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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.
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.
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
OCTOBER 2022 TABLEHOPPING
I wrote about sodium several months ago but because I continue to see a low salt diet mentioned in every consult note I get from other doctors and even in my own literature we give out to patients I am compelled to bring even more evidence that limiting your salt intake is not the most important component to improve your health. I happen to think that if you take diuretics to lower your blood pressure or if you sweat a lot via activity or sauna that you should replace your lost electrolytes. That’s not very controversial. Luckily, you can have the major electrolytes measured anytime you want. Unluckily , the measurement reflects plasma levels of the electrolytes not the true total body amount but it’s better than nothing.
I reviewed three articles that point out that low-sodium intakes are not associated with lower blood pressure . The first study was the Framingham Offspring study. Framingham is the longest and largest longitudinal study ever done in America …….Their conclusion from following 2362 adults aged 30-64 was
“Sodium intake was not associated with CVD risk within the range of intakes generally consumed by these participants. In contrast, higher intakes of both potassium and magnesium were inversely associated with risk of CVD.” See the details here.
https://academic.oup.com/cdn/article/4/Supplement_2/1476/5845928
The next nail in the sodium is bad for you coffin comes from this study PMID: 33314019 “Effects of low sodium diet vs. high sodium diet on blood pressure reading aldosterone catecholamines cholesterol triglyceride” In this study the differences in blood pressure between the groups were minuscule, not tiny, miniscule. Their exact number was ,in white participants, sodium reduction resulted in mean arterial pressure reduction of 0.4 mL of Mercury and 4 mm of mercury in people with hypertension. So if your blood pressure is 200/100 and you adopt a low sodium diet you will now have 196/98. Is that going to prevent a stroke or heart attack? As the authors conclude there is “weak evidence indicates these effects may be a little greater and black and Asian people”. They further point out that the effect of sodium reduction on potential side effects or among the lipids were more consistent than the effect on blood pressure.”
Translation = the negative side effects were more consistent than the benefits. Yes, there are dangers to a low sodium diet see August 2022 Tablehopping for that run through.
Next up is a study called INTERSALT…an International study of electrolyte excretion in blood pressure results for 24 hour urinary sodium and potassium excretion. Type PMID: 3416162 into your browser to be brought directly to the study.
In this large study body mass index and heavy alcohol intake has a strong significant independent relationship with blood pressure in individual subjects The INTERSALT group studied 10,079 men and women aged 20 to 60 from 52 centers around the world. The results are a bit dense “Sodium excretion ranged from 0.2 mmol/24 h (Yanomamo Indians, Brazil) to 242 mmol/24 h (north China). In individual subjects (within centres) it was significantly related to blood pressure. Four centres found very low sodium excretion, low blood pressure, and little or no upward slope of blood pressure with age. Across the other 48 centres sodium was significantly related to the slope of blood pressure with age but not to median blood pressure or prevalence of high blood pressure. Potassium excretion was negatively correlated with blood pressure in individual subjects after adjustment for confounding variables. Across centres there was no consistent association. Bottom line is the last line…across centres there was no consistent association between salt excretion and blood pressure. Salt excretion is a measure of salt intake. Different slants in this study have been used by both sides of the argument and if that’s possible that means the argument for salt restriction cant be that compelling.
Finally , from the Cochrane Review , a respected independent reviewer of the medical literature…..after collating all available data they concluded…..”Despite collating more event data than previous systematic reviews of randomized controlled trials, there is insufficient power to confirm clinically important effects of dietary advice and salt substitution on cardiovascular mortality in normotensive or hypertensive populations.”
If you want to lower your blood pressure, the science says lose weight and stop drinking heavily, add more potassium and magnesium to your diet and cut the carbs and you will have better health and a lower risk for heart disease and stroke. The easiest intervention is to get “lite” salt or “lo-salt” which replaces some of the sodium with potassium . The addition of the potassium is much more important than taking the sodium away. Of course check with your doctor blah blah….but don’t feel so guilty putting that salt on the corn on the cob.
Until next month …get well and stay well
JT BARRY MD
SEPTEMBER 2022 OF TABLE HOPPING
There are a lot of ways to measure your health. Your blood pressure, your heart rate, your blood sugar etc are all metrics of health which you can track easily. There is another marker …heart rate variability which also gives you important information about your overall health. Your heart rate is easy to measure…just feel for your pulse and count the number of beats in 60 seconds and you have the heart rate. Heart rate variability is different. It requires a device like an EKG machine, or an Oura Ring or Whoop to measure it accurately.
There are technically a number of different ways to measure HRV but it’s easiest to use a device like the Oara ring , Whoop or any modern device that measures heart rate should be able to give you a Heart Rate Variability measure.
