Prostatitis

The Real Cause of Prostatitis and How to Treat it Naturally

This morning David, my partner at XY Wellness, sent me this article from BBC news on how a guy, Henri Astier, in his mid-fifties cured himself of prostatitis with meditation.

The National Institutes of Health (NIH) has recognized and defined recognized prostatitis as one of four syndromes as follows:

I –  Acute bacterial prostatitis – typically the patient experiences a fever here and urine analysis is positive for bacteria. About 80% of the times the bacteria responsible is Escherichia coli (E.coli) approximately 5% of patients presenting with acute bacterial prostatitis develop chronic bacterial prostatitis which accounts for approximately 5–10% of all cases

II –  Chronic bacterial prostatitis – here despite there being an infection shown from a urine analysis the person may or may not have symptoms

III – Chronic prostatitis and chronic pelvic pain syndrome (CPPS; further classified as inflammatory or noninflammatory) This is 90 TO 95% of cases where there’s a negative urine analysis but the patient has associated symptoms

IV – Asymptomatic inflammatory prostatitis – this is from an incidental finding, maybe a prostate biopsy, that shows inflammation but the person has no symptoms

How do I Know if I have Prostatitis?

The guy with prostatitis often has two things going on:

  1. Pain, discomfort, achiness in the perineum area (between the scrotum and anus), around the testicles, lower abdominal area and/or on the penis. Pain is often worse after urinating or ejaculating.
  2. Urinary problems, typically urgency and frequency.

Again, both symptoms, pain around the pelvic area and urinary problems have to be present for it to be prostatitis. If there’s only one out of the two, it is something else.

The type of prostatitis you may have is category III. And this is the type Henry from the BBC news article has.  Henry got relief from reading a book,  Teach Us To Sit Still describes how the author, Tim Parks his own form of CPPS through Vipassana meditation. 

Despite feeling better, Henry underwent a prostate biopsy from an elevated PSA. He does not discuss what that PSA value was or the results of the prostate biopsy in the article. However, while I do not know essential details of Henry’s case, i.e., family history of prostate cancer, if nodule found on the physical exam, patients with prostatitis should NOT undergo a prostate biopsy even if PSA is “elevated” chronic inflammation can cause false PSA increase.

Like many of the patients I see, Parks concluded that the pain was “produced by tension: anxiety is often stored in muscles, and pelvic musculature is particularly vulnerable as it is intertwined with nerves. The solution lay in calming a restless mind, “ writes Henry.

At the end of the BBC article, Henry calls his condition, “a blessing” as he is more capable of managing physical life challenges as he approaches his 60”s.

“A blessing!?” – I have never heard that before from any person living with prostatitis. Heard it many times from prostate cancer patients but never, ever from a CP/CPPS patient.

Other Facts About Prostatitis

  • Prostatitis is one of the most common diseases seen in urology practices in the United States, accounting for nearly 2 million outpatient visits per year.
  • Most sufferers are much younger than Henry from the BBC article, typically mid-twenties or thirties. The youngest I’ve seen clinically is fifteen-years-old.
  • Across the globe, areas with widespread sexually transmitted disease (STD) rates and prostitution have a higher incidence of acute bacterial prostatitis. STD is often not the cause, at least in my clinical experience.
  • The first line of therapy is antibiotics, even when urinary cultures show no bacteria. E.coli is the most common type of bacteria when urine culture is positive.

Dr. Geo’s Take and Method to Treating Prostatitis

The first thing to know is that prostatitis does NOT improve by treating the prostate, the person with the prostate must be treated.

Secondly, category III prostatitis,  CP/CPPS,  is not likely to be an organ-specific problem, but a prostate/bladder/pelvic problem. The symptoms are very similar to Interstitial Cystitis and Overactive Bladder.

The cause may begin with an infection or autoimmune reaction causing inflammation or neurological damage in and around the prostate (pelvic floor, bladder, perineum, etc.). If not adequately treated in the early stage, peripheral and then central sensitization could occur.

Once the central nervous system is “pissed off” (pun unintended), the nerves continue to persistently fire away at the pelvic region causing pain and discomfort around the pelvic area.

As a result depression, anxiety, and frustration sets in worsening the symptoms.

The other important point here is that antibiotic therapy is the WORSE approach for prostatitis, particularly the non-bacterial type.

That’s right! This treatment method, while life-saving for some infections, is horrific for prostatitis even though some people feel better initially after treatment to then get symptoms again shortly after the end of the antibiotic course.

And that is FRUSTRATING!

The primary form of antibiotics used for prostatitis are fluoroquinolones, i.e., Ciprofloxacin (Cipro, Cipro XR, Proquin XR), Levofloxacin (Levaquin) typically for 4 to 6 weeks. Not only can fluoroquinolones cause Achilles tendon rupture or tendinitis

Also, fluoroquinolones cause mitochondrial dysfunction of the pancreas where insulin is made called the beta cells leading to low blood sugar (hypoglycemia). Yikes!

But that’s not all.

Misuse or overuse of antibiotics in patients with CP/CPPS can have a direct effect on the gut microbiome, killing off good bacterial flora important for health. The prolong and overuse of antibiotics also contribute to Irritable Bowel Syndrome (IBS) likely by killing off the healthy flora.

