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Preventive Medicine Associates, PLLC

Why We Test Insulin Blood Levels

Customers who order our blood test panels often ask why we measure fasting insulin.

One reason is that higher fasting insulin levels are correlated with lower life expectancy’ and increased risks of cancer2-5 and cardiovascular disorders.6-8

Insulin production is regulated by blood sugar levels and hormones. Fasting insulin increases in response to insulin resistance.9,10

At first, higher insulin levels can initially help drive glucose out of the blood into cells.10

As insulin resistance worsens, even greater insulin secretion fails to adequately normalize blood glucose.10

A missed opportunity for early diagnosis occurs when fasting insulin is omitted from blood panels that measure glucose and Al c.

Higher levels of insulin can temporarily reduce glucose and Al c in a way that masks glycemic control issues.10

Preventive Medicine Associates, PLLC

In other words, glucose and A1c may appear “normal” on blood test results. But without testing fasting insulin, this may create a false sense of security by not recognizing that the “excess” insulin is helping to keep glucose and Alc within ) acceptable ranges.11

Before full-blown type II diabetes manifests, subop¬timal glycemic control is associated with increasing risks of the most common diseases12 of aging.13-16

Further, worsening glycemic control can silently contribute to diabetes, leading to peripheral nerve damage (neuropathy), chronic kidney disease, and/ or loss of vision (retinopathy).17

Newly diagnosed diabetics often ask why so many morbidities afflict them so quickly. The answer is these pathologies were festering for years as a result of suboptimal metabolic control, which could have been identified earlier with proper blood tests.

Some studies have shown that fasting insulin levels are a more accurate predictor of cardiometabolic risk, compared to tests for insulin resistance.18,19

One of the most serious global health problems today is metabolic disorders related to obesity and insulin resistance.20-2 Effective methods (diet and exercise) can slow or halt progression to type II diabetes—but prevention is critical.

That’s why it’s essential to include fasting insulin with glucose and Alc blood testing to get a more accurate understanding of your glycemic status.

Type II diabetes is surging higher worldwide among all age groups.

The Centers for Disease Control and Prevention is running public service ads (one copied on this page) warning that one in three American adults is at risk for prediabetes.20

The term “prediabetes” can be misleading.

Few realize that the initial stages of glucose imbalance inflict severe tissue damage. This happens before full-blown type II diabetes is officially diagnosed.6

These pathologies are not limited to adults. There was an astounding 95% increase in Americans under age 20 living with type II diabetes between 2001-2017.22

Need for Early Intervention

Preventive Medicine Associates, PLLCMost cases of type II diabetes begin when cells slowly become resistant to insulin.20

When this occurs, glucose buildup in blood causes the pancreas to secrete higher levels of insulin to force glucose into cells. This temporarily helps compensate for insulin resistance in target tissues (e.g., skeletal, muscle, liver).

During the period of insulin resistance, weight gain may be an outward sign of loss of glycemic control. This happens as elevated levels of glucose + insulin contribute to unwanted fat storage.1,23

Weight gain and physical inactivity increase the risk of developing insulin resistance.2

As insulin resistance worsens, insulin levels often rise as the pancreas attempts to compensate and literally force glucose into target tissues that have become resistant to the action of insulin at a cellular level.1

Preventive Medicine Associates, PLLCIf a blood test reveals high fasting insulin before glucose and Alc become elevated, this provides an opportunity to identify diabetes earlier in the process, before extensive damage occurs.

Published data suggest elevated fasting insulin can be a useful diagnostic tool for identifying early-stage insulin resistance.24

One study found insulin resistance to be the most important predictive risk factor in the development of coronary artery disease.25

Other studies recognize the prognostic value of fasting insulin and suggest that hyperinsulinemia (high fasting insulin) is often both a result and a driver of insulin resistance.16

A consistent association exists between hyper¬tension (high blood pressure) and elevated insulin.26

Mechanistic factors have been identified to explain why tissue damage associated with “excess” insulin and insulin resistance causes blood pressure to spike.27

Kidney Damage

Chronic kidney disease is surging, coinciding with an increased prevalence of obesity, hypertension, and diabetes.

Insulin resistance and hypertension predispose to premature atherosclerosis28,29 and other pathologies that contribute to chronic kidney disease.21,32

Cardiometabolic syndrome, (a constellation of metabolic dysfunction characterized by insulin resistance, impaired glucose tolerance, dyslipidemia, hypertension, and intra-abdominal obesity) is associated with an increase in cardiovascular disease33,34 and kidney failure.35,36

Recognition of the role of insulin resistance and hyperinsulinemia in cardiometabolic syndrome provides a rationale to measure fasting insulin blood levels.

Based on the currently available data, we believe that fasting insulin above 5 pJU/mL is likely suboptimal. Steps that can be taken to improve metabolic health include a healthy, plant-based diet low in simple sugar, processed animal products, and saturated fat, and high in nutrients that help support metabolic health.37

Physical activity is also important for metabolic health.

Along with these lifestyle changes, and if appropriate for an individual based upon his/ her unique health needs, the use of medications under a physician’s care, including mefformin38,39 and/or an SGLT2 inhibitor40.41 like Jardiance® can further improve metabolic health before full-blown type II diabetes manifests.

Advanced-stage kidney disease is currently irrevers¬ible. Identifying causative risk factors early with blood tests that include fasting insulin can enable one to take corrective actions in time.

Cancer

Preventive Medicine Associates, PLLCInsulin has direct and indirect effects on cancer cell progression, proliferation, and metastasis.42,43

Studies investigating the association between hyperinsulinemia and cancer-related mortality have been inconsistent. Reasons might include the upper-limit reference range used to define hyperinsulinemia.

For example, the standard reference range for fasting insulin begins at 2,6 uIU/mL and extends to a startling high of 24.9 ulU/mL.”

Life Extension® long ago urged readers to target fasting insulin below 7.0 ulU/mL with optimal fasting insulin below 5.0 ulU/mL.

Today’s laboratory reference ranges don’t define hyperinsulinemia until fasting insulin rises above 24.9 ulU/mL. This is 3-to-5-times higher than what we consider optimal.

