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"We have essentially confirmed what many smaller studies have suggested," says Jill Crandall, MD, professor of clinical medicine at the Albert Einstein College of Medicine, the Bronx, who led the new study. "There is a small but significant risk of developing Vitamin B12 deficiency when people take metformin."

The finding, she adds, ''has implications for the consequences of B12 deficiency." These can include cognitive impairment, nerve problems (neuropathy) and anemia (low red blood cell count). B12 is crucial for the proper formation of red blood cells, for neurological functioning and for making DNA.

The link between taking the popular diabetes drug and deficiencies in vitamin B12 has been discussed as long ago as 1969, according to Dr. Crandall. However, few studies have looked at long term use, as her new study has done, tracking people for up to 13 years.

The new study was published online Feb. 22 in the Journal of Clinical Endocrinology & Metabolism.

Overview of the Metformin Study

The researchers evaluated more than 2,000 men and women enrolled in the Diabetes Prevention Program and the Diabetes Prevention Program Outcomes Study. In these studies, researchers enrolled overweight people who had prediabetes (blood sugar levels higher than normal but not high enough to be termed diabetes) to see if modest weight loss or treatment with metformin could prevent or delay the onset of type 2 diabetes, then followed them to see if the effects endured.

Half of the participants were given 850 milligrams of metformin twice daily and half got placebo pills. At the 5-year mark, more of those in the metformin group than the placebo group had low B12 levels, affecting 4.3% of the metformin group but just 2.3% of the placebo group. However, the gap narrowed at 13 years, with 7.4% of the metformin group and 5.4% of the placebo group having low B12 at that point. The narrowed gap seems counter-intuitive until Dr. Crandall explains what is happening.  "As time goes on, the groups are a little contaminated," Dr. Crandall says, because some in the placebo group, as time went on, developed diabetes and had to begin taking metformin.

Years of use was linked with an increased risk of B12 deficiency, Dr. Crandall found. Those taking metformin were more likely to have anemia, regardless of their B12 status. Those taking metformin with low B12 were more likely to have neuropathy.

The study findings suggest that routine testing of Vitamin B12 should be considered in patients on metformin treatment, Dr. Crandall says. Experts think that metformin affects the way Vitamin B12 is absorbed by the body. "People should be aware of this possibility," Dr. Crandall says of the metformin and low B12 link. Currently, she says, there are no official recommendations for B12 testing of those on metformin. 

Metformin & Vitamin B12: Second Opinion

"I think it lends more support to a practice that is already in place with endocrinologists," says Minisha Sood, MD, director of inpatient diabetes at the Lenox Hill Hospital, New York, of the study findings. She reviewed the research but didn't participate in it.

She screens for Vitamin B12 deficiency in her patients ''at least annually if on metformin."  According to Dr. Sood, many endocrinologists do screen for B12 deficiencies in those on metformin. However, she says, many patients with diabetes who are on metformin are cared for by general practice physicians or internists. These patients should ask their doctor's advice about getting screened for B12 deficiencies, Dr. Sood says. 

B12 Deficiency Symptoms & Treatment 

Symptoms of B12 deficiency may include numbness, tingling in the feet, and memory problems, Dr. Crandall says. Loss of appetite, weight loss and fatigue can occur. The deficiency typically develops slowly over time, so the regular screening could detect it early.

Treatment includes a weekly B12 injection and then switching to oral vitamins. 

The recommended dietary allowance (RDA) for B12 is 2.4 micrograms for those age 14 and older.  Foods high in B12 include cooked clams and beef liver, fortified breakfast cereals and fish such as salmon and trout. You can also take a sublingual B-12 Lozenge-FREE Shipping. And of course, best practice is to take care of your diabetes and eliminate your need for meds.CALL US to learn more at 847-577-4455.Next week, join me for a discussion about how acupuncture is gaining momemtum for all kinds of health concerns. SIGN up so you don't miss it.  Our new responsive website is nearing completion and I cannot wait for you to see it.

 

 

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The FDA has recently issued a warning after assessing reports that have associated certain diets with cardiovascular disease. 

Researchers have found that pet foods with peas, lentils, potatoes and other legume seeds have been linked with instances of canine dilated cardiomyopathy, CDC,  a disease of the heart muscle in dogs. The condition can enlarge the heart, often leading to heart failure.

Although the illness is typically found in larger breeds like Great Danes and Newfoundlands, the FDA said “highly unusual” reports of dogs not vulnerable to the disease have contracted it. 

