Case Study: Weight Loss Plateau

Sophie was frustrated – she was stuck in a weight loss plateau,
poor Sophie she was at her wits end. Despite going to the gym 4 times a week and devotedly counting her calories via the calorie king website she could not lose the fat around her abdomen. She also had digestive issues, as she had been prescribed triple antibiotics several times to clear a helicobacter infection in her stomach and despite this the infection kept recurring.

She was fatigued and complained of abdominal bloating, gastric reflux and heart burn and the antacid medication she took daily only partially relieved her acidity.
At 48 years of age she felt like an old fat women!
She weighed 79 kilograms and was an Android body type and thus gained all her weight in the upper body. To discover your Body Type go to Weight Control Doctor Body Type Questionnaire and do our questionnaire to get your answer.

I did some tests on Sophie which showed the following:

• Raised fasting insulin levels of 24
• Slightly elevated blood sugar at 6.0
• Low blood levels of vitamin D at 25 nmol/L
• Fatty liver was evident on the ultrasound scan of her abdomen
• Low iron levels in the blood although her menstrual periods has ceased due to menopause
• A blood test showed she had the HLA DQ8 and 2 genes which made her gluten intolerant

I explained to Sophie that good health begins in the gut and the liver and this was her problem – her liver was fatty and she had an inflamed gut with an overload of candida and unhealthy bacteria.

I prescribed the following program for Sophie –

1. 2 week detox diet during which she would eat only raw vegetable salads, citrus fruits and paw paw and vegetable soups. No meat, dairy or carbohydrates were allowed, except from the vegetables in her soup. The soup was flavoured with miso paste and garlic.
2. Glutamine powder to heal the inflamed gut
3. A good liver tonic to support the fat burning function of her liver
4. A selenium supplement of 200mch daily to support detoxification in her liver
5. Vitamin D supplement of 3000 units daily with food
6. Magnesium to help reduce her high levels of insulin

I explained to Sophie that it would take approximately 6 months to reverse her fatty liver and she was pleased that it could be repaired. After her detox, Sophie was told to follow the diet in my book Fatty Liver – You Can Reverse It. Her fatty liver had been caused by her excess intake of sugar and grains over many years, which had elevated her insulin levels. High insulin levels cause a fatty liver and also keep your metabolism in the fat storing zone.

Sophie returned to see me 6 months later and was very pleased with her results, which now showed normal fasting insulin levels of 6. Her ultrasound scan of the liver showed that it was no longer fatty and it looked completely normal. Sophie now weighed 67 kilograms and wanted to get down to 60 kilograms, which was easily achievable as her weight loss had been slow and steady. She had been helped by my naturopath and weight loss detective Victoria Taylor at my Camden clinic who had provided excellent support and reviewed Sophie’s food diary regularly. Sophie had avoided all gluten containing foods and kept up her supplements. She had also avoided sugar and was using the Nature Sweet Sugar Substitute in her drinks, which is free of carbohydrates. A breath test for the helicobacter infection was clear showing that she no longer had this infection in her stomach. If you want a copy of our new Weight Loss Detective Dairy you need to see one of my weight loss detectives or you can order it from 1800 151 052

Visit www.weightlossdetective.com.au and do our questionnaires to pin point problems that may be stopping you from losing weight.

Fatty liver, gut problems and high insulin levels often go together and are the most common problems that stop your exercise program from working.
 
As I always say “Good health begins in the gut and the liver”



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Cholesterol lowering drugs may increase diabetes risk

Research has shown that the post popular cholesterol lowering drugs (statins) may raise the risk of type 2 diabetes.

Statins are the most prescribed drugs in the world. Lipitor is the best known brand and it is one of the highest selling drugs. However, a review of medical literature has found that statins are associated with a nine percent greater risk of developing type 2 diabetes. The higher the dose, the greater the association with type 2 diabetes.

A high dose of a statin is considered to be 60 to 80 mg per day, whereas a low dose is 10 to 20 mg per day. Statins can reduce the risk of heart attacks and strokes in certain susceptible people (mostly men over the age of 50), and they also reduce inflammation to some degree by lowering blood levels of C-reactive protein.