A study found lung cancer incidence doubled in men in the highest quartile of fasting insulin compared to those in the lowest insulin quartile. The conclusions from this study were:

“Higher fasting serum insulin concentrations,
as well as the presence of insulin
resistance, appear to be associated with
an elevated risk of lung cancer.”45

A gender-based subgroup analysis of seven different studies found significant association between fasting insulin and cancer mortality. The risk of cancer mortality in men with high insulin levels is almost double as compared to those having lower fasting insulin levels.42

Ignorance regarding “optimal” fasting insulin levels might be obscuring the impact of high, but “normal” insulin resistance markers on cancer risk and overall cancer mortality.

Why the controversy?

Life Extension° has published articles over the decades about the disease risks associated with excess fasting insulin.

Yet there are inconsistencies in the literature and in medical opinion as to what levels of fasting insulin increase disease risks.

One impediment in reaching consensus is varying definitions.

Hyperinsulinemia and Cancer

A massive review article (369 references) published in 2021 describes the health risks and mechanistic dangers of excess insulin.46

What follows is an excerpt from this review titled: “Hyperinsulinemia in Obesity, Inflam¬mation and Cancer”:

“Hyperinsulinemia was associated with a 2-fold risk of cancer death.47
This increase of cancer mortality is also observed in people with normal body weight if they had hyperinsulinemia.48
Therefore, hyperinsulinemia is associated with increased risk of both cancer incidence and death. However, unlike hyperglycemia, there is no widely accepted insulin concentration to define hyperinsulinemia, so it is difficult to compare across studies. Nevertheless, the rationale to study the contribution of hyperinsulinemia to cancer is strong.”

Hyperinsulinemia is sometimes defined as:46

“The amount of insulin in blood being
higher than considered normal.”

With laboratory reference ranges defining “normal” as high as 24.9 ulU/mL, doctors who test fasting insulin may not realize the risks in patients with higher than optimal insulin levels.

We believe fasting insulin levels above 5.0-7.0 ulU/mL may indicate cellular insulin resistance, yet today’s laboratory reference ranges define normal as between 2.6 and 24.9 ulLi/mL.

A better definition of hyperinsulinemia is a condition in which:

“There are excess levels of insulin circulating
in the blood relative to glucose.”

Even this definition can make interpretation of blood test results challenging since the majority of Americans today are overweight and prone to large fluctuations in fasting glucose and insulin levels.

Even thin people can suffer from insulin resistance, which is another reason for testing blood for fasting insulin.

A mass education program about insulin resistance is urgently needed, along with knowledge that it can be detected early by properly interpreting fasting insulin, glucose and Alc blood test results.

What you can do today!

Insulin resistance can be reversed by aggressive dietary and lifestyle changes, including increases in physical activity.40,49-54

Nutrients with glucose-lowering effects can help in combination with diet and more physical activity. For some this is not enough, and for these individuals, medications like metformin and/or an SG LT2

Preventive Medicine Associates, PLLC

Hyperinsulinemia is a risk factor for other diseases.

Excess insulin and insulin resistance cause deleterious changes in many biochemical pathways that can lead to a number of degenerative diseases and potentially life-threatening metabolic consequences.

inhibitor may also be needed to optimize metabolic health. SGLT2 inhibitors are sold under brand names that include Jardiance®, Farxiga®, Invokana® and others.

An AMPK-activating drug called metformin improves insulin sensitivity and can reduce fasting insulin levels indirectly, largely as a result of improvement in peripheral insulin sensitivity at the cellular leve1.49,55

Sodium-Glucose Co-Transporter 2 inhibitor (SGLT2 inhibitor) drugs increase urinary excretion of glucose from blood. This drug class helps reduce the progression of chronic kidney disease in patients with type II diabetes and reduces adverse cardiovascular outcomes in many of these patients.56

Some studies show SGLT2 inhibitors reduce fasting insulin, likely a result of the reduction of excess blood glucose.57-69

The first step, however, is blood tests that measure glucose, Alc and fasting insulin.

We suggest you target:

  • Fasting Glucose between 80-86 mg/dL
  • Hemoglobin A1c between 5.0%-5.4%
  • Fasting Insulin <5 plU/mL

While these numbers are not achievable by everyone, you can at least lower them to safer ranges by initiating steps to improve glycemic status.

A popular blood test panel outlined on the next page includes Al c, glucose, fasting insulin, lipids, C-reactive protein, and other measures.

Commercial labs charge about $2,000 for these tests, but once a year we discount the popular Male and Female Panels down to $224.

You can order these tests 24 hours/day by calling 1-800-208-3444 or visting www.LifeExtenson.com/bloodtests

I hope this editorial explains why fasting insulin is included in many of our comprehensive blood test panels.

The article on page 24 of this issue describes an easy-to-take fiber approved by the FDA in 2020. One of the benefits found with this soluble plant fiber is reduced glucose and insulin blood levels.

For longer life,
William-Falcon

Cellular Insulin Resistance

Preventive Medicine Associates, PLLCThe cells of many people with impaired glycemic control tend to be more resistant to insulin-stimulated glucose uptake than those with normal glucose tolerance.

The ability of insulin to stimulate cellular glucose uptake varies widely among individuals.

Resistance to insulin-stimulated glucose uptake and compensatory hyperinsulinemia represents a basic defect in many patients in the early stage of type II diabetes.1

As the condition worsens, insulin-producing pancreatic cells fail, thus some type II diabetics to require insulin injections.1

Increases in pancreatic insulin production can temporarily prevent elevations of glucose and Alc. This does not mean that this compensatory (hyperinsulinemic) response is benign.

Early-stage diabetic development (and related complications) is predictable by including fasting insulin with conventional blood test panels.

How Fish Oil Prevents Heart Disease

Omega-3 fatty acids are healthy fats that serve multiple roles.

