Monthly Archives: August 2008

PUT INSULIN SENSITIZERS eg METFORMIN/ GALEGA (NOT STATIN OR ASPIRIN) IN THE DIET TO LOWER ALL COMMON DEGENERATIVE DISEASES INCLUDING CANCER.

It takes no rocket science to see how increasing fatness parallels increase in all common degenerative diseases, from diabetes to high blood pressure to heart, circulatory, brain, arthritic – inflammatory, depressive, memory, vision  and cancer (Barclay 2008; Hjartåker 2008 )  problems.  Major earlier studies in  eg the Netherlands, USA and UK confirmed this statistically.

 

Similarly, the century-old knowledge that diabetics are more prone to cancer has been confirmed in several countries (Czyzyk  2000), including endometrium, breast, bladder, liver, kidney,  prostate, pancreas and colon.

 

A  Hong Kong study (Yang ea 2008) registered and followed up new diabetics from 1995; showing after a mean of 4.9yrs that from the age of 35yrs on,  compared to nondiabetic controls, standardized cancer incidence in male diabetics  at 0.93% was 36% higher, and   in diabetic women at 0.62% was 27% higher – ie diabetes in  even the mildly average overweight (mean BMI 25 instead of the optimal 21-22kg/sqm)  increases cancer risk by about a third.

 

But more important, what can doctors do to reduce this increasing co-morbidity?

 

Only dictatorships – prisons, not doctors –  can compel  patients to eat, drink, exercise sensibly and not smoke. But for the disaster capitalists that now dominate the world, vice and disease pay too well. So the Disease Industry tries progressively to suppress nutritious natural preventative and curative supplements while promoting sloth,  gluttony and  nonprescription sales of the biggest killers eg sugar, tobacco,  alcohol, and noncurative designer drugs eg non-steroidal anti-inflammatories and statins.

 

STATINS increase inflammation in muscle and liver,  show   no independent  benefit in lowering C-reactive protein CRP , and  no benefit against cancer:

In the 2001 Texas Lovastatin trial  in 6600 well older people, there was no reduction in all-cause mortality, but  statin associated with 41% more cancer deaths;

in the 2002 PROSPER pravastatin  trial in 8800 well people 70-82yrs old, new cancers were 25% higher  on statin than on placebo;  

in the 2005 Oxford CTT metaanalysis  in 90 000 people, statins did not lower the incidence of cancer in  14 statin trials; but in the older –

in the 2008 Baltimore metaanalysis in  51 300 adults  from 60years up, statins associated with 6% more cancer.

 

METFORMIN STUDIES  since 1922  have shown increasing evidence that metformin not only  about halves the incidence of new diabetes and of deaths in diabetics,

it also significantly reduces CRP , reduces the risks of  osteoporosis fractures (Vestergaard 2008; Kanazawa 2008); and cancer in rodent and human cell lines, and

in the UKPDS (1998) after about 13yrs associated with about 1/3 less  all-cause and  cancer  deaths;

in the Dundee Tayside (Evans 2005) diabetic  study metformin,  associated with up to  40% less cancer in those on  the longest. and highest metformin  consumption,

in the Canadian (Bowker 2006) diabetic  study  metformin associated with half the mortality and  30%% less cancer than on other  antidiabetics. .

 

The Hong Kong 2008  study confirmed the well-known U shaped curve relationship between serum cholesterol, cancer and death,  in fact a V relationship with LDL cholesterol, with the lowest cancer  and death rate at  an LDLC of about 3.28mmol/- the risk rising linearly with LDLC below 2.8  or above 3.8mmol/L.

 

Statins lower LDL cholesterol and cardiovascular disease /mortality but not  adiposity, insulin resistance, diabetes, fractures, cancer, depression  or non-vascular  morbidity-mortality.

Metformin about halves  new diabetes, lowers obesity, insulin resistance,  lipidemia, reproductive problems, ischaemic heart disease   and in diabetics lowers both vascular and cancer events and mortality.

 

So it is insulin sensitizers (metformin or a non-prescription mix of a score of natural ones including fish oil ), not statins or nonsteroidal anti-inflammatories that must be promoted over-the-counter to combat the pandemic of overweight- reproductive- diabetes- vascular- malignant and arthritic-immune diseases that is  progressively curtailing by decades  the healthspan of the haves.

 

See the HRT  and supplement papers  below, and the recommended condition-specific supplement product information.. For specialist  internist consultation on appropriate supplements including HRT for individual circumstances, email your concise health details to info@healthspanlife.com ..

  

WHY PRESCRIBE OR TAKE FORTEO- TERIPARATIDE FOR OSTEOPOROSIS?

question: how can I afford Forteo?

