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heart disease

Health for the Body, Men's Health, Nutrition, Supplements, Women's Health

Magnificent Magnesium Deficiency Continued

April 17, 2015
Dark Chocolate for Magnesium Deficiency

Earlier this week, we discussed the intricate relationship between calcium and magnesium (read more about it here), and established the current dilemma we have with overemphasis on calcium consumption while minimizing the importance of magnesium. Because of this, an estimated 80% of Americans are deficient in magnesium. Not only is magnesium necessary for over 300 biochemical reactions in the body and responsible for a host of basic functions such as muscle contraction, nerve conduction, and our heartbeats, but studies have now shown that it may prevent heart disease, diabetes, stroke, and osteoporosis.

What are the risk factors for magnesium deficiency?

  • age – Our ability to absorb anything decreases with age. The elderly are also more likely to be on medications that may interfere with magnesium absorption.
  • over-exercising – Magnesium is lost in sweat.
  • menopause – Magnesium levels fluctuate with menstrual cycles and decrease even more after menopause. (Ever wonder why you crave chocolate before your period? It could be magnesium deficiency.)
  • diabetes – Diabetics have increased magnesium loss in their urine, especially if poorly controlled.
  • kidney disease – Those with unhealthy kidneys will also lose magnesium through their urine.
  • malabsorption or gut problems – Digestive problems such as Crohn’s disease or leaky gut syndrome will interfere with your ability to absorb magnesium.
  • use of certain medications – Diuretics, antibiotics, and certain cancer medications can result in magnesium deficiency as they interfere with its absorption.
  • eating processed foods with high sugar content and drinking soda – This depletes magnesium in our bodies, since magnesium is used to metabolize and detoxify these foods.
  • alcoholism – Alcoholics tend to have low magnesium levels.
  • exposure to heavy metals and environmental chemicals – Magnesium is depleted through detoxification of these exposures.

What does magnesium deficiency cause?

According to Dr. Carolyn Dean, a leading researcher in magnesium and author of the book, The Magnesium Miracle, magnesium deficiency has been found to trigger 22 medical problems including:

  • anxiety and panic attacks
  • asthma
  • blood clots
  • bowel diseases
  • cystitis
  • depression
  • detoxification
  • diabetes
  • fatigue
  • heart disease
  • hypertension
  • hypoglycemia
  • insomnia
  • kidney disease
  • liver disease
  • migraines
  • musculoskeletal conditions (e.g. cramps, fibromyalgia, chronic back pain)
  • nerve problems
  • obstetrics and gynecology (e.g. PMS, infertility, preeclampsia)
  • osteoporosis
  • Raynaud’s syndrome
  • tooth decay

Review: How do I know if I am magnesium deficient?

Early signs and symptoms of magnesium deficiency include fatigue, nausea, headaches, loss of appetite and weakness. Signs of chronic magnesium deficiency may lead to more serious symptoms of numbness and tingling, muscle contractions and cramps, seizures, coronary spasms, abnormal heart rhythms, and even personality changes. An easy way to find out if you are deficient is to get a magnesium RBC test. The “normal values” are between 4.2-6.8mg/dl, but you really want your levels to be 6mg/dl or higher. Once you find out your baseline, check every 3 months to make sure you are taking enough to maintain your levels. According to Dr Dean, unlike most medications, “as your body becomes saturated with magnesium, your body will need less, not more, to maintain these levels.”

How do I increase my magnesium levels?

The foods with highest concentrations of magnesium (per 100mg or 3.5 oz) include:

– seaweed: kelp (780mg), dried agar (770mg)
– dark leafy greens: kale (88mg), swiss chard (86mg), and baby spinach (87mg) (if it’s green, it’s got magnesium, as it plays a central role in the chlorophyll molecule)
– nuts and seeds: pumpkin seeds (534 mg), flaxseed (392mg), sunflower seeds (325mg), almonds (286 mg), Brazil nuts (376mg), and walnuts (201mg)
– fish: mackerel (97mg), halibut (83mg), and wild salmon (37mg)
– legumes: soybeans (86 mg), lima beans (188mg)
– avocado: 58 mg in one avocado (another great reason to eat one a day!)
– dried fruit: dried figs (68mg), dried apricots (62mg)
– cocoa and bitter chocolate: ounce for ounce, dark chocolate (with cocoa content over 80%) delivers the most magnesium (327 mg)

Review: Magnesium supplements

With the depletion of magnesium in our soil, we are probably only getting 200 mg of magnesium from our daily diet versus 500mg in the past. The Recommended Daily Allowance (RDA) of magnesium for young adults is 400mg for men and 310mg for women. In adults over 30, the RDA is 420mg for men and 320mg for women. It is important and necessary to supplement and perhaps even double this recommended allowance through food and supplements, especially if you have stress in your life (who doesn’t?), as stress uses up our magnesium stores even more.

