November 3rd, 2015

Unexpected Benefit from Furry Pets

benefits of petsIntroduction:
When most people think of the benefits of having a dog, cat, or other furry animal they would likely associate feelings of the unconditional love these animals extend to their owners. Pets are often able to boost our mood and fight off feelings of loneliness. They are also able to produce a number of other proven health benefits enhancing social skills, decreasing a person’s risk of heart attack, and reducing the likelihood of allergies.

Historically, the popular medical thought was that furry pet ownership might lead to the development of allergies, but new data from population-based studies disputes this line of thinking. In fact, some studies show that furry pets actually reduce the development of allergies. A new study from the University of Turko in Finland indicates that the responsible factor maybe that exposure to furry animals leads to changes in the human gut flora and resultant changes in the human system to block allergies.

Background Data:
The rate of allergic diseases among urban populations worldwide has increased dramatically over recent years. It is thought that a reduction in the exposure to natural environmental factors may be responsible. One of the important environmental factors may be exposure to animals as several studies have shown that exposure to furry animals, including early-life contacts with livestock, has been reported to be protective against asthma and allergies. While most researchers have focused on the direct immune response to this exposure, there may be another factor – increased exposure to microbial diversity and its influence on the human microbiome.

New Data:
To explore the relationship to furry pet exposure and the development of allergic diseases like asthma, researchers in Finland examined the gut flora of children enrolled in an ongoing randomized placebo-controlled study in children with a family history of asthma, eczema, hayfever, or food allergy.

The researchers identified infants (n = 51) of families having at least 1 furry indoor pet during pregnancy and the first year of life. Infants (n = 64) from families with no pet were selected as controls in consecutive order of recruitment. To determine the development of allergies, skin prick tests (SPTs) were carried out at age 6 months. The antigens tested by SPT included cow’s milk, egg white, wheat and rice flour, cod, soy bean, birch, 6 grasses, cat, dog, dust mite, latex, potato, carrot, and banana. Infants with at least 1 positive SPT reaction were designated as atopic. At six months of age, 19 infants had reactions to at least one of the allergens tested.

The study team also collected fecal samples from diapers when the babies were one month of age. One of the tests performed was DNA analysis for two types of Bifidobacteria that are found specifically in furry animals gastrointestinal tracts and not humans: B. thermophilum and B. pseudolongum. The presence of these bacteria was associated with exposure to a dog, cat, or rabbit as a pet. One third of infants from the pet-exposed group had animal-specific bifidobacteria in their fecal samples, compared to 14 percent of the comparison group. So, even some infants without furry pets at home can acquire these bacteria and have them grow in their own microbiome. It is not difficult to be exposed to these bacteria in a manner that leads to growth in the human intestine. For example, when a dog licks an infant´s face or hand, the pet-derived bacteria can be transferred to the infant’s mouth and ultimately into the intestine.

The results from the analysis indicated that of the 19 children with positive SPTs, none had B. thermophilum bacteria in their fecal samples. This association was beyond coincidence and indicates that pet exposure early in life can have an impact on the composition of the human microbiome in a way that may reduce the risk of allergic diseases.

Here is the bottom line from this analysis, the gut flora (microbiome) plays a huge role in the proper development of the immune system and can prevent the development of allergies. In addition, as I highlighted in a previous newsletter featuring another analysis from this same clinical trial, probiotic supplementation during the first six months of life not only reduced the likelihood of allergies and infections, but also attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders including Asperger’s syndrome. It appears that in addition to probiotic supplementation, exposure to furry pets can also help improve the human microbiome. Maybe, just perhaps, some of the benefits being attributed to therapy dogs (and horses) in kids on the autism spectrum as well as in other situations may be partly due to influencing the microbiome in a positive way.

Nermes M, Endo A, Aarnio J, Salminen S, Isolauri E. Furry pets modulate gut microbiota composition in infants at risk for allergic disease. J Allergy Clin Immunol. 2015 Sep 3. pii: S0091-6749(15)01036-2.

Dr. Michael Murray

October 27th, 2015

Ginger Effective in Relieving Heavy Menstrual Bleeding

how to stop menstrual bleedingIntroduction:

Excessive menstrual bleeding, or menorrhagia, is a common female complaint that may be entirely prevented by a simple herbal prescription – capsules of ginger. The chief cause of functional menorrhagia (i.e., not caused by the presence of uterine fibroids or endometriosis) involves abnormalities in the biochemical processes of the endometrium (the lining of the uterus).

One abnormality commonly found is an alteration in arachidonic acid metabolism. This fatty acid is derived from meat and dairy sources and is converted to hormone-like compounds known as prostaglandins. The endometrium of women who have menorrhagia concentrates arachidonic acid to a much greater extent than normal. The increased arachidonic acid release during menstruation results in increased production of prostaglandin E2 (PGE2), which not only leads to excessive bleeding, but also menstrual cramps.

