Is memory loss a normal part of aging, or does it mean something more serious is going on?

Additional Info

  • Segment Number 2
  • Audio File healthy_talk/1516ht4b.mp3
  • Featured Speaker Stephanie Erickson, Clinical Social Worker
  • Guest Bio Stephanie EricksonStephanie 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: April 16, 2015
    Host: Michael Smith, MD

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

    DR MIKE: So, what are the signs of cognitive loss? Of course, I think this is an incredibly important topic. You know, at Life Extension a couple years ago we started doing some research using Embrel, which is an anti-inflammatory, and we were using it in Alzheimer's patients and we were getting some pretty awesome results. You know, dementia, cognitive loss, Alzheimer's, all of this is important to us as a health foundation because, you know, the incidence and prevalence of these disorders continue to rise. And it's really in industrialized nations that we're seeing these types of dementia and cognitive dysfunction. So, toxins maybe? We don't really know but there's something going on in industrialized nations, so I wanted to talk.

    I have a guest here that is going to help us to really first look at what are some of the signs in somebody where we should be a little bit worried. And then, we will move in and talk a little bit more about seniors who are at risk. Her name is Stephanie Erickson. She's 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. Stephanie provides training and consultation of 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.

    Stephanie welcome to Healthy Talk.

    STEPHANIE: Thank you so much for having me.

    DR MIKE: I appreciate you coming on. So, let's just get right into this. Let's first talk about, and again my audience is a lay audience, men and women 50 years "oldish", and so, I think we should start off with some straightforward questions. What is the difference between Alzheimer's disease and dementia?

    STEPHANIE: Dementia is a noble term that describes neurodegenerative losses. Dementia--so you can kind of think of it as, if I say I have back problems, that's the global term. If I say it's disc five, that's being more specific. So, Alzheimer's is a type of dementia. There are several types of dementia. Alzheimer's is just the most common form.

    DR MIKE: Right. It is the most common form in the United States and, as I mentioned at the introduction, in developed countries, right?

    STEPHANIE: Yes. Yes. Exactly. The prevalence and, as you said also in the introduction, it's increasing over time. People are living longer, so people are more likely to have cognitive losses when they're living into their 90's.

    DR MIKE: How do you know if...but just because I can't remember where I leave my keys sometimes does that mean I should be worried? When do you know that memory loss is maybe just kind of normal versus a problem?

    STEPHANIE: Yeah, I hope it's not where you leave your keys because I do that all the time. (laughing) No, I'm really glad you brought it up because when I talk about this, people start to panic because some of the examples I give are very relatable to their own lives. What I think is important to remember is, if losses are interfering and disrupting your daily life. So, if you set your keys down and you can't find them and then you can a few minutes later, it's not disrupting your life but things that disrupt your life for example you're driving and you have no idea where you are and you know that you're in your own neighborhood but you can't get back home, that's disrupting your life. That's significantly different than just kind of setting your keys down.

    DR MIKE: Yes and the other thing to remember, too, with those kind of memory losses if you forget where your keys are, you get a little nervous about it that anxiety actually makes it harder to recall where you put your keys too so that's something to remember. So, when you talk about not knowing where you're at while you're driving, is this something that consistently happens as well and that's something we should be aware of?

    STEPHANIE: Yes. I mean I think that's another point is you want to look at the frequency. So, if in one moment you have a lapse of memory or you're not oriented to where you are or you forget somebody's name, then it's just a one time thing, I wouldn't worry about it but if you see a repeated pattern over time, yes, it could be an indication that you're having cognitive losses. And I think you would agree that some of these symptoms that I'm discussing have nothing to do with Alzheimer's or dementia. They might be related to other health problems or perhaps medication side effects and such. So again, it's important not to panic but just sort of take note of the time of day and what it is that's happening--the symptom--and then make sure you share it with your physician.

    DR MIKE: Yes. So, okay you mentioned one example--driving around. You know, you're in your neighborhood but you don't know where you're at, that might be something to go talk to your doctor about. What are some of the other kind of common signs and symptoms of dementia in general?

    STEPHANIE: Well, I think when somebody starts having difficulty understand financial documents. So someone who normally can look at their phone bill and figure out what the price is..

    DR MIKE: Uh oh. That's me.

    STEPHANIE: Yes, exactly. But again, it's out of normal. So, what I see sometimes in couples is, let's say in the older generation the husband is managing finances, he becomes ill. Now the wife is managing. Maybe she never learned those things so that would be normal for her to maybe not understand in the beginning. But if it's someone who, let's say, was an accountant and managed the bills for the family and now they're having trouble understanding investments, just writing a check, that's different from normal. So again, that would be a sign that something is wrong. And I also think that judgments...So, some of the things that families report to me is their parents had a new roof put on but they just had the roof done five years prior. So again, poor judgment and being influences by someone else to make a decision that's not in someone's best interest that could be a warning sign as well.

    DR MIKE: Isn't it true, though, that if somebody is having some of these issues these memory lapses that really are causing some problems in their daily lives and they're consistent. They're happening. There's a pattern. Isn't it often, though, a relative that notices it first? And if that's the case, what's your advice to someone to address that with that person?

    STEPHANIE: Yes. I mean 99% of the time, I get a call and it's a relative. It's a family member. Often we don't want to admit that we're having those problems and most of the seniors--I'm saying seniors because it's mostly seniors that have dementia. They're afraid and they're not identifying that it's happening. When a family member notices it, I think it's important to address it to your loved one right away and say to them, "I'm noticing that over the last several weeks you're having a hard time understanding the phone bill. Do you see that too?" Most of the time the client or the person experiencing the symptoms will become defensive. I think that we should just take our time as family members reintroducing the topic over, let's say, a several month period. If there's not high risk and then, maybe, include our adult children in those discussions having the adult children talk to the parent and then, eventually, involving a physician hopefully with the agreement of the person that is having the symptoms.

    DR MIKE: Well, no. That's a good point, right? I mean, I think in many cases probably the person doesn't want to hear about it. "I'm fine. You don't know what you're talking about." I mean, what if a loved one is refusing to listen to what people are saying or refusing to go get help. What do you do then?

    STEPHANIE: Yes. Well, that's probably going to happen with me because I'm pretty stubborn. So, I imagine if my kids told me something was wrong I would tell them to leave me alone.

    DR MIKE: You're going to fight it all the way aren't you? (laughing)

    STEPHANIE: Absolutely. That's what I tell my kids now but just keep pushing, I tell them. What I think I would do is encourage families to, as I said earlier, document the symptoms that they're saying. It's really important. Time of day is important, what the symptom is and the circumstances around that particular symptom that they observed. Document over several months and then communicate that to the physician. Now the physician, as you know, has confidentiality. They can not reveal any of their evaluation but they can certainly receive information so write it all down, send it in a fax and email. Bring it to the physician's office and ask the physician to follow up.

