Can Proton Pump Inhibitors Accentuate Skin Aging?

Skin aging has long been important to human beings and in recent years this field has received tremendous attention by both researchers and the general population. Cutaneous aging includes two distinct phenomena, intrinsic aging and photoaging, and is characterized mainly by the loss of collagen fibers from dermis.

PPI's (by inhibiting the stomach's hydrochloric acid secretion) raise the pH of the stomach juices and surrounding environs to a markedly more alkaline milieu.... and increase intralysosomal (inside the lysosome) pH. By changing the original acid base balance to a more basic medium TGFB secretion is decreased and lysyl oxidase which needs copper to do its job in cross linking collagen to make new skin can't do it's enzymatic best because it may not get the "copper on demand" it requires even though the supply is there.

With this new information on how proton pump inhibitors can accentuate skin aging, they should no longer be viewed as a safe first line therapy for acid reflux.It has been known for some time that PPI's prevent the absorption of certain vitamins (specifically B12)and minerals (specifically calcium) promoting osteoporosis. What we tend to forget is that they primarily prevent normal digestive processes from occurring leading to a myriad of gastrointestinal problems, physician visits and other prescription drug usage with their attendant side effects.

To your health,

Dr. David Blyweiss

Storing Leftovers can "leave" BPA in your system

What do you store your leftovers in? If you’re like most people, you probably use plastic. But that isn’t the healthiest option.

I’ve been concerned about the health effects of plastics since I first learned about them back in the 1990s. Since then, research has shown that those handy plastic containers you put your food in contain dubious chemicals like bisphenol A (BPA) and polyvinyl chloride (PVC) that can leach into your food.

A 2008 study in the Journal of the American Medical Association found that people with the highest levels of BPA were twice as likely to suffer from heart disease and diabetes than those with the lowest levels. These substances can disrupt crucial antioxidant and DNA activity in the body, as well as the normal functioning of the endocrine system. But what worries me even more is that, once inside the body, BPA acts like the hormone estrogen. Based on this characteristic, new studies link BPA to reproductive damage in both men and women. It also boosts the risk of developing breast cancer.

Unfortunately, it’s hard to avoid BPA. Along with some food storage containers, you can also find this hormone-disrupting chemical in plastic water bottles and even in the cans that hold many of the foods you eat. The FDA says that this isn’t a threat, but a new Consumer Reports’ test of canned foods (including soups, juice, tuna, and green beans) found that almost all of the 19 name-brand foods tested contain some BPA.

The consumer group reports that a 165-pound adult eating one serving of canned green beans could ingest 80 times more BPA than the recommended upper daily limit. Children eating multiple servings of canned foods daily with BPA levels comparable to the ones they found in some of the tested products could get a dose of BPA approaching levels that have caused adverse effects in several animal studies.

Perhaps most telling is that in Japan major manufacturers voluntarily changed their can linings in 1997 to cut or eliminate the use of BPA because of concerns about health effects. A 2003 Japanese study found that the levels of the chemical in subjects’ urine dropped by 50 percent after the change in cans was made.

But BPA isn’t the only problem. The PVC used in many brands of plastic wrap is also problematic. This type of plastic contains phthlates—plasticizers which have a similar estrogen-like effect in the human body. And like BPA, PVC has been associated with infertility problems and abnormalities of genital development.

Ideally, you should switch to glass, metal or ceramic containers to store your leftovers. But, I know that’s next to impossible. The next best option is to become well-versed in how to pick your plastics. The best way to tell if a plastic container contains BPA or phthalates is to look at the number on the bottom of the container. Containers marked with a 1, 3, or 7 contain phthalates or BPA, while ones labeled with 2, 4, or 5 are safer.

If plastic storage containers are used, never expose them to heat or use them in the microwave. This can cause even greater leaching. Remove cling wrap from any store-bought meats, cheeses and fish and repackage them in a safer container. It’s also important to throw away any container that is scratched or appears worn since bacteria can hide in these nooks and crannies.

While it’s difficult to completely avoid plastics, minimizing its use can reduce the overall amount of plasticizing chemicals that wind up in your body. And, even though it might seem like a bit more effort when storing your holiday leftovers, opting for safer alternatives to BPA- and PVC-laced containers can give you a big health payoff for years to come.

