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SEPTEMBER 2024 TABLEHOPPING
DOCTOR DOCTOR GIVE ME THE NEWS
How often should you go to the doctor? Well, to me, that depends on whether you are working on your illness or on your wellness. Of course you can go to the doctor for a sore throat or painful joint but how about going to work on actually improving your health.
I think people , even people who think they are healthy, should go to the doctor once a year for a review of their health. From kids to old age. I know you think I am just trying to keep up the business. We are way too busy now to try and round up more work. Trust me…as long as you are eating at fast food places and gobbling sugar like hummingbirds, we health care professionals are going to stay busy.
I recommend a yearly review to consider your overall health. What meds are you on and why? What tests should you consider and why? What’s likely to kill you and can we do any testing for these issues? Are you getting fatter or fitter? There are relatively cheap devices that can tell your doctor how much muscle and fat you have. Why would you not want to track this over time.? Are you up to date on tests like bone density, mammograms and colonoscopies? I am not saying these are mandatory tests but they are tests you should consider and review with your doctor. Do you know your omega 3/6 ratio and your insulin resistance? These are reliable and reproducible markers of your true health.
Unfortunately most health care workers are better with the acute illness stuff like sore throats and sprained ankles than the chronic health issues like . Oh, we have plenty of experience with chronic health issues, but our current medication forward approach doesnt ever really improve the underlying conditions . Giving you a sugar pill or a blood pressure pill can improve your numbers but they do absolutely nothing to correct the underlying condition. Lifestyle changes can correct the underlying condition. Medications cannot. It’s just that pills are easier. Easier for you and the doctor. Check out the Michael Gregor video about the relative merits of medication versus lifestyle. https://nutritionfacts.org/video/The-Actual-Benefit-of-Diet-vs-Drugs/
Not taking any medications and all the tests you want are up to date? So maybe once a year is all you need. However, if you are trying to lose weight, quit smoking, develop an exercise routine, etc you can improve your chances of success by scheduling more visits with your provider to review and reinforce your progress. Sustaining your motivation can be difficult and I find it helps people stay on top of an issue if they know they are going to be held accountable at the next visit. Most of my patients need to work on some aspect of their health and I like to see them quarterly but I also have patients that I see weekly or monthly depending on the issues. As onerous as it can be sometimes to deal with the insurance companies I have yet in my 35 years of practice ever have the insurance companies complain that I was watching the patient too closely or seeing them too often.
When you go to the doctor you should have a list. Two lists actually…the first list should be your meds and supplements. Your doctor may not believe in supplements but they should know what you are on. The second list should be YOUR list of issues you want addressed.
What I focus on with the wellness visits is my basic four…Diet, Exercise, Sleep and Stress. Where are you now and where do you want to be and what are you willing to do to get there. Unfortunately the current primary care training doesn’t focus on lifestyle so YOU have to bring it up. I know I seem to be the odd man out medically, locally anyway, when talking about this stuff since so many providers just wont address them. I take some sucor in the words of Thomas Alva Edison; “The doctor of the future will give no medicine, but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease.”
As Doctor Casey Means writes in her book “Good energy” we “siloed” health care with so many specialties that medical care is overly fragmented. People are going to cardiologists, urologists, gi doctors to treat various symptoms and each provider looks at the problem through their narrow perspective and if the pill they give you doesnt work they suggest the next specialist. Her book is just one more in a growing series of books that comment on how broken our current system is…Exorbitant expenses and poor outcomes and no change in sight. In reality your lifestyle choices result in 80% of your outcomes. Most “experts” say that genetics accounts for only 20% of your health destiny. I don’t know the right ratio but I know a big percentage is lifestyle and that’s really where doctors should focus their attention. Headaches, stomach aches, skin conditions, arthritis, etc etc all respond to lifestyle changes. This has been shown over and over again but my healthcare partners all say they don’t know anything about nutrition or what diet or exercise program to recommend. If only there was some repository of knowledge the doctor could access to get some insight on these issues. Maybe some electronic device that we could somehow interface that might have this much sought after knowledge trove. Oh, wait, it’s called the internet and patients are accessing it and so too should we providers. I hate it when patients tell me the doctor they went to scoffed at them for doing their own research and says something about “where did you get your degree..”
It’s not rocket science …look at the careful sustained scientific work on health by Drs Gundry, Lustig, Perlmutter, Breseden, Hyman, Gregor, Malhotra, Knobbe and a host of others. The way forward to improve your health and the health of the nation is to get back to the basics ..it’s not as easy as prescribing medications but it’s much much more effective. The same lifestyle changes that will improve your symptoms will ultimately improve your health-gevity and that’s really what it’s all about.