Here is the kicker; IBS is common among prostatitis sufferers and treating IBS is a major component for treating prostatitis.

So not only are antibiotics causing all sorts of undesired side effects but likely making the disease worse by causing IBS. (I’m shaking my head)

My treatment approach for treating Prostatitis

I’m privileged of seeing many prostatitis cases at my clinic, likely more than any functional/naturopathic doctor in the nation. While still imperfect, the treatment approach I deliver has worked for many patients.

I believe prostatitis is a neuropathic dysfunction of the urogenital system.

What does all that jargon mean?

Prostatitis is caused by the excess firing of the nerves through the urological system that includes your bladder, prostate, scrotum, and penis. That’s why the burning and achy sensation is felt in those areas after peeing, ejaculating or from doing nothing.

The term “prostatitis” is often a diagnosis of exclusion and just a diagnosis to connect an ICD-10 code number to it for billing purposes. But the real problem is hyperactivity and hypersensitivity of the nerves innervating the urological and digestive system.  That is why treating gut related issues help with prostatitis as well – the two are connected via the nervous system.

OK, so how do we do treat the cause.

  1. Listen to the patient with empathy. Prostatitis patients have been through the mill with their social life and by seeing many urologists, some of whom are likely as frustrated as the patient from seeing these cases with very little results. Listening to prostatitis patients does not only offer some therapeutic solutions but also shows you care – and listening with care is therapeutic in and by itself.

 

  1. Calm the nervous system. There are many ways of achieving this. One is to learn how to meditate like our guy Henry from the BBC article. There are numerous books that teach Mindful Based Stress Reduction (MBSR) and have a calming effect on the parasympathetic system is stimulated from the practice. These books I recommend.

I teach patients how to breathe diaphragmatically and that is calming as well.

  1. Acupuncturea systemic review study in looking at over 470 subjects show efficacy in acupuncture treatment for prostatitis. I attest to it works as I have seen it do wonders for some patients clinically.

 

  1. Botanicals – I use many herbs, too many to mention here as every case I see requires a different protocol – it is not a “one size fits all” approach. A formula packet I use is APS. This formula packet is loaded with ingredients including :

Immune stimulant – Mushrooms, Beta 1,3 glucan, arabinogalactan, Diindolylmethane (DIM), Astragalus, Elderberry, Andrographis, allspice, garlic, basil, sage, Acerola, echinacea,

Anti-inflammatory –Curcumin, quercetin,

Anti-microbial– Astragalus, garlic, goldenseal, clove, Allspice

The reason these botanicals help is that it stimulates the immune system against hidden bacteria often not found in the urinary testing currently available to physicians, there are anti-microbial that are strong but work gently in the body, and herbs to reduce inflammation.

Rye Pollen extract, not included in APS has shown to help men with prostatitis in studies.

   5. Heal the gut. This is done by eliminating foods like gluten and dairy. There might be others a functional medicine or naturopathic doctor can detect but gluten and dairy is a good start. Also, the typical “prostatitis inducing foods” like coffee and spicy food may or may not cause symptoms – everyone case is different.

   6. See a physical therapist specializing in pelvic dysfunction. They can help by relaxing tight muscles in the pelvis that contribute to pain and discomfort.

Lastly, If you have prostatitis I assure you that you are not crazy. The symptoms are real. However, after suffering for a long time with an achy pelvis and the urge and frequency to pee, the mind becomes hypersensitive to the pelvic area even when under normal circumstances, the feeling is a mild itch or twitch down there.

In other words, every guy feels strange things around their scrotum, penis or perineal area at any given time, that’s common, but the person who has never had prostatitis ignores it. The guy with a history of prostatitis often catastrophizes (not sure if this is a real word)  with such familiar sensations and symptoms worsen form the anxiety provoked.

If you do not know where to start, begin like Henry and meditate.

Three Recent Blog Post

Prostate Cancer: Late night eating increases the risk.

How to Prevent a Heart Attack: Part one

Prostate Cancer: The Truth on Dietary Supplements During Radiation Therapy

CaPLESS EVENTS

The CaPLESS Retreat is coming in September to help prostate cancer (CaP) thrivers live their best life by implementing science-based lifestyle practices. I to connect with you there. There is limited space.

 

Part Two: Benign, Non-Cancerous Reason’s why PSA rises

Part one: What is PSA and what it does

Part two: Benign reason’s why PSA goes up

Part three: PSA as a screening tool for prostate cancer

Part four: PSA after prostate cancer treatment

 

More often than not, PSA rises for reasons other than cancer. Still, this biomarker continues to stress men all over the world who get tested for it.

Here are non-cancer reasons why PSA goes up:

  • Ejaculating about 48 hours before the blood draw can cause a false increase in PSA by up to 1.3ng/ml.

 

  • PSA may be higher in smokers compared to non-smokers.

