Friday, September 25, 2015

Cleaning products could be harming your health

Natural Health care practitioners always urge clients to clean up their pantries and the cleaning products used in the household and in the laundry room.

Here is a great article that explains one of the reasons why this is good advice...

Common Cleaning Products Can Trigger Asthma Symptoms

SOURCE: - Occup Environ Med 2015.
(Reuters Health) - Fumes from cleaning products used at work can make existing asthma worse, according to a new study of professional cleaning service employees.
Products such as bleach, glass cleaner, detergents and air fresheners exacerbated asthma-related symptoms for the women, and their reduced lung function lasted until the morning after exposure, in some cases getting worse with time.
"These results support the importance of developing workplace health and safety practices designed to limit exposures to irritant chemicals in cleaning products," the study team wrote online April 23 in Occupational and Environmental Medicine.
A wide variety of cleaning products are used by workers in settings like offices, factories and hospitals, write David Vizcaya, of the University of Montreal Hospital Research Center in Canada, and his colleagues. Professional cleaning services are necessary to clean, disinfect, and control dust and mold on surfaces, but a number of studies in recent years have reported associations between exposure to cleaning products and asthma, the researchers note.
Vizcaya and his team evaluated respiratory symptoms over about two weeks in 21 women who had asthma symptoms within the past year, eight of whom also had a longer history of asthma. All were employees of cleaning companies in Barcelona, Spain.
During the study period, the women recorded the different types of cleaning products they used at work as well as how they used them, such as in spray or liquid form. The list included 14 different generic cleaning agents including bleach, detergents, degreasers, carpet cleaners and waxes and polishes.
On average, the women used just over two different types of cleaning products each day, and on about three out of every four working days the women were exposed to at least one strong irritant, such as ammonia, bleach or hydrochloric acid.
During this period, 17 women reported having at least one upper respiratory tract symptom, such as sneezing, scratchy throat and runny nose. Eighteen women also reported at least one lower respiratory tract symptom, such as coughing, wheezing or chest pain.
There was a stronger association between exposure to cleaning products and developing these symptoms among women with a history of asthma, as compared to the rest of the group.
But due to the small number of participants in the study, the authors caution that these results should be interpreted "carefully," and that more research is needed.
Other recent studies have linked the chlorine in swimming pools and in bleach used for cleaning homes and schools to asthma and respiratory infections among swimmers and school children.
The risk from cleaning products is not only seen among professional cleaners, said Dr. Norman H. Edelman, senior consultant for scientific affairs at the American Lung Association (ALA). Using these products can be dangerous in the home as well.
"The ALA recommends that at least for the home, people use non-toxic cleaners, especially for those with asthma and allergies," Edelman told Reuters Health.
"In an attempt to be vigorous, many people use chlorine bleaches and lye at home, and this can be very irritating to the lungs," Edelman said. "And it is usually not really necessary to use products like this. If people are going to use these products, they often don't know how to protect themselves."
For instance, mixing cleaning products that contain bleach and ammonia can cause severe lung damage, he noted.
In the industrial setting, protection for workers may vary considerably, he added. Safety regulations will not only vary between countries, but also depending on the type of industry.
"Many of the people working in this industry are day laborers, they are not unionized and may be afraid to lose their jobs if they complain or ask for protective gear," Edelman said.
In a large corporation or medical center, these workers may be unionized and safety regulations will probably be more strongly adhered to, but even then, the type of protective gear will make a difference.
"Particle masks are not too expensive or cumbersome to use, but they are not going to keep the fumes out," he said. "To keep out the fumes, they may need more cumbersome equipment."

Monday, September 21, 2015

Low Vitamin D Tied to Testosterone Dip in Healthy Men

Low Vitamin D Tied to Testosterone Dip in Healthy Men

American Urological Association (AUA) 2015 Annual Meeting: Abstract MP51-04. Presented May 17, 2015.

