A nice Thank You from an online questioner

Dear Expert,

One questioner just made a rating to your answer on the AllExperts.com site:

Knowledgeability - 10
Clarity of response - 10
Timeliness - 10
Politeness - 10
Prestige Point - 30
Comment - thank you for taking your time to answer my question about statins. i 
will take your advice and visit your blog. I know you are very busy and i think 
you are doing a great service to people with your advice.

Following is the question information:

Questioner: charlotte
Subject: cholesterol lowering supplements
Date Answered: 2010-05-14 18:25:05

Here is the link of that question: http://www.allexperts.com/expertx.cgi?m=11&expID=1220&qID=4949851


Thank you for volunteering at AllExperts.com.

May 2010 Carolina Mobile MD Newsletter

MAY 2010 Newsletter

This month I am posting an article on Hawthorn (Crataegus) extract and it use in cardiac health, specifically congestive heart failure. This is a natural way to mollify the rages of CHF that can make daily life uncomfortable for most who suffer this malady.

The prior mentioned "Wellness Retreat" for May has been put on the back burner. Details on a wellness retreat will be made once it is back on schedule.

For those interested in learning more about a rather new healthcare model (retainer based/ concierge medicine) that is gaining in popularity [especially in this era of uncertainty regarding health care reform and the future of health care in America] check out a PowerPoint presentation by clicking here.

Hawthorn Extract

by JP Saleeby, MD

The genus Crataegus sp. better known as Hawthorn is a spiny shrub native to the Northern Hemispheres of North America, Asia and Europe. Know for centuries for its medicinal properties, it is the single oldest known herb used in western (or European) medicine. While many of the plant parts such as the flowers, leaves and fruit are used medicinally, those of the dried flowering tops have, at least in the west, stood the test of time and utilization for therapy related to the heart. Chinese medicine (TCM) has used predominantly the berry for its medical uses mostly as a digestive aid.

Extracts of the flower of the Hawthorn plant (specifically C. monogyna and C. laevigata species) have been intensly studies and the extracts show active ingredients in the oligomeric procyanidine (OPC), flavonoid family of compounds. OPCs are responsible for the free-radical scavenging properties probably best seen in reducing damage due to myocardium injury/insult following ischemia or infarct, as they lessen the effects of neutrophil elastase that is the causative agent in scar tissue formed after myocardial injury (heart attack). Research has shown Hawthorn extracts to have positive inotropic effects that increase cardiac output and the force-frequency ratio in a failing human heart. The Flavonoids found in this herb are active against and inhibit phosphodiesterase and also activate the cardiac endothelium-derived relaxing factor making for increased vasodilation, something that is beneficial in cardiac patients. The flavonoids are further effective in reducing platelet aggregation and adhesion. This is beneficial for prevention of thrombosis and occlusion of coronary vessels (arteries) related to coronary artery disease. Much the same action that aspirin (ASA) and Plavix (clopidogrel) have on platelets we see with Hawthorn.

By and large the greatest impact Hawthorn extracts have on the cardiac system is with the myocardium and its positive effects in cases of congestive heart failure (CHF). Some researchers state that this herb also stabilized the myocardium and reduces dysrhythmias or abnormal heart rhythms. There was review and analysis of studies reported in the 2008 Cochrane review that showed "alternative" treatments with Hawthorn stood up nicely to more conventional therapies for CHF. When used against placebo in double blinded studies on CHF patients Hawthorn substantially increased maximal work load tolerance, improved symptoms of fatigue and dyspnea (shortness of breath) and increased exercise tolerance in patients with failure. In a separate study by Tauchert M., et al, published in 1994 in a German peer reviewed journal, Hawthorn was compared to the ACE-inhibitor drug Capoten (captopril) head on and the results were favorable for Hawthorn. Standardized doses of Hawthorn provided equal, statistically significant positive results no different than the pharmaceutical agent Capoten. Capoten is a main stay drug of traditional therapy for CHF. In a trial published in 2008 under the acronym SPICE, Dr. Holubarsch, et. al., showed the protective effects of Hawthorn against cardiac death and sudden death in those entered into the trial.