Answer: why on earth prescribe or use  a synthetic like Forteo? with all it’s risks eg  see http://www.umm.edu/altmed/drugs/teriparatide-121950.htm; and   http://www.drugs.com/forteo.html :
“What is the most important information I should know about Forteo?
This medication has been found to cause an increased risk of bone cancer in animal studies. It is not known if this risk is also increased in humans treated with Forteo. Talk with your doctor about your individual risk.Forteo can cause side effects that may impair your thinking or reactions. ”

So  Insurance is right not to pay for it- all it benefits is the manufacturer, prescriber and dispenser. There do not seem to be any published followup data for Forteo beyond 3 years- not surprising since it involves daily injection at gigantic cost, and was only invented in 2002.  Look at the lesson of bisphosphonates- increasing reports of bone (jaw, long bone) collapse since 1995.

Remember- the chief risk factor  for fractures with osteoporosis is not low bone density but falls- inco-ordination and muscle frailty. So rather use permanently the basket of  safe lowcost natural dozen anabolic supplements  (including vitamins, minerals, proline and appropriate HRT) that protect ALL aging  systems, detailed in previous papers under  https://healthspanlife.wordpress.com/category/osteoporosis/

POLL AMONG WOMEN AND HEALTH PROFESSIONALS ON APPROPRIATE HRT

Let’s hear from women  and doctors on

WHY NOT USE PERMANENTLY BENEFICIAL  POSTMENOPAUSAL HORMONE REPLACEMENT  HRT THAT AVOIDS PERIODS AND BREAST TENDERNESS? (see the preceding paper hereunder).

naturally, for perspective in the poll analysis,  women taking part in this poll should supply their age, profession, and age since menopause.  

Health workers should indicate their profession, age bracket and gender.

   to vote, click on comments

See the HRT  and supplement papers  below, and the recommended condition-specific supplement product information.. For specialist  internist consultation on appropriate supplements including HRT for individual circumstances, email your concise health details to info@healthspanlife.com ..

WHY NOT USE BENEFICIAL POSTMENOPAUSAL HORMONE REPLACEMENT HRT THAT AVOIDS PERIODS AND BREAST TENDERNESS?

The new paper  this week from the WISDOM trial (stopped prematurely  in Oct 2002 as a result of the  precipitous closure of the main premarin-provera prempro arm of the Women’s Health Initiative WHI) concludes that  Combined HT  (ie oral prempro) started many years after the menopause can improve health related quality of life. 

 

 This  trial  in UK, Australia and NZ  was identical to the 2002  (USA) cohort of the WHI – women mean age  about 63.5yrs with uterus,  treated with the xenohormones  prempro  or placebo, BMI mean about 28.3 kg –    except that in the WHI the age range was    50-79yrs ( 45% 60-69yrs; 21.5% were 70yrs plus) versus in WISDOM. age  50 to 69yrs  (74% 60yrs +).

 

As opposed to physiological doses of parenteral human  estrogen-progesterone HRT, apart from the obvious known risks of oral xenohormones – increased fluid retention, gallstones, breast cancer, adiposity, hepatic first pass inflammatory effect –   one striking practical  question arising from these trials is, why would  postmenopausal women- let alone women a mean of about 15 years postmenopausal – want to take hormone therapy causing breast discomfort and menstruation, and known for 30 years to promote latent breast cancer? Surely only men could  so trivialize the needs of women?

 

    In WISDOM, 32% discontinued for this reason (menstruation); and such OHT gave  no relief from tiredness, depression, headache, irritability or migraine, but greatly increased arrhythmia; leukorrhoea,   and breast tenderness (13% who discontinued). These figures were matched in the WHI after a mean of 5.2 yrs, when 40% of women reportedly had to see a gynecologist due to  problem vaginal bleeding on prempro  vs 6% on placebo.

 

The benefits of  OHT for up to 10 years (Nurses study; WHI; Oulu trial (Heikkinen ea 2006) and especially permanent conservative balanced  HRT (testosterone and thus estrogen for men, for women  testosterone-estrogen-progesterone replacement) till past 90years has been overwhelmingly  proven in long term clinics world wide (eg Greenblatt; Schleyer-Saunders; Gelfand; Whitehead & Studd; Burger & Davis; Vliet; Shippen;  Nieschlag & Behre; Carruthers, Kauffman) – all of whom have observed reduction in premature degenerative diseases in their attending patients .

 

       It is common cause that  even appropriate OHT- started soon after menopause- reduces all-cause major illness and mortality by one-third, even after breast cancer. By avoiding OHT, one  may reduce the incidence of breast cancer; but only about 4% of women die of breast cancer – it rarely cripples; more than half of such  women thus suffer and die prematurely from other hormone-deficiency diseases like vascular, dementing  and  osteoporotic problems, which are halved by  appropriate HRT. 