They are particularly concentrated in brain and heart muscle.6,7

Omega-3 fatty acids are essential for balancing inflammatory responses.8

Getting enough omega-3s helps counter several major contributors to heart and blood vessel disease, including:

1. Elevated triglycerides. High levels of these fats in the blood correlate with an increased risk of heart disease. Taking omega-3s reduces triglyceride levels.9,11 The American Heart Association has issued a science advisory that EPA and DHA doses of 2,000-4,000 mg per day are recommended for lowering triglycerides.12

2. High blood pressure. Increasing intake of omega-3 fatty acids can modestly +reduce blood pressure, a major risk factor for heart disease.13.14

3. Insulin resistance. When cells do not respond to the hormone insulin appropri¬ately, the body cannot optimally manage blood sugar. Fish oil intake is associated with improved insulin sensitivity in people with some existing degree of metabolic disease.11,15

4. Blood clotting. Heart attacks and strokes are frequently caused by abnormal clotting (thrombosis) within blood vessels.16 Higher intake of omega-3s can reduce the forma¬tion of blood clots.17-19

5. Chronic inflammation. Persistent inflam¬mation is a major driver of atheroscle¬rosis, the buildup of plaque in arteries. Omega-3s reduce the production of pro-inflammatory compounds and serve as precursors to anti-inflammatory com-pounds.6-8,20,21

The above actions may help slow or halt the devel¬opment and progression of cardiovascular disease.

Observational Studies

The omega-3 index is a blood test that measures the percentage of omega-3s in the blood. The higher the number, the more omega-3s in the body.

An index of 8% or higher is considered ideal.22

In an observational study that evaluated close to 30,000 individuals, having an omega-3 index of 8% or greater predicted about a 30% lower risk of death due to coronary artery disease than an omega-3 index below 4%.22

The Framingham Heart Study is one of the larg¬est and longest-running observational studies in existence.2,23 It has consistently found that a higher omega-3 index is associated with significantly lower risk of total mortality and cardiovascular-related events such as stroke and heart attack.

The Framingham study even found that the omega-3 index is as good at predicting risk of death as factors like smoking, high blood pressure, diabetes, and age.2 Those with a higher index live almost five years longer on average than those with a low index.

In one of the papers from the Framingham study, people with the highest omega-3 index levels com¬pared to those with the lowest, had a 34% lower risk of all cause mortality and their risk of developing car¬diovascular diseases was 39% lower.23

June 2023 TABLE HOPPING

A REAL PAIN IN THE NECK

I ask patients about their hospital experiences all the time and usually the stories are not very encouraging. Recently I was in a hospital in New York City having some surgery. My take on spine surgery is that it may help initially but down the road the parts of the spine that were not worked on wear down sooner than if you hadn’t had surgery. This isn’t a universal finding but between the occasional lack of relief of symptoms, significant infection or new complication , surgery should be reserved until you have tried lots of different modalities. Surgery should be a last resort and yet here I was.

It all started about 5 years ago when I noticed the grip on my dominant right hand wasn’t as tight as I wanted and it affected my racquetball game. After that, I noticed weakness when I was trying to carry heavy objects and pain in my neck and shoulder. The pain and numbness would vary depending on recent activities…sometimes the dojo helped..sometimes it did not…it would bother me intermittently during the day but bother me more consistently at night. It prevented me from ever getting a pain free night. I tried grounding. I tried the PEMF machine. I tried physical therapy and a variety of traction devices. Of course I tried the chiropractor but he said I was “too old” for an adjustment. That was disappointing. I never tried pain pills because I take care of people who have had problems with this class of drugs and dont need more problems in my life.

Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC

It all came to a head when a very thoughtful patient gave me a Christmas present. It was a device that allows you to quickly measure hand grip strength. Grip strength reflects overall strength ;which reflects your ability to stay out of the nursing home. In the past I just asked pts to squeeze my fingers but this tester is far more accurate. Imagine my dismay when I tested myself and got a respectable 90 lbs on my left side but 35 lbs on my right side. That’s a very big difference. That convinced me to put myself through the standard workup including an MRI and Nerve COnduction Studies. The therapist technician was so alarmed at my readings he immediately suggested traction and a particular surgeon in NYC that “all the other doctors go to.” The MRI showed lots of arthritis, bulging or dry discs, bony changes where the particular nerves leave the spinal canal etc. Nothing that an injection from the pain specialist would give a long term fix to. I arranged a teleconference with Dr Daniell Riew in New York City. We reviewed my symptoms, my scans and nerve studies and likely outcomes depending on how much surgery I wanted. I could just fix the worse stuff and wait for the rest to give me trouble down the road or fix it all now and hopefully never need surgery again. THe main difference seemed to be in how much pain you could tolerate. The more aggressive the surgery the more pain postoperatively and apparently we are talking some real intense pain here. I reviewed with the surgeon and his team that I had both rotator cuff surgeries done over the years and was back to work in less than a week. I didn’t mean to challenge him.

It all came to a climax last Monday when I had surgery on my neck. Plenty of people had neck surgery from the back side of the cervical spine. . Lots of surgery is done today from the front side of the neck. I had surgery on BOTH sides of my neck AND extra work done on the sides. The authorization from the insurance company ran to 3 pages which I had never seen before. The paperwork mentioned 8 hours of anesthesia which also had me worried because I know that prolonged anesthesia time is not a good thing as you get older. Furthermore, a plastic surgeon would be involved in the last hour to splice some of my m;uscles across my neck to get better surgical outcomes. There will be two drains in me when I leave the hospital. The usual hospital stay is 4 days but many people who have the less extensive surgery gohome the next day. The paperwork they give you mentions that the post op pain can be “excruciating” but not to worry because it goes away in 3-4 weeks. Yikes !

Excruciating pain and prolonged anesthesia time were worrisome but in the week leading up to the surgery I watched a video of a guy doing jujitsu who was rolled wrong and suffered a broken neck with paralysis. Two days later I am doing some optional continuing medical education via the internet and they prominently featured a case of neck surgery going wrong with resultant paralysis. So, as surgery got closer my anxiety grew and I am guilty of having second thoughts. These second thoughts were banished from my mind by having an MRI of my neck done before surgery. Just the act of lying there flat for the scan was causing increasing neck pain and reminded me of how this chronic nerve impingement was affecting me on a daily and nightly basis and I decided then and there to go ahead and let them try to heal with steel. To cut to cure. I could have had surgery in Syracuse but I had a recommendation from someone in the know and, when I checked it out , Dr Riew only does cervical spines and is recommended by other spine surgerons.Lets commence with the cutting.

