Insane Medicine – Bisphenol A is a danger that is found in Plastic containers: Basic information

Insane Medicine - bisphenol A
Insane Medicine – bisphenol A (BPA)- causes prostate changes and behavioral changes.
  • BPA is found in polycarbonate plastic and epoxy resins. Medical devices and even cash register receipts have the toxin in it. It can leach into food in plastic containers, especially when they are heated or washed with harsh detergents.
  • It can affect behavior and also the prostate and reproductive system.
  • Some BPA-free items still have estrogen-like chemicals in them because they use Bisphenol-S (BPS). You need to find BPA and BPS- free cups or use stainless steel.
  • Avoid food containers, dishes, and cups with “PC” on them, which is polycarbonate, or have recycling label #7 on them. They will have BPA and BPS in them.
  • Choose glass, ceramic, and stainless steel.

Your guide to BPA and avoiding it is below:

http://www.ewg.org/bpa/

http://www.ecobags.com/ <–cotton and BPA safe carrier bags

 

Insane Medicine – Look out for the rise of Camelina oil: Healthful and potentially a rocket fuel!

Camelina Sativa - the source of Camelina oil
Camelina Sativa – the source of Camelina oil
Typical fatty acid content of camelina, canola, linseed and sunflower oils in %.
16:0 18:0 18:1 18:2 (omega-6) 18:3 (omega-3) 20:0 20:1 22:1
Camelina 7.8 3.0 16.8 23.0 31.2 0 12.0 2.8
Canola 6.2 0 61.3 21.6 6.6 0 0 0
Linseed 5.3 3.1 16.2 14.7 59.6 0 0 0.9
Sunflower 6.0 4.0 16.5 72.4 0 0 0 0

 

 

  • Camelina Sativa is a flowering plant also known as false flax or wild flax and is used as an oilseed crop or livestock feed.
  • It has exceptionally high omega-3 fatty acid content (45%) and are 1/3 protein in content. It is high in antioxidants, such as tocopherols and vitamin E. It is a great cooking oil due to a smoke point of 475 degrees.
  • The oil can reduce the bad cholesterol levels (LDL) in the body.
  • Camelina is being cultivated in Montana and is being used as a biofuel for the military, and quite effectively.
  • It has an almond-like flavor.
Insane Medicine -Camelina oil
Insane Medicine -Camelina oil

 

Insane Medicine: Cancer preventing diet considerations.

Recommendations from the Physicians committee for Responsible Medicine offer 6 dietary changes one can make to help prevent cancer:

  1. Decrease dairy products in men as each 35 gm taken in will increase prostate risk by 32%
  2. Decrease alcohol intake to decrease breast and colon cancer.
  3. Decrease red and processed meat as each daily serving increases risk of colorectal cancer by 21%.
  4. Avoid grilled and fried meats.
  5. Eat soy products such as tofu, edamame, and tempeh to decrease breast cancer risk
  6. Consume more fruits and vegetables.

Insane Medicine – Know thy fats! (Before they become fats!)

Insane Medicine - Good fat - Bad Fat - slice of salmon
Insane Medicine – Good fat – Bad Fat – A slice of salmon

 

There are some key facts to know when you are in the store about fats to avoid: No Trans-Fats! The FDA is planning to have these removed from processed foods in the near future.  Lean towards Monounsaturated fats (MUFA) which are heart healthy.

  • Avoid vegetable shortening, which is abundant in baked foods and also sticks of margarine, which have Trans-fats in them.
  • Tub Margarine may be free of Trans- fats, but be careful as they may have partially hydrogenated oil in it.  That is the same as trans-fats! If you see that on the label, chose another brand!
  • For your spreads used in baking, try to aim for those with at last 2/3 oil in them to get the best results.
  • Aim for more MUFA. Olive Oil and Avocado Oil are the best choices to use in baking, dressings, cooking. They have 65% MUFA content!
  • Extra Virgin Olive still has the polyphenol antioxidants and vitamin E in it,. This choice is even better as it is more healthful.
  • Canola Oil is another option for MUFA.
  • Soybean and corn oils are higher in Polyunsaturated Fats (PUFA) . They have higher amounts of omega-6 fatty acids, but too much of this can be unhelpful in that it can increase body inflammation.
  • Hazelnut oil, flaxseed oils, and walnut oils are also healthful. Flaxseed oil breaks down at temperatures of 225 degrees, so it is best used in marinades, salads, but not cooking. Likewise Walnut oil, which smokes at 320 degrees ( a rather low temperature for baking.)
  • As far as nuts are concerned, consider Macadamia nuts, almonds, and hazelnuts for MUFA content. Walnuts have more PUFA in the form of alpha linolenic acid ( ALA) , a form of omega-3 fat that converts to EPA, which is heart healthy. Flaxseed and Hemp both supply ALA as well and are beneficial to health.
  • Fish poducts, especially tuna, salmon, sardines and other oily fish are high in omega-3 PUFA ( EPA – Eicosapentanoc acid and DHA – docosapentanoic acid). They are excellent choices for food. Try to eat two- four ounce servings a week.
  • For meat, consider skinless, breast meat of chicken and turkey.
  • For red meat, which has more harmful saturated fats, aim for ones that have a higher stearic acid content that is found in grass-fed beef and has more omega-3 as well. Remember that eating fish protects against inflammation, arthritis, diabetes, decreases arrhythmias, lowers triglyceride risk, and decreases blood pressure. To avoid contaminated fish (that have mercury, polychlorinated biphenyls, or dioxin), stay away form tilefish, shark, swordfish, and king mackeral. Instead, try tuna (bluefin, yellowtail, or skipjack), halibut, and salmon. Best choices for sustainable fish can be found at:  http://www.seafoodwatch.org/ and http://www.msc.org/ Other eco-friendly and healthful fish include pollack, haddock, albacore tuna, Barramundi, rainbow trout, and farmed shellfish such as blue mussels, oysters, and bay scallops. Farmed seafood offers excellent healthful and sustainable food.
  • Milk, cheese, and yogurt from grass-fed cows also have higher amounts of omega-3 FA content.