Low levels of vitamin D are significantly and independently associated with low levels of testosterone in otherwise healthy middle-aged men, according to a study presented at the American Urological Association 2015 Annual Meeting in New Orleans.
In this new analysis of data from of the World Trade Center CHEST program, blood samples from 824 men were analyzed for various parameters, such as 25-hydroxyvitamin D and total testosterone. Hypovitaminosis D was defined as a 25-hydroxyvitamin D level below 30.0 ng/L.
The Framingham 10-year cardiovascular risk score was used as a proxy for general cardiovascular risk.
Level of 25-hydroxyvitamin D were insufficient in 68% of the samples. And only about 11% of participants with insufficient levels took vitamin D supplements, "which is pretty low," said lead investigator Mary Ann McLaughlin, MD, from the Mount Sinai Hospital in New York City.
Total testosterone was higher in men with normal levels of 25-hydroxyvitamin D than in men with lower levels (341.7 vs 319.6 ng/L; P = .012).
Even after adjustment for the Framingham 10-year risk score, "subjects with hypovitaminosis D still had significantly lower total testosterone than those with normal total testosterone (P = .019)," Dr McLaughlin and her colleagues report.
When levels of 25-hydroxyvitamin D were lower, body mass index was higher than when levels were normal (30.8 vs 29.12 kg/m²; P < .001), waist circumference was greater (41.3 vs 39.8 inches; P < .001), and lipid profiles were less favorable.
In previous studies, testosterone levels were shown to be lower in mice who had the vitamin D receptor genetically deleted, said Dr McLaughlin.
"This suggests that there is something about testosterone synthesis that needs vitamin D," she explained.
Vitamin D Supplementation
In a small German study of healthy overweight men with a low baseline level of 25-hydroxyvitamin D and testosterone levels at the lower end of the reference range, there was a significant increase in total testosterone levels after 12 months of vitamin D 3000 IU daily (Horm Metab Res2011;43:223-225).
When patients ask if they should take vitamin D, Dr McLaughlin said she assesses their levels first.
"When urologists have patients with low testosterone levels, they should consider looking at the vitamin D levels as well," she advised.
Some researchers have suggested that low vitamin D simply is a reflection of the aging process.
"We see calcification of the arteries with aging," Dr McLaughlin explained. "If we can keep those levels of vitamin D adequate throughout the aging process, maybe we can help prevent vascular calcification."
There has been an association between calcium supplementation alone and increased risk for cardiovascular events in men, "so if you are going to take calcium supplementation, you should take it with vitamin D," she added.
Pathway Unclear
The association between low vitamin D and low testosterone levels is real, but that the pathway by which supplementation might improve androgen function and increase the biosynthesis of testosterone is simply not clear, said Abdulmaged Traish, PhD, from the Boston University School of Medicine.
Dr Traish pointed out that the German study was primarily a weight-loss study, and weight loss in and of itself causes increases in testosterone.
"We see that in patients who undergo bariatric surgery to remove visceral fat," he explained. "Once the weight loss has taken place, their testosterone levels normalize independent of anything else."
Dr Traish said he has discussed the potential pathway by which the restoration of vitamin D could restore normal androgen physiology with Michael Holick, MD, also from the Boston University School of Medicine, and the author of The Vitamin D Solution.
"When we talk about this potential association, we still can't understand how vitamin D restoration might affect testosterone," he told Medscape Medical News.
"While I'm sure there are consequences of being vitamin D deficient, we can't quite specify what adverse effects vitamin D deficiency might bring," he said.
This study was funded by the National Institute for Occupational Safety and Health and the Centers for Disease Control and Prevention. Dr McLaughlin and Dr Traish have disclosed no relevant financial relationships.

Wednesday, September 16, 2015

Tylenol and the likes may not be as effective as you were led to believe......

Another reason to try natural medicine first...

