Saturday, May 16, 2015

Don’t Miss this Important Disovery! AMPK Activators: Anti-Aging, Anti-Diabetic, Anti-Obesity and Anti-Fatigue!

AMPK (adenosine monophosphate-activated protein kinase) is an enzyme that regulates energy metabolism.  When the cells sense energy depletion, AMPK is activated to stimulate energy production and limit energy utilization.  Found in every cell, AMPK promotes longevity factors that have been shown to extend life and “turn off” many damaging effects of aging.  AMPK activity declines in aging, excess calorie consumption, and/or low levels of physical activity, increasing the risk of obesity, diabetes, fatigue, and the chronic diseases of aging.

AMPK enhances energy metabolism while suppressing inflammatory responses. It can inhibit the oxidative stresses which are involved in metabolic disorders and the aging process, improve stress resistance and extend the lifespan of cells while reducing inflammation.

AMPK increases glucose uptake in the cells, reducing insulin sensitivity.  It helps control appetite and energy expenditure.  Current evidence indicates that AMPK activation may reduce risk for atherosclerosis, heart attack, and stroke; help manage congestive heart failure; ameliorate metabolic syndrome, reduce risk for diabetes type 2, and improve glycemic control in diabetics; reduce risk of weight gain and improve weight loss; decrease risk for a number of common cancers while improving prognosis in cancer therapy; decrease risk for dementia and possibly other neurodegenerative disorders; help to preserve the proper structure of bone and cartilage; and provide aid in the prevention and control of autoimmunity.

AMPK has been demonstrated to inhibit synthesis of fatty acids, cholesterol, and formation of fatty liver, while increasing fatty acid oxidation, muscle glucose transport, formation of mitochondria and reduction of caloric intake.  It influences metabolism in fat cells while suppressing the adipose dysfunction and inflammation.  It promotes cellular energy production by initiating mitochondrial biogenesis.

AMPK Activators:

·         Exercise—AMPK is activated by exercise and may be why exercise reduces blood sugar, increases metabolism and reduces obesity.

·         Metformin—this diabetic drug causes AMPK to be activated in the liver, suppressing gluconeogenisis, enhancing glucose uptake in the cells and reducing insulin resistance.

·         Berberine—a naturally occurring bright yellow botanical that has been commonly used in traditional Chinese and Korean medicines as an antimicrobial/antifungal and as a treatment for Diabetes Type 2.  It has been shown in clinical trials to be as effective as Metformin in reducing blood sugar and insulin sensitivity, and recent studies show that a good part of the effects of Berberine are because of AMPK activation.

·         Alpha Lipoic Acid—this naturally occurring short-chain fatty acid is an essential co-factor of enzymes in the mitochondria, and is best known for its powerful effects as an antioxidant.  Recent studies have demonstrated impressive effects of ALA on many aspects of metabolic regulation and weight loss, and these appear to be largely dependent on AMPK activation.

·         Polyphenols such as Resveratrol, found in red wine, red and dark grapes, vinegar and other plants stimulate AMPK activity in a variety of cell types including liver, skeletal muscle, neurons, and cancer cells.

Gynostemma pentophyllum
·         Gynostemma pentaphyllum--widely used in Asian countries as an herbal medicine named Jiaogulan to treat dyslipidemia, Diabetes Type 2 and inflammation.  Pharmacological research has indicated therapeutic properties in lowering cholesterol and high blood pressure, strengthening immunity, and inhibiting tumors.  Until recently it was a locally known herb used primarily in southern China and northern Vietnam.  It is known as the "immortality herb", because people within Guizhou Province, where jiaogulan herbal teas are consumed regularly, are said to have a history of unusual longevity. It has been shown in studies to strongly activate AMPK in cultured L6 myotube cells, which increased lipid oxidation and glucose uptake.  One study showed a significant inhibitoy effect on the growth of melanoma B16.  It stimulated Tumor Necrosis Factor and other immune chemicals which caused antitumor effects.  In a 12-week, randomized, double-blind placebo controlled clinical trial in Korea, 450 mg/day significantly decreased total abdominal fat, total weight, body fat mass, percent body fat, and BMI compared to placebo.  There didn't seem to be any negative effects.     

Rose Hips
·         Trans-Tiliroside—derived from the seeds of rose hips, strawberries, raspberries and other dietary plants, shows AMPK activation, along with anti-inflammatory, antioxidant, anticarcinogenic and hepatoprotective activities.  Studies have shown anti-obesity and anti-diabetic activities via enhancement of fatty acid oxidation in the liver and skeletal muscle and significantly reduced blood glucose levels after a loading dose in mice, promoting healthy blood glucose levels and body weight.

