Tuesday, December 23, 2008

Job, Education May Buffer Against Dementia

Cognitive reserve compensates for brain damage, study says
From healthday.com
Having a higher level of education and a mentally demanding job may help protect against the memory loss that precedes Alzheimer’s disease, according to an Italian study.

It included 242 people with Alzheimer’s, 72 with mild cognitive impairment, and 144 with no memory problems. People with mild cognitive impairment have memory problems beyond what’s normal for their age but not the serious memory problems associated with Alzheimer’s disease.

The participants’ memory and cognitive skills were tested, and their brains were scanned to look for changes and damage. They were then followed for an average of 14 months, during which time 21 of those with mild cognitive impairment developed Alzheimer’s disease.

Among people with the same level of memory impairment, those with more education and more mentally demanding jobs had significantly fewer brain changes and damage than those with less education and less mentally demanding occupations.

This was true in both those with Alzheimer’s and those with mild cognitive impairment who developed Alzheimer’s, which suggests the cognitive reserve is already in effect during the mild cognitive impairment that precedes Alzheimer’s.

“The theory is that education and demanding jobs create a buffer against the effects of dementia in the brain, or a cognitive reserve,” study author Dr. Valentina Garibotto, of the San Raffaele University and Scientific Institute and the National Institute of Neuroscience in Milan, said in an American Academy of Neurology news release.

“Their brains are able to compensate for the damage and allow them to maintain functioning in spite of damage. There are two possible explanations. The brain could be made stronger through education and occupational challenges. Or, genetic factors that enabled people to achieve higher education and occupational achievement might determine the amount of brain reserve. It isn’t possible to determine which accounts for our findings,” Garibotto said.

The study was published in the Oct. 21 issue of Neurology.

Saturday, December 13, 2008

Green Tea Antioxidant May Help Prevent Alzheimer's

Green Tea Antioxidant May Help Prevent Alzheimer's

FRIDAY, May 30 (HealthDay News) -- An antioxidant found in green tea appears to prevent the development of amyloid fibrils, a toxic protein associated with Alzheimer's and Parkinson's disease, a new study finds.

Amyloid plaque is commonly seen in the brains of Alzheimer's patients and appears to disrupt the function of cells. Strategies to prevent the development of amyloid plaque are one avenue being explored in the prevention and treatment of Alzheimer's.

Now, a German team says the tea antioxidant, called epigallocatechin gallate (EGCG), has potent anti-plaque ability.

"We can use small molecules like EGCG to convert certain misfolded structures of a protein into a new type of molecule, which is less toxic or not toxic for cells," said lead researcher Erich Wanker, from the Max Delbrueck Center for Molecular Medicine in Berlin.

The findings are published in the May 30 online edition of Nature Structural & Molecular Biology.

The accumulation of amyloid plaque in Alzheimer's and other neurodegenerative diseases, such as Parkinson's, are thought to be caused by the misfolding of certain proteins, which then become toxic to cells. The way proteins fold is key to their function, the researchers explained.

In experiments in the laboratory, the German team found that EGCG seems to change potentially harmful proteins into proteins that are not detrimental to brain cells. "We are able to convert a toxic structure into a less toxic structure," Wanker explained.

Because EGCG binds to unfolded proteins -- which are not associated with Alzheimer's -- the discovery could lead to medications that recognize the more troublesome proteins and convert them to harmless substances.

"This method could be more generally used to get rid of or remove the concentration of misfolded proteins in cells," Wanker said. "This strategy should be tested with patients. If treated early on, it could prevent the formation of amyloid plaque," he speculated.

Whether this type of treatment could reverse plaques that have already formed in the brain isn't known, Wanker said.

He noted that the study remains basic science, and he was cautious about recommending green tea as a way of preventing Alzheimer's disease. "I don't want to do a lot of speculating which could point people in the direction that could be harmful," Wanker said. "We have to go step-by-step."