    DR MIKE: Good points. And I would assume, and to me, it makes sense that the more friends and family members involved in this process, maybe the person who's having these issues might listen a little bit more. So, you know, getting the kids involved, siblings involved, I think you would agree that that's probably important as well. If you've been married 40 years and you try to tell your spouse that they're not remembering things right, that might just start a fight. So, maybe getting some more people involved.

    My guest is Stephanie Erickson. She is the host of a weekly podcast called Caregivers Circle on WebTalkRadio.net and her website is EricksonResource.com.

    This is Healthy Talk on RadioMD. I'm Dr. Mike. Stay well.
  • Length (mins) 10
  • Waiver Received No
  • Host Mike Smith, MD
Since your dog can't speak to you to let you know he isn't feeling well, he might try to show you a different way.

Additional Info

  • Segment Number 1
  • Audio File healthy_talk/1516ht4a.mp3
  • Transcription RadioMD Presents: Healthy Talk | Original Air Date: April 16, 2015
    Host: Michael Smith, MD

    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: Does your dog have allergies? I mean, how do you know? So, let me share with you my experience with this and if you're a frequent listener of Healthy Talk you know that I have a border collie mix her name is Edy, E-d-y. It's from Edy Ice Cream. I think it's maybe mostly in the South. for those of you who know Edy Ice Cream, she's as sweet as that wonderful snack.

    And ,I guess she's getting, gosh, close to 7 years old now and I guess it was a couple of months ago, I had noticed that she was kind of gnawing, chewing on her paws especially at night. And it was really mainly just the front paws and I thought, "Oh. Well, maybe there's something there." I mean, I couldn't see any rash or whatever, but I'm a human doctor. I'm not a dog doctor, so I took her into the vet and he did a very thorough exam.

    I take her to what's called a "VCA Vet Hospitals" in South Florida--just a wonderful group of vets and technicians. So anyway, the vet did his job, checked everything out and everything looked fine. He didn't see anything and he asked me, "So, when do you notice she's doing this? Is she gnawing and chewing very aggressively? And is it hard to distract her from that?" And I said, "Oh, no. Not at all. It looks like she's quite calm and just kind of hanging out laying next to me chewing her paw, I don't know." Yes. He said that usually when they're like that, that they're calm, you can distract them, that usually just means the dog is grooming. If they're more aggressive with it, if the dog is really chewing at the paw, you know, making sniffing noises, is hard to distract, that might be fleas, ticks or allergies.

    That's what I wanted to talk with you today. I mean, how do you really know if your dog has an allergy? Well, that's one way. If they're chewing their paws but it has to be in an aggressive manner and sometimes you'll see a rash and sometimes you don't. That was something else the vet told me that you don't always recognize--the rash. So, that's why after he performed the physical exam on Edy he asked, "How is she acting? What's her behavior when she's doing this?" When I said it was quite calm, he just thought, "No, she's grooming herself." That was good news for me.

    So, no allergies with Edy but, by the way, according to a report from OneGreenPlanet.org foot chewing, I guess technically it should say "paw" chewing, one of the signs of an allergy and again, it has to be pretty aggressive. Now, what allergies cause this kind of behavior in a dog? Usually food allergies that often, if you see a dog chewing on the paw, a food allergy should be the first thing that comes to mind or it could be things that they are actually contacting in the grass. You know, lots of chemicals or pesticides are being applied to the grass, especially around apartment complexes, neighbor's yards and stuff. So, you have to be very careful about that. Especially that little sign that says "keep pets and kids away". You really should listen to that for at least 48 hours. So, usually a contact dermatitis type thing versus a food allergy if you notice foot chewing.

    So, what are some of the other signs and symptoms that your dog may have allergies? Well, obviously, the skin if they're itching in a very specific area over and over and over again, that's a good sign that there could be an allergy, especially, if they're on the flea and tick pills. Now, the flea and tick pills don't stop a flea or tick from hopping on. They really prevent infestation. So, you've still got to make sure that there are no fleas no ticks. If you're ruled that out and they're gnawing on one specific area, that might be a sign that there is an allergy issue. As a matter of fact, talking about this with my vet, he had said that if there's bumps around the area where the dog is chewing, that probably is flea bites but if it's a flat rash, if the skin becomes scaly, that kind of thing, that might lead one to think that that itching might be from some sort of contact dermatitis or again maybe like a food allergy.

    So, you have to start looking at the things you're feeding them; the snacks; have you changed the food; are you bathing with a different cleanser; those types of things. Another sign and symptom, actually, I guess this would be more of a symptom of allergies would be sneezing. Now, every animal sneezes on occasion and I remember when I was growing up during early Spring in Houston, Texas, I'm not kidding you, I could sneeze like 20 times in a row. It was just during the Spring. I mean, achoo, achoo, achoo! They were short and quick, bop, bop, bop. And people would laugh at me. It gave me complex. No, just kidding. But same thing with a dog.

    It's one thing for a dog to sneeze once or twice on occasion but if your dog in the morning during a certain seasons, usually early Spring or early Fall, if they're sneezing away, that's another sign that there could be some allergies. Dogs can be tested just like humans, I found out. They can do a skin test to test for different allergens. According to the VCA Animal Hospital in South Florida, usually you're going to see it during the Spring. Dogs tend to be more sensitive to the pollens, the ragweeds, the molds, the grasses as they flower. You know, we've got to remember grasses are a flowering plant.

    We forget that and that always happens the most in the Spring. So, if your dog is sneezing repetitively everyday it's early Spring, you can go ahead and get an allergy test to see which allergy, if it is an allergy, and to see which one. If it's outside of the Spring you're talking Winter, mid-Summer when it's really hot and a lot of those allergens are actually down, you might consider, is there something indoors? Indoor allergens are just as bad as outdoor. As a matter of fact, there are some people that think the inside is a lot more polluted than the outside. So dust, perfume, carpet powders.

    You know, I had a friend who used one of those pet carpet powders just to help clean up the dirt and the smell and her dog had sneezing attacks with it and she had to stop using that. So, just look at the different types of cleansers and powders that you might be using inside your home as well.

    Ears. What happens with dogs is a lot of fluid builds up in their ears because their ear canals are long. I also found out just like in human kids a lot of times, especially the smaller breeds, the ear canal is--from the sinus to the ear--is kind of flat, so it's easy for fluid to flow from the sinuses into the ears. In human adults that can...Now actually that is traveling up from the sinuses to the ears so there's less chance of that fluid...That's why kids get a lot more ear infections.