Typically, high heart rate variability is a good thing. Think of it this way….two people can have the same heart rate …lets pick 60 beats per minute ….but one has a frisky heart and one has a dull plodding heart….the frisky/ healthy heart beats just a little early sometimes and a little late at other times all the while maintaining the 60 beats per minute overall. The dull plodding / less healthy heart keeps a steady beat..never early …never late. You would think that being regular would be a good thing for the heart….but a healthier heart is a more variable heart.
As expected, things that improve your overall health improve your heart rate variability and you can use this measure as an independent analysis of your health on an ongoing basis. So, better sleep, more exercise, better diet , and less stress all improve heart rate variability. Heart rate varies more in some people than in others and there is day to day variation so it’s very popular to use night time readings to get a more reproducible and trackable number.
So heart rate variability reflects overall health. Although affected by diet, exercise, sleep, alcohol etc, the main determinant of the heart rate variability is the balance between your sympathetic and parasympathetic nervous systems. The sympathetic system is known as the fight or flight reaction and the parasympathetic system is known as the rest and digest reaction. The sympathetic system uses adrenaline to increase the heart rate and the parasympathetic system uses acetylcholine to decrease heart rate and the balance determines both heart rate and heart rate variability.
We are supposed to live in harmony with nature with a balance between the two symptoms but most of us are out of balance with too much sympathetic tone. You can try to restore this balance with exercise ,yoga, deep breathing exercises (see Wim Hof ) sauna, meditation , and cold immersion. Interestingly enough, heavy exercise lowers heart rate variability before it ultimately raises heart rate variability.
Since the vast majority of people have too much sympathetic tone and not enough parasympathetic tone….too stressed out and not enough relaxed we focus on the most basic tools to balance the two which are breathing exercises. Slow, controlled nasal breathing is a great technique to balance the two sides and improve your heart rate variability. So you can immediately improve your health by using simple breathing exercises…what could be easier than that.
Of course this is America so creative people have come up with various devices to help us….Heartmap.com has an interesting combination of a device and smartphone app that helps you increase your parasympathetic tone via controlled breath exercises… There is an interesting device that claims it uses vibration you can’t really feel to improve your heart rate variability. Have not tried it yet but it’s available at https://apolloneuro.com/.
Don’t you find it fascinating that we are measuring a heart derived number to tell us about our autonomic nervous system? Isn’t it great that we can affect our different systems with simple interventions ? The interplay between the systems never ceases to fascinate me. HRV is just one more measure you can easily and safely use to access and improve your health. Until next month…get well and stay well.
JT BARRY MD
JULY 2022 TABLEHOPPING ARTICLE
Magnesium is the stuff of life. I guess you can say that about all the elements really because without them it would be a different universe but Magnesium in particular holds a special place in the heart of modern nutritionists and health care providers because of its protean effects on the body human. Magnesium deficiency is serious but underdiagnosed because the most severe consequences…ie death, are rarely blamed on an electrolyte abnormality.
The same researchers that say magnesium deficiency is rarely apparent clinically will also admit that 75% of Americans are not getting enough from their diet. It would be great to get all the Magnesium you need from your diet but studies have shown this is unlikely .America’s foremost expert on magnesium if not the world expert on magnesium is Dr Thomas Levy who’s also been extensively on vitamin C and on Calcium the former being beneficial and the latter not so much.
Magnesium is easy to measure in the blood but unfortunately the vast majority of magnesium is not in the blood it’s in the cells and in the mitochondria. You can have a normal serum magnesium level and still have magnesium depletion. Experts say you really should check the red blood cell magnesium level to get a more accurate number but even that doesn’t reflect the true magnesium level. There is only one place to get a cellular magnesium level tested in America and unfortunately New York state does not allow that testing. For reasons that continue to baffle me, New York state does not allow a lot of major laboratories to do business in New York. These companies are attempting to provide Health insights that are not available from companies currently practicing in New York state. I have written repeatedly to the Department of Health questioning the policy and asking them to remove these hindrances and allow me to order tests from certified Labs that are important to my patients but so far the Silence has been deafening. I guess they are busy with other issues but you would think at least a bug off letter and response would be appropriate.
Many patients are on diuretics for their blood pressure and many others are on proton pump inhibitors for indigestion and many patients are on both. These medications are chief causes of hypomagnesemia. Low magnesium can have protean manifestations including weakness, poor sleep, numbness, nausea, muscle twitching or cramps, and even personality changes. Eventually when the magnesium level gets low enough you get irregular heartbeats and finally cardiac arrest.
