219
Onions, raw	1 cup	207
Parsley	10 sprigs	164
Cabbage, cooked(or ~ 3 cups raw)	1 cup	163
Asparagus, cooked	1 cup	144
Lettuce, iceberg	1/4 head	33

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Filed Under: Bone Health, Osteoporosis, Women's Health

How to Slow or Reverse Memory Loss and Cognitive Decline

September 1, 2011 By admin Leave a Comment

New cases of memory loss are reaching epidemic proportions. Not only is our population aging, but an unhealthy lifestyle can accelerate memory loss substantially. While we currently lack effective treatments for end-stage memory loss, especially Alzheimer’s disease, there is a great deal that can be done to slow or reverse early cognitive decline if detected early.

Memory loss and cognitive decline are frightening topics for several reasons:

There are many types of memory loss that are totally disabling (e.g., multi infarct dementia and Alzheimer’s disease) and eventually require 24-hour family or institutional support.
It runs in families and people with early memory loss often have memories of watching a loved-one suffer.
Eventually all of us will have some memory loss, but we do not know to what degree it will progress. This is why I measure cognitive function (computerized cognitive testing) in my patients at the Masley Optimal Health Center every 1-3 years.
Once someone has advanced dementia or Alzheimer’s disease, it is too late to reverse this process as the brain has essentially shrunk.

The good news is that there are promising treatments that appear to slow or cognitive decline and memory loss. Rarely, we can stop this progression completely, such as with vitamin B 12 deficiency.

In fact, at the Masley Optimal Health Center we have data showing that many of our patients have cognitive improvement—they are growing mentally sharper over time.

A common question that I hear is “Can’t I take a supplement for my memory?” The simple answer is that proper exercise, nutrition, and adequate rest and sleep are the most effective tools to slow or stop memory loss. So, if you feel you have these symptoms, please see your medical provider to discuss them first.

Once you have been medically evaluated for reversible causes (such as low thyroid function, mercury toxicity, or B12 deficiency) be aware that there are supplements that hold promise for slowing and/or potentially stopping cognitive decline. These include:

Vitamin B12 (usually obtained as part of a multivitamin, but most multivitamins don’t have nearly enough. Look for a multivitamin with at least 100 mcg and up to 1000 mcg daily)
Curcumin
Fish oil; For hints on selecting high quality fish oils, visit Fish oil (omega-3 oils) for details…
Vitamin D (see, How much vitamin D do you need?)
Mitochondrial Support combinations: (Co-Q-10, alpha lipoic acid, carnitine, cysteine, resveratrol—all available with two pills daily as MitoThera)

Six Key Steps to Optimize Cognitive Function and Slow Cognitive Decline:

Meet your nutrient needs as outlined in this section
Add daily exercise, preferably 40-60 minutes of aerobic activity daily
Get enough sleep, most people need at least 7-8 hours daily
Confirm you don’t have high mercury levels (See our article on Mercury for details)
Confirm you don’t have vitamin B12 or folate deficiency (requires a blood test through your medical provider)
At some point, I suggest measuring your cognitive function objectively.

The challenge is to customize a regimen that is realistic and affordable for you. Ideally, no person would develop dementia from something as preventable as B12 deficiency, but sadly, it happens every day. Curcumin and fish oil have many benefits, not just for cognitive function but for arthritis (see our Joint Pain section for details), and fish oil is good for your heart. Hopefully everyone has a normal vitamin D level as well. (See How much Vitamin D do you need?). The good news is that many of these brain protecting compounds are found in our Ten Years Younger with Arthritis Support supplement pack. At first glance, this might seem odd, but when you think it over, this makes sense physiologically as cognitive decline often represents excessive brain inflammation (a brain on fire) and decreasing inflammation is good for your joints, your brain, and many other aspects of aging.

Mitochondrial support compounds have tremendous potential and fascinating biochemical mechanisms to slow or stop cognitive decline, but all remain theoretical at this time as none have been shown (individually or in combination) to stop cognitive decline in clinical trials and likely this will take years, if not decades, to confirm.

Slowing research in this field are a variety of problems, including that supplements that are designed to slow cognitive decline:

Are expensive
Some have questionable absorption
Studies related to long term safety and efficacy are not yet available
And the fact that these compounds don’t last long in the blood stream, so some (Co-Q-10, alpha lipoic acid, etc) need to be taken more than once per day.