Until next month, get well and stay well.
JT BARRY MD
AUGUST 2024 TABLEHOPPING
BEET IT !
High blood pressure , also called hypertension, is no joke. Sustained high blood pressure leads to heart attacks , stroke and hardening of the arteries that lead to kidney failure , dementia, peripheral vascular disease etc. It’s a leading cause of death and disability in the world. Your doctor believes that some people get hypertension and some people don’t. Your doctor will confirm your blood pressure and start meds. That’s a mistake. Hypertension is not the problem….it’s a symptom. What’s causing the hypertension is the problem! Fix that and you have fixed the underlying problem, not just the symptom.
First off, your doctor should not treat the blood pressure he sees in his office. If your BP is up in the doctor’s office it should be confirmed with home readings or, better yet, a 24 hr home BP monitoring unit. The BP most predictive of whether or not you will have a stroke or heart attack is your BP at night while you are asleep and you can only get that info from this type of monitor. It’s a royal pain to wear this monitor but the info obtained can be very helpful.
Secondly, if your blood pressure is elevated you should look for the cause and treat that ! Is it your weight? Is it sleep apnea (a very often overlooked cause for BP)? Is there a blood flow problem to one of your kidneys? Is there an oversecretion of one of your hormones? Is it a deficiency of potassium or magnesium? These issues are all easy to check with a variety of tests.
Why not work with your doctor to cut the carbs, try extra potassium, magnesium , arginine etc, before going to medications. Sure, the pills are easy but it’s much better to treat the underlying cause of the problem. Dr Greger of nutritionfacts.org fame has a great video that shows the benefits of treating the blood pressure with lifestyle changes has a much much more positive and beneficial effect than with meds. Here is the Youtube link:
https://nutritionfacts.org/video/The-Actual-Benefit-of-Diet-vs-Drugs/
Another option you and your doctor should consider is beets! Yes, the vegetables. Beet juice, derived from the root vegetable, Beta vulgaris, is rich in essential nutrients, antioxidants, and nitrates. Beet juice is recognized for its potential health benefits, especially concerning cardiovascular health, athletic performance, and cognitive function.
Beets and beet juice are a super source for nitric oxide which your body uses to relax blood vessels (and hence lower blood pressure). Nitric oxide is what Viagra releases so beet juice may have the same benefit as Viagra ! Beet juice also contains other chemicals which act as anti-inflammatory, polyphenolic etc. Beet products are available as the beet ( and why not try pickled beets ), powder, capsules, gummies etc. I don’t have any studies as to which works best but it’s an easy experiment to do on your own. The studies suggest that beet juice 250 ml per day will lower your blood pressure as much as the leading BP medications.
Now there are two issues with beets to consider. One is that they may change the color of your urine , this is called Beeturia and is harmless. The second is that while beets are high in fiber , and have all these helpful chemicals, they also contain high levels of oxalates. Oxalates are not your friend and in some sensitive people can cause kidney stones and widespread arthritis. So if you have a stone history or feel more aches and pains after starting a beet regime you should probably back off.
Of course, don’t do anything without consulting your healthcare team but why not ask to try some non-prescription interventions before resorting to the drug store. It’s your health and you should be actively involved in maintaining it!
Until next month…get well and stay well.
JT BARRY MD
JULY 2024 TABLEHOPPING
TAKE 3 SHOTS
I’m going to make a recommendation about your health again. Of course you should never take any advice from anyone without extensive consultation with your own health care provider. Nonetheless, this article will at least prompt some conversation about your health and that’s probably a good thing. I have been a 2 shot a day man myself, but I’m going to step up to 3 shots based on my most recent readings. By 2 shots I mean a mixture of cod liver oil and olive oil. Recently I have added a shot of vinegar to the mix. I take the vinegar first then a combo of the cod liver oil and the olive oil. It’s a great idea to just mix them altogether and use the mix as a salad dressing. Ok, it’s not a full shot like in a bar but it’s more than 2 tablespoons of each.