Diets in cases reported to the FDA frequently list potatoes or multiple legumes such as peas, lentils, other “pulses” (seeds of legumes), and their protein, starch and fiber derivatives early in the ingredient list, indicating that they are main ingredients. Early reports from the veterinary cardiology community indicate that the dogs consistently ate these foods as their primary source of nutrition for time periods ranging from months to years. High levels of legumes or potatoes appear to be more common in diets labeled as “grain-free,” but it is not yet known how these ingredients are linked to cases of DCM. Changes in diet, especially for dogs with DCM, should be made in consultation with a licensed veterinarian.

In the reports the FDA has received, some of the dogs showed signs of heart disease, including decreased energy, cough, difficulty breathing and episodes of collapse. Medical records for four atypical DCM cases, three Golden Retrievers and one Labrador Retriever, show that these dogs had low whole blood levels of the amino acid taurine. Taurine deficiency is well-documented as potentially leading to DCM. The Labrador Retriever with low whole blood taurine levels is recovering with veterinary treatment, including taurine supplementation, and a diet change. Four other cases of DCM in atypical dog breeds, a Miniature Schnauzer, Shih Tzu and two Labrador Retrievers, had normal blood taurine levels. The FDA continues to work with board certified veterinary cardiologists and veterinary nutritionists to better understand the clinical presentation of these dogs. The agency has also been in contact with pet food manufacturers to discuss these reports and to further the investigation.

 

The FDA encourages pet owners and veterinary professionals to report cases of DCM in dogs suspected of having a link to diet by using the electronic Safety Reporting Portal or calling their state's FDA Consumer Complaint Coordinators. Please see the link below about “How to Report a Pet Food Complaint" for additional instructions.  I am currently pursuing advanced education in veterinary nutrition and am a pet lover and animal advocate so this is of great interest to me and I am sure to many of you.  Please be exceedingly careful in changing your pet's diet, as pets, just like people are very sensitive to dietary deficiencies.  Feel free to set up a consultation for guidance about your pet's nutritional needs or discuss with your veterinarian.   Next week join me as I discuss a popular diabetes drug that causes vitamin B-12 deficiency.  Sign UP Here.  You can also follow us on our social media pages, links below.  Our 500+ item Natural Pharmacy features brands like: Douglas Labs, Pure Encapsulations, Thorne Research and more.  FREE shipping on every order!  Thanks!

 

 

 

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LOCAL TREATMENT (Vaginal Suppositories)- APPLIED TO THE CERVIX in cervical Dysplasia and Cervical Cancers:

Risk Factors for cervical dysplasia or cervical cancers include: multiple sexual partners, young age at first intercourse, unprotected intercourse, HPV, Chlamydia, and HIV, poor immune status, poor nutritional status, smoking, use of oral contraceptives, and more.  The purpose of today's post is to address use of various vaginal suppositories such as green tea suppositories, vag pak, vaginal depletion pack and others in the quest for remission of cervical dysplasia. I receive daily requests for information regarding buying these vaginal suppositories on a daily basis.  Here is a brief history on their use, my recommendations will follow below.

 

Vaginal Suppositories: Escharotic treatment
The use of escharotic or caustic treatments for epithelial cancers is based on a centuries-old observation that select plant and mineral extracts could be used to treat topical skin lesions. Two small studies show the efficacy of this treatment in reversing cervical dysplasia in women. This treatment is used for CIN I and II after a satisfactory colposcopy is performed and if there is no disease in the endocervical canal and no glandular cells present. Escharotic treatment for cervical dysplasia involves the local application of a natural enzyme, bromelain, to the surface of the cervix. This is left in place for 15 minutes with heat applied to activate the enzyme. The protein dissolving properties in bromelain dissolve the top layer of cells on the cervix which are infected and damaged by the HPV virus. A mixture of zinc chloride and a plant (Sanguinaria) is applied to the cervix to cause sloughing of abnormal tissue. Zinc chloride is caustic and acts to disrupt the cellular membrane integrity and the mucus over coating to allow the Sangunaria to penetrate the cells. Sanguinaria has been shown to have anti-neoplastic qualities. The treatment is performed twice per week with at least two days in between treatments for 4-5 weeks. The ZnCl solution is made by a compounding pharmacist.