Is it possible to extend our healthy life span?  Animal studies are showing positive results with AMPK activation, however, it is too soon to tell with humans.  However, there are enough studies showing positive results from AMPK activation in humans that it is worth considering.

SpringTree Glucose Balance, originally created to assist in blood sugar imbalances, low blood sugar, pre-diabetes and diabetes, also has contained the AMPK activators of Berberine and Alpha-Lipoic Acid.  The new formula just being released contains increased amounts of Berberine, and also includes Gynostemma Pentaphyllum and Trans-Tiliroside in the amounts shown by studies to improve glucose levels and weight loss.  The ingredients in the new formula can now be used to assist in pre-diabetes, diabetes, obesity, energy enhancement, and/or anti-aging.  Blood sugar balance is important in all chronic diseases, including cancer.  We are excited to be releasing this high quality supplement!  It can be purchased at

Until we meet again,
Dr. Judi

Monday, April 6, 2015

The Cause of Heart Disease? NOT Dietary Cholesterol, Goverment finally admits

For 40 years Americans have been eating fewer eggs, butter and red meat with saturated fat and cholesterol because US government policy makers told us not to.  We were told that dietary saturated fat and cholesterol were bad for our health and caused heart disease.  Manufactured foods such as margarine, egg substitutes, and low fat products laden with sugar or high fructose corn syrup to make them palatable were touted as the healthy way to go.
I have been advising my patients for most of my practice to stay away from the manufactured foods and eat whole foods, including eggs, red meat and butter.  And now, the US government finally agrees with me.
In February 2015 the 572-page Scientific Report of the 2015 Dietary Guidelines Advisory Committee was released.  Buried on page 91 it states, "...available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum (blood) cholesterol....Cholesterol is not a nutrient of concern for overconsumption."
When the original recommendations were made in the 1960s and 1970s, the government policy relied on a kind of science called epidemiological or observational studies.  In these studies researchers follow large groups of people over many years.  However, these studies are limited in that they can only show an association between two things, and not that one causes the other.  Therefore a hypothesis can be formed from these studies, but it takes more rigorous studies to prove them.

There are still dietary guidelines in the current report that I don't agree with.  They continue to recommend reducing saturated fats, to the point of recommending that even lean meat be removed from the list of healthy foods, even though several recent meta-analyses have shown that there are no studies that prove that saturated fats cause heart disease.

And they continue to recommend limiting salt intake, even though in 2013 an authoritative study by the Institute of Medicine contradicted that recommendation.