To your better health,

David Blyweiss, MD

Too Little Sleep Leads to Too Many Pounds!

Research into the causes of obesity have expanded out into the "sleep" world. A study conducted by the European Centre for Taste Sciences in Dijon Cedex, France, shows that sleep deprivation increases your appetite! Both food intake and activity levels of 12 men (average age 22) were measured after they had been allowed either 8 hours of sleep or only 4 hours of sleep.

The results showed that after less sleep the previous night, the men reported feeling hungrier during the day, especially before breakfast and before dinner. They ate approximately 22% more calories following a night of too little sleep but oddly, were more physically active during the day (trying to stay awake?).

The hormones Ghrelin (made in the GI tract which triggers increased calorie intake) and Leptin (made in the fat cells to turn off the desire for more calories) are two of the master controllers of hunger and how much we eat. We've known for some time that lack of proper sleep—8 or more hours of restful restorative sleep--increases stress cortisol and affects insulin sensitivity resulting in increased belly fat. This new information reveals that lack of sleep increases ghrelin (and the consumption of refined carbohydrate rich foods) and decreases leptin (a master governor of caloric intake). Unfortunately for morbidly obese people battling the bulge, it appears that the fatter you are the greater your level of sleep apnea which, in turn, continues the cycle of poor sleep which helps keep you fat.

The next step in weight management may well include diagnosis and treatment of apneic sleep and assuring other patients of consistent, quality sleep time to help keep their weight down.

To your good health,

Dr. David Blyweiss

A Gut Feeling

If your bowels aren’t happy, you aren't either. And ulcerative colitis and Crohn's disease—collectively known as inflammatory bowel disease or IBD—can make you very unhappy. In my Boca Raton functional medicine practice, inflammatory bowel disease is one of the main disorders we treat.

IBD is a chronic, relapsing and debilitating condition affecting a patient’s lifestyle and mental state, often causing social embarrassment and isolation. No one knows what causes it or how to prevent it, but at its most basic, IBD involves inflammation of the intestines because of abnormal activation of the immune system. And that can have wide-ranging ramifications throughout the body.

The most common conventional treatments for IBD involve heavy-hitting drugs that include steroids and immunosuppressants. Accompanying these are side effects including anemia, easy bruising, frequent infections and mood swings. Because of the frequency and severity of these side effects, many patients prefer the symptoms of the disease to the problems that accompany treatment.

But if you have IBD, the symptoms—which can include rectal bleeding and diarrhea—aren’t the only thing you have to worry about. When your gut is damaged, your body can’t absorb the critical nutrients it needs to function properly, especially protein, unrefined carbohydrates, healthy fats, water, and many vitamins and minerals. This is especially true if you’ve had surgery to remove part of the bowel.

Because of this, many doctors recommend a multivitamin-mineral supplement for anyone with IBD but if you are taking a standard vitamin pill you might as well flush your money down the toilet! Vitamins made with fillers and binders take too long to break down and become absorbed into your bloodstream. This is especially true if you already suffer from absorption problems. What you need is a comprehensive high-potency liquid multi that is rapidly absorbed by the body.

You also want a multi that contains iron. Most don’t, so check the label. Often, iron absorption is limited if you suffer from IBD and that can compromise the production of the red blood cells that carry oxygen to your body’s tissues. You should have your iron levels checked every year during your annual checkup.

While everyone with IBD is a little bit different, certain foods tend to make symptoms worse. Here are my recommendations for anyone with either ulcerative colitis or Crohn's disease:

• Avoid clothing that is tight around the waist.
• Drink plenty of purified water.
• Eat more natural foods in smaller portions more frequently during the day. Just be aware that fruit may cause problems on an empty stomach
• Avoid high-fat foods. These foods speed up the time it takes food to travel through your intestine. This can cause diarrhea and further prevent proper nutrient absorption.
• Do not eat foods containing artificial fats and sweeteners. Artificial fats (like Olestra) and sweeteners (like sorbitol and aspartame) often cause diarrhea.
• Steer clear of caffeine and soft drinks. Like fat, caffeine also speeds up the movement of food through your intestines and can promote diarrhea.
• Avoid spicy foods since they can cause a flare up. Specific spices to watch out for are black and red pepper, chili peppers and powders, nutmeg and mustard.
• Avoid foods known to cause problems, either through your own experience or through lab testing.
• Avoid the chronic use of prescription and over-the-counter gut-altering medications like NSAID’s, proton pump inhibitors or acid blockers. This can cause mineral deficiencies.
• Feed the gut what it needs (after testing). Initial regimens usually consist of pre and probiotics, colon cell nutrition (glutamine and short chain fatty acids and omega 3 fatty acids.
• Find ways to consistently reduce stress. Stress suppresses good gut bacteria and necessary serum immunoglobulin A.