There are no absolute contraindications for taking Hawthorn extracts aside from allergic sensitivity to the plant. Side effects are minimal and those most common are vertigo and dizziness. It is not recommended during pregnancy and/or breastfeeding as it has the potential for uterine stimulation. It is estimated by Dr. Zick, et. al., in a 2005 study that as many as a third of patients with CHF are taking Complimentary and Alternative Medical (CAM) supplements and that these may have untoward effects in combination with standard drug therapy. Care must be taken with the use of Hawthorn root and such medications as digoxin, vasodilators, ACE-inhibitors, calcium channel blockers. There is the theoretical concern of the potentiation effect of the combination of Hawthorn extract with these other cardiac drugs. However no data exists of problems with concomitant use of digoxin, another drug commonly used in CHF. The dose can range depending on the patient and practitioner, but standard doses are 600 to 1800 mg divided into two or three doses. The German Commission E (to Germany what the Physician Desk Reference (PDR) is to the USA) specifically recommends hawthorn leaf and flower as a therapeutic herb for CHF in its monographs. The German Commission E monographs are some 380 monographs detailing herbs, their uses, dosages, adverse effect and drug interactions along with pharmacological effects that comprise a respected therapeutic guide to herbal medicine practitioners.

Ref:

1. Dahmer S , Scott E Health Effects of Hawthorn, J. AFP, February 15 2010 Vol. 81 No. 4:465-468.
   
2. Tauchert M, et. al, Effectiveness of hawthorn extract L1 132 compared with the ACE-inh. Capopril. Much Med. Wochenschr. 1994;136:S27-33.
   
3. Holubarsch CJ, et. al., Investigation of Crataegus extract WS 1442 in CHF (SPICE) trial study group. Eur J. Heart Fail. 2008;10(12):1255-1263.
   
4. Zick, SM, et. al., The prevalence and pattern of complementary and alternative supplement use in individuals with chronic heart failure. J Card Fail. 2005;11(8):586-589.
5. The Complete German Commission E Monographs, Therapeutic Guide to Herbal Medicines, 1st ed. 1998

(c) 2010

---------------------

May 2010 Newsletter

DID YOU KNOW: In the February 17th, 2010 edition of Journal of the American Medical Association (JAMA) an article was published on how DNA evidence obtained from the mummy remains of King Tut and his relatives were able to prove ancestry. Additionally it shed some light on some genetic and pathologic disorders of Tutankhamun's family.

Quote of the month: "The whole of science is nothing more than a refinement of everyday thinking." - Albert Einstein

(http://docs.google.com/present/view?id=dd4kzr8w_326sqcdsbdg&interval=10) (http://docsaleeby4.blogspot.com/2010/05/hawthorn-extract.html)

Teff - an obscure grain of exceptional nutritional content

Teff: Obscure Grain w/ exceptional nutritional content

by JP Saleeby, MD

As it is the "flavor of the day" nutrients come and go. Whether it is Big Pharma promoting omega 3-fatty acids this month (as if they were just discovered yesterday) or the top vitamin retailer singing the glories of chia seeds, many times these things have been around and utilized for ages by ancient people. Many dietary supplements will wax and wane in popularity, but the fact remains they are often crucial in our diet and well being in the future as they are touted today and were in the past, lest we forget them and move onto the next big craze. Teff for example is a rather obscure grain in the West. It is an annual grass and species of lovegrass which is native to the northern plains of Ethiopia. Teff has it origins as a cultivated grain in Northeastern Africa as far back as 4000 BC, having the hardiness as a plant to adapt to environments ranging from wet and waterlogged soil to that of drought stressed earth.

This plant is not only limited to the lands in Africa, for now it is cultivated in far away places such as India, Australia, Bolivia, Peru and yes even in the USA. There are test fields growing in Kansas right now and it has actually been raised with economic viability in Idaho. Move over potato! Teff can even be harvested successfully in higher colder latitudes such as Alaska due to its ability to be cultivated at steeper elevations and with shorter growing seasons. While the seeds are used to make breads and porridge, the hay is a great feed for livestock as it conveys the same nutritional components.

