ACAM Integrative Medicine (IM) Blog

Pharmageddon: Can a New Weight Loss Drug Really Save Us?

by Mark Hyman, MD

This week, in an act of desperation to turn back the tide of the obesity epidemic that now affects almost seven out of every ten Americans and over 80% of some populations (African American women), the advisory committee to the Food and Drug Administration (FDA) voted 20 to 2 to recommend approval of Qnexa, a “new” obesity drug that is simply the combination of two older medications, phentermine (the “phen” of phen-fen”) and topiramate (Topamax).

It is a misguided effort at best, and a dangerous one at worst.  Mounting evidence proves that the solution to lifestyle and diet-driven obesity-related illnesses including heart disease, diabetes, dementia, and even cancer, won’t be found at the bottom of a prescription bottle.

By 2020, over 50% of the US adult population will have type 2 diabetes or prediabetes, with annual costs approaching $500 billion. By 2030, total annual economic costs of cardiovascular disease in the US are predicted to exceed $1 trillion. By 2030, globally we will spend $47 trillion; yes trillion, to address the effects of chronic lifestyle-driven disease.

Prescription medication for lifestyle disease has failed to bend the obesity and disease curve.  Statins have been recently found to increase the risk of diabetes in women by 48%. And large data reviews by independent international scientists from the Cochrane Collaborative found that statins only work to prevent second heart attacks, not first heart attacks, which means they are not helpful and most likely harmful for 75% of those who take them.

Avandia, the number one blockbuster drug for type 2 diabetes has caused nearly 200,000 deaths from heart attacks since it was introduced in 1999.  The drug was designed to prevent complications of diabetes, yet heart attacks are the very disease that kills most type 2 diabetics. In 2011, the FDA issued stricter prescribing guidelines for Avandia, but the drug is still on the market.

The large ACCORD trial found in over 10,000 diabetics that intensive blood-sugar lowering with medication and insulin actually led to more heart attacks and deaths.

Something is deeply wrong with our medical approach.

The problem of chronic disease, including obesity, diabetes, and heart disease, is not a medication deficiency, but a problem with what we put at the end of our fork.

The emperor truly has no clothes.  Why would good men and women of science vote to approve a medication for a condition that is a social disease and requires a social cure?  The social, environmental, economic, and political conditions of America and increasingly the global community have created an obesogenic environment.

Clearly we need to do something.  But it is not better medication or surgery or more angioplasties and stents, which have no proven benefit in over 90% of those who receive them. The data show they work for acute coronary events, but not stable angina or blockages.

We continue to pay for expensive treatments for chronic disease, despite the fact that they don’t work, while insurance does not pay for nutrition counseling unless the patient has kidney failure or diabetes.

Chronic disease is a food-borne illness.  We ate our way into this mess and we must eat our way out.

How is your Glutathione?

by Matt Angove, ND, NMD

In 1994, the Journal of Nutritional Biochemistry stated, “Disease states due to glutathione deficiency are not common.”

Well, 25 years and 90 thousand journal articles later we have found this statement to be false on all levels. Glutathione is recognized as an extremely important intracellular antioxidant that also plays a central role in the detoxification and elimination of potential carcinogens and toxins. Studies have found that glutathione synthesis and tissue glutathione levels become significantly lower with age, leading to decreased ability to respond to oxidative stress or toxin exposure.

The higher the glutathione peroxidase in the plasma or red blood cells, the more your body is running through and out of glutathione. Now consider the follow…

Total glutathione peroxidase activity was elevated in females 65 years of age or older. Cigarette smoking significantly elevated glutathione peroxidase. Alcohol elevated glutathione peroxidase, with the highest levels seen in drinkers who also smoked. Increased glutathione peroxidase was also seen in vigorous exercise, especially triathletes and marathoners.

According to the National Cancer Institute, dairy products, cereals and breads are low in glutathione. Fruit and vegetables have moderate to high amounts of glutathione. Frozen versus fresh foods had similar amounts of glutathione. Processing and preservation resulted in considerable loss of glutathione.

A 27% reduction in glutathione has been reported in the cerebrospinal fluid of schizophrenic patients.

Studies have shown that dietary glutathione enhances the metabolic clearance and reduces net absorption of dietary peroxidized lipids, which cause intense cellular damage.

• High altitude exposure reduces glutathione levels.
• Glutathione functions as an antioxidant and can maintain vitamin C in its reduced and functional form.
• Chronically low glutathione levels are seen in premature infants, alcoholic cirrhotics and individuals with HIV.

Glutathione increases sperm motility patterns and sperm morphology. In a double-blind, placebo-controlled crossover trial of infertile patients, patients were randomly and blindly assigned to treatment with one injection every other day of either glutathione at 600 mg or an equal volume of placebo. All the glutathione selected patients showed an increase in sperm concentration and a highly statistically significant improvement in sperm motility, sperm kinetic parameters and sperm morphology. Want to get pregnant? Make sure your husband has optimal levels of glutathione.