Unfortunately statins are also well known for causing several unpleasant and potentially harmful side effects. Before I describe those, I’d like to point out that this research doesn’t conclusively prove that statin drugs cause diabetes; it only shows an association. In general, people who take statins are overweight (particularly around their abdomen), they may have high blood pressure and they probably eat a lot of carbohydrate. They are all risk factors for type 2 diabetes. These people may have gone on to develop diabetes anyway, and their doctor would probably have recommended a higher dose of statins for them.

Other problems associated with statin drugs

Cholesterol is an extremely important substance that has many vital functions in your body. You need adequate cholesterol in order for your immune system and brain to function properly. Focusing on getting cholesterol levels down is a convenient way for drug companies to ensure steady profits, but it is not the best way to prevent heart attacks and strokes.

Cholesterol lowering drugs are associated with the following problems:

--Mood changes, particularly depression. Your brain is largely made of fat, and studies have shown that cholesterol lowering drugs may reduce serotonin levels in your brain. Adequate serotonin is vital for a happy mood.

--Muscle aches and pains. Statin drugs are notorious for causing this side effect. It is more likely to occur in people who exercise regularly and people taking a high dose of a statin. Taking a co enzyme Q10 supplement can partially remedy this symptom in many cases.

--Liver inflammation. Statins can cause raised liver enzymes, meaning they can cause damage to liver cells. This is especially problematic for people with a fatty liver because they often already have raised liver enzymes. Having a fatty liver makes it more likely that you will have high cholesterol and triglycerides. Statin drugs are obviously not the solution.

--Hormone imbalance. Cholesterol is a steroid molecule and your sex hormones are steroids as well. Therefore cholesterol is a building block for several hormones in your body. People taking cholesterol lowering drugs are prone to hormone deficiencies.

You can read more about cholesterol and heart disease in our book Cholesterol: The Real Truth

Reference: Current Opinion in Lipidology, December 2011;22(6):460-466

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Is poor blood sugar control giving you a foggy head?

A foggy head is a common complaint among our patients. Many of them complain about difficulties concentrating, being easily distracted, forgetful and just not being as sharp mentally as they’d like to be. Most of us have extremely busy lives and we heavily rely on our brain to enable us to accomplish our job and errands each day. Work and life in general are easier if you are feeling mentally sharp and on the ball.

A number of different health problems can cause a foggy head, however recently Japanese researchers have discovered that poor blood glucose control is one culprit. Their research showed that poor blood sugar control places a person at 70 percent greater risk of cognitive problems.

Another study recently published in the New England Journal of Medicine analysed 97 previous studies that involved more than 820 thousand people. The studies compared people over the age of 50 who had blood sugar problems with people in that age group who had normal blood sugar. People with good blood sugar control lived an average of six years longer. Clearly maintaining a healthy blood sugar level is vitally important for health and longevity.

What does poor blood sugar control mean? It basically means that you either have diabetes or insulin resistance (Syndrome X or pre-diabetes). An ideal fasting blood sugar level is between 3.6 and 5.4 mmol/L (65 to 97 mg/dL). Many people have a blood glucose level higher than this.

Even if you have not been diagnosed with diabetes, if your fasting blood sugar is higher than 5.4 mmol/L or 97 mg/dL, the excess glucose is causing harm to your body. Having high levels of glucose in your bloodstream is harmful because glucose sticks to proteins and changes their shape and ability to function. We are basically made almost entirely of protein, and this is why high blood sugar and diabetes cause so many varied terrible health consequences.

Maintaining healthy blood sugar control is one of the most important things you can do to keep yourself healthy and slow down the aging process. The easiest way to keep your blood sugar down is to maintain a healthy weight. As a person’s waistline expands, their blood sugar tends to rise. It is also important to watch your intake of carbohydrate rich foods like sugar, flour, bread, pasta, rice, potatoes and breakfast cereals. All of those foods are digested into glucose. If you are a diabetic or pre-diabetic you already have too much glucose in your bloodstream.

There is an easy to follow low carbohydrate eating plan in our book Diabetes Type 2: You Can reverse It Naturally.