 

  • Inflammation of the prostate, or prostatitis, may cause an elevation in PSA. Symptoms of prostatitis include; pain or discomfort in the perineal area (between the scrotum and the anus), feeling of “sitting on a golf ball,” lower abdominal pain, lower back pain, burning, pain or discomfort after urination and/or ejaculation. Urinary frequency and urgency also appear in men with prostatitis. Treating prostatitis lowers PSA by close to 40%.

 

  • A digital rectal exam (DRE) before the PSA blood draw can increase PSA by 0.4ng/ml, which many physicians think it’s not a big deal. However, when a biomarker like PSA cause so much anxiety when elevated, anything you can do to keep the number low is a good idea, don’t you think? Also, the more vigorous the exam, PSA can go higher than 0.4 points.

 

  • Needle biopsy of the prostate raises the PSA level by seven times its normal value and stay elevated for up to 4 weeks.

 

  • Benign Prostatic Hyperplasia (BPH) or enlarged prostate cause an increase in PSA. One of the best methods to determine if PSA is high from BPH and less likely from prostate is by doing a PSA density. This is a simple calculation where the prostate size, best measured by an MRI, second best by ultrasound, is divided over PSA value. If the result of that calculation is higher than 0.15, the elevated PSA is likely from prostate cancer. If the PSA density is less than 0.15, it is likely from an enlarged prostate. PSA density should not be the only determining factor for prostate cancer diagnosis. Lastly, a group of pharmaceutical drugs called, 5-alpha reductase inhibitors (5-ARI), falsely reduces PSA by about 50%, meaning, that one can harbor prostate cancer and have a low PSA when being on these drugs. Finasteride and Dutasteride 5-ARI’s are the two main drugs used for BPH.

 

  • Riding a bicycle for long distance can increase PSA score by up to 10% by putting pressure on the perineum area close to where the prostate is located. Cycling for short distances may not make a difference. Similar to after ejaculating, it is best to abstain from riding for at least 48 hours before the blood draw.

 

  • Any form of vigorous exercise a day or two before a blood draw may result in a false increase in PSA.

Next week you will learn the use of PSA as a screening tool for prostate cancer and uncover the confusion associated with it.

Last 3 Blog Posts:

What is PSA and what it Does

ADT, Apalutamide, Exercise in the treatment of prostate cancer

Traditional Chinese Medicine treatment for Erectile Dysfunction

 

7 Easy Do’s & Don’ts to Having a Happy Thanksgiving

7 Easy Do’s & Don’ts to Having a Happy Thanksgiving

 

Thanksgiving
1. Don’t stuff yourself. Overeating feels good for about 10 minutes, and then you are bloated, tired, disengaged, and feeling guilty. 

Do have a little of everything you like. And enjoy it.

2. Don’t be sedentary and watch football games all day.

Do go play football or something. Work up a sweat. Go to the gym and get in a workout for 30 to 60 minutes at least three out of the four days this Thanksgiving weekend.

3. Don’t go into the event, dinner, party, bash (or wherever you plan to go this long-weekend) with an empty stomach. You go in hungry, and you will overeat. You know it’s true.

Do eat a good meal before you leave. It doesn’t have to be fancy. It can be a protein smoothie, leftovers, or simply a snack like Mary’s Gone Crackers with hummus or avocado.

4. Don’t be afraid to eat some pumpkin pie! It’s delicious.

Do mind #1.

5. Don’t take your family and friends for granted as you share time with each other. Not to be somber here, but we just never know when is the next time you will be with each other. 

Do be grateful for all you have. Sometimes we focus way too much on what we don’t have.

6. Don’t forget to take your dietary supplements – especially if you plan to “fall off the horse” a little. The right supplement regimen can be protective and offset most dietary diversion.

Do take them and stay on track.

7. Don’t get sucked into family drama. We all have a little of that. Rise above it, for the sake of your stress. 

Do have fun and laugh a lot with those you love. And, be thankful that they are in your life.

 

From my family and the whole DrGeo.com team –

Happy Thanksgiving!

Probiotics Lowers Blood Pressure – new study

Probiotics Improves High Blood Pressure in A New Study

 

Probiotics2

Doggy Bag Message First:

Consuming probiotics – over 100 billion CFU’s a day – can moderately lower blood pressure. Probiotics have many other health benefits so its one of my big three. Exercise, low carb eating and fish oils also helps with lower blood pressure as well, likely by reducing body fat and controlling insulin insensitivity.

 

Study Details

A meta-analysis looking at over 540 participants total showed the following:

•    Those  who consumed 100 billion CFU or more had the lowest reduction in  blood pressure.
•    Probiotic species varied among the trials; four studies used yogurt as the source of probiotic bacteria, two used fermented and sour milk, one used probiotic supplements in capsule form, one used probiotic rosehip drinks, and one used probiotic cheese.
•    The reductions in systolic and diastolic blood pressure were approximately 3.5 mmHg systolic (upper number) and 2.4 mmHg diastolic (lower number).
•    Researchers observed larger reductions of blood pressure among those who consumed multiple probiotic species compared to those who consumed just one species.

LINK to the Abstract of this study.

Some Basics First About Probiotics:

What are probiotics? Probiotics are live microorganism which when consumed can offer a variety of health benefits. They can be consumed in a variety of forms; yogurt, cultured milk capsules, beverage, kimchi, kefir pickled cabbage and others.

