Healthy Talk w/ Dr. Michael Smith

Ask Dr. Mike: What Are the Latest Theories on ALS?

Listen in as Dr. Mike provides the answers to a wealth of health and wellness questions.

Additional Info

Segment Number 5
Audio File healthy_talk/1522ht4e.mp3
Featured Speaker Mike Smith, MD
Organization Life Extension
Guest Website Healthy Talk MD
Transcription RadioMD Presents: Healthy Talk | Original Air Date: May 28, 2015

RadioMD. It's time to ask Dr. Mike. Do you have a question about your health? Dr. Mike can answer your questions just email This email address is being protected from spambots. You need JavaScript enabled to view it. or call now (877) 711-5211. The lines are open.

DR. MIKE: So, a listener named Mary sent me an email and said,

"I just watched the movie The Theory of Everything about Stephen Hawking. I was just curious about what causes ALS."

All right. So, we're going to look...So, I'm going to use this as an opportunity to talk a little bit about Amyotrophic Lateral Sclerosis or Lou Gehrig's disease, ALS, and, again, focusing more on what we think are the current causes. It's a motor neuron disease. It's really affecting the nerve to muscle junction.

It breaks it down. There's muscle wasting. It becomes hard to swallow. It can even affect the respiratory muscles and it's just this progressive disease. Once there's a diagnosis of ALS, the prognosis is quite poor, even still today, two to five years is the expected life expectancy. Once somebody, unfortunately, is diagnosed with ALS, the treatments have gotten a little bit better. We're able to extend life a little bit and there's some new stuff there but the focus here, for Mary, is on what are the causes of ALS.

I saw the movie too, great movie, incredible acting. I forget who that actor is that played Stephen. I mean, incredible acting but they didn't really get into the disease itself it was definitely more about Dr. Hawking's life, his work and how ALS was affecting all that but it wasn't about ALS too much. So let's get into this, Mary.

What are the latest theories? We don't know what exactly causes ALS. It's still a mystery. I think when I first learned about it--and this is back in the early 90's--when I was in medical school and at the University of Texas in Dallas, most of the theories were centering around a post-viral infection and there was even some thought that maybe there's even an autoimmune component here.

So, you get this viral infection and your body over responds to the virus and there's what we call kind of like a cross reaction to normal receptors at that neuro muscular junction and your immune system starts to eat it up and but that hasn't really panned out all that much. I don't think there's been much headway in this post viral infection type theory. There are some other things, Mary, that have come up in the last, say, decade or so about the causes.

The first one is a genetic mutation and it's a genetic mutation in a gene called SOD1, S-O-D 1, and this gene's normal codes for very important enzyme called superoxide dismutase. So, SOD1 is a gene that codes, or makes, or produces superoxide dismutase. That enzyme SOD-- it's one of the most powerful antioxidants we have and it helps to control the superoxide free radicals that can form in the body just from normal metabolism and some of those superoxide pro-oxidant compounds are very damaging if they build up.

So, the theory is and, by the way, Mary, this theory about this mutation really began with a recognition that about 20% of all ALS cases have a family link. Out of those cases, the 20% that are familial, 2% have this SOD1 gene mutation. So, the theory is that maybe there's the SOD1 gene, which is very complex, that can have multiple mutations and what are called polymorphisms and that's leading to the inability to produce normal functioning superoxide dismutase which then leads to a buildup of oxidative stress.

So, that's one theory. Interestingly they've been looking at this for a while now, Mary, this SOD1 gene mutation and through the research just kind of looking at the gene trying to figure out where the mutations are at and what mutations are worse, they've come up with some other theories from that--this gene mutation.

This SOD1 gene mutation can damage neurons in other ways, outside of not being able to make superoxide dismutase, and so they have found that mutant SOD1 genes produce, again, these abnormal superoxide dismutase molecules which can lead these enzymes--the super oxide dismutase enzymes--to clump together. That clumping disrupts that neuromuscular junction that, even in the neurons in the brain, it disrupts how they communicate together, almost like an amyloid beta type picture in Alzheimer's disease. So, here you have a theory that says a mutation in the SOD1 gene produces an abnormal superoxide dismutase which then allows the buildup of very powerful free radicals based on a compound called superoxide pro-oxidants.

So, you get this huge oxidative stress that damages the neurons, damages the neuromuscular drum and there's your problem but then they go onto say that this gene mutation produces such an abnormal SOD enzyme that they clump and that it almost causes an Alzheimer type picture not with amyloid but with clumping of superoxide dismutase. So, that's one theory, this SOD1 gene mutation. Another theory is just the oxidative stress theory. You know, studies have found elevated levels of oxidative stress in the central nervous system and just in the periphery in your normal blood stream in ALS patients. Of course, oxidative stress can damage neurons and, as a matter of fact, it's one of the theories of Alzheimer's disease.

So, a lot of people do believe that although antioxidants aren't going to necessarily treat ALS, they are going to play an important role in controlling the progression. So, the beta carotenes, vitamin C, vitamin E, selenium, the pigment in antioxidants like zeaxanthin and lutein, because they can get into the brain, all can play a very, very important role in at least maybe controlling the progression of disease.

Another theory is glutamate toxicity. Now, glutamate is a neurotransmitter and it's an important neurotransmitter. Under normal conditions glutamate is really, really tightly regulated because if you get too much glutamate, it over excites the brain and that over excitation can lead to seizure disorders, dementias and the theory is ALS and it appears that this system, this glutamate regulating system, is abnormal in patients with ALS. This results in the accumulation of glutamate and this excess glutamate level in the brain over excites the nerves beyond their capacity to function normally. It can eventually lead to nerve cell death.

Dr. Shaw, in 1995, showed that patients with ALS do, in fact, have elevated levels of glutamate in their cerebral spinal fluid and that does support this hypothesis. By the way, too, one of the drugs used to treat ALS is kind of an anti-glutamate drug. It's called Riluzole and it is a drug that brings down the glutamate levels. It works so that supports some of that theory.

Lastly, mitochondrial dysfunction, I don't have a lot of time to go into that but when you don't have normal functioning mitochondrial within the brain cell, which is a very active cell, the amount of cell energy production drops off significantly which is ATP. The brain cell then becomes dysfunctional. Once that happens free radicals build up inside the cell and you get kind of this high level of intracellular oxidative stress and that can lead to damage as well.

This is Healthy Talk on RadioMD. I'm Dr. Mike. Stay well.
Length (mins) 10
Waiver Received No
Host Mike Smith, MD

Ask Dr. Mike: Top Supplements for Prostate Cancer, Alzheimer's & Migraines

Listen in as Dr. Mike provides the answers to a wealth of health and wellness questions.

Additional Info

Segment Number 4
Audio File healthy_talk/1522ht4d.mp3
Featured Speaker Mike Smith, MD
Organization Life Extension
Guest Website Healthy Talk MD
Transcription RadioMD Presents: Healthy Talk | Original Air Date: May 28, 2015

You're listening to RadioMD. It's time to Ask Dr. Mike on Healthy Talk. Call or email to ask your questions now. Email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 877-711-5211. The lines are open.

DR. MIKE: So, I get a lot of questions, something like, "What are the best supplements for blank?" "What are the top three supplements for this?" "What are the latest treatment findings on this?" Probably half of the questions that come into the Life Extension Health Advisor – Life Extension is a great company.

We have health advisors that you can call and ask just about anything you want but half of them are those types of questions. "What's the best thing for blood pressure?" Something like that. I went through my emails that came from listeners and also from some of the advisors. They send me some questions over as well. I just went through all of them and found five or six of those types of questions. I thought this would be a great segment to run through some of my top supplement suggestions for a few of these disorders. There were many more in there. These were just the ones I saw first.

Let's start with this one.

"What are the top supplements for prostate cancer?"

I am just paraphrasing the question. This one was actually asked about three times so this is on the top of a few listeners minds.

So, what are the top supplements for prostate cancer? Number one, saw palmetto about 160-200 milligrams a day. Saw palmetto helps to block the conversion of testosterone to estrogen and helps to control how the body metabolizes estrogen. We know that estrogen is linked to prostate issues. Saw palmetto is one of the top choices for men with healthy prostates and diseased prostates. That's number one. Number two would be boron. It is a mineral – about 3 milligrams a day. There is a lot of good research on boron in slowing down what is known as the PSA doubling time.

The PSA is the prostate specific antigen. That is the main blood test that we use. It's not the greatest one out there. There are better ones that are now coming on the market. There is this idea that with prostate cancer the PSA will double very quickly.

It will go from one to two, from two to four, or four to eight, that kind of thing, in a short period of time. The faster the PSA doubles, the worse the disease and the worse the prognosis. Boron decreases the PSA doubling time quite significantly.

Here is even better—when you add boron 3 milligrams a day to 40 milligrams of lycopene. Lycopene is the pigmented antioxidant that gives tomatoes, for instance, that red hue. When you take 3 milligrams of boron and add it to 40 milligrams of lycopene the effect on PSA doubling time is even better. The combination of boron and lycopene has been shown in a couple of well-designed clinical trials to bring down that PSA doubling time and improve prognosis. Lastly – and this is really for any cancer - Vitamin D3 least 5000 units if you are dealing with cancer. Better to know your blood level.