Background Data:

Historically, the majority of complaints for which ginger (Zingiber officinale) was used concerned the gastrointestinal system as well as pain and inflammation. Ginger is generally regarded as an excellent carminative (a substance that promotes the elimination of intestinal gas) and intestinal spasmolytic (a substance that relaxes and soothes the intestinal tract). Several double-blind studies have shown ginger to yield positive results in a variety of gastrointestinal issues, especially those related to nausea and vomiting.

In regards to pain and inflammation, numerous clinical studies have supported this use with positive results in various forms of arthritis, chronic low back pain, muscle pain, and painful menstruation.

Ginger has been shown to produce equal results in reducing migraine headaches as the drug sumatriptan (Imitrex), but without the side effects like nausea, dizziness, drowsiness, muscle weakness, heart attacks and seizures.

Ginger has shown to produce profound effects on prostaglandin metabolism including reducing PGE2, the prostaglandin implicated in excessive menstrual blood loss and menstrual cramps (dysmenorrhea). This effect suggests a potential use in heavy menstrual bleeding.

New Data:

In order to assess the effects of ginger on heavy menstrual bleeding (HMB), 92 young women aged 15–18 years were enrolled in a double-blind study. These young women met the following criteria:

  • Had regular menstrual cycles
  • Experienced HMB that was clinically verified during the first three assessments cycles prior to the intervention.
  • And, did not have any of the following exclusion criteria:
    • Did not have irregular menstrual cycles;
    • Were not diagnosed with any gynecological diseases such as endometriosis, ovarian cysts, etc.;
    • Were not any taking regular hormonal medications or NSAIDs;
    •  infection or pelvic inflammatory disease;
    •  and overweight/obesity (BMI > 25) or underweight (BMI < 18.5)

The women took either a 250 mg of dried ginger capsule or a placebo capsules three times daily starting from the day before menstrual bleeding until the third day of menstrual period (for four consecutive days). The women were then followed for three additional consecutive menstrual cycles.

Results were determined by having the women assess blood loss through a Pictorial Blood Assessment chart with the following scoring system:

  • Pads: 1 point for each lightly stained towel ; 5 points for each moderately soiled towel; 20 points if the towel is completely saturated with blood.
  • Tampons: 1 point for each lightly stained tampon; 5 points for each moderately soiled tampon; 20 points if the tampon is completely saturated with blood.
  • Clots: 1 point for small clot; 5 points for large clot.

For the three menstrual cycles prior to the treatment period, the average score for both groups was 113. During the treatment period, the level of menstrual blood loss dramatically declined during the three intervention cycles in ginger by 46% while the placebo group only dropped by 2% (p<0.001).

The researchers concluded, “ginger may be considered as an effective therapeutic option for HMB.”


There are a couple other important considerations in menorrhagia. The first issue is iron deficiency. With increased menstrual blood loss, many women with menorrhagia will experience low iron levels. Interestingly, low iron levels can also cause menorrhagia creating a positive feedback loop. Therefore, in any woman with menorrhagia, it is important to rule out low iron stores by getting a blood test for serum ferritin (an iron binding protein that reflects total body iron stores). Iron supplementation is indicated in any woman with a serum ferritin below 60 ng/ml.

Next, as menorrhagia is associated with increased arachidonic acid availability in the uterine lining, it makes sense to decrease the intake of animal products and increase the intake of omega-3 fatty acids and other beneficial oils. Consuming higher intakes of fish, nuts, and seeds and supplementing with fish oils may yield beneficial effects by reducing the tissue levels of arachidonic acid. A dosage of fish oils to provide 1,000 to 3,000 mg of EPA+DHA is recommended.


Kashefi F, Khajehei M, Alavinia M, Golmakani E, Asili J. Effect of ginger (Zingiber officinale) on heavy menstrual bleeding: a placebo-controlled, randomized clinical trial. Phytother Res. 2015 Jan;29(1):114-9.

Dr. Michael Murray

October 20th, 2015

Statistics on ER Visits Due to Dietary Supplements Misleading

emergency room statisticsIntroduction:

The media has once again failed to report the whole story or put things into the proper perspective when they reported on a study from the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA). The headlines and superficial reports were completely blown out of proportion. Keep in mind that it is estimated that over-the-counter and prescription drugs are responsible for more than 4 million emergency room (ER) visits annually. In addition, adverse drug reactions are estimated to cause over 100,000 deaths each year. These numbers are sobering and reflect the real issue that the media should focus on. If anything, this new report shows how safe dietary supplements are.