    Same thing with dogs. Apparently, especially in smaller breeds, that ear canal tends to be more even. It doesn't have to go uphill from the sinuses to the ears, so you get a lot of fluid in the ears which then leads to the infections. So black gunk in the ear, a lot of itching in the ear, you want to go get that checked out as well.

    And I want to mention, so what do you do if your dog does have allergies? Are there treatments? Well, it turns out after doing some research, I found this on DogsNaturallyMagazine.com and I did confirm this with the VCA Hospital in South Florida. Dogs can use quercetin. I've been using quercetin in humans for allergies for a long time. It helps with my sneezing, as a matter of fact. Quercetin comes from the peel part of citrus fruit.

    The human dose is about 250-1000 milligrams a day, so the question always becomes. "Well, how much do I give my dog?" Well, there's a formula that I found, again, on DogsNaturallyMagazine.com. You take your pets weight and you multiply it by 500 and then divide that by 125. So, if I use Edy for an example, she's 40 pounds, I multiply that by 500 and divide by 125. I come out to 160 milligrams a day of quercetin. That's what I would do for Edy. So, quercetin is an answer to some of these things. Of course, go talk to the vet first, please, but at that point talk to your vet about starting quercetin using that formula.

    This is Healthy Talk on RadioMD. I'm Dr. Mike. Stay well.
  • Length (mins) 10
  • Waiver Received No
  • Internal Notes NO GUEST
  • Host Mike Smith, MD
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/1516ht3e.mp3
  • Transcription RadioMD Presents: Healthy Talk | Original Air Date: April 14, 2015
    Host: Michael Smith, MD

    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.

    So remember you can send your email questions you can be as detailed as you want. You can be vague. You can give your name or not give your name. You can even tell me when you would like to hear it read on air and I'll do my best. My producer Sheldon Baker said don't guarantee anybody that you'll be able to read their question but I'll do my best to do that and I'll respond, I'll reply to your email and then tell you hey I'm going to shoot for one of these two days. So you can actually hear your question and hear the answer. This email address is being protected from spambots. You need JavaScript enabled to view it..

    So next question from Claire: "What are whole food supplements and why should I consider whole food supplements over traditional supplements?"

    Okay so let's start by talking—let's answer the first part of that question "what are whole food supplements?". And then I'll go into what are the—because here Claire talks about I guess traditional supplements and I think I'm going to have to make some assumptions there what she's talking about. So let's just first define whole food base products and I'm going to way oversimplify this because there's really no exact definition for this but let me use the spice turmeric and we know that the key compound in that is called curcumin.

    If you are a company that believes more in the whole food philosophy where you don't want to separate components out, you don't want to standardize anything you just want to give somebody some extra turmeric. So in a sense you take the spice, you create the powder, you put it in a capsule and you pretty much sell it. Now there's more to it than that they can still put the exact amount in, they can put dose in they can do that but for the most part none of the key components are separated out it's just the whole spice, oils and all just put in there as best they can. And there's nothing wrong with that that's a certain philosophy.

    There are whole food based companies out there and they're great companies. And so that's what a whole foods supplement is. Now that is in contrast to a company like Life Extension for instance that is more of an extraction-based company, a standardization based company. So we recognize that the spice turmeric is awesome, cook with it that's great, but we also know from the research that the main compound in the spice that gives us the benefits to inflammation to the brain, to the immune system, to joints, heart, all that, is curcumin. So our philosophy as an extraction-based company is to take that curcumin out of the spice and concentrate it in the capsule. So a whole foods based company is going to give you the spice we're going to give you the curcumin.

    That's whole food based versus extraction-based. It's not that one of them is right or wrong they're just two completely different philosophies on how to deal with supplements. We kind of follow, my company Life Extension, we kind of follow more of that medical process where we're going to concentrate the key compound, we're going to standardize it, we're going to make sure that there's 400 milligrams of curcumin versus just the spice. And that's just how we approach it. So that's whole food versus extraction. Why should I consider these supplements over traditional ones? I don't think you should consider—I don't think you should try to say whole food versus extraction personally I think extraction is best that's my opinion but for the consumer I think it's really just what you want.

    There are some people who really believe in that whole food based products because they believe that there's this essence of the food that's there in the capsule that you don't get in an extraction or in a standardization and that's fine I'm not going to argue that, it's really a preference thing. So I don't think you—why should I consider these supplements over traditional? I don't think you have to consider them over traditional ones assuming you mean by traditional you mean the standardized one the extraction ones.

    They're both good products the turmeric product is good and the curcumin product is good you're going to get benefits from both of them. The curcumin one like the one we produce at Life Extension might give you more specific health benefits to say inflammation or the brain or something but the turmeric one is good for you. It's a nice, whole food based spice, based product. Awesome take it. Hopefully that helps.

    Next question. "Why are some of my medical doctors adverse to my supplement intake and what can I do to help educate my healthcare team to the benefits of supplements?"

    And I wanted to answer these questions knowing I just had a really good friend of mine on, Julia Schopick, she wrote a book about Honest Medicine, she does a lot in patient advocacy, so I thought this would be a good day to cover these questions.

    "Why are some of my doctors adverse to supplement intake?" I thin it really goes back to the fact that most doctors—well maybe twenty years ago most doctors believed that supplements were not tested or regulated. I think that's where most of the negativity comes from. Now that's changing I mean just go to PubMed.com that's the site I always use for my research my listener's know that. Type in pomegranate, type in fish oil. I mean you'll see all kinds of studies. But there was a time when a lot of your middle aged to older doctors who are practicing right now, there was this idea that supplements were not regulated or tested and they've carried that on in their practice.

    They've carried that with them through the years. And so when you tell them I want to take pomegranate because I hear it's good for the heart they just "no there's no research! There's no proof! It's not even tested! How do you know it's high quality?" It's just those same questions that keep coming up. So what you need to know as a consumer, as a listener, is that that's not true. There's tons of research every year on supplements from multivitamins to anti-oxidants to plant-based extracts to spices to essential oils. I mean there's tons—at Life Extension we've done like $150 million in twelve years I mean there's research out there both in the lab and both in humans in clinical research. And we are regulated I just did a whole section on DSHEA (Dietary Supplement Health and Education Act 1994) which outlines exactly how supplements are to be regulated so we are regulated and there is research support for what we do.