One expert believes the approach could yield real results, however.

"Red wine, yellow curry and green tea have suspected health benefits because of high content of antioxidants," said Greg M. Cole, a neuroscientist at the Greater Los Angeles VA Healthcare System, and associate director of the Alzheimer's Disease Research Center at UCLA David Geffen School of Medicine. He was not involved in the study.

"This study provides evidence that a compound called EGCG, one of the major polyphenols in green tea, may be useful for diseases like Parkinson's and Alzheimer's, because it can block the formation of the filament-forming protein aggregates implicated in causing disease," Cole said.

One novel aspect of the study is the authors' demonstration that EGCG prevents toxic filament formation by redirecting the aggregating proteins to make non-toxic proteins, Cole said.

"This is surprising, because similar protein aggregate spheres called amyloid oligomers can be highly toxic to neurons and synapses," Cole said. "It will be important for the authors to prove that the EGCG-directed proteins also lack toxicity to synapses which were not present in the systems used to test toxicity," he said.

Assuming that the green tea compound has a stable effect and chronically blocks toxicity to real neurons and synapses, it could have genuine potential for Alzheimer's patients, Cole said.

"The major caveat is the very poor absorption and delivery of EGCG seen in some studies," Cole said. The fact that EGCG isn't available for patenting by pharmaceutical companies might be a problem, too, he said, since it could "limit the investment needed for clinical trials of sufficient size to prove that it really works."

In related research, a team of American scientists said that interrupting a key signaling pathway in immune system cells allowed those cells to enter the brain and attack and remove amyloid plaque.

Reporting May 30 in Nature Medicine, a team led by research scientist Terrence Town, of Cedars-Sinai Medical Center, Los Angeles, conducted their study in genetically engineered mice. The group blocked a molecule that typically suppresses a portion of the immune response. Once the system was freed up, immune cells called macrophages made their way to the brains and devoured up to 90 percent of amyloid plaques, the team said.

"If these experimental animals are representative of the clinical syndrome of Alzheimer's disease, we may have a therapeutic target that we did not have before," study co-author Dr. Jun Tan, of the University of South Florida, said in a statement.

Sunday, December 7, 2008

Chronic Fatigue Syndrome Linked to Hormone

Chronic Fatigue Syndrome Linked to Hormone

Women With Chronic Fatigue Syndrome May Have Lower Levels of Cortisol in the Morning
By Miranda Hitti
WebMD Health News
Reviewed by Louise Chang, MD

Jan. 18, 2008 -- Chronic fatigue syndrome may be linked to the stress hormone cortisol, at least in women, according to a new study.

The study shows that women with chronic fatigue syndrome had lower cortisol levels in the morning, compared with healthy women.

The study included 185 Georgia adults, 75 of whom had chronic fatigue syndrome. Those patients had fatigue lasting at least six months with no known cause and accompanied by at least four other symptoms, such as muscle pain or memory problems.

Participants provided saliva samples taken as soon as they woke up, and again 30 minutes and an hour later. The CDC's William Reeves, MD, and colleagues measured cortisol levels in the saliva samples.

Chronic fatigue syndrome was associated with lower morning cortisol levels among women, but not among men. Morning cortisol levels were similar for men with and without chronic fatigue syndrome.

The study doesn't prove that low morning levels of cortisol cause women's chronic fatigue syndrome. The researchers don't know which came first -- low morning cortisol levels or chronic fatigue syndrome -- but their findings may be a clue for researchers.

The study appears in The Journal of Clinical Endocrinology & Metabolism.

Friday, November 28, 2008

Spices May Protect Against Consequences Of High Blood Sugar

As people who know me know I focus on helping you to heal blood sugar issues. Here is an article from Sciencedaily.com

ScienceDaily (Aug. 7, 2008) — Herbs and spices are rich in antioxidants, and a new University of Georgia study suggests they are also potent inhibitors of tissue damage and inflammation caused by high levels of blood sugar.