Probiotics usually contain a genus, a species and strain.

For example, most people recognize the genus acidophilus and say, “I need to get my acidophilus” as if it’s a brand of probiotics.

Acidophilus is only one species of a variety of genus’ of probiotics.

So, Lactobacillus (genus) acidophilus (species) is what you would read on the label. There are hundreds of probiotics genus and species in the market.

Here  are a few commonly found in probiotic supplements and foods: Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium longum, Bifidobacterium bifidum, Lactobacillus brevis, Lactobacillus bulgaricus, Lactobacillus casei, Lactococcus lactis, Lactobacillus paracasei, Streptococcus thermophilus.

What do Probiotics do: Probiotics are found through out the digestive system, mainly in the small intestine and they have a variety of functions including stimulating the immune system, eliminating the bad bacteria and making vitamin K.

When purchasing probiotics a few things need to be taken into account:

  • How many organisms are alive in the product
  • The genus and strains on the label should match what’s in the bottle
  • If taking a probiotic supplement, the capsule must pass through the stomach ( an acidic environment) and work its way down to the intestines.
  • Not contain any harmful organisms

Lastly, probiotics are measured in number of live organisms per dose – using CFU as units. CFU stands for; C – colonizing, F – forming, U – units.

My Take On This

Probiotics are a top three supplement on my list of most important nutrients. Hands down. You get a slew of benefit from consuming probiotics including; better digestion, gentle way of promoting bowel movement and strengthening the immune system.

Now we know probiotics can help with moderately lowering  blood pressure.* By the way, a drop of 3.5 points systolic and 2.5 points diastolic is not insignificant.

To compare, researchers from the  Heart Outcomes Prevention Evaluation (HOPE) study showed a 3.3 mmHg reduction in systolic blood pressure, along with a 1.4 mmHg reduction in diastolic blood pressure, with the use of the pharmaceutical ramipril, an angiotensin-converting enzyme (ACE) inhibitor . This moderate reduction in  blood pressure (not as significant as the probiotic study by Khalesi et al.)  was associated with a 22% reduction in risk of cardiovascular mortality, heart attack or stroke.

Which probiotic is right for you? Not and easy question for me to answer since I was involved in the formulation of this probiotic. So I’m a bit biased.

Other’s I have used successfully which I am not financially associated with includes; Natren’s, iFlora, Probiotic supreme and Biotics Research BioDoph-7plus.

There are other additional good probiotic brands out there but these are the ones I have the most experience with.

Bottom line: Take probiotics everyday by food or though a good dietary supplement. Choose one with the highest CFU’s per serving and with as many genus and species as possible. And take as many 30 to 60 billion CFU a day for general health. If you are trying to control blood pressure naturally consider upwards of about 100 billion CFU according and one with as many species as possible according to the Khalesi et al. study. * However, you may not need that high of a dosage if your are doing others things to support your cardiovascular system – stay away from  refined sugar and simple carbs and exercise everyday.

Oh, and yes, take fish oils. If you read this blog post – consuming  2 grams (or 2000 mg) a day of fish oils can also reduce blood pressure according to research.*

Reference:

Khalesi S, Sun J, Buys N, Jayasinghe R.Effect of Probiotics on Blood Pressure : A Systematic Review and Meta-Analysis of Randomized, Controlled Trials.Hypertension. 2014 Jul 21.

ConsumerLab.com has a great review on probiotics and a list of those that “don’t pass muster” – you may need to become a member for a fee to see the article. If you are a big supplement consumer then the fee may be worth it.

 

Men with Interstitial Cystitis / Bladder Pain Syndrome – What to do

Men with Interstitial Cystitis / Bladder Pain Syndrome

 

man IC
About 6 weeks ago I saw a pleasant 28 year old male at the clinic , we will call him John, with Interstitial Cystitis / Bladder Pain Syndrome (IC/BPS). Admittedly, I have seen about a handful of cases of men with IC / BPS since this condition often affects women.

What is Interstitial Cystitis / Bladder Pain Syndrome (IC /BPS)?

IC / BPS is a condition with chronic inflammation of the bladder causing pain in the lower abdominal and pelvic area. Pain is accompanied with urinary urgency and frequency.

In about 5% of patients a physician would find ulcers in the inner lining of the bladder with a cystoscopy. But this is rarely the case which makes this condition very difficult to diagnose.

What should you do if you are a man with IC / BPS?

First, realize and accept that there is no perfect way of diagnosing IC/BPS. And this is the frustration for both you and your doctor. There are no biomarkers to distinguish IC/BPS from prostatitis or urethritis. In fact, the symptoms of IC /BPS and prostatitis are very similar to each other.

So here’s how I learn to distinguish IC /BPS from prostatitis in men

First of all, once an infection is ruled out, there is no lab test that can help with a diagnosis.
Figuring out the problem with  the patients clinical presentation, medical history and physical exam is all there is.

Cystoscopy with hydraulic distention of the bladder in males appears to be the technique most commonly used to diagnose IC in this population.

With IC / BPS there is constant pain below the umbilicus that comes and goes. It often flutters. This pain is accompanied by urinary urgency and frequency.