    Okay so you go into your doctor who's against supplements I mean if you tell them "No that's not true doctor. There is research supporting these things I want to do and the company that I'm going to buy from has a good track record and they produce good quality products-they have their Certificate of Analysis proving the label. They're GMP compliant and they follow DSHEA" and you say all of that stuff I don't know if that's going to mean anything to the doctor. You know? They have this idea that the level of quality control the level of legislation the amount of research is far less than that of pharmaceuticals and that's not necessarily the case but I don't know how you convince them of that.

    I don't. I think we just keep little by little doing our best like a grass roots effort. I think the most important thing I could do as a physician is start speaking to younger doctors medical students, residents, get them when they're young because once a doctor starts practicing and pretty much has things set in their ways it's hard to get doctors to change. It's hard to get doctors to change to a new drug it's just human nature.

    So I think it comes down to the fact that there are doctors that still believe supplements are not regulated and there's no research support and that's not true-so that's the problem. The solution is education. Listening to shows like this Healthy Talk, other shows on RadioMD and just really focusing maybe on the younger doctors I think that's how we're going to get rid of these myths. This is Healthy Talk on RadioMD. I'm
  • Length (mins) 10
  • Waiver Received No
  • Internal Notes NO GUEST
  • Host Mike Smith, MD
Listen in as Dr. Mike provides the answers to a wealth of health and wellness questions.

Additional Info

  • Segment Number 1
  • Audio File healthy_talk/1516ht3d.mp3
  • Length (mins) 10
  • Waiver Received No
  • Internal Notes NO GUEST
  • Host Mike Smith, MD
The key isn't necessarily to live longer, but to live healthier.

Additional Info

  • Segment Number 3
  • Audio File healthy_talk/1516ht3c.mp3
  • Transcription RadioMD Presents: Healthy Talk | Original Air Date: April 14, 2015
    Host: Michael Smith, MD

    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 yeah. Did you know that certain prescription drugs in kind of an off label use do have longevity benefits? And, I mean, I think this is an appropriate topic I am-- most of my listeners know--I'm the senior health scientist for Life Extension and we are the world's largest non-profit anti-aging and supplement research organization. I mean, we've done—the number keeps going up but its $150-160 million or so in the last on this type of research so we have a nice little database of things, supplements, foods, and even drugs that have been shown to increase human longevity.

    Now the real mission at Life Extension is to help us all live healthier longer, not just longer it's not—because, you know, by the way, this conventional approach to health which is really a disease approach, it's really sick care, it's not healthcare, but that approach has increased antibiotics, heart drugs, brain drugs, keeping your bones from osteoporosis type drugs. All those things have actually impacted longevity but not necessarily in a healthy way. I mean, go to an internal medicine doctor or a general practitioner or cardiologist or whatever. Yes, there's a lot of people in their 80's even 90's in those waiting rooms but they don't look good. So, conventional medicine has increased human lifespan, not necessarily healthy human lifespan.

    So, at Life Extension that's the difference-it's not just about looking at things, researching things, suggesting things that are going to help you live longer and just add years, we're adding healthy years. And I want to talk about some prescription drugs that do that. The first one is Metformin. Metformin is a diabetic drug, Type II diabetic drug. Metformin is more and more becoming the go to drug for diabetics ultimately because it's really good at what it's supposed to do which is lower blood sugar.

    It also improves insulin sensitivity, which is extremely important to diabetics but it doesn't cause weight gain. Some of the other original diabetic drugs, the older ones, the older generation ones, they didn't really work all that well. They stopped working after a few years, plus people gained weight. Metformin is a more—I guess it's a not really a new generation because there are newer ones out there but it's a middle generation diabetic drug. Metformin, though--and I'm going to go into the reasons why--is also a longevity chemical.

    It is what is known as an AMPK activator. AMPK is an enzyme in every cell of your body it stands for adenosine monophosphate activated protein kinase. We'll just call it AMPK. At Life Extension, we kind of consider this the master switch for managing how a cell produces and/or stores energy. By the way, that process right there is critical for optimal cellular function.

    A cell has to be able to produce and/or store energy in an effective manner. As we get older cells tend to not manage that energy creation, energy storage process very well and they become gunked up, they become clogged, they become dysfunctional when they're not able to manage energy and AMPK is critical. It's an enzyme that's critical to help cells manage energy. It declines as we age. We know that.

    We know that age, eating too much food, and lack of exercise are the primary ways that AMPK activity decreases and that pretty much describes just about everybody, sorry. Well, I said just about everybody. We're all aging so everybody is going to lose a little bit of AMPK that's just natural but again I go back to that standard American diet (SAD). It's sad. It's a calorie overload with very little nutrition.

    Overfed but undernourished. That's going to lower AMPK activity so Metformin is a drug that can activate AMPK, I should say reactivate AMPK. When that happens, whether you're 50, 60, 70, 80, 90 doesn't matter, when you reactivate AMPK you're going to help cells manage energy better and when a cell manages energy better it's going to function better and if the cell functions better then the tissue functions better. If the tissue functions better the organ like the heart functions better and if the heart functions better ultimately the organism, you and me, we're going to function better. So, Metformin as an AMPK activator is improving cell health, it's a cell health drug.

    Now, there's other side benefits here, too, if you improve how insulin works, how cells can uptake sugar better, all that kind of stuff, if you can do that which AMPK does, that's why Metformin is a diabetic drug, that also has longevity implications.

    There's research showing that you're going to have improved body composition with AMPK, you're going to improve, as I said, insulin sensitivity, sugar management. You're going to have a better lipid or fat profile in your body. You're going to improve inflammatory processes, immune system. I mean it goes on and on because AMPK is managing energy in every single cell. Also Metformin through reactivation of AMPK about 750 milligrams a day, that's a lower dose than what a diabetic would take, you're going to have some cell longevity benefits, tissue longevity benefits, organ longevity benefits and eventually organism, you and me longevity benefits. So that's the first one.

    Number two, I wanted to mention is called Depranil. I have a sheet here that I pulled from a Life Extension research protocol. Depranil works by inhibiting an enzyme that breaks down dopamine, thereby elevating dopamine levels in the brain and in the central nervous system. Elevated levels of dopamine can confer an anti-depressant affect, it can increase libido, but it's also been shown to extend maximum life span in animal studies.

    Depranil is used mostly like in neurodegenerative disorders like Parkinson's, tremor disorders, seizure disorders and it's even being used a little bit in Alzheimer's now with some awesome effects. But we know that in every decade of life after say starting around 45, you lose about 13-15% of your dopamine producing brain cells. And if you do that every decade by the time you get to your 70's, 80's, I mean, you're not making a lot of dopamine and dopamine is a critical neurotransmitter for muscle coordination, for metabolism, for mood. I mean, dopamine is one of the--if I could say--premier, primary, whatever neurotransmitters in the brain. And so losing dopamine is anti-longevity, it's pro-aging, so Depranil is a drug that can increase the amount of dopamine in your brain and animal models show that that does increase maximum lifespan and we do believe the same can be said for humans. So we're trying to really do more Depranil human research studies as well.