Why is this element so important? Magnesium is the second most abundant cation, that is, positively charged ions, inside the cells of the body after potassium. It’s an essential cofactor for hundreds of critical enzymes and is known to be involved in roughly 80% of all known metabolic functions in the body. Not impressed yet ? It has been found to be critical for the metabolism of ADP which is one of the energy generating systems in each cell. It’s also required for protein DNA and RNA synthesis as well as for the synthesis of fatty acids and the conversion of vitamin D into its active form in the body. Magnesium may also play a critical role in the production of glutathione, the most important and most concentrated antioxidant inside the cells. inside the cell magnesium works to keep sodium and calcium levels lower and potassium levels higher. At the cellular level calcium is dangerous…when cells die they usually due so because they are flooded with calcium. Excess calcium intake has been associated with higher all-cause mortality. Magnesium is an intracellular calcium channel blocker and you recognize the term because so many blood pressure meds are calcium channel blockers. So magnesium , a natural substance, does the same thing those prescription drugs do.
Studies have shown that deaths from all causes jump 40% in subjects with the serum magnesium below 0.73 millimoles per liter which is found in about 25% of the population. As Dr Levy points out, randomized double-blind clinical trials have shown that magnesium supplementation is an effective treatment for metabolic syndrome. Furthermore, higher dietary intake of magnesium was associated with reduced cardiovascular mortality in a large Japanese study and a similar result was seen in the Hawaiian study with a 30-year follow-up. A study was able to demonstrate that increasing dietary magnesium intake was significantly associated with reduced risk of heart failure and stroke diabetes and all-cause mortality.
Likewise magnesium plays an important role in both increasing and sustaining higher free plasma testosterone levels. Testosterone also increases cortisol levels and Vitamin D also appears to have an independent linear linear association with free testosterone.
Now there are many different forms of magnesium supplements. The only one I don’t recommend is Magnesium Oxide because it’s so poorly absorbed. Liposomal magnesium probably has the best absorption but you have other options including magnesium citrate which also helps with insomnia and constipation. Magnesium sulfate also called epsom salts is great for baths and you can absorb magnesium through your
skin that way. Magnesium taurate is easier on the bowels and the taurine is important for eye health. Magnesium gluconate is also very well absorbed and also has properties that chelates heavy metals like calcium iron and copper. Magnesium chloride has anti infective properties. Magnesium glycinate is well absorbed and the glycine is a component of glutathione which is also used in synthesis of collagen and creatine. Magnesium threonate is best at crossing the blood brain barrier. If you are trying to use magnesium to lower your blood pressure your best bet is the liposomal magnesium. Liposomal means the magnesium is inside a fat globule which greatly increases its absorption.
Obviously I think Magnesium is very important but, of course, you should do nothing without checking with your healthcare provider. Unless your level is high (which, I can tell you from reviewing thousands of samples, is very rare) you should consider trying some supplement and see how you feel and how it affects your health. This is especially important if you are taking a water pill (diuretic) for your blood pressure which many people do and if you are one of those people who treat your indigestion with drugs like prilosec, aciphex, protonix etc. Many people whom I have recommended Magnesium supplementation to have reported feeling better in many different ways. Why not give it a try and see for yourself. There’s that N of 1 experiment I keep referring to. Until next month…..get well and stay well
JT BARRY MD
JUNE 2022 TABLEHOPPING
PEMF
Recently , because several different patients have been urging me to investigate it, I have gotten into energy medicine. Unfortunately , there is little information in the conventional medicine world that deals with anything but how to treat problems with pills because ..that’s where the money is. Nonetheless, there is real science there and if it can help patients we should be familiar with the topic. The Hindus around 4000 BC used magnetized stones called lodestones to treat illness. The Chinese around 2000 BC had protocols for using lodestones on acupuncture points. Cleopatra was said to have worn magnetic jewelry (lodestones)to prevent aging. Hippocrates , in Greece, was known to use magnets for pain . More recently, the Russians have been using electric devices for decades to promote healing and health.
One of the earliest scientific accounts of using magnets is found in the book De Magnete,written in 1600 by William Gilbert, the personal physician of the English Queen. This natural philosopher used “lode stones” to treat a variety of health problems of ordinary British citizens and even the Queen of England. Contemporary magnet therapy began in Japan immediately after World War II by introducing both magnetic and electromagnetic fields in clinical practice. This modality quickly moved to Europe, first in Romania and the former Soviet Union. During the period of 1960–1985, nearly all European countries designed and manufactured their own magnetic therapeutic systems which utilized various waveshapes. In fact , the first book on magnet therapy, written by Todorov, was published in Bulgaria in 1982 summarizing the experience of utilizing magnetic fields for treatment of 2,700 patients having 33 different pathologies.