The attractiveness of this plant is simple; it is rather nutritious. It is high in fiber and iron and provides a rich source of protein and calcium. Additionally, this grain is high in phosphorus, copper, magnesium, thiamin and lysine. In fact it contains all eight essential amino acids. Similar to millet and quinoa in the way it is cooked the Teff seed is, however, much smaller and requires less time to cook. Less time cooking equates to less energy expenditure. So while it may be the food for the masses some time in the future, it will also be a "green grain" for its energy conserving features.

The name Teff is derived from the word tef, from Ethio-Semitic roots meaning "lost." Given the very small size of the grain, it is often lost when scooped up in the hand. In the book "Lost Crops of Africa" published by the National Research Council in 1996, "Teff has as much, or even more, food value than the major grains: wheat, barley, and maize, for instance. However, this is probably because it is always eaten in the whole-grain form: the germ and bran are consumed along with the endosperm."

Something worth noting about Teff is that it contains no gluten. With the lack of gluten there are not issues with abdominal bloating and gastrointestinal symptoms in those folks having gluten allergies or Celiac Disease. While Teff comes in colors from white to brown, consumers tend to prefer the white despite the fact that it is rather bland in comparison to the red and brown versions and also a bit lower in nutritional composition. This must come from years and years of desiring the "white rice" and "white bleached wheat" loafs of bread Westerners have grown so accustom.

--------------------
Nutritional Information (Teff/ Eragrostis tef)

Moisture (g)	11	Cystine	1.9
Food energy (Kc)	336	Isoleucine	3.2
Protein (g)	9.6	Leucine	6.0
Carbohydrate (g)	73	Lysine	2.3
Fat (g)	2.0	Methionine	2.1
Fiber (g)	3.0	Phenylalanine	4.0
Ash (g)	2.9	Threonine	2.8
Vitamin A (RE)	8	Tryptophan	1.2
Thiamin (mg)	0.30	Tyrosine	1.7
Riboflavin (mg)	0.18	Valine	4.1
Niacin (mg)	2.5
Vitamin C (mg)	88
Calcium (mg)	159
Chloride (mg)	13
Chromium (μg)	250
Copper (mg)	0.7
Iron (mg)	5.8
Magnesium (mg)	170
Manganese (mg)	6.4
Phosphorus (mg)	378
Potassium (mg)	401
Sodium (mg)	47
Zinc (mg)	2

Teff grains are reported to contain 9-11 percent protein, an amount slightly higher than in normal sorghum, maize, or oats. However, samples tested in the United States have consistently shown even higher protein levels: 14-15 %.

The protein's digestibility is probably high because the main protein fractions—albumin, glutelin, and globulin—are the most digestible types. The albumin fraction is particularly rich in lysine. Judging by the response from Americans allergic to wheat, teff is essentially free of gluten, the protein that causes bread to rise. Nonetheless, teff used in injera does ''rise" [due in part to the fermentation process].

-From "Lost Crops of Africa" Vol. 1;Grains (1996)

-----------------------------

My wife and I recently partook in an Ethiopian dinner complete with Injera, the bread made of teff. Here teff is mixed with water and allowed to ferment for a few days, it is then poured over a hot clay plate (traditionally, called a mogogo) which is usually placed over an open fire. The product is a crepe like bread, spongy in nature and with a distinct but subtle sour flavor. Again the white (nech), red (kay) and brown/black (tikur) variants exist, the darker colored breads having a more substantial flavor. Interestingly the bread acts not only as "bread" but a means of serving Ethiopian food. Traditionally, Ethiopian meals are comprised of stews of beef or lamb, with salads and vegetables all served on a "plate" of Injera. The Injera is torn into smaller pieces and used as a "utensil" to pick up and eat the food all the while absorbing the juices the foods produce. The meal is over literally when not only the food is consumed, but when the plate and utensils are consumed as well.

(c)2010

Hawthorn extract

Hawthorn

by JP Saleeby, MD

The genus Crataegus sp. better known as Hawthorn is a spiny shrub native to the Northern Hemispheres of North America, Asia and Europe. Know for centuries for its medicinal properties, it is the single oldest known herb used in western (or European) medicine. While many of the plant parts such as the flowers, leaves and fruit are used medicinally, those of the dried flowering tops have, at least in the west, stood the test of time and utilization for therapy related to the heart. Chinese medicine (TCM) has used predominantly the berry for its medical uses mostly as a digestive aid.