    So, the third one I wanted to mention quickly, I don't have a lot of time, is something called Naltrexone, specifically, a low dose form of Naltrexone. Naltrexone is an opioid antagonist, so it's used in a lot of drug recovery programs but it's been shown to be very beneficial in auto-immune disorders like MS, pain, cancer, HIV and it also increases maximum lifespan in animal models. So, that's Metformin, Depranil, and low-dose Naltrexone-drugs with longevity benefits.

    This is Healthy Talk on RadioMD. I'm Dr. Mike. Stay well.
  • Length (mins) 10
  • Waiver Received No
  • Internal Notes NO GUEST
  • Host Mike Smith, MD
How can you find a doctor who is open to patients who advocate for themselves and their loved ones?

Additional Info

  • Segment Number 2
  • Audio File healthy_talk/1516ht3b.mp3
  • Featured Speaker Julia Schopick, Author
  • Book Title Honest Medicine: Effective, Time-Tested, Inexpensive Treatments for Life-Threatening Diseases
  • Guest Bio Julia SchopickJulia Schopick is a best-selling author of the book, Honest Medicine: Effective, Time-Tested, Inexpensive Treatments for Life-Threatening Diseases.

    She is a seasoned radio talk show guest who has appeared on over 100 shows and is often invited back. Through her writings and her blog, HonestMedicine.com, Julia's goal is to empower patients to make the best health choices for themselves and their loved ones by teaching them about little-known but promising treatments their doctors may not know about.

    Julia's writings on health and medical topics have been featured in American Medical News (AMA), Alternative & Complementary Therapies, the British Medical Journal and the Chicago Sun-Times.
  • Transcription RadioMD Presents: Healthy Talk | Original Air Date: April 14, 2015
    Host: Michael Smith, MD

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

    DR MIKE: So, I'm going to talk about improving doctor/patient relationships. My guest is Julia Schopick. She's author of the best-selling book, Honest Medicine: Effective, Time-Tested, Inexpensive Treatments for Life-Threatening Diseases. She's a seasoned radio talk show host herself. She's been on all kinds of shows. I think over like 100 different shows and is often invited back. She's been on my show before. She has a great website, HonestMedicine.com. Julia, welcome to Health Talk.

    JULIA: Dr. Mike, it's so good to be back here. I enjoyed you the last time and I'm looking forward to today.

    DR MIKE: Yes. No, this is good. What an important conversation. You know, so when I was in medical school—actually, no. When I was in my internship, Julia, I did internal medicine at the University of Utah and once a week or maybe once every couple of weeks, we had a physician who would come in. He would in his 80's. He was retired and the reason he brought him in was because the program director wanted us to learn the art of listening. The art of physical exam because what has happened, doctors have become so dependent on technology, that they don't really listen anymore. They don't touch anymore. So, when you wanted to talk to me about this building a better doctor/patient relationship, I really relate to this and I thought that what a great topic. But, just real quickly, how did you become such a patient advocate?

    JULIA: Well, I became a patient advocate, actually, Dr. Mike, because I had to. That was when my husband, at the age of 40, became a diagnosed brain tumor patient and for the first few years, I actually didn't advocate for him. You know, we were so frightened, so terrified, that we just went in lockstep with what the doctor said and that was surprising for me because my dad was a doctor and he told me, "Do not be passive before the medical system." He said, "Be wary." But, you know, when you're confronted with a diagnosis like a brain tumor, all heck breaks loose and you just...

    DR MIKE: Yes. Yes. Scary.

    JULIA: It was very, very scary.

    DR MIKE: So, when was this, if you don't mind me asking? What year?

    JULIA: Absolutely not. I don't mind you asking at all. He was diagnosed in 1990. He was 40 years old and, as I said, for the first few years, we just went in lockstep with what the doctor said, but then, after that, I noticed he was outliving his prognosis.

    DR MIKE: Oh, nice.

    JULIA: They gave him 3 years. He was living longer. So, I started becoming an advocate. You know, in the beginning, it had nothing to do with the doctors because, you know, we were just doing things on our own, like nutrition and good diet and, you know, we got a nutritionist. But then, in 2001, he had a recurrence and what I found was that his skin would not heal. He had had radiation previously. I know we don't have a long time, so I'm trying to cut the story short a little bit.

    DR MIKE: Sure.

    JULIA: But, he had had radiation and his skin wouldn't heal and at that point, I really, really learned about the miscommunication between doctors and patients because...

    DR MIKE: So, you talk about the empowered patient, right? That's kind of your...What do you mean by the empowered patient?

    JULIA: The empowered patient...By the way, I'm not crazy about the word "empowered" but if you can think of another one, I'll take it.

    DR MIKE: I'll work with you on that one.

    JULIA: I'm not because it's sort of in the self-help group, they use empowered a lot in self-help groups. But, the empowered patient is one who does not just take what the doctor says. You know, who knows if the doctor gives a diagnosis and treatments that are working, to accept them. But, not if they're not working. To speak up. To—I don't want to say "defend yourself" because it acts like that's a big fight, but, you know...

    DR MIKE: But, Julia, look at...Let me play devil's advocate for a second because there's a lot of doctors, especially doctors that were trained in the 80's and 90's. I was trained in the late 90's, you know, that's when technology was just having this boom and we lost a little bit when it came to that, I think, doctor/patient relationship because we're so reliant on that technology. A lot of doctors from that age group are kind of...They take on this paternal type role with their patients. So, what does an empowered patient do if their doctor doesn't want to...Do you just have to fire the doctor and go find another one?

    JULIA: Well, that's an option, but I want to tell you something that made a segway a little bit because you're going to laugh at this. My dad, actually was a doctor in the 60's and a little bit into the 70's and, at that point, tests were coming into favor. Never as many tests as we have now, but he used to say, "All those damn tests. Doctors don't listen anymore."

    DR MIKE: Right. Yes. Well, that's when it kind of exploded was the 80's and 90's, right? It was when technology really took off.

    JULIA: That's when technology took off, but, Dr. Mike, tests started to be developed way before then. My father was known to be able to tell what was wrong with a patient by looking at him or her, feeling his or her skin and asking questions and then being quiet and listening.

    DR MIKE: So, how do we find...so, how can somebody find a doctor who's more like an advocate for them versus that paternal-type role. How do you go about finding that right doctor?