It wasn’t until the late 1970s that Americans Drs. Andrew Bassett and Arthur Pilla created a noninvasive PEMF device that succeeded in healing a non-union fracture..The 1980s also saw the introduction of the first FDA-approved PEMF system, intended for use as a bone stimulator to treat nonunion fractures. The seminal book “Body Electric: Electromagnetism and the Foundation of Life” was published in 1986 by Dr. Robert Becker and Gary Selden. This book is important because it was one of the first descriptions of the body as an electromagnetic apparatus and therefore very susceptible to magnetic field therapies Since then thousands of studies using many different devices have shown that electromagnetic fields can have a profound effect on cellular health and as we and fond of saying cellular and mitochondrial health IS health.
For a long list of scientific articles about the benefits of emf fields you can check out DrPawluk.com. Dr William Pawluk is an American physician who probably has the most experience with emf generators of all kinds. For those of you skeptical about how emf fields can affect the body you need only look at your iphone. Your iphones battery can be recharged by putting it on a mat that emits an emf field. So too can your body’s batteries be recharged by placing it on a mat that emits the appropriate frequencies, intensities and waveform. We know that emf fields in our environment have the potential to harm us. Why would you doubt that emf fields therefore have the potential to heal us.
Need more? Of course you do …let’s get down to basic science. As taken directly from Dr Pawluks website…..All matter is made up of moving particles. Forces exist in space around these moving particles. These forces are magnetic fields. By definition force is an interaction that changes the motion of an object. An electric field is the force field created by the flow of electricity caused by attraction and repulsion of electric charges. A magnetic field is a force field created as a consequence of the flow of electricity. Electric fields and magnetic fields always exist together. One cannot exist without the other. An electromagnetic field, then, is the combination of an electric field and a magnetic field. Our bodies are fundamentally electric. When a person goes into cardiac arrest, for example, a defibrillator is used to apply electric energy to the heart so that they can re-establish a normal rhythm. So, the electricity flowing through our bodies creates electromagnetic fields. External magnetic fields and the bodies native electromagnetic fields interact in proportion to the strength of the fields. Because of these interactions a magnetic field passing through the body will have an effect on the cellular level. Electric and magnetic fields control our chemistry by changing and influencing the motion of charged particles. This movement stimulates a vast array of chemical and electrical actions and tissues helping them rebalance or heal themselves where necessary. Additionally this increased motion of ions and electrolytes help cells increase surveillance energy by as much as 500%.Magnetic fields affect the charge of the cell membranes, rebalancing it so that the membrane channels can open up. These channels are like the doors and windows of a house, by opening them oxygen and nutrients are better able to enter the cell and carbon dioxide and waste are more easily eliminated from the cell. This helps to balance and restore optimum cell function. Electromagnetic fields affect the charge of the cell membrane. This is the basis for a magnetic field therapy, perfecting and improving basic cellular function in order to combat a variety of health conditions and when possible prevent cellular damage from happening in the first place. Still skeptical? Here’s an article about the benefits of emf therapy from our own SUNY Upstate Medical University.
A PULSING ELECTROMAGNETIC FIELD PROMOTES THE DIFFERENTIATION OF OSTEOBLASTS (MC3T3) AT LOW CELL DENSITY IN VITRO. *Button, C; +**Spadaro, JA; **Margulies, B S; **Allen, M J; **Wang, Y; **Damron, T A; *Dept. of Neuroscience and Physiology, **Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY
Believing in this technology I bought a PEMF machine for my patients to use in the office. My plan is to measure patients phase angle and their arterial flexibility and see if it changes before and after a treatment. I will also be offering it to my patients with acute and chronic pain to see if it helps. It’s not covered by insurance so your doctor will have nothing to do with it. But, there are PEMF machines available in Syracuse to use but you have to do the internet legwork on your own. If I found the guy in Liverpool you can too.
PEMF is not a cure all. But, if you have chronic pain or feel low energy why not give this very safe modality a try? PEMF is not recommended for use in infants under 2 weeks, pregnant women and patients with implantable devices like pacemakers, defibrillators and pain stimulators. This is by no means new technology but it’s new to me and I am eager to check out its potential. Until next month….get well and stay well
JT BARRY MD
MAY 2022 TABLEHOPPING ARTICLE
Dementia may have worked its way up to the third leading cause of death behind heart disease and cancer. I think dementia is particularly devastating because it has such a profound effect on both the patient and their families. The costs of dementia far exceed the cost of heart disease and cancer combined. So, obviously it’s a terribly important personal and public health issue. Unfortunately over 200 drug trials have been done in the last decades with only one oral drug approved (which has very limited benefits) As you recall, the one IV drug approved recently was so controversial that all the independent doctors who recommended the drug not be approved resigned when the FDA approved the drug over their objections. The drug did nothing clinically but made the brain scans look better so that was enough for the FDA.
So, the conventional approach to dementia is for your primary care doctor to possibly run a blood test or two…if they are aggressive you get a brain scan ..if they are not you get a referral to a neurologist and he checks a few labs and gives you a pill that’s been around since 1996 that does nothing to the underlying causes of dementia and whos benefits are no longer measurable after 12 weeks. Most doctors will shake their heads and tell you there is really not much that can be done for you. It’s common, it’s progressive and there is really nothing you can do about it.