No urinary problems means no IC in men.

With prostatitis the pain is experienced in the area between the testicles and anus (perineum) and is also accompanied with urinary symptoms.

No urinary symptoms and only pain present means it is not prostatitis and likely only pelvic pain.

Sometimes there is only penis or testicular pain. But when performing a prostate exam the pain in the testicle or penis gets worse. The pain on the prostate is also pretty bad.  These patients have chronic, non-bacterial prostatitis.

Only penis pain is often diagnosed as urethritis.

Only testicular pain is often diagnosed as just that – chronic testicular pain.

Causes Interstitial Cystitis / Bladder Pain Syndrome in men
My patient John was abusing a recreational drug known in the streets as Special K.  Special K is made from Ketamine, a schedule three drug used in human anesthesia and veterinary medicine.
Special K is very short acting hallucinogen with effects lasting sixty minutes when inhaled or injected and up to two hours when ingested, the total experience lasting no more than a couple of hours.
Special K is known to damage the bladder wall and cause pain and urinary problems. (Tsai TH et al. 2009)
John’s case was interesting in that; he was an America male in his upper 20’s and Special K is most common amongst teenage Asian girls.
Ketamine is also used in humans in emergency medicine as a pain killer or for respiratory problems. There again bladder pain can be induced when Ketamine is used legally for medical purposes.

Natural Treatment Options for men with Interstitial Cystitis / Bladder Pain Syndrome

De-Stress – you know stress makes pain worse. Stress tightens muscles in the around the pelvic area and bladder making pain worse. Read and practice meditations from Jon Kabat Zynn. There’s also a phone App that helps with stress called Headspace.

Have an outlet. Guys are notorious for ‘holding things’ in. Physical exercise that includes boxing on punching bags helps to release tension.

Try Acupuncture – Collectively there has been more than 400 subjects studied for prostatitis showing efficacy with acupuncture.

The right combination of phytotherapy can reduce inflammation and reduce symptoms without side effects. Natural agents to consider include: quercetin, curcumin and rye pollen extract. By reducing inflammation naturally you can also benefit from other health problems since IC /BPS is almost never experienced alone. Most sufferers also have Irritable Bowel Syndrome (IBS), fibromyalgia or some other autoimmune disease.

Some foods can be a problem. Typically these include; tomato’s, caffeine, citrus fruits and juices and wine. I find wheat and gluten can also be a trigger for many.

The trick is to work on all of these together. Monotherapy fails with the treatment of IC / PBS. Throw the ‘kitchen sink’ at this thing for relief.

 

Reference:
Tsai TH, Cha TL, Lin CM, Tsao CW, Tang SH, Chuang FP, Wu ST, Sun GH, Yu DS, Chang SY. Ketamine-associated bladder dysfunction. Int J Urol. 2009 Oct;16(10):826-9.

Helpful Resources:
http://www.ic-network.com/
http://www.ichelp.org/

http://www.prostate.net/

 

An NYU Clinical Trial for Enlarged Prostate (BPH)

 NYU Urology is enrolling patients who have an enlarged prostate for this unique study
stream

This clinical trial is called  PLUS 1. READ MORE HERE ON PLUS 1.

 

Who should consider joining this clinical trial?

Any male who has and enlarged prostate (BPH) who has tried the available drugs for such condition and;

  • do not like the side effects of BPH drugs
  • the drugs don’t work
  • have also tried dietary supplements for BPH and they don’t work either

Symptoms of an enlarged prostate (BPH) include:

  • Urinary frequency (having to use the restroom often)
  • Excessive nighttime urination ( called nocturia in medicine)
  • Urinary urgency (When you have to go and can’t hold it)
  • Slow urinary stream (slow stream evident by how weak your urine hits the bottom or the toilet)

PLUS 1 is a new alternative therapy that does not involve pills or invasive surgery for men that are suffering from frequency urination, getting up at night frequently or those that have a slow urinary stream from an enlarged prostate.  If the patient qualifies the treatment involves an injection of a protein directly into the prostate.  This protein causes the prostate cells to break open and should improve there symptoms.

 

If you want to join the trial;

You’d need to act quickly. Enrollment ends in two weeks (8/1/14).

Contact Lauri or Joseph to answer some simple questions and find out about the next steps.
Laurie.Mantor@nyumc.org
Joseph.Weintraub@nyumc.org

Enjoy the rest of your day!

Please share this post with friends and family. You never know, they may have urinary problems too.

 

My Opinion on the Wizard of (Dr.) Oz

Please allow me to opine on Dr. Oz (or the Ozter, as I like to affectionately call him)  and his show.

oz1

Having worked where Dr. Oz practices at Columbia University Medical Center (CUMC) in the department of Urology about 10 years ago, I knew Dr. Oz (the cardiologist) before he was Dr. Oz ( the TV personality and health guru). His office was actually not too far from mine and I used to bump into him every now and then .  I thought he was a nice guy. I still do.

The Ozter is the first allopathic physician I know to incorporate alternative modalities like music therapy to his surgical patients.