You want to get it up closer to 80 nanograms per deciliter range. If that takes 10,000 units a day, that's fine. You do the amount of vitamin D that is necessary to get you on that higher end of the range – the optimal range -- which is 50-80 nanograms per mil. You want to be on that higher end of that range. Do whatever you have to do to get it up there. That's the first one. Saw palmetto, boron, lycopene, vitamin D3 – my top four suggestions for prostate cancer.

"What are the top supplements for migraines?"

Again, I am paraphrasing the question. "Migraine headaches--what are the top supplements?" Number one, magnesium threonate about 144 milligrams.

Magnesium is critical for lots of biochemical processes, including in the brain. The problem is, we are not able to get magnesium into the brain. If you are deficient in magnesium in your body, you are really deficient in your brain. Magnesium threonate is the form that gets to the brain and, as a matter of fact, we know that magnesium can decrease that initial intense pain of a migraine and make you feel better very quickly.

As a matter of fact, with severe migraines, often the first thing the emergency room doctor does is give you a bolus, an injection, basically, of magnesium. But magnesium threonate will get to the brain better than any other form. Butterbur is an herb – about 150 milligrams. It is 50-50 with butterbur.

I have seen it work wonders with people with migraines and seen it do nothing with people with migraines. Butterbur is about 50-50. Number three is ginger root – 250 milligrams a day. It probably has some anti-inflammatory effects. It's able to decrease inflammation in the vessels that supply the brain so there is less irritability and constriction of those vessels and that might help. Gingko – 120 milligrams a day might be helpful. The last one is interesting. Melatonin for migraines. Melatonin. Yes, it's the sleep hormone. Most people take it for sleep issues but it is not just for sleep.

We are learning that melatonin is quite complex. It has influences on how nerve cells communicate, on neurotransmitter production. You have to do a higher dose of melatonin than you might normally do just for sleep. Most people for sleep use a milligram to maybe 3 milligrams.

But for migraines the starting dose is going to be around 5 milligrams. You want to make sure that if you want to do melatonin for a migraine headache and you are going to do the 5 milligrams that you are not driving, you are not at work, you are at home, that type of thing. But that is just the starting dose for migraines. Most people, to get a nice benefit, less pain, less nausea, from the migraine you are looking at even more – 10 or even 15 milligrams of melatonin. You have to build up to that slowly. That's magnesium threonate, butterbur, ginger root, gingko and melatonin for migraines.

"What are the top supplements for Alzheimer's disease?"

The easiest way for me to do this one is to talk more about the categories than specific supplements. I can name some specific supplements but anybody with Alzheimer's, especially early on, or even if you are at risk for Alzheimer's – maybe it runs in your family and so you're worried about it. Maybe you live in a city environment with a lot of toxins – the first class of supplements need to be the anti-inflammatories – the fish oils, boswellia, black cumin seed oil. The anti-inflammatories are critical. A lot of neurologists will tell you Alzheimer's is simply the brain on fire – inflamed.

The anti-inflammatories are critical. Number two would be the antioxidants. There is a high level of oxidative stress in Alzheimer's patients. There are clear laboratory studies showing that if you take brain cells and put pro-oxidants into the petri dish that cause oxidative stress, they become damaged and the production of the abnormal protein amyloid goes up significantly. That's been clearly shown.

A lot of great studies coming out of China were showing that three of four years ago. Oxidative stress is really high in Alzheimer's patients. You have to do anti-oxidants that are able to get into the brain. Pigmented anti-oxidants like zeaxanthin and lutein and meso-zeaxanthin and astaxanthin. Those are really good for reducing oxidative stress in the central nervous system. Of course, blueberries as well. The third category would be immune. There is this idea that Alzheimer's might have an immune issue going on.

When you develop an abnormal protein like amyloid beta in the brain there are macrophages that can eat that up and clear it up and there is no problem. But in Alzheimer's patients those macrophages aren't working as well. So, we want to boost the macrophages in the brain and it turns out that curcumin from turmeric can do that – about 400 milligrams. Coriolus, the mushrooms can help with that. So, there you go.

There's the anti-inflammatory category with Alzheimer's; the anti-oxidant category with Alzheimer's and the immune category with Alzheimer's. I will tell you, real quickly, too, there's good research showing that there is an infection in the brains and sinuses in Alzheimer's of patients called spirochaete. Maybe antibiotics are appropriate.

Also there is a drug called Enbrel which is for rheumatoid arthritis has been shown to help Alzheimer's patients as well. So, there is prostate cancer, migraine and Alzheimer's--my top supplements.

This is Healthy Talk on RadioMD. I'm Dr. Mike. Stay well.
Length (mins) 10
Waiver Received No
Host Mike Smith, MD

The Tools of a Forager

What if you don't know anything about plants?

Additional Info

Segment Number 3
Audio File healthy_talk/1522ht4c.mp3
Featured Speaker JJ Murphy, Wild Edibles Forager
Book Title Joyful Foraging: Learn How To Feast On The Food Growing All Around You
Guest Website The Joyful Forager
Guest Bio JJ Murphy is a wild edibles forager on a mission to change the understanding of healthy eating. Her goal is to raise awareness of the delicious foods that are quite literally all around us and available for free.

JJ's foraging philosophy is simple: savor the abundance of edibles nature provides us each season of the year. Take only what you need, as gently as possible, doing no harm to the environment.

After earning a Masters degree in Broadcast Journalism from the University of Kansas, she moved to New York City and began writing about food and the environment. Her articles have appeared in the publications Wildness! Magazine, Outdoors Unlimited, and Spores Illustrated. JJ now writes The Joyful Forager column for the Shawangunk Journal in New York's Hudson Valley and is working on her first cookbook.

Her ebook, Joyful Foraging: Learn How To Feast On The Food Growing All Around You, is available for purchase on her website, TheJoyfulForager.com. Ms. Murphy regularly forages in urban and rural settings with her peers, including television host, Wildman Steve Brill, Gary Lincoff and Leda Meredith. She lives in Highland Mills, NY, at the foot of Schunemunk Mountain.
Transcription RadioMD Presents: Healthy Talk | Original Air Date: May 28, 2015

Healthy Talk with Dr. Michael Smith MD. And now, here is the country doctor with a city education, Dr. Mike.

DR. MIKE: So, I am here with J J Murphy. She is a wilds edible forager. And she wants us to not only save money but just to understand how to eat more healthy and use what's right in our environment. But of course, do it in a gentle way that we are not harming the environment. J J, welcome to Healthy Talk.

MURPHY: Hello. How are you doing today?

DR. MIKE: I am doing great. So, I have your website here, www.thejoyfulforager.com. I like it. It has a lot of pictures, very easy to follow. We like websites like this, J J, so you really did a very good job there. You mentioned in the previous segment you have a book. Do you want to just quickly tell us about the book?

MURPHY: Yes, it's called Joyful Foraging: Learn How to Feast on the Food Growing All around You. It is available exclusively at my website. And it profiles 10 plants that grow in abundance. There is no danger of overharvesting them. They grow where people live, in urban, suburban and rural environments. And they are -- I chose plants that are distinct looking that you wouldn't have a hard time mixing them up with other plants.

DR. MIKE: Good. Yes, that's important I would think because we don't all have time to become botanists and learn everything there is to know about the plant. Let me ask you something, J J, how did you get started on this?

MURPHY: Well, I think like everyone else, I was looking for a way to eat healthy and delicious food without going broke. I don't really like going to the store and shopping. And I began to notice that there is a lot of green plant life and many of the plants that, "Honey, get the weed whacker," really are tastier. They are more nutritious. Of, the cultivated plants, they are watery in comparison.

And, I just like to eat well and I thought why not? I certainly started, as I would advise everyone to start. If you are walking to school or work or around the block or walking your dog or whatever, start noticing those green things growing around you. Not just stuff growing from the earth but in flower boxes and all kinds of places where little plants grow up. Whenever the soil is disturbed or dug or scratched, or whatever, moved for any reason, a plant will grow. And many of those plants are edible. I began with the ones that --

DR. MIKE: It's funny -- I was just going to say, J J -- I am on your site right here -- I'm reading, you mentioned it's just not things growing in the ground. Here you talk about a quickweed growing into a forgotten terrace flower pot. What is quickweed?

MURPHY: Quickweed is my second favorite plant. It is also a plant that tastes like spinach. It's in the daisy family. And it has kind of a fuzzy leaf with little itty bitty daisy like flowers. So, it's better cooked. But the thing I like best about quickweed is you know how when we get a big bunch of spinach and you cook it and you get a little tiny bit of spinach? Well, when you cook the quickweed it doesn't lose volume. So, you've got -- whatever you harvest, you're going to have. If you harvest enough to fill a bowl, you'll have that after it's cooked. And that's one of my favorite things about that plant.