Luckily there is a neo conventional approach. Dr Dale Breseden who wrote the book The End Of Alzheimers and who heads the Buck Institute in California understands that dementia is caused by multiple factors therefore one medication is never going to address all the multiple factors and therefore the medication approach alone is never going to be the answer.
Dementia is an epidemic and it increases as populations adopt Western Lifestyles. So if something about our lifestyles is causing dementia ….if we change our lifestyles can we affect dementia. Most doctors will say no but they have never tried a program to change lifestyles so they never see any benefits.
Dementia can be broken down into 5 categories….atrophic, inflammatory, toxin related, vascular and traumatic. Each category obviously has to be handled differently. Dr Breseden has put together a program that other doctors can use that thoroughly evaluates patients for mold, lyme, nutrition, stress, sleep, supplement use etc and develops a detailed care plan for IMPROVING BRAIN FUNCTION AND BRAIN SIZE. There are programs that will take a brain MRI and measure all the different parts of the brain so when you work on a patient you can actually share with them whether the intervention is working or not. . It’s a very holistic approach that I don’t think many health care providers have time or training for.
The RECODE program , as Dr Breseden has developed it, is a step by step evaluation of the different causes of brain deterioration and a step by step treatment approach based on the testing done. I see a lot of records from neurologists and other doctors..;…never have I seen anything close to what Dr Breseden has put together. So here’s the part where I recommend an existing program that you can access locally. Unfortunately, just as there is no Dean Ornish treatment center in Central New York, there is no RECODE program that I know of locally. As an aside , ask your cardiologist if he supported attempts to bring the Dean Ornish program to the area. The Dean Ornish program is a well established , medicare approved approach that uses diet , exercise, and stress management to reverse heart disease without surgery. You would think that with all these local hospitals cranking out the major heart surgeries they would have at least a passing interest in a non surgical approach but nothing doing. Zero point zero interest and I know because I personally tried to bring this program to Syracuse but without support from even one cardiologist ( and I wrote to every cardiologist office and all 4 hospitals ) I don’t have the patient base to hire all the necessary personnel.
So, no Dean Ornish for the heart but yes to the RECODE program for the brain because I can do this without outside help. I have just finished the RECODE course which involved hours and hours of studying nutrition, toxicology, gut health, brain imaging, brain training, supplement use etc. I have my Nurse Practitioner Nancy Popp also getting trained up because it’s a lot of work for the patient and the practitioner but it will be worth it when we make a difference in patients lives. I didn’t sign up for this program to make money….we doctors are doing fine thank you even without a raise from medicare or the insurance companies for years. I took this course and will offer this program because it’s a critical health care issue and no one else in the area is offering the program.
I am still working out the costs and program details. ….some of which will be covered by insurance but whatever the cost is trivial compared with the tremendous cost of nursing home care or even adult home care. My clinic is already full , I don’t need more patients but local patients need this care and I am going to make it happen. I don’t need a certain number of patients to be successful.
Working on memory loss is not going to be easy. It involves making real changes in lifestyle and I think there will be a fair number of people who simply cant make the necessary changes but for those patients and families struggling with dementia we finally have real choices. Don’t call my office ….check out this link for further info and contact info…..by the time this is in print I should be up and running and available through this link. https://www.apollohealthco.com/solution/recode/
You don’t have to change doctors. You do not have to join my concierge program. This is a completely separate program for people who have been told …”there is really nothing to be done” . I don’t think that’s true any longer. You can just watch your loved one slip away into that dark night of dementia or you can try something different.
I was struck recently by a comment made by one of my patients. He ran into a local doctor who was prominent in the community but had retired prematurely due to signs of dementia. My patient, very interested in nutrition, suggested to his wife that they embark on a nutritional approach to treat their illness but the family stated they’re going to stick with the conventional approach. Well, the conventional approach is infective medicines, worsening condition over time until the nursing home. Why would you settle for that approach when something else is available? it could be due to inertia but it shouldn’t be due to ignorance anymore, The RECODE program offers you something previously unavailable to Central New York. You want easy? Let’s talk quantum physics but if you want results….check out the RECODE program. Its your brain, its your family, its your future…..it’s in your hands and it’s up to you !
Until next month….get well and stay well
J BARRY MD
APRIL 2022 TABLEHOPPING ARTICLE
Dr Malcolm Kendrick has just released his latest book….the Clot Thickens and its another must read. His prior books…the Cholesterol Con and Statin Nation both laid out in detail the many failings of the cholesterol causes heart disease hypothesis and the sustained efforts of the pharmaceutical industry to make you believe that statins make a real difference in heart disease. Unfortunately most doctors and health care providers have drunk the kool aid and still believe that cholesterol is a major factor in heart disease and that everyone should be on a statin. I have a very hard time convincing even my own Nurse Practitioners to stop looking at the guidelines and start looking at the data. It’s hard to go right when everyone else is going left.