Magnesium glycinate provides the highest level of magnesium absorption. Metagenics comes in 100mg tablets (take 2 twice a day for a total of 400mg/day) and OrthoMolecular Products offers 235mg in 2 tablets (also taken twice daily for a total of 470mg). It is probably best to start with the recommended dosage and adjust according to your levels.

The many benefits of magnesium

1) Magnesium protects the heart.

Studies have reported a a 34% lower risk of sudden cardiac death in women who took higher levels of magnesium. When a heart attack occurs, there can be increased damage to heart muscle when calcium rushes into the muscle. Blood clots can block blood vessels to the heart. Decreased circulation can cause blood vessels to constrict. New formed arrhythmia in the injured area can occur. Magnesium counteracts these events by dilating blood vessels, preventing spasm in the blood vessels and heart, opposing the action of calcium which increases spasm (remember, magnesium is the “calming” mineral with a relaxing action), dissolving blood clots, lessening the site of injury thereby preventing arrhythmia, and using its antioxidant activity against free radicals that may form at the injury site.

2) Magnesium may prevent diabetes.

Magnesium reduces insulin resistance. In a study with overweight subjects, the group taking 365 mg of magnesium daily for 6 months had lower fasting blood sugar levels and less insulin resistance than the control group. It seems that magnesium controls the activation of the enzyme tyrosine kinase, which is required for proper functioning of our insulin receptors.

3) Magnesium may prevent and treat symptoms of stroke.

A study found that for every 100mg increase in magnesium intake, risk of stroke was decreased by 8%. Intravenous magnesium has also been used for neuroprotection in patients with acute stroke.

4) Magnesium may prevent osteoporosis and hip fractures.

Magnesium is involved in bone formation and bone health. It regulates osteoblast activity (cells involved in bone formation) as well as osteoclast activity (cells involve in bone breakdown). It influences parathyroid hormone and vitamin D, which are both major regulators of bone homeostasis. Researchers also discovered that women with osteoporosis had lower serum levels of magnesium than women with osteopenia or women without osteoporosis or osteopenia. In Norway, a study found that those who drank water with magnesium had a lower risk of hip fracture in both men and women.

4) Magnesium has been used in colorectal cancer prevention.

Higher intakes of dietary magnesium was correlated with lower risk of colorectal cancer. The data from this study showed that for every 100mg increase in magnesium intake, the risk of colorectal cancer tumor decreased by 13% while colorectal cancer risk decreased by 12%.

5) Magnesium promotes weight loss.

Finally, we see a positive correlation between magnesium intake and weight loss. The more magnesium we have in our bodies, the more our bodies are able to regulate insulin and control our blood sugar levels, leading to prevention of diabetes and obesity.

Hopefully, I’ve give you plenty of incentive to check your magnesium levels and start supplementing as needed! Have a great weekend!

In health and wellness,
Dr. Elain

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Fitness, Health for the Body, Herbs, Men's Health, Nutrition, Supplements, Women's Health

10 Things To Do To Stay Heart Healthy and Prevent Heart Disease

April 9, 2015
Avocados to prevent heart disease

The follow-up post to our discussion on cholesterol and heart disease is here! To sum up what we last talked about, cholesterol and saturated fats are not the “bad guys” that they have been portrayed to be in the 80’s and 90’s. In fact, it plays a number of essential roles in our bodies. Low cholesterol levels would not only prevent our bodies from functioning properly, but we could potentially get very sick. Sadly, it has also been used as the scapegoat for heart disease, the leading cause of death in the world. Now, more and more research on people taking statins to lower their cholesterol has refuted this “lipid hypothesis” where dietary fat and cholesterol are the culprit of heart disease. There has already been a movement in Sweden (which started several years ago), where people were getting healthier (and more fit) by stopping their statins and eating high fat and low carbohydrate diets. It is time to relearn what we know about preventing heart disease! Here’s what you need to do to.

1) Eat a heart healthy diet. 

a) A heart healthy diet is high in healthful fats and low in processed carbohydrates and sugars. Healthful fats include:

  • monounsaturated fats like olives and olive oil, avocados, nuts and seeds (macadamia nuts, hazelnuts, pecans, almonds and almond butter, cashews and cashew butter, pistachios). Food fact: Adding one avocado per day to a moderate fat diet lowers LDL more than a moderate fat diet without the avocado.
  • polyunsaturated fats which include omega-3 and omega-6 fatty acids. Omega-3’s are turned into anti-inflammatory hormones in our bodies to decrease inflammation. Foods with high levels of omega-3’s include salmon, mackerel, herring, sardines, anchovies, flaxseed, chia seeds, butternut, and walnuts. Food fact: Eating four walnuts a day raises α-Linolenic acid, or ALA, and improves your lipid profile.