I had one question for the surgeon during our pre surgery visit: Doctor …are you excited to be doing this operation? He looked at me quizzically with that ” where are we going with this line of questioning” look. He finally replied that although he liked doing this extensive surgery it wasn’t exciting. That’s the answer I was looking for. If he admitted he was excited it would have meant he still found it very challenging and I want my surgeon to be very comfortable with the procedure but not yet bored by it .

Post op I woke up next to a paralyzed guy. He wasnt paralyzed by the surgery …He was just a paralyzed guy having surgery but I thought it put any complaints I might have after surgery in perspective. The pain wasn’t that bad, I was moving everything , the drains were working, etc. They have a very aggressive pain management program which starts preop and continues post op and includes the pain-med-on- demand I.V. My blood pressure was running high and they actually took one of my suggestions regarding what meds to use and I thought that was unusual and welcome. The meds really screwed up my sense of time and my wife reports that I texted her at 1130 at night that I was ready for discharge. I thought it was 1130 the next morning.

When the surgical teams rounded the next day I confirmed that if some other people can be discharged the next day then unless there is some problem I would like to get out under the same timeframe. Usual length of stay is 4 days. My length of stay is 1.5 days. I wanted to show everyone that I had a high pain tolerance, that I was in good shape, clean living, clean liver etc etc. When I awoke from surgery I could feel that the chronic numbness and intermittent spikes of pain were gone completely. I could lie on my back without the increasing pain down my shoulder and back and neck. I didn’t press the pain med button more than a couple of times early in recovery. Sure I felt stiff and swollen but wasn’t feeling any real pain. Good to go.

WRONG ! Big Mistake ! I knew that the next day the pain would be worse but with so little pain after the operation what could that look like? My wife drove us back from the city and I dove into bed but when I got up the next morning the pain was indeed excruciating. Breathtaking at times despite an array of meds to help me. I should have stayed in the hospital and would have used that pain buzzer until it buzzed like I was a jeopardy champion. . They had great care in the Hospital …nice room, semi healthy menu , great nursing care…I was treated like a king. Most of the people taking care of me didn’t seem aware that I was a doctor so that did not affect my care. I rushed out of the hospital thinking that would mean getting back to work quicker but that did not work out at all. I needed a full two weeks to get back on my feet and wasn’t pain free for a month. Ice has made a big difference as it did with my shoulder surgeries. Besides the pain , because I had such extensive surgery there was a lot of swelling in my neck and throat and I felt on the verge of being choked for weeks. I could not swallow any solids for over two weeks and even liquids challenged me on a regular basis but that’s also mostly in the rear view mirror.

Being on the patient’s side of the doctor patient experience was interesting. It’s good to get different perspectives. I hope I don’t get the opportunity to get any more new perspectives in the near future. Next month back to the science of wellness.

Get Well…Stay Well

JT BARRY

MAY 2023 TABLE HOPPING

THE CASE FOR THE KINASES

My patients say that their cardiologists say there is no way to effectively reverse heart disease…just take your meds which may slow things down a bit and have your heart attack and if you survive the first event ( 70% do and 30% don’t) they will be there to bypass you. Every cardiologist receives training that proper diet and exercise are the foundations of good heart health but how much time do they spend with you on those issues? According to the experts …less than two minutes and it’s off to the prescription closet. I think it’s likely that they just don’t think people are capable of change so why not just get right to what they can offer which is prescriptions and procedures.

I , however , have seen that people can change…they can lose weight, they can quit drinking and smoking, etc if they have the motivation and the tools. In my experience , and I have done hundreds and hundreds of stress tests, the stress test will only alert the cardiologist if your blockages are bad enough that you need immediate intervention with a stent or bypass operation. You can easily have 60% or 70 % blockage of two or three arteries and still “pass” a stress test. That’s why I do the CT scan called the Cardiac Calcium Scan. Check out the video on youtube “Widowmaker” for details. This test allows me to measure the calcium buildup in your arteries. The more buildup the higher the likelihood of having a cardiac event. This test allows us to find blockages much earlier ..when changing diet and adding supplements can make a difference in changing your score and changing your destiny.

So , I scan my patients and if they don’t have a good score we make a plan to change their diet and add supplements to see if we can’t stabilize or improve your score. Which supplements work best at this is still being determined but Magnesium, Vitamin D, Vitamin K2 and Vitamin C have all been used in various combinations along with other substances like chanka piendra and the kinases.

Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC

A Kinase is an enzyme that causes ATP to transfer a phosphate group to another molecule. They act on the body as natural anticoagulants, breaking up clots in your system. If you have a heart attack doctors will sometimes use a similar agent called TPA to break up the clot causing the blockage. So this idea is not crazy and there is commercially available forms of these agents that act to thin the blood so to speak.

There are three commonly recognized kinases: nattokinase, lumbrokinase and serrapeptase. Only the first two are recognized clinically. Nattokinase comes from natto which is a cheese-like food made of soybeans fermented with Bacillus subtilis, Lumbrokinase is thought to be 30 times more powerful at reducing clots and it comes , interestingly enough , from earthworms.

As Dr Mercola pointed out in a recent article “ Fibrinolytic enzymes are antihypertensive, anti-atherosclerotic, lipid-lowering and anti-platelet agents, which also have neuroprotective effects. Much research into fibrinolytic enzymes has focused on nattokinase (NK), an active ingredient in natto, or fermented soybeans. It’s likely due to its high nattokinase content that natto consumption is linked to a decreased risk of heart disease mortality and increased longevity in the Japanese population.”

Dr Sherry Rogers and others have long promoted lumbrokinase as a natural anticoagulant and its getting increased attention in the era of covid infections. Clearly covid infection is associated with a dramatically increased risk of clotting. I believe the covid vaccine presents the same increased risk for clotting but that science is still being elaborated.