The question  is, where is the logic of commercial marketed HT that forces the postmenopausal endometrium and ductal breasts to go on proliferating cyclically? One would have thought  that doctors and women learnt their lesson by 1980  with the increase in endometrial and breast cancer on long term unopposed oral estrogen therapy – mostly premarin in USA. Physiological testosterone replacement in men does not do this to the prostate, nor to the breasts or other organs in women. .

The published trials show that unopposed transdermal estradiol gave much lower rates of endometrial bleeding than OET- but seldom none at all.. 

And recently Horwitz and Sartorius  showed that even progesterone combined with estradiol  can be the trigger of latent breast cancer. .

 

Yet Medline reports  plainly that William Masters and  peers had firmly recorded by the time they reported the first randomized controlled HRT trial in 1953 that parenteral (intramuscular)  testosterone TT- estradiol E2 abolished endometrial and breast problems in even older, institutionalized  women (about 20 years post menopausal)- with nothing but benefits for the majority  of the women (remarkably only one-third failed to improve). They determined by trial and error that the optimal ratio was 20:1  TT:E2 – and they persevered for a mean of 13 months with a dose of TT 20mg plus 1mg E2 esters  twice a week (ie averaging about 2.8mg TT and 0.4mg E2 a day) .

       We have followed their regime for about a decade, but using a physiological approach with only 20mg TT ester and 1mg E2 ester subcutaneously every +-  fortnight  ie about 1mg TT and 0.05mg E2 a day. W rarely have to vary this ratio or dose in young women, whereas elderly women tolerate far less, complaining of breast and pelvic  tenderness  on the youthful dose. So for those who eschew the tiny injections and can afford cream, we use a combination of about 0.125% estrogen (80% E3, 20% E2) with 1% testosterone and 0.75% progesterone for young women, and about 1/8th that strength for the elderly. We

 let women  titrate the dose to symptom and bone  improvement without unwanted symptoms. With such combination in conservative balanced doses, we find that women have no more periods, and their endometrium and breasts  remain quiescent  on followup ultrasound and mammography respectively. .

 

 Recently the Karolinska Institute (Zang et al)  has  confirmed that combining testosterone with estradiol reduced the proliferative effect of estrogen on the endometrium- but they ignored Masters’ and Grody’s papers of 1953, the Karlinska trial used vigorous doses of oral HT in a too-low ratio of TT 10: E2 1.

 

And a separate paper  (Hofling et al) from the Karolinska  also confirms the findings of Zhou and Dimitrikakis, and Thomas Clarkson’s team at Wake Forrest,  that testosterone suppresses breast proliferation in humans, rats and monkeys.

        It is common cause that the healthy young woman has an average serum TT:E2 ratio of about 4:1 (mean sTT about 1.5-2nmol/L, mean sE2 about 0.4-0.5nmol/L)- compared to in healthy lean young  men , sTT about 25-30nmol/L, sE2 about 0.1nmol/L ie >270:1- men being relatively resistant to testosterone. .

 

     .Exogenous unopposed estrogen promotes adiposity, thrombosis, arrhythmia, autoimmunity, inflammation  cellular proliferation, and profound vaginal collagen loss (hence doubling that rate of stress urinary incontinence) –  but  has no demonstrated benefit ie anabolic effect on mood or muscle (except the uterus) – ie the opposite effects of TT.

So  it defies logic why normally mildly testosterone-dominant young women are sentenced by most doctors- at the dictate of drug companies marketing their profitable horsepills –   to have their necessary androgen levels (both ovarian and adrenal) either naturally depleted by age and surgery, or worse, further suppressed by HT (without balancing TT), as in the case of the combined OC pill, depotprogestin injections, or postmenopausal estrogenic herbs, or estrogen +- progestin therapy- especially in 20 times higher doses widely prescribed  OHT  than are necessary parenterally. . .

        Appropriate patenteral HRT (esters of TT:E2 20mg:E2 1mg, or just TT 200mg for men) fortnightly by tiny subcutaneous self-injection need cost no more than R40 or US$5/month .  In the absense of lowdose progesterone in the injection, adding lowdose progesterone cream quadruples the cost.

IS THE BBC ONE MINUTE HEALTH NEWS BAD FOR HEALTH? RECOMMENDING ASPIRIN RATHER THAN FISH OIL?

