Letter from Dr. Janson
DHEA (and More) for Menopause
Vitamins Help Alzheimer's Disease
Lung Function and Mortality
In the Health News
Recipe of the Month: Tangy Sauce for Veggies
I just returned from the Scientific Conference of the American
College for Advancement in Medicine (ACAM), and it was a great
meeting attended by more than 350 doctors interested in cutting
edge medicine. About 150 exhibitors also attended, not only
to show their products to the physicians, but also to learn
from the scientific sessions.
One of the researchers, John Classen, MD, reported on the
higher incidence of type I diabetes (insulin dependent diabetes
mellitus, or IDDM) in people who have been vaccinated for
various childhood diseases and tuberculosis (the BCG vaccine,
more common in Europe than in the US). The risk stems from
immunizations given after the first eight weeks of life. IDDM
is an autoimmune disease, resulting from destruction of the
pancreas cells that produce insulin. Immunization against
whooping cough (pertussis, the P in DPT), is strongly
associated with increased diabetes. The same is also true
for other immunizations, but is reversed if immunization is
done during the first eight weeks.
What is especially interesting is the way the manufacturers
and government agencies are able to deny the association.
They simply cite studies that show the difference, but that
are too small to be statistically significant, so they can
point to no difference between the two groups.
This erroneous conclusion is comparable to those from other
manipulated data designed to show what the sponsors of the
studies want to show. For example, the recent study on St.
Johns wort that I reported in the last edition had problems
beyond those that I mentioned.
Dr. Joseph Glenmullen, author of Prozac Backlash (his website
is www.prozacbacklash.com), revealed that this study on major
depression was too short for studies of St. Johns wort,
which takes longer than drugs to work, and it did show a difference
between the two groups in favor of St. Johns wort, but
the difference was not statistically significant.
One of the details not reported was that the researchers used
a scale of depression that can show improvement (for example
a drop in score from 24 to 12), but they did not count anyone
whose score did not show cure (a drop in score
all the way to 6).
Another feature of Dr. Glenmullens presentation was
the report of side effects from anti-depressant drugs. Interestingly,
the frequency of side effects in reports from the manufacturers
of various drugs is different from that shown in studies done
by their competitors (at least their financial interest may
play to our benefit). He also went into the many other valuable
treatments for depression and anxiety, including exercise,
caffeine and alcohol avoidance, kava kava, valerian, and more.
The information on the value of alternatives to drugs and
even surgery continues to impress me. Ill continue to
bring you reports from these important biannual ACAM meetings.
I have previously reported on the value of the hormone dehydroepiandrosterone,
or DHEA. It is an adrenal hormone precursor, or mother
hormone, as well as a free-radical inhibitor, but DHEA
production declines with age, making it worthwhile to consider
DHEA reduces platelet aggregation, protects blood vessels
from atherosclerosis, restores depressed immune function,
and it reduces the damage from burns if administered after
thermal injury. In addition, it reduces insulin resistance
in obese patients, thereby improving their sugar regulation.
Some patients and colleagues have wondered if DHEA might
increase the growth of some cancers, as it is converted to
both estrogen and testosterone, but this appears not to be
the case. DHEA provides protection against cancer by inhibiting
the proliferation of cancer cells. It has been shown in animals
to prevent and arrest the growth of malignant liver tumors,
and the immune support it provides should help the body cope
Men with prostate cancer tend to have lower DHEA levels than
those without cancer, so it is unlikely that any connection
exists between DHEA supplements and prostate cancer. Although
some reports express concern about increased risk of other
cancers, partly depending on levels of estrogen already present,
the weight of the evidence suggests the opposite. It only
slightly increases the level of estrogen, even with supplements
of 50 mg daily.
In menopausal women, the normal levels of adrenal-derived
testosterone drop, and DHEA supplements increase those levels
and help to increase sexual interest and satisfaction, as
well as energy, mood, and bone density.
The opinions on the right dose vary quite a bit, from 5 to
50 mg for women and 10 to 100 mg for men, and without a check
of blood levels I would recommend staying with the lower doses
for people over 50. This would mean taking 5 to 25 mg for
women, and 10 to 50 mg daily for men. If you have your blood
level checked (DHEA-sulfate is the appropriate test), it is
then best to take the amount that brings your level into the
normal range for a younger person.
Many other health habits help to reduce menopausal
symptoms and reverse some of the effects of aging for anyone.
One of these is regular exercise, including aerobic, stretching,
and resistance training for maintaining muscles and bone density
as we age, increasing physical capacity, controlling weight,
increasing flexibility and suppleness, and reducing depression.
This is an impressive array of benefits for something that
is free, fun, playful, and can be implemented at any age.
Diet also helps if you avoid the junk and fast food that
is so prevalent in the Western diet, and spend a little time
with food preparation. Eat lots of fresh vegetables and fruits,
plus some whole grains and legumes, and to that add some fish,
seeds, and nuts, and perhaps some organic eggs and low-fat
yogurt. Keep sugary foods and beverages to a minimum, as these
contribute to bone loss and depression. (Notice that I do
not recommend meat or chicken.) The ads for milk that promote
it for bones are misleading! In countries with the highest
milk intake, they have the highest rates of fractures from
Finally, if you have specific menopausal symptoms you could
take supplements of black cohosh (80 to 160 mg a day), agnus
castus (400 mg), or dong quai (400 to 600 mg), gamma-linolenic
acid (240 mg), and magnesium (500 to 1000 mg), as well as
vitamin E (400 to 800 IU) and bioflavonoids (1000 to 2000
mg) for hot flashes.