Because of problems with absorption and length of time they are actually active in the blood stream, it is extra important to ensure that if you choose to take supplements aimed at slowing cognitive decline, that you don’t try the cheapest products on the market. The Ten Years Younger with Brain Support kit is designed to provide a high quality version of an anti-inflammatory and mitochondrial support for someone with cognitive decline. Taking one pill of each of the following twice daily. This combination of pills will support mitochondrial function beautifully and minimize inflammation levels–both of which are critical for normal brain function.

Multivitamin with Advanced Cognitive Support with the six capsules listed below taken twice daily. If this exceeds your budget our pill intake capacity, consider option 2 below.

1 multivitamin capsule with adequate vitamin B 12
1 fish oil with extra vitamin D and vitamin K capsule
1 curcumin capsule
1 Co-Q-10 capsule
1 carnitine
1 resveratrol

Multivitamin with Cognitive Support (Less pills and expense than option 1 above)

2 multivitamin capsule with 400-1000 mcg Vit B12 once daily
2 fish oil with extra vitamin D and vitamin K capsule once daily
1 curcumin capsule once daily
1 MitoThera tablet twice daily

Optionally, add a Nrf2 activator pill 1-2 times daily for additional mitochondrial and brain support.

Lastly, if you or a loved one have early signs of cognitive decline, you need a comprehensive evaluation to see if there is a reversible process and I always recommend monitoring cognitive function longitudinally over time. I would highly recommend an evaluation at the Masley Optimal Health Center. Please visit www.drmasley.com for details.

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Filed Under: Lifestyle and Nutrition, Memory Loss, Memory Loss, Women's Health

How to Decrease Joint Pain & Slow Progression of Arthritis

August 20, 2011 By admin 1 Comment

How can I decrease my joint pain and stiffness, plus slow the progression of my arthritis?

Joint pain and joint stiffness is a hot topic, especially now that we have new, better, and safer treatment options. Rarely, joint pain can be a serious medical issue, so always check with your medical provider to exclude anything worrisome, especially if you aren’t improving.

The most common cause of joint pain is osteoarthritis (also called degenerative joint disease), which is caused by wear & tear or trauma to our joints, and impacts 20 million Americans. As the cartilage padding in the joint thins, the joint becomes inflamed, and if allowed to progress, eventually you have bone grinding on bone–causing substantial pain.

Daily non-pounding exercise is the best treatment for early to moderate arthritis. Movement keeps your joints flexible, prevents stiffness, and builds the muscles that support your joints.

Surprisingly, your diet has a big impact on joint pain. Eating refined carbs and bad fats increases inflammation, especially in arthritic joints. White rice, white flour, sugar, skinless potatoes, fatty meats, and fatty dairy (including 2% reduced fat dairy products that aren’t really low fat) all increase inflammation substantially. Enjoy exercise and a diet including lean protein, more seafood, abundant fruits and vegetables, beans, nuts, virgin olive oil and organic canola oil for cooking. With this type of dietary intake, many people achieve substantial joint pain relief within a couple weeks.

Medications help arthritis symptoms, but they have serious risks and they don’t slow progression of joint damage. Anti-inflammatory drugs (NSAIDs; e.g., Advil, Alleve, Naprosyn, Ibuprofen, Celebrex) improve joint pain, but increase your risk for heart attacks and strokes, kidney damage, fluid retention, and they often put microscopic holes in your gastro-intestinal system. So do not rely on Advil, Ibuprofen, Alleve, etc without talking to your doctor first. Tylenol (acetaminophen) is safer than NSAIDs, nearly as effective if taken regularly, but at high dosages taken long term it has been associated with memory loss in clinical studies. (Stewart WF et al. Neurology, March 2007)

If you would like herbal supplements to reduce your joint pain and potentially slow the progression of your arthritis, follow Dr. Masley’s simple steps for joint support:

1. First confirm that your vitamin D level is normal! Low vitamin D increases bone, muscle and joint pain, and is associated with higher cancer and cardiovascular risk. A normal level is >32, optimal level is 40-70, and most people need at least 1,000 to 2,000 IU of vitamin D daily.