This is one of the products I use to help with blood sugar.

Researchers, whose results appear in the current issue of the Journal of Medicinal Food, tested extracts from 24 common herbs and spices. In addition to finding high levels of antioxidant-rich compounds known as phenols, they revealed a direct correlation between phenol content and the ability of the extracts to block the formation of compounds that contribute to damage caused by diabetes and aging.

“Because herbs and spices have a very low calorie content and are relatively inexpensive, they’re a great way to get a lot of antioxidant and anti-inflammatory power into your diet,” said study co-author James Hargrove, associate professor of foods and nutrition in the UGA College of Family and Consumer Sciences.

Hargrove explained that when blood sugar levels are high, a process known as protein glycation occurs in which the sugar bonds with proteins to eventually form what are known as advanced glycation end products, also known as AGE compounds. The acronym is fitting because these compounds activate the immune system, resulting in the inflammation and tissue damage associated with aging and diabetes.

The researchers found a strong and direct correlation between the phenol content of common herbs and spices and their ability to inhibit the formation of AGE compounds. Spices such as cloves and cinnamon had phenol levels that were 30 percent and 18 percent of dry weight, respectively, while herbs such as oregano and sage were eight and six percent phenol by dry weight, respectively. For comparison, blueberries – which are widely touted for their antioxidant capabilities – contain roughly five percent phenol by dry weight.

Study co-author Diane Hartle, associate professor in the UGA College of Pharmacy, said various phenols are absorbed differently by the body and have different mechanisms of action, so it’s likely that a variety of spices will provide maximum benefit.

“If you set up a good herb and spice cabinet and season your food liberally, you could double or even triple the medicinal value of your meal without increasing the caloric content,” she said.

She added that controlling blood sugar and the formation of AGE compounds can also decrease the risk of cardiovascular damage associated with diabetes and aging. She explained that high blood sugar accelerates heart disease partly because AGE compounds form in the blood and in the walls of blood vessels. The AGE compounds aggravate atherosclerosis, which produces cholesterol plaques.

The UGA researchers tested for the ability to block AGE compounds in a test tube, but animal studies conducted on the health benefits of spices lend support to their argument. Cinnamon and cinnamon extracts, for example, have been shown to lower blood sugar in mice. Interestingly, cinnamon lowers blood sugar by acting on several different levels, Hargrove said. It slows the emptying of the stomach to reduce sharp rises in blood sugar following meals and improves the effectiveness, or sensitivity, of insulin. It also enhances antioxidant defenses.

Hargrove said their findings suggest it’s likely that the herbs and spices they studied will provide similar benefits in animal tests. He points out that because humans have been consuming herbs and spices for thousands of years, they come without the risk of possible side effects that accompany medications.

“Culinary herbs and spices are all generally recognized as safe and have been time-tested in the diet,” he said. “Indeed, some of spices and herbals are now sold as food supplements because of their recognized health benefits.”

Study co-author Phillip Greenspan, associate professor in the College of Pharmacy, noted that most people don’t get their recommended five to nine servings of fruits and vegetables a day. Rather than seasoning their food with salt – which provides no beneficial phenols and has been linked to high blood pressure – he recommends that people use a variety of herbs and spices to help boost the nutritional quality of their meals.

“When you add herbs and spices to food, you definitely provide yourself with additional benefits besides taste,” Greenspan said.

Saturday, November 22, 2008

Here is an article I found helpful in explaining to patients about why they should avoid wheat. In my office I use EnteroLab, a lab company that analyzes stool for the diagnosis of gluten sensitivity. I have pasted the article below or you can follow the link to the original.