In this, his latest book, Dr Kendrick reviews these issues but goes into much more depth about the true causes of heart disease inflammation (and its many causes) and the delicate balance between bleeding and clotting. He gets right to the bottom line in reviewing what interactions really change life expectancy. The evidence shows that by sunbathing you can gain up to a 10 years increase in lifespan. Just going outside , spending time in the sunlight which is simple, free, and enjoyable. On the other hand, 40 Years of statins will give you the lifespan expectancy gain of just under a month..that’s right … 3 days extra for every 5 years of taking a statin. So, take a statin for 40 years to gain just under a month of life expectancy or do some sunbathing and gain 10 years ! Does this seem like a hard choice to you?
What about shortening life expectancy? Of course smoking leads the list. Smoking takes at least 10 years off your life expectancy and that’spretty well accepted. What’s not accepted or well known is that taking proton pump inhibitors (prilosec, omeprazole, aciphex etc ) causes on average a reduction of 2 years in life span ! The mechanism of action is that the PPIs have an adverse cardiovascular effect via a reduction in nitrous oxide production. Dr Kendrik points to a data mining exercise examining records from 2.9 million patients who were on proton pump inhibitors were associated with a 1.16 fold risk of having a heart attack and a 2 fold increase risk of cardiovascular mortality. That’s a doubling of cardiovascular mortality by taking a Prilosec or other drug chronically. So one of the most popular drugs in the world has clearly and repeatedly been shown to increase your risk of dying…what did your doctor say about that?
So his suggestions as to how to keep cardiovascular diseases at bay include focusing on the items that have the biggest effects. Data inthe United Kingdom from 3,878,256 patients analyzed over 10 years and machine learning was used to evaluate cardiovascular risk prediction. The top conditions related to CVD risk factors were :
- #1 COPD / smoking
- #2 Steroid prescription
- #3 Age
- #4 Severe mental illness
- #5 South Asian ethnicity
- #6 Prescription of immunosuppressant
- #7 Socioeconomic status quintile number 3
- #8 Socioeconomic status quintile number 4
- #9 Chronic kidney disease
- #10 Socioeconomic status Quintile number 2
Diabetes and hypertension did not make the top 10! Socioeconomic status quintiles refer to a patient’s status economically. This was based on massive computing analysis of many patients but doesn’t prove causation. Lower socioeconomic status equals more stress and Dr Kendrick points to loads of data both clinically and biochemically wherein stress is a major risk factor for heart disease. Is severe mental illness associated with heart disease because most of those patients smoke or is it because most of those patients are chronically stressed out ?
When you look at it, severe mental illness, steroid prescription and immunosuppressant prescription all work in the same function affecting the hypothalamic-pituitary-adrenal axis with resultant insulin resistance. Stress does the same thing. It’s not just some new wave mumbo jumbo …there are direct physical, chemical, and hormonal pathways linking stress to health consequences.
Where did LDL (what your cardiologist calls the “bad” cholesterol) fall on the list of associations with heart disease? It ranked 46 out of 48. Yet another proof that LDL cholesterol was not a significant risk factor for heart disease. Ok, this study was done in the United Kingdom but it’s probably more relevant to heart disease in America than one done in China or Chile.
What were Dr Kendricks personal recommendations regarding reducing heart disease risks? Of course he talks about smoking reduction, exercise , sun exposure (which increases nitric oxide production) sleep and stress management but he also talks about supplements…none of which he has any financial interests in. He particularly mentions terms of supplements ; Vitamin D, Vitamin C, Potassium, Magnesium, L-Arginine, and L- Citrulline. These are his recommendations to well people. If you have diagnosed heart disease he adds Chondroitin Sulfate (which acts to protect the glycocalyx ), thiamine, CO Q -10 ( since most of these patients are on statins ) and viagra like drugs (which increase nitric oxide production). He also favors considering aspirin and avoiding nonsteroidal drugs and proton pump inhibitors. If you have diabetes he recommends a low carb diet, short burst exercises, reducing alcohol and consider chelation therapy. This last one will be discussed in future columns.
I don’t know if it’s more important for you or your health care provider to read this book. Well, it may be too difficult for your health care provider to change how they think and how they practice but it’s not too late for you to improve your health. Look at the evidence in this book or his prior books not at the recommendations of the guidelines because these guidelines have been hopelessly corrupted by Big Pharma. Don’t get me wrong…there is a time and place for pharmaceuticals but they must come after the basics of diet, exercise, sleep and stress and not be used as a substitute.
