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Archive for December, 2018

830 epigenetics intergeneational

The notion that genes dictate our destiny has been solidly debunked in favor of epigenetics, the study of external or internal mechanisms that switch genes on and off. Exciting new research shows epigenetic memory can span multiple generations.

Studies have linked epigenetics to cognitive dysfunction, autoimmunity, reproductive disorders, cardiovascular disease, and nearly all cancers.

The Centers for Disease Control (CDC) estimates that genetics are responsible for a mere 10 percent of disease, while the remaining 90 percent is due to environmental variables.

Consider these research findings:

In rats, maternal exposure to endocrine-disrupting chemicals caused infertility in male offspring that was passed down to 90 percent of males in four subsequent generations.

Adaptations to traumatic experiences can also be passed down multiple generations as a way to inform offspring about methods for survival.

For example, mice who learned to fear a scent associated with a negative experience passed the response down two generations, despite the offspring never having experienced the same situation.

A similar transfer of responses has been observed in humans:

Exposure to starvation during pregnancy is associated with poor health outcomes for offspring such as:

  • Lower self-reported mental health and quality of life
  • Major mood disorders
  • Antisocial personality disorders
  • Schizophrenia
  • Decreased intracranial volume
  • Congenital abnormalities of the central nervous system
  • Enhanced incidence of cardiovascular disease
  • Hypertension
  • Obesity

Descendants of people who survived the Holocaust show abnormal stress hormone profiles, in particular low cortisol production. Because of altered stress response, children of Holocaust survivors can be at increased risk for PTSD, depression, and anxiety.

Children of women exposed to intimate partner violence during pregnancy have higher predisposition to mental illness, behavioral problems, and psychological abnormalities due to transgenerational epigenetic programming of genes acting in the hypothalamic-pituitary-adrenal axis (HPA axis), a complex communication pathway between glands involved in our stress response.

Classic genetic theory states that genetic change occurs over a time scale of hundreds to millions of years.

Epigenetics explains how our lifestyle, diet, environment, and experiences affect the expression of our genes over multiple generations, but it does not account for actual changes to our genetic code.

How do genetics and epigenetics relate?

Via epigenetics our genes can be influenced by factors such as:

  • Diet
  • Sleep habits
  • Where you live
  • Who you interact with
  • Exercise habits
  • Smoking
  • Environmental toxins
  • Heavy metals
  • Stress level
  • Social support (or lack of it)
  • Medications
  • Method of birth (cesarean vs. vaginal)
  • And more

We inherit one variant of each gene from each parent. Epigenetics can turn off one of these two gene variants (this is called “imprinting”).

This can result in a negative health outcome if the other, still-active variant is defective or increases our susceptibility to toxins or infections.

The cumulative impacts of our lives on our genes

Related to epigenetics is the exposome, the cumulative measure of all the exposures of an individual in a lifetime — starting at conception — and how they relate to our health. Some consider the exposome the environmental equivalent of the human genome.

The exposome is divided into three overlapping categories:

The environment inside our bodies that affects our cells:

  • Hormones and other cell messengers
  • Oxidative stress (excess highly reactive and damaging molecules)
  • Inflammation
  • Lipid peroxidation (damage to cell membranes and other molecules containing fats)
  • Body shape
  • Gut microbiota
  • Aging
  • Biochemical stress

The external environment to which we expose our bodies:

  • Diet
  • Lifestyle
  • Occupational factors
  • Pathogens and toxins
  • Radiation
  • Medical interventions

The general external environment, including broader sociocultural and ecological factors:

  • Socioeconomic status
  • Geopolitical factors
  • Psychological stress
  • Education status
  • Urban or rural residence
  • Climate

Using epigenetics to positively impact the future

Epigenetic processes are natural and essential to many bodily functions. But if they go wrong they can negatively impacts not only our health but the health of our children. Researchers feel the ability for these changes to be passed down has significant implications regarding evolutionary biology and disease causation.

There are factors we have no control over such as certain environmental toxins, method of birth, and exposure to some level of stress. The good news is we can affect change in many areas that can powerfully affect our epigenetics:

  • Anti-inflammatory diet
  • Daily exercise
  • Stress-relief activities
  • Good sleep habits
  • Who we interact with
  • Antioxidant status
  • Not smoking
  • Social support
  • Addressing food intolerances
  • Mediating autoimmunity

Functional medicine offers many avenues to support healthy epigenetic expression. If you seek ways to help your body express its genes in the best ways possible, contact my office for help.