DR. MIKE: So, when you see something like quickweed or you see a different type of plant may be cut and growing out of the ground, or whatever, what kind of tools do I need? What's the proper way or correct way to actually harvesting that plant?

MURPHY: Well, the first thing I want to do is be sure of my identification. So, before I eat it I will study it. I'll take pictures or draw it. Make sure that I am sure of my identification. But not everybody can eat everything.

So, the next thing I'll do, which is safe, you can't get into any trouble, is you touch it your lips or your tongue, and just wait. If you don't have any kind of reaction, it doesn't tingle or make you go numb, then you are not going to have problem. If you eat a small portion like one ounce of it and then wait and make sure that it's not rough on your digestion or whatever. And learn one plant at a time. There is no rush here I think.

DR. MIKE: I see...

MURPHY: I think, this is something for me that is joyous because I enjoy spending my time... I'd rather spend 15 minutes walking around the edge of a park or a yard or something and harvesting the plants I know, than stressing myself in the store wondering who else has been touching the food and how long it's been there and where it came from in the first place.

So, you know, this is a lifestyle but I am convinced that plants I am eating not only taste good but -- I do not take any pharmaceutical medication. I rarely go to the doctor. I have great energy and eating has become fun instead of an ordeal or chore.

DR. MIKE: Yes. I liked what you said about if you are not sure, you could just touch it to your lips or your tongue and...I was watching, J J, a show about the Navy Seals and that's what they teach them to do. If they ever get lost or out in area that they are not familiar with. You can just take something that you think looks pretty good, you just touch to your mouth and see what happens. Right? Is that kind of what you do?

MURPHY: Well, fortunately we are not in a survival situation, so we do have the leisure. What I'll do is, a lot of times, take a plant-- may be I have eaten it in its baby stage and I've never seen in its full, mature stage and I want to be a hundred percent sure. So, I'll take that plant and I'll press it in a notebook or I'll consult a Seal's guide or I'll go to my colleagues and say, "Is this is what I have here?" just be sure. I use the analogy, if I invited you to a party where you didn't know anyone.

Everybody would look strange and indistinct until you started noticing details of someone's waist or their posture or their gestures. Well, that's the same with the wild plants. Spend a few minutes. Give yourself a gift of a mini-vacation, turn off the cell phone and sit with that plant for a few minutes. And the magic there is, you will start recognizing it wherever it's growing, wherever you walk. New York City is one of my favorite--

DR. MIKE: That's a nice analogy.

MURPHY: Yes. New York City is one of my fun places because I was in the city a few months ago in the summer time and lambs quarters was being sold as wild spinach for $12 a pound. One of the things --

DR. MIKE: And that's a lot right?

MURPHY: Well, spinach was $4 a pound. So, you tell me. Lambs quarter is my free spinach, which, by the way, I have in my kitchen as we speak. Another way to help yourself in identification is buy it there or ask for a sample of a leaf there and compare it what you see in your yard. It's really not hard to learn. It's just the matter of making the decision, "I am going to this," in the same as you make a decision to learn anything.

DR. MIKE: Yes. J J, I think something that you are hitting on is really important here. You know, we live such crazy lives today right? I mean, we are all just going, going, going. Everything is instant gratification and everything has to be right now. I mean, we go out, we walk our dog, and we are in a nice wooded area and all we see is just dirt and the same -- what looks like the same plant-- everywhere.

What you are saying is slow down, take your time out there, look at the plant, you'll start recognizing the differences, and you'll start seeing these different varieties. I think it's just something we -- not only is it healthy eating and saving us money -- it's just going to be good for us. Right?

MURPHY: Yes and that, again, 15 minutes out of a whole day isn't that much time. And I really am a big believer in baby steps. If you're standing at the bottom of a flight of stairs, you're not going to leap to the top step. You are going to go one step at a time and so...I do want to mention while we have our time what it is that goes to--

DR. MIKE: J J, I am sorry we are going to actually have to end it right there. We are pretty much at the end. Let me just go ahead and give the website to my listeners. It's www.thejoyfulforager.com. Go check it out. You can look at her e-book. And get outside and see what you can do when it comes to foraging.

This is Healthy Talk on RadioMD. I am Dr. Mike. Stay well.
Length (mins) 10
Waiver Received No
Host Mike Smith, MD

How to Cut Your Grocery Bill by 30 Percent

How does foraging save money?

Additional Info

Segment Number 2
Audio File healthy_talk/1522ht4b.mp3
Featured Speaker JJ Murphy, Wild Edibles Forager
Book Title Joyful Foraging: Learn How To Feast On The Food Growing All Around You
Guest Website The Joyful Forager
Guest Bio JJ Murphy is a wild edibles forager on a mission to change the understanding of healthy eating. Her goal is to raise awareness of the delicious foods that are quite literally all around us and available for free.

JJ's foraging philosophy is simple: savor the abundance of edibles nature provides us each season of the year. Take only what you need, as gently as possible, doing no harm to the environment.

After earning a Masters degree in Broadcast Journalism from the University of Kansas, she moved to New York City and began writing about food and the environment. Her articles have appeared in the publications Wildness! Magazine, Outdoors Unlimited, and Spores Illustrated. JJ now writes The Joyful Forager column for the Shawangunk Journal in New York's Hudson Valley and is working on her first cookbook.

Her ebook, Joyful Foraging: Learn How To Feast On The Food Growing All Around You, is available for purchase on her website, TheJoyfulForager.com. Ms. Murphy regularly forages in urban and rural settings with her peers, including television host, Wildman Steve Brill, Gary Lincoff and Leda Meredith. She lives in Highland Mills, NY, at the foot of Schunemunk Mountain.
Transcription RadioMD Presents: Healthy Talk | Original Air Date: May 28, 2015

Anti-aging and disease prevention radio is right here on RadioMD. Here is author, blogger, lecturer and national medical media personality, Dr. Michael Smith, MD with Healthy Talk.

DR. MIKE: So, would you like to spend 30% less or so on your groceries? Which won't be so bad, right? And we going to talk about that. We're going to do that through a process called "foraging" and I am really excited to have my next guest come on in. I like all my guests by the way, but even in a just short brief introduction I had to J J Murphy about a minute ago, I can already tell I am going to like her a lot.

J J Murphy is a wild edibles forager on a mission to change the understanding of healthy eating. Her goal is to raise awareness of the delicious foods that are quite literally all around us and available for free. J J's foraging philosophy is simple.

Savor the abundance of edibles nature provides us each season of the year. Take only what you need, as gently as possible, doing no harm to the environment.
J J Murphy, welcome to Healthy Talk.

MURPHY: Thanks, Dr. Mike. So glad to be here.

DR. MIKE: I went on your website, thejoyfulforager.com and I think that – well, I think that's where I saw this J J. It was a video of you, I want to say in New York City, and you were just walking around, literally in the middle of Manhattan and you were pointing out edible foods. Was that on your site?

MURPHY: Yes. Yes, it was. And I was in New York City.

Dr. Mike: Can you really do that?

MURPHY: I continue to do that. I happen to live at New York's Hudson Valley. But I go to New York City quite often and there is, as you said in your introduction, quite literally free food all around us. One of the things that I feel is really important is for people to be able to recognize which plants are food and incorporate them into the diet. That gives you the opportunity to savor delicious, freshly harvested food as opposed to something that has been sitting in store for a while. And to stretch your budget.

DR. MIKE: And everybody is looking to do that now, right, J J?

MURPHY: Well, you are right. And one of the things that I've noticed is all of the information out there on stretch your budget. A lot of it when you look deeper, requires you to have a fully stocked pantry or to shop in bulk, like a case of olive oil or something. And even though I live north of the city, I still have very limited space to store that much volume.

And so The Joyful Forager is not only on my website, I also have a book which teaches 10 plants that -- I do everything but personally take you by the hand to show you what they are, where they grow, how to harvest them and how to prepare them. What I've done today for your listeners is I went out -- I created an entree menu that I would consider family friendly or even something I would serve to guests. I will work my Joyful Forager magic on this dinner menu.

DR. MIKE: Nice!

MURPHY: Preparing it would be service for four and, if you like, I'll give you the menu I started with.

DR. MIKE: Sure!

MURPHY: Okay. Baby spinach salad with vinaigrette dressing, sage rubbed grass-fed roast beef with roasted Yukon gold potatoes, and steamed green beans with slivered almonds. And what's going to happen is, I will take you item by item. I shop at Fairway, and Stop 'n Shop and Shop Right. I'm not shopping at gourmet stores or stores that are specialty stores. This is where most of the people I know shop. And I am going to shift out ingredients to include lambs quarter salad with apple in a vinaigrette dressing and mugwort rubbed grass-fed beef and roasted Jerusalem artichokes with olive oil and--

DR. MIKE: Let me make sure I understand this. So what you have done here is you have taken a standard recipe, right? And so what you have done through foraging is you changed the ingredients a little bit and you used them in the same recipe to come up with a dinner for four that has some ingredients right from the city you live in. Is that kind of what you did here?