While there may be a general correlation between high serum levels of cholesterol and heart disease, it is only oxidized cholesterol that leads to atherosclerotic plaque (hardening of the arteries).  High levels of non-oxidized serum cholesterol are actually protective and essential to life and all cells.  Studies of the elderly show that those with low cholesterol levels have higher death rates than those with high cholesterol levels.
We should be focusing on what oxidizes the cholesterol.  Inflammation in the arteries causes oxidation of cholesterol, platelet aggregation and atherosclerotic plaque formation.  Rather than focusing so much on the cholesterol levels, in our office we test Lp-PLA2 levels, a marker for inflammation and plaque in the arteries, and Cardiac C-reactive Protein, a marker for inflammation in the body.
What causes inflammation in the arteries?  The two most common causes are high blood glucose and insulin levels and high Homocysteine levels.  Anything else that causes inflammation in the body, such as autoimmune diseases, chronic infections, etc. can also increase inflammation in the arteries.
The increase of consumption of low fat, high simple carbohydrate diets high in sugar and processed grains has caused an explosion of pre-diabetes and diabetes.  The insulin levels rise to try and lower the blood glucose levels and try to drive glucose into the cells.  The cells start to become resistant to the high levels of insulin, and blood glucose levels rise. 
When blood glucose rises, it attaches to the proteins in a process called "glycosylation," which damages the protein and cells.  The amount of glycosylation in the body is measured by the Hemoglobin A1C.  If that level is elevated, is shows that damage is already being done in the body and in the arteries, even though it may not yet be considered full-blown diabetes.
When insulin levels rise, blood pressure rises, triglycerides and sometimes cholesterol increases, and it causes inflammation in the body and in the arteries.
Therefore, the recommendations by the government and the American Heart Association to cut down on dietary fat and cholesterol may have even worsened our health.  By cutting out meat and eggs, we have eaten more grains, pasta, sugar, high fructose corn syrup and polyunsaturated fats.  Over the past 50 years, Americans have cut saturated fat intake by 25% and increased carbohydrates by more than 30%.  However, well done studies are showing that a diet high in sugar, refined grains and polyunsaturated fats increases the risk of obesity, diabetes and heart disease much more than a diet high in natural fats and cholesterol.
Homocysteine is a non-protein amino acid, important in the synthesis of methionine and cysteine.  High Homocysteine levels can cause endothelial (cells that line the inner arteries) cell injury, causing inflammation and atherosclerotic plaques.
High levels of Homocysteine are caused by a reduction in three simple nutrients:  Folate, B-12 and B-6.  Today most of our processed foods contain these nutrients as additives.  Red meat and whole grains have higher levels of these vitamins.  However, around 40% of the population has a genetic defect which keeps the body from creating the activated form of these vitamins which are necessary to reduce Homocysteine.  This is a mutation of the MTHFR genes (See my blog from February to find out more about this mutation).  If you have a family history of heart disease, make sure you are tested for this mutation.
So what is my advice on reducing heart disease?
  • Check inflammatory markers Lp-PLA2 and Cardiac C-reactive protein
  • Check Homocysteine levels
  • Reduce oxidation of cholesterol with high levels of anti-oxidants such as those found in SpringTree SuperMulti Plus.
  • Balance insulin and blood glucose with a whole foods low carbohydrate diet.  Don't forget the natural fats--they balance blood sugar and give us energy in place of the carbs.  Also consider using SpringTree Glucose Balance
  • Reduce Homocysteine levels with the activated forms of B-12, folate and B-6, called methylcobalamine. 5-MTHF, and P-5-P, as found in SpringTree Methylation Factors.
  • Reduce inflammation with fish oil
  • Reduce inflammation with proteolytic enzymes and herbs such as turmeric, found in SpringTree's Pain and Inflammation supplement.
SpringTree Supplements can be found at
Until we meet again,
Dr. Judi

Saturday, April 4, 2015

Diabetic Peripheral Neuropathy--Causes and Treatment

 Diabetic Peripheral Neuropathy (DPN) is often one of the most painful results of diabetes.  The Neuropathy Association reported in 2013 that neuropathy in the United States is "skyrocketing."  Between 15 and 18 million Americans have DPN.  DPN affects the nerves in the hands and feet, causing numbness, tingling and pain.  Nerve problems may also occur in the digestive tract, the heart, eyes and other organs. The pain can be a "pins and needles" feeling, a burning sensation, and/or shooting and electric shock pains.

There is often confusion in the medical profession as to how diabetes causes DPN.  Some theorize that the excess blood sugar affects the protective coating on the nerves.  Others believe decreased blood flow to the nerves can cause damage.

However, there is more evidence forming that the largest cause of DPN and even peripheral neuropathy not related to diabetes is a B-12 and/or folate deficiency.  B-12 deficiency causes demyelination of the nerves, allowing damage to the nerves and increased sensitivity.  Folate deficiency reduces the expression of Nerve Growth Factor and increases lipid peroxidation.

Symptoms and signs of B-12 deficiency can include fatigue, depression, abdominal pain, megaloblastic anemia (enlarged red blood cells), bleeding gums, weakened immunity, bruising, eczema, rapid heart beat, hair loss, muscle cramps, and tingling and numbness in the extremities (peripheral neuropathy).

Symptoms and signs of folate deficiency can include fatigue, grey hair, mouth sores, tongue swelling, growth problems, peripheral neuropathy and megaloblastic anemia causing persistent fatigue, lethargy, pale skin, irritability, and diarrhea.

Deficiencies of both B-12 and folate can cause a swollen, geographic or cracking tongue and beaded vertical ridges on the fingernails.

Causes of B-12 deficiency include low stomach acid (common in diabetes), a vegan diet, celiac disease from gluten, stomach surgery (including surgery to reduce obesity), and less common, pernicious anemia, a lack of intrinsic factor in the stomach.

A concerning cause of B-12 deficiency is the use of the most common diabetic medication Metformin (Glucophage).  Metformin in general is a good medication for diabetes, but it causes B-12 deficiency, and too many physicians are not watching the B-12 levels of their patients on Metformin.

Causes of folate deficiency include poor diet with inadequate vegetables, excessive alcohol use, medications such as birth control pills, dilantin for seizures, antibiotics with trimethoprim such as Bactrim and Septra, chemotherapy agents such as methotrexate, often used for autoimmune diseases such as rheumatoid arthritis, celiac disease, giardia infection, and low stomach acid.

