August 17th, 2016

Another Nail in the Acetaminophen (Tylenol) Coffin: New Study Links its Use to Attention Deficit Disorder with Hyperactivity

Equate_AceteminophenIntroduction

Another damning study indicates it is simply time to pull the plug on this outdated drug. The study just published in JAMA Pediatrics once again indicated that women who take acetaminophen during pregnancy are more likely to have a child with attention deficit hyperactivity disorder (ADHD). The researchers also found that prenatal exposure to the medication was associated with a higher risk of having children who exhibit other emotional or behavioral symptoms.

Recent detailed analysis of clinical studies on acetaminophen (Tylenol) have concluded that this popular drug was ineffective for low back pain and provided no significant clinical relief of hip or knee osteoarthritis (OA) pain, while quadrupling the risk for liver damage.

All together, the results from all of these analyses further calls into question whether this drug should still be on the over-the-counter market or at all.

Background Data:

Acetaminophen is the only remaining member of the class of drugs known as “aniline analgesics” that is still on the market, as the rest were discontinued long ago. Acetaminophen only blocks the feelings of pain and reduces fever, it exerts no significant anti-inflammatory or therapeutic action.

It is well-known that acetaminophen is very hard on the liver. About 40% of regular acetaminophen users show signs of liver damage. Acetaminophen reduces the liver’s store of the important detoxifying aid and antioxidant glutathione. When acetaminophen is combined with alcoholic drinks or other compounds toxic to the liver including other medications, its negative effects on the liver are multiplied. It should definitely not be used in anyone with impaired liver function and given the stress the liver experiences during pregnancy, it appears unwise to use it while carrying a child for both mother and the developing fetus.

Acetaminophen is often the drug of choice in children to relieve fever. However, use for fever in the first year of life is associated with an increase in the incidence of asthma and other allergic symptoms later in childhood. Asthma appears to be another disease process that is influenced greatly by antioxidant mechanisms. Acetaminophen severely depletes glutathione levels not only in the liver, but presumably other tissues as well, and should definitely not be used in people with asthma.

Each year acetaminophen causes over 100,000 calls to poison control centers; 50,000 emergency room visits, 26,000 hospitalizations, and more than 450 deaths from liver failure. In addition, regular use of acetaminophen is linked to a higher likelihood of Alzheimer’s disease, infertility, and hearing loss (especially in men under 50 years of age). Acetaminophen use during pregnancy has also been linked to the development of ADHD confirming animal studies showing acetaminophen use in pregnancy can disrupt normal brain development.

New Data:

To more closely assess the associations between maternal prenatal acetaminophen use and behavioral issues in their children, researchers in the United Kingdom collected and analyzed data 7,796 mothers along with their children. The data included acetaminophen use and behavioral assessment of the children were 7 years old. From this data the estimated risk ratios for behavioral problems in children after prenatal exposure to acetaminophen was determined.

The results showed that prenatal acetaminophen use at 18 and 32 weeks of pregnancy was associated with a 42% increased risk of the child having conduct problems and hyperactivity symptoms, while maternal acetaminophen use at 32 weeks was also associated with a 29% increased risk of the child having emotional symptoms and a 46% increase in total behavioral difficulties.

Obviously, the researchers concluded “Children exposed to acetaminophen prenatally are at increased risk of multiple behavioral difficulties, and the associations do not appear to be explained by unmeasured behavioral or social factors linked to acetaminophen use.”

Comment:

The results from this study and others are clear. Stay away from acetaminophen. Most people consider acetaminophen (e.g., Tylenol) as being an extremely safe pain reliever for both children and adults. The reality is that it can be extremely dangerous and causes significant side effects. The FDA has done a poor job alerting the public to the dangers of acetaminophen. In my opinion, it is a drug that serves no real medical purpose in the 21st century. Bottom line, it is time to pull it from the market.

As far as alternatives to acetaminophen during pregnancy, I would recommend ginger. Historically, the majority of complaints for which ginger (Zingiber officinale) was used concerned the gastrointestinal system as well as pain and inflammation. Several double-blind studies have shown ginger to yield positive results in a variety of gastrointestinal issues, especially those related to nausea and vomiting including severe morning sickness. In regards to pain and inflammation, dozens of clinical studies have supported this use with positive results in various forms of arthritis, chronic low back pain, muscle pain, and painful menstruation.