Ohara, T., et al, “Glucose tolerance status and risk of dementia in the community: The Hisayama Study,” Neurology. Sep 20, 2011;77(12):1126-1134.
The Emerging Risk Factors Collaboration, “Diabetes Mellitus, Fasting Glucose, and Risk of Cause-Specific Death,” N Engl J Med. 2011;364:829-841.

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Are you deficient in vitamin B 12? Hopefully not, because you wouldn’t want your brain to shrink

New research has shown that vitamin B 12 deficiency promotes brain atrophy (shrinkage) and impairs cognitive function, potentially leading to dementia.

Vitamin B 12 deficiency is quite common, particularly in older people and people with digestive or immune system problems or vegetarians. B 12 is mainly found in animal foods such as seafood, poultry, red meat, eggs and dairy products. Some vegetarian foods are fortified with vitamin B 12, such as breakfast cereals. Its presence in mushrooms and yeast is controversial. Symptoms of vitamin B 12 deficiency include fatigue, pale skin, depression, anaemia, poor appetite, a sore tongue and tingling in the arms or legs. These are not uncommon symptoms.

What causes vitamin B 12 deficiency?

It is not easy to absorb B 12 through food; you really need good digestion to achieve the task. You need good levels of stomach acid and your stomach must also produce adequate levels of a substance called intrinsic factor. This is vital for proper absorption. People with the autoimmune disease pernicious anaemia cannot make intrinsic factor in their stomach and therefore they must receive B 12 injections. People with other autoimmune diseases also commonly do not absorb B 12 well and they must be tested for deficiency.

B 12 deficiency is extremely common in people over the age of 60, largely because the ability of our stomach to secrete hydrochloric acid declines with age. Many older people take medication that blocks stomach acid and this is a huge problem. Acid blocking drugs reduce your ability to absorb all nutrients from food and it has been known for some time that they increase the risk of dementia. Anyone with poor digestion, bloating, irritable bowel syndrome or celiac disease may be B 12 deficient and should be tested. Metformin is the most commonly used drug for type 2 diabetes and it causes B 12 deficiency. This is bad news for diabetics, who are already at increased risk of dementia due to high blood sugar.

Testing for vitamin B 12 deficiency

Your doctor can order a blood test for vitamin B 12 and this is useful. However, it is more effective to get a blood test for a substance called homocysteine. This is a type of protein found in the bloodstream that is a more reliable indicator of how well your body absorbs and utilises vitamin B 12. It’s also an indicator of your B 6 and folate levels. You want your homocystein level to be as low as possible.

What did the research show?

A study published in the journal Neurology compared markers of B 12 deficiency with brain MRI scans (to measure brain shrinkage) as well as neuro-psychological tests to measure brain function. The study lasted five years. Researchers discovered that low levels of vitamin B 12 were associated with brain shrinkage as well as poorer memory and cognitive function. Interestingly it was the blood homocysteine level that predicted these symptoms, rather than blood B 12 level.

How to correct B 12 deficiency

If, despite eating animal foods regularly, your B 12 levels are too low and/or homocysteine is too high, you need to take a B 12 supplement. Tablets usually aren’t very effective because they don’t overcome the problems of low stomach acid and low levels of intrinsic factor. Sublingual (under the tongue) supplements exist, as well as injections. It is certainly worthwhile making sure you obtain adequate levels of vitamin B 12; your brain will thank you for it.

Tangney CC, Aggarwal NT, Li H, Wilson RS, DeCarli C, Evans DA, Morris MC (2011) Vitamin B12, cognition, and brain MRI measures - A cross-sectional examination. Neurology 77:1276-1282

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Would you recognise the symptoms of a heart attack?

Heart attacks are one of the leading causes of death in western nations (along with cancer); we hear about heart attacks in the media regularly but do you actually know the symptoms? Most people think of chest pain when they think of heart attacks, but there is a lot more to the story. Most people experience other symptoms before they get any chest pain, and some people don’t get chest pain at all. Furthermore, the symptoms of a heart attack are usually quite different between men and women.


