Obvious circumstances with Covid-19 virus have made a "people gathering" for my normal talks in Los Angels and Sacramento postponed this month March (2020) and indefinitely. But I was able to record my talk with audio and my Powerpoint slides so you can have even better access to the information and take you time review it.
The talk's title is "Eat MORE 'Good Carbs' & Less Fat! & Reverse Your Diabetes & Insulin Resistance." There are about 70ish slides with 4 short videos mixed in. The videos are excellent and the slides are dense with information.
Bottom line is diabetes is the 6th leading cause of death in the United States but is largely a preventable and many times reversible condition that increases the risk to all other chronic diseases. It is also one of the risk factors in those that are more susceptible to Covid-19 being more lethal to ones health. So good blood sugar control or reversing diabetes is an important thing to do for your overall health and
resistance to disease.
Listen and watch my Powerpoint and Talk Here:
My “Diabetes Resource” page is here:
My "Diabetes Quick Start Handout" is here:
Take care. Be safe and will talk to you soon.
Kirk
Kirk Hamilton PA-C
Call for Brief Medical Questions Mon-Fri 8-9 a.m. PST (916) 489-4400 http://www.healthylivingforbusypeople.com/
http://www.stayinghealthytoday.com/
Fat Causes Insulin Resistance Which is Seen In Diabetes and Alzheimer's Disease! Check Out the Neuroquant Brain MRI to See The Reason Behind Your Memory Issues!
Most people, including health professionals don't realize that if you reduce insulin resistance you not only reverse type 2 diabetes (>90% of diabetics) but you also help prevent Alzheimer's disease and reverse early cognitive decline. Alzheimer's disease has been described as "Type 3 diabetes."
Additionally most of the public and health professionals don't know that it is fat, especially saturated fat (from animals) in the muscle, liver and pancreas that causes the insulin resistance, blocking the ability for insulin to "open the door" and allow sugar into the cell to be burned as energy. Consequently your blood sugar goes up as well as your body pumps out insulin to try and "kick the cell's door open to allow sugar in." If you reduced the saturated and trans fats in the diet, eat a low fat diet of less than 15%, eating only whole-food carbohydrates (fiber intact) you can reverse type 2 diabetes, reduce insulin requirements in type 1 diabetes and improve cognitive function (and prevent Alzheimer's disease).
The role of fat in diabetes is explained simply and clearly by Dr. Rosane Oliveira director of U.C. Davis Integrative Medicine (READ HERE)
Watch This Video on “Fat Toxicity Causing Insulin Resistance”
What Causes Insulin Resistance?
So if you improve your insulin resistance you not only can get rid of your diabetes but you can prevent Alzheimer's disease and reverse cognition and memory issues.
BRAIN IMAGING FOR COGNITIVE DECLINE - ALZHEIMER'S OR OTHER CONDITIONS?
”Neuroquant Technology!”
Many people want to know if they can do a test to see if they have Alzheimer's disease. There really is no one perfect test. But a type of Brain Scan (MRI) using the Neuroquant Program to evaluate brain structures can go a long way in pointing to you where you may have brain structural changes that suggest Alzheimer's, inflammation, infection or conditions like mold or Lyme toxicity which can be other reason's for cognitive decline and memory loss aside from Alzheimer's. The only place in Sacramento that uses the Neuroquant technology is is Diagnostic Radiological Imaging (DRI). The test is paid for by Medicare with the appropriate diagnostic codes for memory loss and cognitive decline. Cash price for those who
have no insurance or an HMO is $780.
What makes this test so exciting to me is to able to differentiate between different causes of memory and cognitive issues and then treat accordingly. Also, at DRI I have access to an excellent radiologist who does nothing but look at Neuroquant MRIs to simplify reading the report and interpreting them for me.
Watch here for information about the Neuroquant MRI to evaluate cognitive decline.
Then give me a call between 8-9 a.m. to discuss - 916-489-4400 or come in for an appointment to discuss my approach to Alzheimer’s, memory issues and reversing diabetes.
__________________
Come join me for my talk "Reverse Diabetes Now! Carbs are Not the Cause but The Solution to the Diabetes Epidemic" and we will discuss in depth insulin resistance and how to reverse it.
HOPE TO SEE SOME OF YOU NEXT WEEK IN TORRANCE, CA (Wed, 3/18/20) at 6:00 p.m.
OR March 20th in Sacramento, CA, 6:00 p.m.
Get "Mastering Diabetes" the book. Take Robby and Cyrus's Diabetes Coaching Program. Will save you thousands of dollars and for some of you save your life or add many more good health years to your life.... I mean it! ORDER THE BOOK FROM HERE:
"Mastering Diabetes: The Revolutionary Method to Reverse Insulin Resistance Permanently in Type 1, Type 1.5, Type 2, Pre-diabetes, and Gestational Diabetes"
WATCH: The animation and narration in this short video by Robby Barbaro, MPH, a type 1 diabetic and Co-Author of "Mastering Diabetes" (has to take insulin) is straight forward and so simple to apply. (5:28 MIN)
Be Well,
Kirk
Kirk Hamilton PA-C
Call for Brief Medical Questions Mon-Fri 8-9 a.m. PST (916) 489-4400
HealthyLivingForBusyPeople.com StayingHealthyInTheFastLane
Sugar, Sugar Everywhere! It's Up To You To Be Smart! Government & Business Won't Help!
Actually I don't want the Government telling me what to do or eat even if a "Benevolent Dictator" saying you couldn't eat anything but whole, unprocessed carbohydrate would save a lot of lives... That one diet rule would wipe out most chronic diseases in this country. BUT watch this video on Sugar in the US Diet and what our own Government and the free market have done. I am not in favor of government restrictions on foods. I am for an educated public. So educate yourself and don't make poor food choices. Your health is in your hands and "between your ears."
