Category Archives: GLYCATION END PRODUCTS

TOURISM HEALTH: SAFARI HEALTHSPANLIFE HEALING CAPE TOWN HOLIDAY 2013.

Health- slante, l’chaim!, hayah, sawubona! – in any country or language  is a blessing, a gift- not a right. It is insurance that has to be planned and enforced. Leaving it to fate, illness and hoping for a cure is often too late, sometimes crippling if not often  fatal. With comprehensive natural supplements, we can and should all die peacefully at an  active fit advanced  age  90years +  –   not old, incapacitated and demented. We owe this prevention to both ourselves, our  kids and our aging seniors.

So sensible lifestyle aside, promoting health  includes simple low-cost  (no-xray/no-laboratory) periodic screening:  for all,  from childhood:  of weight,  girth, eyes, teeth, bloodpressure, brainfunction- memory; and ultrasound bones – at any pharmacy/ optometrist, school or clinic;                         and  for women:  checking the breasts and pelvis for risk of  cancer.

The HealthSpanLife  South African Natural Medicine Clinic SANMC next to Cavendish Mall on the slopes of Table Mountain in beautiful Cape Town – one of the favourite world tourist  and heritage centres-  is a specialist clinic  staffed by experienced  registered professional practitioners- a medical internist specialist  (also UK registered);  a homeopath;  and a Muslim nursing sister.

It provides  one-stop holistic screening and diagnostics, and – uniquely-  evidence-based  natural remedies- nutritional support for all symptoms and chronic conditions-  also  for menopause-andropause-genitourinary- breast-sexual dysfunction- obesity-pain/headache –chiropractic  and detox ,

as well as if needed  appropriate modern specialized  testing and prescription medicines for all chronic major conditions including bio-identical hormone replacement for both genders (including implants);

and integrated referrals nearby (and in Gauteng)  as patients desire eg for autism, acupuncture, aromatherapy, physiotherapy, aquarobics,  advanced scopes, delicate restorative micro (eg hands, toes)-as well as major (eg bariatric, spinal,eye-, ear- neuro-)  surgery, infertility, xray/other scans, cancer, hyperbaric oxygen, spiritual intervention, psychiatric-hypno- therapy, and eg genetic profiling and counselling,   dialysis and transplantation, and stem cell therapy. …

Gentle Non-xray  ultrasound bone-density measurement (recommended by Cape Town , UK, and USA universities),  and tactile mechanical breast mapping (recommended by CANSA, UK, USA, Indian and Chinese studies) are available at SANMC (and in Gauteng) by appointment, and are covered by some medical aid plans;  whereas menopause consultations are covered by all open plans.

As typified by a new review last month,    World opinion is to use xray  mammography and  xray bone density imaging  only as last resort and only  in the elderly – or in staging those with breast cancer- because of the major problems and risks of xray imaging..   As world experts Profs Cornelia Baines epidemiologist in Canada, Mike Baum breast surgeon  in London and Peter Gotzsche epidemiologist  in Denmark  say,  there never has been any independent scientific evidence to support hazardous routine mass mammography crush xray screening of well women, let alone any repeated mass xray screening for decades, or the dangerous fictitious marketing hype of the American radiology-Breast Surgeons and Curves International nonsense  that xray mammo screening saves lives ..

While health tariffs must rise with inflation,  where med aid doesn’t cover, New Year 15% discount applies through January on cash-paid clinic services and in-house products. . .

For out-of-town/ overseas  visitors, accommodation and travel locally and throughout Africa and beyond can be arranged by outside experts around  clinic appointments. .  http://www.capetown.gov.za/en/visiting/Pages/default.aspx

For appointments visit  the SANMC at 1st floor no.  15 Grove Medical Bldg on Pearce St  cnr Grove Ave (parking opposite at ABSA on Grove);    or  phone +2721-6831465/  -6717415; or fax  +27865657215; or email the manageress, doctors or Sister at   sales@healthspanlife.co.za  to discuss needs,  timing and preliminary costing. For details, references  and rationale for screening and prevention,  see https://healthspanlife.wordpress.com/?s=screening.

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CHRONIC ILLNESS- MANAGED ANTIAGING & GENERAL PRACTICE CLINIC SOUTH AFRICA

update 6 April 2015

In Claremont  Cape Town

A  Specialist Family Internist Clinic offers consultations by appointment especially for managing (and ideally preventing)  the major chronic degenerative diseases of aging  and  maintaining physical, mental (and why not sexual?) vigour to a ripe and healthy old age; as well as preventing and managing acute disease at all ages.

The clinic (a specialist physician and a nutritionalist)  offers all-system evaluation and if available, natural  (as well as essential prescription orthrodox) prevention/treatment including metabolic – weight-endocrine-diabetes; heart-lung -kidney; hypertension; neurological-pain; joint & muscle; abdominal, immune system ie infection, cancer and auto-immune  support;  genito-urinary, & sexual problems;

and appropriate screening – ECG, non-xray ( no-touch thermography- eg thermomammogram;   SureTouch tactile) mammograms, non-xray (ie  ultrasound) BMD ie  bone fracture risk measurement, body composition, and appropriate hormone profiling/replacement.

Phone during office hours for appointment: for Claremont office  ph 021-6717415  or 6831465 (or 083-6299160) – at Grove Medical Bldg 1st floor no 15 (opp ABSA Bank Parkade c/o Grove Ave Pearce Rd)  , or neil.burman@gmail.com ;  or consultation by telephone/Skype or email .

by appointment only:        OFFICE HOURSby appt: ph office:  9am-5pm weekdays, 9am-1pm Saturdays.  AFTER  HOURS up to 9pm any day generally at office: –  email doctor   neil.burman@gmail.com  or ph 6am to 9pm  0836299160. EMERGENCIES  cannot be dealt with- acute emergencies and trauma, bleeding cases  must go to any  Emergency Unit .