More recent studies are showing the large number of diabetics with the MTHFR DNA mutation.  This mutation keeps the MTHFR enzyme from adding a methyl group (1 carbon and 3 hydrogen atoms) to B-12 and folate, considered the activated form of B-12 and folate and necessary for the cells to be able to use them.  An MTHFR mutation increases the risk of both diabetes and nervous system disorders, especially peripheral neuropathy.  (See my blog post of Feb. 20, 2015 for more information on this common mutation.)

Many studies have been done using folate and B-12 as treatment for peripheral neuropathy.  The FDA has approved a "medical food" by the name of Metanx for the treatment of DPN, which includes methylcobalamine (methyl B-12), 5-MTHF (methylfolate) and P-5-P (the activated form of B-6).  This medication has been proven to improve DPN, but it is expensive and insurance companies often don't pay for it.

SpringTree Methylation Factors contains the same ingredients plus more to improve the functioning of the activated forms of B-12, folate and B-6.  Our SuperMulti Plus also contains 1000 mcg each of the methylated forms of B-12 and folate, along with high antioxidants and glucose tolerating factors which help reduce the damage from high insulin and blood glucose.

Our treatment recommendations for DPN include:
  • a high protein and fat, including red meats, high vegetable, no grain and low carbohydrate diet (see previous blogs)--diet is VERY important!
  • SpringTree Glucose Balance 2 capsules with each meal to assist in balancing blood sugar and insulin levels
  • SpringTree SuperMulti Plus 4 capsules/day
  • SpringTree Methylation Factors--start with 1 capsule/day and increase to 3/day if there are no negative symptoms.  (If there is increased nervousness, pain, headache, etc. you could be experiencing over-methylation.  Take niacin 50-250 mg. to stop the symptoms)
  • SpringTree Pain and Inflammation 3 capsules one to 3 times a day to reduce the inflammation and the pain caused by DPN
  • We also highly recommend getting tested for the MTHFR DNA mutation.  If it is positive we also recommend detox protocols.
SpringTree supplements can be obtained from

Until we meet again,
Dr. Judi


Sunday, March 1, 2015

Can I Change the World?

Many on the earth today are watching the signs of the times and are concerned about all of the horrible things they see happening around them.  The problems seem so huge that they seem like an avalanche that is about to bury us all and we can do nothing about it.  We read and hear the prophecies of the end times, and believe there is nothing we can do about it.

I see and hear daily the great pain everyone is dealing with:  illness and physical pain; depression, anxiety and other mental illnesses causing such emotional pain; divorces and other painful relationship issues; abuse of all kinds; financial fears and loss.  I heard a story yesterday from a girl that was kidnapped by a neighbor as a teenager and kept locked in a room, right here in Utah County, for 6 weeks, until somehow they didn't lock the door and she escaped and found a cell phone and called her family.  I hear stories of ritual abuse, spousal abuse, sexual slavery, and more.  The stories are not only heard in my office--they are in my family, in my church, among my friends.  The world seems so dark that it feels like I am being swept in a tidal wave that will never stop.

But I refuse to believe that.  I feel that I can make a difference, that the little things I do can ripple out to increase love in the hearts of mankind, and bring a little light into the world.  I believe that there are many of us in the world doing what we can to be kind, compassionate and loving, and as more hearts shift, the collective consciousness will shift and things can change. 

Jonah was told to preach to the people of Ninevah, a violent people, to change their hearts or they would be destroyed.  They were so violent he was afraid of them and ran away, getting on a boat going in the opposite direction.  But after 3 days in the belly of the great fish, he chose to go preach to them.  He didn't believe they would change, but they did!  And they were not destroyed.  The prophecies of the future are based on what will happen if we don't change.  How many of us believe, like Jonah, that the "wicked" in the world will never change?  Do we not even consider that there might be a possibility of change?

I have not been called by God to go preach to ISIS, or the Taliban, or the murdering gangs.  There are those that have been called to do so and, like Jonah, are putting their lives in danger as they strive to change hearts.  There is a story in the Book of Mormon about four brothers who felt called to preach to their enemies, whom they had been at war with for a long time.  Their enemies were a violent people, and killed easily.  They were putting their lives at risk.  Many believed they were on a fruitless mission, as their enemies had been this way for centuries and would never change.

However, a very large group of their enemies changed their hearts, buried their weapons of war and vowed never to murder or go to war again.  It was not all of the wars that had changed them, but four young men going about serving them, loving them and teaching them.  Hearts can change!