Acetaminophen Ineffective for Back Pain, Knee/Hip OA

Acetaminophen (paracetamol, acetyl-para-aminophenol; APAP) was ineffective for low back pain and provided only clinically insignificant relief of hip or knee osteoarthritis (OA) pain while quadrupling the risk for liver function abnormalities, according to a systematic review and meta-analysis published March 31, 2015 by Australian researchers in the British Medical Journal. On the basis of this analysis, the researchers suggest that acetaminophen's front-line place in OA and back pain clinical treatment guidelines should be reconsidered.
However, Raveendhara R. Bannuru, MD, PhD, director, Center for Treatment Comparison and Integrative Analysis; assistant professor of Medicine at Tufts University School of Medicine; and member of the Special & Scientific Staff at the Tufts Center for Arthritis and Rheumatic Diseases, Tufts Medical Center, Boston, Massachusetts, told Medscape Medical News that the Australian study added to a growing body of evidence supporting reconsideration of the role of APAP.
Dr Bannuru, who was not involved in this study, recently reached similar conclusions in a meta-analysis of pharmacologic interventions for knee OA.
"I would definitely expect all the concerned societies involved in developing OA guidelines to take a closer look at this study, as well as our study in reassessing their recommendation on the use of acetaminophen," Dr Bannuru said.
Drugs are the most common first-line approach to treating spinal pain and OA. Acetaminophen is recommended as first-line treatment in major treatment guidelines, including those from the American College of Physicians and the American Pain Society, those from the European League Against Rheumatism, those from the American College of Rheumatology, those from Osteoarthritis Research Society International, and those from the National Institute for Health and Care Excellence.
Little Evidence of APAP Efficacy in Low Back Pain, Knee/Hip OA Found
Gustavo C. Machado, a PhD student at the George Institute for Global Health, University of Sydney, Australia, and colleagues, working with Associate Professor Manuela L. Ferreira, PhD, from the University of Sydney Institute of Bone and Joint Research, analyzed data from 13 randomized controlled trials that compared the efficacy and safety of acetaminophen with placebo in more than 5000 patients with low back pain (n = 1825) or hip or knee OA (n = 3541). Primary outcomes were pain (scale of 0 - 100), disability (scale of 0 - 100), and quality of life. Secondary outcomes were adverse effects, adherence, and use of rescue medications, and the researchers used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to evaluate quality of evidence.
In low back pain, the authors found high-quality evidence that acetaminophen was ineffective in the short term for reducing pain, reducing disability, or improving quality of life.
In hip and knee OA, the authors found high-quality evidence that acetaminophen produced a statistically significant reduction in pain, but the difference (−3.7) was far below the −9.0 criterion for minimal clinically important difference. Similarly, the −2.9 reduction in disability did not meet the criterion for clinical importance.
Maurizio Cutolo, MD, director, Research Laboratories and Academic Division of Clinical Rheumatology, University of Genova, Italy, who was not involved in the study, told Medscape Medical News, "At least for back pain, which is a very acute and disabling condition, APAP is not effective as first-line treatment. The severity of the pain and the multitude of possible causes are so intensive that a combination treatment must be started in case of early back pain." Dr Cutolo recommended consideration of local depot steroid injection, physiotherapy, and nonsteroidal anti-inflammatory drugs or major analgesics where needed.
Acetaminophen Liver Toxicity Remains a Concern
Patients who took acetaminophen were 3.8 times more likely to have abnormal liver function tests, but the researchers note that this finding is of uncertain clinical importance. Acetaminophen and placebo groups had similar rates of adverse events, serious adverse events, study withdrawal resulting from adverse events, treatment adherence, and use of rescue medication.
Dr Michna commented that the clinical effects of the liver changes reported in the study are unclear, and that rates of significant liver disease and failure are still relatively small (except in overdose) compared with the gastrointestinal complications that occur in much greater numbers with nonsteroidal anti-inflammatory drugs and the problems of overdose and addiction associated with opioids. Dr Michna also raised the concern that in cases where APAP does not produce adequate pain relief, patients might take even more than the recommended dose in the hope that more might be better, further increasing the risk for liver toxicity.
"If medications are not helping, they need to be stopped. Patients have to have this point reinforced. There is no point taking medications that are not helping that could have harmful effects," Dr Michna said.
Four of the coauthors received research support from GlaxoSmithKline. Machado also received support from GlaxoSmithKline for a PhD scholarship. Dr Michna and Dr Bannuru have disclosed no relevant financial relationships. Dr Cutolo is a member of the advisory board for Horizon Pharma AG.
BMJ. 2015;350:h1225.

Monday, September 14, 2015

Tylenol may not be your safest option....