A note on omega-6 fatty acids: The essential omega-6 fatty acid that our bodies need in small amounts is linoleic acid, or LA, (not to be confused with α-Linolenic acid, or ALA, the omega-3 precursor of DHA and EPA). I know, I get confused with these terms too. Omega-6’s are turned into pro-inflammatory hormones in our bodies to increase inflammation when we catch a cold or sprain an ankle. This acute inflammatory process is basically turning our immune systems on to fix a problem. So inflammation is necessary! However, problems occur when our bodies are out of balance and our immune systems cannot shut off, resulting in chronic inflammation and autoimmune disease. Ideally, we should be eating an omega-6:omega-3 ratio range of 1:1 to 5:1, but the American diet’s ratio range is more like 20:1 or 50:1. This is because processed and deep-fried foods are rampant with omega-6 fatty acids so we will rarely be deficient in omega 6’s.

Food fact: Nuts, such as walnuts and pine nuts, also contain high concentrations of omega-6 fatty acids. Potato chips contain omega-6’s because they are fried in vegetable oil. You want to eat more of the nuts and less of the chips, because the omega-6 oils from the potato chips have been oxidized and damaged in the frying process, while nuts contain their own antioxidants that protect the oils from damage. Think of oxidation when you peel an apple and it starts to turn brown from being exposed to the air. Make sense?

b) The low-down on saturated fats:

  • Saturated fats or cholesterol laden foods such as egg yolks, fatty meats (including red meat), poultry (chicken with skin), full-fat dairy products (milk, yogurt, cheese), butter, coconuts, coconut oil, and palm oil are not bad for you. In fact, including them in your diet can decrease the risk of heart disease by lowering lipoprotein a, Lp(a), which correlates with a strong risk for heart disease.  Some research has even concluded that it may be to our advantage to include fats in as much as 50% of our diets. (Not ready for that yet? It’s ok, baby steps). It’s not a far-fetched notion since breast milk, the ideal diet for developing infants, has been found to average anywhere from 41-46% saturated fats, based on mothers from different cultures.
  • The saturated fats you do want to stay away from are those produced through hydrogenation of vegetable oils. If the label says “hydrogenated,” then steer clear.

Note on meat and dairy: you want to choose grass-fed beef that is not injected with added hormones or antibiotics rather than corn-fed beef. If you’re going to eat bacon (one of my favorites =) choose bacon that is nitrate free (uncured). And sorry for those of you who love Popeye’s chicken (my husband included), deep frying chicken in trans-fat oils will negate the effects of saturated fats. Also, eating too much dairy has been linked to allergies as well as increased dampness (phlegm and mucus) in your body. Dampness is one of the external pathogenic factors in Chinese medicine that I will discuss soon. If you are someone who tends to have more phlegm and mucus, or is more allergy prone, I would minimize dairy products in your diet.

c) Trans-fats are what you want to avoid:

  • Trans-fats found in partially hydrogenated vegetable oils, shortening, and margarine were previously used by companies in processed and fast foods (for deep frying and re-frying) because they were easy to use, inexpensive to produce, and had long shelf lives. A study published in 2009 found that “in 87,000 U.S. women followed over 26 years, trans-fat intake was linked to increased risk of sudden cardiac death among those who had underlying coronary heart disease. In this group, the women eating the most trans fats were three times more likely to die of cardiac arrest!” Yikes!

d) Increase the amount of organic or locally grown fresh vegetables. A great way to do this is visit your local farmer’s market at least once a week. A recent study done in 2014 showed that eating 5-7 servings of fruits and vegetables per day had a 36% lower risk of dying from any cause.

e) Eat organic foods as much as possible to avoid exposure to harmful agricultural chemicals such as glyphosphate.

f) Avoid genetically modified ingredients (GMO’s) that are detrimental to your health and have been linked to chronic inflammation, heart disease, cancer, and infertility.

g) Decrease sugar and eliminate processed foods. Diets high in sugar and processed foods increase insulin resistance and the risk of diabetes. This is a hard one for me too! I have trouble strictly adhering to this and have been known to eat the occasional Krispy Kreme donut or Egg McMuffin and hashbrowns for breakfast (it just brings back childhood memories for me =).

h) Avoid food or sugary and/or diet drinks loaded with artificial sweeteners such as Equal, Nutrasweet, Splenda, Sweet N Low, and high fructose corn syrup. Opt instead for the stuff nature intended – cane sugar, raw sugar, or raw honey. (Diet drinks have also been known to cause severe neurologic problems).