I have not been called to put my life on the line to inspire others to change their hearts.  But I feel that it is important for me to do whatever I can to change my own heart so that the energy of my love and compassion can change the collective energy of all of us.

There is one responsibility which no man can evade,
that responsibility is his personal influence.
Man's unconscious influence is the silent, subtle radiation of personality,
the effect of his words and actions on others.
This radiation is tremendous.
Every moment of life man is changing, to a degree, the life of the whole world.
Every man has an atmosphere which is affecting every other man.
He cannot escape for one moment from this radiation of his character,
this constant weakening or strengthening of others.
Man cannot evade the responsibility by merely saying it is an unconscious influence.
Man can select the qualities he would permit to be radiated.
He can cultivate sweetness, calmness, trust, generosity, truth, justice, loyalty, nobility,
and make them vitally active in his character.
And by these qualities he will constantly affect the world.
This radiation, to which I refer, comes from what a person really is,
not from what he pretends to be.
Every man by his mere living is radiating either sympathy, sorrow, morbidness, cynicism,
or happiness and hope or any one of a hundred other qualities.
Life is a state of radiation and absorption.
To exist is to radiate;
To exist is to be the recipient of radiation.

--David O. McKay

This quote has had a profound effect on my life.  It has caused me to really go inside and see what I am radiating that is affecting the world--for positive or negative. 

Am I at war with myself?  Am I hating myself?  Am I treating myself worse than I would treat my children or my best friend?  Am I judging myself?  Am I judging others--my relationships, my neighbor, even ISIS and other groups who murder and rape and seek to control the world?  Am I hating rather than loving?  Am I judging another to be worthy or unworthy of my love, of my compassion, of my service?  Am I holding grudges and not forgiving?  Do I hold my financial blessings to myself out of fear that I will lose them?  Am I able to let go of offenses, seeing that they are not really about me, but only my reaction to what another has said or done which triggered pain that was already inside me? 
Do I see that I have the capacity to change my heart, or have I given up on myself?  Am I allowing myself to be all of who I really am?  Do I hide myself from others because I fear how they will judge me?  Do I allow myself to be who I was created to be and love myself in spite of my weaknesses, or do I hold myself back because of fear of my weaknesses?

The only way I can change the world is to change my own heart to be and act the way I would like others to be and act.

During the many years I have been a doctor, I have seen many people that desire to heal, but have not developed enough trust in their own power.  Therefore, as I recommend treatments that their insurance may not pay for, they believed they cannot afford it and therefore did not receive the treatment that might assist them in healing.  For many years I believed what I was taught, that it was important for me to charge what I was worth and people would figure out how to pay for it.

However, when I opened Diamond Springs Wellness Center four years ago, I felt my heart was directing me to change the world.  The world is in the middle of a financial crisis.  People were losing jobs and homes.  The rich are getting richer and the poor are getting poorer.  What could I do to change that?  All I can do is change my own heart.

The change I wished to see in the world was that love, charity from the heart, would allow those that had to lift those that had not.  So I chose to be the change I wish to see in the world.  As I opened my new practice I made a new policy, "Pay what you can honestly afford."  I felt if I were able to do all that I could for others, that love and compassion could radiate out and allow others to do the same in whatever way worked best for them.

I have to admit this has been a struggle.  The office has barely survived, and often bills have been paid late.  Sometimes I get paid late or not at all, and I definitely don't get paid a regular family practice doctor's wage, nor do my staff.  But miraculously the office is still open, and we are still able to provide that service, and many, many people have been served who would not have been otherwise.  It is such a blessing to see people's lives shifting because of their physical and emotional healing, and they are able to serve the world in ways they could not have before.

I do not share this to brag or to lift myself up, but to say that everyone has a gift they can give to the world.  Even the seemingly smallest act of kindness can make a shift.  I see so much good being done in the world, so much love and giving in ways that may seem impossible to others.  I know if we can believe in ourselves, if we can work on changing our own hearts, if we can work on stopping the war in our own hearts, if we can allow ourselves to let go of judgment of ourselves and others, if we can cultivate compassion for ourselves and others, if we can forgive ourselves and others, if we can find peace in our own hearts, the world can find love and compassion and forgiveness and peace!

Until we meet again,
Dr. Judi

Friday, February 20, 2015

The Common MTHFR DNA Mutation: a Risk Factor for Many Chronic Physical and Mental Diseases

What is an MTHFR DNA mutation?