Acetaminophen Risks May Have Been Underestimated

Paracetamol, known as acetaminophen in the United States, may have more risks than originally thought, particularly when it is taken at the higher end of standard therapeutic doses, according to a new systematic review.
The authors and an outside expert recommend caution when interpreting the data, as they are observational in nature and are subject to uncontrolled confounders. That said, the authors do note that the dose–response curves seen for each adverse outcome examined suggest "a considerable degree of paracetamol toxicity especially at the upper end of standard analgesic doses."
Emmert Roberts, from South London and the Maudsley Mental Health Trust, Maudsley Hospital, London, United Kingdom, and colleagues present their findings in an article published online March 1, 2015 in BMJ.
"Paracetamol is the most widely used over-the-counter and prescription analgesic worldwide. It is the first step on the [World Health Organization] pain ladder and is currently recommended as first-line pharmacological therapy by a variety of international guidelines for a multitude of acute and chronic painful conditions," the authors write.
They conducted a systematic literature review to determine the adverse event profile of paracetamol by searching Medline and Embase from the date of inception to May 1, 2013. They identified observational studies written in English that reported mortality, cardiovascular, gastrointestinal, or renal adverse events in adults in the general population who took standard analgesic doses of paracetamol.
Ultimately, they included eight of 1888 studies retrieved. All of the included studies were cohort studies. The researchers assessed study quality using Grading of Recommendations Assessment, Development and Evaluation. They pooled or adjusted summary statistics for each outcome.
Both studies that examined mortality risk among adults who took paracetamol and those who did not found an elevation in overall risk. In one study, the standardized mortality ratio was 1.9 (95% confidence interval [CI], 1.88 - 1.94) for those taking the drug. The other study showed an overall risk of 1.28 (95% CI, 1.26 - 1.30), as well as a dose-response increase in the relative rate of mortality from 0.95 (95% confidence interval [CI], 0.92 - 0.98) at the lowest exposure, compared with nonusers, to 1.63 (95% CI, 1.58 - 1.68) at the highest exposure.
Of four studies that reported cardiovascular adverse events, all found a dose-response, with one study demonstrating an increased risk ratio of all cardiovascular events from 1.19 (95% CI, 0.81 - 1.75) at the lowest exposure to 1.68 (95% CI, 1.10 - 2.57) at the highest.
One study that reported gastrointestinal adverse events found a dose-response with relative rate of gastrointestinal adverse events or bleeding increasing from 1.11 (95% CI, 1.04 - 1.18) to 1.49 (95% CI, 1.34 - 1.66).
Four studies reported adverse events; of those, three found a dose-response, with one that reported an odds ratio of 30% or more decrease in estimated glomerular filtration rate increasing from 1.40 (95% CI, 0.79 - 2.48) to 2.19 (95% CI, 1.4 - 3.43).
Caution Warranted
"Because this literature review was based on long-term observational data, there are many potential biases that could influence the results, so it cannot be called 'hard' data at all," study author Philip Conaghan, MBBS, PhD, professor of musculoskeletal medicine, University of Leeds; consultant rheumatologist, Leeds Teaching Hospitals National Health Service Trust; National Institute for Health Research senior investigator; and deputy director, National Institute for Health Research Leeds Musculoskeletal Biomedical Research Unit, United Kingdom, told Medscape Medical News.
"For example, one confounder that is impossible to measure is the use of over-the-counter medicines, which are usually not recorded and can include drugs with significant side effects, such as ibuprofen. Of course it's almost impossible to get long-term data from clinical trials: They usually don't run for many years, so we are dependent on this sort of imperfect data to explore long-term potential drug side-effects," Dr Conaghan said.
"I don't think this study is reproducible because of the softness of the data. [Also], that kind of risk profile is very hard to imagine is meaningful," Norton M. Hadler, MD, emeritus professor of medicine and microbiology/immunology, University of North Carolina at Chapel Hill, told Medscape Medical News.
Implications for Clinical Practice
The first thing clinicians should do when reading studies like this is to closely examine the methods of the study and not simply rely on the abstract, Dr Hadler noted.
Moreover, clinicians should ask themselves whether a patient needs medication in the first place, Dr Hadler said. Although over-the-counter medications are generally safe, it makes sense for clinicians and patients to try nonmedication ways of relieving pain first.
Dr Conaghan agrees. "First they should assess if paracetamol is needed for a given patient. It might not add much to people also taking other pain killers such as [nonsteroidal anti-inflammatory drugs] or opioids. Second, they should ask their patients about all their pain killers, including over-the-counter pills, to get a complete picture of analgesic use (note [that nonsteroidal anti-inflammatory drugs] are analgesics too). Thirdly, they should be conscious that people using moderate to high doses of paracetamol over long periods of time may be more prone to certain side effects that they need to look out for," Dr Conaghan added.
"I am assuming that the common long-term use of paracetamol is for musculoskeletal pain in this response.... [T]here is a massive need for pain control with ageing communities, increased levels of back pain and osteoarthritic joint pain, and lots of people can't tolerate aspirin and ibuprofen," he concluded.
He also noted that it is worth reassessing every so often whether the drug is still helping the patient. "That might mean stopping it for a couple of days and seeing if it makes much difference to their pain. Then they have to consider if they are doing the simple things that effectively improve joint pain (if that's their problem) without side effects; for example, muscle strengthening exercises followed by increased physical activity, and weight loss if needed, all help knee pain. Fitting these things into busy lives is difficult, but ultimately they are more effective and safer than pills," Dr Conaghan explained.
"[W]e should consider the benefit-risk ratio for particular conditions, and would need to see where paracetamol has demonstrated benefits. A recent study in Lancet suggested paracetamol wasn't effective for treating acute lower back pain, although its safety was good over the 4-week period of that study," Dr Conaghan said.
The authors and Dr Conaghan have disclosed no relevant financial relationships.
BMJ. Published online March 2, 2015.