Billing according to means ie specialist professional rates:  eg as a preferred provider for Discovery Health-  consultation procedure  0190; for needy patients, what the medical scheme pays  Detailed medical report and advice protocol provided at R300. Even Hospital Plans have to pay for outpatient consultation for scores of PMBs ie Prescribed Medical benefit conditions like Menopause.

 Needy patients desiring brief consultation can be seen by arrangement at GP rate.    Bone density scan  (covered by some medical schemes)  procedure 3612..  Non-xray mammograms are not yet covered by medical schemes codes: R650 for SureTouch including clinical consultation, R800 for thermomammogram.

MAGNIFICENT METFORMIN

neil.burman@gmail.com

only 5 weeks since our last review,

twelve  new papers further confirm the supremacy  of the galega plant extract  metformin as the most important chronic preventative drug ever, alongside other natural nutrient supplements eg – fish oil, vitamin C, the human hormones  vitamin  D, sex hormones, thyroid:

PCOS:

1. Aled Rees’ team at Wales’ Cardiff  University  show in a randomized controlled double-blind RCT that obese  women with PCOS (hirsutism and failing periods) even at a mean of 30 (18-35) years have evidence of insulin resistance and early vascular disease; which at their weight around 96.5kg and BMI 35kg/sqm, with waist around 108cm and hips around 120cm, is reversed by metformin: 1500mg/day compared to placebo for 12 weeks  reduced weight by 2kg, body fat by 2.5%, waist by 5cm, bloodpressure by 7% and improves circulation; with 18% fall in insulin resistance (HOMA-IR) , 15% fall in free androgen index, and 21% fall in the testosterone: estradiol ratio.

2.A Tehran University Iran (Ashrafinia) RCT (although not big enough to be statistically significant)  shows that metformin is 81% better than ovarian diathermy in treatment of PCOS inferrtility.

3. and the  German University Erlangen open study –Effect of Metformin Treatment for 2 Years without Caloric Restriction on Endocrine and Metabolic Parameters in Women with Polycystic Ovary Syndrome-(Oppelt)  similarly showed that  even without calorie restriction,   while “no significant changes in body mass index or HOMA-IR were observed,  on metformin  a significant decrease in hirsutism, in fasting and 2-h insulin levels was observed,  with a significant increase in sex hormone-binding globulin (SHBG) levels, while total testosterone (TT) levels and the free androgen index decreased significantly; with significant improvement in lipids.”

These bear out what this column has previously  reported about the superiority of metformin over surgery or other (designer synthetic) hormone therapy  from the work of eg Charles Glueck and  Louis Ibanez for PCOS metabolic syndrome and infertility. .

Diabetes :
4. A retrospective Massachussets study (Brownstein) shows again that  in recent diabetics, the relative risk for heart attack with rosglitazone Avandia  was  120% higher  compared to metformin or  pioglitazone Actos;
5. and a retrospective UK study (Tzoulaki) that pioglitazone was associated with reduced all cause mortality compared with metformin.
But these are retrospective studies, not controlled prospective trial.  they do not mention  the cardinal fact that  pioglitazone does the opposite of metformin, it increases body weight,  heart failure and fracture rate;  and that after a decade of intensive pioglitazone  promotion and trials, there is no evidence from hundreds of direct randomized controlled trials in at least 26 000 patients  that pioglitazone reduces all-cause mortality and chronic diseases  including cancers by a third, as metformin did in the longest RCT ever, the 20year UKPDS, and in many other studies.  No modern designer drug does what metformin does .
6.A systematic review in children by University Sydney shows that   metformin for about 6 months lowers insulin resistance and overweight.
and in new rodent studies:
7. from Russia, (Anisimov ea)  metformin significantly reduces cancer risk, increasing lifespan by 8% and breast cancer latency by 13%, halving breast cancer transplantability and with melatonin reducing Ehrlich tumour growth by 40%  ; 8. from North Carolina (Quaile) that the minimum toxic dose of metformin in the diet was equivalent (by the usual average 10:1 conversion for faster rodent metabolism) to between 60 and 120mg / kg/day ie about 4-8gm /d  for about 5 years in humans;

9. and from Poland (Labuzek) that metformin shows beneficial effects in experimental models of neuroinflammatory diseases like Alzheimers.

10 In June an international team   (Jiralerspong ea Texas/ Germany) showed in an observational study that Diabetic patients with breast cancer receiving metformin and neoadjuvant chemotherapy have a 3fold higher pCR pathological complete response rate (24%) than do diabetics not receiving metformin (8%) . In response,  Garcia & Tisman from California point out yet another mechanism for this improvement,  that metformin induces malabsorption deficiency of both folate and especially metabolically active holotranscobalamin; which is  potentiated by neoadjuvant chemotherapy induced lowering of holotranscobalamin., despite apparently normal measured  total B12 levels.