 Please understand that this is a very simplistic explanation of a very complex problem.

 In 2003, with the completion of the Human Genome Project, it was discovered that a relatively high level of the population had mutations in the methylenetetrahydrofolate reductase (MTHFR) genes.  These are very important genes related to our health.  Mutations of these genes have been implicated in increasing the risk of heart disease, Alzheimer’s and dementia, neural tube defects, colon cancer, leukemia, breast cancer, prostate cancer, mood disorders and schizophrenia, autistic spectrum disorders, neuropathy and other nervous system disorders, chronic fatigue, fibromyalgia, irritable and inflammatory bowel syndrome, miscarriages, migraines, chemical sensitivities, elevated levels of toxins which increase other diseases, and more.

The MTHFR gene is the code to create the MTHFR enzyme.  This enzyme is important in the methylation cycle, which happens in every cell in our body.  MTHFR adds a methyl group (-CH3) to folate and B-12 to create the activated forms of these B-vitamins:  5-MTHF (methylfolate) and methylcobalamine. 

The active forms of folate and B-12 are used in many functions in the body.  The most commonly noted is how they are used to convert the amino acid homocysteine down to the essential amino acid methionine, which is used by the body to make proteins, utilize antioxidants, assist the liver to process fats, assist in the detoxification process, etc.   Low methionine has been linked to depression and inflammation.  Methionine also helps convert estradiol (E2) into estriol (E2), the estrogen most prevalent in a pre-menopausal woman, and least likely to cause cancers.

Methionine is converted into SAM-e, which is anti-inflammatory, supports the immune system, helps produce and break down serotonin, dopamine and melatonin, and is involved in the growth, repair and maintenance of your cells.

When homocysteine cannot be converted to methionine because of the lack of 5-MTHF and methylcobalamine, the levels of homocysteine rise.  Homocysteine irritates the lining of the arteries and increases risk of heart attacks and stroke.

 These vitamins are also necessary in creating neurotransmitters, in forming a healthy central nervous system in the fetus, red blood cell formation, synthesis and function of nerve tissues such as myelin, energy production from the Kreb cycle, and much more.

 Testing for the mutation is usually done through a blood test, though 23andme and other genetic testing companies use a saliva sample.  As yet, health insurance does not usually pay for the testing, at least in Utah.

 There are at least 30 genetic SNPs that affect the MTHFR enzyme, but the greatest effect seems to be from 2 genes: C677 or A1298.  Each gene carries 2 strands, one from each parent.  If only one strand of one gene is mutated, it is called “heterozygous.”  If both strands of one gene are mutated, it is called “homozygous.”  Approximately 40% of the population is heterozygous for one gene.  This often causes minimal symptoms when younger, but still increases the risk of chronic diseases with age.  A person who is homozygous for one gene has an increased deficit and will often show symptoms earlier in life.  Most of those who are homozygous for both genes do not survive fetal life. If a person is heterozygous for both genes it can reduce the methylation process by up to 70-80%.

About 10% of the North American population are homozygous for the C677 gene.  The risk is higher for those of Mediterranean/Hispanic descent, and less for those of African descent.  This population will generally have elevated homocysteine, and are at increased risk for heart disease, stroke, certain leukemias and colon cancer.  There is also an increased risk of schizophrenia, dementia and Alzheimer’s.

The A1298 mutation does not seem to affect the MTHFR enzyme or increase homocysteine levels.  It does, however, affect the conversion of MTHF to BH4, an important cofactor in the production of neurotransmitters, synthesis of the important nitric oxide, and detoxification of ammonia.

 Treatment for the MTHFR mutations

 A genetic mutation cannot be fixed, but the nutrients that cannot be created by the body can be given in the form of supplements.  The most important are providing the activated forms of folate and B-12 that are already methylated, since the body is unable to do that well.

When a body has been depleted of adequate amounts of activated folate and B-12, often toxins have built up.  Sometimes if high levels of these vitamins are taken negative symptoms occur because the body starts detoxing heavily.  We recommend starting slowly and building up, and if you suspect high levels of heavy metals or other toxins see your integrative health care practitioner for testing and specific detox protocols.

We recognize that diet is all important, especially eating whole rather than processed foods, which support how the genes are expressed.  Processed foods also often have folic acid as an additive, which can make the problem worse. 