The authors of the study clearly stated that the numbers of ER visits were less than 5% of the numbers that have been previously reported for pharmaceutical products and the severity of the adverse effects are considerably less for dietary supplements. But somehow, this important perspective was lost by the media.

Background Data:

One of the greatest myths the media loves to perpetuate is that the dietary supplement industry is not regulated. The truth is that all dietary supplements, including vitamins, minerals, herbs and specialty products must conform to federal regulations that control manufacturing, labeling and advertising practices. Specifically, the FDA has the power to:

  • Refer for criminal action any company that sells a dietary supplement that is toxic or unsanitary.
  • Seize dietary supplements that pose an “unreasonable or significant risk of illness or injury”.
  • Stop a new dietary ingredient from being marketed if the FDA does not receive enough safety data in advance.
  • Stop the sale of an entire class of dietary supplements if they pose an imminent public health hazard.
  • Obtain an injunction against the sale of a dietary supplement that has false or unsubstantiated claims.
  • Require dietary supplements to meet strict manufacturing guidelines, called Good Manufacturing Practices, including potency, cleanliness, and stability.

The safety of dietary supplements has been well established over the years. Issues such as the contaminated L-tryptophan in the 1980s due to a change in the manufacturing process by one manufacturer or the abuse of ephedrine as weight loss agent were unfortunate occurrences, but should not detract from the excellent safety profile of dietary supplements. After all, even more significant issues have occurred in the food supply, as well as with prescription and OTC drugs.

It is estimated for the past two decades that roughly 70 percent of Americans utilize dietary supplements. In 2010, over 60 billion doses of nutritional supplements were ingested. According to the annual report from the U.S. National Poison Data System, not a single death was caused by a vitamin or mineral supplement. Again, keep in mind that in that same year prescription and OTC drugs caused well over 4 million ER visits and over 125,000 deaths. So why the big concern with dietary supplements?

New Data:

To evaluate the safety of dietary supplements, the CDC evaluated the adverse event reporting (AER) data from 63 emergency departments over a 10-year period (2004-2013). The researchers estimated that based upon the data, dietary supplements are responsible for approximately 23,000 ER visits and 2,000 hospitalizations annually. Weight loss and energy products were responsible for 72% of AERs while sexual enhancement and body building products accounted for 14%. So, these two categories together equal 86% of the reported AERs. Now, in these 86% of cases, 90% of the time, the presenting AERs were heart palpitations, chest pain, or increased heart rate related primarily to caffeine ingestion and these patients were subsequently discharged from the ER.

The two other primary causes for ER visits were swallowing problems and unsupervised ingestion by children. About 50% of the swallowing problems occurred in elderly subjects and involved calcium supplements. In over two thirds of children presenting to the ER due to a AER it was related to unsupervised ingestion of a multiple vitamin and mineral formula and these visits were mainly precautionary.

Putting these numbers into perspective it is first important that the study did not highlight any serious AERs or deaths due to dietary supplements. Second, the major issue appeared to be people reacting to the caffeine in energy, weight loss and body building products. One of the problems of the report is that it did not detail the simultaneous ingestion of other sources of caffeine by subjects, reporting only side effects due to dietary supplements.


One issue that the report touched on is that the dietary supplement industry still contains some unscrupulous companies that market adulterated products – sometimes laced with prescription drugs. These are the rare exception and not the norm. This issue simply is non-existent among well-respected brands that adhere to high quality good manufacturing practices (GMP). Buyer beware that a product being called “Herbal Viagra” being marketed by a company on the Internet with zero distribution in health food stores and no history may be one of the products that has been shown to be adulterated with actual Viagra. Again, a well respected established brand, is simply not going to do that. From 2004 through 2012 more than 200 products were recalled by the FDA as containing unapproved regulated substances (i.e., drugs) or impurities.

Here should be the take away from this report.

  • Dietary supplements are remarkably safe given their widespread use and lack of ER visits.
  • Don’t use dubious natural products, especially those being marketed with weight loss, body building or sexual enhancement claims.
  • If you are going to use a product containing caffeine, do so wisely and do not exceed the recommended dosage levels on the label, and also take into consideration additional intake of caffeine or other stimulants you ingest.
  • If you have difficulty swallowing large pills, choose smaller pills or other delivery methods. Soft gels are generally easier to swallow and most supplements are now available in powder or liquid form.
  • If you have children, make sure that your supplements are out of their reach.

These simple precautions would likely dramatically reduce the relatively small number of people using supplements from ever having to visit an ER due to a possible side effect.


Geller AI, Shehab N, Weidle NJ, et al. Emergency Department Visits for Adverse Events Related to Dietary Supplements. N Engl J Med. 2015 Oct 15;373(16):1531-40.

Dr. Michael Murray