WATCH: "The Recommended Daily Added Sugar Intake"
MY NEXT TALKS - MARCH 18 & 20, 2020:
"Reversing Diabetes by Understanding How Diet Can REDUCE Insulin Resistance and INCREASE Insulin Sensitivity" will be on:
March 18th, Torrance, CA (See for Details)
March 20th Sacramento, CA (See for Details)
Get "Mastering Diabetes" the book. Take Robby and Cyrus's Diabetes Coaching Program. Will save you thousands of dollars and for some of you save your life or add many more good health years to your life.... I mean it!
ORDER THE BOOK FROM HERE:
WATCH: The animation and narration in this short video by Robby Barbaro, MPH, a type 1 diabetic and Co-Author of "Mastering Diabetes" (has to take insulin) is straight forward and so simple to apply.
Be Well,
Kirk
Kirk Hamilton PA-C
Call for Brief Medical Questions Mon-Fri 8-9 a.m. PST (916) 489-4400
Come to "Reversing Diabetes Now!" Talk and Potluck. Learn What Your Physician Probably Doesn't Know About Diabetes.
If you watch this five minute video which walks you through the causes of the diabetes epidemic and it's solution you will no more than 90% of physicians and health professionals that the cause of diabetes is not "Carbs" but excess fat in your muscle and liver cells! The animation and narration in this short video by Robby Barbaro, MPH, a type 1 diabetic (has to take insulin) who co-directs an online Mastering Diabetes Coaching Program (WATCH!!!), is straight forward and so simple to apply.
Come join me for my talk "Reverse Diabetes Now! Carbs are Not the Cause but The Solution to the Diabetes Epidemic"
MY NEXT TALKS IN MARCH, 2020:
Torrance, CA, Lundquist Institute (see flyer) - Wednesday, March 18, 2020, at 6:00 p.m.
and
Sacramento CA, Health Associates (see flyer) - Friday, March 20, 2020, at 6:00 p.m.
Get, Read or Listen - "Mastering Diabetes" the book.
Take Robby and Cyrus's Diabetes Coaching Program. You will save thousands of dollars and for some of you save your life or add many more good health years to your life.... I mean it!
Be Well,
Kirk
Kirk Hamilton PA-C
Call for Brief Medical Questions Mon-Fri 8-9 a.m. PST (916) 489-4400
HealthyLivingForBusyPeople.com and click on “Diabetes Tab”
StayingHealthyToday.com Type in “Diabetes” in the “Search Podcast” Box
New Book! "Mastering Diabetes".... Eating More Good Carbs and Less Fat and Meat Improves Insulin Resistance…
My friends and professional colleagues Robby Barbaro, MPH and Cyrus Khambatta, PhD (nutritional biochemistry) have just come out with their outstanding new book: "Mastering Diabetes: The Revolutionary Method to Reverse Insulin Resistance Permanently in Type 1, Type 1.5, Type 2, Pre-diabetes, and Gestational Diabetes" ....on how to reverse type 2 diabetes, pre-diabetes and gestational diabetes, and dramatically reduce your insulin need in type 1 and 1.5 diabetics. And even more importantly reduce your disease risk to heart and vascular diseases, stroke, hypertension, cancer, kidney disease, neuropathies and Alzheimer's disease which diabetics have a staggering increase risk of.... If you trust me this is a must read for any level of blood sugar problem you have.
Since Robby and Cyrus are type 1 diabetics (they must take insulin to survive) this book is loaded with information for type 1 (insulin dependent) diabetics which are about 10% or so of the diabetics population.
In there book they explain in detail the one great dogma that is so misunderstood today, not just by the public but by most medical professionals as well, that is carbohydrate rich foods are not the cause or problem in diabetes. It's the fat, especially animal fat (or maybe the animal protein), along with excess calories from any source with lack of exercise that causes diabetes.
They go into a "deep dive" on why the ketogenic diet works initially, but is NOT the long-term solution to diabetes. They go into a "deep dive" showing that it is the fat in the muscle cell (liver and pancreas as well) that blocks insulin's ability (insulin resistance) to allow sugar to go into the cell easily (insulin sensitivity) and be burned as energy (please watch video illustration of this below. Most physicians have no clue about fat and insulin resistance) WATCH....
ORDER THE BOOK FROM HERE:
"Mastering Diabetes: The Revolutionary Method to Reverse Insulin Resistance Permanently in Type 1, Type 1.5, Type 2, Pre-diabetes, and Gestational Diabetes"
WATCH/LISTEN/READ MY PAST INTERVIEWS WITH ROBBY BARBARA, MPH AND CYRUS KHAMBATTA, PHD ON THE TOPIC OF IMPROVING "INSULIN SENSITIVITY", DECREASING "INSULIN RESISTANCE" BY DIET AND EXERCISE.....
Reversing Insulin Resistance and Diabetes With Whole Carbs, Not More Fat and Protein!
How to Dramatically Improve Insulin Sensitivity in Type 1 & Type 2 Diabetes with Diet – An Interview Robby Barbaro, Instructor, Mastering Diabetes Coaching Program
How You Reverse Insulin Resistance (and Diabetes) with A Low-Fat, “Whole” Carbohydrate, Plant-Based Diet – An Interview with Cyrus Khambatta, PhD
Reversing Your Diabetes…The Mastering Diabetes Retreat and Coaching Program – An Interview with Robby Barbaro and Cyrus Khambatta, PhD
MY NEXT TALKS IN MARCH, 2020:
"Reversing Diabetes by Understanding How Diet Can REDUCE Insulin Resistance and INCREASE Insulin Sensitivity" will be on Wednesday and Friday 6:00 P.M.
March 18th, Torrance, CA & March 20th Sacramento, CA.
One of the most important talks I give. If you really understand how to normalize your blood sugar your will not just reverse and prevent diabetes but also dramatically reduce your risk to ALL cardiovascular diseases (heart, hypertension, stroke, peripheral vascular disease) and kidney diseases and Alzheimer's disease and cognitive disorders.
Get "Mastering Diabetes" the book. Take Robby and Cyrus's Diabetes Coaching Program. Will save you thousands of dollars and for some of you save your life or add many more good health years to your life.... I mean it!