Thursday, September 10, 2015

Cut out sugar....

Forget Cholesterol, but Cut Sugar: New Dietary Recommendations Make Some Changes

WASHINGTON, DC February, 2015 — An expert panel has released its new recommendations to the US government for healthy eating in a 570-page report that provides some new advice and supports a pattern that promotes health and prevents disease[1].
Published this week, the recommendations include advice staples such as focusing on the consumption of fruit, vegetables, whole grains, low- or nonfat dairy, seafood, legumes, and nuts and limiting the consumption of red and processed meat, added sugars, and refined grains. But the recommendations also include some twists, such as giving a green light to a moderate amount of caffeine consumption and no longer trying to control the amount of dietary cholesterol Americans eat.
"Strong evidence shows that it is not necessary to eliminate food groups or conform to a single dietary pattern to achieve healthy dietary patterns," according to Dr Barbara Millen (Millennium Prevention, Westwood, MA) and Dr Alice Lichtenstein (Tufts University, Boston, MA), the chair and cochair of the 2015 Dietary Guidelines Advisory Committee (DGAC), and their coauthors. "Rather, individuals can combine foods in a variety of flexible ways to achieve healthy dietary patterns, and these strategies should be tailored to meet the individual's health needs, dietary preferences, and cultural traditions."
The recommendations from the committee, 18 months in the making, cite "new scientific evidence" to inform the revisions to the  2010 Dietary Guidelines for Americans. The review of the evidence and their recommendations were presented to the US Departments of Health and Human Services and Agriculture. The departments, which are responsible for writing the US dietary guidelines, will consider the recommendations when they draft their final report later this year.
In the US, approximately 155 million individuals are overweight or obese and 117 million individuals have chronic, preventable diseases.
Taking the Long View
In terms of one of the most important changes, the advisory committee, which is made up of physicians and nutritionists, takes the long view on the nation's food supply and focuses on the sustainability of food choices, something it has not done in the past. As part of the evidence review, the committee said it examined the near- and long-term sustainability of healthy dietary patterns and components of the modern diet, such as caffeine.
There is moderate to strong evidence showing that healthy dietary patterns rich in plant-based foods, such as vegetables, fruits, whole grains, legumes, nuts, and seeds, as well as lower-calorie animal-based foods, are associated with more favorable environmental outcomes, such as lower greenhouse-gas emissions and more favorable land, water, and energy use, according to the DGAC.
"Healthy, sustainable dietary patterns also may provide new themes for consumer education and communication on lifestyle practices that can promote food security now and for future generations and create a 'culture of health' at individual and population levels," they add.
Some Surprises in the Report
Aside from accounting for the environmental aspects of food, the committee includes a few more surprises in the report. For example, the recommendations diverge slightly from past guidelines in that they no longer put a limit on the amount of dietary cholesterol individuals should eat.
In the 2010 dietary guidelines, the daily cholesterol target was set at less than 300 mg. Now, says the committee, dietary cholesterol is "not considered a nutrient of concern for overconsumption" and current evidence suggests there is "no appreciable relationship" between heart disease and dietary cholesterol.
The recommendations also provide good news for coffee lovers in that caffeine is no longer considered an enemy of the people. In fact, the advisory committee says consuming three to five cups of coffee per day can be part of a healthy diet and that data to date suggest that coffee reduces the risk of type 2 diabetes and cardiovascular disease. This amounts to approximately 400 mg of caffeine per day. The consumption of added sugar, fatty milk, or rich creams with the coffee, though, is not advised.
Regarding sodium, the DGAC points out that Americans still consume way too much, with the average individual consuming nearly 3500 mg per day. As part of the dietary recommendations, the goal is for individuals to cut at least 1000 mg of sodium from their daily diet to get daily intake down to 2300 mg per day, a recommendation in line with the Institute of Medicine. The advisory committee no longer recommends a daily target of 1500 mg for any individuals, even those with hypertension, diabetes, or chronic kidney disease.
The committee also recommends consuming no more than 10% of daily calories from saturated fat. Regarding added sugars, the same rule applies, with the recommendation that no more than 10% of calories come from added sugar. This amounts to just 12 teaspoons of sugar per day. Currently, the average American takes in anywhere from 22 to 30 teaspoons daily, often in the form of juices and sugar-laden drinks.
To combat how much sugar is consumed in the US, especially by kids in the form of pop and energy drinks, the guideline authors say that water is the preferred beverage choice. "Strategies are needed to encourage the US population, especially children and adolescents, to drink water when they are thirsty," they write.