MURPHY: Yes, sir. That's exactly what I did and one of the things is not only do you save money but the flavor profiles are very, very similar to a store ingredient. But the flavors themselves are going to be more intense and fresher because there is a shorter time from field to kitchen.

DR. MIKE: Yea. Obviously because you're just going out and doing it yourself. How do I know that though, J J? How do I know – okay. So, let's say there is some sage in a recipe -- how do I know what is comparable in a foraging sense to sage? Does your book cover that kind of information?

MURPHY: It certainly does. In fact, all of the plants that I am talking about today are in my book and on my website also, if you are to go there I have, for free, some getting started information that will help you learn where to look, what kinds of environments to look, in urban, suburban and rural locations and the simple tools, most of which you can find around the house to harvest. It's really actually easier than pushing the shopping cart. So...

DR. MIKE: Let's do this -- J J, let's do this. And we only have couple of minutes left in this first segment. Why don't we do this? That the recipe you just described, why not just take one of those foods, one of the things that you are now using from foraging in the recipe. Just tell us about that.

MURPHY: Alright, let me do the Spinach Salad. One bunch of baby spinach would cost you $4. Olive oil at 20 cents an ounce, I am going to use a 4 ounces that's 80 cents. Balsamic vinegar, because spinach can taste kind of bitter to some people -- 2 ounces of that is 57 cents an ounce. That's $1.14.

And the apple will cost you a dollar. Now the lambs quarters, same flavor profile -- better flavor profile -- more like Swiss Chard. I am going to swap Balsamic for apple cider vinegar, that's 14 cents.

DR. MIKE: Okay! Wow!

MURPHY: Olive Oil, the same, and the apples. Your salad from the store was $6.94 and from foraging it's $1.94.

DR. MIKE: That's significant, right? Now, I guess – okay9 here is the problem, though, and I think this is what most -- my listeners are probably thinking right now, J J. That sounds great. That sounds like something that they're interested in but there's two problems. They don't know how to forage, right? And number 2, they don't necessarily even know what they are looking for. So, your book will go through like the how part of this and also what to look for? Because we don't want to pick something that's not good for us, right?

MURPHY: Correct. And lambs quarters has a very, very distinct shaped leaf. There's nothing else like that looks like it. I also want to say I am not hauling plants out of the earth and scattering dirt everywhere. I am taking my scissors and trimming the tender top so the plant continues to grow and it will grow around the base of your house. It will grow on the way to your driveway, around your mail box. It grows in New York City -- I have a spot where I go. It grows in urban and suburban environments. And it is the one plant that I have used to turn a doubter into a believer.

Dr. MIKE: Yes. Well, J J that's definitely part of your philosophy, right? Take only what you need, as gently as possible, doing no harm to the environment. When we come back we are going to continue our discussion about foraging with J J Murphy.

This is Healthy Talk on Radio MD. I am Dr. Mike. Stay Well.
Length (mins) 10
Waiver Received No
Host Mike Smith, MD

Bad Air Is Bad for Your Heart

Recently, the European Environment Agency (EEA) stated that air pollution was the leading environmental cause of death in urban Europe.

Additional Info

Segment Number 1
Audio File healthy_talk/1522ht4a.mp3
Featured Speaker Mike Smith, MD
Organization Life Extension
Guest Website Healthy Talk MD
Transcription RadioMD Presents: Healthy Talk | Original Air Date: May 28, 2015

Healthy Talk with Dr. Michael Smith MD. And now here is the country doctor with a city education, Dr. Mike.

DR MIKE: From a group coming out of Europe called EuroActive, a group of scientists, socialists - you know, what have you - from a report that they put out: "Bad air is bad for your heart." Bad air is bad for your heart. Responsible for 400,000 deaths each year globally, air pollution has yet to be sufficiently addressed by the world's government, researchers have warned.

So, let's talk about this connection between pollution, air pollution in specific, and heart disease. You know, the World Health Organization (WHO) ranks heart disease -- it's interesting how they actually state heart disease. They say that "heart disease is the number one cause of premature deaths".

That's interesting because what they are saying is, if we took better care of our cardio-vascular systems, if we took care of our heart muscle, the heart valves, the rhythm of the heart; if we kept the vessels' openings clear so oxygen can get in and other nutrients can get in and waste products could get out; we would live longer. As a matter of fact, the heart, if we take care of it and the cardio-vascular system, we would live longer lives and when we don't take care of it, it leads to a death that happens at a younger age or pre-mature age.

I think, that's interesting how they actually state it.
In Europe, 4 million people die from heart disease. 1.9 million come from the EU, Europe by itself. That's according to the European Society of Cardiology. In the United States, 2011--that's the latest numbers I could find--787,000 people die from heart disease, right here in this country. That's from the Heart Foundation and a CDC report. It's a lot and I agree with the World Health Organization that these are young deaths, these are premature deaths, in many cases.

As a matter of fact, the founder of Life Extension, where I work, Bill Faloon, was a mortician. He started out as a mortician; that was his family business. And it was a fact that younger and younger men and women – women, too --were coming in dead from heart attacks. Even he, and that was back in '70s, he recognized the premature aspect of dying from heart disease.

So, we have this report that is linking air pollution to damaging the heart. This is according to an expert physician paper, published in the European Heart Journal. Many types--and this is the conclusion from this report--many types of cardiovascular disease are linked to poor air quality.

Not only does air pollution exacerbate existing heart problems but also appears to play a role in development of heart disease in otherwise healthy people. The researcher said there is particularly strong evidence of harmful effects of suspended particles as opposed to gas pollution. So, suspended air pollutants is really the issue. So, what are some of these particles they are talking about?

Well, among the most -- and there's a lot of pollutants in the air -- but I guess from a health point of view, from a cardiovascular point of view, the researchers outlined that the main gases and particles that they are concerned about are ozone, nitrogen dioxide, volatile organic compounds like benzene - anything that you may spray, like an air freshener -- carbon monoxide and sulphur dioxide. So ozone, nitrogen dioxide, volatile organic compounds, carbon monoxide, and sulphur dioxide--those are the main ones causing the heart problems. The sources of these types of gases and particles are road traffic, power generation, industrial processes, and, believe it or not, domestic heating. Homes, heating up homes, releases a lot of these volatile compounds.

Air pollution. You know, the European Environment Agency is kind of the equivalent of the EPA here in United States. They published a report before this publication in European Heart Journal.

It's kind of saying the same thing, and linking lots of the air pollution to cardiovascular disease and heart attacks. As a matter of fact, in that original report from the EEA, they said that cardiovascular disease and heart attacks are the main cause of deaths due to air pollution, 80%. Cardiovascular disease and heart attacks are the main causes of death due to air pollution. So, air pollution, when you look at all the problems it could cause, it mostly affects the cardiovascular system. Out of all the deaths that air pollution can cause, 80% of those are due to heart attacks, heart disease.

Out of all the problems in deaths that air pollution can cause, it mainly affects your heart. I keep repeating that because I think we've been misinformed maybe. We know that a lot of the pollutants in air are linked to things like Alzheimer's, dementia, even cancers and that seems to be where we've focused most of our attention. Turns out that shouldn't be the case.

The main organ in your body that air pollution affects -- it's not your lungs; it's not your brain-- it's your heart. It's your heart. Okay. Yes, so what are we going to do about all this? We have an air pollution problem throughout most of the world today. In the United States, we've done a little bit better job, I think, of cleaning up the air.

We have to be careful about relaxing some of the standards and regulations we've placed on, for instance, power generation--power plants.
I grew up in Southern California in the '70s and I distinctly remember -- now we were closer to the beach.

I lived in Mission Viejo, California, which is in Orange County just south of LA. And I can remember, we are may be 10 minutes from the beach and maybe 30 minutes away from the mountain range called Saddleback Mountain, and I remember at times being at the beach or even just at my house and looking east towards the mountain range and not being able to see anything but pollution -- just grey stuff and couldn't even see the mountains and they weren't that far away. Specifically, I remember those days when you could see the mountain range.

It was so rare in the '70s. People would actually comment about it, "Oh, my God! There's Saddleback Mountain. You can see it. Woo hoo! What a great day, get outside." That was in the '70s. The good news today is, it is more common to see the mountain ranges to the east of LA and Mission Viejo and San Diego than it is not.

So, in Southern California they have at least done a better job and I think the air quality has improved throughout the South and Northwest. I am not so sure about the North East. So, we've made some headway. But, obviously, one of the points of this whole report coming out--again, published in the European Heart Journal--was that we need more of a public action, we need more of the EPA, the European equivalent of the EPA. We need to be more stringent about controlling air quality.

And, you know, I would have to agree with that. Who doesn't? I mean, don't we want to breathe clean air? What can you do, though, personally? I mean from a personal level, there is not much you can do. There are little things you can do. Your impact as an individual in the outside air isn't going to be as great as your impact could be on the inside air, the indoor air quality. So, maybe that's where you can focus.