This reminds us of  three  truisms:
diabetics are more prone to cancer and neuropathy and homomocysteinemia, these  need to be more concientously screened for;
diabetics are even more in need of all micronutrient supplements as antioxidants, insulin sensitizers, anti- glycation agents, nitric oxide providers, neurotropics;
and where cancer occurs, the golden rule is that no supplements  (other than metformin) should be given until conventional (radio/chemo/surgical) therapy  of the cancer has been commenced or refused. Folate and B12 should not be withheld simply because they may antagonize one link in the carcinogenic chain- there are dozens of dietary adaptations and micronutrients that are major anticancer adjuvants. without putting the patient at greater risk from vascular and osteoporotic disease than ever she was from cancer.
So that is at least 2 new studies a week confirming metformin’s supremacy.
Hence the obligation grows to prescribe as anchor support metformin to comfortable safe tolerance for life not just in all diabetics but also in all overweight people- starting if necessary in childhood-  who cannot maintain both optimal BMI, blood sugar and lipids off it.  And for protection against cancer and Alzheimers and vascular disease, to all perhaps over 50years.

But of course, global  metformin / galega use  along with other supplements  (from vitamins- minerals to all the other useful natural biologicals and insulin sensitizers- – from arginine to zeaxanthine including appropriate sex hormone replacement SHRT)-  will do away with perhaps 90% of the grounds for modern prescription drugs and non-post-trauma surgery/procedures, and much infertility and obstetric problems.  Painful shrinkage for the massive and toxic new -drug / disease/ hospital/hightech industry and the millions of workers it employs as lobbyists and marketeers. Hence redoubling of the effort by the Disease Industry and most governments  to suppress such natural prevention at all costs, by buying over politicians, medical regulators and powerful medical associations and patient groups..

14 Nov 2009   METFORMIN THE MASTER DRUG: FIGHTING NEMESIS- ADVANCED GLYCATION ENDPRODUCTS, AGES.

It’s just a month since this column reviewed the only “drug” that is (like fish oil)  a universal panacea: A STUDY OF THE CENTURY: METFORMIN PREVENTION OF THE TIMEBOMB  DIABETES.

Now a  new study from Univ. N Carolina (Cantrell ea) shows that metformin is not just major benefit against prostate and  breast cancer but also against endometrial (womb) cancer.

de la Monte and Wands (2005-2008)  from Brown University RI crystallize what has been obvious the past decade, that Alzheimers disease- they call it type 3 diabetes mellitus-  is not an inevitable part of aging but  is as much a product of insulin resistance – the  overweight  (fast food- couch potato- stress) pandemic- as are all the other interrelated  common diseases that constitute premature aging;   and therefore even more reason for everyone  to take galega/ metformin or other insulin sensitizers preventatively from as young as possible.

And a new novel study from Colorado University (Nadeau ea) again demonstrates that even juvenile type 1 insulin dependent diabetics have insulin resistance and need metformin and all the other anti-AGES agents  as well.

The McMaster University (Lemon Boreham and Rollo) landmark Supermouse Trial   5 years ago used a a novel model of our current self-induced obesity pandemic- a transgenic  mouse-  to show  that unlimited access to ‘balanced’ chow grows, learns, sickens and kills  far earlier than normal mice – which even in a lab environment neither overeat nor get lazy nor fatten. .   But 10fold increase in all the scores of evidence-based conditioned essential micronutrients (that deplete as we age) greatly increased the supermice’s learning, healthspan and lifespan. Such supplements include many powerful  natural insulin sensitizers.

Emory Univ Atlanta (Narayan and Williamson 2009) claim in a new review that “trials show that lifestyle intervention reduces diabetes incidence by over 50% and is more efficacious than metformin. But neither experience nor realistic long term  trials show this.

Now a  followup report from the landmark Diabetes Prevention Program DPP in the USA ( first reported in 2002) in  middleaged overweight laizzez- faire volunteers (not patients) gives the longest ever controlled observation study (the DPPOS) – a mean of 8.5 years- of the benefits of strenuous lifestyle+ diet (LSD) alone for 8.5yrs, or with metformin  for 8.5yrs plus  strenuous LSD added for 5.7yrs,   or just adding LSD  for 5.7yrs  to the initial placebo laizze faire group.
The outcomes are impressive:
The original placebo group (on average attempted diet + exercise) had a diabetes incidence in the first 2.8years of 11.0 (9.8-12.3)% ie per 100 patient years (ie an enormous 5.5% a year, or perhaps 55% over 10 years); with LSD for the next 5.7 yrs their incident  diabetes halved to 5.6 (4.8-6.5)% ie perhaps 1% a year- a reduction of about 82% .
The original LSD group after 2.8yrs had had a new diabetes rate of 4.8%; continuing this regime for 3 times as long saw their new diabetes rate climb to 5.9%;
but the just metformin group– who had new diabetes rate of 7.8% – with added LSD for 5.7yrs saw their new diabetes rate fall further to 4.9% (compared to 11% on placebo and routine counseling) – and unlike the LSD-alone group, they maintained their original weight loss, in fact those over 60years maintained a further 2kg weight loss. Compared to the original placebo group diabetes incidence of 55% over 10years, metformin plus sustained exercise lowered new diabetes to about 8,9% over 10years ie 84% reduction in risk.

Thus this unique 10year study confirms that adding even lowdose metformin to LSD more than halves the incidence rate compared to  the average laizzez- faire patient on feeble diet-exercise alone, and maintains better fatloss than either mild or strenuous LSD alone. We know from clinical experience that titrating metformin to tolerance can maintain weight loss of 8% -provided it is not combined with psychotropes that hugely increase weight gain..

Thus there is every reason to always add metformin cautiously from the beginning to diet-exercise counseling in every overweight patient battling to lose fat and regain fitness, to abolish the lethal risks of metabolic syndrome and its diverse consequences- diabetes, cancer, cardiovascular disease, arthritis, dementia  etc.