We’ll start with the symptoms of a heart attack in men. The vast majority of men experience chest pain and a heart burn sensation in their chest, along with shortness of breath. However, they may have experienced the following symptoms one or two days before the heart attack:

--Extreme fatigue. The type of fatigue where you think you are coming down with the flu.
--Feeling lightheaded.
--Being in a very bad mood.
--Nausea, which may or may not lead to vomiting.
--An infection like the flu or a bad cold sometimes precedes a heart attack. If you are at the tail end of such an infection, you are at higher risk of having a heart attack (provided you also have other risk factors).
--Pain in the neck or upper arm. This type of pain is often mistaken for a muscle strain.

Some people get such mild symptoms, they had no idea they actually had a heart attack.

Symptoms of a heart attack in women

Studies have shown that only around 30 percent of women who have had a heart attack experienced chest pain. The most common symptoms are unusual fatigue, sleep disturbance and shortness of breath. If women do experience an uncomfortable sensation in their chest, it is usually far milder than in men. It is important to keep these symptoms in mind because far more women die of heart attacks than from breast cancer. Most women are continually reminded to be vigilant about breast cancer detection, and are very scared of the disease, yet heart attacks are a much greater cause of death.

We will all die of something one day, but far too many people die far too young from heart attacks. It is important to take good care of your heart and blood vessels, as you want them to be healthy as long as possible. Most heart disease prevention in the media focuses on cholesterol; however cholesterol is a minor player in the equation. Yes you should know what your cholesterol level is, but there are several other things you should have tested; these include your blood pressure, fasting glucose, fasting insulin, C reactive protein and homocysteine levels. You can read all about heart attack prevention in our book Cholesterol the Real Truth.

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Exercise helps prevent polyps growing in your bowel

Exercise helps to reduce your risk of bowel cancer; researchers have known that for some time. Now it has become clear that regular exercise helps to prevent polyps from growing in your colon. Polyps can be a forerunner to bowel cancer.

Bowel cancer is one of the most common forms of cancer in western societies and a great number of people die from it every day. Bowel cancer often spreads quickly because the lining of the intestines is so thin, therefore tumours tend to grow through it quite quickly. The liver is in very close proximity to the intestines, therefore tumours often spread there first. Earlier studies have shown that regular exercise can reduce the risk of colon cancer by up to 25 percent.

New research that analysed 20 former studies has focused on colon adenomas; these are precancerous polyps that get removed by a doctor during a colonoscopy or sigmoidoscopy. If these polyps are allowed to remain, there is a risk they will change into cancerous tumours. The research showed that regular physical activity was associated with a 16 percent reduction in the development of colon polyps and a 30 percent reduction in the risk of developing polyps that are large and advanced (and are likely to become cancerous).

According to one of the researchers, Dr Wolin, exercise reduces the risk of cancer because it:
• Boosts the immune system
• Reduces inflammation in the bowel
• Reduces insulin levels

Exercise really is potent medicine when it comes to protecting you against cancer.

How much exercise is enough? The study’s authors recommend at least half an hour of moderate exercise each day.

Other ways of reducing your risk of bowel cancer

• Make sure you have adequate blood levels of vitamin D. There is a strong relationship between vitamin D insufficiency and bowel cancer.
• Keep your blood insulin level low by reducing your intake of sugar, grains, cereals, carbohydrate rich foods and alcohol.
• Maintain regular bowel habits. You should be having a bowel movement at least once a day.
• Make sure you have plenty of good bugs in your intestines by taking a good quality probiotic.
• Take a selenium supplement. It is virtually impossible to get enough of this vital mineral through food. Selenium helps to protect your DNA from damage.

Source: Br J Cancer 2011;104:882-885

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The truth about iodine

Many of our patients who have a thyroid condition are quite confused about iodine. They are not sure whether they should be taking it in supplement form or not, and are confused about what dose is best. I’ll try to clear up some of that confusion.

Iodine is a mineral that is critical for optimum health. Many people are iodine deficient; in fact that vast majority of the patients who come to our clinic are found to be iodine deficient after we give them a urinary spot iodine test. This is a handy test that your own doctor can order for you. Since October 2009, all bread in Australia (except organic bread) has to be fortified with iodine. This is an effort by the government to attempt to correct widespread iodine deficiency in this country. Many other parts of the world are also iodine deficient, including the USA and Europe.
Iodine is critical for healthy thyroid gland function because thyroid hormones are basically built from iodine molecules attached to the amino acid tyrosine. If you do not have enough iodine in your body, your thyroid gland will struggle to produce enough hormones. This places you at much greater risk of developing an enlarged thyroid gland (goiter) and thyroid nodules. Both of those conditions are frighteningly common.