Ginger powder, ginger tea or a shot of fresh ginger juice added to any fresh fruit or vegetable juice is certainly a much better option to acetaminophen anytime, but especially during pregnancy.

My overall interpretation of the study is that depletion of glutathione caused by acetaminophen leaves cells, especially brain cells, susceptible to damage. I believe that future studies will not only show more evidence of a link to ADHD, but also autism as well. Glutathione is absolutely critical in protecting cellular function. Any factor that depletes glutathione is obviously going to alter proper development. In addition to acetaminophen, the following factors can deplete glutathione:

  • Alcohol
  • Pesticides, herbicides
  • Acetone, cleaning solvents, paint removers
  • Heavy metals (mercury, lead, cadmium, copper, etc.)
  • X-rays, UV radiation, and electromagnetic fields (EMF)

To boost your glutathione level it is important to focus on a diet rich in colorful fruits and vegetables. Their rich source of antioxidant phytochemicals and nutrients spare the use of glutathione and help to keep cellular levels high.

Reference (click)

Dr. Michael Murray
8/17/2016

August 4th, 2016

Smell Test Outperforms Brain Imaging in Predicting Dementia

Predicting DementiaIntroduction:

The ability to correctly identify odors may prove to be a more functional approach to identifying people at risk for early stages of Alzheimer’s disease (AD). Currently, physicians have to rely on expensive medical imaging (CT, MRI, or PET scans) to look for changes in the brain that are characteristic of AD. However, one of the problems with brain imaging beyond their cost is that it simply like taking a picture of the brain. Although sometimes these pictures provide valuable information, they do not evaluate the actual function of the brain.

Research has suggested that simple smell tests evaluating a person’s ability to identify odors may prove to be a practical screening tool for AD and age-related mental decline. Now a new study from Columbia University researchers has shown that a simple, inexpensive scratch and sniff test was shown to be better than an MRI measurement in predicting the early stages of AD.

Background Data:

The new study utilized the University of Pennsylvania Smell Identification Test (UPSIT). This simple test is commercially available for smell identification. It has become the gold standard of smell identification tests and has now been administered to about 500,000 patients so far. Developed by Dr. Richard Doty, the test has also been used as screening test in identifying early stages of AD and has been found to be superior to other non-diagnostic clinical measures in predicting cognitive decline. The loss of odor identification is based on memory and is not the same as a loss of the sense of smell.

Several other studies have also identified altered sense of smell in cognitive decline. For example, in a very simple approach to screening for early stages of AD, University of Florida researchers asked participants to smell a spoonful of peanut butter at a short distance from their nose. The participants had a confirmed diagnosis of early stage AD, some had other forms of dementia, while others had no cognitive or neurological problems. The results showed that patients with early stage AD had trouble smelling the peanut butter. Interestingly, when these patients blocked their right nostril, they had even more difficulty smelling the peanut butter. They typically were able to smell the peanut butter from 4 inches farther away with their right nostril than their left. The researchers found that this difference in smell between left and right nostril was unique to early stage AD.

In a more sophisticated study at the Mayo Clinic, it was found that older subjects with an average age of 79 years old who had the worst test scores on a smell test were 2.2 times more likely to develop impaired cognition and memory over the three and a half year study. If at the beginning of the study a patient was already exhibiting memory problems and had a low smell test scores, they were more likely to progress to Alzheimer’s disease. The smell test used was more elaborate than the peanut butter test and included six food items and six non-food items.

New Data:

The University of Pennsylvania Smell Identification Test (UPSIT) used in the new study involves scratching a surface, sniffing the odor that’s released, and identifying it from a multiple-choice list. The test consists of 4 different 10 page booklets, with a total of 40 questions. On each page, there is a different “scratch and sniff” strip embedded with a microencapsulated odorant. There is also a four choice multiple choice question on each page. The scents are released using a pencil. After each scent is released, the patient smells the level and detects the odor from the four choices. There is an answer column on the back of the test booklet, and the test is scored out of 40 items. The test is scored from 0 (no correct answer) to 40 (all answers correct). A low score indicates a decreased ability to correctly identify odors.

Again, the loss of odor identification is based on memory and is not the same as a loss of the sense of smell. The study included 397 patients with an average age of 80 from Manhattan, New York, who had undergone MRI and UPSIT and had no dementia at baseline. Researchers then followed these participants for 4 years. Analysis found that UPSIT and MRI predicted transition to dementia, but UPSIT was better. UPSIT was also able to predict general cognitive decline while MRI did not. In addition, when subjects scored very well on the UPSIT (score of more than 35 out of 40), almost nobody went on to get AD even though their average age was 80 years old.