Finally , if you prefer a more conventional source here are some articles from Pubmed “ Effective Management of Atherosclerosis Progress and Hyperlipidemia with Nattokinase a Clinical Study with 1,062 Participants” .This is from Frontiers in Cardiovascular Medicine August 2022 PMID number 36072877. They studied the carotid artery because it’s easier to study than the coronary arteries but they found dramatic improvements in carotid intimal thickness and in the degree of plaque burden. Not a little Improvement dramatic Improvement on the order of 66 to 90%. Statins cannot do this. No other medicine we have has demonstrated this type of improvement.

Also from PubMed from the Journal of Biomarkers Insights comes an article entitled “ Nattokinase: a Promising Alternative and Prevention and Treatment of Cardiovascular Diseases.”This was published in July of 2018 . PMID number 30013308.

The expanding research in both human and animal models shows that the lumbrokinase and nattokinase besides having a fibrinolytic effect, that means to break up clots and clots are what kills you, also are antihypertensive and may improve all of the cholesterol parameters including triglycerides. So these agents work on blood clots effectively thinning the blood like aspirin and have likely antihypertensive and beneficial effects on cholesterol so they look to be a triple winner.

Part of the reason for writing this article is to show you that people like Dr Mercola and Dr Rogers are not quacks. They’re on the frontier of medicine. What they have been promoting for years is now being published about in conventional medical research circles. Interestingly enough one of the commercial supplements I recommend for people trying to stabilize their coronary calcium score comes from New Zealand and it’s called CX-8. and one of their 8 ingredients is nattokinase. This supplement also contains Vitamin D3 Vitamin K2 Tocotrienols and other natural ingredients that may stabilize coronary calcification. And of course never forget magnesium which is the natural antidote to calcium.

Don’t go out and just buy some nattokinase because I’ve written an article about it. Like everything else you should work in concert with your health care provider to evaluate all your supplements as well as your prescriptions on a regular basis. Go ahead and look up whatever you want on Google but don’t be your own doctor.

Until next month….get well…stay well

JT BARRY MD

APRIL 2023 TABLEHOPPING ARTICLE

I have been working a lot on the cholesterol and statin issue and my Nurse Practitioners have asked where I get all my material from. It’s certainly not what they are reading in the institutions that trained them. If I still trained medical residents I would ask them about their curriculum as well but I doubt they are focusing on the metabolic state and the microbiome. Excess insulin from excess carbohydrates creates inflammation that affects everything from diabetes, cancer, heart disease and even dementia. Just like the Omega 3/6 oils that also have a major impact on your health at the cellular level , your insulin level is easily measured. According to Drs Gundry and Attia insulin is probably the best marker of both your current health and a predictor of your future health. Yet, the vast majority of healthcare providers are still practicing under guidelines that were outdated years ago.

However, once you start down the rabbit hole on youtube you encounter credible source after credible source that reviews the science and the studies and paints a very different picture than the status quo. I have already given you links to the great Dr Nadir Ali ….a cardiologist who has many videos like “Do statins prevent or cause heart disease.”

Of course Dr Aseem Malhotra, again a cardiologist and public health expert, has weighed in on this issue with his video “Too much medicine and the great statin con”…https://www.youtube.com/watch?v=mAoTwfx1Sic&t=1303s but he also addresses the issue with big pharm in this video entitled “Evidence based medicine has been hijacked”.

Ivor Cummins the engineer and systems analyst covers the major determinants of your health including insulin resistance in this great video “Avoiding and Resolving Modern Chronic Disease”

No one does a better job talking about the dangers of the seed oils in our diet than Dr Chris Knobbe “Omega 6 Apocalypse: Do Seed Oils Cause Obesity & Chronic Disease”..they are everywhere and they are poisoning you and you can easily get the levels checked with your blood work.

However, Dr Paul Mason really shines in his videos that combine the sordid history of statin drugs with the dangers of the seed oils that are really clogging your arteries even as they are given the Heart Association’s seal of approval because they lower cholesterol. He reviews the articles that show that 70% of people admitted to hospital did not have elevated LDL (the so-called bad cholesterol).He also focused on the triglyceride / HDL ratio as being the really important measure of your lipid profile..NOT your cholesterol or your LDL! He reviews the multiple studies that show that plant sterol which looks like cholesterol are probably the real cause of hardening of the arteries. Plant sterols which are proinflammatory and cause generalized oxidation are concentrated in the seed oils you love to use in cooking, frying and salad dressings. If it’s not Olive oil or Avocado oil or MCT oil it’s not good for you. Ok there is one processed oil that is actually good for you from Zero Acre Farms. The reason this oil is healthy is because it’s fermented and that’s about as natural a process as you could ask for.

Part 1 ‘The truth about high cholesterol

Part 2 The shady truth about statins.

Part 3 Hard science on the cause of heart disease

If you watch any of the three videos just listed it will change forevermore your thoughts on saturated fats, cholesterol, statins and heart disease. If we could get your primary caregiver or your cardiologist to watch these videos it just might get them to question everything they have been saying for years. It’s difficult to look at information that challenges your beliefs but that’s how science works. I am always looking for any health care professional who is willing to discuss this on the radio show….cardiologist or otherwise. Likewise I am open to any infectious disease expert to discuss the vaccine, masking etc. Let the public hear both sides of the argument and come to their own conclusion. I’m not holding my breath.

Until next month…get well and stay well

Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC

JT BARRY MD

MARCH 2023 TABLE HOPPING

New Memory Program On The Block

Pretty much everyone agrees that heart disease and cancer are the top two killers of Americans . There is some dispute about the third leading cause of death with either dementia or doctors as number three. Don’t believe that doctors could be a leading cause of death? The study was published by Johns Hopkins in 2018. But there are many other studies that point in the same direction. So many people getting so much care mistakes inevitably will happen. Many of them revolve around medications and most of you are on multiple meds and that puts you at risk. I’m not telling you to stop your pills. I am telling you to focus on the underlying problem, not the symptoms. When your blood pressure is up you can treat the number by taking medication or you can find out what you are doing wrong that is causing your blood pressure to go up. That’s what transformed my practice of medicine over the years. A shift in focus from the symptoms to what’s really wrong and that’s your lifestyle and diet most of the time.