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829 berberine for high blood sugar

In functional medicine one of the most common causes we see for many health disorders is imbalanced blood sugar. The good news is it is also one of the easiest things to remedy. A powerful tool in this process is a botanical compound called berberine.

An epidemic of blood sugar imbalances

According to the CDC, nearly 84 million American adults — more than one out of three — have prediabetes, or metabolic syndrome, a serious health condition in which blood sugar levels are too high but not high enough to be diagnosed as type 2 diabetes.

Ninety percent of people with prediabetes don’t even know they have it. Prediabetes puts you at increased risk of type 2 diabetesheart disease, stroke, obesity, autoimmunity, infertility, dementia, and other disorders.

In fact, high blood sugar is so clearly linked to Alzheimer’s that researchers refer to the disease as “Type 3 diabetes.”

Berberine for high blood sugar and diabetes

A natural plant compound, berberine is found within the stems, bark, roots, and rhizomes (root-like subterranean stems) of numerous plants such as barberry, goldenseal, Oregon grape, tree turmeric, and Chinese goldthread.

Berberine is generally well tolerated and has been used in Chinese and Ayurvedic medicine for thousands of years to treat digestive issues and infections. The extract has a deep yellow color and is also commonly used as a dye.

Recently, berberine has become known for its ability to reduce high blood glucose. By working at a cellular level, it helps move glucose (sugar) from your blood into your cells where it’s most needed.

Berberine also promotes healthy blood sugar levels that are already in normal range.

Berberine works by activating AMPK (adenosine monophosphate-activated protein kinase), an enzyme that that regulates how the body produces and uses energy.

AMPK senses and responds to changes in energy metabolism on both the cellular and whole-body level. It regulates biological activities that normalize lipid, glucose, and energy imbalances.

Metabolic syndrome happens when AMPK-regulated pathways are turned off. This triggers fat storage and burning abnormalities, high blood sugar, diabetes, and energy imbalances.

Depleted energy activates AMPK while excess energy inhibits it. In other words, high blood sugar inhibits AMPK while exercise and calorie restriction activates it.

Berberine’s effect is similar to what you’d see in someone who increased exercise while restricting calorie intake because it activates AMPK, making it a useful tool in the management of type 2 diabetes.

Berberine as effective as metformin

Other known AMPK activators include resveratrol and the diabetes drug metformin. Berberine is so effective at balancing blood sugar that both animal and human studies compare it to metformin in its effectiveness.

Berberine has also been shown to be as effective in treating other conditions that respond positively to metformin, including polycystic ovary syndrome (PCOS), the reduction of weight gain triggered by antipsychotics, and potentially cancer.

Berberine’s many qualities

While berberine is most commonly considered for metabolic syndrome, inflammation, and cancer, its potentially helpful for a long list of other disorders, including high cholesterol, obesity, small intestine bacterial overgrowth (SIBO), leaky gut, lung inflammation, Alzheimer’s disease, and heart disease due to these actions.

Below are additional functions of berberine:

  • Supports healthy blood cholesterol levels.
  • Has antioxidant and anti-inflammatory qualities.
  • Has a moderate weight-loss effect.
  • Exhibits antibacterial qualities.
  • Reduces the effects of tobacco smoke-induced lung inflammation.
  • Inhibits growth and proliferation of cancer cells.
  • Enhances neuro-protective factors.
  • Stimulates the release of nitric oxide, a signaling molecule that relaxes arteries, increases blood flow, and protects against atherosclerosis.
  • Stimulates bile secretion and bilirubin discharge.
  • Reduces dysfunction of the intestinal mucosal barrier.

How much berberine should I take?

For diabetes and blood sugar support, the recommended dose is 500 mg two or three times a day. It’s important to spread your dose out throughout the day because berberine has a short half-life in the body and taking it all at once might rob you of the full benefits. Make sure to take berberine prior to or with a meal.

Studies show that gut bacteria play an important role in transforming berberine into its usable form. Therefore, supporting microbiome diversity and abundance is a smart way to increase its effectiveness. Make sure to eat varied and plentiful produce (go easy on the sugary fruits) and consider supplementing short chain fatty acid supplementation (SCFA) to help your gut bacteria thrive.

How long should I take berberine?

Continual use of berberine can impact cytochrome P450 (CYP) enzymes in the liver which may affect drug-to-drug interactions. Therefore, it’s recommended to use it in a pulsed 8-week cycle with two to four weeks off, then starting again if symptoms have not resolved.