2. Get your fish oil! Everyone should get at least 1,000 mg of long chain omega-3 fats daily for general good health. You cannot get this from flax or vegetable omega-3 oils. You need to confirm that your fish oil is not rancid and that the oil is at least 75% EPA and DHA. Sadly, this eliminates 90% of fish oil sold in America. More than any other supplement, be sure you buy high quality fish oil. If you have arthritis, taking 2,000 to 3,000 mg daily can provide substantial joint relief. If you eat three 4-5 ounce servings per week of salmon or sardines, this food intake will provide 1,000 mg daily, which isn’t usually enough to help people with arthritis. Always let your doctor know if you take more than 2,000 mg daily and be sure to stop high dosages one week before having surgery as high fish oil dosing may increase bleeding risk.

3. Take glucosamine! Not only does glucosamine sulfate decrease arthritis pain (especially effective for knee arthritis), but published clinical trials have shown that it slows progression of osteoarthritis of the knee. This supplement usually takes 6-8 weeks to work, and most people need 1,000 to 2,000 mg daily. Don’t be fooled into using chondroitin or other forms of glucosamine (stick to glucosamine sulfate), as they increase the price without any proven extra benefit.

A simple way to get all these items with good value and excellent quality is to try my Ten Years Younger Multivitamin with Joint Support pack; each box gives you a 2-month supply with an excellent multivitamin, 1000 mg of high quality fish oil (combine this with seafood intake 2-3 times per week and you average ~2,000 mg daily), 1500 IU of vitamin D, and 1,000 mg of glucosamine sulfate, plus extra calcium and magnesium.

4. You should notice a clear difference in just 8 weeks with the joint support, especially if you follow the Ten Years Younger lifestyle Program. If you need extra support, start with or switch to the Ten Years Younger Multivitamin with Arthritis Support. It contains the same excellent ingredients as the Multivitamin with joint support, plus adds Curcumin 500 mg daily. Curcumin is an incredible natural agent that lowers inflammation, but from multiple clinical and laboratory studies it has been shown to improve arthritis symptoms as well and over the counter anti-inflammatory medications, and is also associated with reducing cancer and Alzheimer’s risk. Always check with your medical provider before changing your supplement regimen if you have medical problems, especially if you take anti-coagulant medications.

5. For cases that defy normal therapy options, check with your doctor and, consider going on my Ten Years Younger Elimination Diet for at least 3 weeks.

6. If nothing helps and your doctor and medical imaging confirm a diagnosis of osteoarthritis, then you might also be a good candidate for joint injections by your physician. Cortisone injections have been offered for years for advanced arthritis, but new injection options that I’ve had success with and have been extensively studied (200 million injections given worldwide) include purified hyaluronate (such as Supartz). This can be injected directly into arthritic joints to decrease arthritis symptoms, but currently only osteoarthritis of the knee has an FDA approved indication, while other joints are being evaluated in clinical trials).

To your health and to less joint pain and stiffness too!

Steven Masley, MD, FAAFP, CNS, FACN

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Filed Under: Joint Pain, Joint pain, Women's Health

Menopause

August 18, 2011 By admin Leave a Comment

Menopause. Overview and Natural Therapy Options

Like puberty, menopause is a normal transition for a woman. The good news is that lifestyle choices improve bothersome symptoms for many women. Unfortunately, nearly a third of woman have severe symptoms that can last for years, so clearly they need help and support as outlined below.

Menopause Background Facts

Menopause occurs on average at 52 years of age, but can happen between late 30s to early 60s.
Menopause is defined when menses and hormonal cycling stops for at least 12 months, and specific pituitary hormones (FSH and LH from a blood test) are noted. Obviously, many women don’t need 12 months or a blood test to figure this out.
25% of women enter menopause surgically (they have their ovaries removed)
~30% of women take synthetic hormone replacement therapy (HRT)
~50% of women who start synthetic HRT stop in 1 year
Menopause occurs when the ovaries stop producing estrogen, with estrogen level decreasing by 50%. Estrogen still produced by the adrenal glands and from fat cells.
Many women have menopausal symptoms before menopause starts if they don’t ovulate and their progesterone production drops (Peri-menopause)

Menopause symptoms vary greatly but typically include hot flashes, night sweats, insomnia, cognitive dysfunction (sometimes described as brain fog), and vaginal dryness. Most of my patients can tolerate the hot flashes and night sweats to some degree, but the insomnia and slowed thinking are the most bothersome.