Be Well,
Kirk
Kirk Hamilton PA-C
Call for Brief Medical Questions Mon-Fri 8-9 a.m. PST (916) 489-4400
http://www.healthylivingforbusypeople.com/
http://www.stayinghealthytoday.com/
Learn How to Lose 59 lbs in 4 1/2 Months SAFELY! That Won’t Lead to “Yo Yo” Dieting
...Not Mandatory but Bring a Plant Based Dish or Food to Share (no oil please)
______
CASE STUDY 59/5 LB WEIGHT LOSS IN 4 1/2 MONTHS!
Want to know how this 63 year-old male lost 59 1/2 lbs in 4 1/2 months by eating without any limits on the quantity of plant food he consumed? Come tonight and we will discuss!
9/3/19 Weight - 330.8 lb, BP 143/93, P 44
9/5/19 Weight - 326.2 lb, BP 128/82, P 47
9/19/19 Weight - 318.6 lb, BP 139/87, P 59
10/4/19 Weight - 309.6 lb, BP 138/82, P 68
11/5/19 Weight - 298.0 lb, BP 141/86, P 56
11/18/19 Weight - 291.4 lb, BP 153/94, P 67
12/19/19 Weight – 282.0 lb, BP 129/86, P 69
1/20/20 Weight – 271.0 lb, BP 129/78, P 65
****Even though he was deficient in testosterone from the very beginning of his program he received no testosterone or testosterone enhancement till after he had lost 32 lbs (11/5). The enhancers of testosterone production really didn't work in this subject. All the weight loss up to this point was from his own efforts with diet and exercise and desire!
NO HORMONES
9/3/19 Testosterone, Total 313 250-1100 ng/dL (330.00 lbs.)
9/3/19 Testosterone, Free 45.1 46.0-224.0 pg/Ml
9/3/19 Testosterone, Bio 94.6 110.0-575.0 ng/dL
11/5/19 Testosterone, Total 287.0 250-1100 ng/dL (298.0 lbs.)
11/5/19 Testosterone, Free 31.8 46.0-224.0 pg/mL
11/5/19 Testosterone, Bio 64.0 110.0-575.0 ng/dL
CLOMIPHENE 50 MG 3 X WEEK
11/18/19 Testosterone, Total 328.0 250-1100 ng/dL (291.4 lbs.)
11/18/19 Testosterone, Free 40.2 46.0-224.0 pg/mL
11/18/19 Testosterone, Bio 8.0 110.0-575.0 ng/dL
HCG CHALLENGE TEST 1000 UNITS EVERY OTHER DAY
12/19/19 Testosterone, Total 438.0 250-1100 ng/dL (282.0 lbs.)
12/19/19 Testosterone, Free 39.6 46.0-224.0 pg/mL
12/19/19 Testosterone, Bio 83.1 110.0-575.0 ng/dL
NO HORMONES
1/20/20 Testosterone, Total 299.0 250-1100 ng/dL (271.0 lbs.)
01/20/20 Testosterone, Free 37.2 46.0-224.0 pg/mL
01/20/20 Testosterone, Bio 68.4 110.0-575.0 ng/dL
Testosterone is not the answer to every males weight issues! I use it but want the patient to find out how much he can do on their own. If you give testosterone right away you are taking away a patient's power and you are attaching him to taking testosterone the rest of his life! Any physician ever tell you that? It's testosterone for life in reality.... Again I use testosterone in patients.... It can be incredibly valuable!..... BUT I try and give it AFTER a really good effort by the patient using lifestyle! Patients need to know how much they can achieve on their own... even if you are deficient in the hormone like this gentleman.
PROBLEMS
Anxiety – better
Cognition – better
Depression – much less. Of medication. Using SAMe
Drive – much better
Erections – erections have been good with Viagra
Family history of CHF – no issue
Hypertension – better with less medication
Hyperlipidemia – better with less medication
Joint - back, knees and right ankle – better
Libido – still would like more – better
Lose Weight – has lost 59 lbs in 4 ½ months
Nocturia 3-4 times at night
Sleeps more easily
Stomach no problem
Tired – more naps lately – has excellent energy now
OCCUPATION: retired general engineering – heavy earthwork, commercial centers
MEDICATIONS
Alprazolam .5 mg 3 x day
STOPPED - Hydrocholorothiazide 25 mg/d
STOPPED - Ibuprofen 600 mg 1-2 x daily
HCG .5 cc/1000 units every 3rd day
Losartan 100 mg/d
STOPPED - Neurontin 300 mg/d
STOPPED - Propranolol 40 mg
STOPPED - Ranitidine 150 mg/d
STOPPED - Rosuvastatin 20 mg/d
Sildenifil 100 mg/d
STOPPED - Tylenol #3 with codeine not regularly – back
SUPPLEMENTS
Active CoQ100 2/d
Aged Garlic Extract 2/d
Aloevera juice 1 tablespoon per day
Arterosil 2/d
Berkeley Life Nitric Oxide 2/d
Cal/Mag Liquid 1 tablespoon before bed for stools and sleep
Metabolic Synergy 2/d – multiple vitamin/mineral
SAME 400 mg 3 in the morning (for mild depression)
Visbiome 1/d
DIET
1-2 - 70 Oz smoothies per day - Smoothie Inflamx 2 scoops in each drink 2 times per day
LARGE VEGETABLE SALAD with beans in it
Snacks: Garbanzo, black beans
LOTS OF WHOLE FRUIT PER DAY
Soups and whole plant-based recipes – His wife is cooking plant-based dishes
Swim or walk 1 hour daily
Follow-up in 1 month
JANUARY 20, 2020 – WEIGHT 271.0, BP 129/78 (September 3, 2019 – 330.8 lbs, BP 143/93 )
THOUGHTS ON SUCCESS…
Patient was…..
Committed from day 1
Ate mostly raw – 70 oz green smoothie
Salad daily
Ate beans as snack daily
Exercised an hour daily – no excuses (AND NO PUSHING FROM ME)
“Avoid drinking and environment where he would drink
Wife was participating
Rapid weight loss motivates
Rapid reduction in pain motivates
Rapid improvement in mental function and energy
Commitment to monthly follow-up
YOU CAN DO THIS TO!