These results mean that odor identification appears to be a better predictor of who will get AD as well as suffer from loss of mental function and memory (mild cognitive impairment).

Comments:

A screening test is really only as good as the resultant next steps. In the case of AD and mild cognitive impairment, that next step should involve dietary and supplement strategies to improve brain structure and function. As a special gift, read the Latest Research on Alzheimer’s Disease & Natural Medicine detailing all of my suggestions for preventing AD and boosting brain power.

Reference:

Scratch-and-Sniff Test Beats Imaging in Predicting Cognitive Decline. Medscape. Aug 03, 2016.

Dr. Michael Murray
8/4/2016

July 22nd, 2016

Helping with Anxiety During Perimenopause and Menopause

Helping with Anxiety During Perimenopause and Menopause

Although hot flashes get a lot more attention, another common symptom during menopause is an increased feeling of anxiety.

In general, anxiety is twice as common in women than in men. During menopause as well as the time just prior (perimenopause), anxiety in women is especially common due to the hormonal changes taking place. Lower estrogen levels, in particular, are thought to trigger feelings of anxiety in many women.

Defining Anxiety

Anxiety refers to an unpleasant emotional state ranging from mild unease to intense fear. Anxiety differs from fear in that, while fear is a rational response to a real danger, anxiety usually lacks a clear or realistic cause. Though some anxiety is normal and even healthy, higher levels of anxiety are not only uncomfortable but can lead to significant problems.

Anxiety is often accompanied by a variety of symptoms. The most common symptoms relate to the chest, such as heart palpitations (awareness of a more forceful or faster heart beat), throbbing or stabbing pains, a feeling of tightness and inability to take in enough air, and a tendency to sigh or hyperventilate. Tension in the muscles of the back and neck often leads to headaches, back pains and muscle spasms. Other symptoms can include excessive sweating, dryness of the mouth, dizziness, digestive disturbances and the constant need to urinate or defecate. And, along with anxiety of course comes the inability to relax, which may lead to difficulty in getting to sleep and constant waking through the night.

Generalized anxiety disorder (GAD) is characterized by a persistent state of exaggerated worry and fear (at least six months), often when there is little or nothing to provoke it.

Severe anxiety will often produce what are known as “panic attacks”—intense feelings of fear. Panic attacks may occur independent from anxiety but are most often associated with generalized anxiety or agoraphobia. Agoraphobia is defined as an intense fear of being alone or being in public places. As a result, most people with agoraphobia become housebound.

Natural Approaches to Anxiety

As women in their 40s and 50s are going through menopause, declining estrogen levels often produce feelings of anxiety. This link is the result of the effect that lower estrogen levels have on brain’s regulation of moods and emotion. Changes in estrogen levels lead to alterations in important neurotransmitters (brain chemicals that transmit nerve impulses)—including serotonin, norepinephrine, dopamine and melatonin—that play a huge role in how we feel. About one in four women will experience more noticeable anxiety or depression during perimenopause and menopause.

Before offering some suggestions with specific natural products to address anxiety, there are important dietary recommendations that can help during this change of life. Perhaps the most important is simply to increase the consumption of plant foods, especially those high in phytoestrogens, while reducing the consumption of animal foods. Phytoestrogens are plant-derived substances that are able to weakly bind to the estrogen receptors in mammals and have a very weak, estrogen-like effect in some tissues and a weak anti-estrogen effect in other tissues.

Soy foods and flax seeds contain a high content of phytoestrogens and have received a lot of attention as phytoestrogen sources, but many other foods such as apples, carrots, fennel, celery, parsley and other legumes also contain phytoestrogens, though in smaller amounts.

A high dietary intake of phytoestrogens is thought to explain why hot flashes and other menopausal symptoms, including anxiety, appear to occur less frequently in cultures consuming a predominantly plant-based diet. In addition, such a diet is promising for disease prevention, with some research showing a lower incidence of breast cancer and heart disease in women consuming high-phytoestrogen diets.

Fish Oils

Fish oils concentrated for the omega-3 fatty acids EPA and DHA have been shown to have positive effects for patients with many different types of psychological disorders associated with stress, including anxiety, depression, bipolar disorder (manic depression), borderline personality disorder, and attention deficit disorder with hyperactivity (ADHD).