Research has shown that combining berberine with cinnamon may increase its bioavailability. What’s more, cinnamon has also been shown to support insulin sensitivity.

Berberine cautions

While berberine is highly recommended for high blood sugar issues, it does come with some cautions:

  • Berberine is considered UNSAFE for pregnant women and nursing mothers. It may cross the placenta during pregnancy, and some newborns exposed to berberine developed a type of brain damage. It also can be transferred to babies through breast milk.
  • Berberine can interact with a number of medications, increasing the risk of adverse reactions.
  • Taking berberine when you are on medications that reduce blood sugar can push your blood glucose levels too low.
  • Berberine can lower blood pressure, so it should be used with caution by anyone who already has low blood pressure. 

If you are concerned about your blood sugar status and want to discuss non-medical methods for helping regulate your blood sugar, contact my office.

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827 weight training best for seniors

Weight training is not the first exercise choice that comes to mind for seniors. Instead we think of chair yoga, walking, dancing, or aqua aerobics. However, science shows weight training is one of the best types of exercise for aging whether you’ve been doing it your whole life or have never touched a barbell in 60-plus years.

Of the 57 million deaths worldwide in 2008, more than 5 million were caused by lack of physical activity. Roughly 80 percent of adults fail to meet recommended guidelines for physical activity.

For seniors in particular inactivity and a sedentary lifestyle are dangerous, increasing the risk of health conditions such as:

  • High blood pressure
  • Heart disease
  • Stroke
  • Obesity
  • Cholesterol issues
  • Metabolic syndrome
  • Diabetes
  • Cancer
  • Depression

There is a common misperception that the elderly should stay away from strenuous activity. It is important to use safe equipment, focus on correct form, and warm up and cool down properly, but using your muscles as you age isn’t inherently dangerous.

In fact, studies show that lifting weights — whether heavy or light — helps us in many ways as we age.

Weight training reduces the risk of falling by maintaining or even increasing muscle mass and helping maintain bone density. This makes the elderly much less susceptible to age-related and disabling bone breaks from falls or accidents.

This also helps stave off loss of independence, one of the greatest worries around aging.

Strength training can promote mobility and function and even help combat depression and cognitive decline.

An analysis of the National Health Interview Survey (NHIS) database found that adults 65 and older who strength trained twice a week had a 46 percent lower mortality rate. He also found strength training reduces all causes of death, including cancer and cardiac death.

Drawing from the data, the analysis outlined 78 science-backed benefits for seniors who lift weights. The main categories include:

  • Combat age-related muscle loss and sarcopenia
  • Burn fat and increase muscle mass
  • Support functional independence
  • Improve quality of life
  • Improve osteoarthritis and bone health
  • Increase cardiovascular health
  • Improve mental health and cognitive functioning
  • Reduce mortality risk
  • Fight Type 2 diabetes
  • Improve quality of sleep
  • Recover from hip fractures

The study showed that those who had lifted regularly for some time were protected against numerous age-related health issues related to neuromuscular functioning, sarcopenia, muscle force-generating capacity, cognitive functioning, overall functional capability and performance, and mitochondrial impairment.

Is weight lifting riskier in old age?

Lifting weights risks at any age, however, hundreds of studies have shown weight training to be safe, enjoyable, and beneficial as we get older.

Anyone can get injured when working out, so knowing how to safely use equipment, warming up and cooling down properly, and using proper form will keep you in action.

Before starting, have a medical checkup or ask your doctor for clearance. This is especially true if you haven’t exercised before or have taken a long break from physical activity.

What type of weight training is best?

Weight training is an activity anyone can start regardless of age. It doesn’t take lifting like a competitor to gain major benefits, and many of the benefits are immediate. As you train, your cardiovascular and musculoskeletal fitness will improve, thus helping you to prevent injuries as you progress.

Whether you train using your body weight, dumbbells, systems weights, full Olympic style, or with some other style, focus on gradually increasing intensity and power.

A personal trainer can help you meet your goals with a form that works for you, plus teach you how and when to safely increase your challenges. Finding a weight training style you like will motivate you so you keep showing up for workouts — whether it’s at the gym or in your living room.

Before starting any exercise program, be sure to consult with your health care practitioner, and if you are uncertain where to begin, reach out to a local certified personal trainer who can guide you.