Let’s have a little primer on the ingredients:
Olive oil is rich in monounsaturated fats, which are known to support heart health in part by increasing good cholesterol (HDL) . It also contains powerful antioxidants like vitamin E and polyphenols, which combat oxidative stress and inflammation . Studies suggest that regular consumption of olive oil can lower the risk of chronic diseases such as heart disease, stroke, and certain types of cancer. Additionally, its anti-inflammatory properties can help manage conditions like arthritis . Unfortunately, there is a lot of adulterated olive oil so read the label carefully. Personally, I like the olive oil from the family farm in Turkey that’s available at the regional market ..It’s called AYVACO. I first ran into it at the State Fair. (And , no, I don’t get any kind of discount). Of course, any oil you intend to put in your mouth should be kept in a glass container and stored in a cool dark place. Don’t buy a year’s worth at a time as any oil starts to oxidize once it’s exposed to air.
Next let’s go over my favorite…Cod Liver OIl. You can use any fish oil capsules you like but you need to take 4 capsules a day to get any meaningful improvement and why not just slug down some Cod Liver OIl. I only use Carlson labs Cod Liver Oil with lemon in the green bottle. It really tastes nothing like what grandma used to give you.
The essential fatty acids , a vital part of your health , were never really covered in med school and still isn’t and the issue isn’t really discussed in nursing or the PA programs as well. The omega-3 fatty acids in cod liver oil are essential for brain health, reducing inflammation, and supporting cardiovascular health. These fatty acids are critical for proper brain and heart health and are a component of every cell membrane in the body. They can be easily measured by your doctor and you can see how far from optimal you really are and trust me you will often be surprised by the poor results. IIts like changing the oil in your car. You have to put the right oils in your body as well. Some critics say that fish oil increases risk of irregular heart rhythm and it did very minimally in one study. They also claim it raises bleeding risk. Dr William Harris is the best known Omega 3 researcher and he points out the fact that people with high levels of fish oil (EPA and DHA) in their blood lived an average 5 years longer than people with the lowest levels in their blood . This included death from any and all causes. This was shown in multiple large studies so the evidence is solid. What I really like about fish oil and cod liver oil etc is that you can easily and directly measure the levels in your blood to prove you are doing the right thing. QUEST the lab offers a very simple OMEGA 3/6 check.
Finally , the most recent addition to my morning routine is vinegar. Acetic acid. It’s fine as plain white vinegar but when you make it balsamic vinegar you get the polyphenols as well. Acetic acid is an essential food for the good bugs in your gut. Vinegar can help regulate blood sugar levels, making it beneficial for individuals with diabetes and prediabetes and that’s 80% of us. . It may also aid in weight loss by promoting satiety and reducing appetite .Acetic acid is much less acidic than the hydrochloric acid in your stomach and it is often used to help patients with indigestion. Read Dr Steven Gundry’s book Gut Check for more info on these postbiotics and the role of fiber and fermentation in your health. So maybe add some pickles to your dietary regimen as you have added pickleball to your exercise regimen.
Remember the blah blah blah check with your doctor. Until next time Get well and stay well.
JT BARRY MD
JUNE 2024 TABLEHOPPING
It’s getting closer to real summer and so I have a couple of reads for you. I have to watch a lot of videos and read many articles and lots of books as well. Some are written by the Doctors I follow like Dr Gundry, Dr Greger etc. Many articles are also suggested by my patients. Yes, I still get to read for pleasure so I sandwich in some Steven King etc between the study stuff. Recently I read two books that I thought were important so I wanted to share them with you. Both are about health but one is more about physical health and one is more about mental health.
Let’s start with GUT CHECK by Dr Gundry. I have been a fan since the book the PLANT PARADOX and have read all of this stuff but this latest is another great look at what really controls so many aspects of your health…the care and feeding of our microbiome. I am firmly in the camp that most diseases are due to metabolic issues and mitochondrial issues and this book looks in detail at both. Almost all chronic diseases are diseases of metabolism and what you eat, when you eat, how you eat affects your health directly . This book has lots of insights and helpful hints but fiber and fermentation are big issues which are well covered. Personally , I am staying far away from Kimchi and Kambucha but I am a big fan of pickles and vinegar. Dr Gundry points out the math…fiber is important, fermented food is important and the two together are synergistic so 1 plus 1 = 5. Sure Dr Gundry sells lots of supplements on the internet but that doesn’t invalidate his 25 years of nutritional research. Change your diet , change your life and health destiny.
Moving on to mental health we have THE FIVE LOVE LANGUAGES by Gary Chapman. It’s easy to fall in love. It’s not so easy to stay in love. I am always amused by people who put zero energy and effort into maintaining relationships and wonder how it went bad. Love , like your mind and outlook, is a garden that needs constant attention if you want it to grow right. Now, I am no expert at marital things and I dont have the experience of those of you who have been married two or three times but I think anyone who is in a long term relationship can benefit from reading this book. The five love languages are;
- Words of affirmation.