From the journal of Digestion: Glutathione is extremely important in normal functioning of the pancreas, being needed for normal folding of the proteins that will ultimately form key digestive enzymes when the pancreas is stimulated after a meal. In patients with chronic pancreatitis, it has been found that glutathione is often significantly depleted, suggesting that lack of glutathione has a role in the generation and/or maintenance of the disease. In addition, many patients suffering from chronic pancreatitis appear to be under xenobiotic or oxidant stress, creating an even greater need for glutathione. Since the pancreas is under relative glutathione “stress” during the normal process of packing and secreting digestive enzymes, it is easy to see how the lack of glutathione could have a role in chronic pancreatitis.

From the Journal of Brain Research Reviews: Glutathione depletion can enhance oxidative stress and may increase levels of excitotoxic (toxins that excite neurons to the point of death) molecules, which may initiate cell death in specific nerve cell populations. Evidence of oxidative stress and reduced glutathione status is found in Lou Gehrig’s disease, Parkinson’s disease and Alzheimer’s disease.

From the Annals of Pharmacotherapy: Glutathione is important in DNA synthesis and repair, protein and prostaglandin synthesis, amino acid transport, metabolism of toxins and carcinogens, enhancement of immune function, prevention of oxidative cell damage and enzyme activation.

From the Journal Acta Dermato-Venereologica: Low levels of blood glutathione were found in patients with pemphigoid, acne conglobata, polymyositis, rheumatoid arthritis, scleroderma, systemic lupus erythematosus, atopic dermatitis, eczema and psoriasis.

From the Journal of the Federation of American Societies for Experimental Biology: Intracellular glutathione enhances the immunologic function of lymphocytes (perhaps the most important immune cell line in preventing infection and cancer). Low levels of glutathione limit the optimal functioning of T cells. Cytotoxic T cell (necessary to eliminate cancer) responses and interleukin-II-dependent functions are inhibited even by a partial depletion of the intracellular glutathione pool.

From the journal of Ocular Pharmacological Therapy: Susceptibility of the lens nucleus to oxidative damage and loss of transparency has been shown in experimental animal models, including exposure to hyperbaric oxygen, x-ray and UVA light. Depletion of glutathione allows the levels of oxidant to damage lens tissue and structure. From the Journal of Laboratory and Clinical Science: An increased incidence of low glutathione levels in apparently healthy subjects suggests a decreased capacity to maintain metabolic and detoxification reactions that are stimulated by glutathione. The authors stated that glutathione status, physical health, and longevity are closely related.

From the Lancet: The plasma glutathione in young, healthy adults was 0.54 umol/L; in healthy elderly it was 0.29 umol/L; in elderly outpatients it was 0.24 umol/L; and in elderly inpatients it was 0.17 umol/L. Aging results in a decrease in plasma glutathione and an increase in oxidative damage in apparently healthy individuals.

Simply put, if you want young cells and the ability to overcome disease you need to work on getting your glutathione levels up!

 

Visit Dr. Matt Angove's blog here for more information http://drwholeness.com/blog/.

Eat Your Greens

by Therese Patterson, NC

Most people don’t realize that not all types of salad greens are created equal. I personally like to include a variety of different types of lettuce in my salad. Not only will a variety of greens allow you to enjoy a variety of different flavors and textures, but you also get to enjoy the range of nutrients each green has to offer. And while lettuce or salad greens are not often recognized as a great source of nutritional value, some varieties pack a surprising vitamin and mineral punch as you can see from the chart below.

Nutritional Comparison of Salad Greens Based on a 1 Cup Serving

Salad Greens	Calories	Vit A (IU)	Vit C(Mg)	Calcium (Mg)	Potassium (Mg)
Romaine	8	1456	13	20	65
Leaf Lettuce	10	1064	10	38	148
Butterhead (Bib and Boston)	7	534	4	18	141
Arugula	5	480	3	32	74
Mixed Greens	9	1495	9	30	174
Baby Spinach	7	1200	8	20	–
Iceberg	7	182	2	10	87

Iceberg lettuce is included in the chart, not because I recommend it, but because it is so commonly served when eating out. Romaine lettuce has eight times more vitamin A and six times more vitamin C than iceberg lettuce, so iceberg would not be my lettuce of choice. After selecting your salad greens, creating a wonderful salad is only limited by your imagination— nuts, seeds, fish, poultry, beans, cheese, grains (try a spinach salad with lentils, garbanzo beans, tomatoes, cucumbers, feta and a light vinaigrette of olive oil and lemon juice-yum-o!).

Calorie for calorie, leafy green vegetables like spinach, with its delicate texture and jade green color, provide more nutrients than any other food. Baby spinach is a good source of calcium, fiber, iron, magnesium, provitamin A and vitamin C.