We often start our patients on the multivitamin-mineral supplement SpringTree SuperMulti Plus, which has 1000 mcg each of 5 MTHF and methylcobalamine, along with many co-factors that assist with their function.  Only a very small percentage react negatively to that amount with symptoms of over-methylation (irritability, depression, anxiety, sore muscles, headaches, joint pain, migraines, rash, acne, heart palpitations, nausea, insomnia).  SuperMulti Plus is also a good supplement to use when you know you have a mutation but have no symptoms, to assist in preventing future problems.

If there are no negative effects from SuperMulti Plus, we may add the supplement SpringTree Methylation Factors, which includes the activated B-vitamins, B-6, trimethylglycine (another methyl donor) and added ingredients to reduce the risk of becoming over-methylated.  Depending on the severity of the mutation and the symptoms of the patient, we can have the patient take 1 to 3 or more capsules per day.

SpringTree Methylation Factors

At $24.95 per 90-count bottle, Methylation Factors is probably the least expensive high quality methylation supplement on the market.  It has added ingredients most other methylation supplements don’t have with the goal to improve the breakdown of the methyl products after they are used to reduce the risk of over-methylation.

Each capsule contains:
·         5-MTHF 1000 mcg—the activated form of folate
·         Methylcobalamine 1000 mcg—the activated form of B-12
·         Pyridoxyl-5-Phosphate                 25 mg—the activated, methylated form of B-6, often necessary in the cell’s utilization of B-12 and folate
·         Betaine Anhydrous (Trimethylglycine) 250 mg—a methyl donor
·         Riboflavin 25 mg—low levels of riboflavin may interfere with the metabolism of folate, particularly in individuals homozygous for the MTHFR C677T gene variant
·         Zinc  5 mg—many of the enzyme processes utilizing B-12 and folate are zinc dependent
·         Inositol Hexanicotinate (non-flush niacin) 25 mg—used in breaking down methyl products after they have been used; reduces the “over-methylation” effects
·         N-acetyl-cysteine 100 mg—the precursor of glutathione, more absorbable and less expensive than glutathione itself.  An MTHFR mutation may reduce the production of glutathione, the body’s most powerful anti-oxidant and detoxifier.  Increased glutathione also reduces the “over-methylation” effects by both means—reducing oxidation and detoxifying.
·         Tumeric  100 mg—many people with MTHFR mutations have high levels of inflammation which increase the risk of side effects from methylation products.  Tumeric has been shown to reduce inflammation and prevent increased pain.
·         Milk Thistle Extract 150 mg—supports the liver through the increased detoxification that comes with taking the methylated vitamins.
·         Potassium 50 mg—restoring  B-12 after long-term deficiency can cause potassium deficiency because as B-12 is restored, the body starts making more blood cells, and this process uses up potassium, increasing muscle pain and spasms.

Caution is advised to start slow and increase slowly.  If one capsule causes symptoms, start with just a methylcobalamine supplement to get the body used to the methylation.  Some people need higher levels of niacin to break down the extra methyl products.  Work with an integrative health care practitioner that is knowledgeable in the MTHFR mutations.  With care the great majority of people with these mutations can improve in health and well-being.

Monday, January 12, 2015

Osteoporosis Medications -- Do they really help?

An 88 year old patient arrived at my office today after a hard fall from a ladder to the ground onto her right hip.  She was very sore and bruised, but I was surprised that there was no fracture.  She is a feisty woman, and said, "I take all kinds of things for my bones except medicine, because I don't want to die like my mother.  She had osteoporosis and they gave her Fosamax.  She had a spontaneous fracture in her thigh bone, one of those strange ones that those drugs cause, and she went downhill from there, dying soon after."

Why not take osteoporosis medication?  This blog will tell both sides of the story.

Osteoporosis a progressive bone disease that is characterized by a decrease in bone mass and density which can lead to an increased risk of fracture.  Fractures in the elderly are often devastating and increase risk of death, but more than that is the debility from the pain of spinal compression fractures.

Osteoporosis in and of itself causes no pain or other symptoms.  The pain associated with osteoporosis is usually related to spinal vertebral compression fractures or other fractures, most often rib, hip and wrist.  They happen in situations in which a normal person would not get a fracture, so they are called "fragility fractures." 
The most important risk factors for osteoporosis are advanced age (in both men and women) and female sex; estrogen deficiency following menopause or oophorectomy is correlated with a rapid reduction in bone mineral density, while in men, a decrease in testosterone levels has a comparable (but less pronounced) effect.  There are higher levels in those of European or Asian ancestry, and it can be hereditary.