Today I want to focus on the other leading cause of death…dementia. Just as cancer affects every family so too has dementia and from vast experience I know that living with someone with dementia is much much more difficult than living with someone with heart disease or cancer. Dementia is usually insidious and progressive and the few FDA medications approved usually have very limited benefit. Most doctors and patients think there is really nothing that can be done. But like the guy says in the commercial…”There is always something that can be done”.

Dr Dale Bredesen, author of the book “ The End of Alzhiemers”, is a world expert in dementia. He has established a program called ReCode which is by far and away the most comprehensive program I have encountered for ANY disease process.

Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC

ReCODE “is a comprehensive and personalized multi-therapeutic program for reversing symptoms of cognitive decline and optimizing brain health, using a targeted algorithm based on biochemical and genetic risk factors for cognitive decline”. This program does everything from evaluating for unsuspected sleep apnea, testing for toxins, checking for the genetic risk of dementia, measuring brain size, and routinely doing brain exercises. There is a big focus on changing the diet which is consistent with the metabolic dysfunction model of dementia. People refer to Alzhiemers as diabetes type 3 which alludes to insulin’s role in inflaming the brain and the need to lower insulin which leads to better health overall. The ReCode program is for people who have current dementia and there is a PreCode program for people who want to prevent dementia in the first place. It’s a combination of web based interactions as well as health care practitioner visits to evaluate progress.

This is not a theory. This has been put to the test. Dr Bredesen conducted a trial with 255 people with all stages of dementia..PMID: 34680464. It looks like every metabolic parameter measured was improved in the treatment group. People with really advanced dementia did not seem to be helped but the people with moderate and mild dementia had improved scores on a very common memory test. These results were statistically significant. The results weren’t off the chart so to speak but there were all in the right direction. Many drugs get FDA approval for less impressive results. The original study got positive results with a simpler and less comprehensive approach than they use now. The program evolves based on ongoing research which is another thing I like about it.

I visit a lot of websites. I have been involved in multiple interventions where some organizations try to interact with patients to achieve better health outcomes. The web site for the ReCode program blows all the others away. It’s incredibly user friendly and comprehensive in its offerings. I’ve never seen anything else like it. The web site is apollohealthco.com. When I first checked out the website, after reading his books and doing other research there were no local providers. There are now. I am one of them. I don’t need the extra work. . You would not become full patients in the practice , these visits are like going to a specialty clinic. My practice is full but I feel so strongly about this issue and this program that I felt compelled to get involved. My mother suffered from dementia and I saw first hand how her diet and lifestyle contributed to her decline. I’m not sure she would have done the program if it was available but at least now people have an option. If someone else becomes a local provider I am happy to give them the work. Check out the apollohealthco.com website for details.

Until next month…get well and stay well.

J T BARRY MD

FEBRUARY 2023 TABLE HOPPING

It’s February so I should be writing about something romantic but I’m not in the mood. Instead let me focus on your heart in a medical way. Unfortunately what I am writing about will contradict everything your cardiologist and primary care doctor are telling you. I am not alone in my opinion. Check out ANY of the references below The Weston Price Foundation does an excellent job as well reviewing this issue in very simple terms. Here’s the reference.

https://www.westonaprice.org/health-topics/modern-diseases/dangers-of-statin-drugs-what-you-havent-been-told-about-popular-cholesterol-lowering-medicines/?gclid=CjwKCAiA2fmdBhBpEiwA4CcHzVU_PWigYmMRP2CvvFTsKnAIo3kFl_bjiJGnPZwQX7qvWe-0ztL4xxoCG4cQAvD_BwE#gsc.tab=0

I know everyone and their sister are on statins. You have been told that somehow cholesterol is bad and that statins will prevent a heart attack. Your doctor looks at a number on a piece of paper and reaches for the prescription pad putting you on medication for life.! No discussion , no research, no debate….just take a pill. Don’t worry …everyone is on these meds and they are safe and effective. These hypotheses are not proven and the bulk of the evidence suggests that both ideas are wrong. Dr Malcom Kendrik has written multiple books on this including The Clot Thickens and The Great Cholesterol Con. Dr Sinatra on this side of the pond has written similarly in his book The Great Cholesterol Myth. If you are not into books and would rather Youtube it I offer the following…

Dr Malhotra

Dr Paul Mason

But my all time favorite is the one by Dr Ali who is a practicing interventional cardiologist. If you watch the video below you may never blindly trust your doctor again. I think that’s a good thing. Dr Ali quickly goes through the major statin trials and shows that despite significant reductions in LDL cholesterol mortality was reduced by less than one percent ! In the FOURIER trial there were more people who died in the treatment group than in the control group. How in the world does the FDA approve a drug or treatment where the group being treated has more deaths than the control group !? The same thing happened in the Pfizer mRNA vaccine trial for covid but that’s another column altogether.

Dr Nadir Ali

These are not polemic diatribes recorded by non physicians…Drs Malhotra and Ali are Board Certified Cardiologists ..that’s right heart doctors that have independently looked at the data…and come to very different opinions than the guidelines. By the way did you know that there is a group called the Cholesterol Treatment Trialists Collaboration…they are the biggest source of data for the cholesterol trials but they REFUSE to release the raw data for other doctors and scientists to independently verify their statements. Trust us there are no side effects and everyone should take statins. Did you know they were funded by the drug companies? How can you possibly trust statements from a group that is funded by the statin makers and who refuses to release the full data.

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Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC

By the way, just as they are trying to marginalize , and demonize doctors who are asking about the excess deaths since the covid vaccine came out there is now a move to sanction doctors who are spreading “misinformation” about statins.