i) Try eating one third of your food raw and avoid cooking foods at hot temperatures to maintain nutritional integrity of the food for absorption (read more about how the different ways of cooking affect foods here).

j) Drink plenty of water. This article explains very well how to tell if you are not drinking enough water. Signs and symptoms include:

  • Fatigue and/or mood swings
  • Hunger even though you’ve recently eaten
  • Back or joint aches
  • Dull, dry skin and/or pronounced wrinkles
  • Infrequent urination; dark, concentrated urine, and/or constipation

2) Supplement yourself to bridge the nutritional gaps

  • Omega-3 lower triglyceride levels and raise HDL levels. Find a high quality fish, krill, or algae oil (for vegetarians) with high concentrations of DHA (at least 300mg) and EPA (read more on Omega-3’s here).
  • Vitamin D – A recent study in 2014 has shown that supplementing with only 400 I.U.’s of Vitamin D improves serum 25-hydroxyvitamin D levels in menopausal women which improved their lipid profiles (increased HDL, decreased LDL and triglycerides). Supplement with enough Vitamin D to get your levels between 40-60ng/ml (read more on Vitamin D here). See how everything is coming together?
  • Multi-vitamin mineral use has been found to reduce the risk of cardiovascular disease in women. In the study, women, but not men (sorry gentlemen), who took a multi-vitamin mineral supplement for at least three years had a 35% lower risk of dying from heart disease. (This doesn’t mean that men should not be taking one either.) Look for a whole food based multi-vitamin rather than synthetic, for obvious reasons. The brand I like to take is MegaFood. Whatever you choose, make sure your multi-vitamin does not contain sodium selenite or selenate, which have been found to be carcinogenic and genotoxic.
  • Magnesium is a mineral that is important because calcium depends on it to function correctly. In addition, magnesium deficiency may result in many cardiac symptoms such as angina, arrhythmia, and hypertension. I will talk more on how to determine whether you are magnesium deficient and what to do about it.
  • Herbs – Chinese herbs that have been found to improve lipid profiles include Reishi Mushroom and Gynostemma which I will also discuss in more detail later.

3) Exercise Regularly –  Exercising is beneficial for heart disease and diabetes because it can help normalize your blood sugar, insulin, and leptin levels. It releases endorphins, which gives you that high afterwards and is a great stress reliever. It also helps you sleep better, maintain a healthy weight if done correctly, and optimizes brain function.

If you are not used to exercising regularly or are overweight, the best exercise to start with is walking. It is recommended to take 10,000 steps per day, which can easily be tracked using a pedometer. Start slow and begin walking 5-10 min per day if you are out of shape. The key is to be consistent and listen to your body. Don’t push yourself beyond your limitations. As you build endurance you can increase length and intensity of training. Incorporate strength and resistance training with weights. Again, start with lighter weights and increase as you improve your strength. A study has shown that doing 1 set of repetitions (or reps – the number of times any muscle or group of muscles is used) is just as effective as doing 3 sets of reps. Building core strength to prevent back injuries and stretching are also important aspects to add to your fitness program.

Note: Studies show that endurance type exercise, such as marathon running, may damage your heart and increase your cardiac risk. This is because running long distances may increase inflammation and trigger a cardiac event. For those with documented heart disease or heart failure, it is imperative not to overdo it and add extra stress on the heart, as it is already decompensated and weakened.

4) Don’t Smoke – Smoking is all-in-all a bad habit for your health. It can lead to so many devastating diseases such as cancer, heart disease and stroke, which you won’t see until many packs per day later. If you smoke, try to quit and make sure that your diet is in good shape before you quit as health problems from poor diet may actually be worse than smoking.

5) Alcohol in Moderation – This means 1-2 drinks/day for men and 1 drink/day for women. There have been studies done on mice that show the antioxidants from polyphenols, called resveratrol, found in red wine may benefit the heart by protecting them from obesity and diabetes as well as lower LDL. But to get the same dose of resveratrol used in mice in these studies, a person would have to drink 1000 liters of wine every day. Ahem, this is not advisable. My thinking is if you don’t have alcoholic tendencies or liver disease, and a glass of wine a day makes you happy and helps you wind down, do it. (See #10 below)

6) Avoid Statins and also Diabetic Medications – I discussed this in my previous post. If you must take statins, make sure you add at least 100mg (if not 200-300mg) of CoQ-10 to your supplement regimen. Anyone over 40, take the ubiquinol (most reduced form) of Co-Q10 as your body’s ability to convert CoQ-10 to ubiquinol decreases with age. The ubiquinol form is also more bioavailable.