COME TONIGHT AT 6:00 P.M. AND DISCUSS AND EAT!
HEALTH ASSOCIATES MEDICAL GROUP WAITING ROOM!
”FOOD IS THE MOST POWERFUL MEDICINE!”
Be Well,
Kirk
Questions Call Kirk 916-489-4400 8-9 PM M-F PST
HealthyLivingForBusyPeople.com
Intermittent Fasting, Fasting Mimicking Diet - Hype or Valid Health Practice?
Totally support the concept of fasting. Recommend the book "The Longevity Diet" by Valter Longo, PhD. His 5 day fasting mimicking diet Prolon is no gimmick and has a proven track record on reducing lipids, blood sugar, inflammation (CRP), central weight, stimulates autophagy (cellular clean-up) and stem cell production. I think the most important thing it does after 3-6 consecutive months of doing this modified fast 5 days out of the month is people get control of their food intake and addiction. They just say they don't need the food. That is the best effect as far as I am concerned. You can order it on line. Our patients at Health Associates can get it through the office at a significant discount versus the online price. Highly recommend it. Done it myself and supported many patients through it. Have an MS patient who has been with us a long time. She has just added the monthly 5 day Prolon to her normal regimen and after 5-6 months she is walking better, has more balance and is stronger (and has lost some weight. In animal models there has been some promising data with MS. Can't hurt and can only help. If you are on multiple medications. Especially blood sugar or blood pressure regulating medications you should be followed my your health practitioner. Come to my weight loss talks next month and I will have a few slides and discussion on the Fasting Mimicking Diet:
Torrance, CA, Lindquist Institute on February 12th
Health Associates, Sacramento, CA on February 14th (Yup Valentines Day!)
Also if in SoCal in early February go see Dr. Michael Greger speak on his new book, "How Not to Diet".... He is an outstanding speaker. Thursday, February 6, 2020 at 6:30 310-517-4666
Kirk
Questions Call Kirk 916-489-4400 8-9 PM M-F PST
Visit: Living to 100 at HealthyLivingforBusyPeople.com
Similar Approaches to Diabetes and Macular Degeneration with Nutrition and Lifestyle - An Ophthalmologist's Perspective - Shalesh Kaushal, MD, PhD
Kirk’s video overview of Dr. Kaushal's interview (7:13 min) Kirk’s podcast with Dr. Kaushal (39:21 min)
India’s Diabetic Crisis
The WHO projects that India by 2020 will have 300 million new diabetics, China 200 million and the United States 100 million. The major cause of this diabetes epidemic is diet change. The traditionalIndian diet has changed considerably with the increased consumption and availability of fast, fried and processed foods. In Northern India there is a higher use of processed oils in preparing foods and in processed foods themselves. There is also a higher consumption of processed sugars added to foods and carbonated soft drinks. As people migrate to the cities from rural areas for jobs there is more processed foods consumed with added fats, oils, sugar and animal products compared to the traditional rural diet. There has been a significant increase in non-vegetarians over the last 20-30 years in India.
How Does Dr. Kaushal Approach the Diabetic Patient?
Dr. Kaushal is a retinal specialist and ophthalmologist as well as having PhD in biochemistry, with a focus now on nutritional biochemistry and metabolic diseases. The retina is the most metabolically active tissue in the body and has the largest oxygen supply. It has the largest blood supply per unit weight in the body. Virtually every human disease has a retinal manifestation in the body. Hypertension and diabetes can be detected in the retina. So chronic diseases can be detected early by observing retinal changes.
Age-Related Macular Degeneration and Chronic Eye Conditions
The number one cause of blindness is cataracts, followed by glaucoma, macular degeneration and diabetic retinopathy, in particular swelling of leaky blood vessels in the area of central good vision which is called diabetic macular edema. The number one cause of missed work days in the United States is diabetic macular edema. It is a very serious medical and economic problem. The same risk factors for macular degeneration are the same risk factors for coronary artery disease and Alzheimer’s disease. Insulin dysregulation appears be a significant factor in the initiation and progression of these and other chronic conditions, as well as the diabetic state. Statins don’t appear to help macular degeneration but are the number one cause of reversible muscle weakness and a cause of some reversible dementias.
Age Related Macular Degeneration (AMD), Diet and Lifestyle
Dr. Kaushal tells patients initially that AMD is similar to other chronic illnesses – diabetes, hypertension, coronary artery disease, obesity, age-related muscle loss and age-related bone marrow dysfunction because they are all found to be caused by low grade inflammation in the body or retina in AMD.
ARED Studies (Age-Related Eye Disease Study) on AMD
Dr. Kaushal is not a big fan of the AREDS eye supplement designed to treat AMD containing beta-carotene, vitamins C and E, and minerals zinc, copper because they showed a very minimal benefit in AMD and a very minimal improvement in vision. There are good epidemiology studies showing the average nutrient deficiencies in the body are more than 40 essential vitamins and minerals that the body requires for normal bodily function (production of enzymes and structural proteins). Research has shown that Americans are deficient in more than 80% of these essential nutrients. Dr. Kaushal questions why we would only replace five of 40 nutrients that are deficient with the AREDS product. (See National Eye Institute – “What the Age-Related Eye Disease Studies Mean for You”)
Nutraceuticals and AMD
Dr. Kaushal recommends a high potency vitamin and mineral supplement. He doesn’t test for all these nutrients. It is somewhat cost prohibitive. He also adds omega-3 fats because the retina has the highest concentration of omega-3 fats in the body. He educates his patients on how to lower their omega-6 fatty acid intake, which are proinflammatory, while simultaneously increasing their omega 3s by using fish oil, krill oil, cod liver oil, or omeg3 fatty acids from algae. It is critically important to lower the omega-6 side by reducing processed food consumption, their use in cooking, and consuming animal products where animals have been fed omega-6 fatty acid enriched acid feed to “fatten” the animals. He wants individuals to consume any type of omega-3 fatty acids but he likes krill oil which is rich in astaxanthin. He also likes cod liver oil which has vitamins D and E and has compounds called the retinoids which can improve the functioning of the retinal cells.