  1. 2015 Dietary Guidelines Advisory Committee. Advisory report to the Secretary of Health and Human Services and Secretary of Agriculture. Published February 2015.

Monday, September 7, 2015

Common Food additives linked to Crohn's Disease and Colitis

Study Links Common Food Additives to Crohn's Disease, Colitis

WASHINGTON (Reuters) February 25, 2015 - Common additives in ice cream, margarine, packaged bread and many processed foods may promote the inflammatory bowel diseases ulcerative colitis and Crohn's disease as well as metabolic syndrome, scientists said on Wednesday.
The researchers focused on emulsifiers, chemicals added to many food products to improve texture and extend shelf life. In mouse experiments, they found emulsifiers can change the species composition of gut bacteria and induce intestinal inflammation.
Such inflammation is associated with the frequently debilitating Crohn's disease and ulcerative colitis as well as metabolic syndrome, which increases the risk for type 2 diabetes, heart disease and stroke.
Mice were fed emulsifiers diluted in drinking water or added into food, which were found to trigger low-grade intestinal inflammation and features of metabolic syndrome such as blood glucose level abnormalities, increased body weight and abdominal fat.
Consuming emulsifiers increased the risk of colitis, mimicking human inflammatory bowel disease, in mice genetically susceptible to the condition, the study found.
Georgia State University microbiologist Benoit Chassaing, whose study appears in the journal Nature, said the effects seen in mice "may be observed in humans as well."
The study involved two widely used emulsifiers, polysorbate 80 and carboxymethylcellulose. The researchers are planning human studies and are already studying other emulsifiers.
Emulsifiers are used in margarine, mayonnaise, creamy sauces, candy, ice cream, packaged processed foods and baked goods.
A key feature of inflammatory bowel diseases and metabolic syndrome is a change in the gut microbiota in ways that promote inflammation. In mice given emulsifiers, the bacteria were more apt to digest and infiltrate the dense mucus layer that lines and protects the intestines.
Incidence of inflammatory bowel disease and metabolic syndrome started rising in the mid-20th century at roughly the same time that food manufacturers began widespread emulsifier use, the researchers said.
"We were thinking there was some non-genetic factor out there, some environmental factor, that would be explaining the increase in these chronic inflammatory diseases," Georgia State immunologist Andrew Gewirtz said.
"And we thought that emulsifiers were a good candidate because they are so ubiquitous and their use has roughly paralleled the increase in these diseases. But I guess we were surprised at how strong the effects were."
Nature 2015.

Wednesday, September 2, 2015

Probiotics...gut cells in the brain and brain cells in the gut.