- Quality time.
- Physical touch.
- Acts of service.
- Receiving gifts.
What I like about this book is the section at the end where you can find out for yourself what your love language is and what your partner is and you can do this in an interactive way that I think will tell you something about yourself and who you love.I found out my wife already knew my love language. I also found out that just because someone knows your love language doesn’t mean they will use it ! A patient suggested this book to me and it took forever for me to get around to it but I am glad I finally did.
So, one book on physical health and one book on mental health. Next month we will take on the topic of the sun. Life giver or death dealer. Stay tuned.
Until next month…get well and stay well.
JT BARRY MD
May 2024 Table Hopping
MAY 2024 TABLEHOPPING FIND A NEW EXCUSE
As you must know by now, I’m all about 4 basic foundations of your health. My mom used to say her 4 F’s for living were faith, family, finance, and fitness. She lasted into her 90”s so she must have known something. My 4 foundations for health are; diet, exercise, sleep and stress and today we tackle exercise.. Whether you are a couch potato or a fit person these exercises will challenge you in a short period of time. As I question my patients about their exercise habits I often hear that they don’t know what to do. They don’t know where to go. They don’t know how to get started. They don’t know what exercises are right for them and they’re afraid of getting hurt and mostly they don’t have the time.These exercises I’m going to recommend today can be done by pretty much anyone, can be done in your own home, and take a very short period of time. Of course, any physical activity outside of your normal present the opportunity to injure yourself. Do I really have to tell you not to go crazy and do things that you are obviously not ready for? Check with your people.
Do we really need to spend any time talking about why exercise is important? independent studies have shown that your VO2 max which is a measure of your cardiovascular fitness and your muscle strength and balance are all important indicators of Aging well. As a geriatric specialist I see a lot of people who make it to age 80 but some of them are playing golf and some of them are in a wheelchair in the nursing home and the data strongly supports that exercise is very important in which pathway you go down. It’s not all in your Genes.
The beautiful thing about getting the exercise part of your life right is it also helps with the sleep and stress aspects of your life as well. Some people equate exercise with hours on the Peloton or the rowing machine or pushing iron in the gym. My suggestion is that a simple exercise done for shorter periods of time may give more noticeable results. You can do what everyone else does and blow it off as the rantings of yet another fringy healthcare provider or try the exercises and see for yourself.
Let’s start with the plank. How To: Plank It’s basically assuming the position if you were going to do a push up but never going down. You simply maintain this position for as long as you can without letting your gut sag. You can do this on your hands or on your forearms and this is a great one because it involves so many muscle groups in the body and it’s intense and most people can’t do it for very long to begin with. Start with whatever you can do and time yourself and you will notice that you can improve over time. Once you get to doing it for a minute or two you’ll understand.
The second exercise is to hang by your hands from a bar above your head. The Benefits of Hanging from a Pull-Up Bar – Also for Beginners The longer you hang the better it is for your shoulders, your back, your abdominal muscles Etc . Again, this exercise takes a very short period of time before you fatigue. don’t let that bother you, just keep track and see that you’re getting better on a regular basis..This all ties in with grip strength which has been shown to be an independent predictor of your mortality. I measure grip strength with a device in the office with my patients but more important than measuring it is trying to improve it and that’s what the hanging exercise is all about.
As pointed out in an article recently published by Dr Mercola, research done in the Journal of Cachexia Sarcopenia and Muscle which showed that grip strength is a reliable marker of your biological age . Interestingly they were using DNA methylation tests to assess premature aging. There was another study in 2022 that concluded measuring hand strength allowed for preliminary predictions on the current level of immunity and inflammation in the body. Again you can use those tennis balls and squeeze them with those hand gripper things that were popular years ago but if you want to improve your grip strengths you hang from a bar from as long as you can.
Finally we have the great doctor Zach Bush’s four minute exercise. ZACH BUSH MD | 4 Minute Workout. No getting down on the floor for this one. Everything is done standing up and it releases nitric oxide in that 4 minutes which has many robust beneficial health effects. It exercises 16 different muscle groups and as the name suggests only takes 4 minutes.