A recent study published in Lancet Diabetes and Endocrinology showed that patients who manage diabetes with drugs that lower glucose or blood sugar, may be at higher risk for heart failure. The study was also presented in March 2015 at the 64th Annual Scientific Session of the American College of Cardiology in San Diego, CA. What?! Looks like I will have to dedicate a different post to this subject.

7) Get enough sleep – I mentioned in the previous post that our brains make cholesterol when we sleep. Sleep is so important to recharge your brain and give your body the rest it needs to replenish itself. A recent study showed that poor sleep may lead to brain shrinkage and may even accelerate Alzheimer’s onset. Here is the most recent recommended sleep guide from the National Sleep Foundation:

Age GroupRecommended # of hours of sleep needed
Newborns (0-3 months)14-17 hours
Infants (4-11 months)12-15 hours
Toddlers (1-2 years)11-14 hours
Preschoolers (3-5)10-13 hours
School-age children (6-13)9-11 hours
Teenagers (14-17)8-10 hours
Young adults (18-25)7-9 hours
Adults (26-64)7-9 hours
Seniors (65 and older)7-8 hours

8) Manage your stress – There is not doubt that emotional stress affects you physically. I have not expounded too much on the mind-body connection yet, but there is a clear correlation between emotional stress and physical disease. This is actually one of the tenets of Chinese Medicine. We are spiritual souls connected to a physical body. Emotional stress from anger, frustration, depression, grief, worry, fear, and anxiety cause mind-body blockages, a disconnect between our spirit and our bodies which can lead to physical disease if not promptly addressed. So besides exercising to relieve stress, what else can you do? See #9

9) Get regular body tune-ups – If you take your car in for tune-ups and oil changes every few thousand miles, why would we think that our bodies don’t need the same maintenance? The tune-ups I get are the treatments that my father and I give to our patients on a regular basis. The treatment we do is a powerful form of acupuncture, which my father coined Neuro-BioEnergetics Treatment or NBE. In short, we combine the Chinese Medicine principle of acupuncture with Western anesthetic injections or trigger point injections. We inject acupuncture points with a diluted solution of anesthetic and clear these mind-body blockages that occur in your body from stress in your life, emotional or physical trauma, eating wrong, not exercising, not sleeping enough, drinking too much, smoking…the list goes on. I will expound on this more in future posts, but you can check out what we do on drtong.com

10) Do something every day that makes you happy or makes you laugh – Finally, to be heart healthy, you have to be happy. Why is this? The emotion associated with the heart in Chinese medicine is love, joy, and happiness. A blockage in these emotions, can also cause blockages in your physical heart. Whatever makes you happy, whether it is watching a comedy, taking a dance class, cooking, or reading a book, try to do it daily. There is something to be said about laughter being the best medicine.

What makes you happy?

In health and wellness,
Dr. Elain

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Health for the Body, Men's Health, Nutrition, Supplements, Women's Health

Cholesterol – Facts and Myths

April 6, 2015
High Cholesterol Foods

Cholesterol has gotten so much recent press that I feel it is a topic that needs to be addressed. Last month, a 6 year Finnish study of 9,000 men concluded that the cholesterol lowering medication, atorvastatin and simvastatin, increased the risk of Type 2 diabetes by up to 46% – the higher the dosage, the greater the risk. It appears that statins “increase a person’s insulin resistance” and also “impair the ability of the pancreas to secrete insulin.” And now, the Dietary Guidelines Advisory Committee (DGAC) is saying that “cholesterol is not considered a nutrient of concern for overconsumption.” So what is going on? Cholesterol lowering medication is causing a disease (diabetes) that can lead to a disease (heart disease) that it was originally trying to prevent? And we shouldn’t be concerned about having too much cholesterol in our diets? It seems that everything about cholesterol originally ingrained in our knowledge has done a complete 180. Let’s get the facts straight.

Cholesterol 101 – What is it and why do we need it?

  • Cholesterol is not a fat, but a steroid alcohol that is not water soluble. Around 75% of the cholesterol in our bodies is produced in the liver while the other 25% comes from food.
  • Cholesterol is essential for the production of all our cell membranes, bile acids (for digestion, fat metabolism, and elimination of cholesterol), sex hormones (such as testosterone, estrogen, progesterone), adrenal hormones (such as cortisol, DHEA, aldosterone), and Vitamin D (read more about Vitamin D here).
  • It maintains structure in our cells and blood vessels, and regulates protein pathways for cell signaling and communication between all our cells.
  • It is essential in our nervous systems, helping us with learning, memory, and cognitive function.