Think about that for moment; in a highly conventional and conservative institution like CUMC he incorporated music therapy with his surgical heart patients, an alternative modality that seemingly, at minimum, helps with alleviating pain post-surgery (Özer et al. 2013).

So, what do I think of the Dr. Oz show?

First of all, I’ll admit that I don’t watch the Dr. Oz show much – I don’t have time and recording shows like 60 minutes is more valuable to me, frankly. Lately, however, I’ve seen a couple of segments since  he recently had a hearing with congress regarding weight loss claims connected with certain dietary supplements.

All in all, in my opinion, Dr. Oz has done a whole lot more good than bad. Most physician’s, especially integrative physician’s disagree with me.  But I think he does a fine job educating, inspiring and motivating his audience on being pro-active and in finding alternatives and natural methods (often less toxic than conventional approaches) for overcoming numerous health problems. He also has done tons of good in spreading the word on integrative and naturopathic medicine –  healthcare options which time for accessibility has come. Many excellent naturopathic and reseachers like; Dr. Dean Ornish, Dr. Pina Loguidice, and Dr. Susan Blum have been on the show spreading the good word on effective unconventional strategies to overcoming common ailments.

Man, when is my turn coming? I sure have lot’s of good material to convey. 😉

As as a health care practitioner, I too get frustrated when patients emphatically tell me “Dr. Oz says  I should take..” this, that or the other – as if they are consulting with the Ozter personally.  Arghhh! That’s really annoying. Mostly because, at times, he is giving the wrong information and most importantly, spreading the wrong “miracle cure” message.

Additionally, unscrupulous dietary supplement companies jump on the opportunity to sell poorly manufactured supplements as miracle cures when the Ozter mentions it on his show as is the case with green coffee bean extract.
Is not that coffee bean extract has not shown to increase metabolism and be a nice weight loss aide for some people, but the  “miracle in a bottle” message that he voices on his show can be misguiding and harmful to the public.

To be clear: There’s is no simple miracle cure in a bottle for anything. Period.

To his credit though, he doesn’t get paid a dime to promote any  natural remedy. He can probably make zillions with supplement companies if he did,  but he doesn’t endorse any brand. Paradoxically, Senator Claire McCaskill, who grilled Dr. Oz last week at the congressional hearing accused the natural health guru of peddling quack weight loss products — even though Oz actually runs a very meticulous, science-based operation where dietary supplements are heavily researched before being recommended to the public.

Meanwhile, Senator McCaskill, who chairs the consumer protection subcommittee, receives funding from prescription retailers like Express Scripts, the genetic engineered food (GMO) giant Monsanto and others.

Please understand; I’m not saying Dr. Oz is “innocent of all charges” and that  “bad players” in the dietary supplement industry are not culpable. They are both ” guilty, ” especially the latter.

I just think Oz is a passionate person who believes in what he says on his show and is also under tremendous pressure to keep ratings up.  Granted, network pressure is not an excuse when you are as charismatic as Oz and have the level of influence he does. People, probably millions, make health decisions based on the “Dr. Oz effect.”

Welcome to prime-time Ozter.

Yes, he needs to (and I believe will) stop the miracle cure claims. At minimum, toning down the misleading hype will save my integrative medical colleagues and me precious time from doing serious ‘damage control’ with patient’s and friends.

And dishonest, irresponsible dietary supplement companies who have poor manufacturing practices need to get their act together or get out of the supplement industry altogether. Legitimate  nutraceutical companies are getting a  bad rap by association. Frankly, I think ‘fly by night’ supplement companies are the biggest problem here, not supplement companies as a whole.

If anyone has an opinion on the Ozter –  and I know you do too –  chime in down below at comments section. I would love to hear from you.

Now, for kicks, check out this hilarious 16 minute parody by John Oliver on Oz and the latest congressional hearing.

😉 Enjoy!

Reference:

Özer N1, Karaman Özlü Z, Arslan S, Günes N.Effect of music on postoperative pain and physiologic parameters of patients after open heart surgery. Pain Manag Nurs. 2013 Mar;14(1):20-8.

NOTE: Good, useful content is guaranteed. Perfect, typo-less grammar from this mission-driven , hardworking, sometimes tired doctor and father of 3 is not. 🙁

5 Reason’s You Don’t Sleep Well and What you can Do About it

5 Reason’s You Don’t Sleep Well and What you can Do About it

sleep

Sleep is likely the most undervalued health practice in the Western world.

In my clinical experience, when laying out a health plan for patients, getting good sleep (and sometimes exercise) is what they shun most.

When times get tough, deadlines to meet, kids are acting up or uncertainties arise, you (and I) sleep less. Are we paying a heavy price for snoozing less?

We might be.

Recent research from the United States and Iceland, studying over 900 men, suggest’ a good night’s sleep could protect against the development of prostate cancer.  Higher levels of melatonin in men’s morning urine were associated with a decreased risk for prostate cancer, particularly advanced disease.

Melatonin is a hormone that is produced exclusively at night. Higher levels have been tied to longer, more restful sleep.
If melatonin is only released at night, does that mean that night shift workers  are at an increase risk of cancer? Yup.