    JULIA: So, the way you do it, actually, is probably to interview different doctors. To ask your friends. To talk to the friends, especially, who are more active kinds of people and who wouldn't just, you know, want a passive relationship. But, the problem comes when you're diagnosed with a very serious, serious illness. What do you do if the neurosurgeon, as in our case, is very paternalistic? Then you've got a problem and you have to really stand up for yourself and say, you know, "Doctor, I was hoping you could explain this a little bit better." And, "Doctor, I'm not sure I agree with you on this. What do you think?" And then, if they get very hostile, you do have to go look for another one even if it's a serious illness and that is difficult.

    DR MIKE: Yes. So, in your book, Honest Medicine, which really is a collection, right? Of people you've interviewed, people who have, you know, really taken over, as you say, empowered themselves and have some great success stories. So, are all of these stories you tell in that book, are these people who really sought out a better doctor/patient relationship? Were they using...When you went through their research, did you find all these patients you interviewed, were they kind of like that empowered patient?

    JULIA: You know, they became like that empowered patient, but I have to tell you, in the beginning, they were like we were. You know, my husband and I, when they got their diagnosis. They waited too long and one of the messages of the book, of my book, Honest Medicine, is to follow you gut. Listen to your gut and if the doctor is not saying things that resonates with you, move on—which is what a lot of patients in my book did.

    DR MIKE: So, I've told some friends of mine, even Life Extension members, I've suggested to them, if there's something you want to try, especially in the supplement world, right? A lot of the conventional doctors are still kind of not sure about all that. What about just bringing in some of the literature that supports what it is you want to do?

    JULIA: Well, this is a very good idea and it's one that I use a lot. But, here's the big but, you have to make sure that you present the literature in a way that is really, really thought out ahead of time. In other words, my dad used to always complain that patients were bringing in the Reader's Digest and thinking that the Reader's Digest knew more than they. What patients do today is they bring in literature, but they kind of don't present it in a very coordinated manner. And, I have developed a system. I'm glad you asked this because I do coaching sessions with patients on how to bring material to your doctor and the way to do it is...

    DR MIKE: Well, let me...Julia, we're out of time, basically. Is that information on how to do this on the website HonestMedicine.com?

    JULIA: It's actually going to be on the website, HonestMedicine.com because I'm adding a chapter to the book now which I will place on the website first.

    DR MIKE: So, I'm going to tell my listeners to go check out Julia. She's wonderful. HonestMedicine.com. Julia, thanks for coming on.

    This is Healthy Talk on RadioMD. I'm Dr. Mike. Stay well.
  • Length (mins) 10
  • Waiver Received Yes
  • Host Mike Smith, MD
Why do men tend to lose weight faster, even if they're on the same diet as women?

Additional Info

  • Segment Number 1
  • Audio File healthy_talk/1516ht3a.mp3
  • Transcription RadioMD Presents: Healthy Talk | Original Air Date: April 14, 2015
    Host: Michael Smith, MD

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

    DR MIKE: So, why is it easier for men to lose weight than women? I mean, and I think that's what most women would tell you is their experience. There's even a commercial—I don't even remember what the product is for, but there's a woman and a man. They're out having a picnic and they're talking about losing weight and no more cheeseburgers, no more sodas and as she's saying that, the guy's getting skinnier and skinnier and skinnier by the second and the woman's not losing any weight. I don't know. Maybe you've seen that commercial.

    There may be some truth in it, though. You know, men do lose weight a little bit easier than women and I think I have some reasons for that. But, what I want to share with you first, was a report that I found on a website that I like. You know, I have hundreds of health websites that I play around on, check out, get a lot of good ideas from. This came from MedicalDaily.com and they started this article by asking the question, "Why do men hit their weight loss goals first?" And, you know, to me...and I'm going to get to this here in a moment. I went right to hormones and I'm going to get there in a second, but they didn't even talk about that. They went into something, they gave an angle that was a little bit different than I thought they would, so I wanted to share this with you.

    Again, MedicalDaily.com:"Men lose weight faster because they're bigger to begin with." Hmm. So, where are they going with that?

    "In fact, how fast a person loses weight isn't necessarily a gender issue. It's more of a big person/little person issue. Whether a person is bigger due to his height, weight or muscle mass, he has the physiological benefit when it comes to losing weight compared to a smaller person. Since men tend to carry around more height, weight and muscle mass than women, their bodies need..." and this was the key point in here. "Their bodies need to burn more calories to function. Because they're caloric needs are higher, any modifications that they make will create larger calorie deficits.

    "It's an interesting angle. So, let's talk about calorie deficits for a moment. I've done this lecture before. It's called, "The Science of Weight Loss" and in this lecture, by the way, it was developed with a good, good friend of mine. She's a chiropractor. She has her own supplement company now, Dr. Stacy Nottingham. And, in this lecture, we talk about calorie deficits, right? I usually begin the lecture by saying, "You know, your weight, on a day to day measurement, even just moment to moment, meal to meal, whatever. Your weight is determined by a very simple mathematical equation. Your weight or your change in weight equals calories that you bring in minus calories you burn."

    It's that simple. The weight equation is simple math. Calories in minus calories out. If you bring in, through eating and drinking, whatever, more calories than you burn out, you have a calorie excess and you gain weight. If, on the other hand, you are burning more calories than what you're bringing in, you have a calorie deficit. That's kind of where this article went. It was talking about the fact that men who have a greater calorie need--caloric need--when they deprive themselves of bringing in some calories and maybe burning more through exercise, the deficit—that negative number in that equation—is greater for a man than a woman. Eh. Maybe.

    I mean, I agree with the calorie deficit part of this, but that's assuming that all men have a greater mass, let's say, muscle, that kind of stuff, than women. I don't know if that's always true, but it's an interesting way to start off this article. Now, the article also goes into the fact that women don't hit the gym quite as much as men and, specifically, hitting the free weights, the weight training part of the gym.

    Women go to the gym and do a lot of the aerobics, but not necessarily the weights and the argument they make at MedicalDaily.com is there's this distorted, pre-conceived notion that if women start using free weights and start building muscle mass, whatever, that kind of stuff. They're going to become bulky and less feminine. Okay. Maybe. Maybe that's true. I don't know. Again, I think it's an interesting argument. So, in answering that question, "Why do men lose weight easier, faster, however you want to say it, than women, they're going with the fact that there's a greater calorie deficit created in men when they diet and exercise than women and that women don't hit the muscle-building as much as men and that's important because it is true. Muscle tissue is your best way to burn calories. The more muscle tissue you have, the higher your muscle mass versus fat mass.