As a listener of Healthy Talk, focus on cleaner indoor air. There are some people who would tell you that indoor air can be worse than outdoor air. There's a great book on this by the way, My Sick Home, or My Sick House. I forget the author's name, too. Just go ahead and look that up My Sick Home, My Sick House. There are things you can do inside that will clean up the air quality. Stop using anything that produces volatile organic compounds, by the way, like air fresheners and stuff like that. There are more natural air fresheners that you can use. Clean out your lungs. N-Acetyl cysteine, artichoke extract, antioxidant and great for your lungs.

Clean out your liver. Help your liver detox this gunk with milk thistle and melon extracts which help the enzymes in the liver to detoxify these compounds. So, there are things you can do more personally.

So, yes, bad air equals bad hearts. This is Healthy Talk on RadioMD. I am Dr. Mike. Stay Well.
Length (mins) 10
Waiver Received No
Host Mike Smith, MD

Ask Dr. Mike: Do You Need the Shingles Vaccine if You're Healthy?

Listen in as Dr. Mike provides the answers to a wealth of health and wellness questions.

Additional Info

Segment Number 5
Audio File healthy_talk/1522ht3e.mp3
Featured Speaker Mike Smith, MD
Organization Life Extension
Guest Website Healthy Talk MD
Transcription RadioMD Presents: Healthy Talk | Original Air Date: May 27, 2015

It's time for you to be a part of the show. Email or call with questions for Dr. Mike now. Email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 877-711-5211. What are you waiting for? The doctor is in.

DR MIKE: That's This email address is being protected from spambots. You need JavaScript enabled to view it.. Send me your email questions. This is sometimes my favorite part of the show. Here's a question about shingles vaccine.

"There are a few commercials promoting the vaccine. I'm 67 years old, healthy, but did have chicken pox as a kid. Should I consider the vaccine or are there alternatives for preventing shingles? Thanks. Dean from Texas."

That's where I went to medical school. All right, so I think this is an opportunity to spend a little bit more time talking about shingles and what we have to offer as far as prevention and treatment for it, both conventionally and with supplements.

Just as a reminder, the virus we're talking about here is a herpes virus. It's called varicella zoster. It causes chicken pox in kids, but it's a nasty little virus because once the chicken pox is over, the virus isn't gone out of the body. It just becomes dormant. It can hide in what is called lymph tissue, immune type tissue, lymph nodes that kind of stuff, in certain cells and it just kind of lays there inactive.

Now, the good news, in most cases, as a person gets older and older and older, nothing really ever happens. Most people don't get shingles. But there is a risk once you've had chicken pox, as you do get older, there is a risk for the virus, this herpes virus, to reactivate and once it does, it causes a different type of disease--a disease that involves the nerves, specifically the nerves that supply the skin called dermatomes and that's why often you see this rash kind of like in a circle around like the trunk or the chest area, the buttocks, the arm, but the virus reactivates and causes this nerve/rash type symptoms along what are called dermatomes.

What is the risk factor for this virus to reactivate and cause shingles? Well, its age. About half of all patients over 60 are at risk. Patients aged 80 to 89 are ten times as likely to develop shingles as children under the age of ten. So, you do see it in kids. Kids that have had chicken pox. There are rare cases of some of these kids, two or three years later, getting shingles. It's rare, it's usually something that occurs as we get older, 60s, 70s, 80s and it usually happens when our immune system becomes weaker and weaker as we get older. That's called immunosenescence, the weakness or the weakening, I should say, of the immune system.

Other risk factors besides age would be anybody that's immune compromised either because of drugs, like steroid use, maybe infections like HIV, what have you, but people that are immunosuppressed are at risk and for whatever reason, I don't think we have a great answer for why but white women are at a greater risk of reactivating the chicken pox virus, varicella zoster. By the way, African-American individuals are at the lowest risk; haven't quite figured that one out.

At least, I don't think. If you do get shingles, the common treatment is an antiviral drug called Acyclovir. That's pretty much the main one. It does reduce pain. It helps to increase recovery and the healing of the rash and it's only recommended in patients, I think, over 60--no younger than that, over maybe 40 or 50.

You really can't have any complications from the shingles. Shingles can turn into some dangerous things like pneumonias and stuff. Once that happens, that takes hospitalization. That's a different treatment course, but as long as you're say, around 50 or older, you don't have any complications, you can take Acyclovir and it does work. Here's the big problem though, you have to start the drug within usually around 72 hours of the shingle outbreak.

The longer and longer you wait, the less effective the drug is. That's the real problem with conventional treatment right there. Usually people will develop the rash and it hurts. That's why they notice it. You put a shirt on and you're like, "Ow. What is going on?" and you look in the mirror and there's a rash going around your breasts or around your stomach or your arm, whatever.

It's usually you rub up against something, clothing, whatever, you feel that it hurts and that's when you notice it, but it could have started a week ago and you're kind of passed that deadline for starting Acyclovir. Now, most doctors in the community, if you're over 40, 50 and if you don't have complications, they're still going to put you on a course of Acyclovir. It's just not as effective as if you started it within 72 hours.

You can do creams to help the pain a little bit, non-steroidal creams that can help. There's some research that capsaicin creams-- you know, capsaicin from hot peppers--may be able to help. Capsaicin, we know, increases a substance, a neurotransmitter, called substance P in the nerves and when that happens, it kind of deadens the nerves so it can control pain that way. That's capsaicin. But it does seem, it has be in the cream form, you can take capsaicin orally for like cardiovascular health, but it has to be in the cream form. Now, back to the question, though, about the vaccine.

So, this gentleman wants to know, Dean from Texas, wants to know, he's pretty healthy. He had chicken pox. He's just worried about it. He's seen the commercials. Should I get the vaccine? Well, the vaccine, let's see. I have some information about it here. It is called Zostavax. It was licensed in 2006 by the FDA. When administered to individuals over the age of 60 with a healthy immune system, so you, again, have to have no complications.

This vaccine reduces the risk of developing shingles by 55 percent. That's pretty good. Studies of this vaccine found it was safe for patients over 60 with the most common side effects being swelling, redness, warmth and pain at the vaccination site. A small percentage of participants in these studies developed a varicella-like rash, almost like a shingle-like rash, consisting of a small number of fluid-filled vesicles that occur at the site of the injection, but it did not spread. The biggest barrier to this vaccine is cost. It's very expensive. At this point, unless the cost comes down, it's not going to be used widespread. It's just not.

Now, Dean, personally, I think this is a good vaccine. Knowing how devastating shingles can be for some people and the complications that can happen, it's something you might consider. Now, you tell me you're pretty healthy and all that kind of stuff. There might be some natural things you can do just to keep your immune system up. You might want to consider strengthening the immune system, especially against viruses: vitamin C, vitamin D, reishi, zinc, one of my favorites lactoferrin. There is even some evidence seaweed extracts. Seaweed has a compound that might have some anti-herpes properties to it. Dean, you have to definitely reduce stress.

That's one of the best ways to prevent, besides the vaccine, is to reduce stress because usually it takes some sort of physical stressor, emotional stressor to reactivate the virus because the stress brings down your immune system. So, reduce stress, try some of those supplements, but listen, if you can afford it, the vaccine looks pretty good and it can reduce the risk of shingles by 55 percent, so it's not a bad choice if you can afford it, but try some of the supplements as well.

This is Healthy Talk on RadioMD. I'm Dr. Mike. Stay well.
Length (mins) 10
Waiver Received No
Host Mike Smith, MD

Ask Dr. Mike: Acne Inversa, Treating CIDP & IGF for Wound Healing

Listen in as Dr. Mike provides the answers to a wealth of health and wellness questions.

Additional Info

Segment Number 4
Audio File healthy_talk/1522ht3d.mp3
Featured Speaker Mike Smith, MD
Organization Life Extension
Guest Website Healthy Talk MD
Transcription RadioMD Presents: Healthy Talk | Original Air Date: May 27, 2015

RadioMD. It's time to ask Dr. Mike. Do you have a question about your health? Dr. Mike can answer your questions. Just email This email address is being protected from spambots. You need JavaScript enabled to view it. or call now 877-711-5211. The lines are open.

DR MIKE: Alright. So, recently, I answered some questions about wound healing and a listener named Mike, I think he's a little upset. It's okay. I got you Mike. I have some information for you. He emailed me and said, "You forgot to mention growth factors like IGF for wound healing. Could you review the research on these and then it goes dot, dot, dot please." Sorry, Mike. You're right. When it comes to wound healing, I talked about the importance of enough calories. I talked about proteins, fats, carbs, Vitamin C.

There's a whole bunch of ones I went into in answering some wound healing questions. There was another question about wound healing. Mike, if you remember, I talked about amino acids and aloe vera. But you're right, I did not talk about growth factors and also hormones involved in this like human growth hormone. Give me a chance here, Mike, to correct my mistake.

So, we are talking about chronic wounds. If you cut yourself, depending on how bad it is or how large the wound is every day you, should see improvement. There should be less pain, less redness, the wound should start to close little by little by little.