If you have some associated depression and anxiety, you could
take some St. Johns wort (300 mg three times a daydivided
doses appear to minimize the sun sensitivity that is sometimes
seen), or some kava kava (250 to 500 mg). Valerian (200 to
400 mg) also helps with anxiety. All of my herbal recommendations
and doses refer to standardized extracts.
In addition to DHEA, other natural hormone replacement helps
for menopause and aging. Natural estrogens from compounding
pharmacies mimic the human estrogen balance, unlike Premarin,
which is derived from horse urine and has a different composition.
Natural progesterone is not the same compound as Provera,
which is chemically modified and has a range of side effects.
(For aging men, natural testosterone from a compounding pharmacist
may be beneficial.)
A recent study showed that low levels of both vitamin
B12 and folate (folic acid), when considered together, are
associated with twice the risk of developing Alzheimers
disease. Even low amounts that are not usually considered
deficiency levels were significant, and related
to atrophy of the cerebral cortex. The association was even
greater among those patients whose brain function was considered
to be higher at the start of the study.
Vitamin B12 and folate are commonly low in elderly people,
making this finding even more significant. Supplements of
B12 and folic acid are simple to take and relatively inexpensive.
I recommend a sublingual tablet of B12 for better absorption,
usually 2500 mcg per day. Folic acid is usually available
up to 800 mcg per day, but I often recommend up to 5000 mcg
(5 mg) for patients. This new evidence shows further benefits
from these nutrients.
In addition to B12 and folate, you can help yourself preserve
brain function with other health practices. Other recent studies
have shown that maintaining intellectual activity, physical
activity, and practicing stress management can all contribute
to prevention of brain deterioration. Community and family
support contribute to maintenance of good intellectual function.
Try as much as possible to avoid toxic metals, such as lead
and mercury, which may damage brain tissue. Mercury is a preservative
used in contact lens solution and mercurochrome topical antiseptic,
and it is also found in many vaccines. As I mentioned an earlier
issue, it is also found in fish. Workers exposed to lead (from
lead batteries, for example) have an increased risk of Alzheimers
Supplements of vitamin E and ginkgo biloba both help maintain
brain function, and ginkgo can apparently provide some reversal
of decline for elderly patients who have already begun to
lose cognitive ability. In one study the placebo group showed
a decline over six months in all parameters that were studied,
and the ginkgo group improved in most assessments. The dose
of ginkgo that the researchers used was 120 mg daily of standardized
Good lung function is an important predictor of health
and longevity, although this is not as well known as other
risk factors for heart disease or cancer. The Buffalo Health
Study followed 1200 people for 29 years. A greater ability
to expel air from the lungs is related to lower mortality
from all causes, and particularly to fewer heart disease deaths.
This was independent of obesity, blood pressure, smoking,
and other known risk factors.
This is especially important in light of another recent study
showing that antioxidants can protect lung function. Vitamins
C, E, and A, and carotenoids (beta-cryptoxanthin, lutein/zeaxanthin,
and beta-carotene) were beneficial, independent of smoking,
weight, and other variables. The strongest associations were
with vitamin E, beta-cryptoxanthin, and vitamin A. Yet further
reasons to eat a healthy diet, exercise for better lung function,
and take your supplements.
Lead is a nervous system poison, and children
are particularly susceptible to the damage. Levels formerly
thought to be safe are actually associated with
decreased cognitive function (Lanphear BP, et al., Cognitive
deficits associated with blood lead... Public Health Rep 2000
Nov-Dec;115(6):521-9). Although 10 mcg per dL is officially
considered acceptable, in children 6 to 16 years old, for
every 1 mcg/dL increase in blood lead level there is a significant
reduction in arithmetic scores, reading scores, and nonverbal
reasoning, and a 0.5-point drop in mean scores on a measure
of short-term memory. The associations even held true for
levels below 5 mcg. It appears that no amount of lead can
be considered safe. Supplements of vitamin C and zinc can
help remove lead, as can EDTA chelation therapy or DMSA treatment.
A report from the FDA on herbs suggests that
they harbor bacteria and fungi. But the conclusion that they
might therefore be dangerous is misleading, because these
products are foods, and our foods are also not sterile. Reliable
manufacturers test raw materials to make sure their herbal
capsules do not harbor pathogenic organisms. (Reuters Health,
American Society for Microbiology Meeting, May 23, 2001)
A diet high in apples and tomatoes can protect lung
function, according to a report from the annual meeting of
the American Thoracic Society (Reuters Health, May 22, 2001).
British researchers tested the FEV1 (the volume of air you
can expel in one second), and found that over a 10 year period
regular consumption of apples and tomatoes, both rich in antioxidants,
was directly related to preservation of pulmonary function.
They also found that eating apples, tomatoes, and bananas
was associated with less wheezing, a symptom of asthma.
Tangy Sauce for Veggies
Often I just do not have time to prepare an elaborate meal,
so Ill just steam some vegetables and make an easy,
tasty sauce to put over them. Usually Ill just rinse
and trim some broccoli or cauliflower, or I might add potatoes
or butternut squash if I want to have more variety (start
the potatoes and squash first as they take longer to steam).
Then I blend some crushed garlic with sesame tahini (crushed
sesame seeds, try health food stores for organic brands),
fresh lemon juice diluted with water to taste, ground pepper,
thyme, fresh or dried basil, a dash of cumin and cayenne,
and other herbs. If I do make an elaborate dinner, I can serve
these vegetables with lemon-tahini sauce as a side dish. Experiment
on your own with different herbs and spices.
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