Our brains, which constitute only 2% of our body weight, contain 25% of the cholesterol in our bodies, and most of that 25% is made in our brains when we sleep. This is why babies sleep so much — while they sleep their brains are making more cholesterol to help them grow and develop. Infants and toddlers also need adequate amounts of cholesterol in their diets for proper brain development. For the elderly, it was found that those with high cholesterol in their brains had the best memory function, while those with low cholesterol had a higher risk for depression and even death! For all of us in between, it goes without saying that we also need cholesterol to function properly.

Ok, so now we have established that cholesterol is very important and ESSENTIAL to life.

If cholesterol is so good, why do statins even exist??

Let’s define the main components that make up cholesterol.

LDL – This is the “bad cholesterol” contributing to plaque build up in your arteries causing them to harden, also known as atherosclerosis. If a blood clot forms and blocks a narrowed artery, then a heart attack or stroke may result. However, what is not commonly known is that there is “good” LDL and “bad” LDL as well. According to Dr. Ron Rosedale, M.D.:

“LDL particles come in many sizes and large LDL particles are not a problem. Only the so-called small dense LDL particles can potentially be a problem, because they can squeeze through the lining of the arteries and if they oxidize, otherwise known as turning rancid, they can cause damage and inflammation.”

HDL – This is the good cholesterol that carries LDL away from the arteries and back to the liver where it is processed and eliminated.

Triglycerides – This is fat that contributes to atherosclerosis. It is caused by being overweight or obese, lack of exercise, alcohol, smoking, and a diet high in carbohydrates (more than 60% of total calories). High triglycerides are actually a higher risk factor than LDL for developing diabetes and heart disease. (You’ll see why in a second).

VLDL – Very low density lipoproteins are considered bad cholesterols.

Lipoprotein (a) or Lp(a) are made up of LDL plus a protein (apoprotein a). High levels of Lp(a) also contribute to diabetes and heart disease.

Total cholesterol (TC) is the sum of all the above components.

So how do statins work?

Statins block the synthesis of cholesterol by inhibiting an enzyme in the liver called HMG-CoA reductase. This enzyme is what controls the production of cholesterol in the liver.

The problem is that HMG-CoA reductase also makes CoQ-10 in our bodies which is a major energy source for our hearts and responsible for energy production in all our cells. Therefore statins also decrease CoQ-10.

Statins increase insulin levels in our bodies. Chronically elevated insulin levels can cause inflammation and ironically, heart disease. Isn’t this the reason why people are prescribed statins — to decrease heart disease? Elevated insulin levels may also cause high blood pressure, heart attacks, thyroid issues, Parkinson’s disease, Alzheimer’s and even cancer.

Statins increase the risk of diabetes because it raises your blood sugar levels. How? Excess sugar that you eat from a meal is shunted to the liver where it should then be processed and stored into cholesterol and triglycerides. If the cholesterol production is blocked, then the sugar is kicked out of the liver and back into your blood stream, raising your blood sugar levels, which increases your risk of diabetes. This is exactly what the researchers in Finland discovered in their study.

How do I know if I’m at risk for heart disease?

If you visit your PCP or cardiologist, they will check your lipid profile to assess your risk for heart disease. The old school of thought is that your total cholesterol should be 200mg/dl or lower and under 150mg/dl if you already have heart disease. Your HDL should be over 40mg/dl, your LDL should be under 100mg/dl or under 70mg/dl for high risk patients, and your triglycerides should be under 150mg/dl. (Note: The lipid panel should be done fasting.)

Better and more accurate indicators of your risk for heart disease is using the following criteria according to Dr. Joseph Mercola:

1) HDL/Total Cholesterol Ratio : Divide your HDL by your Total Cholesterol and multiply by 100. This should ideally be 24% or higher. If your ratio is 10% or lower, then you are at significant risk.

2) Triglyceride/HDL Ratio: Divide your triglycerides by your HDL. This should ideally be under 2.

I’ll use my own numbers to illustrate 1 and 2 above.

TC = 194  HDL = 68 LDL = 116 Triglycerides = 61

My HDL/TC ratio is 68/194 x 100 = 35% > 24%

My triglyceride/HDL ratio is 61/68 = 0.89 < 2

As you can see from the ratio calculations, LDL is not even a factor considered in assessing heart disease risk. This indicates that lowering LDL does not have as much influence in lowering your risk as raising HDL and lowering triglycerides levels do.

3) NMR lipoprofile: This test measures the “bad” LDL levels discussed above, the “smaller more damaging LDL particles.” These particles can cause inflammation and are also connected with insulin and leptin resistance.

4) Check your fasting insulin: Normal insulin levels are under 5, but should ideally be under 3.

5) Check your fasting blood sugar: Those with a fasting blood sugar of 100-125mg/dl have almost 3 times the risk for heart disease than those with levels under 79mg/dl.