Results from trials in menopausal women showed particularly interesting results. For example, in a 2009 study conducted in Quebec, Canada, 120 women going through menopause were given either a fish oil supplement providing 1,200 mg of EPA+DHA or placebo for eight weeks. The baseline level of hot flashes was an average of 2.8 per day. After eight weeks, the hot flash frequency decreased by 55 percent in the EPA+DHA group, but only 25 percent decrease in the placebo group. Fish oil supplementation was also associated with an improvement in quality of life scores as well as mood.

Black Cohosh

In the last 30 years, black cohosh (Cimicifuga racemosa) has emerged as the most studied of the herbal alternatives to hormone replacement therapy for menopause symptoms. The collective findings in black cohosh studies and long-term clinical anecdotal evidence on black cohosh indicate that it is most effective for menopause symptoms of hot flashes day time or night time, mood swings, sleep disorders and body aches. It also appears to be helpful in reducing anxiety as well as symptoms of anxiety such as heart palpitations.

Some recent studies have used black cohosh extract in combination with other botanical extracts, such St. John’s wort, red clover, soy and chaste berry. Of these, St. John’s wort deserves some additional attention.

St. John’s Wort

As most people even superficially familiar with herbal medicine know, St. John’s wort extract (SJWE) research has focused in the area of mild to moderate depression. Yet, there are several studies that have also been conducted with SJWE to evaluate its effects on menopausal symptoms. These studies have not only shown SJWE to improve mood, but also reduce hot flashes (most significantly after two months of use).

In regard to improving mood, the effects were also most obvious after two months of treatment (at 900 mg per day). Women in the St. John’s wort group reported improvements in psychological symptoms linked to menopause, significantly better quality of life scores, fewer sleep problems, as well as a feeling of sexual well-being.

Maca

Another botanical medicine that can be of great benefit in relieving anxiety during menopause is maca (Lepidium meyenii)—an historic herbal remedy from Peru often used to enhance male sexuality, but which also has some very interesting effects on women. Research on menopausal women using a maca indicates that unlike hormone replacement therapy (HRT) and phytoestrogenic botanicals, maca can increase the body’s production of estrogen—versus simply adding estrogen replacement to the body—and lower levels of cortisol.

What makes this especially interesting is that, from other research conducted on the composition of various powdered preparations of maca root, it appears that the herb does not contain plant estrogen or hormones. It has been suggested that maca’s therapeutic actions rely on plant sterols stimulating the hypothalamus, pituitary, adrenal and ovarian glands, and therefore also affecting the thyroid and pineal glands, thus improving sleep, mood, fertility, energy and hot flashes. As such, maca tends to treat menopausal symptoms as a whole; it doesn’t treat any one specific symptom of menopause (such as hot flashes) alone.

In one double-blind four-month study of early postmenopausal women, patients were given either placebo or two 500 mg capsules of maca twice daily for a total of 2 g/day. After two months, maca stimulated estrogen production and suppressed cortisol. It also had a small effect on increasing bone density and alleviated numerous menopausal symptoms including hot flashes, insomnia, depression, nervousness and diminished concentration.

In regard to these herbal approaches to menopausal symptoms, here is a little clarity:

• Choose one of the following for general symptom relief:
o Black cohosh extract: The dosage of the extract used in the majority of clinical studies has been 2 mg of 27-deoxyacteine twice daily.
o Maca: Gelatinized maca extract 1,000 mg twice daily or dosage equivalent to 3,500 dried, powdered maca root daily.

• If symptoms of anxiety or depression are significant (can be used with either of the two approaches above):
o St. John’s wort extract standardized to 0.3 percent hypericin 900 to 1,800 mg daily

Final Comments

Increased lactic acid levels may be an underlying factor in many cases of anxiety. There are at least six nutritional factors that may be responsible for elevated lactic acid levels in people with anxiety:

1. Alcohol
2. Caffeine
3. Sugar
4. Deficiency of the B vitamins niacin, pyridoxine, and thiamin
5. Deficiency of calcium or magnesium
6. Food allergens
By avoiding alcohol, caffeine, sugar and food allergens, people with anxiety can go a long way toward relieving their symptoms. In fact, something as simple as eliminating coffee can result in complete relief from symptoms of anxiety. This recommendation may seem too simple to be valid, but substantial clinical evidence indicates that in many cases it is all that is necessary!

Dr. Michael Murray
7/22/2016