 There are several things that are modifiable that can increase the risk of osteoporosis:
  • Excessive alcohol consumption
  • Vitamin D deficiency
  • Tobacco smoking
  • Eating disorders, underweight and malnutrition
  • Inactivity and the opposite--endurance training
  • Heavy metals, especially cadmium and lead
  • Excessive soft drink consumption
  • The extensive use of steroids such as prednisone
  • Long term use of proton pump inhibitors (antacids used for GERD and ulcers)
  • Other medicines such as lithium, anti-epileptics, too high levels of thyroid medication, anticoagulants, some diabetic medications
There are two major types of bone remodeling cells:  osteoclasts, which remove old or injured bone (bone resorption), and osteoblasts, which build new bone (bone formation). They are both very important for the maintenance of strong, healthy bones.  In osteoporosis there is an imbalance of bone formation and resorption.  Either peak mass was never reached because of malnutrition, etc., or there is decreased formation and/or increased resorption.

The osteoporosis medications called bisphosphonates work by suppressing a key enzyme in osteoclasts, causing these cells to die.  Without osteoclasts to clean out old or injured bone cells, the osteoblasts build new bone on the old sick bone, creating an unhealthy foundation.  The bones are thicker, which is what is measured by bone density exams, but not necessarily always stronger.  The use of bisphosphonates increases the risk of atypical femoral fractures (the thigh bone).

Other side effects you may experience from bisphosphonates.  Many doctors do not do the proper follow up care, and are not even aware that they should be watching for these effects:

  • Lower levels of calcium in your blood (hypocalcaemia) – This is because it takes calcium and other minerals from your blood to build the bone more rapidly.  You need blood tests to check the levels of calcium and other minerals such as potassium and magnesium
  • Bone and joint pain can be controlled by a mild painkiller such as paracetamol
  • Changes in your bowel movements (constipation or diarrhoea) that usually only last for a few days – it is important to drink plenty of fluids (6 to 8 glasses a day)
  • Tiredness and low energy levels may occur with some types of bisphosphonates but are usually mild
  • Feeling sick is usually mild and gets better after a few days – if it continues or is severe, your doctor or nurse can give you anti sickness tablets
  • Kidney damage – you will have regular blood tests to check how well your kidneys are working
  • Damage to the jaw bone (osteonecrosis) is a rare side effect that may happen if you take bisphosphonates for longer than a year. You should have a dental check up before you start treatment. Always tell your dentist that you are having bisphosphonate therapy or tell your doctor if you need dental treatment
  • Esophagitis. Tell your doctor If you already have a condition of your esophagus or if you develop new symptoms such as pain or difficulty swallowing.  It is important to follow directions on when to take the medication, how to take it, when to eat, etc.

  • If you choose to take one of these medications, it is important to ask your doctor to watch for these problems.

    If you choose to not take these medications, luckily there are other things you can do which often work as well or better than the medications without causing abnormal bone to grow.

    1. Calcium -- ideally from foods such as eggs, fish, meat, almonds, liver, bone meal, dairy (not the best source of calcium), potatoes and green vegetables.  If supplementing don't take more than 800 mg because the body doesn't absorb more than that, if that much.  Taking more than 1000 is associated with an increase level of atherosclerosis (hardening of the arteries).
    2. Vitamin K2 -- fermented dairy foods and soy contain vitamin K.  Vitamin K2 assists in moving calcium around in the body--such as to your bones rather than lining your arteries.
    3. Magnesium -- vital in helping your body absorb calcium.
    4. Vitamin D3 -- test your Vitamin D, 25-hydroxy levels, you want the levels to be between 50-80 ng/mL.  Vitamin D is essential to the bones--low levels can cause Ricketts, a softening of the bones.
    5. Boron -- supports the function of Calcium, Magnesium, and Vitamin D.
    6. Vitamin C and vitamin E are also important for bone health.
    SpringTree SuperMulti Plus contains all of these at optimal levels, plus much more.

    Of course, regular light to moderate exercise, including weight bearing exercise, signals your bone cells to keep working to remodel and rebuild healthy bone with the natural nutrients you are giving your body.

    Bio-identical hormones are necessary for some women and men who have severe osteoporosis to assist in building bone.

    If you have arthritis remember that it is important to also support the bones, which provide a healthy foundation while controlling the inflammation in the joints.

    The summary of this is that bisphosphonate medications DO increase the density of bones, but do not create normal bone, and there is increased risk for atypical hip fractures.  There are also side effects from the medications that you don't get from the natural supplements.  However, each person gets to decide for themselves what course of treatment to follow.

    Until we meet again,
    Dr. Judi