Insane Medicine – Parkinsons disease symptoms can be improved by Vitamin D supplementation

Insane medicine - old man walking
Insane medicine – old man walking – note the wide based walking pattern and hunched over – this may be a presentation of Parkinson’s Disease, even if there is no tremor.

 

  • There is an apparent link between Parkinson’s disease (PD) severity and lack of vitamin D! Increased serum levels of vitamin D (25-OH-D) are associated with less Parkinson’s symptoms!
  • Studies in which patients with PD were supplemented with vitamin D to raise their serum vitamin D levels had improved outcomes and less need for PD medications relative to those who did not take Vitamin D supplementation.
  • Apparently there is a genetic component in the response to vitamin D supplementation for PD patients. Those PD patients with the VDR Fokl TT or VDR Fokl CT gene types responded better to supplementation.
  • How much vitamin D? 1200 Units a day – not that much at all!
  • Why does this work? The VDR gene is expressed in the substantia nigra of the brain, an area involved with movement, and is depleted in PD patients. Dopamine is what allows an individual to move normally, and this is depleted in PD patients. Vitamin 1, 25-Hydroxy D ( a metabolite of the Vitamin D we take over the counter), when increased by supplementation, increases the rate limiting enzyme Tyrosine hydroxylase in the brain, which produces more dopamine to allow better movement.
  • Levels of serum vitamin-D that we want is greater than 30 ng/ml.
  • Of note, there are benefits shown from other studies, that in patients with knee osteoarthritis and low vitamin- D the use of  oral vitamin D3 (Cholecalciferol) results in less knee pain after a year relative to untreated individuals! These people received 60,000 IU Vitman D3 once a month.

Insane Medicine – Stool DNA tests for detecting colon cancer

  • The FDA approved Cologuard (Exact Sciences) to screen average risk adults for colorectal cancer. Age must be over 50. This is a DNA-test performed on a stool sample.
  • Options for screening for colon cancer include barium enemas, flexible sigmoidoscopy (the doctor uses an instrument to look in the colon under sedation), CT colonoscopy using a CT scan with contrast, or colonoscopy to look for cancers.
  • Current guidelines recommend that at the age of 50, a colonoscopy be done every 10 years.
  • The stool DNA test can be used for those who refuse a direct visualization of their colon. The DNA test looks for something called KRAS mutations and NDRG4 and BMP3 methylation, as well as hemoglobin to determine if there is a probability of colon cancer.
  • The test detected 92% of the cases of colorectal cancer in people without symptoms. It had a fair amount of false positive tests, meaning that it gave a positive result when, in fact, the patient did not have the disease. Obviously, a colonoscopy must be done if the test is positive to look directly at the colon.
  • The test is done by having the Cologaurd kit sent to your house and providing a stool sample that is shipped back to the company. How convenient!
  • Again, this is another option to screen for colorectal cancer.
Colon cancer
Colon cancer invades the colon wall.

Insane Medicine – Get your Influenza vaccine!!!

  • Get your Influenza vaccination!! The strains covered by the vaccine are based on circulating strains in the southern hemisphere from the prior year. It is effective in 50-80% of young adults if the match is close between the vaccine components and the circulating strain, but even if not, there is a reduced risk of death from influenza.
  • Older people have less response to the vaccine.
  • The intranasal vaccination is a weakened live preparation sprayed in the nose of patients age 2 to 49. Pregnant patients cannot get this one. This works better than the inactivated vaccine if you are less than 6 years old, whereas the opposite it true in adults. The shot works better for adults.
  • The elderly, especially those older than 65, do not respond as well to the regular vaccination. There is a Fluzone High-Dose vaccination that has four times as much antigen in it and is more effective in preventing influenza.
  • The vaccination decreases the risk of cardiovascular events in patients with heart problems, and it prevents risk even more in those who recently had a heart attack.
  • All pregnant patients need to be vaccinated – this protects the mother, and the antibodies protect the baby  for six months after delivery! It takes two weeks for the vaccine to be fully effective inpatients.  Remember that pregnant patients must not get the live vaccine.
  • If you have an egg allergy, you can get the FluBlok vaccination.
  • Vaccination should be done from October until May.
  • Side effects for the injection form of the vaccine include aches at the injection site and a small risk of a nerve condition called Guillian-Barre syndrome. The live nasal mist can cause nasal congestion and a sore throat. Patients who get this vaccine shed live virus for a few days after and should not be near people who have poor immune systems from problems such as chemotherapy.
  • Either way, the influenza vaccine SAVES LIVES!!