50% of women rate their symptoms as severe, 33% moderate, and 17% mild to none. 18% report their symptoms resolve after 1 year, 56% that they last 1-5 years, and 26% >5 years.

Natural Treatment Options for Menopause–Ideally You Won’t Need HRT!

Hormone replacement therapy (HRT) is effective, but has clear medical risks, such as heart attacks and strokes, so treatment should only occur when symptoms are fairly severe and over time attempts to wean off therapy are warranted.

What natural menopause therapies are shown to work? None are as effective as estrogen therapy, but add all these up and the combination can be nearly as effective for many women.

Daily exercise (30-40 minutes can lower symptoms 20-30%
Meditation 30 minutes 3+ times per week lowers symptoms 20-30%
Yoga 1 hour daily has been shown to improve symptoms
2 servings of soy products consumed daily lower symptoms 20-30%
Siberian rhubarb (not American rhubarb root that causes diarrhea) can lower menopause symptoms by 60-70%

Soy foods include edamame, soy milk, tofu, and various soy food products (like soy sausage, soy burgers, soy chick nuggets). the latest evidence on soy food intake and breast cancer is that soy decreases the risk of getting breast cancer, especially if consumed by teenage women, and if you have breast cancer, moderate soy food intake decreases the risk of dying from breast cancer too.

For menopause-induced insomnia, cognitive dysfunction, emotional ups and downs, and anxiety symptoms, Siberian rhubarb extract is very effective. I have had excellent results using a standardized extract of Siberian rhubarb, ERr-731 (sold as Estrovera) which has been studied in several clinical outcome trials. It has been shown to be very safe and effective. Of interest, Estrovera stimulates Beta estrogen receptors, not alpha estrogen receptors that are associated with uterine and breast cancer.

What hasn’t been shown to be effective? Studies using Black Cohosh and yams at best have shown mixed results and large randomize trials suggest they are not better than placebo. Dong quai is used commonly, but we don’t have randomized trials showing that it is effective and safe.

Pharmaceutical HRT

If for some reason none of these natural therapies control your menopause symptoms and you are considering pharmaceutical hormone replacement therapy, I have 3 strong recommendations, but every woman is special so please discuss these options with your doctor.

Use the lowest dosage that is effective and try weaning off your treatment every 6-12 months as able.
If you use estrogen, insist on topical estradiol. Topical estradiol comes in various FDA approved patches and is safer than taking oral estrogen.
If you use progesterone, insist on micronized progesterone, using 100 to 200 mg orally in a pill taken daily. Don’t use Provera (medroxyprogesterone) or other synthetic progestins as they are associated with both heart attacks & strokes and breast cancer.

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Filed Under: Women's Health

Cancer, What Supplements to Consider to Optimize Your Cancer Therapy?

June 6, 2011 By admin Leave a Comment

Supplements Cancer Patients Should Discuss with Their Physicians

Certain supplements may help decrease cancer progression. There is tremendous controversy about using supplements during chemotherapy or during radiation treatments, but there are useful options for some patients after completing cancer chemotherapy or radiation therapy. Patients with cancer should speak to their physicians regarding the option of adding the following to standard medical therapy. I do not recommend you use these on your own without discussing your treatment regimen with your physician as the worst thing to do would be to unintentionally block your current therapy from working:

Curcumin 4-6 grams once daily orally (Dr. Aggarwal, MD Anderson)
Inositol plus (Ip6) (Hexaphosphate) 40 mg/kg of body weight once daily orally (Dr. Irana Vucenik)
EGCg 250 mg twice daily orally
Maitake mushroom extracts may also provide benefit for certain cancer types 1 mg/kg of body weight orally of the MD fraction (Altern Med Rev 2002;7(3):236-239)

In addition, confirm that vitamin D levels are in the normal range (40-70 considered optimal) as these levels are associated with preventing cancer growth.

It is worth noting that cancer cells have limited metabolism and can only use glucose for energy, while human cells can use many substrates for energy. Many studies suggest that cancer cells cause insulin resistance, increasing glucose blood levels and stimulating their growth. Hence, if someone has terminal cancer and their goal is simply to be comfortable, one doesn’t need to restrict food intake and living it up with food might make good sense. Yet, if the patient has the possibility of their cancer being cured, or extending their life substantially, then the aim should be for excellent blood sugar control (level <90 mg/dl) by restricting all refined carbohydrate intake, including products made with sugar, flour (like bread), potatoes, white rice, and more than 1 serving of alcohol daily.