It’s also important to mention enzymes. It isn’t uncommon for people with IBD to be deficient in pancreatic enzymes. Taking digestive enzymes may not only reverse this deficiency, it will also enhance nutrient absorption. While most multivitamins don’t include critical enzymes, I’ve included an array of important digestive enzymes in my liquid multivitamin-mineral.

IBD is a serious, chronic, perplexing disease. As with so many chronic diseases, it’s a combination of genetics and environment—the persistent stimulus in an individual who has a genetic predisposition to this disease. Managing IBD symptoms, while challenging, requires a proactive nutritional approach—starting with the tips I’ve outlined above. And, ultimately, you should always trust what your gut is telling you so that the “gut feeling” you get is the best you can have.

To your good health,

Dr. David Blyweiss

Burned Out? Stress May be Weakening Your Adrenal Glands!

If you are overworked, overstressed, or simply feel overwhelmed, you may be setting yourself up for problems. Chronic stress will weaken your adrenal glands and can seriously compromise your body's ability to reenergize. Known as adrenal fatigue, this energy thief seems to be affecting more and more Americans. That’s one reason why I am seeing an uptick in patients with nondescript ailments or a variety of unrelated health problems that range from insomnia to muscle pain to low blood sugar.

The adrenal glands secrete cortisol and adrenaline, hormones that kick into high gear during moments of intense anxiety or physical strain. If stress has become your status quo, constant cortisol and adrenaline secretion may deplete your adrenal glands and wipe out your energy reserves.

Although stress affects everyone in different ways, I’ve found that most people can endure two to five years of a high-pressure lifestyle before reaching adrenal fatigue. The amount of time it takes to recover from adrenal insufficiency depends on how depleted you are, but it can be anywhere from months to years. The good news: Simple tweaks to your self-care regimen can work wonders in boosting your adrenal health.

Vitamins C and B5 are particularly important to adrenal health. Increase your vitamin C intake by taking 1,000 to 4,000 mg. of supplemental C daily...Read More.

David J. Blyweiss, M.D.

Functional Medicine Physician

Sanctuary Medical Aesthetic Center

Boca Raton, FL

Anti-inflammatory supplements lower inflammation in a study of healthy, overweight men

It’s long been thought that a primary contributor to disease is the presence of low-grade chronic inflammation, especially in individuals who are overweight. What too many physicians fail to understand is that unrecognized and untreated silent, systemic, low-grade inflammation is the root cause of all chronic degenerative illness...whether it be heart disease, obesity and diabetes, dementia or cancer.

Netherlands scientists recently performed a study of overweight (but otherwise healthy) men to see if the use of certain supplements might lessen inflammation and, therefore, lessen the potential to develop diseases. The researchers treated the test subjects with only a handful of common nutrients known for their anti inflammatory effect...with good results. The supplements included green tea extract, Vitamins E and C, Resveratrol, Omega 3 fatty acids and tomato extract.

In the study, the scientists used C-reactive protein as an inflammatory marker (interleukin 6 is another). A CRP test is a common blood analysis here in the US used to reveal the level of inflammation in an individual’s body.

The men were split into 2 groups, one group receiving a placebo and the other receiving the supplements for a period of 5 weeks. Blood draws and urine samples were taken to measure nflammatory and oxidative stress defense levels along with 120 plasma proteins, 274 lipids, free fatty acids, and polar compounds, and the transcriptomes of peripheral blood cells and fatty tissues.

The results of the study were not as clear-cut as hoped. Although the plasma adiponectin concentrations increased by 7%, showing improvement (low plasma adiponectin levels are found in obese individuals and predict the development of type 2 diabetes) but C-reactive protein levels did not change—in other words, the levels of inflammation remained constant. Nevertheless, some slight changes were detected such as decreased inflammation of fatty tissue, improved endothelial function, affected oxidative stress, and increased liver fatty acid oxidation, all positive indicators that the supplements were improving the individual’s levels of inflammation.