Vaginal suppository treatment
Vaginal depletion packs have been in use since the 1800s. Vaginal depletion packs, Vag pak, work by the action of the substances within the packs, which draw infection out of the cervical cells and boast the immune system. Each suppository contains: magnesium sulfate, glycerin complex, hydrastis tincture, thuja oil, tea tree oil, bitter orange oil, vitamin-A (as palmitate) 100,000 iu, ferric sulfate,ferrous sulfate in polybase. Hydrastis canadensis is effective against many microbial pathogens, as are the essential oils of tea tree, thuja and bitter orange.Vag Pak suppositories are often used for mild dysplsia and/or high risk HPV.

Green tea suppositories are also effective for cervical dysplasia and HPV. ECGC in green tea was evaluated on cervical epithelial; cells and cervical cancer cells and HPV. Green tea inhibited cancer cell growth, induced apoptosis, decreased gene expression, and cell cycle changes. As mentioned green tea has been shown to be effective against HPV.

Critics of natural medicine say there is no published evidence that these options work or are backed in science. There are several recent published articles explaining the science and patient outcomes. One can be found at http://www.ncbi.nlm.nih.gov/pubmed/19679625

SUMMARY
As a specialist in the area of HPV, cervical dysplasia etc, I feel it is important that a woman be informed of her options for managing cervical health. In my opinion, and clinical experience the very best outcomes occur with an individualized program addressing the patient's immune system, diet and lifestyle factors. The least invasive, most natural, safe and effective treatments that address the cause should be offered. There are times natural medicine is not an exclusive option for treating cervical cell changes due to the severity and location of disease but in many cases naturopathic treatment of cervical dysplasia and HPV is the safest and most effective option. I do not advocate suppositories alone as the condition can and does recur. With the right comprehensive treatment protocol, most of my clients reach remission in 3 to 6 months.  I do work long distance with clients so please feel free to call to schedule an appointment at 847 577-4455.  Thank you!  Next week I will investigate a phenomenon causing deaths of dogs due to pet food. Sign up here for more information and future blog posts.   Don't forget to visit our Natural Pharmacy for great prices, FRESH NEW EFFECTIVE products and free shipping on hundreds of "doctor only"products.We add new products daily. If you'd like us to offer something send us an email at DocTaryn@apple-a-day-clinic.com and I will be happy to add it.  Thanks so much. Our new website is still being developed I appreciate your patience as we perfect it. Thank you!

REFERENCES
1. Synder U. A look at cervical cancer. Medscape OB/GYN & Women's Health. 2003;8(1):1-12
2. Wheeler C. Advances in primary and secondary interventions for cervical cancer: prophylactic human papillomavirus vaccines and testing. Nat Clin Pract Oncol. 2007;4(4):224-235.
3. ACOG.org
4. Wright TC, et al. 2006 consensus guidelines for the management of women with abnormal cervical cancer screening tests. Am J OB/GYN 2007;11:346-355.
5. Wright TC, et al. 2006 consensus guidelines for the management of women with cervical intraepithelial neoplasia or adenocarcinoma-in-situ. Am J OB/GYN 2007;11:340-345.
6. Synder U. A look at cervical cancer. Medscape OB/GYN & Women's Health. 2003;8(1):1-12
7. Weinstein SJ, et al. Low serum and red blood cell folate are moderately, but nonsignificantly associated with increased risk of invasive cervical cancer. J Nutr. 2001;131:2040-2048.
8. Schiff MA, et al. Serum carotinoids and risk of cervical epithelial neoplasia in southwestern American women. Cancer Epidemiol Biomarkers Prev. 2001;10:1219-1222.

 

 

 

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Several studies have confirmed the immune-boosting power of elderberries.

In fact, studies from 2004 and 2009 demonstrated its ability to cut flu duration in half, and in many cases eliminate symptoms within 48 hours.

A more recent 2016 study, shows the berry works similar miracles on colds.

The 2004 study, published in the Journal of International Medical Research, showed that when elderberry extract is used within 48 hours of the onset of the influenza A or B virus, it shortens the duration of flu symptoms by an average of four days.Bottom of Form

 

Patients received 15 ml of elderberry syrup four times a day for 5 days.

In a 2009 study, published in the Online Journal of Pharmacology, H1N1 and avian flu patients were given four 175-milligram doses of elderberry extract daily.

While a group of patients receiving a placebo showed no improvement or worsening symptoms, those who received the extract “showed significant improvement within 24 hours.”