Extracts of the flower of the Hawthorn plant (specifically C. monogyna and C. laevigata species) have been intensly studies and the extracts show active ingredients in the oligomeric procyanidine (OPC), flavonoid family of compounds. OPCs are responsible for the free-radical scavenging properties probably best seen in reducing damage due to myocardium injury/insult following ischemia or infarct, as they lessen the effects of neutrophil elastase that is the causative agent in scar tissue formed after myocardial injury (heart attack). Research has shown Hawthorn extracts to have positive inotropic effects that increase cardiac output and the force-frequency ratio in a failing human heart. The Flavonoids found in this herb are active against and inhibit phosphodiesterase and also activate the cardiac endothelium-derived relaxing factor making for increased vasodilation, something that is beneficial in cardiac patients. The flavonoids are further effective in reducing platelet aggregation and adhesion. This is beneficial for prevention of thrombosis and occlusion of coronary vessels (arteries) related to coronary artery disease. Much the same action that aspirin (ASA) and Plavix (clopidogrel) have on platelets we see with Hawthorn.

By and large the greatest impact Hawthorn extracts have on the cardiac system is with the myocardium and its positive effects in cases of congestive heart failure (CHF). Some researchers state that this herb also stabilized the myocardium and reduces dysrhythmias or abnormal heart rhythms. There was review and analysis of studies reported in the 2008 Cochrane review that showed "alternative" treatments with Hawthorn stood up nicely to more conventional therapies for CHF. When used against placebo in double blinded studies on CHF patients Hawthorn substantially increased maximal work load tolerance, improved symptoms of fatigue and dyspnea (shortness of breath) and increased exercise tolerance in patients with failure. In a separate study by Tauchert M., et al, published in 1994 in a German peer reviewed journal, Hawthorn was compared to the ACE-inhibitor drug Capoten (captopril) head on and the results were favorable for Hawthorn. Standardized doses of Hawthorn provided equal, statistically significant positive results no different than the pharmaceutical agent Capoten. Capoten is a main stay drug of traditional therapy for CHF. In a trial published in 2008 under the acronym SPICE, Dr. Holubarsch, et. al., showed the protective effects of Hawthorn against cardiac death and sudden death in those entered into the trial.

There are no absolute contraindications for taking Hawthorn extracts aside from allergic sensitivity to the plant. Side effects are minimal and those most common are vertigo and dizziness. It is not recommended during pregnancy and/or breastfeeding as it has the potential for uterine stimulation. It is estimated by Dr. Zick, et. al., in a 2005 study that as many as a third of patients with CHF are taking Complimentary and Alternative Medical (CAM) supplements and that these may have untoward effects in combination with standard drug therapy. Care must be taken with the use of Hawthorn root and such medications as digoxin, vasodilators, ACE-inhibitors, calcium channel blockers. There is the theoretical concern of the potentiation effect of the combination of Hawthorn extract with these other cardiac drugs. However no data exists of problems with concomitant use of digoxin, another drug commonly used in CHF. The dose can range depending on the patient and practitioner, but standard doses are 600 to 1800 mg divided into two or three doses.

The German Commission E (to Germany what the Physician Desk Reference (PDR) is to the USA) specifically recommends hawthorn leaf and flower as a therapeutic herb for CHF in its monographs. The German Commission E monographs are some 380 monographs detailing herbs, their uses, dosages, adverse effect and drug interactions along with pharmacological effects that comprise a respected therapeutic guide to herbal medicine practitioners.



Ref:

1. Dahmer S , Scott E Health Effects of Hawthorn, J. AFP, February 15 2010 Vol. 81 No. 4:465-468.
2. Tauchert M, et. al, Effectiveness of hawthorn extract L1 132 compared with the ACE-inh. Capopril. Much Med. Wochenschr. 1994;136:S27-33.
3. Holubarsch CJ, et. al., Investigation of Crataegus extract WS 1442 in CHF (SPICE) trial study group. Eur J. Heart Fail. 2008;10(12):1255-1263.
4. Zick, SM, et. al., The prevalence and pattern of complementary and alternative supplement use in individuals with chronic heart failure. J Card Fail. 2005;11(8):586-589.
5. The Complete German Commission E Monographs, Therapeutic Guide to Herbal Medicines, 1st ed. 1998.