The keys to an anti-cancer diet would follow a low glycemic index food plan with extra lean protein, long chain omega-3 fats, low glycemic vegetables, berries, nuts, and legumes. Herbs and spices should be used extensively, especially garlic, ginger, turmeric and curry blends, rosemary, and other Herbs de Provence. There is also some evidence that unsweetened pomegranate juice is of benefit, in particular for prostate cancer.

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Filed Under: Cancer, Cancer, Women's Health

How to Reverse Depression

June 2, 2011 By admin Leave a Comment

Depression is frequently the end result of longstanding, overwhelming stress that has not been adequately managed. People often think of depression as sadness, but in a medical sense, a major depression actually refers to diminished brain chemical function that persists for a prolonged period of time.

Often, bereavement (a normal response to a sudden devastating event (death, divorce, etc), can lead to depression over time if the stress related to the loss is not adequately dealt with and supported. Nearly 50% of people become depressed over 2-3 months after a life event that causes profound grieving.

Outline for Understanding and Dealing with Depression

What are the symptoms of a major depression?
What causes depression?
How do you prevent depression when stressed?
What are treatment options for depression?

What are the Symptoms of a Major Depression?

Symptoms of prolonged and depressed brain function would be:

Low energy
Poor concentration
Problems with sleep (either excessive sleep or inability to sleep, in particular with frequent awakenings at night)
Low drive (exercise drive, romantic drive, appetite drive)
Anhedonia (inability to experience pleasure, nothing seems fun anymore)
Other symptoms could be sadness, chronic pain, and anxiety

Three of the first five would be suggestive, with five of the first five typical for a major depression with depressed brain chemistry. Sign #5 (anhedonia) is the strongest single sign of depression.

What Causes a Major Depression?

Depression clearly runs in families and there is a genetic predisposition. Yet, the most likely thing to cause a major depression is not your genes, but rather chronic stress that is not managed and leads to depressed brain chemistry, especially depletion of serotonin function in the brain. Your lifestyle plays a critical role in whether you manage the stress in your life adequately to prevent or reverse depression.

How Do I Prevent Depression When I’m Chronically Stressed?

Keys to preventing depression are the same keys the Ten Years Younger Program uses to help soothe and induce relaxation

Get regular exercise, ideally 5-6 days per week. Exercise helps to burn away tension, and is much more effective than prescription or non-prescription drugs.
Get adequate sleep. Most people need at least 7-8 hours of high quality sleep nightly. (See: Tips to Dealing with Insomnia)
Don’t overdo alcohol or caffeine. Alcohol in particular makes people depressed. Having more than 1-2 servings of either on a daily basis is simply too much.
Add 15-30 minutes of peace and calm daily. Go to a yoga class, try meditation, or listen to relaxation tapes. You need some mental peace to drop your stress hormones daily.
If you are deficient in B vitamins and/or long chain omega-3 fat (fish oil), then this increases your risk for anxiety and depression. So be sure to eat well, take a high quality multivitamin, and be sure to get your vitamin D and fish oil daily, especially when you are chronically stressed.
If you are not coping, then seek counseling from a mental health profession. Do not wait until you feel desperate.

If you reach the point where you are desperate and suffer from a major depression, it is much harder to recover. If you have 3 or more of the vegetative signs of depression noted above, you need to seek medical attention. If you ever reach the point where you cannot face going on and you have suicidal thoughts, then you need emergent medical help.

What Are Treatment Options for Depression?