A study published at the American Journal of Epidemiology looked at over 3100 Canadian men Compared with men who never worked at night, men who worked night shifts had an increased risk for prostate cancer, non-Hodgkin’s lymphoma, pancreatic cancer , rectal cancer , colon cancer , bladder cancer and lung cancer. (Parent et al. 2012)

Poor sleep also leads to more car accidents, irritability and decrease work performance.

5 reason’s why you can’t sleep and what to do about it.

1. Sleep procrastination

Sleep procrastination is a term used in a recent study from Utrecht University where they studied the sleep habits of 177 participants. Night-time TV watching (i.e. nighttime news) , staying up  connecting on social media, or surfing through the internet is all part of sleep procrastination.

What to do: Have discipline. And practice transition time. Transition time are practices between your daytime and nighttime life. Transition time includes; shutting down all electronics at, say 9pm. Taking a warm bath. Drinking relaxing tea like chamomile. Meditating before bedtime. Most importantly, resist the temptation of watching TV, Netflix or surfing the net.

2. You have too much going on.

Two or three days of sleeping less due to upcoming deadlines or preparing for “big event” is no big deal. We all do it. Chronic sleep deprivation due to everyday challenges, however, is a big problem.
What to do: Write it all down. Rest your brain on paper by writing down your concerns and next day to do list.

3. Uncomfortable sleeping at night – tossing and turning.

What to do: You might need a new bed. The right bed makes all the difference in the world. Some beds like the tempurpedic can be expensive. Friends and family who have the Tempurpedic love it. ( I am not financially connected to this product) All mattress’ don’t have to be as expensive. Just find one you like, try it for a month and send it back if it does not work for you. Most bed companies allow you to that.

4. Urinating all night

What to do:  Getting up once a night to urinate is not a big deal, although not preferable. Getting up two or more times a night is. In men, prostate enlargement (or BPH) maybe the problem where urine flow is obstructed. A clinically tested prostate formula that works extraordinarily well is Prost-P10x. I admit to being a bit biased here since I formulated Prost-P10x but I clinically seen this formula work very well for prostate health.  On Amazon there are over 240 reviews with 4 ½ stars on Prost-P10x.
If a natural approach is not good enough to control prostate size then harsher treatments like surgery may be necessary. The gold standard surgical treatment for an enlarged prostate is a TURP and Green light laser.

5. Mind racing.

What to do:  Practice meditation. It works well. It does take time to get used to. The guru in this area is Jon Kabat-Zinn. Get this book if you find you need to calm your mind. Meditative techniques are essential to managing stress and controlling pain, even bladder pain, and nighttime urination.

 

 

Reference:

Parent MÉ1, El-Zein M, Rousseau MC, Pintos J, Siemiatycki J.Night work and the risk of cancer among men. Am J Epidemiol. 2012 Nov 1;176(9):751-9.

The So Many Names of Sugar

The Disguise of Sugar.

At this point, almost all health experts agree that sugar is the single most harmful chemical we consume. It’s a big deal that almost all scientist, nutritional physician’s and researchers believe sugar is so damaging to the body considering universal agreement among expert in anything is such a rarity.

The problem is most people don’t know what sugar is and where it is hidden, especially when it has a different name like maltose, fructose, etc.

Rule of thumb – if the name ends with the suffix – ose, it’s sugar.

Don’t be fooled with all the different sugar names.

Watch this excellent 4 minute video on Sugar and let me know if you have any questions.

 

Sleep – 12 easy steps for better sleep

Sleep – 12 easy steps for better sleep

 

sleep2

An occasional sleepless night usually isn’t much of a problem, but running a sleep deficit over time can cause a lot of problems. Every system in your body is affected by lack of sleep.

Restorative sleep is an essential ingredient for a healthy mind and body. Hyper-competitive people and much of Western society in general think that sleep is a waste of time and a luxury for the lazy. The notion that “successful people” can get by with just a few hours of sleep a night reinforces a common perception that sleep is a waste of time. There is nothing wrong with being competitive or successful – both can be healthy.

But when sleep is consistently sacrificed to obtain a competitive edge, you may damage your overall health long-term and be promoting cancer.

Sleep is a fundamental need of the body. Since the body is often pushed to its limits on a daily basis, it needs adequate time to recharge, recover and rejuvenate.

Sleep is also far from the single phenomenon it is sometimes assumed to be: the brain activities behind its different stages can be as distinct from each other as they are from wakefulness.

And performance also drops significantly according to a recent report on Forbes Magazine.

 

Why is Sleep important ?

First off, It is important to get the bulk of your sleep at night. Those that work night-shift in a Japanese study showed had higher rates of prostate cancer. The reason for this is because there is a hormone called melatonin that is only released at night in the dark.

Previous blog post on melatonin HERE

There are 2 main hormones that are affected when there is not enough good quality and quantity sleep:  Melatonin (decreases) and Cortisol (increases).

Melatonin

Melatonin is a powerful antioxidant that helps the body suppress the production of estrogen, a possible contributor to prostate cancer according to recent research and is also protective against free radicals. If you consistently do not go through your sleep phases at night, your body may end up producing less melatonin.