So now you have three different very short exercises almost anyone can do. You’ll have to find a new excuse as to why you are in the shape you’re in ! Until next month….get well and stay well…..JT BARRY MD
April 2024 Table Hopping
THE FDA IS OFF THE RAILS
Like everyone else I would love to believe that the government is in place to protect citizens and provide services but unfortunately as I get older and maybe a wee bit wiser I see the things are not as cut and dried as I’d hoped. This is ,unfortunately, especially true in medicine because the medical schools and the residency programs are not driven by science alone. You can no longer have full faith and trust in the federal government agency in charge of medications and treatments. I’m not writing about the incredibly incestious relationship between the pharmaceutical industry and the FDA. That’s about politics and this column is about facts. The FDA is approving drugs based on surrogate markers , not actually patient relevant results. This isn’t a one time thing…I will show multiple very recent examples. I don’t want to be the guy critical of big government and big pharma but this stuff could potentially affect a lot of patients and people aren’t getting this perspective readily elsewhere.
Here’s a great excerpt from an article published in one of the many JAMA variants entitled “Review Of Evidence Supporting US FDA Drug Approvals”. “Our results highlight a trend toward less rigorous standards for novel drug approvals that has evolved over the past few decades. In contrast to 2016, when 4 of 20 products (20%) were approved based on a single trial, single studies justified 65% of the 2022 approvals. In 2016, 55% of products were approved based on 3 or more studies, in comparison with 11% in 2022.1 “ The long and the short of this is that drugs are being approved with less and less rigor all the time. I’m going to give three examples from three different fields of medicine on how broken the system is. This review also pointed out that despite the regulatory requirements many drug trials do not get published so the real world efficacy of these drugs cannot really be easily ascertained.
One of my main complaints when reviewing these drug trials is all the fun and games they play with statistics …using composite and surrogate endpoints and misleading doctors with relative differences instead of absolute difference. For example if there is a drug trial with 1,000 people in each arm of the trial…test drug and placebo…Let’s say the test drug group had one heart attack and the placebo group had two heart attacks…Using relative risk you can say the drug cut the risk of heart attack by 50% but using absolute risk its one person in a thousand that benefits. What if the test drug group had more cancer diagnosis ..would they have to report that? Not really. I look for the ONE marker it’s hard to hide during anytrial…The number of deaths. The number of lives saved. Any important drug…a pill for heart disease, stroke , or diabetes should be measured not by how much lower your blood pressure is , how low the cholesterol number goes but by seeing that patients taking these drugs had less deaths. Lowering death rates , to me, is the most important marker of a drug’s effect.
Unfortunately , modern medicine has become so specialized that doctors lose focus on the big picture and just focus on their specialty. The neurologists don’t care if the drug they give you might increase heart attacks or increase cancer risk as long as it decreases stroke they are all for it. If you have a stroke the neurologist will want you on a statin because they have been shown to lower risk of recurrent stroke. The SPARCL study..High-Dose Atorvastatin after Stroke or Transient Ischemic Attack | NEJM used the highest dose of lipitor to show that it reduced recurrent strokes in patients who had a stroke. Lipitor did indeed reduce strokes ..by 2.2 percent but it doubled the number of hemorrhagic strokes which are usually worse than the more common ischemic stroke. Also total deaths and cancer deaths were HIGHER in the statin treated group. So the drugmakes the neurologist happy but using the highest dose of the drug had ZERO effect on whether you lived or died.
Sticking with cholesterol for the moment , let’s look at another recently approved drug, Bemedoic acid marketed as Nexletol. This drug was approved after only one trial that involved 13,970 patients. The FDA likes this drug because it lowers cholesterol. This next quote comes directly from the published trial “Bempedoic acid had no significant effects on fatal or nonfatal stroke, death from cardiovascular causes, and death from any cause.” That’s right, no effect on stroke, heart attack or death from any cause. ! And yet the drug was approved !
The FDA also approved Repatha. Evolocumab and Clinical Outcomes inPatients with Cardiovascular Disease | NEJM
This is another class of drugs designed to lower cholesterol and thereby lower heart attack and death rates due to CAD. This is a very expensive class of meds ( monoclonal antibodies which need to be injected ) and lowers cholesterol dramatically. Despite lowering cholesterol by an average of 60% (which is a huge reduction) there was only a slight reduction in heart events from 11.3 % to 9.8 %
there were more deaths in the group given the drug. How can the FDA approve ANY drug or intervention if the treated group has more deaths?
Speaking of more deaths in the treatment group. An independent analysis of Pfizer’s original covid vaccine trial showed also there were more deaths in the group of people who got the original vaccine than in the group who got placebo. Here’s a slide from the CDC itself showing this.