Until next month….get well and stay well.
JT BARRY MD
MARCH 2022 TABLEHOPPING ARTICLE
A big topic amongst many people concerned with longevity and “health gevity” is the use of supplements. I’m not talking about Vitamin D or fish oil. I am talking about more controversial supplements like NR, NMN, and Fisetin. Will these supplements prolong your life and increase your health or will they cause cancer and wreck your metabolism?
We are talking about medications / supplements that affect metabolic pathways of aging including mTOR, but work primarily by affecting the Sirtuin Pathway. This pathway was discovered in the 1970’s and is a major anti-aging force. Aging is not just a date on a calendar …it’s a progressive loss of certain nutrients and an accumulation of certain toxins that ultimately affect basic cellular function including the mitochondria…the powerhouses of your cells.
Let’s start with the basic Niacin or B3. This water soluble vitamin is the backbone of one of the most basic and necessary energy molecules ..NADH that is only second to ATP as an energy store in the body. You can make niacin from the amino acid tryptophan but you can also get it from leafy veggies , liver, most meats, etc. There are several steps in between Niacin and NADH including a compound called Nicotinamide riboside which has been commercially available as a product since 2014. This , in turn, is turned into nicotinamide mononucleotide also called NMN. Two of these NMN molecules make up one unit of NAD which can now act as a hydrogen transporter / energy generator. We know that when we supplement yeast and mice with these agents they are healthier and live longer than unsupplemented animals. What about humans? Well we just don’t have enough answers for me to recommend any of these supplements except Niacin which I recommend people get as a B Complex or B Complete . Dr David Sinclair at Harvard is currently experimenting with all these compounds as well as Resveratrol and other senolytic molecules like ficiden and quercetin which may improve health and extend lifespan..quercetin reduces fatty liver and other markers of poor health/ inflammation. …ficiden is a plant molecule found in grapes, apples and is available as a supplement. Resveratrol also activates the sirtuin pathway but you would need to drink more than a hundred bottles of red wine a day but you can get 250 mg as a daily supplement which should be taken with some olive oil or other fat to improve absorption.
There are clinics in Florida and California where people are going for injections of NAD which they claim helps with depression, addiction and hangovers.
Now there are other classes of drugs that have promise. The drug rapamycin and its analogs have shown benefit of extending life span in every species studied so far it acts to inhibit mTOR it mimics fasting and mimics the effects of a low protein diet.This drug is available as an immunosuppressant for transplant patients so it its commercially available but it’s a stretch I’m not willing to make to take it now for possible health benefits.
Ok, How about spermadin ? These are crystals found in sperm , oddly enough by the inventor of the microscope Antoine Van Leeuwenhoek, and it stimulates autophagy and stabilizes the epigenome…1.2 grams a day improved memory in one trial…you can get it in wheat germ if you like.
What about metformin? This is an AMPK activator drug which is used worldwide for diabetes. Its so safe that in half the world its available over the counter. The drug lowers ATP and produces an increase in mitochondria….its an mTOR inhibitor and raises NAD levels so what’s not to like? Well it’s still artificial and I would like to age as naturally as possible but I am looking forward to better studies and certainly respect people who want to try these compounds.
Which leads us to Berberine which is a plant molecule similar to metformin…it can mimic metformin…it reduces chemical reactions in the body and the body responds by making more energy and mitochondria. You have to use 1-2 grams a day. I plan to try the Berberine for a month and see if it improves any metrics of my health and see how I feel but I will hold off on the others until I see more study results. I am sure there are many more compounds I have left out but that leaves fodder for another column. Until then ….work on the basics of diet and exercise….don’t expect any supplement to be as beneficial as eating health and getting a workout. You know the drill but have to find the motivation to do it. Someone once said change comes from inspiration or desperation ….which will it be for you? Until next month Get Well and Stay Well
JT BARRY MD
FEBRUARY 2022 TABLE HOPPING ARTICLE
FRUIT ISN’T ALL THAT !
This article draws heavily from great work on carbohydrate metabolism by Dr Gary Fettke, a Tazmanian surgeon who drew the ire of the nutritional service at his hospitals when he suggested diabetic patients could prevent further amputations if they lowered their carbohydrate intake. Even though the government guidelines suggest you should get half your calories from fruits and grains, excessive carbohydrate intake is dangerous. For millenium carbohydrate intake was seasonal and fruit based and since we began to bake and use grains our health has deteriorated. Fruit was intended to fatten us up for Winter. We now have endless Summer in our groceries so we are not seasonal anymore and it shows in our waistlines.