Just look at the basic issue. How can cholesterol be bad when it’s in breast milk? How can cholesterol be dangerous if it’s one of the 4 main fats in your brain? People born with a genetic defect that lowers their cholesterol level die prematurely. Cholesterol and its metabolic pathway are involved in many different functions in the body and blocking cholesterol has many unintended consequences downstream…too many to mention here but well covered in Dr Ai’s video.

Your doctor gets his information from the major medical journals, not from studying the trials themselves. The former chief editor of the most prestigious medical journal had this to say. Marcia Angell wrote, “ It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.”

Finally….In a study NOT controlled by the drug companies, an article from Pubmed “ Association between low density lipoprotein cholesterol and all-cause mortality: results from the NHANES 1999-2014” this study found , in Americans, that the LOWER your LDL cholesterol the greater your risk of dying from ANY cause including cancer. PMID: 34764414

Let me close by referencing Dr Duane Graveline former astronaut, aerospace medical research scientist, flight surgeon, and family doctor who wrote a book entitled Lipitor Thief of Memory about his personal experience on a statin.

This column only touches on the surface of this important issue but the references provided will take you much deeper. I know it’s going to upset some physicians…I have already had multiple patients that say that when they approached their doctors about this controversy they were met with “Who’s the doctor here?” , “ Are you putting Google against my 30 years of professional judgment?” and “I don’t have time to look at your references.” The facts are what the facts are and it’s very clear that the guidelines are controlled by big pharma. If your provider is not open to your questions and the fact that you are interested in your health and doing your own research you should get another provider. Your healthcare should be a cooperative endeavor and you have every right to ask questions and get real answers.

Until next month…get well and stay well

JT BARRY MD

JANUARY 2023 TABLEHOPPING

What’s the to do about Methylene Blue?

Rather than remonstrate and castigate you about your New Year’s Resolution or lack thereof I am writing about something completely different to begin the new year. I’m not sure how it caught my attention but multiple different sources lead me to check out Methylene Blue. This very interesting compound has been around for over one hundred years but remains medically relevant today.

Of course this is for informational use only and you would be crazy to try anything without the express agreement of your personal healthcare provider. In particular if you have a genetic condition called G6PD deficiency or are taking an antidepressant you should avoid this compound.

Methylene blue (MB) or methylthioninium chloride (quite a mouthful ..try saying that three times fast) is a dye and drug that was first discovered in 1876 by Heinrich Caro and used to stain fabrics including blue jeans. It is a powerful competitive inhibitor of monoamine oxidase activity, especially of MAO-A which is responsible for the breakdown of serotonin. Hence the warning above.

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Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
 
Preventive Medicine Associates, PLLC
 

Aside from its start as a fabric dye it quickly gained use in many l other situations. It’s used to disinfect fish tanks whilst the fish are still swimming in the tank. It is a dye used in some surgeries to differentiate tissues. It is a dye used in staining some microscope slides. It is a tricyclic phenothiazine, approved by the FDA and EMA for the treatment of methemoglobinemia and malaria. Its daughter compounds are chloroquine which is used to treat malaria and hydroxychloroquine which is used as an immunosuppressant in people with certain medical conditions like lupus. It is also used to inactivate viruses in blood products for transfusion, in the presence of UV light and has been used for this reason since 1991. Methylene blue has antiviral , antiparasitic and antibacterial activity and was previously used to treat recurrent bladder infections. Did I mention that methylene blue may be the most effective treatment for cyanide poisoning and is used along with hyperbaric oxygen for carbon dioxide poisoning. It appears to be a direct electron donor in multiple sites in the electron transport chain that the mitochondria use to make energy. Cyanide blocks one of the multiple sites and Methylene Blue overcomes that blockage. That’s how I was introduced to it…based on its effects at the cellular level at sites like cytochrome C oxidase which is further along on the electron transport chain. It appears to re-energize cells that are having trouble with these chains and there are many reasons these chains get into trouble primarily due to the processed foods in your diet and other poisons ingested knowingly or unknowingly. It has the interesting side effect of turning your urine green.

Recently Methylene Blue has been in the news as a possible med to help with covid long haul symptoms. It certainly looks like something to try that has a very low risk profile, especially at the low doses suggested for this in the literature. This drug has an interesting metabolic pattern…low doses do one thing and higher doses do the opposite ..so like in much of medicine..more is not necessarily better. For some general information check out articles like this one in the National Library of Medicine PMC3087269. Don’t just start buying this stuff off the internet without doing some real research because unless its pharmaceutical grade it may very likely contain toxic metals which are no problem when you are dying jeans or staining slides but a real problem for you.

Again ,this column is not intended as medical advice; it’s intended to open conversations about health care and different options and opinions that you are not getting elsewhere. Here’s wishing you a Healthy and Happy New Year in 2023 and beyond.

JT BARRY MD

DECEMBER 2022 TABLEHOPPING

Ok, it’s holiday time and I , of course, have some suggestions for you. Not the usual eat better and get more exercise although you could use a dose of that …rather these suggestions are for holiday gift giving. Why not try something different than the usual sweater or that bundt cake. Not sure what to get the person who has everything? Problem solved with this article. Looking for something different to get this year? Read on Garth.

First let me recommend Dr Sheri Rogers monthly newsletter from Prestige Publishing. It’s a health newsletter like no other. Give yourself or a friend a very different perspective on your health. You can get it delivered electronically and it’s very affordable. Want to go a little deeper ? Is it time to reorient that brother of yours? There are three books that will change your mind about everything you thought you knew about vaccines and all of them are convincing reads. Dr Susan Humphries Dissolving Illusions, The Virus and the Vaccine by Deborah Bookchin and Jim Shumacher and Turtles All The Way Down which is edited by O’toole and Holland. Sure this is a controversial topic but what are the holidays for if not for controversy. This would be an especially good read for the medical person in your life.

What to get for the exerciser in your life who has everything? How about blood flow restriction bands which allow you to get the most out of a workout. You don’t need to get the original Kaatsu bands but don’t get the cheapest ones either. My buddy Amazon will kit you up with a lot of choices.