C4591001 COVID-19 BLA Safety and Efficacy Data For ACIP
How can you make it a mandatory vaccination if more people died in the treatment group than in the placebo group? I guess the infectious disease doctors would say..at least you didn’t die of covid.
Finally, and I could go on and on with examples , we have the new drugs for dementia. Now ,dementia is a real and growing problem in this country and elsewhere and we have had a real dismal track record of drug treatments for this with hundreds of trials not producing meaningful results. Big Pharma is focused on the plaques in the brain which can be seen on scans . We now know these plaques are a sign of the disease not the cause of the disease. Aducanaumab was the first approved drug in 2021 but is already being taken off the market by the manufacturer Biogen. Lilly has a drug, donanemab, which did not get approved inJanuary 2023. Finally there is Lecanamab made by Eisai which was approved July 2023. Like the other drugs , Lecanamab had very little clinical benefit, had significant side effects (i.e. bleeding in the brain) and made an important subset of demented patients worse! Somehow this doesn’t matter to the FDA but it does to me. I’m not sure what to do about all this except remain skeptical as always. Don’t be so quick to look for an answer to your health problems from a pill, look at your lifestyle. That’s where the real changes have to be made. Until next month…get well and stay well ….JT BARRY MD
CO Q 10 AND YOU
It’s time to focus once again on a supplement. When I first heard about CO Q 10 I thought it was a scam. After all, what happened to CO Q 1 through 9? However , as I did more reviews of the basic physiology of the cell, the cell membrane , and the electron transport chain responsible for creating energy in our cells , there it was ! CO Q 10 is a powerful fat soluble antioxidant that also has anti-inflammatory properties and plays a critical role in energy production . It’s found throughout your body in cell membranes but it’s most abundant in the heart, liver, lungs, kidney, spleen, pancreas and adrenal glands. Apparently production of CO Q 10 peaks around the age of 25 then begins to decline so that by the age of 65 your body makes only about half the amount. CO Q 10 exists in two forms ubiquinone and ubiquinol the latter is the reduced form that’s more easily absorbed but both forms are used by the body so don’t sweat that small stuff.
According to a review in the Journal of Pharmacy and Bioallied Science C0 Q10 is essential for the health of virtually all human tissue and organs. In some lists it is the third most consumed dietary supplement. Vitamin D usually tops these lists and for good reason but that’s another column. C0 Q10 protects the cellular membranes from oxidative stress induced by free radicals. Supplementation with 60 mg to 500 mg for 8 to 12 weeks can significantly reduce Tumor Necrosis Factor Alpha, Interleukin 6 and C Reactive Protein, all important markers of inflammation.. CO Q 10 is involved with cholesterol metabolism, regeneration of vitamin C and E, maintaining liposomal pH , sulfur metabolism, gene expression and amino acid metabolism.
Cardiac muscle cells have about 5,000 mitochondria per cell. Mitochondria are where C0 Q 10 concentrates. For further comparison, mitochondria make up 35% of the volume of cardiac tissue and only 3% to 8% of the volume of skeletal muscle tissue. In one study, 102 patients with atrial fibrillation were divided into two groups; one was given CO Q10 supplementation while the other group was given a placebo, after a year 12 people in the placebo group had a fib compared with only 3 people in the COQ10 group. Furthermore, a systematic review and meta-analysis of cardiovascular risk factors spanning 884 randomized control trials with 883,627 participants showed decreased all cause mortality in those taking the supplement.
CO Q10 acts directly on the endothelium lining our blood vessels and can directly lower your blood pressure. CO Q10 also decreases aldosterone ,a hormone that makes you retain salt and water research thereby also lowering blood pressure so there is a direct and indirect effect on blood pressure. Studies suggest CO Q10 can reduce ischemic lesions and improve outcomes after stroke. Interestingly, if you suffer from migraine headaches, CO Q10 may play a preventable role in that condition. A meta-analysis of five studies found CO Q10 was more effective than placebo for migraines.
Now, a major problem with CO Q10 is that it is blocked by statins. These are cholesterol lowering drugs like lipitor , crestor, pravachol, etc which doctors give out like candy because a number on a sheet of paper is higher than they like. So you lower your cholesterol number ( which I assert has little or nothing to do with heart disease but that’s another column) but you also block the beneficial effects of CO Q 10. Statins lower CO Q10 because they block the HMG coenzyme reductase enzyme involved in cholesterol production. The problem with blocking this enzyme is that it also blocks production of other important compounds including CO Q10. So , patients taking statins, and that’s most of you, should be supplementing with C0 Q10. Of course , check with your doctor or cardiologist but be prepared for a blank look because they dont bring this up in med school.