If it's not, the first thing you have to do is get it cleaned, make sure there's no infection in there. Then, you can do things like I mentioned: Vitamin C, Vitamin D, aloe vera, the right amount of fats. All this kind of stuff can help. Glucosamine was something I talked about. Alanine, glutamine--these are all important factors for helping wounds to heal if it's not really healing at a good pace. Mike brings up a good point.

There are these things called growth factors and growth hormones that really are...I think a better way of describing these types of compounds in the body is these are repair compounds. Let's just talk about growth hormone for a second.

When you are a child and/or adolescent and you are growing, there is this hormone that really dictates all of that growth and stimulates a lot of that metabolism. Next to thyroid, that is the growth hormone. Once you're done growing, growth hormone doesn't go away. It's still there.

It's just not helping you grow in the sense of getting taller and thicker and all that kind of stuff. Instead, it really becomes a hormone about repair and regeneration of healthy tissue. So, these growth factors, growth hormones are really repair and regeneration compounds and factors.

I'm glad Mike did bring this up. I don't want to get into the whole issue or debate of growth hormone injections. I will tell you that I've had some experience of injecting growth hormone into some bad joints, like in the knees. I'm definitely not an expert in it. I worked with some doctors who were and the results were awesome. I mean, amazing results with growth hormone injections. At least into a specific body part like a joint.

It makes sense – it's helping the body repair and regenerate. So, that is something to consider. There are doctors who specialize in growth hormone injections and applications for chronic wounds. If you have a chronic wound, you should reach out to those kinds of doctors and see what they have to offer.

But there are other things. You don't necessarily have to go right to that injection. There are things you can do. For instance, Mike and his questions mentions IGF. That's insulin-like growth factor. Insulin-like growth factor is connected to growth hormones. So, there are natural supplements, over the counter, oral supplements that you can take that boost IGF--Insulin-like growth factor compounds--that then can have an impact on growth hormone. There are over the counter supplements that you can do.

If you look at what these growth factors or repair and regeneration factors are doing in the body, they help to form new tissue called granulation tissue. They increase connective tissue production by creating new blood supplies which is very important.

They promote remodeling and growth of new skin and they help to attract protein and immune cells to come in there and fight the infection and clean the debris up so that the healing can occur.

The most common of these growth factors insulin-like growth factor, epidermal growth factor, the growth hormone. There's a whole array of these different types of growth factors that are available in supplement form that you could check out and see if they will work for you.

I wanted to mention this. In my answer previously, a listener asked a question about amino acids and wound healing and I had talked about arginine and glutamine which are important. There was another one that I left out that really falls more under this category of what you call growth factors and it's ornithine. Or, in a specific form of ornithine called ornithine alpha-ketoglutarate (OKG). Its two molecules of ornithine and one molecule of ketoglutaric acid. It promotes wound healing and protein synthesis within the wound itself.

There's a lot of good research evidence that the ornithine compound, glutamine and arginine--really those three can play a major role along with these other growth factors in healing a chronic wound. Mike, you are right. I should have talked about that and I just missed it. Thanks, Mike. I like when my listeners keep me on my toes.

Next question. "I have acne inversa – that's lumps under my armpits and groin. I read that a new drug is in development. Have you heard of this?"

I don't know of the new drug but I do know that acne inversa is exactly kind of what the name sounds like. It's kind of like a pimple on the inside. Have you ever had a pimple on the inside of your nose? Its red, it's painful but it's not necessarily one you can see. You can just kind of feel it.

That's what acne inversa is for people that have this condition. It usually does occur in the groin and under the arms. It can get real big. They can be small. They can cause some redness but they are painful, usually, to touch. There's really no treatment. I know that when it's really severe, they will do surgery and remove some of them. Then, when that happens there's an increased risk of too much wound healing, by the way, in the formation of what are called keloids which is a raised scar under the arm or groin and no one wants that. So, there really isn't much out there in treating acne inversa – these bumps under your arms and your groin. I did find there's a company called Cellceutix.

A very interesting company by the way. They focus a lot on rare diseases that kind of stuff. They have a new antibiotic that's coming out. I do know this company is meeting with the FDA. I just did some research and found their website. They are meeting with the FDA to talk about a potential treatment for acne inversa. But there wasn't any detailed information on what that drug was.

Real quickly, I think I have time for this.
"Is there anything on the horizon for treating CIDP – chronic inflammatory demyelinating polyneuropathy?"
CIDP.

It's a big thing, a big word. That's a damage to the myelin sheath of a nerve. It causes a lot of pain. It might be related to reflex sympathetic dystrophy. It often follows trauma, past infections and that kind of stuff.

In many cases, it just happens. We don't know why. You might consider you have to replace that myelin sheath in this type of disease. This also might apply to M.S.

Ceramides – a type of fat for your skin may work there and anything with phosphorylcholine. Ceramides and phosphorylcholine make something called sphingolipids which is the pre-cursor to myelin sheath.

This is Healthy Talk on Radio M.D. I'm Dr. Mike. Stay well.
Length (mins) 10
Waiver Received No
Host Mike Smith, MD

Caring for the Caregiver

How can you balance working and caregiving?

Additional Info

Segment Number 3
Audio File healthy_talk/1522ht3c.mp3
Featured Speaker Stephanie Erickson, Clinical Social Worker
Guest Website Erickson Resource Group
Guest Bio Stephanie Erickson is a clinical social worker with over 20 years of experience as a geriatric social worker. Her primary area of practice focuses on dementia and decision-making capacity.

She works with seniors living autonomously, in care facilities, in acute care at the hospital, and who are living with family. Stephanie also provides training and consultation to families, the Alzheimer's Society, community groups, financial and legal institutions and at professional conferences. She hosts her own weekly podcast called Caregivers' Circle on WebTalkRadio.net.
Transcription RadioMD Presents: Healthy Talk | Original Air Date: May 27, 2015

Living longer and staying healthier. It's Healthy Talk with Dr. Michael Smith M.D. Here's your host, Dr. Mike.

DR MIKE: So I'm here with Stephanie Erickson. She's a social worker with over 20 years' experience in social work. She focuses a lot in the elderly, dementia, decision making capacity and she has her own podcast called Caregivers Circle on WebTalkRadio.net. Stephanie, welcome to Healthy Talk.

STEPHANIE: Thank you.

DR MIKE: So, Stephanie, we just ended up talking about home care versus assisted living. We were talking a little bit about cost. You really surprised me with a number that you came up with. [Inaudible] You mentioned $120,000 or so a year?

STEPHANIE: You have full time home care. That's full time 24 hours/7 days a week.

DR MIKE: Are there financial aid programs for families that want to go that route?

STEPHANIE: Well, there are insurance products that cover that kind of care that people can purchase. I mean, I purchased that already because I'm in the business and I know what to look forward to as I age. For those that don't qualify for Medicare or Medicaid aid, you are really looking at some basic resources that perhaps the Alzheimer's Society or some other organization can give to you. But nothing is going to be full-time care. You might get three or four hours a week but, unfortunately, it's never really sufficient for what the family needs.

DR MIKE: Let's switch the conversation over to the caregiver. I think this is just as important. Caregivers are taking care of parents that are getting older. As you mentioned before, there could be memory issues or full blown diagnoses like Alzheimer's and stuff. I think sometimes the caregiver forgets about themselves, don't they? How often do you see caregivers not taking care of themselves?

STEPHANIE: I would say 100% of the time. Now, the not taking care of themselves, there is a range, but every single caregiver that I have ever met neglects some part of themselves whether it's something that they were passionate about, a hobby, perhaps its hygiene or sleep or their own medical appointments, their social relationships. There is always something that the caregiver is not doing for themselves and, instead, is pouring that energy into their loved one.

DR MIKE: How do you define a caregiver? I think when I hear the word caregiver, I'm thinking of the spouse that is taking care of the other spouse full-time with Alzheimer's. Or, I'm thinking of a daughter taking care of her mom full-time. There's more of a wide range of caregivers, aren't there?

STEPHANIE: There really is and I'm really glad that you asked that question because I think part of the reason why caregivers don't take care of themselves is because they are not identifying as such. They are identifying as "I'm a daughter". That's it. "I'm a daughter and I'm assisting my mom." Again, I think that caregiving begins very early on.

So, it's simple things. Like in my own family, my mother-in-law, every time she goes to see her financial advisor, she wants my husband to go with her. Now, she doesn't need help really making decisions but already he's doing little things here or there. Or, she doesn't like to drive at night so we pick her up and drive her to our house to have dinner. This is already our introduction into being a caregiver even though we are not defining it as that. That really is the beginning of a long journey.

DR MIKE: You talk about a working caregiver. Do you want to explain that?

STEPHANIE: Yes, that's a large percentage of the people. A working caregivers is someone who is putting in full or part-time hours into traditional business. They are a lawyer; they work at the retail outlet, whatever it might be. At the same time, they are providing support for their aging relative.

That support could be everything that I said, like doing a little bit of transportation, going to appointments, going to their house and making dinner, cleaning out their refrigerator, shoveling the snow for them during the winter. At the same time, they really have their own work responsibilities and, really, their own family responsibilities most of the time.