Is subclinical gluten sensitivity sabotaging your health?

by Mary Shomon

Gluten intolerance -- also known as celiac disease, celiac sprue, and sprue -- is a genetic autoimmune condition that makes it difficult for the body to properly absorb nutrients from foods. It affects an estimated 1.5 million Americans.
What happens in gluten intolerance is:

  1. The body lacks a particular digestive enzyme, intestinal glutaminase, that can digest gluten products
  2. Gliadin antibodies are produced as the body's reaction to the presence of the gluten
  3. the villi in the bowels become flattened, making them less able to sweep along waste products and filter out toxins
  4. The bowel, in a state of irritation, becomes more permeable, allowing larger proteins to pass through, which further aggravates the "allergic" response
  5. The body responds by producing more histamine, seratonin, kinins, prostaglandins, and interleukins -- which can trigger or aggravate autoimmune and inflammatory conditions
The incidence of full-scale gluten intolerance has been found to be substantially higher in people with autoimmune thyroid disease. A study reported on in the February 2000 issue of Digestive Diseases and Sciences found that undiagnosed celiac disease may be part of the process that triggers an underlying autoimmune disease. In their findings they wrote: ""We believe that undiagnosed celiac disease can cause other disorders by switching on some as yet unknown immunological mechanism. Untreated celiac patients produce organ-specific autoantibodies."

Of perhaps greatest importance to thyroid patients, those researchers found that the various antibodies that indicate celiac disease - organ-specific autoantibodies (i.e., thyroid antibodies) -- disappear after 3 to 6 months of a gluten-free diet.

The researchers suggested that patients with autoimmune thyroiditis "may benefit from a screening for celiac disease so as to eliminate symptoms and limit the risk of developing other autoimmune disorders."

Celiac antibodies blood testing can help diagnose the full-scale version of the condition, but formal diagnosis requires biopsy. Because the full-scale diagnosis of the condition is not that common, many doctors and patients do not realize that a milder version of the condition -- subclinical gluten intolerance/celiac disease -- may be the cause of chronic symptoms in millions more thyroid patients. Diagnosing the subclinical, reversible version requires newer "intestinal permeability" or "mucosal barrier" tests, along with clinical observation of symptoms made by an experienced practitioner.

What are the symptoms of subclinical gluten intolerance and celiac disease:
  • Recurring abdominal pain and bloating
  • Gas, intestinal difficulties
  • Aggravated allergies
  • Difficulty losing weight
  • Muscle aching
  • Joint stiffness and pain, especially in hands, with swelling
  • Fatigue
  • Burning sensations in the arms and legs
  • Numbness and tingling in hands, arms and legs
  • Brain fog, memory problems, disorganized thinking
  • Sores inside the mouth
  • Painful skin rash on elbows, knees, and buttocks
  • Hives
Many of these symptoms are also common in people who have long-term chronic autoimmune hypothyroidism. This raises the operative question: When your hypothyroidism symptoms do not go away despite what is considered sufficient treatment, what is still going on in your body? And could it be something that actually triggered your thyroid problem in the first place?

The first step in answering this question would be to consult with a practitioner who is familiar with the intestinal permeability/mucosal barrier testing. Your practitioner can then run those tests,along with the gluten intolerance antibody testing to determine if you have evidence of subclinical sensitivity or full-scale gluten intolerance. If full-scale celiac disease is suspected, your doctor may suggest a endoscopic biopsy.

Once diagnosed, the next step is a gluten-free diet.

The Gluten Free Diet

(Featuring information from the federal government's NIDKK site)

The only treatment for celiac disease is to follow a gluten-free diet--that is, to avoid all foods that contain gluten. For most people, following this diet will stop symptoms, heal existing intestinal damage, and prevent further damage. Improvements begin within days of starting the diet, and the small intestine is usually completely healed--meaning the villi are intact and working--in 3 to 6 months. (It may take up to 2 years for older adults.)

The gluten-free diet is a lifetime requirement. Eating any gluten, no matter how small an amount, can damage the intestine. This is true for anyone with the disease, including people who do not have noticeable symptoms. Depending on a person's age at diagnosis, some problems, such as delayed growth and tooth discoloration, may not improve.