The body makes its own CO Q10 but it goes down dramatically as you age. You can get some CO Q10 from food as well, especially wild caught salmon, mackerel, sardine, eggs and organ meat. Good luck with that …I will take a capsule thank you. Now if you’re going to take CO Q10 as a supplement you have to avoid any CO Q10 that has vegetable oil in it. The unsaturated fat will damage the CO Q10 and it will not work properly.
You can take your health for granted or you can work actively to maintain this incredibly complex bio-electrochemical system we call the body. If you are curious, why not try the supplement and see if it gives you more energy or more vitality. There seems to be no real toxicity at the recommended levels. Of course, check with your health care provider yada yada yada.
Until next month…get well and stay well……
JT BARRY MD
February 2024 Table Hopping
Well, it’s February so love should be in the air. Valentine’s day is coming up so what medical advice do I have for you on this occasion? First, if you are waiting around for one day a year to express your affection to someone you are missing the proverbial love boat. Increasingly , modern medicine is recognizing the critical role that stress and social isolation have on your mental and physical health. All those little pills in your cabinet may not actually do you as much good as a long walk with friends. Dr Malcom Kendrick in his book The Clot Thickens points out a study wherein they used advanced computing methods to really investigate the factors leading to heart disease. Of the top ten causes, six were related to social isolation and stress !
We in the medical profession put way too much emphasis on the pills because it’s easy for everyone. Easy for us and easy for you but wrong. Ask your doctor who put you on the statin drug for your cholesterol, instead of working on your diet, how much longer you will live if you take the statin. According to a study published in the prestigious British Medical Journal “ The median postponement of death for primary and secondary prevention trials were 3.2 and 4.1 days, respectively.” PMID: 26408281. That’s right , published studies show you will live 4 days longer taking a statin. Dr Micheal Gregor from NutritionFacts.org has a great video that shows that medication really only makes a 5% difference in health outcomes…95 % comes from lifestyle .
https://nutritionfacts.org/video/The-Actual-Benefit-of-Diet-vs-Drugs/ and here’s a great video by him specifically regarding statins.
https://nutritionfacts.org/video/are-doctors-misleading-patients-about-statin-risks-and-benefits/ Ok, to move away from the heart and back to love..don’t expect any love making tips from me but I can give you a few suggestions as to how to improve your sex life. First off, regular exercise makes sexual performance better. Second, there are safe supplements to help with your testosterone levels including DHEA, DIM , and fenugreek. Yes, women have testosterone as well so I am not just speaking to the male readers.
If your testosterone levels are low , make sure you get checked out for sleep apnea as it’s a well known cause of low testosterone, along with alcohol, obesity, diabetes and narcotic use. Third, if you need to use viagra or cialis you should understand that erectile dysfunction is your penis’s way of saying you are not living right. As an aside…using goodrx coupons which are free on the internet at their site will drastically reduce the cost of these pills.
My son recently got engaged and I was wondering if he was looking for any advice on marriage. So far he hasn’t asked but if he does I will relate the lyrics from the old Charlie Pride song…”Kiss an angel good morning and love her like the devil when you get back home.” Don’t be blase about the most important person in your life.
Maybe you don’t have a special person in your life. All the more reason to stay connected to others via some organization or club/ group. There’s the Optimists, the Kiwanis Club, the Rotary, and church groups galore. Be a part of something bigger than yourself.
Until next month..get well and stay well
JT BARRY MD
January 2024 Table Hopping
It’s the beginning of the year and there must be untold columns, blogs, and podcasts preaching some type of resolution. Not me. Not this column. Resolutions put too much pressure on you. Some people change by taking baby steps and some people change by taking giant leaps…which one are you? As someone more eloquent than I said … .change comes from desperation or inspiration which won will persuade you? Unfortunately it’s desperation for most people, a new cancer or heart disease diagnosis CAN be very motivating but even then most people don’t really change their underlying habits.