(c) 2010

SubClinical Hypothyroidism

Shakeology Endorsement

"After evaluating the independent study, analyzing the ingredient list I have to
say Shakeology has no competition in the marketplace as either a meal
replacement or stand alone dietary supplement.  With it's well balanced and all
inclusive bled of vitamins, pre- and probiotics, super foods and adaptogen herbs
it has the ability to make "right" was is "wrong" in the average diet of most
Americans."

JP Saleeby, MD
BeachBody/Product Partners
Medical Advisory Board
4/22/2010

Why Lovaza?

It never ceases to amaze me what BigPharma gets away with. The recently introduced Lovaza (Omacor) which is a Omega-3-Fatty Ethyl Ester compound manufactured and promoted by GlaxoSmithKline is nothing new to nutritionally minded physicians (but new to traditional MDs) and does it come with a price.

The cost is a whopping $150.80 average retail cost for a month supply with a dose of 2-grams daily (double that for the recommended 4-grams per day regiment). Consider similar pharmaceutical grade fish-oil n-3FA products such as Vita Sanus Opti-EFA where a 2-gram/d regiment would only cost $39.00/month.

From the Lovaza Site http://www.lovaza.com/benefits-of-lovaza/prescription.html :

• LOVAZA uses a 5-step purification process that helps remove mercury and other environmental toxins that can be present in fish oil and ensures reliable concentration of EPA and DHA in every capsule
  
  
• The FDA-approved dose of LOVAZA is 4 capsules per day. It could take up to 14 capsules per day of an omega-3 supplement to provide the same amount of EPA and DHA found in 4 capsules of LOVAZA
  
  

Nice illustration of purification process.... so what. Non-FDA approved pharmaceutical grade n-3FA supplements go through pretty much the same process to detox fish oil of heavy metals and increase the EPA and DHA content. As far as GSK's 14 caps vs 4 caps, that is absolutely false.. with Opti-EFA for example, a 4-gram dose you would only need 8-gel caps compared with 4 of the Lovaza.

By definition pharmaceutical grade:

Pharmaceutical grade fish oil has the following characteristics:

•	Concentration of EPA and DHA > 60%
•	Ratio of EPA/AA > 25:1
•	Concentration of PCBs <>

From http://vitasanus.com/vsn_products/opti_efa.htm


Furthermore given that Lovaza advertises that one gram (one gel cap) has 1 gram of n-3FA and 465 mg of EPA and 375 mg of DHA, the VS Opti-EFA trumps its EFA & DHA content with an equivalent one gram (2-gel caps) equivalent dose having 600 mg of EPA and 400 mg of DHA. All at a much more comfortable cost. You will spend over $150/month for Lovaza when you can spend under $40/month for Opti-EFA or similar brands and get a bigger bang for your buck on DHA/EPA content. Do the math, it is a no brainer.

Low TSH is Safe in bHRT

Is it safe for patients taking thyroxine to have a low but not suppressed serum TSH concentration?

Graham Leese & Robert Flynn

University of Dundee, Tayside, UK.

---

For patients taking thyroxine replacement guidelines generally recommend aiming for a target TSH within the laboratory reference range. The evidence for this guidance is generally based on an extrapolation of data from patients with endogenous subclinical thyroid disease. We aimed to examine the safety of having a TSH which was either suppressed (≤0.03 mU/l), low (0.04–0.4 mU/l), ‘normal’ (0.4–4.0 mU/l) or raised (>4.0 mU/l) in a population-based cohort of patients all of whom were treated with thyroxine.

We used a population-based thyroid register (TEARS) linked to outcomes data from hospitalisation records, death certification data and other datasets between 1993 and 2001. The endpoints of cardiovascular disease, dysrhythmias and fractures were assessed. Patients were categorised, using a time weighted mean of all TSH recordings.