How Fast Can Change Be Seen
Dr. Kaushal gives the analogy that turning AMD around is like turning a tanker around, not a speed boat. This chronic disease didn’t occur overnight, so while improvement can be seen very rapidly (within a month sometimes), the actual pathology of AMD reversal is a gradual process. He uses Saturday morning group visits to reinforcement these principles. Genomic predisposition and evaluation of the patient’s metabolic status including mTOR, autophagy, insulin signaling, inflammation, oxidative stress and nutrient sensing pathways are of value.
Program for Diabetes and AMD
A whole food, mostly plant-based diet, with minimal processed carbohydrates with a high potency multivitamin and mineral, omega-3 fatty acids and additional nutrients which Dr. Kaushal labels as molecular rheostats are astaxanthin, Ashwagandha, turmeric, Lei Gong Teng (celestrol) and alpha lipoic acid (ALA). ALA improves mitochondrial function and number, and production of ATP. Acetyl-L-carnitine works synergistically with ALA in improving mitochondrial function. Nutraceuticals work differently than pharmaceuticals. Nature works by compounds that effect multiple cellular pathways all at once and are effective at re-stablishing cellular balance. They are useful in the retina, brain, heart, liver and other organs effecting chronic diseases. Exercising 30 minutes a day as a minimum can stimulate mitochondrial function as well. Chelation therapy may help with removal of toxic metals which can be oculo-toxic, but direct benefit of chelation studies showing benefit is lacking in AMD.
The Retinal and Alzheimer’s Connection
Both preservation of vision and memory are at the top of the list of patient concerns regarding healthy aging and independence preservation. Evaluating retinal health can also be an early detection tool for Alzheimer’s disease. Dr. Kaushal noted his talk on AMD is very similar to neurologist Dale Bredesen MD’s talk on Alzheimer’s disease prevention and reversal recognizing their similar pathophysiology.
Shalesh Kaushal, MD, PhD’s Background and Training
He was born in India and his family moved when he was 5 years old to Michigan where his father obtained a master’s degree in electrical engineering. His father previously had earned a masters in mathematics from India. They moved to Vermont where is father worked for IBM on the first PCs. He went to Yale University as an undergraduate and wanted to be a theoretical physicist but found he was good at solving problems and finished his undergraduate work in molecular biophysics and biochemistry. He went to John’s Hopkins Medical School and wanted to be a neurosurgeon. He had two mentors there in ophthalmology which influenced him greatly into becoming an ophthalmologist. He then wanted to pursue research and went to MIT. He did his ophthalmology residency at U.S.C., a retina fellowship at Washington University in St. Louis and did a year training in London at the Moorfield’s Eye Hospital. He worked for a short period at the University of Minnesota and work for many years at the University of Florida. He had an endowed chair and an endowed lab at the University of Florida and eventually transitioned to private practice in Florida. His practice’s website is www.comprehensiveretinaconsultants.com and has two locations in Florida presently. They treat macular degeneration and other chronic conditions with the state-of-the art diagnostic equipment that would rival any academic center. At his clinic they evaluate vascular and autonomic system health with the Max Pulse, EndoPat and the Glycocalyx Check. They have outstanding noninvasive structure-function testing of the retina as well and other metabolic testing for chronic diseases. He is the lone physician ophthalmologist in his practice with a significant support team.
Comprehensive Retina Consultants, Shalesh Kaushal, MD, PhD, 1501 N US HWY 441 Bldg 1100 , Ste 1106 The Villages, FL 32159 Phone Number: 352-775-0852 /Fax: 352-751-1869 and 203 South Seminole Avenue Inverness, FL 34452 Phone: 352-794-1500 Fax: 352-341-3870 www.comprehensiveretinaconsultants.com
Be and Stay Well,
Kirk
You can call for "brief" medical questions 8-9 a.m. PST Monday-Friday 916-489-4400 KwikerMedical.com StayingHealthyToday.com Kirk's Healthy Living Tip Sign Up Kirk's FREE "21 Day Healthy Living Program" Kirk's FREE "Alzheimer's, Heart Disease, Diabetes Living to 100 and Obesity 'Reversal' Programs" Kirk’s Healthy Living Tips Archives
A Nitrate-Rich Beetroot Supplement Lowers Blood Pressure Like a Drug and Improves Artery (Endothelial) Function in Pre-Hypertensive Subjects
Kirk's overview video of Dr. Budoff interview (4:00 min)
Kirk’s audio interview (podcast) with Dr. Matthew Budoff (12:12 min)
Why Study a Nitrate Rich Beetroot Product?
Dr. Budoff is interested in studying nutraceutical products claiming they can increase nitric oxide to validate their efficacy and understand how they work. Nitric oxide is a potent vasodilator and protects the endothelial cells against atherosclerosis. Nitric oxide is a cardioprotective substance, but in the past it was difficult to measure nitric oxide limiting research on it.
Study Intention
This study evaluated pre-hypertensives in the 130-140 range systolically (with new guidelines defined as stage 1 hypertension). If these patients drop their blood pressure 6-10 points, they might be able to avoid prescription medication.
Nutraceuticals vs. Drugs
The difference between treating with a drug and a nutraceutical is potency and proof of outcome. In the pharmaceutical the active ingredient is highly purified. The example would be comparing red yeast rice and lovastatin. They are both lovastatin but there are more milligrams of lovastatin, and more consistent amounts of lovastatin in the pharmaceutical lovastatin than in red yeast rice. The same named nutraceutical may vary from product to product in potency and content of active ingredients. There is more consistency and more proven outcomes with pharmaceuticals.
Treating Hypertension with A Nutraceutical
A nutraceutical, such as a nitrate rich beetroot product (Berkeley Life Nitric Oxide Support), will almost always have a better side effect profile, be safer and have better acceptance by patients than a pharmaceutical. So, there is a big advantage to treating patients with a natural product. But you wouldn’t want to treat someone with really high blood pressure, for example at 180 mm systolically with this beetroot product alone if you only going to get a 10 point drop in blood pressure. The patient would still be at risk for stroke and other cardiovascular complications.