This study leads researchers to believe that the use of certain dietary supplements can decrease inflammatory processes. If this is the case, it shows great promise for a non-drug treatment that can be started with many individuals right now.

The list of things which cause chronic inflammation and, therefore, chronic disease is short and relatively easy to modify or rid yourself of. They include:

• Poor food choices such as refined white sugar and corn syrup, flour and rice, processed foods with saturated and trans fats;
• Stress
• Lack of exercise
• Chronic or hidden infections: viruses, bacteria, parasites and fungi
• Hidden environmental or food allergies
• Heavy metal or pesticide or mold toxicities

An anti-inflammatory lifestyle is easier to follow than you might think, but you have to be the one to lead it, too.

The study can be found by following this link.

Feel free to send me a health question!

To your health,
Dr. David Blyweiss

The Effect of Low Hormones on your Emotions

Slowly and steadily our hormone levels begin to decline as we age, beginning in our late 20’s to early 30’s. This may cause vague or mild symptoms in some. At some point, more significant and different symptoms develop including emotional lability, anxiety, depression, irritability and moodiness. This is the beginning of the unfortunate years-to-decades-long period of wildly fluctuating hormones known as perimenopause. It is the fluctuation of hormone coupled with the decline that is responsible for these symptoms. It is the same type of imbalance that is responsible for the same set of symptoms in many with PMS.

The medical mainstream rarely recognizes these symptoms as being due to hormonal decline or imbalance and frequently pushes anti-depressants as the answer. They are not! Simple hormone replacement and rebalancing will usually take care of the problem and return one to their “pre-menopausal” state of physical and mental health.

Perimeopause Symptoms at 31?

The question I seem to be getting more and more these days is, “I am only 31, can my symptoms really be caused by perimenopause?" My answer is usually YES! It is possible that a woman can begin going through the early stages of menopause at such a young age.

Perimenopause is generally believed to encompass a brief period of time in a woman’s life as she ceases menstruating and goes through hormonal change leading to hot flashes and night sweats. This could not be further from reality. Hot flashes and night sweats are the hallmark symptoms of Perimenopause and they are caused by FLUCTUATING hormone levels. This fluctuation of hormones can last years to decades! Once the hormones bottom out these symptoms always disappear. Unfortunately, the other perimenopausal symptoms such as lack of energy, fatigue, decreasing libido, vaginal dryness, and all the others will persist forever.

The solution is simple. No matter where a woman is on the compendium from “Normal” to “Menopause”, return her hormonally and physiologically to pre-menopausal or “Normal” levels and ALL symptoms will disappear. And it is that simple – we do it everyday!

See our bioidentical hormone information for more details on treating perimenopause and menopause symptoms.

Don't Worry. Be Happy and Avoid Heart Disease

A 10-year Canadian study tracked nearly 2,000 adults to determine whether attitude affects the development of heart disease. The study, published just last week, is thought to be the first to show a relationship between emotion and heart disease.

"Being happy means you have less likelihood of having a heart attack 10 years later," said psychologist Karina Davidson, director of the Center for Behavioral Cardiovascular Health at Columbia University Medical Center in New York. "What we don't know yet is if you're not a happy person and you were to get an intervention to help you increase your happiness, would that offset your risk?"

The research team looked at the association between positive affect (which was defined as “the experience of pleasurable emotions such as joy, happiness, excitement, enthusiasm and contentment”) and cardiovascular events in 1,739 adults in the 1995 Nova Scotia Health Survey. Trained nurses interviewed the 862 men and 877 women.

"We had to wait quite a few years as these people had heart attacks, and then we looked to see whether being happy predicted fewer heart attacks, and indeed it did."

Over the 10-year period, researchers discovered that participants with no positive affect were approximately 22% more likely to have heart attack or angina than those with a little positive affect, who were themselves at 22 per cent higher risk than those with moderate positive affect. However, Davidson warns that this is an observational study, and rigorous clinical trials are needed to support the findings.

From my view as a functional medicine physician, however, these findings make perfect sense to me. Happy people, those who don't take things too seriously, have lower levels of stress cortisol, compared with type-A people with higher stress-induced cortisol levels. They also tend to have stronger, closer support networks. All of these attributes leave them happier, healthier and longer lived.