Fever, headache, muscle ache and nasal congestion were all significantly reduced within 24 hours.

“Within 48 hours of treatment, nearly 90% of the elderberry extract treated patients were either symptom free or had only mild symptoms,” the researchers wrote.

A 2016 study, published in the journal Nutrients, showed elderberry to reduce the duration and symptoms of a cold in air travelers.

Travelers using this herb from 10 days before travel until four to five days after arriving overseas experienced on average a two-day shorter duration of colds and also a significant reduction in cold symptoms.  You need a FRESH,quality product for these benefits. Try ours: FREE Shipping and discover the hundreds of PROFESSIONAL quality natural products we offer online, and at our office.    Next week I will discuss the benefits of vaginal suppositories in the treatment of HPV and cervical dysplasia.  Sign UP and receive notifications of articles by email.  A beautiful, responsive design website is nearing completion. Until then I am unable to publish a calendar for the month.  Our facebook page@appleadayclinic is also available for health tips.  Hope to see orders, visits and referrals from you. Thanks!

 

 

 

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Sunlight helps to protect against a wide range of disabling conditions including heart attacks, strokes, asthma, obesity, and multiple sclerosis beside the effects of vitamin D, and has been shown to boost libido and mood.

Exposure to the sun is believed to prompt the body to produce nitric oxide which helps to protect the cardiovascular system, as well as the feel good chemical serotonin; and there is a correlation between more sun and less disease in many conditions such as atherosclerosis.

Karolinska Institutet researchers have concluded that avoiding the sun is just as bad for a person as smoking. Non-smokers who avoided the sun were found to have had similar life expectancy as smokers in the highest sun exposure group.

Dr. Richard Weller of Edinburg University suggests that advice on healthy sun exposure should be reconsidered, publishing a report warning that older individuals in particular need more sun exposure. His team established that sun exposure may lower blood pressure and cut risks for stroke and heart attack due to sun exposure lowering blood pressure by causing blood vessels to widen.

Cambridge University scientists suggest that sunlight alters gene behavior, showing the expression of 28% of the genetic make-up varies from season to season. Researchers reported activity of anti-inflammatory genes increase in summer, and sunlight may prompt the body to shut down inflammatory responses.

Sunlight may even help to keep the body slim and healthy according to a team of researchers from the Universities of Edinburg and Southampton, results show that ultraviolet radiation may suppress development of obesity and symptoms of type 2 diabetes.

People tend to feel happier when exposed to the the sun. Research shows the main wavelength of light in sunlight helps to stimulate sensors in the retina which regulate the body clock, that in turn regulates the amount of melatonin the body releases, disruption of which is linked to depression, Alzheimer's and Parkinson's disease.

Those who live in sunnier climates do have more skin cancer, but there is no proof that sunlight shortens life. Epidemiology studies suggest overall those who get more sunlight tend to live longer despite getting more skin cancer.

Avoiding sunlight or using sunblock constantly could be a new risk factor for heart disease. However it is not recommended to spend hours sunbathing. Sunscreen should still be used sparingly so as to not block out all of the benefits of sunlight. Vitamin D3 influences healthy telomere length. The sun appears to be a double edged sword as the right amount is beneficial but too much or too little is not.

Cutaneous malignant melanoma is a serious form of skin cancer representing about three quarters of all skin cancer deaths. New studies now suggest avoiding the midday sun will decrease risk of sunburn, but it can increase risk of cancer.

Optimal time for sun exposure turns out to be between 10AM and 2PM as you will need shorter exposure time, and when the sun gets lower in the sky UVB is filtered out more than UVA; UVA is correlated with wrinkles and melanoma while UVB is what produces vitamin D.

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A study published this week in the journal Cell follows multi-generation immigrants from Southeast Asia to the United States. As they moved, their gut microbes responded. Once in the United States, the immigrants' gut diversity dropped to resemble the less-varied microbiomes in European Americans. At the same time, obesity rates spiked.

 

“We found that moving to a new country changes your microbiome,” said Dan Knights, a computational microbiologist at the University of Minnesota and an author of the paper. “You pick up the microbiome of the new country and possibly some of the new disease risks that are more common in that country.”

 

 

 In the United States, immigrants in the study ate foods richer in sugars, fats and protein. Microbiomes changed within months of moving. “People began to lose their native microbes almost immediately after arriving in the U.S.," Knights said. “The loss of diversity was quite pronounced: Just coming to the USA, just living in the USA, was associated with a loss of about 15 percent of microbiome diversity.”