It is common knowledge that less than 10% of patients maintain significant weight loss on any diet and exercise regime- it goes against human nature. The DPPOS confirms that preventative metformin to tolerance plus sensible diet and exercis is  the only regime that maintains weight loss and thus improves all health- drastically lowers all-cause premature disease and mortality.

No heavily marketed  designer “appetite/weight suppressant” drugs remotely achieves all the benefits of metformin, a unique  anti-glycation antioxidant,  appetite and weight suppressant, and anti-cancer, -stroke, -vascular , -infection, -arthritis , -infertility, and -dementing- disease natural nutrient. Hence as previously described, Big Pharma and the Disease Industry do all they can to suppress it’s preventative use (including having Regulators threaten us) , since no modern designer drug can compete. A short-term study (3 months) like the new University California Davis trial (Banazewska ea) (of statin versus metformin in PCOS) says nothing about the longterm benefits that matter to patients– not the Drug Industry whose concern is shorterm profit at all cost.

URGENT UPDATE: AMERICAN/MEXICAN SWINE FLU IN SOUTHERN AFRICA

URGENT WARNING:

The first 2 pneumonia deaths associated with swine flu have now been reported from South Africa. Until details  of their  illness and  pathology tests and  autopsies and treatment   are revealed, as usual we will never know what other underlying risk factors there were.

What can we do to protect ourselves?

New Vitamin D data fits with what we know about fighting infection  – that in both the malnourished ( Dar-es Salaam) and nourished  eg (Canada) AIDS+TB patients, boosting vit D3 , let alone vitamin C,  b-carotene,  zinc,  aloe,  sutherlandia, and  deficient iron, drastically reduced mortality.  eg Grant 2009- Vitamin D also reduces the production of proinflammatory cytokines ie the cytokine storm for which antioxidants – free radical scavengers– are recommended .

Since we queried 3 months ago why only Mexicans were dying then, many deaths linked to the new H1N1 American-Mexican swine flu  have occurred outside Mexico (although at a far lower rate than in central- the poor- Americas), mostly in the frail but undoubtedly also in the healthy wellnourished very young- in whom the problem seems to include cytokinin storm overwhelming the lungs with  hyperimmune response to a new virus.

Us oldies have both less immune response, and also tolerance from previous exposure. Perhaps (just as us oldies may have inherited some resistance- tolerance from our parents/ grandparents who survived the 1918 & mid-19th Century Russian H1N1 epidemics), our adult children have also inherited tolerance thrrough  us.
Whereas  those who are malnourished AND have AIDs/TB  may have too weak immune systems to respond fatally to this ‘new’ virus.
Dr Barry Shoub head of the National Institute of Communicable Diseases NICD at his UCT  lecture July 2009  agrees – its a relief to hear confirmed that while this virus has spread like wildfire here, there is no increased mortality being reported from the townships where AIDs and  multiple resistant  MRTB are the most rampant and fatal in the world. .   On the other hand, unfortunately cortisone treatment has also not been reported to help those with the apparent hyperimmune response to this new flu.

We mustn’t depend on, wait for rescue with  Tamiflu, Relenza ( resistance spreads rapidly, and adverse effects are serious),  or on a hasty  untested American Swine Flu vaccine – especially if it is laced with squalene let alone mercury or aluminium?.

We urgently need to boost both the frail, and the very young, with what we have: oral antioxidants: vitamin D between 5000-10000 iu/day or 50 000 iu/week; b-carotene about 10 000 iu/day;  zinc 30-60mg/day;    vitamin C+bioflavinoid 50/50(Enhanced Vitamin C) 1/2gm  to 5gm (a heaped teaspoon)  twice a day- increasing gradually over a week to tolerance ie  the dose that doesnt cause diarrhoea; vits E, lipoic acid;  and extra calcium carb 1/2gm twice a day also to minimize vit C diarrhoea;  Probiotics; Aloe; fish oil (eg cod liver oil) a tsp or 4gm a day); sutherlandia; and colloidal silver ACS nasal spray and orally; with a good nonspecific multinutrient. . .

And since this flu virus seems to kill the lungs if it does serious  harm, we need to boost lung defense specifically  with For-Lungspan- N-acetyl cysteine (an antioxidant) and guaifenesin each  a few hundred mg/day.

These all- natural nutritional supplements are  available over the counter – and the more malnourished the person, the less will already make a big difference to nutrition and resistance.

And obviously in the malnourished, or  frail, it is crucial to check hemoglobin and iron levels and reverse iron deficiency if present- deficiency can be assumed  in poor girls/women who are still menstruating, in those with chronic heartburn  let alone previous bowel bleeding or absorption problems, the pregnant, and in poor township kids who are likely riddled with parasites – if their hemoglobin is below ~12g, add iron for sure. .

And obviously general nutrition is crucial: with mass unemployment, and rampant endemic price fixing abuse of basic foodstuffs which business and politicians choose to ignore if not conspire in,  the poor may not be able to afford nourishing balanced diet. But many  do spend money on buying essential supplements – for which they need guidance as above..

And for solace the poor spend more on smoking and alcoholism –  the greatest killers of both users and those they encounter: it is incomprehensible that businesses  employ staff who destroy themselves and others by smoking or  alcohol  abuse, since these are choices. This despite the fact that in most countries suicide – especially assisted suicide- is illegal.