Always make an appointment with a medical professional if you have reached the point that you have signs of a major depression.
Don’t let your nutritional intake fall. 80% of Americans don’t meet their key nutrient needs. If you don’t get your B vitamins, vitamin D, and long chain omega-3 fats (fish oil) you will have a much higher risk for developing depression, of not responding to anti-depression medications, and (if you start medication) being unable to wean off of them over time. The simplest approach to ensure you meet your minimal nutrient needs for depression would be a good quality multivitamin plus fish oil plus extra vitamin D.
Get daily exercise! Like proper nutrition, daily aerobic exercise helps prevent depression, makes it more likely you will respond to anti-depressant medication, and makes it more likely that you will get off of your medication without any relapse. If you need help with your exercise routine, then hire a trainer or make an appointment with one of our exercise coaches. See Coaching.
There are supplements that have been shown to be effective for minor depression, and that can compliment medications when used under the direction of your physician. St John’s Wort and SAM-e have been shown to be effective in clinical trial for mild depression; WARNING, some supplements do interact with anti-depressant medications (and can cause significant adverse reactions when combined with certain medications). Therefore you must discuss using these preparations with your physician before combining them with anti-depressant medications.

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Filed Under: Depression, Depression, Women's Health

Skin Rejuvenation

May 30, 2011 By admin Leave a Comment

Yes, your skin can be younger, softer, lighter, less wrinkled, and less likely to tear or bruise. The following six easy steps to Ten Years Younger skin can make your skin healthier, more radiant, and decrease your future risk for skin cancer (for details, refer to my Ten Years Younger book, Chapter 9).

Step 1: Don’t allow sunlight to age your skin

The first step to skin rejuvenation is to stop damaging your skin with excessive sunlight exposure. Tanning is a sign of skin damage and is not healthy. 80% of facial skin aging is attributable to sun exposure. Sun tanning produces vitamin D, but you can easily get your vitamin D through a supplement without aging your skin. You can safely enjoy 15-20 minutes of sun before 10 am and after 3 pm, but if you plan to stay out longer, or go out during the 10 am to 3 pm time, wear some form of sunscreen.

Sunlight contains two types of ultraviolet rays that damage your skin. UVB are the burning rays that cause sunburn and skin cancer. UVA rays don’t burn, but instead age your skin, in particular by damaging collagen which is the protein that gives your skin elasticity, support, and structure. Many sunscreens provide adequate UVB protection (preventing burning) but not enough UVA protection (leaving your skin wide open to accelerated aging).

The Ten Years Younger Program has elected to use skin care produced produced by Skin Medica. The sunscreens produced by Skin Medica block UVA and UVB rays and are made with high quality ingredients that don’t harm your skin and are not greasy.

Step 2: Increase your antioxidants

Surprisingly, your food choices can rejuvenate your skin. Lycopene, the orange-red pigment in tomatoes and watermelon protects your skin as do many other plant pigments. Enjoy at least five cups of colorful fruits and vegetables daily to protect your skin. For example, during a typical day have a bowl of blueberries, a big green leafy salad with sliced red tomatoes, an apple, and a double portion of sauteed broccoli, yellow peppers, and red onions.

Avoid oxidants, such as tobacco which greatly accelerate skin aging. Have you ever noticed that smokers have twice the wrinkles they should? Each puff approximately doubles their rate of skin aging.

You can also add antioxidants to skin lotions, with agents like CoQ 10, green tea extract, vitamin C, and vitamin E. Keep in mind that many less expensive brands are not designed to actually penetrate into the skin.

Step 3: Hydrate Your Skin

Moisturizing your skin won’t make it physiologically younger, but it will clearly make it look and feel better. Top end products do more than moisturize as they often include anti-aging hydrating agents with antioxidants to repair skin damage noted below, plus SPF sunscreen to protect your skin from the sun.

Moisturizers help your skin by trapping the moisture within your skin.

The cheaper and most common lotions help the outer skin layer retain fluid, they don’t really provide much skin hydration. Good examples are lanolin and paraffin.

Hydrating agents include alpha hydroxy acids, propylene glycol, tocopheryl acetate and urea. These agents penetrate into the skin and diminish the appearance of wrinkles making your skin feel younger and softer.

In contrast, avoid soaps and detergents that dry and chap your skin. The more you bathe and expose your skin to soap, the worse your skin becomes. Much wiser would be to use a cleanser, made especially for your face. A high quality cleanser should remove dirt and environmental pollutants without harshly drying your skin. The best cleansers contain hydrating agents.

Step 4: Add Vitamin A to Your Skin

Vitamin A (also known as retinol or retinoid) skin creams have been used for decades to improve skin appearance and to treat early signs of skin cancer. If you add Vitamin A to your skin on a regular basis, it will be shinier, smoother, less wrinkled, stronger (with more collagen), will show less irregular discoloration plus, will reduce your risk for skin cancer.