    You're going to burn more calories even at rest. Having good tone, muscle mass, you're resting metabolic rate—which is how many calories you burn at rest—goes up. So, they have some points here, but I think they missed something here and that was the discussion about hormones. When I first saw this, that's what came to my mind—that it's a hormone issue. I can say this from my medical experience. Working with Life Extension customers, working with patients in my past, first and foremost, a lot of women—men, too—but mostly women in this country have hypothyroidism and don't even know it. Or, maybe they don't have overt hypothyroidism, but they have low-functioning thyroids.

    Sometimes what we call "subclinical thyroid". You know, your thyroid hormones, it's your metabolic throttle. It's what accelerates metabolism. So, if you don't have enough thyroid hormone, even if it's just a drop and a little bit. You know, a little hypothyroid. Just a little low in thyroid hormone production, just a little bit. It's an uphill battle, then, to lose weight. So, first and foremost, and this is really for men and women, but I'm speaking to women specifically here. Before you start any diet program, five pounds, 10 pounds, whatever it is, you've got to check your thyroid hormone. Be careful, now, when you do that and you're going to your conventional doctor, they're usually going to look at TSH, total T4 and free T3. TSH, total T4 and free T3. Those are usually the three kind of standard hormone tests now. If you go by the conventional levels, the conventional numbers, for what's normal and not normal.

    You could be a little low on thyroid, making it hard to lose weight, but your doctor will tell you your thyroid's fine. So, when you get your thyroid tested, the TSH should be between 1 and 2. If it's greater than 2, you could have subclinical thyroid issues. It could be hard to lose weight and that's probably the most common test that you're going to get is that TSH. So, you want to at least be between 1 and 2 on that one. So, check your thyroid. The other issue is this relationship between estrogen and progesterone in women, especially in women in their 30's, 40's, 50's, peri-menopause to post-menopause. You see, estrogen and progesterone kind of balance each other. Estrogen builds things up, but gets you ready for pregnancy. Progesterone calms everything down.

    Estrogen is at the front of the cycle where it builds up the endometrium, it builds up breast tissue, it builds up fat because you might have a baby. So, you have to have all these reserves. So, estrogen's this building hormone. Well, progesterone, if you don't get pregnant, is the one that comes along and says, "Okay. Let's calm everything down, but as women get older, there is this imbalance between estrogen and progesterone. We call it "estrogen dominance". Even though both hormones are dropping, the progesterone drops off at a far greater rate, it creates this imbalance called "estrogen dominance" and that can also make it really hard to lose some weight.

    So, maybe it is a calorie deficit issue. Maybe the women aren't hitting the weights as much, but, personally, I like to look at the hormones first.

    Check your thyroid. Check your estrogen. Check your progesterone. By the way, Life Extension physicians, you can give them a call. They can go over those more optimal numbers with you and help you succeed in losing some weight.

    This is Healthy Talk on RadioMD. I'm Dr. Mike. Stay well.
  • Length (mins) 10
  • Waiver Received No
  • Internal Notes NO GUEST
  • Host Mike Smith, MD
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/1515ht5e.mp3
  • Transcription RadioMD Presents: Healthy Talk | Original Air Date: April 10, 2015
    Host: Michael Smith, MD

    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: That's This email address is being protected from spambots. You need JavaScript enabled to view it.. I could use more questions, so send me whatever you want to talk about. It can be an idea you have. It can be a question about drugs, disease, acupuncture. As I said, I have a whole staff of health advisors at Life Extension that help me answer questions, so send them. Send them my way.

    So, this question comes from Diane: "With April being National Autism Month, are there any new theories of autism? Thanks for your show. Diane."

    So, when I get questions like this, to me this is kind of like an update kind of question about a disease or a condition and so I've got tell you, I'm not just saying this because I'm the Senior Health Scientist for Life Extension. You know, we have over 140 some odd protocols that are updated with this kind of information. So, I went to LifeExtension.com and went to their "Autism Protocol" so the first thing that I want to mention, it is National Autism Month and I encourage you to go check out, I think, oh shoot. I didn't write the website down. I think it's the NationalAutismAssociation.com, but just Google it. There are just different ways you can help in terms of helping to raise money and awareness. So, go check out some of those sites.

    Back to the question that Diane has: "What are some of the new theories?" Well, I think the first one is inflammation and, specifically, inflammation that happens in utero, when the embryo is developing. There are, you know, some studies that are looking at the effects of certain inflammatory proteins and one, in particular, NF-kappa beta. When that is high in the mom, for a variety of reasons, maybe even autoimmune disorders, chronic infections, whatever, when NF-kappa beta is high, it does cross into the placenta, into the developing embryo, and that has been shown to increase the risk of autism, so, again, why and how? The specifics is still not worked out, but more and more researchers are looking at in utero inflammation. Inflammatory mediators passing from mom to embryo. That seems to be a current theory. Another theory would be the genetics. Wait. I'm sorry. Let me back up. I missed this. Again, this comes from the Life Extension protocol. This is about the inflammation again. I wanted to read this.

    A study published last year, so, this protocol that Life Extension was updated at the end of 2014, so this is a study published in 2013. So, a study published in 2013 followed 1.2 million pregnant women in Finland and measured the expectant mothers' levels of c-reactive protein, one of those inflammatory mediators. You know, the higher the level, it's an indication that there's some inflammation. Researchers found a 43% increased risk in children of mothers with the highest levels of c-reactive protein."

    So, that's, again cause/effect? No. Association? Yes. So, there's an inflammatory component, an inflammatory association with the risk of developing autism. AF-kappa beta, in this case, c-reactive protein. There are several other inflammatory proteins that could be involved. So, the question becomes, "What's going on?" I mean, how, number one, we need to be managing inflammation in moms. That's right there. Is it the pregnancy in some women that causes higher inflammation? Is it smoldering, chronic infections that haven't been diagnosed? Do we need to be working that up in pregnant women initially? I mean, does that need to be part of the normal work up now? So, these are all questions now that are coming out from some of these studies.

    So, inflammation is, I think, probably the leading theory right now. Now, there's also a genetic component. A study published last year in the New England Journal of Medicine analyzed the brain tissue of children with autism. This was done by scientists from the University of California, San Diego School of Medicine and the Allen Institute for Brain Science in Seattle, Washington. They looked at 25 genes in the brain tissue of deceased children with and without autism, including genes that have been linked to autism as well as several control genes. So, they took children that died, with and without autism, and they identified, or they looked at 25 different genes. Some of them associated with autism, some of them not associated with autism. Those are the control genes. Researchers found that the brains of autistic children were missing key genetic markers across multiple layers of brain cells. This was the first study to actually look at the brains of children because, until it was done, scientists had only ever studied the brain tissue of adults with autism and sought to figure out what may have occurred developmentally when the patient was diagnosed as a child.