DR MIKE: Is it a common scenario, let's say you have a family, maybe you have two or three siblings, maybe the father passed away, maybe the mom has some memory issues, how often do you find that it's just one sibling doing most of the caregiving? If that's the case, what kind of advice can you give that caregiver to get more of the family involved?

STEPHANIE: I would say that that's the most common scenario. It's not necessarily a bad scenario because as you probably know with the position, healthcare professionals like to have one person to speak with. They don't want to have to explain everything to a million family members.

It's good when one person takes the lead. However, if that person needs assistance, it's really important that the other family members chip in and do their part. That's not always possible because of dynamics within relationships, trust issues, history of family conflict.

DR MIKE: Geography, too.

STEPHANIE: I always encourage the caregiver to be honest with their family members. Instead of telling them what they should be doing, ask them what they are capable of offering. That way they don't feel like they are being forced but they can just offer what it is that they want.

DR MIKE: So, leading the care for a parent or a spouse is fine but that's not the same thing as doing everything yourself, right? So, delegating a little bit to some other family members is important.

STEPHANIE: There is a difference between "I'm the one doing all of the work" but there's also" I'm the one organizing it all". I'm creating a schedule so, my sister, I'm asking if maybe she's going to be visiting my mom Monday, Wednesday, Friday. I'm going to visit my mom Tuesdays, Thursdays and the weekends.

My brother, who is a lawyer, he's going to be taking care of managing all of the money because he's really good that way. And we can sort of divide and conquer.

DR MIKE: What's the best way for a caregiver to care for themselves?

STEPHANIE: I think they need to understand and recognize what it is that their neglecting first. Because most of the time caregivers say "No, no, no, I'm fine". So, I think just really reflecting and looking deep within and saying "Who was I. What did I do prior to taking on this additional responsibility?"

Then, we can start to say, "These are the pieces of my life that I am missing". Then, literally, pen and paper in hand, make a plan to make sure that you are giving yourself back some of those things that brought you enjoyment prior to taking on the responsibility.

DR MIKE: It's okay to take a break as a caregiver, right?

STEPHANIE: In fact, you have to. If you don't, you're not going to do your job as well. You might be resentful, you might be angry, fatigued and in the end you will hurt the person that you are trying to help because you are so exhausted and angry and resentful. So, it's really mandatory, in my mind, that caregivers take a break for themselves.

DR MIKE: I had some experience with this. A friend of mine was taking care of her mom and she wasn't taking care of herself at all. I noticed, just like you said Stephanie, some of the things she used to enjoy she wasn't doing. Some of the hobbies. She used to love to do yoga. She wasn't doing that anymore. She was also and she still is very headstrong and I knew that I couldn't just go in there and say – I don't want say her name- "Alright you have to go to your two-hour yoga class today".

She just wasn't going to do that. So, we took the dogs for a 20 minute walk. We just did little things to get outside again and little by little she started getting back in. That was somewhat successful for her. She's still not doing enough though, to be honest, Stephanie. Now, you have a personal website. Do you want to give that to my listeners?

STEPHANIE: Sure. It's ericksonresource.com.

DR MIKE: And what kind of information is on that site?

STEPHANIE: I have a blog that goes up all the time. Information about my podcast is up there and I write a lot of articles. I also have worksheets and webinars that people can access. It's a very active site, so you can find a lot of information and resources about caregiving.

DR MIKE: Stephanie, thank you so much for what you're doing. I really am impressed by the work you do and I just want to say thank you.

This is Healthy Talk on Radio M.D. I'm Dr. Mike. Stay well.
Length (mins) 10
Waiver Received Yes
Host Mike Smith, MD

Home Care vs. Assisted Living: Is One Better than the Other?

How do you know the right time for an aging relative to move?

Additional Info

Segment Number 2
Audio File healthy_talk/1522ht3b.mp3
Featured Speaker Stephanie Erickson, Clinical Social Worker
Guest Website Erickson Resource Group
Guest Bio Stephanie Erickson is a clinical social worker with over 20 years of experience as a geriatric social worker. Her primary area of practice focuses on dementia and decision-making capacity.

She works with seniors living autonomously, in care facilities, in acute care at the hospital, and who are living with family. Stephanie also provides training and consultation to families, the Alzheimer's Society, community groups, financial and legal institutions and at professional conferences. She hosts her own weekly podcast called Caregivers' Circle on WebTalkRadio.net.
Transcription RadioMD Presents: Healthy Talk | Original Air Date: May 27, 2015

Healthy Talk with Dr. Michael Smith M.D. And now here's the country doctor with the city education, Dr. Mike.

DR MIKE: Some of my listeners might be having to go thru a really tough decision right now. And that is trying to decide whether somebody they love can undergo home care or they need to go into assisted living. I'm going to be perfectly honest with my listeners. I've really never thought of this before, I wasn't aware that a lot of people go through this. It makes sense that people go through this tough decision. I just never thought about it.

When I saw Stephanie Erickson, she's a social worker, she pitched Healthy Talk and this idea of how to make this decision, and I jumped all over it. I really like it. I'm happy she's on. She's a social worker with over 20 years of experience. Her primary focus is in dementia and decision making capacity.

She works with seniors living by themselves and in care facilities and acute care in hospitals. She also provides training and consultation to families, The Alzheimer's Society, community groups, financial and legal institutions and at professional conferences. She has her own weekly podcast called Caregivers Circle on WebTalkRadio.net. Stephanie, welcome to Healthy Talk.

STEPHANIE: Thank you so much for having me again.

DR MIKE: Homecare or assisted living? This is obviously really tough for people, isn't it?

STEPHANIE: It's extremely tough because I find that most of the time, the adult children want one thing but the senior, him or herself, wants something else. To me that probably presents the greatest challenge. More than what is the most appropriate environment, it's actually how can we decide as a family what is going to be best.

DR MIKE: Just the way you presented it right there – that's a dilemma. Here you have a maybe a father, a mother, an older uncle who wants to live by themselves but maybe you feel that's not necessarily safe for them. So, we have to balance that freedom they want, that autonomy they want versus what's safe for them. And that's obviously going to be very tough. Let's start here. What's the difference between assisted living/assisted residency and full care facilities?

STEPHANIE: Assisted residency is usually in a much larger environment. Typically, the services that are offered for all of the people that live within the environment are meal services. So, usually three meals a day. There's very likely not a kitchen within their own personal apartment but there may be. That's kind of a flexible option.

Often an assisted residence also provides medication services and perhaps a little bit of hygiene care but the person is more autonomous. They can go to the dining room, back and forth themselves. Maybe they just have some slight memory problems and just need a few prompts and guidance but generally they are functioning on their own.

A full care residence would be somebody that has severe memory losses or perhaps some physical disabilities or physical loss of mobility problems and they require much more care and services. Ambulation, transferring assistance, for sure there is no kitchen within that person's room and often the person is sharing a room as well.

DR MIKE: In the assisted residence, is that someone living maybe almost in a smaller apartment by themselves versus more like the traditional hospital or something?

STEPHANIE: Well, it's not really a hospital. It could be a regular apartment building but there's going to be a main dining room. Sometimes it's on the ground floor but often it's on the second or third floor within the residence.

So, they have their own small apartment but they take the elevator and go down to the dining room for their meals. The nurse checks in on them, let's say twice a day, when they are obtaining their medication. Other than that, they are sort of free to come and go as they please.

DR MIKE: Let's help my listeners. Let's say there is a listener who's maybe in this tough decision. What are some of the things or some of the advice you could give that person? When is it the right time to move somebody into assisted living or to get them home care? What are some of the things you look for?

STEPHANIE: Well, in terms of what signs in the home – because that's going to be the first indication for the family. Number one, you're going to look at the person's physical health. So, things like weight loss, mobility problems, falls, the home environment in terms of hygiene, personal hygiene problems and they are going to consider the cognitive functioning of that person. And those signs and symptoms would be things like expired food in the home, disorganization of papers, utilities or rent or mortgage not being paid, taxes not being paid, burning pots on the stove – those sorts of things. When you're deciding if it's the right time there are a few factors you have to look at.

One is safety. That is the most important thing. Medication compliance issues obviously present them pretty high risk. Second would be wandering. If the person is leaving the home and not able to find their way back. That's a pretty significant risk as well. But always you have to consider, financially can we afford to bring care into the home? Enough care, enough hours to keep the person safe in comparison to what the cost would be for residence.

DR MIKE: So, let's say you get to a situation where all the signs are there. You feel, based on the things you are seeing, like you mentioned the medicine compliance and leaving stuff on the stove, all the signs are there. Is there a better way to then approach your mom or dad who you feel needs to move into an assisted living, is there some advice you can give my listeners there?

STEPHANIE: Yes, hindsight is always 20/20. So, my first advice would be actually start talking to your parents now when they are healthy. Talk about what environments they would want to live in should they need assistance. So, that way we sort of already know what our parents want and it's going to help us if a crisis arises.