Testing for Nitric Oxide
The saliva was tested for nitric oxide from a test strip and nitric oxide was also tested in the blood (test strip made and supplied by Berkeley Life Professional). Nitrate (NO3) in the beetroot converts to nitrite (NO2) in the saliva and then to nitric oxide (NO) in the mouth and stomach.
Endothelial Function Testing
An indirect test for NO in the endothelium is testing brachial flow mediated dilation. This is the oldest test and gold standard for testing endothelial function. It puts a cuff over the arm and restricts blood flow for a certain period of time then releases the cuff and measures the speed and the extent to which the blood vessel dilates after being constricted. A robust response is a big dilation of the artery suggesting a healthy artery (endothelium) and increased nitric oxide, while a blunted response (a small or no increase in the artery diameter) is a more dysfunctional endothelium or one that is given the placebo.
The Study and Results (See ACC Study Poster Presentation)
In this study a significant improvement was seen in those taking the beetroot extract by increased flow mediated dilation, but there was not a significant change in those that received the placebo. This 12-week study was long enough to assess endothelial function, blood pressure and parameters like cholesterol levels. They enrolled 67 people so they would have at least 30 subjects in each arm of the study (active ingredient – beetroot product (30) and placebo (32)) and tested them at baseline, two hours after their first dose (acute effect) and again at the end of the study. The beetroot product was 1 pill containing 314 mg of NO3 (nitrate) from the beetroot extract along with thiamine, potassium and vitamin C (Berkeley Life Nitric Oxide Support, www.berkeleylifeprofessional.com). The product was very well tolerated with no side effects, but long-term studies would have to be done to confirm absolute safety.
“Dramatic” Blood Pressure Results
There was a dramatic response with a blood pressure drop of 12.5 millimeters in systolic blood pressure over 12 weeks which would be very comparable to prescription therapy. The net reduction was a 6 millimeter drop in blood pressure because the placebo group dropped 6 millimeters which is commonly seen in the placebo group when evaluating anti-hypertensive medications. This placebo group effect could be from patients being more compliant and reducing their salt intake. There was also a significant drop in the diastolic blood pressure.
How to Use This Beetroot Extract
This product could be used alone in pre-hypertensive subjects or in combination with an anti-hypersensitive medication safely. Dr. Budoff’s main concern is people with high systolic blood pressure (ex.170 mm systolically) using the beetroot extract only and this won’t be adequate to bring their blood pressure down enough, and they will be at risk for complications from the hypertension. He doubts any significant interactions with other pharmaceuticals, possibly a compounding effect with vasodilators such as nitrates (i.e. nitroglycerin, nitrites, etc.) or PDE inhibitors such as Cialis or Viagra.
Long-Term Anti-Hypertensive and Artery Protective Effects
Dr. Budoff believes these 12-week benefits in blood pressure reduction and improved endothelial function would be sustained as long as one is taking the supplement because the blood pressure lowering effect was sustained over the 12-week period, but a longer trial is needed. Also, it is reasonable to assume, though this would have to be proven over a year-long trial, that the improvement in endothelial function and reduction in blood pressure might lead to slowing of coronary calcification and possibly the reversal of soft plaque. Lowering of blood pressure, plaque regression and slowing of coronary calcification (atherosclerosis) has been shown with aged garlic extract in over five studies with the early studies showing similar reductions of blood pressure and improvement in endothelial function as this study. But at least a year-long study with this beetroot supplement is needed to confirm this assumption.
Future Research
Dr. Budoff was very favorably impressed and actually surprised to see such a significant blood pressure lowering effect of this beetroot extract product. The Berkeley Life Nitric Oxide Support product also had a nice improvement in the brachial blood flow indicating improved endothelial function. He would like to do a year-long trial with this product and evaluate these same parameters along with assessing coronary calcification and plaque growth or regression
Matthew J. Budoff, MD, Prof Medicine, UCLA, Director, Cardiac CT & Fellowship Program, Division of Cardiology, Harbor-UCLA Med Cent 1124 West Carson Street, RB-2 Torrance, CA 90502 Lundquist Institute (formerly LABiomed) Budoff@ucla.edu (310) 222-4104/ (310)787-0448 (FAX)
Be and Stay Well,
Kirk
You can call for "brief" medical questions 8-9 a.m. PST Monday-Friday 916-489-4400 KwikerMedical.com StayingHealthyToday.com Kirk's Healthy Living Tip Sign Up Kirk's FREE "21 Day Healthy Living Program" Kirk's FREE "Alzheimer's, Heart Disease, Diabetes Living to 100 and Obesity 'Reversal' Programs" Kirk’s Healthy Living Tips Archives
Is The Benefit of IV Chelation Therapy in Heart Attack Patients, Especially Diabetics, and The "Saving" of Gangrenous Limbs Due to Removal of Toxic Metals, Oral and IV Vitamins, or Both?
Kirk's video overview of Dr. Lamas interview (9:39 min)
Listen to Audio Interview with Dr. Gervasio Lamas - Click Here (30:07 min)
Background To The TACT 1 & TACT 2 Trials of IV Chelation in Patients with Previous Heart Attacks Dr. Gervacio Lamas has been studying chelation therapy for more than 20 years (TACT 1, [9/2003-8/2012] and TACT 2 [10/2016-4/2021 estimated completion] Trials). He chose to study chelation therapy to challenge his own belief that chelation therapy was not valid after being asked by a patient in August of 1999 if chelation therapy was a legitimate cardiovascular therapy. He later acknowledged that he based his initial skepticism from his professional bias and it was not evidence-based. (JAMA. 2013 Mar 27;309(12):1241-50.) (Full Article; Abstract ; ClinicalTrails.Gov)
Kirk Hamilton's original interivew (audio) with Dr. Gervasio Lamas in May, 2013 Interview Transcripts
Early Chelation Studies
Initially he looked at studies on chelation and it was split down the middle. There were positive case studies on the one side and on the other there were 3-4 small studies by conventional cardiologists saying chelation therapy didn’t work and had no validity. The negative studies were so small you couldn’t exclude that there was some benefit. EDTA was developed in 1937. One of the first reports was in 1956 "Treatment of Angina Pectoris with Disodium Ethylene Diamine Tetraacetic Acid" Am J. Sci. 1956;6:54 [PubMed] [Google Scholar]. EDTA lost its patent in the 1960s. It’s current I&D (FDA license to use in research) is under Dr. Lamas’s name.
