MARCH 21, 2019 SLEEP APNEA AND SLOW HEART BEATS

An evaluation for sleep apnea needs to be done for patients with slow heart rhythms as sinus node dysfunction, bradycardia, and sinus pauses. I also feel these patients should be screened for Lyme disease . It has been shown that treatment of sleep apnea offer cardiovascular benefits beyond reduction in nocturnal slow heart rates ( bradycardia)

It is important to make a correlation with appropriate testing of the amount of bradycardia in the face of sleep apnea. We do know that permanent pacemakers are recommended regardless of symptoms for patients with acquired second degree AV block Mobitz Type II, high grade block or third degree block.

Permanent pacemakers are not recommended for patients with AV block that are due to reversible causes as Lyme carditis.

Any patient with a history of snoring and day time tiredness should be evaluated for sleep apnea. There is also a major correlation between sleep apnea and coronary artery disease

Until tomorrow…

MARCH 20, 2019 ANTIBIOTICS AND KIDNEY STONES

Antibiotics do serve a purpose. Sometimes these antibiotics can be miraculous cures, but there are side effects. The main side effect is a disruption in the gut microbiome. Now there is also evidence that patients with kidney stones ( nephrolithiasis) have an altered gut microbiome compared to those without kidney stones. This is important information

The question is how this could happen ? The proposed mechanism is that changes in the gut microflora ( due to antibiotics) alter macronutrient leading to increased calcium formation. This increased calcium formation will lead to kidney stones.

Another hypothesis is that antibiotics select for multi resistant pathogens that promote kidney stone formation. It has been shown that 70 % of bacteria cultured from stones are multi resistant pathogens.

This has to be researched and studied more

Until tomorrow…

MARCH 19, 2019 OBESITY AND CANCER

WE do know that obesity increases the risk of developing cancers. It has been studied and well documented that obesity increases immune aging, tumor progression and even other proteins.

What is more paradoxical is that obesity or excess weight helps immunotherapy drugs kill cancer cells.

This study was done in mice and more needs to be done. The same study was mirrored in man. Those cancer patients with a higher body mean index had better survival than those lean cancer patients.

It was found that there was a difference in T cell function in obvese and non obese individuals.

Until tomorrow…

MARCH 18, 2019 AVOCADOS

WHY EAT AN AVOCADO?

An avocado is power packed with nutrition for many reasons. There are more than 20 vitamins and minerals in an avocado - It provides 21 % potassium, 25 % vitamin C , 30 % folate an d 39 % vitamin K. Each one of these supplements can be used for a variety of conditions.

The healthy fats in an avocado is great for heart health and reduces heart attacks and strokes by lowering total and bad ( LDL) cholesterol. I feel this is a good food for a diabetic as it reduces blood sugar and great at regulating insulin levels.

Since an avocado is packed with B vitamins it is great for the pregnant female It contains lutein and zeaxanthin which is important for eye health

Eat an avocado at least two to three times a week

Until tomorrow…

MARCH 13, 2019 FISH OILS

There was a positive primary endpoint of the REDUCE -IT trial when it comes to the benefit of omega 3 ( EPA). It was presented at the American Heart Association Scientific Session to an outstanding applause. The mechanism might be poorly understood and even accepted but the results are compelling.

This was a large multicenter trial compared patients with high cardiovascular risks and elevated triglycerides who took 4 grams of EPA /day to a group that took a mineral oil placebo. At the end there was a 4.5 % lower risk of dying from cardiac events or experiencing myocardial infarctions, stroke, coronary revascularization than than those who took the placebo

With such results, there was speculation about the placebo oil and if it caused harm. The other flaw was other cardiac risk factors were not measured.

I will continue to describe omega 3 ( EPA) supplementation to my cardiac patients.

Until tomorrow…

MARCH 12, 2018 RED MEAT CONSUMPTION

In December 2018, an article published in the Journal of Clinical Investigation discussed the link of red meat consumption tied levels of a chemical linked to heart disease. A chronic red consumption of 8 oz significantly raises levels of a gut generated chemical called Trimethylamine N oxide (TMAO) which is linked to heart disease

We do know that a diet in red meat has higher levels of TMAO compared to white meat and non meat protein by three fold. TMAO levels do vary from person to person and also varies with kidney function. .

Therefore it was postulated if we find ways to lower TMAO levels we can lower the risk of heart disease. After reading the article I believe it has a lot to do with the gut microflora. I feel many of the chronic inflammatory diseases are associated with the gut microbiome ( which is not clearly understood )

There is enough data today to tell a patient to reduce his/her red meat consumption

Until tomorrow…

MARCH 11, 2019 PSORIASIS AND BONE DISORDERS

There is emerging evidence that patients with psoriasis with or without psoriatic arthritis are a greater risk for osteopenia and osteoporosis. The exact mechanism is not known but it certainly does point to chronic inflammation of these diseases.

It has been shown cytokines involved in the pathogenesis of psoriasis have recently been shown to be involved in the regulation of bone metabolism and the pathogenesis of osteoporosis.

More studies need to be studied, I believe these studies should include all autoimmune diseases.

Until tomorrow….

MARCH 9-10, 2019 CBD AND THC

I have utilized the CBD oil for many patients in the last 10 years. I have seen remarkable results with CBD oil alone and in combination with THC ( that is medically prescribed by a doctor and the dispensary ) The vast multitude of benefits from CBD have been studied and researched for years. Only in the last few years are we seeing these remarkable results

There are some differences between CBD and THC

Tetrahydrocannabinol (THC) and cannabidiol (CBD) are both derived from the cannabis plant. 

Together, they are part of the cannabinoid group of compounds found in hashish, hash oil, and most strains of marijuana. 

THC is the psychoactive compound responsible for the euphoric, 'high' feeling often associated with marijuana.

THC interacts with CB1 receptors in the central nervous system and brain and creates the sensations of euphoria and anxiety. 

CBD does not fit these receptors well, and actually decreases the effects of THC, and is not psychoactive. 

CBD is thought to help reduce anxiety and inflammation. 

Until tomorrow…