 

Obesity rates among many of the study immigrants increased sixfold. Those who became obese also lost an additional 10 percent of their diversity. “And the children of immigrants,” Knights said, “had yet again another 5 to 10 percent loss.”

 

As microbial diversity decreases, the risk of diseases such as obesity and diabetes increases. “It's been known from previous studies that people in developing nations tend to have more gut microbiome diversity and lower risk of metabolic diseases,” Knights said. “It was also known that moving from a developing nation to the U.S. increases your risk of those diseases.” But no one had tested whether the microbiome changed after immigration, too.

 

 

 “The association made between changes in dietary factors, toward a more ‘Westernized' nutritional diet, and the loss of bacterial diversity” was “particularly striking,” said Eran Elinav, who studies the human microbiome at the Weizmann Institute of Science in Israel. (In 2014, Elinav and his colleagues reported that traveling to distant time zones by plane alters the microbiome, as though the germs were jet-lagged.)

 

But changes in diet were slower than changes in microbiome, suggesting factors beyond American food were at play. “We found that diet alone wasn't enough to explain the rapid Westernization of the microbiome,” Knights said — differences in drinking water and antibiotics possibly contributed as well.

 

The new study supports hypotheses that Western lifestyle influences the microbiome. Industrialization is correlated with a drop-off: Indigenous South American people, for instance, have about twice as many species in their guts, compared with a person in the United States.

 

  “We have known from some small, not well controlled studies that the microbiome does change — and we have known for many years that adopting a Western lifestyle is associated with an increase in disease,” said microbial ecosystem expert Jack Gilbert, director of the University of Chicago's Microbiome Center, who was not involved with the current study. “This brings those two concepts together.”

 

Knights and his colleagues examined microbiomes in stool samples from more than 500 women. Two ethnic groups from Asia, the Hmong and Karen people, represent a large portion of immigrants in Minnesota. (Men were not included, because substantially more women from these communities moved to the state.)

 

Some Hmong and Karen women in this study lived and remained in Thailand. Others were first- and second-generation U.S. immigrants. To get a before and after snapshot, researchers also took microbiome samples from 19 Karen women before their departure and after their arrival. The scientists compared all of these microbiomes with those of 36 European Americans born in the United States.

 

  The dominant species in the gut changed from strains of bacteria called Prevotella to a group of bacteria called Bacteroides. Prevotella bacteria produce enzymes that digest fibrous foods more common in Asia than the United States. In Thailand, the women ate more palm, coconut, a fruit called tamarind and the bulbous part of a plant named konjac.

 

“The diet analysis is as good as it can be for any populations. Yes, lifestyle factors could influence these trends, but the trends we observe could easily be explained by diet changes,” Gilbert said.

 

"We know from studies in animals that having the wrong set of microbes can cause obesity,” Knights said. In pioneering work at the Washington University in St. Louis, scientists took germs from obese women and transplanted the microbes into healthy mice. Those mice grew heavier, even when they ate the same food as their lean rodent equivalents.

 

  The authors of the current work, though, do not have evidence the microbial changes directly increased obesity risk in immigrant women. It is possible that a Western lifestyle leads to obesity while the microbiome independently adjusts. Or a sequence of events could occur: A new diet and lifestyle leads to different microbes, and those microbes, as the mouse studies suggest, have a direct effect on obesity. For the time being, no “formal proof” exists to link microbiome alterations to human disease, Elinav said.

 

 

Knights suspects these patterns hold for people elsewhere across the world who adopt Western countries or lifestyles as their own. “Because we were able to confirm the same findings in two different ethnic groups, we expect that we would see something similar happening in the other immigrant groups,” he said. But, as always, future research will show whether this prediction rings true.  Sources for this article include the Journal Cell and the Washington Post.  If you would like to learn about your microbiome, please contact me for an appointment at 847 577-4455. To learn more about stool testing click this link.   May I also suggest our highly regarded Maxbiotic, and other top quality probiotics available from our store-FREE shipping!  We sell hundreds of professional quality products from brands such as Metagenics, Thorne, Pure Encapsulations and much more at GREAT prices, and are authorized distributors.  Our new website is being updated as we speak and it is GORGEOUS!  You will love it!  Next week discover the health risks of too little sunshine!  SignUP! 

 

 

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