Insane Medicine – Lineoleic acid decreases cardiovascular death risk

Insane Medicine - Omega fatty acids
Insane Medicine – Omega fatty acids come in two flavors – omega-3 and omega-6!
Insane Medicine - fat pyramid
Insane Medicine – fat pyramid

 

  • Omega-6 fatty acids are also important for heart health. Evidence suggest that linoleic acid, an omega-6 fatty acid, when found in higher levels in the blood, decreases the chance of death from cardiovascular disease .
  • Sources of linoleic acid are: walnut oil, sesame oil, sunflower oil, corn oil, safflower oil.

Insane Medicine – Hearing loss associated with acetaminophen and ibuprofen use!

  • The frequent use of ibuprofen and acetaminophen may contribute to hearing loss in women. This risk is increased up to 24 % in women who take the products more than twice a week, especially if they are younger than 50. There is no association with hearing loss in women and the use of aspirin.
  • Aspirin use in some studies, was associated with hearing loss in men.
  • This hearing loss results from damage to the cochlea in the ear,  which is central to auditory perception. The use of these medications may decrease blood flow to the cochlea, causing the damage.  Using these medication more often increases the chance of hearing loss. For example, the use of ibuprofen 6 or more times a week was 24% more likely to cause hearing loss, whereas use of it only twice a week resulted in a 13% increased chance of hearing loss.
Insane Medicine - The cochlea
Insane Medicine – The cochlea – involved with hearing.

American Journal of Epidemiology

 

Insane Medicine – Ebola threats continue to rise

ebola virus infections

Insane Medicine -Reported ebola cases - they continue to rise and unreported cases are definitely increasing as well!
Insane Medicine -Reported ebola cases – they continue to rise and unreported cases are definitely increasing as well!
  • Are US hospitals prepared for Ebola? Not really. The entire process of protecting health care workers has been in a state of flux. The CDC itself has been changing the rules of engagement for healthcare providers in terms of the protective mechanisms that need to be applied in the event of an Ebola patient’s arrival.
  • Most Emergency Departments would need to shut down after the arrival of such a patient due to decontamination needs. As was seen in Texas, even with protocols the disease still is able to spread to healthcare workers. It seems logical that patient with risk factors in the US for Ebola should be transported immediately to centralized facilities capable of handling such biohazards. They should bypass smaller ED’s and free-standing ED’s., where staff have little or no training in biohazard protection. In the US, there are probably less than 15 dedicated isolation centers for hazardous infections, Emory having two of them.
  • The disease continues to increase in the number it has infected. There is no current accepted treatment for it. The graphs above show the large numbers infected and the continued rise in affected individuals. As expected, some of those with the disease will travel abroad…
  • There are many gaps in the current data for infections, the total number being vastly under-reported. The fall in the number of infections in some areas may be due to overwhelmed facilities turning away Ebola victims, many of whom go on to die elsewhere. Those people fall through the cracks of epidemiological surveys. Many patients may not be seeking medical care because they live far away or the facilities are full. They die at home and are buried.
  • Many patients in Africa do not get tested for the disease but have symptoms of it. There are not enough resources to test in many areas. In Liberia, only 22% of the cases were confirmed by testing.
  • The worst case scenario per the CDC is that 1.4 million people may be infected in Africa by January 20. Currently, the number of cases is doubling every three to four weeks and is continuing. The key to containment will be control measures to prevent spread in theses areas, including safe burial practices.
  • In the US, the presence of a single infected patient who flew into Texas demonstrates the degree of risk and magnitude of strain on resources that occurs. Tracking hundreds of contacts on planes and casual contacts is very difficult and costly.

Links to Ebola related reports are as follows:

http://www.sciencemag.org/site/extra/ebola/  < Science Magazine special collection.

http://maimunamajumder.wordpress.com/2014/10/09/ebola-new-updated-charts-14/  <– statistical data from MIT

http://healthmap.org/ebola/#projection  < Ebola infection data model of number of infections.

 

  • Currently, two vaccines are being developed in trials for Ebola. NewLink genetics (NLNK) has a vaccine in trials now that uses the Ebola surface protein in a weakened version  of vesicular stomatitis virus (a virus that attacks farm animals). GlaxoSmithKline is developing and testing another Ebola vaccine, in which genes for a surface protein from two different strains of Ebola have been stitched into a chimpanzee adenovirus. Hopefully one of these systems will be effective.

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