So is the use of sugar, which is one of the deadliest addictions (for promoting  decay, infection, glycation) – especially when it is so easily substituted by a safe alternative sweetener  like stevia or  saccharine-cyclamate, and when the food chain is now stuffed with high-calorie cornstarch.

All commercial sweetened  “cooldrinks” should be banned if they contain the adverse additive  problems of  caffeine  sugar   aspartamate  benzene and/or phosphoric acid.  Like its fermentation product  alcohol C2H5OH,  sugar C6H12O6  is a deadly intoxicant and corrosive oxidant, and should like alcohol be red-labeled  in cooldrinks for sale  solely to consenting adults, since these destabilize the brain (le alone immunity) just like alcohol does, by sending the blood sugar and then insulin soaring and plummeting wildly.  Compare the chemical effects of  about 12-24gm alcohol – 72-150kcalories (an average sugary  a”glass” or two  of beer  or  wine, a generous “tot” of spirits)  with  that of one or two Red Bulls or even Cokes or Fantas.

And undiluted or adulterated commercial “fruit juice” is bad by the glass since it is high in sugar (fructose), it should be used if at all in small volumes diluted in water- and one has to drink perhaps 6 litres a day (or 6kg of fruit)  to obtain 3 gm vitamin C .

If tap water (the best) is not enough, there are  rooibos or  other  teas, chicory, modest coffee, skim milk, and soda water to satisfy all desires- and  for those with a sweet tooth, a relatively safe concentrate to dilute well like Eleven to One in a wide range of fruit flavours. Fresh fruit in moderation, and coloured veggies are always the best, for their roughage, polyphenols, vitamins, antioxidants etc- but they do not provide enough of these for our polluted stressed depressing  and contagious world, especially for the longerlived. .

And with rampant overweight-obesity-(pre)diabetes, fatfree cooking must be enforced, to minimize intake of both carcinogens and worse, glycates , AGES— sugar fused with fat or protein.

PER ASTRA AD ARDUA: ASTROLOGY, STATINS AND SCAMS: AN ASTEROID AND AN AURORA FOR JUPITER.

ASTEROID-   a new study from Harvard and the Cleveland Clinics – boasts the safety and efficacy of achieving very-low low-density lipoprotein cholesterol LDLC with highdose  rosuvastatin Crestor.

But it notes carefully: “on-treatment atheroma volume, change in atheroma volume, and the high % of patients with atheroma regression did not differ by the achieved LDLC level. ”

Since the trial lasted only 2 years in only 471 average obese (BMI ~28.5kg) patients aged around 58yrs, it was far too small and short to determine whether there was any non-cardiovascular benefit or risk from the drug in this high-risk metabolic syndrome population, 95% of whom were hypertensive, 13% diabetic, and who have a high risk of future cancer, dementia, arthritis.

So the only purpose it served is to show that there is no shortterm benefit in highdose versus lowdose statin, in more than moderate lowering of LDLC and raising of HDLC.

In the  AURORA* trial in dialysis patients, “although the mean LDL cholesterol was reduced by 43% in the rosuvastatin arm of the study at three months, no difference in the primary end point (death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke) was demonstrated at an average follow-up of 3.8 years. [1]

The stark reality- which ( fungus extract) statin, and more modern  antidiabetic drug   proponents hate- is that metformin (a plant derivative)  is the only panacea, patented drug ever that reduces not just heart attack by half in type 2 diabetes but also reduces all-cause mortality by at least one-third; and when used preventitively and to optimal titrated tolerance  in the overweight, reduces the incidence of new diabetes by up to 90%. That just about puts it ahead of vitamin D and fish oil and appropriate HRT  as miracle agents.

And statin proponents  studiously remain silent that while titrated metformin has zero persisting adverse effects in controlled trials of up to 20years, statins produce insidious adverse effects (depression; myo-hepatorenal, memory loss,  non-natural deaths, lowering of sex hormones and erectile function) in up to a quarter of longterm users – with  significant increase in cancer (especially of the breast) when the LDLC is  severely depressed; and fail to influence insulin resistance and diabetes long term.

So, like most statin trials ,  JUPITER and ASTEROID reports  are twisted to promote statins, whereas they do nothing to recommend statins,   show that they are anywhere near as good and safe for longterm mortality reduction as   natural non-patent agents-  metformin, appropriate HRT and eg fish oil and vitamin-mineral-biological-plant supplements – which lack the insidious adverse effects of the statins. .  After some 40 years of use, the only indication for statins remain (if any) those rare patients with severe resistant hypercholesterolemia above perhaps 8 or 10 mmol/L.

And rosuvastatin is apparently the strongest as well as the youngest (preteen) of the current statins; so it should be used in low dose if at all. Have we learnt nothing from stilboestrol, thalidomide, practolol, cerivastatin,  troglitazone, Vioxx?

It is obvious why statin promoters- the manufacturers and their hirelings- continue to spend $millions promoting the $billion statin trade. But it is doctors and especially Authorities- academics and regulators-  who must explain why they are jeapordizing patients’ lives, why  a high percentage of older patients- especially the overweight- are on  the hugely advertized statins when they should be on the safe and highly beneficial metformin, fish oil and the other proven  multibeneficial supplements eg vits-minerals, biologicals including appropriate HRT, and plant extracts.

PER ASTRA AD ARDUA ET LUCRUM:

The promoters of rosuvastatin – Crestor-  make studious use of astrology- ASTEROID, JUPITER, AURORA–  astronomical eponyms – to deviously promote the mystique of statins through their trial titles. But at least astute astrological physicians like Shakespeare’s contemporary  Dr Simon Forman had some justification- there was seldom better treatment at the time, often far worse, and it was harmless (with romantic overtones)  apart from perhaps distracting from more onerous changes in lifestyle and diet; and  had  grains of truth in the as-yet not scientifically recognized planetary and solar-lunar changes in weather etc which influence health..