 

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827 breast implants linked to autoimmunity

After assurance from breast implant makers that concerns about silicone leaks were a thing of the past, more than 10 million women worldwide have received silicone breast implants in the past decade. However, a growing body of research — supported by increased symptom reporting by women —links silicone breast implants to autoimmune disorders and a rare form of immune cancer.

Silicone breast implants linked to autoimmune disease

Doctors commonly advise potential breast implant candidates that the risks are minimal, yet multiple recent studies indicate otherwise.

A recent study at the University of Alberta comparing nearly 25,000 women with breast implants to nearly 100,000 without them confirmed that nearly one in four implant recipients is at risk of developing an autoimmune disorder.

The risk for women with breast implants developing an autoimmune disease is 45 percent higher than for those without implants.

While former studies on the topic have been criticized because they were based on self-reporting by subjects, this study used doctor-based diagnoses to confirm results.

Previous research has also found surgical mesh implants used for gynecological or hernia repair may be linked to autoimmune disorders such as rheumatoid arthritis and lupus. Additionally, patients with allergies prior to the procedure were significantly worse afterward.

In the Alberta study, the strongest links were shown between silicone implants and these autoimmune conditions:

  • Sjögren’s syndrome, an autoimmune disorder of the salivary and tear glands.
  • Sarcoidosis, an autoimmune disorder of the lung, skin and lymph nodes.
  • Systemic sclerosis, an autoimmune disorder of the connective tissue affecting the skin, arteries, and visceral organs such as lungs and kidneys.

The theory behind these findings is that foreign material of the mesh and silicone implants causes an activation of the immune system. The body continues to fight the “invader” and over time autoimmunity develops.

In the largest-ever long-term safety study of breast implants, a similar study this year at The University of Texas MD Anderson Cancer Center linked silicone implants with higher rates of Sjögren’s syndrome, rheumatoid arthritis, scleroderma, dermatomyositis, and melanoma compared to the general population.

Emerging form of breast implant-related cancer on the rise

Individuals with breast implants are also at risk of developing breast implant large cell lymphoma, or BIA-ALCL. BIA-ALCL is not breast cancer but a form of non-Hodgkin’s lymphoma, a cancer of the immune system.

In most cases BIA-ALCL is found in fluid and scar tissue near the implant, however there are cases where it spreads throughout the body.

The FDA states, “At this time, most data suggest that BIA-ALCL occurs more frequently following implantation of breast implants with textured surfaces rather than those with smooth surfaces.”

Plastic surgeons have identified 615 cases of BIA-ALCL worldwide with the disease occurring at higher rates among women with textured implants. French authorities have recommended against the use of textured implants due to the cancer risk.

At present, however, the risks are difficult to determine due to significant limitations in world-wide reporting and lack of data.

Lax reporting rules at fault for lack of patient awareness

Prior to 2017 the FDA allowed breast implant companies to report breast implant injuries as routine events that did not require public disclosure. This effectively kept the information from the public and may have skewed opinions on the safety of using them.

In 2017 reporting rules were changed and reports of injuries soared. At the current rate, they are slated to increase more than 20-fold in the last two years from the previous two-year period.

According to an ICIJ analysis of FDA data, after the rule change the number of suspected breast implant injuries skyrocketed from 200 a year to more than 4,500 in 2017 alone.

In just the first half of 2018, that number almost doubled to more than 8,000 filed reports.

The increase in reports doesn’t mean implants are suddenly going bad but that they may never have been as safe as patients were told in the first place.

The FDA has acknowledged a “transparency issue” regarding the undisclosed injury reports and that the increase in numbers reflected the change in reporting rules.

Changing the system to better protect breast implant recipients

The FDA warns that as many as one in five women who receive breast implants will get them removed within a decade due to complications such as rupture, deflation, and painful contraction of scar tissue around the implant, but currently there is no warning about autoimmunity.

The good news is that in response to the new information, the FDA and agencies around the world acknowledge that more research needs to be done to determine the autoimmune and cancer risks of implants.

While current studies do not prove breast implants cause these diseases, they do show that women with the implants suffer them at significantly higher rates than women without implants.

It’s proposed that bacterial infection of a biofilm that surrounds the implants is the likely cause of implant-related illness, including BIA-ALCL.

Patient advocates propose rules requiring breast implants to be sold with “black box” label warnings, which are reserved for life-threatening and other serious risks.

Undoubtedly, it will take much larger and longer studies to root out the details and bring about protective actions, and in the meantime doctors and patients need to have deeper conversations about the benefits and risks of silicone breast implants.

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