This inhibits your immune system, and your resistance to many types of cancers. Lack of sleep and exposure to lights during sleep will disrupt your production of this vital antioxidant. This is the reason that sleeping with the TV on may not be such a great idea, or any electronic device that emits light for that matter.

Latest study on melatonin HERE.

Cortisol

Cortsol helps to regulate immune system activity – including the release of certain “natural killer” cells that help the body battle cancer. Cortisol levels typically peak at dawn, after hours of sleep, and decline throughout the day. If cortisol continues to be released thoughout the whole day, not just in the morning, then this is considered counter productive and may actually contribute to cancer progression. Excess cortisol is usually released from improper stress management.

Remember, with cortisol, as is with most hormones, balance is key.

Women night shift workers, who have higher rates of breast cancer than women who sleep normal hours, are more likely to have a “shifted cortisol rhythm,” in which their cortisol levels peak in the afternoon. At least two studies show those women typically die earlier from breast cancer.

Breast cancer research is particularly interesting for prostate cancer because they are both hormonal disease’s that have similar ways of development and progression.

People who wake up repeatedly during the night are also more likely to have abnormal cortisol patterns.

Cortisol during times of anxiety and may play a role in the development and worsening of cancer and other conditions.

Also, sleep deprivation make pain worse in people who suffer from chronic pain from any source – headaches, back pain, bladder, etc.

 

Sleep and Stress

There is a strong connection between sleep and stress.
Research shows that cancer patients who manage their stress in group therapy, with good social networks, or with regular exercise often fare better than patients who don’t manage stress effectively.

People who are depressed or anxious have a specific pattern of sleep disturbances. And if you had a bad night’s sleep, you don’t handle stress as well. Conversely, those who better manage stress are more likely to have good sleep patterns.

How to get good restful sleep

You first need to know that all aspect of this program is interrelated – all parts of the program feeds the other. Managing stress help with sleep, sleep helps manage stress, exercise helps with sleep, the more nourished you are the better you’ll be able to manage stress and the better sleep you will get.

Second, find out why you’re having difficulties sleeping. Stress, depression, rumination, sleep apnea and anxiety could be the cause and to resolve the problem, these issues have to be faced. For severe depression and anxiety a physician should treat you.

Sleep MUST be a priority. You can get away with one or two late nights, but on the third night, you should pay back the sleep time lost. You must schedule sleep like any other daily activity, so put it on your “to-do list” and cross it off every night. But don’t make it the thing you do only after everything else is done – stop doing other things so you get the sleep you need.

Rule out Sleep Apnea – sleep apnea is a sleep disorder characterized by abnormal pauses in breathing or instances of abnormally low breathing, during sleep. Each pause in breathing, called an apnea, can last from a few seconds to minutes, and may occur 5 to 30 times or more an hour.[A sleep study should be done in a sleep clinic so the best solution can be found. There are many solutions, ranging from a splint to keep your jaw moved forward to special breathing masks called a CPAP machine or just losing weight if you are over weight.

Turn off all of your lights and electronic devices. Make sure the room is completely dark, so that you cannot see your hand in front of your face. Keep electric clocks at least 3 feet away from your head. Better yet, get an battery operated clock. Take the TV out of the bedroom. This one can be difficult but you will thank us. Some people think that watching TV helps them go to sleep. This is not true. You probably just need some other white noise like a fan or sounds of ocean waves or something. TV and other electronic devices lower melatonin and interfere with good quality sleep.

Exercise – Most people benefit the most when it comes to sleep quality from working out in the morning or before dinner, but everyone is different. Experiment with your workout times, and see which is most effective for you.

12 Easy Steps to Sleep better

1.    Leave your troubles outside the bedroom door. Write down all of your concerns and worries and possible solutions in a notebook, so you don’t need to ruminate in the middle of the night.

2.    If you are unable to fall or stay asleep, leave your bedroom and engage in a quiet activity elsewhere. Do not permit yourself to fall asleep outside the bedroom. Return to bed when – and only when – you are sleepy. Maintain a regular arise time, even on days off work and on the weekends.

3.    Use your bedroom only for sleep and sexual intimacy. Avoid watching television, computer use, talking on the phone or reading stimulating books in the bedroom. Reading calming books for 5 to 10 minutes can promote sleep. (You may want to remove the television and/or phone from the bedroom.)

4.    Avoid strenuous exercise 5 hours of bedtime – but get the appropriate exercise regularly. Best time for exercise is in the morning.

5.    Get an hour of outdoor light each day, even if it is divided throughout the day.

6.    Take a warm 15 – 30 minutes bath about an hour before going to sleep.

7.    Drink a warm cup of chamomile tea.

8.    Keep the right temperature in your bedroom. Usually fresh air promotes sleep so crack the window open if the weather and noise permits.

9.    Keep your room as quiet and as dark as possible.

10. Avoid electromagnetic fields (EMF) exposure during sleep. This means electric blankets, heaters or waterbeds. Keep electronic devices such as alarm clocks as far away from your head as possible.

11.Sleeping garments, including sheets and sleep wear should be 100% natural fibers like cotton or silk.

12.     Make your last meal the lightest most of the times and have it 2 to 3 hours before bedtime.