6) Waist to hip ratio (waist measurement/hip measurement) is a much better indicator than Body Mass Index (BMI) because BMI underestimates obesity rates by not accurately measuring your visceral, or belly fat. An ideal ratio for men is under 0.8. For women, the ideal ratio should be under 0.7. A ratio over 1 for men and over 0.85 for women is considered high risk.

7) Iron levels: Excess iron levels can potentially damage blood vessels, increasing the risk for heart disease. Check your ferritin levels and make sure they are under 80mg/dl. The best way to get rid of excess iron is donating blood.

Should I take statins if I am at risk or already have heart disease?

I rarely, if ever, prescribe statins. And if a patient comes to me on a statin, I will usually take them off the statin and use diet, supplements, and herbs to treat them. The only benefit that has been seen with statins is with middle-aged men who already have documented heart disease (according to cardiologist Dr. Stephen Sinatra) or those born with a genetic defect called familial hypercholesterolemia which prevents them from normalizing cholesterol levels (these patients come in with extremely high numbers: TC >300 and triglycerides > 400). Even then, your total cholesterol levels do not need to be lowered below 150mg/dl nor does your LDL need to be below 70mg/dl. Lowering your cholesterol to these levels puts you at risk for cognitive issues including depression (low cholesterol levels may indirectly link to lower serotonin levels in the brain since cholesterol is needed in nerve cell membranes for serotonin receptors to work properly), memory loss, and Alzheimer’s dementia (with low HDL levels as a risk factor). Instead, use the ratio calculations above to make sure your lipid profile is in the optimal range.

Another valid reason to take the lowest dose of statins, if you must take them, is because there have been hundreds of studies (900!) validating the damaging side effects from statins including muscle pain, cognitive loss, neuropathy, anemia, frequent fevers, cataracts, and sexual dysfunction. In addition, studies have shown that lowering cholesterol levels with statins don’t lower mortality rates from cardiac related deaths but actually increase the mortality of cancer. Researchers now also believe that high LDL levels are not the culprit of heart disease risk since those people dying from heart related diseases had the lowest levels of cholesterol ever (i.e., the 3 year mortality rates of heart attack patients with low LDL were twice as high)!

Also, if you are taking a statin — you must supplement with at least 100mg of CoQ-10 daily (if not 200-300 mg) as this is depleted in those taking statins. And if you are over 40, it is better to supplement with the ubiquinol form of CoQ-10 (more about this later).

Coming soon: I’ll talk about effective ways to improve your cholesterol health and prevent heart disease. For now, be comforted in knowing that eating foods high in cholesterol and saturated fats such as eggs and uncured bacon, as well as foods high in unsaturated fats such as avocados are a step in the right direction towards these goals.

What does your cholesterol profile look like?

In health and wellness,
Dr. Elain

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Baby Nutrition, Health for the Body, Men's Health, Supplements, Women's Health

Vitamin D – The Sunshine Vitamin

March 27, 2015
Sunshine and Vitamin D

One of the most important supplements I take is Vitamin D. Ideally, we should be getting Vitamin D from the sun. Realistically, most of us are indoors all day and do not soak up nearly the amount of sun we need to make enough Vitamin D.

Why is Vitamin D so important?

Vitamin D is actually a misnomer, because it is not a vitamin, but, in fact, a fat-soluble steroid hormone obtained from sun exposure, the foods we eat, and supplementation.

A few of its vital roles include:

  • absorption of calcium to promote strong bones and teeth
  • regulation of the neuromuscular system for muscle control
  • regulation of the immune system to fight infection
  • support of the cardiovascular system for heart function and circulation
  • support of the respiratory system for lung function
  • aiding brain development
  • anti-cancer effects

Recent studies have shown that Vitamin D deficiency has been linked to breast cancer, colon cancer, prostate cancer, heart disease, weight gain, and inflammation as well as Type 2 Diabetes and emotional disorders such as depression, dementia, and Alzheimer’s. It was found that people with higher levels of Vitamin D generally have a lower risk of these diseases. This is possibly because scientists have discovered about 3,000 genes that are controlled by the Vitamin D levels in our bodies.

How do I get Vitamin D and how is it metabolized in my body?

1) Sunlight is the best way to get Vitamin D. Your body can potentially produce 10,000 – 25,000 International Units (I.U.’s) of Vitamin D in half the time it takes your skin to turn pink or burn in the sun during mid-day (e.g., if it takes you 30 minutes in the sun to burn, expose your skin for 15 minutes). The most Vitamin D is produced when a large part of your skin is exposed to the sun (i.e., the skin on your back, rather than just your arms and legs).