 Has the BBC Health Bite 23/08/08  done it again?   –  perhaps putting vulnerable people at risk  – by recommending aspirin  from middle age for primary prevention based on  a local retrospective  observational study in only 12000 people;
 
when  the latest  (2006, 2006)  metaanalyses of the six major aspirin  primary prevention trials  in over 90 000 subjects  showed  no significant benefit on all cause mortality, or stroke,  or cardiovascular mortality;  and  BBC  fails to mention the real aspirin problems –  that 28% may be aspirin resistant, or the legion problems that can be caused by even low dose aspirin, which offset it’s trivial cost. .
 
This contrasts with the latest metaanalysis of fish oil prevention, from Tufts in Boston 2006   which concludes that consumption of  n–3 FAs from fish and fish-oil supplements reduces all-cause mortality, cardiac and sudden death, and stroke” without any noteworthy linked adverse events… not to mention major benefit on behaviour, learning/ memory, arthritis, depression, eyes, skin, and  reduction in obesity-diabetes- insulin resistance.
         And recommending aspirin without including the dozens of multibenefit evidence-based  preventative supplements – many of which can mitigate the risks of aspirin- is surely more risky – especially in a high- alcohol-intake nation?
    The low  benefit:risk ratio of aspirin applies also to warfarin. 
Thrombolytics, heparin and then  warfarin may be indispensible after highrisk thromboses, but it has yet to be proven that  for chronic prevention those high-risk therapies which require regular laboratory monitoring are as safe let alone as good as fish oil and oral EDTA.
 Warfarin has far more risks (than aspirin) -apart from bleeding there is – as a result of vitamin K antagonism –  vascular calcinosis, osteoporosis and malignancy.
       So in view of the risks, and the scant benefits, of longterm aspirin and warfarin, if any trial is needed it is one to disprove the obvious,  that combining fish oil with EDTA gives far higher benefit :isk long term than warfarin and/or aspirin.
See the HRT  and supplement papers  above and  below, and the recommended condition-specific supplement product information.. For specialist  internist consultation on appropriate supplements including HRT for individual circumstances, email your concise health details to info@healthspanlife.com ..

FOR DEBATE: ESTRIOL E3 AS PART OF OPTIMAL HRT

The FDA in January issued a circular   warning about false claims for estriol and other BioIdentical Hormone Therapy, citing a citizen petition by Wyeth. 
The FDA has been criticised for “banning” estriol, but it sets the record straight on it’s website.

  However, FDA concedes that it has never received any aderse effect reports about estriol – merely the gripes from the Drug Industry about competition..
In the recent scientific literature  ie Medline, there are no serious adverse events or side-effects reported in the 8 trials of Estriol listed. Nor any case reports of SAEs related to estriol use.

Olivia A.M. Franks, ND and Jonathan V. Wright, MD,  Life Extension Scientific Advisory Board Member   Magazine August 2008 review :  Estriol: Its Weakness is Its Strength
Estriol, an estrogen that has virtually been ignored by the mainstream medical community, is one of the three principal estrogens produced by the body. Estriol was originally thought to have little significance due to its weak estrogenic activity when compared with estrone and estradiol. Nonetheless, research has found that its weakness may very well be its strength…  read on

FOR OPTIMAL AGING IN MEN AND WOMEN: APPROPRIATE NATURAL SUPPLEMENTS INCLUDE HUMAN HRT:

 ie  

melatonin –  essential unless you get plenty of sleep and sunlight;

 

insulin sensitizers including Vitamin D,  fish oil  if the slightest overfat,

even before diabetes develops;     

          plus  balanced

*thyroid+cortisone+estrogen +progesterone+teststerone

if their measured levels are not optimal. *these  require medical supervision.

 

 

Remember that the aging ie postmenopausal woman

who still cares about her  looks

should use estrogen-progesterone  cream on the face,  but

for best (ie cheapest) absorption- and optimal mood, bone and pelvic floor protection

use the testosterone  cream  internally.

(or for lowest cost- use   progesterone cream  on  the face.

plus  testosterone + estradiol by tiny injection ~ fortnightly),

.

In both genders,

like balanced estrogen plus  testosterone,

solo progesterone  protects the

skin, hair, heart, breasts, mood, brain, thyroid,  bladder, immunity  and circulation,

but not   strength, bones or hearing

 

only the  right  balance of estrogen  and testosterone  does so.

 

Remember- there is no upper age limit on appropriate supplements

the key to health is –  we don’t stop eating because we age!

We  may need less food, but we need more natural micronutrient supplements including human hormones to make up for their  increasing (relative) deficiency  in our food chain and our own  metabolic reserves, as well as to  counter  increasing pollution and the demands of increasing  longevity.. 

See the HRT  and supplement papers  below, and the recommended condition-specific supplement product information.. For specialist  internist consultation on appropriate supplements including HRT for individual circumstances, email your concise health details to info@healthspanlife.com ..