And rosuvastatin studies only appear on Medline from 2001- barely a decade ago -so there cannot be any longterm experience let alone trial (as there is for metformin)  on this wannabe chronic prevention drug for at least another decade. And  the history of rosuvastatin, it’s discoverer and place of origin, is mysteriously not apparent  on the AstraZeneca or any other website. This at 20 times the cost of simvastatin in UK .

Clearly  Big Pharma and their lobbyists – with the glad connivance of Regulators and Medical Schemes-  – still depend on age-old psychology to bluff doctors let alone patients.

*Aurora has two meanings, both of which are apposite for their use in statin ie Astra-Zeneca marketing :

  • while Astra refers to the wandering stars!

Clearly the manufacturers of Crestor (Astra-Zeneca)  wish  these glowing images and more as their $reward for boosting their protege drug. And Zeneca is also under fire that “Women concerned about breast cancer are being bombarded with a massive advertising campaign for the drug tamoxifen” – which like all other modern drugs has no evidence base for longterm preventitive use.

AVOIDING ANTIDIABETIC DRUGS APART FROM METFORMIN FOR AS LONG AS POSSIBLE

A new review last week from Quebec Universities of insulin use in 69674 elderly diabetics is both limited in application, and instructive. We regularly see older patients who were started on insulin when they were first diagnosed diabetic because they were acutely ill, but who mostly should have been weaned off insulin fairly soon onto metformin etc, since even insulin is associated with higher mortality let alone complications. The topic is thoroughly discussed recently.

Since hypertensive and glycation damage is a common consequence of even the prediabetic metabolic syndrome, a  crucial issue is what we see in practice, that for the treatment of hypertension,  the triple combination of low-dose thiazide diuretic eg HCT 12.5mg combined with amiloride  1.25mg as eg amiloretic /coamilozide and with lowdose reserpine (rather than betablocker) has no risk of aggravating or causing diabetes. It is unsurpassed for the gentle normalization of most  mild to moderate hypertension- especially when combined in the overweight with metformin to tolerance  so as to virtually abolish the future risk of developing diabetes. This combination brings no serious  problems, unlike the betablockers or the now-heavily punted but troublesome  calcium channel and angiotensin blockers.

It is encouraging  to see confirmed that in these elderly Quebecois (even with only 71% on metformin; 29% on sulphonylurea  monotherapy – which like cortisone doubled the risk of needing insulin; 25% on thiazide and 30% on betablocker therapy, and 5740 on 16 or more drugs) –   the incidence of becoming dependent on insulin is only 1% a year over the 7years of this study – possibly less since

1. we have no idea how many of these patients were coached enough on avoiding sugars and reducing both cooked fats, salt, alcohol and fructose, and

2. it is  better to start early especially antidiabetic antioxidant antilipidemic antiatheroma  balanced minerals, vitamins B C D E K, and biologicals (including the likes of fish oil, metformin/galega, coQ10,  arginine, carnitine; appropriate parenteral balanced human HRT (estrogen, testosterone, progesterone) , and  relevant other herbs). All these combined (in just  two  blends) can in a first-world population  largely avoid both need for cortisone and  insulin therapy,  fattening, diabetes, vascular / renal disease, dementia, osteoporosis, blindness, and cancer ;

3 taking metformin to tolerance (which is bizarrely uncommon practice) is far better  before if necessary adding sulphonylureas/ glitazones/ insulin which promote fattening and other problems,  with little net benefit..

4. starting on  metformin preventatively ie  well before diabetes presents  can reduce the incidence of new diabetes, pancreatic burnout and cancer  by up to 80%.

Yet preventative metformin- with zero serious adverse effects  and halving of mortality in appropriate use- is still  irrationally vociferously  objected to. Is this  because of the Disease Industry’s driving force, to avoid prevention at all cost since only disease pays: effective prevention with natural supplements  like metformin and appropriate parenteral HRT would deplete surgeries and hospitals of serious chronic degenerative illnesses.

The BARI study showed clearly that by the time vascular disease presents in diabetics, surgery has no better outcome than medical therapy. All four major diabetes prevention programs (in China then USA then India then Greece) confirmed the major benefit (even against cancer) of adding metformin early if the patient cannot implement permanent effective diet and exercise.

So why are “Authorities” still not mandating  preventative metformin in the resistant overweight at all ages? Why are those who should know better still  attacking  preventative physicians for practicing evidence-based medicine ie using appropriate metformin in a life-threatening situation- progressive or persistent overweight ie BMI above 25kg/sqm?

One hopes that this Quebec analysis pushes authorities to enforce that metformin built up slowly from eg 250mg/d  to tolerance -ideally with blood level control-  is the only firstline chronic drug   therapy of type 2 diabetes, even where the new patient has also to be temporarily stabilized with  insulin.

ndb

Fighting the 8th AGE: the mandatory panacea metformin and other natural supplements.

Exciting new anti-aging evidence has been published this year:

The Bard  spelled out the 7 ages of man. Now we know we have to deal with more AGEs – Advanced Glycation End Products- , and more evidence to prolong the healthy ages of man.

GLYCATION: some of us are fudge addicts. Fortunately with the natural supplements available, we can have  a little of our cake and safely eat it.