There were a total of 16 426 patients on thyroxine replacement (86% female, mean age 60 years) with a total follow-up of 74 586 years. Cardiovascular disease, dysrhythmias and fractures were increased in patients with a high TSH (adjusted hazards ratio 1.95 (1.73–2.21), 1.80 (1.33–2.44) and 1.83 (1.41–2.37) respectively), and patients with a suppressed TSH (1.37 (1.17–1.6), 1.6 (1.1–2.33) and 2.02 (1.55–2.62) respectively), when compared to patients with a TSH in the laboratory reference range. Patients with a low TSH did not have an increased risk of any of these outcomes (HR: 1.1 (0.99–1.123), 1.13 (0.88–1.47) and 1.13 (0.92–1.39) respectively.

People on long-term thyroxine with a high or suppressed TSH are at increased risk of cardiovascular disease, dysrhythmias and fractures. People with a low but not suppressed TSH did not have an increased risk of these outcomes in this study. It may be safe for patients treated with thyroxine to have a low but not suppressed serum TSH concentration.

---

Endocrine Abstracts (2010) 21 OC5.6

CardioFactor / PreFight by AdapTx Labs

AdapTx Labs CardioFactor. Supplement formulated by Dr. Saleeby for the MMA arena. Athletic enhancement, stamina and strength, safe and legal.

PreFight by AdapTx Labs, formulated by Dr. Saleeby as an adjunct to CardioFactor for training and better recovery times.

Can Chia help with stamina? I know CardioFactor can.

I recently had a patient ask a question the other day about agents to fight fatigue. He was wondering the effects of Chia seed. My response was there are better proven supplements that can improve stamina and shorten recovery time:

A thousand years ago, chia was prized by the ancient Aztecs as a food for energy, endurance, strength and good health. For many generations, natives of the southwestern deserts of what is now part of the United States depended on wild chia seed as a staple food and a source of remedies. According to a book by James Scheer (a nutritionist/writer), historian Harrison Doyle, who, in the early 20th century lived with various tribes in the Americas, wrote that "it was nothing for tribesmen to run for 24 hours on a tablespoon of chia seed and a gourd of water." Unfortunately, is really nothing more than testimonial and anecdotal evidence to date on chia and stamina. More research is required. The real research findings are with adaptogen and other eastern and western herbs. While chia has the potential, more research (double blinded studies) are needed to "prove" its worth in stamina and endurance and fatigue fighting properties.

I have researched and formulated two products for a niche market (Mixed Martial Arts fighters). It was developed as a me-too supplement already in use by endurance cyclists but with a focus on MMA and a very unique formulation never before seen on the market. Besides strength, these fighters rely on endurance, to outlast their opponents should a match go beyond 2 rounds. I developed two products one called CardioFactor and the other PreFight. Both products were very well researched with quite a substantial backing of evidence via scientific study and not just "hear say" or subjective testimonials.

If you are interested in learning more, the products are manufactured in the USA by AdapTx Labs and can be purchased online. I will disclose that my financial interest with this product was in the research and formulation of these products. https://www.adaptxlabs.com for more information.

AdapTx Labs products:

Serving Size: 2 Capsules PREFIGHT
Amount Per Serving
Vitamin B3 (Niacinamide USP) 20 mg
Vitamin B6 5 mg
Adaptogen HotMixTM
Jiaogulan 98% (Leaf)
Yerba Mate (20% caffeine) (Leaf)
Panax Ginseng (80% extract) (Root) 750 mg *



Serving Size: 4 Capsules CARDIOFACTOR
Amount Per Serving
Rhodiola rosea (min 3.0% total rosavins) (root) 3000 mg *
Cordyceps sinesis (min 7% cordycepic acid) (mycelia biomass) 600 mg *
Mitochondrial MatrixTM
Suma (Pfaffia paniculata) (root)
Acetyl-L-Carnitine
L-Citrulline Malate
Resveratrol (min 20%) (root) 1,100 mg *




JP Saleeby, MD
www.saleeby.net
www.CarolinaMobileMD.com

Niacin for HDL-C

A recent reader of my DocSaleeby & Wellsphere blog was concerned about his abnormal ECG showing evidence of possible myocardial injury and his cholesterol. He wanted to know if he should start back on high dose Niacin.