The Beginning of TACT 1 (Trial to Access Chelation Therapy)
He contacted colleagues at the National Institutes of Health (NIH) and stated there was the methodology available to put the question of whether chelation therapy was valid or not to the test and he felt that chelation would be found to be non-efficacious and the question of chelation’s value would be put to rest. Three years after that he received a 30 million dollar grant to do the TACT 1 study (Trial to Assess Chelation Therapy). Ten years later in 2012 the study became unblinded (1708 subjects, 55,222 chelation infusions, 40 chelations per participant (infusions including vitamins with the EDTA – vitamin C and B vitamins) all subjects had previous heart attacks, were at least 50 years of age, and had adequate kidney function). The statisticians were from Duke University, the cardiac events were judged to be real or not from Harvard. He made sure he had the best statisticians (Duke University) and clinical event evaluators (Harvard University).
TACT 1 Study Results
When they looked at the data they were surprised to see that the study was positive. They were able to show a reduction of the combined clinical endpoint for death, heart attack, stroke, bypass, angioplasties, hospitalizations for unstable angina in all subjects who previously had a heart attack, which was a “spectacular” result.
A third of the patients had diabetes (633 patients) in TACT 1 and the effect of the EDTA chelation was spectacular, reducing the combined cardiovascular end point by 41%; reducing the risk of death from all causes over 5 years by 43%; reducing the risk of another heart attack in these diabetics by 50%.
Eighty-three percent of these patients were taking statins. There was no reduction of effect with or without statins. So chelation works by a different mechanism than statins. Compared to the old statin studies (statin vs. a placebo) the effect size of the chelation was much greater.
How Does Chelation Work – Toxic Metal Excretion?
EDTA chelates positive divalent ions with great efficacy – like the metals lead and cadmium (++). Measuring metals in the urine before and after the IV EDTA challenge you will find after a challenge individuals will excrete 3000-4000% more of these metals into the urine harmlessly.
Lead runs with calcium and goes initially into the red blood cell, then after one month it goes into bone. Lead has a half-life in bone of 30 years. About 50% of cadmium is stored in your kidneys and the rest is the liver, lungs, neural tissue, the soft organs essentially.
You don’t want any metals in your body. Lead slowly leaches out of bone. In older people lead will have blood levels of 1-2 micrograms/dl. The EPA says this is acceptable. Lead is very “vasculo-toxic.” It poisons the endothelium, the lining of the arteries. It replaces calcium in intracellular reactions and “gums-up” the works.It is an oxidant stressor and increases oxygen free radicals.
All of these toxic metals increase oxidative stress. And then each metal has their own individual metabolic mechanism of cellular poisoning. Diabetics live in a state of high oxidative stress and may be more susceptible to the toxic effects of heavy metals.
Lead and cadmium effect the acetylation of histones, the proteins that unspool DNA or ‘spool it back up’ your DNA. These metals may “gum up” how your DNA is transcribed (created).
We all have these toxic metals being taken up by our bodies. These metals may be causing or contributing to disease and health professionals are not paying any real attention to this problem and have no real knowledge how this toxic metal burden is contributing to common diseases.
Dr. Lamas equates the current situation with everyone being exposed to toxic metals, and probably having a significant burden of them, to the problem of smoking after World War II and the Korean War. Everyone smoked so initially it was difficult to prove that diseases were caused by smoking. But eventually people started looking at smoking as a cause of many diseases. Like-wise, sooner or later, the medical community will eventually start to ask and study the question of what effects do all these toxic metals have on the body and the burden of chronic disease. Cadmium and lead are just two of 5-10 toxic metals seen frequently in the urine upon EDTA IV provocation.
Dr. Lamas’s focus is to look at the effect of toxic metals and chelation with respect to cardiovascular diseases which he believes is significant and can be potentially treated. To look at the effect of toxic metals as a global health problem is beyond the scope of his investigations, but the environmental and health problems from global toxic metal burden are probably significant. He notes science and medicine moves forward in small parts and pieces by evaluating and testing aspects of one disease. In this case he is focusing on cardiovascular disease and the effect of chelation therapy.
TACT 1 Trial Results, The Acceptance of EDTA for Cardiovascular Disease and the FDA
He went to the FDA and sat down with the experts in cardiovascular disease in 2014 and requested from the results of TACT 1 that EDTA chelation therapy be approved for the treatment of cardiovascular disease. The FDA said the study was positive, the drug (EDTA) was safe, but it was only one study. None of the other previous studies mattered because they were too small and with questionable outcome. In reality the FDA said when only one study shows a positive outcome a drug is usually not approved. Without a second confirmatory study of cardiovascular benefit EDTA would “fade” off in the public and health professional’s memory as something that failed and was “shot down.” So, the FDA recommended doing the study again (TACT 2) studying the most responsive group in the TACT 1 trial which was diabetic patient who had a previous heart attack. If the outcome was as positive as the first study, as it should be if EDTA chelation really is a valid therapy, then he could come back to the FDA and it would be “smoother sailing” to getting EDTA chelation therapy approved for cardiovascular disease.
TACT 2 Trial
TACT 2 will follow 1200 diabetic patients with a previous heart attack (MI) who will receive 40 infusions. Presently (April, 2019) they have almost 700 patients enrolled in TACT 2. The study is ongoing and proceeding smoothly in multiple centers and there will be an answer in a couple of years.