We doctors suck at motivating people. Even though focusing on diet and exercise, sleep and stress should be the fundamental issues you deal with when you go to the doctor, we usually focus not on the underlying problem but on a medication to treat your symptoms. Watch the great video by Dr Michael Gregor https://www.youtube.com/watch?v=P0y-lO2YpuQ It’s entitled “the actual benefit of diet versus drugs”. It will be an eye opener for you. I shared this video at a Monday meeting we have at the office to review issues with the staff and I hope it will persuade some of my providers to look at your health differently. Sure, it’s very easy for doctors and very easy for patients to just take a pill to cover up the symptoms but the pills usually have very little impact on your health and underlying condition whereas changing your lifestyle can have a very very dramatic effect not only on symptoms but on the underlying disease process. You can take a pill to treat your indigestion or you can embark on the often frustrating mission of figuring out what’s causing the indigestion. Same thing for blood pressure, diabetes, headaches, etc.
So, trying to get you to change via inspiration rather than desperation seems like the better choice. As I said, doctors are not trained to motivate people so you are on your own in this regard but you are not without resources. My most successful patients ( and by success I mean in terms of health improvement) motivate themselves DAILY with something they read, or watch. Maybe it’s something inspirational, something informative or something challenging. All these options are available one click away on that device of yours. Of course, you know me, I think the cellphone has been transformative in the way we live and learn and its capacity to help you improve your health is only equaled by the damage it’s doing to us culturally.
Dr Robert Lustig addresses this beautifully in his book The Hacking of the American Mind which he summarizes in this lecture. https://www.youtube.com/watch?v=x4sRsb0a30Y. For something more local try Tim Smith of smiletherapy.com based right here in Camillus He will send you daily emails that inspire, amuse and get you thinking. It makes a great gift for that certain someone in your life….you never know what to get your grandkids anyway …why not try this?
Personally, I like watching short motivational videos like Arthur’s Inspirational Transformation https://www.youtube.com/watch?v=qX9FSZJu448. If that doesn’t get you thinking and moving maybe nothing will.
I hope this year you will find some way to improve your health and I hope it doesn’t stem from desperation. Focus on improving your health day by day now or focus on your illness and disabilities down the road.
Until next month…get well and stay well……JT BARRY MD
DECEMBER 2023 TABLEHOPPING
Well, it’s that time of the year to dispense with strict medical advice and lean into the holiday. SInce I’m an old heterosexual white male I am sure I am completely out of touch. I am happy to have new holiday experiences but I am drawn to my traditional favorites. My wife and I watch the same holiday movies, listen to the same holiday music etc. We have done the Lights on the Lake a bunch of times and often take in the Syracuse Stage show that’s holiday themed. One year we saw a play at Syracuse Stage one week and listened to a lecture by the original author of the same play a week later. We never miss the Solstice Celebration whenever someone produces that. We are down for seeing live Xmas shows of all kinds and we also never miss the DeSantis Christmas Show. Previously at the Palace but now ensconced for the second year at the Landmark Theater. The show is Sunday Night December 11th. It’s live holiday music from one of the last big bands in the area with great vocalists who really bring the holidays home. . What’s not to like? Don’t get your Mom another sweater, get her the gift of a night out together. Doesn’t have to be this show…there’s lots of shows now and throughout the year. As I have mentioned on the radio show I read a study recently that looked at what really made people happy and it wasn’t money it was time together with others in conversation especially over meals. Give someone a gift certificate to a restaurant you want to support or you know they like. Better yet, go out to dinner with them. Avoid the french fries of course.
Holidays are stressful and you better believe stress kills. So why not try to reduce your stress by expanding your social network. Some of you may be spread too thin already but most of my patients as they get older have a smaller and smaller social network and that’s not a good thing. Use the holidays as an excuse to get together and go from there. Is there a Christmas gift better than seeing a smile on someone’s face?
Speaking of happiness …Do you know there is a real difference , a biochemical difference between pleasure and happiness? Pleasure involves the dopaminergic parts of the brain and happiness involves the serotonergic parts of the brain. There is a great video by Dr Robert Lustig entitled “The Hacking of the American Mind” which you can find on Youtube.
Get outside, enjoy the cold while we have it because it will warm up in 7-9 months. Go for a walk ,safely , with someone and get some time outside. It’s very good for your immune system, your hormonal system, the cardiovascular system etc. Check out the sleigh rides at Highland Forest for that unique experience or try the ice at the rink downtown. If you want to be a force for good in the Universe, leave a note in someone’s mailbox if you like their Christmas decorations.
Sorry , none of my suggestions involve an app or swiping left or right…You don’t need the internet for any of the events I suggested. .I did tell you I was a traditionalist. Merry CHristmas and don’t forget the reason for the season. Until next month…get well and stay well……
JT BARRY MD