A small percentage of people with celiac disease do not improve on the gluten-free diet. These people often have severely damaged intestines that cannot heal even after they eliminate gluten from their diets. Because their intestines are not absorbing enough nutrients, they may need to receive intravenous nutrition supplements. Drug treatments are being evaluated for unresponsive celiac disease. These patients may need to be evaluated for complications of the disease.

If a person responds to the gluten-free diet, the physician will know for certain that the diagnosis of celiac disease is correct.

A gluten-free diet means avoiding all foods that contain wheat (including spelt, triticale, and kamut), rye, barley, and possibly oats--in other words, most grain, pasta, cereal, and many processed foods. Despite these restrictions, people with celiac disease can eat a well-balanced diet with a variety of foods, including bread and pasta. For example, instead of wheat flour, people can use potato, rice, soy, or bean flour. Or, they can buy gluten-free bread, pasta, and other products from special food companies.

Whether people with celiac disease should avoid oats is controversial because some people have been able to eat oats without having a reaction. Scientists are doing studies to find out whether people with celiac disease can tolerate oats. Until the studies are complete, people with celiac disease should follow their physician or dietitian's advice about eating oats.

Plain meat, fish, rice, fruits, and vegetables do not contain gluten, so people with celiac disease can eat as much of these foods as they like. Examples of foods that are safe to eat and those that are not are provided below.

The gluten-free diet is complicated. It requires a completely new approach to eating that affects a person's entire life. People with celiac disease have to be extremely careful about what they buy for lunch at school or work, eat at cocktail parties, or grab from the refrigerator for a midnight snack. Eating out can be a challenge as the person with celiac disease learns to scrutinize the menu for foods with gluten and question the waiter or chef about possible hidden sources of gluten. However, with practice, screening for gluten becomes second nature and people learn to recognize which foods are safe and which are off limits.

A dietitian, a health care professional who specializes in food and nutrition, can help people learn about their new diet. Also, support groups are particularly helpful for newly diagnosed people and their families as they learn to adjust to a new way of life.

Saturday, November 15, 2008

Exercise helps breast cancer prevention

Exercise helps breast cancer prevention,

A couple of weeks ago I was asked to speak to a group of women at Curves. The topic was breast cancer prevention. Here is an article I found that was very informative. I thought I would share it with you.

Last Updated: Friday, February 16, 2007 | 6:28 PM ET

Exercise may help to prevent breast cancer and help women who have it to feel better, two studies suggest.

Researchers in the U.S. interviewed 1,630 women without breast cancer, 1,689 survivors of non-invasive breast cancer and 6,391 survivors of invasive breast cancer about their physical activity, occupation, family history of breast cancer, menopausal status, and body mass index. The women were all between the ages of 20 and 69.

'The take-home message for women should be that it is never too late to begin exercising.'—Study author Brian Sprague

Women who said they did six or more hours per week of strenuous exercise may have reduced their risk of invasive breast cancer by 23 per cent compared to sedentary women, according to the study in the February issue of Cancer Epidemiology Biomarkers & Prevention.

"A woman's hormone levels naturally fluctuate throughout her life, and we have found that exercise likely offers protection against breast cancer regardless of a woman's stage in life," said the study's lead author, Brian Sprague, of the University of Wisconsin. "The take-home message for women should be that it is never too late to begin exercising."

High levels of estrogen have been linked to a higher risk of developing breast cancer. Women who exercise heavily tend to be older at the time of their first period and produce estrogen for a shorter time, lowering their exposure to the hormone over their lifetime, the researchers said.

It is also possible that exercise helps by preventing weight gain, regulating insulin sensitivity and changing immune function, the team said.

The benefits were only seen in women without a family history of breast cancer. Other risk factors for breast cancer were taken into account.

The team called for more research into forms of physical activity, such as household chores in addition to recreational and occupational activity.