There is an oral vitamin arm of the TACT 2 trial since in TACT 1 chelation patients also took oral, high dose, antioxidant-rich supplements as part of the IV chelation protocol. Dr. Lamas is a conventional cardiologist and he is not an expert in dietary supplement use and asked a consensus panel of expert chelation doctors on what should a multivitamin and mineral supplement contain to be given along with the intravenous chelation therapy. In the TACT 1 trial there was a vitamin supplement arm and a placebo arm along with the chelation therapy. There was an 11% reduction in cardiovascular events in the vitamin consuming group in TACT 1 which was not clinically significant, but this doesn’t necessarily mean there was no benefit from the oral vitamins. There may not have been enough patients to have statistical power to show an effect. It was also observed that there was a “HUGE” benefit from the vitamins in the 27% of subjects who were NOT taking statins. In the 83% of subjects who took statins there was no appreciable benefit in cardiovascular risk reduction with vitamin supplementation. Dr. Lamas has no idea what the mechanism might be from this possible benefit of the vitamin supplements in the statin non-users in the TACT 1 trial, but this is another reason they are studying an oral vitamin supplemented group in the TACT 2 trial. If this benefit is confirmed in this diabetic population then this will open up a whole new area of study on the role of high dose antioxidant supplements and their use in cardiovascular disease patients.
Side Effects and Conventional Cardiologist’s Attitudes Towards Chelation
Most traditional cardiologists still believe that chelation therapy has no benefit and may have side effects like causing kidney problems, which it doesn’t. Dr. Lamas has recently given lectures to leading cardiologists at Harvard University, Brigham’s and Women’s Hospital, where he worked and is well received. There was no hostility, no disbelief and patronizing. There were friendly questions and the desire for more information. The physicians saw the evidence, along with pictures of case studies of gangrenous limbs being reversed (amputation avoided) with chelation therapy, and they wanted more information. That said you won’t find these open-minded conventional cardiologists who want more information prescribing chelation therapy or referring their patients to chelation doctors.
Chelation Therapy at Mount Sinai Medical Center, Miami, Florida
Mount Sinai Hospital (Miami, Florida) is the only hospital that he knows of in the U.S. where chelation has been approved through the pharmacy and therapeutics committee and can be prescribed, though it is rarely done so. Dr. Lamas is not out there as a chelation physician but as a scientist trying to develop a new treatment for an unrecognized risk factor for cardiovascular disease. Like cholesterol was before the Framingham study, he is out to prove that chelation therapy is a valid new therapy for cardiovascular disease, possibly my reducing toxic metal burden. He would have no problem putting patients on a statin and utilizing chelation therapy concurrently. They are both proven and safe therapies with no adverse interactions.
Dr. Lamas’s Diet Recommendations
He has poor compliance with any dietary recommendations he makes and doesn’t recommend a specific diet. The diet pattern he encourages is the one that assists the patient in losing weight. He just wants less weight in his patients because “fat is toxic.” He is open to plant-based diets and Mediterranean diets if people will adhere to them and if they have lost weight.
Infection as A Cause Atherosclerosis?
He has not seen any good evidence of an infectious cause of atherosclerosis. Chronic infections in general may increase overall inflammation and may have an adverse effect on the endothelium and other components of the blood vessels in a secondary kind of way. He has not seen evidence of microorganisms growing in plaque that could be treated with an antibiotic or antimicrobial that would lead to a reduction in cardiovascular events. He still believes that coronary calcification is do to microvascular ruptures of inflamed plaque that is walled off by the body with calcium.
Dr. Lamas's Closing Comments
He hopes that individuals who hear this recognize that there I s much more than meets the eye in terms of cardiovascular risk factors.
Critical Limb Ischemia Studies With Chelation Therapy
He just started TACT “3A” which is a 50-patient study with critical limb ischemia subjects (impending amputation). Thirty will receive active treatment and 20 will receive placebo. I shared a case study of an 83-year-old diabetic female who was partially blind who was to have her foot amputated because of a non-healing ulcer. After 2-3 weeks of daily chelation the wound started to heal and she didn’t have to have the food amputated.
Dr Lamas stated, “There is something just so sterile about the Kaplan–Meier curve. You can…you know you can just say well blah blah blah, blah blah blah. You can’t ‘blah blah’ a foot that has gangrene, that had gangrene six months ago and it is still attached now without gangrene. YOU CANNOT ‘SCIENCE’ THAT AWAY" after chelation therapy! He shared that’s how he finished his talk at Brigham’s and Women’s Hospital at Harvard speaking to a cardiologist audience about the TACT 1 & 2 trials and there was nothing that the audience could really respond to with regards to in these critical limb ischemia patients who didn’t lose their limbs due to gangrene because of intravenous chelation therapy.
Kirk Hamilton's original interivew (audio) with Dr. Gervasio Lamas in May, 2013 Interview Transcripts
Gervasio A. Lamas, MD, Chairman of Medicine and Chief of the Columbia University Division of Cardiology at Mount Sinai Medical Center in Miami Florida. He received his B.A. in Biochemical Sciences from Harvard and his M.D. from New York University. He completed his internship, residency and cardiology training at the Brigham and Women’s Hospital at Harvard Medical School. I interviewed Dr. Lamas almost 6 years ago in May of 2013 on the TACT 1 Study – or Trial to Assess Chelation Therapy published in JAMA. 2013 Mar 27;309(12):1241-50.)
Gervasio A. Lamas, MD, Columbia University Division of Cardiology at Mount Sinai Medical Center 4300 Alton Road, Suite 2070 Miami Beach, Florida 33140 Telephone: 305-674-2690, 305-674-3936, 305-674-2169 (f), Gervasio.lamas@msmc.com
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Be and Stay Well,
Kirk
You can call for "brief" medical questions 8-9 a.m. PST Monday-Friday 916-489-4400 KwikerMedical.com StayingHealthyToday.com Kirk's Healthy Living Tip Sign Up Kirk's FREE "21 Day Healthy Living Program" Kirk's FREE "Alzheimer's, Heart Disease, Diabetes Living to 100 and Obesity 'Reversal' Programs" Kirk’s Healthy Living Tips Archives