My response:

Niacin may be one of the most potent agents out there for elevating HDL-C. However, once myocardial muscle (heart muscle) is damaged it goes through changes as all damaged tissue does, resulting in fibrosis and loss of elasticity, etc. and this cannot be reversed. Once heart muscle is damaged it cannot be repaired, hence the formation of scar tissue which hinders wall motion (as seen on ECHO) and in severe cases aneurysm formation. Prevention by plaque formation, stabilization of plaques, and reduction with the use of natural or synthetic statins (extract of fermented yeast of red rice or pravostatin for example) to reduce LDL-C is proven effective.

Raising HDL-C as a scavenger lipid is also proven and may be more beneficial to lowering LDL-C. If an ECG shows myocardial damage then it is wise to see a cardiologist to be studied further (Cath, ECHO, stress test) to determine the extent of you Coronary Artery Disease (CAD), as lipids are only one risk factor. You may have small coronaries, stable and/or unstable plaque formation (genetically predisposed), or other processes (hypercoagulable state) that may need specific attention and therapeutics. I recommend a daily dose of Aspirin (ASA 81mg) to all my patients over 45 if they are able to tolerate. For more on CADz, read my blog at www.DocSaleeby.blogspot.com

In good health,

JP Saleeby, MD

Thyroid function and diet

I recently had a patient ask me how diet and/or supplements could affect thyroid function. This particular patient has mild hypothyroid, but was reluctant to start on any hormone therapy (natural or synthetic). This was some advice given her on her quest for a better balanced thyroid function with just diet/herbal control:


Researchers have identified that the isoflavones in soy act as potent anti-thyroid agents, and are capable of suppressing thyroid function, and causing or worsening hypothyroidism. Soy is a phytoestrogen, and therefore acts in the body much like a hormone, no surprise that it interacts with the balance of the thyroid's hormonal systems. High consumption of soy products (either by high dose soy supplements or a high concentration of soy and soy-products) in our diet can be detrimental. Very high doses have been proven to cause goiter. I would suggest limits on soy and soy-based foods. In adults, just 30 mg of soy isoflavones per day is the amount found to have a negative impact on thyroid function. This amount of soy isoflavones is found in just 5-8 ounces of soy milk, or 1.5 ounces of miso. So use these products sparingly and definitely NOT daily.

Of course Iodine is very important to thyroid function. Low iodine intake can cause goiter and low thyroid hormones, but in America we have iodinated (iodized) salt to help obliterate this cause of hypothyroid. Make sure you use occasional iodinated salt in you cooking (most processed foods with salt in them don't use iodinated salt). And also a good source of Iodine is sea food (cod, sea bass and shellfish). Kelp is a vegetarian source of iodine.

Additionally, the lauric acid in coconut oil has a stimulant affect on thyroid function. This was discovered in the 1940's, so using coconut oil in your cooking or taking it as a daily supplement may help stimulate higher levels of T4 and T3 naturally.

With fluoridation of water (and fluoride toothpaste) we can see an impact on iodine. Fluoride displaces iodine in the body, so intake of iodine (by iod. salt and seafood) is important to counter the unavoidable fluoridation of municipal water systems and toothpaste.

Some herbals that have a history of increasing thyroid function are: bladderwrack, iceland moss, oat straw, saw palmetto berries, calamus root. There are preparations out there that have these as single or grouped supplements for thyroid health.

A 1/4 teaspoon of iodized table salt provides 95 micrograms of iodine. A 6-ounce portion of ocean fish provides 650 micrograms of iodine. Most people are able to meet the daily recommendations by eating seafood, iodized salt, and plants grown in iodine-rich soil. Recommendations for females age 14 and older: 150 mcg/day of iodine.

JP Saleeby, MD
www.saleeby.net
www.CarolinaMobileMD.com

Moving Carolina MD practice to Uzbekistan

JP & Sharon have decided after much contemplation and planning to move to Uzbekistan. We are moving mostly because we like their flag. Or was it their exceptional health care system?

PS: Oh, don't worry....April Fools!

You need to WATCH THIS

What will become "required viewing" for all my patients is a 2008 documentary on our Food Industry. The title is "FOOD, Inc." and it is available on DVD from NetFlix and others.

I urge you to rent and watch and learn from this video and change you dietary habits for your better and the betterment of our country.