But if your listeners are already in the situation, the first thing I suggest is that the listeners start documenting all the signs and symptoms that they are seeing over maybe a two or three week period and then presenting those to their parents. "Mom, I love you very much. I've observed a few things over the past few weeks and I really scared about your safety and your health. Can we talk about it?"

So, not going in and saying, "Mom, you're not doing well, it's time to move" but coming from love and asking for the senior's opinion and their own perception of what they think is going on.

DR MIKE: So. what about the actual place that you are looking at? Are there things that we want to look for that might indicate that a place is not so great in assisted living or are there things that say, "Hey, that's a great place" ? How do I pick the right place is what I'm asking.

STEPHANIE: I think it depends on what issues you are trying to resolve. If it's a memory loss problem and we know that they person has dementia, that's a progressive and persistent disease. It's only going to get worse. So, you are going to want to find a place that has a continuum of care so the person doesn't have to be moving around a lot. If you are looking at physical problems then, obviously, you are looking at something else. But I tell families, more than anything else there are two things that I recommend. Number one, go to at least four places. At least.

And pop in and make sure you go during lunch time and try a meal because you want to check out how the food is. Number two is to make sure you meet the director in charge and get a feeling how he or she runs that residence. And the third point is don't doubt yourself.

The way that you feel when you walk into a place, even if you can't put words to it, that should be considered and its absolutely important information to keep in mind when you are evaluating.

DR MIKE: So, my guest is Stephanie Erickson. She's a social worker for many, many, many years and has a great podcast called Caregivers Circle on WebTalkRadio.net. Stephanie, how much does all of this cost? Do we have any average cost on home health care versus assisted living?

STEPHANIE: Well, if you wanted home health care and you needed 24 hour care--not everybody needs that-- you're looking at about $120,000 a year for full time health care. It's crazy. That's if you go with private home care companies. There are some other options that you can do that would lower the cost.

DR MIKE: We will come back to that cost question. That's a lot of money , Stephanie, for the private caregiver. When we come back we will continue our discussion with Stephanie.

This is Healthy Talk on Radio M.D. I'm Dr. Mike. Stay well.
Length (mins) 10
Waiver Received Yes
Host Mike Smith, MD

Is Wine Really Healthy? The Debate Continues

A constant back-and-forth debate may have left you wondering if you should skip that glass of vino at dinner.

Additional Info

Segment Number 1
Audio File healthy_talk/1522ht3a.mp3
Featured Speaker Mike Smith, MD
Organization Life Extension
Guest Website Healthy Talk MD
Transcription RadioMD Presents: Healthy Talk | Original Air Date: May 27, 2015

Anti-aging and disease prevention radio is right here on RadioMD. Here's author, blogger, lecturer and national medical media personality, Dr. Michael Smith MD, with Healthy Talk.

DR. MIKE: So what do you think? Is wine really healthy? Oh, I hope so. I enjoy wine. I'm a light wine drinker. I belong to a wine club that sends me two bottles of red and white every other month from around the world and I get to try different varieties. I really enjoy it. So when I saw this headline - this came from a Life Extension blog. You can check it out at blog.lifeextension.com. It caught my attention when I read it so I wanted to talk about and discuss the research with my listeners.

So, is wine healthy? That's the question. Scientific opinion has really, over the years, flip-flopped on the issue of alcohol and alcohol consumption. Is it good? Is it the alcohol? Is it the grape? It goes back and forth. As a matter of fact, there was a report recently that showed -- Gosh, what did it say? It said alcohol consumption, forget wine, just the ethanol, alcohol itself, is beneficial at least up to the age of 65.

And at that point, you've got to start limiting alcohol consumption. I don't know if it teased out why. You know, you drink, maybe you're prone to fall and if you're over 65 and you fall and there's a -- I don't know, if you're drinking that much.

So anyways the medical community, the scientific community, just goes back and forth, flip flops, and I think the consensus now is a moderate amount of ethanol, alcohol itself, does offer some benefits. And I have a couple of studies I'm going to share with you from the blog.

But we have to be careful with it, too, because I can also cite some other research that shows certain cultures, certain religious groups that prohibit alcohol use, have a lot of longevity running in their people in their groups. So, obviously, there's a lot to longevity, there's a lot to health. It's not just alcohol, it's not just fruits and vegetables and healthy -- I mean genetics plays a role, culture plays a role.

So, just keep that in mind. As a matter of fact too, the French paradox, that whole thing about it, all the French eat as bad as we do here in America. Butter and they fry everything and it's thick sauces and heavy meats but they live longer and that's because of wine. Don't you remember that? I think I learned that in the 80s or something. The French paradox. It's all about the wine.

No, the wine may play a little bit of a role but we also now know -- I mean you just look at serving sizes. Can I say this? We're pigs in this country. Nothing against pigs but we way overeat. Our portion sizes are getting ridiculous. I mean, if anything, the French paradox is connected to portion size, really giving some credibility to the idea of everything in moderation. So, again, we flip-flop a lot as doctors whether we should be allowing our patients to drink a little alcohol.

My overall take is if you're a guy, you can have a couple drinks a day. If you're a woman, one. And I'm not being sexist there. Sorry, gals, studies have shown that men can do a little bit more alcohol and still maintain benefit. There's no doubt that there is a point of diminishing returns with alcohol consumption and that begins around three or four drinks, maybe five drinks depending on the size of the guy; two or three drinks, again depending on the size of the woman.

So, a couple drinks for guys, a drink or so for women a day, and that's probably pretty good. And that's coming from the alcohol consumption, the ethanol.

But now, let's go back to this idea, 'Is wine healthy?' The headline, 'Wine drinkers may live longer than non-drinkers.' Okay. So, that sounds pretty good for someone like me. In July 2014, an analysis of close to 400,000 men and women found an increased risk of death over an average of a 13 year period among heavy drinkers compared to moderate drinkers who consumed about 0.1 to 4.9 grams of alcohol per day.

That's a couple drinks. However, moderate drinkers had a lower risk of death compared with those who reported no drinking at all. So, this is interesting. Heavy wine drinkers didn't do very well in this study. If you're drinking four, five, six glasses of wine a day, problem. That's not good. But if you're doing one or two glasses a day -- let's forget the genders first. Let's just say, men or women, doesn't matter. Two to three glasses of wine a day, one or two glasses of wine a day, something like that, probably okay. So, don't grab for that third glass.

A study of 128,000 Californians found a relationship between more frequent wine drinking and a lower death risk over a 20 year period, which was strongest for deaths from respiratory causes and heart disease. Okay, so again, that moderate, light wine drinking, lower risk of death in one study over 13 years and in another study over 20 years. These were published, by the way, in the British Medical Journal and the American Journal of Epidemiology. So, these are good peer-reviewed publications.

So, let's go to the question, then. Is it the ethanol, the alcohol in wine or is it the antioxidants? You know grapes are good for you, right? The skin of the grape, in particular, and the seed, by the way, but let's just focus on the skin of the grape.

A lot of grape plant-based antioxidants called polyphenols. So, the question becomes what's really giving us this benefit? Is it the alcohol or is it the polyphenols? We know that the red variety of wine, which is my favorite, contains a lot of these polyphenols. And we know polyphenols generally do offer cardiovascular benefits.

In a study involving rats given a standard diet and one that was high in cholesterol, researchers evaluated the effects of alcohol-free red wine for five months. So, this is interesting. They basically give them grape juice, right? So, they gave these rats -- by the way this was published in the Journal of Homeostasis Medicine, 2005 -- they gave these rats alcohol-free red wine.

This is a good way to test this, right? So, you have regular red wine and now you have alcohol-free red wine and this is going to help you to tease out which group is living longer. Is it the alcohol red wine or the alcohol-free red wine? While animals on the high cholesterol diet experience an increased risk for blood clots, these effects were almost completely reversed by the addition of alcohol-free wine.

The authors of the article concluded that wine, rather than alcohol may be able to prevent blood clots associated with high cholesterol levels.
So, there you go.

So, maybe it is the polyphenols that are at least conferring a cardiovascular benefit, not necessarily the ethanol. Of course, you know you have to take this in -- when we present data, I know myself on my show, Healthy Talk, and there's a lot of other great programs on Radio MD -- when we present data, I think we're pretty good at reminding you that we have to really look at a consensus of all the research.

So, here we have some research really pointing to the polyphenols in red wine. But there are some other studies that have shown ethanol itself provides a certain amount of benefit as long as you don't overdo and get to that point of diminished returns. Right?

Here is another study of 67 men--we're moving from rats to men--at high cardiovascular risk. Alcohol-free red wine was shown to decrease blood pressure. So again, it's the polyphenols and we've known that. So, you know, if you can't drink wine or you don't like it, how about some grape juice that doesn't have any added sugar? Or maybe a polyphenol supplement product with a bunch of different berries in it. That might be a good way to go. So, wine is healthy in my opinion.

This is Healthy Talk on Radio MD. I'm Dr. Mike. Stay Well.
Length (mins) 10
Waiver Received No
Host Mike Smith, MD

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