But as Wiki details,  such  lethal exogenous glycations and (AGEs) Advanced Glycation Endproducts “are typically formed when sugars are cooked with proteins or fats (eg fudge, baked puddings, sweet crackling/baked beans !). Temperatures over 120°C (~248°F) greatly accelerate the reactions, but so do  lower temperatures with longer cooking times. These compounds are digested with about 30% efficiency. Browning reactions (usually Maillard type reactions – like fudge, crackling!) are evidence of pre-formed glycations. Indeed, sugar is often added to products such as french fries and baked goods to enhance browning. Glycation may also contribute to the formation of acrylamide, a potential carcinogen, during cooking. Until recently, it was thought that exogenous glycations and AGEs were negligible contributors to inflammation and disease states, but recent work has shown that they are important.”

“Although most   research work has been done with reference to diabetes, these results are important for all, as exogenous AGEs are implicated in the initiation of retinal dysfunction, cardiovascular diseases, type II diabetes, cancer and many other age-related chronic diseases. Food manufacturers have added AGEs to foods, especially in the last 50 years, as flavor enhancers and colorants to improve appearance. Foods with significant browning, caramelization, or with directly added preformed AGEs can be exceptionally high in these proinflammatory and disease initiating compounds. A long list of foods with very high exogenous AGEs includes:  donuts, barbecued meats, cake, and dark colored soda pop”

This explanation of one of the root causes of the multisystem degenerative diseases of aging dispels the myths that the fast food chain and what the  Drug Industry promotes are healthy, that we need a patent drug per disease eg statin for lipidemia, antihypertensives for hypertension, anti thrombotics for thromboses,  anti-inflammatories  for pain, etc.

GALEGA METFORMIN: THE LONGEST-USED ANTIGLYCATION MEDICINAL:  The longest randomized controlled drug trial RCT ever, the UKPDS (Holman 2008) in type 2 diabetes DM2 showed that long term metformin double-blind for up to 20 years (mean 13.6yrs) (and up to 30years open use), lowers all-cause morbidity and mortality by about 1/3.  Other anti-diabetic drugs eg Sulphonylureas by contrast do little but lower hyperglycemia – without reducing mortality, but adding major risk of hypoglycemia – increasing the risk of dementia long term..

According to Schnider and Kohn from Ohio in 1980 (via Pubmed) , the concept of advanced  glycation/glycosylation in human aging and diabetes was  already well described, so the clinical concept is over 35 years old — but metformin has been under intensive research since 1922 ie for over 85years, and in human use (as the parent herb galega officinalis) for thousands of years – although the first mention on Pubmed of metformin as a blocker of glycation end products was in 1995. .

A new Dutch study (Kooy 2009) in humans has confirmed that metformin (850-2550mg/d) in the medium-term (a mean of 4.3yrs) added to insulin in DM2 lowers macrovascular endpoints by 39% p.02, weight by a mean of 3kg, and insulin requirement by 20iu/d.

A Buenos Aires study (Schurman 2009) notes that “AGEs  are implicated in the complications of diabetes and aging, affecting several tissues: in bone cells in culture, metformin treatment of osteoblastic cells prevented these AGE-induced alterations.”

There can be no doubt that,  given that the lethality of advanced obesity and  DM2 is as bad as smoking, it is crucial to reverse early ie prevent from developing all the mechanisms of obesity- diabetic damage including from hyperglycema itself; wasting from intracellular energy deficit due to insulin resistance; oxidation, nitric oxide deficiency; and above all else, AGEs from sugars fusing with fats or protein – especially fructose.  “It appears that fructose and galactose have approximately ten times the glycation activity of glucose, the primary body fuel. Glycation is the first step in evolution of these molecules through a complex series of very slow reactions in the body known as Amadori reactions, Schiff base reactions, and Maillard reactions; all lead to AGEs.  Some AGEs are benign, but others are more reactive than the sugars they are derived from, and are implicated in many age-related chronic diseases such as: type I and II diabetes mellitus (beta cell damage), cardiovascular diseases (endothelium, fibrinogen, and collagen are damaged), Alzheimer’s disease Vitek ea 1994 (amyloid proteins are side-products of the reactions progressing to AGEs), cancer (acrylamide and other side-products are released), peripheral neuropathy (myelin is attacked), and other sensory losses -deafness ( demyelination) and blindness (mostly  microvascular damage in the retina).”

“This range of diseases is the result of the very basic level at which glycations interfere with molecular and cellular functioning throughout the body. Glycated substances are eliminated from the body slowly, since the renal clearance factor is only about 30% ie half-life about double the average cell life. As a consequence, long-lived cells (such as nerves, brain cells), long-lasting proteins (such as eye crystalline and collagen), HBA1c and DNA may accumulate substantial damage over time. Metabolically-active cells such as the glomeruli in the kidneys, retina cells in the eyes, and beta cells (insulin-producing) in the pancreas are also at high risk of damage. The endothelial cells of the blood vessels are damaged directly by glycations, implicated in atherosclerosis. Atherosclerotic plaque tends to accumulate at areas of high blood flow (such as the entrance to the coronary arteries) due to  increased presentation of sugar molecules, glycations and AGEs at these points. Damage by glycation results in stiffening of the collagen in the blood vessel walls, leading to high blood pressure. Glycations also cause weakening of the collagen in the blood vessel walls, which may lead to micro- or macro-aneurysms; causing strokes if in the brain.”.