Exercise for women with breast cancer

A second study in Friday's online issue of the British Medical Journal looked at the benefits of exercise for women with early breast cancer.

Nanette Mutrie, a professor of exercise and sport psychology at the University of Strathclyde in Glasgow, Scotland, and her team studied 203 women with early-stage breast cancer who were 51 years old on average and were sedentary.

The women all had a lumpectomy or mastectomy and were getting chemotherapy or radiation therapy to prevent a recurrence of cancer. The participants completed surveys about their mood and quality of life, did a walking test and had their shoulder mobility assessed.

Half of the women then took a 12-week group exercise class and the rest did not. Those in the exercise were offered two 45-minute classes with an exercise specialist each week and similar exercises to do at home once a week.

After the 12 weeks, those in the exercise group showed better physical functional ability, such as walking greater distances or moving their shoulders, and psychological well-being, based on their outlook.

After six months, most of the beneficial effects in the exercise group were maintained, the team found.

"Clinicians should encourage activity for their patients. Policy makers should consider the inclusion of exercise opportunities in cancer rehabilitation services," the study's authors concluded.

Thursday, November 13, 2008

Gluten Sensitivity

ScienceDaily (Apr. 30, 2002) — ST. PAUL, MN – You may have gluten sensitivity and not even know it, according to a study published in the April 23 issue of Neurology, the scientific journal of the American Academy of Neurology. Loss of coordination (ataxia) may result from gluten sensitivity. This disease is known as gluten ataxia. The study found that some patients might never experience the gastrointestinal symptoms that prompt them to seek treatment for the disorder.

“Gluten ataxia is a common neurological manifestation of gluten sensitivity,” according to M. Hadjivassiliou, M.D., of the Royal Hallamshire Hospital, Sheffield, UK. “It remains unclear why some patients with gluten sensitivity present solely with neurological dysfunction when others present with gastrointentestinal symptoms (gluten sensitive enteropathy) or an itchy skin rash (dermatitis herpetiformis).”

Although the cerebellum (the part of the brain responsible for coordination) and in particular the Purkinje cells (output neurons of the cerebellum) appear to be most susceptible to damage in patients with gluten ataxia, other areas of the brain are not spared. “We were interested to determine the mechanism by which Purkinje cells are damaged in gluten ataxia,” commented Hadjivassiliou. Study results show that patients with gluten ataxia have antibodies against Purkinje cells and also that antibodies against gluten (antigliadin antibodies) cross-react with Purkinje cells.

“These results strengthen our contention that eliminating these antibodies through strict adherence to a gluten-free diet may have important therapeutic implications for patients with gluten ataxia,” concluded Hadjivassiliou.

The study was supported by the Friedreich's Ataxia Group, UK, and the Telethon Foundation, Italy.

The American Academy of Neurology, an association of 18,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research.

For more information about the American Academy of Neurology, visit its website at www.aan.com.

Adapted from materials provided by American Academy Of Neurology.

Tuesday, August 26, 2008


In our office we have a Zyto biofeedback unit. It has been very helpful in managing many patients.

Monday, August 25, 2008

About Me

I have been blessed to be able to provide service to a wonderful group of patients. In one of the best places in the world.
I am a board certified chiropractic neurologist. I have attended post graduate courses through The Carrick Institute of Graduate Studies. I am a family practice doctor located in Sonora, California. I have been practicing in this county for 10 years.

Tuesday, August 19, 2008

Back Vitilizer

One of my recent purchases is a Back Vitilizer. It is a product by Perspectis. It is a back support and proprioceptive trainer for your lower back muscles providing lumbo-pelvic stabilization.

It helps your back.

It has been wildly popular because it is comfortable, you can't fall off of it and it works.
Visit their web site and view their slide show.


This blog was created as a reference for patients, friends, family and the blogging community. I will be updating periodically and have useful links for you to access.