Retinol is used in high prescription medications to treat acne and the early forms of skin cancer, but these pharmaceutical products are often greasy and cause redness, peeling, and irritation.

Milder forms of retinol creams can be used daily long term, usually providing the vitamin A benefit without the side effects of Vitamin A prescriptions. The challenge is finding an over the counter product that contains enough retinol within to actually work. The best product I have found for this purpose is Tri-Retinol Complex, which is gentle on your skin. If you need a little more powerful agent, which for gentle skin may cause modest peeling, I like Tri-Retinol Complex-ES.

Step 5: Use Natural Hydroxy Acids on Your Skin

Hydroxy acids are natural compounds found in fruit juice, wine, milk and willow bark. They speed the skin cell cycle encouraging your skin to shed the rough surface cells. Cleopatra applied sour goat’s milk to her skin, while Marie Antoinette used wine; they knew their skin would be more radiant with regular use.

High potency concentrations are used by spas and doctors to induce chemical peels. But regular lower dosage lotions are safer and over the long term provide the same type of benefit.

One caveat to remember. Using hydroxy acids will make your skin younger looking, but it will sun burn more easily as well. If you do not use sun protection from hats or sun block, then do not use hydroxy acids on your skin.

Step 6: For Skin Damage, Apply Skin Cell Growth Factors

Burn research has made tremendous progress over the years with burn centers growing skin from human stem cells that can be used to treat severe burns. Stem cells used for burn patients release skin cell growth factors that promote skin healing, collagen formation, and when applied to the skin in a gel or lotion will truly reverse skin aging and fine wrinkles.

A worthy question should be, “Where do they get the stem cells?” The good news is that they do not come from embryos or infertility clinic cell lines, rather they come from foreskins that are discarded after a circumcision.

This technology does not come cheap but if used twice daily for six months, can reverse past skin damage especially if combined with retinol and hydroxy acids. One of my reasons for choosing the Skin Medica skin care product line is that they have a patent on TNS, which contains these stem cell growth factors.

Baseline photo

3 months after TNS Recovery complex

SKIN CARE SUMMARY

To have success at rejuvenating your skin, you need to choose a plan that is simple and realistic. Two suggested plans are listed below, the first is the minimum I would recommend for skin rejuvenation, and the second is more comprehensive.

If you want to aim for the minimum plan to save on expense:

In the morning wash your face gently with a nondrying cleanser. Then apply a moisturizer with a mild SPF sunscreen . If you venture out into intense sun, add a 30 SPF sunscreen every 2-3 hours as needed.
In the evening before going to bed, wash your face gently with a nondrying cleanser. Apply a retinol cream Tri-Retinol Complex or Tri-Retinol Complex ES. Then add a hydroxy acid cream at this time.

More comprehensive and beneficial long term:

In the morning wash your face gently with a nondrying cleanser.
Apply TNS Recovery Complex or TNS Essentail Serum to your facial skin.
Then apply a moisturizer with a mild SPF sunscreen (10-20). If you venture out into intense sun, add a 30 SPF sunscreen every 2-3 hours as needed.
In the evening before going to bed, wash your face gently with a nondrying cleanser.
Next, apply TNS Recovery Complex or TNS Essentail Serum to your face, perhaps the backs of your hands as well.
Over the TNS Recovery Complex, apply Tri-Retinol complex, or, the Tri-Retinol Complex ES (extra strength)
Lastly, cover with a moisturizing lotion with hydrating ingredients, such as Ultra Sheer Moisturizer or Dermal Repair.

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Filed Under: Skin Aging, Skin Aging, Women's Health

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Outline for Understanding and Dealing with Depression

What are the Symptoms of a Major Depression?

What Causes a Major Depression?

How Do I Prevent Depression When I’m Chronically Stressed?

What Are Treatment Options for Depression?

Step 1: Don’t allow sunlight to age your skin

Step 2: Increase your antioxidants

Step 3: Hydrate Your Skin

Step 4: Add Vitamin A to Your Skin

Step 5: Use Natural Hydroxy Acids on Your Skin

Step 6: For Skin Damage, Apply Skin Cell Growth Factors

SKIN CARE SUMMARY

Dr. Oz recommends Ten Years Younger!

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