Scientists discover the secret of aging

The UK’s Financial Times reports that scientists have solved the question as to how and why living cells age. Though they have no plans to create a Fountain of Youth, this information may be the harbinger of better drugs for age-related diseases such as diabetes and cardiovascular disease, not to mention skin wrinkling, fading eyesight and diminished hearing, all associated with aging.

An international team of scientists in Newcastle, UK worked in conjunction with the University of Ulm in Germany. Through a comprehensive systems biology approach utilizing computer modeling, cell culture experiments and genetically modified mice, they set out to discover why cells age.

What they learned from their research, published in Molecular Systems Biology Journal, is that when a cell detects damage to its DNA (due either to wear and tear or a disease state), it sends a signal that instructs the cell to self-destruct or simply stop dividing. This signal is actually delivered by free radical molecules created by the cell’s energy storehouse, the mitochondria. If this signal is not delivered, aging cells that continue to replicate can result in weaker systems, such as failing hearts, and more fragile bones and skin, and their free radical molecules can cause the cells to become cancerous.

One of the team’s scientists, Thomas von Zglinicki, cautioned about the research’s next stage, which is to explore ways to prevent cellular aging. “It is absolutely essential to tread carefully in trying to alter processes that cause cells to age, because the last thing we want is to help age-damaged cells [sic] to break out to become malignant,” said Mr. von Zglinicki.

We, in the Functional Medicine Department at Sanctuary Medical, will be watching this closely for more updates on the research!

Diabetes Meds May Decrease BMI in Obese Teens

The obesity rate among children has tripled since 1960, with 32% of US children considered overweight or obese. Obese kids suffer some of the same weight-related problems as do adults: diabetes mellitus type 2, hypertension and cardiovascular disease. The February issue of Archives of Pediatrics & Adolescent Medicine included a report by Darrell M. Wilson, M.D., of Stanford University and the Lucile S. Packard Children's Hospital, Stanford, Calif., and colleagues in the Glaser Pediatric Research Network Obesity Study Group.

The research group randomly assigned 77 obese teenagers, ages 13 to 18, to a “lifestyle intervention program” which included dietary changes and increased physical activity plus either 2,000 mg of Metformin XR or a placebo. The study ran for 38 weeks and participants were monitored for an additional 48 weeks after they stopped participating in the study. The use of Metformin showed a significant impact on BMI over the initial 52 weeks of the study, but the teens’ BMIs shot back up within 12-24 weeks after the drug was discontinued.

An obese child/teen has more adipocytes (fats cells) than a normal weight child. This will make it harder for them to maintain a reasonably healthy weight. Add to that a lack of experience and knowledge in what they should and could be eating for better health, as well as poor adult examples of what a meal or a snack should consist of, and you have set them up for a future of weight gain.

So parents, clean out the cupboards and fridge of the "Frankenfoods"...any pseudofood made with trans fats, food colorings/dyes/preservatives and high fructose corn syrup, and replace them with nutrient-rich whole foods (organic if possible). Shop the perimeter of the food market where the fruits and vegetables wait for you. Buy foods that come from nature, not from a lab. Try to cook together to teach your children (depending on age) simple basics of putting a meal together. Let the kitchen be the central point where the family meets, greets and eats together. Turn off the TV, leave your cell phone, put a leash on your dog and go for a walk together. Formalized exercise routines can be built later on, but for now, "go outside and play" should be heard more than the sounds of X-box, PS3 or video games.

Feel free to send me a health question!

To your health,
Dr. David Blyweiss

WHAT IS AGE MANAGEMENT?

Age Management is a proactive, preventative health care specialty committed to the creation of optimum human function and quality of life at every age.

Its goals are to slow, reverse and/or moderate the process of aging as it relates to age-related disease and disability. This is accomplished through initial extensive medical history, lifestyle assessment and physical exam as well as initial and ongoing laboratory analyses.

Treatment plans include patient education towards a life-enhancing diet, exercise and stress management techniques and appropriate medical interventions including, but not limited to, nutrition and supplementation, appropriate hormonal balancing, weight management and other medical modalities to establish a personalized youth-enhancing program that allows our patients to live at their maximum potential at every age.