Vesalius Skeleton

ECI Public Announcement on Tipping Point in ED Medicine

http://www.eci-med.com/psa/03_2010/

March 2010 Newsletter

This is the First installment of a monthly health and wellness newsletter. With a topic of the month and health and wellness "pearls" and announcements. I will keep it short and easy to read. This month we will discuss Omega-3 Fatty Acids and options you have for obtaining safe and effective dietary intake of this proven cardiovascular risk reducing supplement.

I am currently working with a retreat center near Charlotte, NC for a weekend of wellness education and relaxation/rejuvenation. More information is forthcoming on the details of the program and location but the tentative date is set for the weekend of May 14th.

Krill Oil the New Omega-3FA Benchmark

By JP Saleeby, MD
Krill oil is an Omega-3 Fatty Acid (n-3FA) rich oil harvested from a very small marine crustacean. Krill are small shrimp like animals ranging from about ½ to 2 inches in length and are one of the most abundant animals in the ocean. Krill is at the bottom of the ocean’s food chain and are eaten by a host of other animals from fish to squid to seals and whales. They in turn feed on phytoplankton which occupies the bottom rung of the food chain. The commercial fishing of krill occurs primarily in the northern Pacific Ocean and southern oceans along the coasts of Canada and Japan. In Japan, krill is fished directly for food and is considered by the Japanese a delicacy called okiami. But other commercial uses include use in aquaculture, sport fishing bait and the production of very high quality n-3FA oils.
In addition to it useful source of a high quality, krill oil shows a lower contaminant level of heavy metals and toxins. For this reason n-3FA is becoming popular as a supplement. Another reason is because of a unique antioxidant that it contains. Astaxanthin is a type of antioxidant that occurs in this marine animal that can protect the human body from the damages of free radicals and oxidative load. The characteristic red-pink color attributed to krill and other crustaceans (like shrimp and lobster) comes from the red pigment in astaxanthin, and is due to the type of algae that the krill ingest.
As we know, antioxidants protect our body from harmful highly reactive substances called free-radicals that are implicated in human disease and degenerative disorders. One unique property of astaxanthin not found in many of the other antioxidants is that it crosses the blood-brain barrier, thus protecting the brain, eyes and our central nervous system where other antioxidants cannot.
Krill oil may become a favorite for those supplementing with n-3FAs as it may be preferred over fish oil (derived from a higher food chain ocean animal) that can accumulate higher levels of mercury and other toxins because they live longer. Another reason is because krill oil does not come with the fishy taste often associated with fish oil. Flax oil is a vegetarian form of n-3FA but there are those people who do not possess a critical enzyme that converts the substrate fatty acid to the desired n-3FA. Remember, krill oil also contains a higher amount of astaxanthin than does fish oil. Flax seed oil contains no astaxanthin.
Krill oil in one scientific study of 120 people with elevated LDL-Cholesterol compared with placebo showed a reduction in LDL by 34% and an increase in HDL (good cholesterol) by 43.5%. When fish oil was compared it had less of an effect on LDL and HDL. Krill also was shown to lower Triglycerides.
Pro-inflammatory conditions such as the discomfort common in premenstrual syndrome and arthritis were relieved by krill oil. Krill oil at a dose of 300mg daily was effective in reducing arthritic symptoms in a study published in the Journal of American College of Nutrition.
Those with allergies to seafood should use caution when taking krill oil as there may be reactions. With the use of any n-3FA, one can realize an increase in bleeding time and thus those on blood thinners or those going in for elective surgery should refrain from use. Additionally, people using blood thinners, anti-platelet medication or NSAIDs must use caution and only use high doses of krill oil under physician supervision. Herbs such as garlic, ginkgo biloba and ginseng can also increase bleeding times.

http://docsaleeby4.blogspot.com/2009/12/krill-oil-article.html

Pearl of the Month:

DID YOU KNOW About 47-million adults in the United States (almost 25% of the population) have metabolic syndrome, and the numbers continue to grow. Metabolic Syndrome will be the focus of the May 2010 Wellness & Rejuvenation Retreat. Stay tuned for more information.


Quote of the month:

"It is well to be up before daybreak, for such habits contribute to health, wealth and wisdom."
-Aristotle (384-322 BC)