Metabolically speaking, when UVB rays from the sun hit your skin, Vitamin D3 is produced and taken to the liver where it is changed to 25-hydroxyvitamin D3. 25-hydroxyvitamin D3 is then sent to your kidneys and transformed into its activated form or 1,25-hydroxyvitamin D3, the form that allows Vitamin D to carry out its various tasks.

2) Some foods that contain higher levels of Vitamin D include:

– Cod liver oil – 500 I.U.’s per teaspoon
– Fatty fish – 792 (eel), 645 (trout), and 307 (wild salmon) I.U.’s per 3 ounce serving
– Portobello and Maitake mushrooms – 384 I.U.’s per diced cup (86g)
– Cheese – 134 I.U.’s per cup (122g)
– Egg Yolks (hard-boiled) – 44 I.U.’s per egg

When you ingest Vitamin D supplements or foods containing Vitamin D, your gut will send Vitamin D3 to your liver and repeat the same reactions mentioned above.

3) Vitamin D3 supplements are necessary if you can’t get enough sun exposure or eat enough Vitamin D rich foods to produce sufficient amounts in your body.

Who is at risk for Vitamin D deficiency?

Risk factors for Vitamin D deficiency include:

  • age > 50 – With age, our ability to convert sunlight into Vitamin D and our kidneys’ ability to convert Vitamin D into its usable form decreases.
  • people with more melanin in their skin (darker skin) – If you have dark skin, you may need up to 10 times more sun exposure to produce the same amount of Vitamin D as someone with fair skin.
  • obesity – Vitamin D is fat soluble and gets trapped in fatty tissue preventing metabolization in the body.
  • people with malabsorption or gut problems – Any gastrointestinal issues that may affect your ability to absorb fat will also affect your ability to absorb Vitamin D (e.g., Crohn’s Disease, Whipple’s Disease, Cystic Fibrosis, Celiac Disease, any type of liver disease).
  • sunscreen use and staying indoors – Using sunscreen blocks the UVB light needed in our skin to convert Vitamin D to its usable form. This is a dilemma as we also need sunscreen to protect against skin cancer from prolonged sun exposure.
  • geographic latitude – People who live north of 35 degrees latitude receive less sunlight.
  • use of certain medications – Anti-seizure medications, glucocorticoids (steroid medications), Rifampin (Tuberculosis medication), HIV medication, and St. John’s Wart have been found to affect Vitamin D metabolism.

What levels should my Vitamin D be at?

The old school of thought shows a wide “normal” range for Vitamin D levels from 30-100ng/ml. Extensive research has now shown that the optimum level should be between 40-60ng/ml. We will revisit how researchers have come up with this number in a later post.

How much Vitamin D do I need to take to reach optimum levels?
First, get your baseline Vitamin D levels checked. The test you want is a 25-hydroxyvitamin D or 25(OH) D test (remember, this is what is produced in your liver). If you are not deficient, you may only need 1000-2000 I.U.’s daily to maintain your levels. If you are deficient, (i.e. under 40ng/ml), the guidelines are as follows:

Age Under 5: 1000 units daily
Age 5-10: 2500 units daily
Adults: 5000-6000 units daily
Pregnant and Nursing Women: 5000-10000 units daily

In general, to achieve optimal levels, most adults and the geriatric population need to be taking between 5000-6000 I.U.’s of Vitamin D daily, especially during the winter months, and from all sources combined (sun, food, and supplements). Don’t worry about overdosing, as there have been no reported cases of Vitamin D toxicity below 10,000 I.U.’s of Vitamin D per day. As with anything, everyone responds differently to supplementation. Some people may require a smaller dose to reach optimal levels while others may require more. These are, of course, rough guidelines and the best way to determine how much you need is to recheck your levels at least once a year and adjust your dose accordingly.

What is the best form of Vitamin D to take and when should I take it?
Because it is a fat-soluble vitamin, the best form to take is liquid Vitamin D3 with your heaviest or fattiest meal of the day to maximize absorption. When I am pregnant or nursing, I take 6000 I.U.’s of Ortho Molecular Products Liquid Vitamin D3 daily. Otherwise, I take 5000 I.U.’s daily. For my son, I gave him Carlson Super Daily D3 drops for babies, 400 I.U.’s daily until he was 6 months old. Afterwards, I increased his dosage to 1000 I.U.’s daily using Ortho Molecular Product’s Vitamin D3. My most recent level (taken last summer) was 44ng/ml, while his level was 49 ng/ml. As you can see, taking 5000-6000 I.U.’s daily kept me just above the optimal level!

I hope you now have a better understanding of the basics of Vitamin D. Have a great weekend!

In health and wellness,
Dr. Elain

References:
Mercola.com
The Vitamin D Solution (Book Excerpt) by Micheal F Holick, PhD MD

Contact Dr. Elain
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