Michael Carlston, M.D. - Family Practice & Complementary Medicine

Carlston, M.D.
Family Practice and Complementary Medicine

www.carlstonmd.com

May 3, 2007

Dear Patients

I think you will find this newsletter interesting. It covers a wide range of topics so something in it will be of relevance for you. Maybe another way of looking at it is that it is like the weather, it is all over the map. Look for an announcement of my new multiple vitamin and mineral supplement very soon. I am excited about it.

Best,
Michael Carlston, MD
www.carlstonmd.com

The Highs and Lows of Blood Pressure
Exercise Reduces Breast Cancer Risk
Hormone Replacement Therapy
Beef
Vitamin D – New Recommendations and Wheezing
Food, Supplement and Herb Purity

The Highs and Lows of Blood Pressure
In the medical/media hype pushing for lower blood pressure normal levels, the downside of low blood pressure for many is overlooked. Many people, including some suffering from chronic fatigue syndrome, have symptoms from their blood pressure being too low. A link between Alzheimer’s and low blood pressure has been reported. More recently an analysis of the death rate of people 85 or older demonstrated a connection between “normal” blood pressure and an increased risk of dying.

People whose upper blood pressure number (systolic blood pressure) was less than 140 were 35% more likely to die than everyone else. Those individuals whose systolic BP was elevated above 159 were no more likely to die than those whose blood pressure was only elevated in the 140-159 range. So the highest risk group included those people who had a “good” blood pressure. It seems that what is “good” in this age group needs some reconsideration.

These data found that elevated blood pressure in elderly people did not increase their risk of death, and might, in fact, be healthier. I would not overreact to this information, however, as markedly elevated blood pressure in the elderly still appears to be associated with problems (strokes, kidney damage), and the effect on quality of life was not measured in this study. This reminds me of the research showing a similarly inconsistent relationship between “elevated” cholesterol in the elderly and living longer. Hopefully, it is a reminder to all of us to avoid overreaching assumptions.

Exercise Reduces Breast Cancer Risk
Regular exercise is one of the most powerful things you can do to maintain and improve your health. A recent study confirmed the beneficial effect of exercise on breast cancer rates.

15,000 women, half with a history of breast cancer, were interviewed about their breast cancer risk factors and lifestyle patterns. Nearly 80% of the women with a history of breast cancer had an aggressive form (invasive) of the disease. Exercising strenuously for 6 or more hours a week reduced the risk of invasive breast cancer by 23 percent.

Unfortunately exercise did not reduce the risk for women with a family history of breast cancer.

Hormone Replacement Therapy
The new, more detailed analysis of the Women’s Health Initiative study data is generating confusion, and unmasking the biases of publishers. The outcomes of this data analysis have been slanted in all directions in the media. Some articles were written as if this proves hormones are safe. The reality is that the study showed that using hormones closer to menopause is just less risky than using them later. While that is good news, especially to women who really want to use them temporarily to cope with hot flashes, it is quite at odds with the “now we know they are safe” portrayal. In fact, we have more and more data showing a marked drop in cancers since the study a few years ago that strongly linked hormone replacement therapy with cancer.

Beef
If you eat food laden with sex hormones, there is a good chance it will have hormonal effects on you. Seems pretty obvious doesn’t it? Now, if you are pregnant, you can expect the effects to extend to the developing child you carry.

A study in the medical journal, HUMAN REPRODUCTION, reports that sons born after their mothers ate large amounts of beef during pregnancy are more likely to have low sperm counts and difficulty with fertility. As the average male sperm count for the last 20 years is below the level considered infertile 50 years ago, this is not good news, or maybe it is. The news might be good, as it may provide an explanation for that dropping sperm count, and show us what should be done.

Vitamin D – New Recommendations and Wheezing
A panel of experts called for a reassessment of international agency Vitamin D recommendations. Published in the AMERICAN JOURNAL OF CLINICAL NUTRITION, they wrote that current advice is erroneous and places the public needlessly at risk. Based upon recent scientific findings, they recommended that the tolerable upper intake level of D3 should be raised to 10,000 iu/day. They also recommended that supplement manufacturers increase the level of vitamin D in their products, and governments consider increasing vitamin D fortification of foods.

Two studies of maternal vitamin D intake and wheezing found a strongly protective effect from vitamin D. Wheezing in young children is very common and often later diagnosed as asthma. Women who consumed an average of 724 iu of vitamin D daily during pregnancy were 61% less likely to give birth to a child who suffered from wheezing than women who average 356 iu/day. Receiving the D from food or supplementation had the same impact. Every 100 iu of Vitamin D reduced the likelihood of wheezing by 19%. The other study confirmed the same pattern, but also discovered that children born from low vitamin D moms were less responsive to bronchodilators. So, children with low vitamin D were more likely to need a medication but then the medication was less likely to be effective.

Food, Supplement and Herb Purity
Recent headlines have offered a disturbing reminder of the importance of food and supplement purity. When I was young, gas stations offered a variety of promotions to encourage motorists’ loyalty. One of the more practical was the plastic melamine plate giveaway. Now, you can get it for free in food for you pet and yourself. This is progress?

Melamine is used to make plastics. Interestingly, it also makes food materials test falsely high for protein. It is also cheap. Consequently, the product appears to be more nutrient rich and valuable. So, in China, some have been adding it to animal feed. The problem is that it is toxic as well. Since the pet food contamination was discovered, there have been other discoveries, including the one that 3 million American chickens were fed melamine-containing feed. All of those chickens have already been eaten. As of last Friday the FDA announced it would begin testing imported vegetable proteins (wheat gluten, corn meal, rice protein, etc) for melamine contamination.

As one reader of this newsletter pointed out to me, this is only the tip of a contaminated iceberg. Spot on.

A colleague who is one of the world’s experts on the science of herbal medicine and runs the research and development department of an herbal manufacturing company in Asia, tells me that they have to reject 30% of the herbs they buy from China and India. The usual reason is that they are contaminated with pesticides. Studies have confirmed the frequency of this problem. At one point it got so bad that the Chinese government temporarily shut down herbal manufacturers to improve oversight. Unfortunately the problem remains. While it is certainly not always the result of deliberate deception, environmental contamination and misidentification of herbs will be an issue for the foreseeable future.

Please respond to these facts by making certain that the herbs and supplements you use have been tested both for purity and to confirm that what is on the label is inside the bottle.

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May 3, 2007

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