As Desai & Wu from University  Saskatchewan  sum up  2007,” AGEs are unavoidable byproducts of various metabolic pathways formed by reactive metabolic intermediates such as methylglyoxal (MG), glyoxal, and 3-deoxyglucosone. These reactive intermediates bind to proteins, DNA, and other molecules and disrupt their structures and functions, leading to aging – vascular complications of diabetes, atherosclerosis, hypertension, Alzheimer’s disease. In recent years, compounds that prevent the formation of AGEs or degrade the existing AGEs have been recognized or patented including 1. galega-metformin -guanidine; 2. pioglitazone (patented), 3 angiotensin blockers , 4) pentoxyfylline (patented), 5) metal ion chelators desferoxamine and penicillamine, 6) antioxidants such as vitamin C or E, etc.. ”

CROSS-LINKAGE AND AGING: Ward Dean 2009 spells out “the Crosslinkage Theory of Aging: AGEs and Crosslinkages – New Respect for Crosslinkage Theory.  Dr Johan Bjorksten in 1941 first proposed The Cross-linkage Theory of Aging   that aging was caused by inter- and intramolecular crosslinks in proteins, nucleic acids, and other vital macromolecules that caused them to gradually stiffen and lose their function”.

OTHER ANTI-AGEs BLOCKERS: Cataract formation is associated with low vitamin C (Tessier 1998); while Quian ea in 2000 showed that both vits C & E lowered AEGs in diabetic rats. Other natural AGEs blockers include taurine; L-Carnosine, L-Arginine, DMAE dimethylaminoethanol ;   PABA (para aminobenzoic acid); Thiamine HCl ; Alpha R Lipoic acid; Pyridoxal 5’ phosphate;  and to inhibit Amadori products: EDTA,  vits B1,B6, C & E , coQ10, Green Tea, Hawthorn, Grape Seed, Milk Thistle, Ginger Root, Ginkgo, bioflavinoids (Morimitsu 1995 ); curcumin ; and melatonin (Sailaja 2000);  to which one can add for antiaging:  huperzine A and DMAE.

Many companies are racing to market new ie patentable synthetic anti-AGEs agents like peptides ; benfotiamine and pyridoxamine . But as with some 1000 available natural insulin sensitizers, there are plenty of natural anti-AGEs supplements, starting with : galega officinalis (50% guanidine with negligible content of galegine) and it’s extracts aminoguanidine, galegine and dimethylguanidine-metformin. Already in 1999 Tanaka ea showed in rats that metformin treatment may be effective in the prevention of diabetic complications through not only lowering plasma glucose, but also directly inhibiting AGEs formation.   Sowers 2002 theorizes that the reason that statins “do not reverse endothelium-dependent and -independent vascular dysfunction in DM2 (in contrast to in non-diabetics) is precisely because of AGEs.  But Jinnouchi 2006 shows that atorvastatin also reduces AGES.

These studies affirm that  METFORMIN is the Gold Standard (Bailey ea 2007: Merck Sante), arguably both the safest and the most pluripotential therapeutic agent ever discovered, being an age-old medicinal plant extract (Werner and Bell 1922).

So we do not need patent designer inhibitors (of AEGs  or reactive oxygen species or insulin resistance or lipidemia or inflammation or appetite-weight gain) – there are dozens available from nature, with galega- metformin the longest and  broadest potential proven and used, that when simply and safely titrated slowly upwards to good tolerance, at least halves the incidence of new diabetes and thus adds at least a decade to health and longevity.

THE GODDESS PANACEA: A panacea is defined as a “cure all”, to “retard the aging process”, and to increase the “quality of life”. Today a balanced diet and lifestyle is far from a guarantee of healthspan.  Despite  denial by  the food and drug industry (aka the FDA, the Disease Industry  who want to suppress the old so as to sell  their   new  designer patents) metformin fulfills all the criteria for a panacea in a stressed fattening population, from promoting copulation, conception and pregnancy to healthy  old age.

An old study from Germany (Hammes 1996)  shows again a potential trap of testing one substance in isolation and in rodents – in this case, EPA + DHA (as Maxepa) about 130mg/day for 6 months if anything harmed the retina in diabetic rats. Does this have any bearing on the global benefits of natural EPA+DHA and brod supplements  in  humans?

By contrast, El-seweidy ea in Egypt in 2002  showed also in diabetic rats that “combined treatment with galega (aminoguanidine) and omega3  markedly reduced all the adverse blood markers and nearly restored the atrophy of islets of Langerhans and the peripheral lymphocytic infiltration compared to untreated diabetic rats and those treated only with guanidine.”

The cardinal principle of nutrition and medicine is synergy- that we do not or should not eat single foods in isolation, nor expect disease to respond to a single extract/medicine;   nutrients and nutriceuticals complement each other. This is obviously contrary to the imperative of the Disease Industry to sell a profiteering rainmaker snake-oil per disease..

GALEGA/METFORMIN AS MANDATORY PREVENTION AND THERAPY: The common lethal poisons that humans consume – sugar, salt, alcohol, aspirin, paracetamol, ibrufen and cigarettes – are freely sold over the counter.

Metformin must thus similarly be released for over the counter sale as the only proven panacea (aside perhaps from fish oil) and the only drug ever in RCT for 20year AND  proven to be without any major adverse effect – including for halving deaths in diabetes, and (in four major trials on four different continents) halving the incidence of new diabetes in the overweight, and reversing progressive weight gain. And it can be simply and cheaply manufactured from basic chemicals in 5 minutes.

It  must thus be made mandatory prescription to tolerance for prevention obesity and diabetes in the overweight (ie those whose BMI persists despite attempted correction above about 25kg/sqm),  let alone in all diabetics.