Being iodine deficient can also make you feel very tired and sluggish. Losing weight is a lot more difficult if you don’t get enough iodine in your body. Iodine is critical for proper brain development in babies, therefore it is vital that pregnant and breast feeding women do not become deficient in this mineral. Some research has also shown that iodine deficiency increases the risk of hormonal disorders in women; specifically it can worsen estrogen dominance symptoms. Iodine deficiency increases the risk of breast cysts and painful breasts, as well as ovarian cysts.

It is difficult for most people to get enough iodine in their diet because not many foods provide significant quantities. Most iodine in the world is found in the oceans; therefore seafood is the richest source. Unfortunately most seafood available these days is farmed and therefore is a poor source of iodine. Seaweed is rich in iodine but not many people eat it regularly. Iodised salt is the other reliable source of iodine, but you’d have to consume quite large quantities of it regularly.

The fact is most women need to take an iodine supplement. Thyroid conditions are far more common in women than men, and breast and ovarian cysts are also increasingly common. Some doctors tell their thyroid patients to avoid iodine supplements. I strongly disagree. Iodine is important but it should be taken in the correct dose. Some of our patients take very high doses of iodine and this can suppress the thyroid gland and produce symptoms of hypothyroidism. We also see patients who take large doses of iodine and develop temporary hyperthyroidism. If you have been iodine deficient for some time (and most of you have), it is important to start with a small dose of iodine and gradually increase it if needed. Generally we recommend taking between 150 and 400 micrograms of iodine per day if a urine test has shown you to be deficient.

Iodine supplements are not the main solution for most thyroid problems. Most thyroid conditions are caused by autoimmune disease, and the underlying immune dysfunction must be addressed if you want to help your thyroid. People with an over active thyroid (hyperthyroidism) should not take iodine supplements while their thyroid is over active because it makes treatment of this condition more difficult.

Do you have any questions about iodine or the thyroid gland?


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Magnesium reduces hot flashes

New research published in the journal Support Cancer Care has shown magnesium supplements to be extremely effective for reducing the frequency and severity of hot flushes in menopausal women. This is great news for women who want to avoid hormone replacement therapy.

This particular study looked at women who have had breast cancer. These women often get severe hot flushes, mostly caused by the drugs used in the conventional treatment of breast cancer. Hormones of any kind are contraindicated in women with a history of breast cancer because they may cause a return of the disease.
Researchers studied 20 breast cancer patients with an average age of 53.5 years. Eight of the women were taking tamoxifen, nine were taking an aromatase inhibitor and 14 were taking an antidepressant. All of the women experienced at least 14 hot flushes each week. The women were given 400 mg of magnesium each day for four weeks. They could increase the dose to 800 mg per day if they felt like they needed to. 17 of the women did increase their dose.

The women experienced fantastic results. Magnesium greatly reduced the frequency and severity of hot flushes. There was an average reduction in the incidence of hot flushes from 52.2 per week to 27.7 per week. More than half of the women experienced a greater than 50 percent reduction in hot flush severity. They were also thrilled to experience significantly reduced sweating, fatigue and distress.
This is a great finding because former breast cancer patients usually get the most severe case of hot flushes; because of the oestrogen blocking medication they are given. If magnesium can greatly improve the quality of life for these women, it should significantly help the average menopausal woman who has not had breast cancer. Magnesium is a safe and effective remedy for more than just hot flushes. Research has shown that magnesium helps to reduce the risk of cardiovascular disease, osteoporosis, Alzheimer’s disease and insulin resistance (syndrome X).

Source:
Park H, Parker GL, Boardman CH, Morris MM, Smith TJ. A pilot phase II trial of magnesium supplements to reduce menopausal hot flashes in breast cancer patients. Support Care Cancer. 2011;19(6):859-863.

Have you found a remedy that reduces hot flashes?





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