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Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC

For the person in your life who loves their dog more than they love you I recommend an Advent calendar meant for dogs. I know it sounds funny but it’s filled with dog treats and dog toys. I saw it at Costo and it will definitely be a winner and get you on Fido or Rex’s good side. The pets don’t even have to be catholic. While you are at Costo get some of their winter socks…these are the most comfortable socks I have ever put on my feet and if you don’t find them when you go it’s because I bought them all. Makes a good stocking stuffer. Make sure you look for the winter ones because they have all kinds of socks but the winter ones are the winners.

Of course the best gift you can give some people is the gift of time together. Stop by Aunt whatsername and sit a spell. Take Uncle whoseitnow for a walk by the canal. Get those old tapes from years ago converted into a format you can watch with the family. Then sit and watch with them. Making memories while watching memories …then go for that walk. Don’t forget the real reason for the season. It’s about Faith and Family and you don’t need a shopping list for either of those!

Until next month….get well and stay well

JT BARRY MD

NOVEMBER 2022 TABLEHOPPING

MISSION NOT IMPOSSIBLE

I am on a mission. A mission to drag you and your medical provider into the 22 Century. There are simple, inexpensive blood tests you should have done that are not getting ordered routinely and they are much more important than your blood type , your cholesterol , your blood glucose etc. The two tests are your insulin level, done fasting, and your omega 3:6 ratio.

Although vital for life, excess insulin is linked to pretty much every inflammatory process in your body from heart disease, diabetes, and cancer to dementia. Those of you who follow Dr Peter Atia know that he believes this is the most important blood test you can do to assess your current health and it’s the best marker to predict your future health. Dr Gundry believes the same thing. Your insulin level will be abnormal years and years before your blood sugar or HAIC ( a marker of diabetic control) levels are abnormal. It’s a simple blood draw and when combined with your blood sugar you can calculate your insulin resistance. The lower your insulin and the lower your insulin resistance the better your health. I do this test all the time on my patients and I never get blowback from the insurance companies .Tell your doctor to use the codes for insulin resistance or metabolic syndrome.

Just as important in my metabolic book is the Omega 3:6 ratio. To grossly oversimplify the Omega 3 essential fatty acids DHA and EPA are key ingredients to every cell membrane in the body. The Standard American DIet is so low in these essential fatty acids that we have to supplement if we want to get sufficient levels in our bodies. Anthropologists have speculated that it may be that Homo Sapiens beat out Neadethals because we lived mostly in coastal areas, ate more fish which contain abundant EPA and DHA and therefore grew bigger brains and outcompeted the Neanderthals. I wasn’t there so it’s only a theory but it seems plausible and attests to the importance of these nutrients in the brain and the body. Here is a general reference about the vital role these fatty acids play in our body. PMID=22332096. Just type that number into your search bar and the article will pop up.

So, these essential fatty acids play a critical role in cell membrane function and involve every cell in your body and luckily can be measured by the lab and impacted by our diets and supplementation. Historically , we are supposed to have a one to one ratio of the healthy anti inflammatory omega 3’s to the inflammatory omega 6’s. Omega 6 fats are found in fried food and in almost all the seed oils like canola, corn, sunflower etc. You need both omega 3 and omega 6 but just like a good cake recipe there is the proper ratio for these fatty acids. So ideally we should have a 1:1 ratio but with the modern American diet which is low in Omega 3 and high in Omega 6 many people have a 10:1 ratio or a 20:1 ratio. This altered ratio is a disaster for the function of the cell membranes and therefore for your health. Two proponents of measuring Omega 3 / 6 ratios are Dr Chris Knobbe and Dr Paul Mason both of whom have great Youtube videos on this issue. Dr William Harris is probably the world expert on Omega 3 and he focuses on just the Omega 3 level. Best health outcomes are with an Omega 3 level above 8. Worse health outcomes are with an Omega 3 level of less than 4. In between is a work in progress.

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Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC
Preventive Medicine Associates, PLLC

One of my functions at my office is to work with my Nurse Practitioners to help them understand these fundamental metrics of your health as these are still not really covered in their schooling nor is it really covered in medical school. I have shared with them articles that detail the importance of Omega 3’s and the right ratio of Omega 3 to Omega 6. This article focuses on the Omega 3 levels and risk for heart disease. The lower the Omega 3 level the higher the risk for heart disease. PMID =20551373.

This article discusses a correlation between the Omega 3 level and Telomere length. Telomeres are found at the ends of your chromosomes and the longer the telomere the longer your life expectancy. Higher Omega 3 levels are associated with longer Telomere length. PMID= 35189049. This article correlates Omega 3 levels with brain MRI scans showing inflammatory changes. The higher the Omega 3 levels the less inflammation of the brain. Inflammation equals dementia. PMID = .22371413.

Finally here is an article that evaluates the Omega 3 levels in 42,400 patients. The higher the Omega 3 the lower the all cause mortality. That’s all cause mortality and it’s pretty impressive. PMID=33888689.

So, work with your provider to get these labs ordered. You can follow your Omega 3 level, you can follow your Omega 3:6 ratio and you can follow your insulin and insulin resistance. These are vital signs for your metabolic status. These are not expensive labs and I use them over and over to measure whether patients are working on their diets. It’s not just about measuring your weight.

Ok, I have told you that Omega 3 is good and high insulin levels are bad. Let me translate that for you. Lower your carbohydrates to lower your insulin. To improve your Omega 3:6 ratio stop using most commercial salad dressings and cut down the fried food. As importantly, to improve your Omega 3 level, get more fish and nuts in your diet. However, if you want to get your Omega 3 level really in the right range you need to supplement with fish oil , krill oil or my favorite….Carlson’s Lab Cod Liver Oil in Glass with Lemon Flavor. This is not your grandma’s cod liver oil. This is really quite palatable and will greatly improve your Omega 3 level and your Omega 3:6 ratio. Try it for yourself and see. Get your numbers measured. Take action and remeasure.

This isn’t just about improving numbers on a piece of paper. I am convinced that if you lower your insulin level and raise your Omega 3 level you will feel better. Why not see for yourself?

Until next month….get well and stay well

JT BARRY MD