All carbohydrates are sugar…There are many different sugars ..glucose, sucrose, fructose for example. The human body goes to great lengths to remove excess sugar from the bloodstream. Any excess sugar in the bloodstream is dealt with aggressively by the body to keep the levels low because too much is toxic. Turns out more than a teaspoon of sugar has a toxic effect
It’s all about energy production and that brings up the Krebs cycle in which acetyl coA is converted by the mitochondria into energy….ATP to be exact. ..Acetyl coA can be produced from fatty acids, sugar and amino acids. There is no absolute need for sugar as an energy source in contrast to fatty acids and amino acids which are absolutely essential. Glucose can be consumed by us or created by gluconeogenesis and from glycogen stores. Excess glucose triggers an elevation of sugar which in turn stimulates insulin. More than one teaspoon calls for a response. A slice of bread contains 5 teaspoons of sugar so that’s a lot of extra sugar that the body has to remove from circulation. .Glucose and fructose are very similar sugars but are handled very differently by the body. Fruits contain both glucose and fructose in roughly even proportions.
Chronic elevation of sugar causes advanced glycogenated end products to build up. This in turns oxidized fats etc to contribute to inflammation. These AGE’s affect the brain, the eyes, the heart, the kidneys, wound healing , infection and cancer. Elevated glucose levels also glycate other tissues and lipids. The glycocalyx is a coating of every endothelial blood vessel….its critical to health and is fragile …this organ of sorts is particularly affected by elevated blood glucose. Damaging the glycocalyx is analogous to damaging the lining of your gut causing leaky blood vessels much as you get a leaky gut.
Excess sugar triggers increased insulin which is generally inflammatory. There is a direct correlation between insulin levels and degree of inflammatory markers in the knee as shown in a study done within the last 5 years and mentioned by Dr Fettke. Insulin reduces vitamin D absorption, Insulin stimulates tumor growth; Insulin lowers magnesium levels which are required in myriad biochemical pathways and insulin increases clotting measures.
Now Fructose in particular is mostly metabolized in the liver… Fructose raises uric acid which is also inflammatory and elevated uric acid negatively affects the production of nitric acid which is a critical component of vascular heath. Uric acid decreases white cell function and adversely affects our response to infection. Fructose actually increases hunger via both the leptin and ghrelin pathways if you want to get technical. Fructose increases the oxidation of ldl…the type of lipid your doctor calls the “ the bad cholesterol “
Just as an aside…why do they give you so much sugar in the hospital? . It’s not just in the food…breakfast pizza and pecan pie are touted as healthy…Sugar is directly toxic to the immune system but how many people are getting a sugar water Intravenous solution.?! One more thing to worry about when you go into the hospital.
One way to manage your sugars is obviously via your diet. Keto diets are low carbohydrate/ low sugar diets that directly address this issue of carbohydrate toxicity. Many physicians are leery of a keto diet but let’s look at the keto diet in the most vulnerable population we have…..unborn babies. We have a long and consistent medical record here. Mothers with morning sickness are often in ketosis…this is something we have seen and measured . The other end of the spectrum is babies whose mothers have gestational diabetes. So. Some babies are exposed to very low sugar and some babies are exposed to high sugar levels and we can track their outcomes. . It’s no surprise that the keto exposed babies are healthier in every metric compared to the gestational diabetes babies….premature births, birth defects etc all worse in the high sugar good.
Scheduled obesity is the process of turning sugar into fat during times of plenty. There were papers published as early as 1948 that connected sugar with illness. By 1992 the food guide suggested 5-9 fruits and vegetables a day but there is no real science behind that recommendation. In 2005 the CDC partnered with the produce industry to continue to promote fruits along with vegetables. The Epic Study in Europe involved over 500,000 people and lasted for over 15 years and did not show a correlation between fruits and veggies and cancer rate.
How much sugar is healthy according to the World Health Organization? ….25 grams which is 6 teaspoons of sugar a day. We have gone from 5 pounds a year of sugar consumption to 152 pounds a year. And that’s an average.
Well, what about all the other nutritional benefits of fruit in terms of minerals, vitamins and micronutrients. ? Fruit nutritional value is overstated. Look at antioxidants….a cup of coffee has much more antioxidants than most fruits/ Look at vitamins …..well green leafy veggies have much more vitamin E, vitamin A etc. Look at minerals….again green leafy veggies ie spinach has more potassium than the banana Fruit also has less phytonutrients and fiber than many vegetables.
So let’s start the New Year off right and keep things in perspective. Fruit may not be the substance you should base your diet on but it’s way healthier than any fast food, fried food , processed food and liquid calories like soda and fruit drinks. Have fruit but seasonally and sporadically like your ancestors experienced and see how you feel. If you want to try to lower your carbohydrates in your diet I would refer you to Keto Syracuse on facebook. Keto Phil knows what he is talking about and has all the references you would ever want and more.
Knowledge is power . Make this the year you become truly powerful.! Until next month….get well and stay well.
JT BARRY MD