    So now, this is the first study really looking at the brains of kids, identifying certain genetic defects. Now, we've got to go back, map those genetic defects and maybe we can start developing some genetic markers for autism. So, here you have inflammation on one hand, and potentially some genetic markers on the other.

    The third one, and this theory may be more associated with the inflammatory theory that I already talked about, but it has to do with autoimmune disorders in the mom. Studies have also shown that women with autoimmune diseases are more likely to produce a kind of antibody that attacks the brain of the developing fetus. So, again, I don't know...I didn't look into what that antibody was, what type of autoimmune disorder, so those are all questions. Maybe we can go back to Life Extension and see if there was some more there. But, again, moms with autoimmune disorders apparently make certain auto antibodies—that's what we call them. They do cross into the developing embryo and can cause some brain damage in the developing fetus.

    Why? But, it brings up the question, though. What's driving all of this? So, here you have an inflammatory theory, okay? A really nice Finland study. 1.2 million women looking at CRP in women that had high levels of CRP, and had an increased risk of having a kid with autism. I mean, that's well-established. There's studies with NF-kappa beta and other inflammatory markers. You have this genetic analysis going on and you've got this link to this auto antibody. Again, it brings up the question, though.

    Well, why now? Why are we seeing such a sharp rise in autism? And, I do think it is reasonable to believe that on one level, maybe 20-30 years ago, we didn't recognize autism and the spectrum of autistic disorders. I know when I was in medical school, we didn't appreciate all of that. That was just, you know, gosh, almost 20 years ago. I mean, 20 years ago, we didn't have an appreciation for the spectrum of autistic symptoms and disorders. We didn't learn that. So, one hand, we are recognizing it better which may be driving some of the increased diagnosis, but when you factor that out, there's a definite increase in autism and we have this inflammatory theory; this genetic theory; this autoimmune theory. What's driving all of this?

    Well, a lot of doctors really think that we need to think of the chemical toxins in our environment that is that overarching umbrella that's driving the inflammation; driving some of these autoantibodies; driving some of these genetic abnormalities and we need some more transparency and understanding of what chemicals are out there; what dangers they may or may not pose. We just don't have that kind of information and it's time that I think we do. So, there you go.

    This is Health Talk on RadioMD. I'm Dr. Mike. Stay well.
  • Length (mins) 10
  • Waiver Received No
  • Internal Notes NO GUEST
  • Host Mike Smith, MD
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/1515ht5d.mp3
  • Transcription RadioMD Presents: Healthy Talk | Original Air Date: April 10, 2015
    Host: Michael Smith, MD

    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: So, my first question relates to this episode that I was on with Fox News. Their main medical correspondent is Dr. Manning. I think his last name is Alvarerro? But, they call him "Dr. Manning". I was on his show and we were talking about some supplement myths and so this person saw that and they say:

    "I saw you on Fox News with Dr. Manning. You said that we all need to take a multivitamin, even if we eat healthy. Can you provide specific references or studies that conclude a multivitamin can improve overall health?"

    This is a common type question we get or the argument that is made against multivitamins that there's no evidence that a daily multivitamin in somebody who is healthy and eating well is going to help them in any way, shape or form. So, I do have some specific references. Now, we have to define first, though. Let's be fair. We have to define what we mean by "health".

    I mean, this person says, "Provide me with some studies that conclude a multivitamin can improve health." Well, we have to define what we mean by health, you know? No. There are no studies showing that a multivitamin will make you wake up more energized and don't need coffee and you just skip out your door in the morning singing or whatever. No. What do we mean by health? There's no studies showing a multivitamin is going to just help you tackle your issues for the day. No. But there are specific studies looking at things like cancer, heart disease, cognition and there are studies that show people who take multivitamins do better in those categories, okay?

    So, I pulled up a couple here. This first one is from the Physicians' Health Study-II. PSH-II. And, they found that a multivitamin supplement was associated with an 8% reduction in overall cancer incidence and a 12% reduction in cancer death after 11.2 years of follow up. Physicians Health Study-II. By the way, that was a study looking at a bunch of physicians. It was all men and there you go. I mean, it was a nice long study. They followed these doctors who did these surveys and, again, we know you can't draw any definite conclusions from surveys, but you would think this population is a little more keen and a little more understanding about the importance of being truthful on these surveys, so maybe there's a little more confidence in this study and we have a 12% reduction in cancer death.

    There you go. How about that one? Physician Health Study-II. From that same study, by the way, they found a 39% reduction in fatal heart risk in those taking a multivitamin. How about that? That's pretty good. Okay. I've got another one for you. Let's see. The supplementation in vitamins and mineral oxidants study, and if you want to look it up, it's usually abbreviated "SU.VI.MAX". SU.VI.MAX study. This study found a 30% reduction in total cancer incidence in men that supplemented with a multivitamin. When the SU.VI.MAX results in men were combined with the Physician Health Study-II results, the risk for all cancer incidence was reduced over 10 years of follow up. You know what was interesting about this, though? There was a group of doctors who got together and combined the results from the Physician Health Study and the supplementation in vitamins and mineral antioxidant study.

    They were absolutely biased against taking a multivitamin. In their analysis—in this combined data pool which showed a reduced risk of cancer incidence over a ten year follow up, even though it was right there in their analysis, it was nowhere to be found in the conclusion. Bias. Hmm. In addition, one trial also found a—how about this one? A 58% reduced incidence of cancer for those just taking Vitamin D and calcium for over 4 years. That's not really a multivitamin, but that's just another, you know, adding some credibility to the basic vitamins and minerals. I mean, I'm not going to keep going. There are studies showing benefit to cognition, to memory. You just saw a couple here with cancer and heart disease.

    So, yes. If you eat healthy, great. Exercise, great. But, taking a multivitamin, providing some additional levels of these antioxidants—these vitamins and minerals---can make a major impact on your health. That's why, in my book, The Supplement Pyramid, I put a multivitamin as the very first supplement that everybody should be taking.

    Okay. Next question. Alright. I think I'm doing pretty good here on time. Next question.

    "Hi Dr. Mike. Wondering if you can comment on the agreement that was reached between the New York Attorney General and GNC? In the article I read, the reporter said that nutrition president, Steve Mister, called the move 'face-saving' by the Attorney General. Do you think the damage has been done? Or, will consumers who, perhaps, had some doubt feel reassured that supplements are safe and effective? Sincerely, Sylvia."

    Well, first of all, so this goes back to the fact that the New York Attorney General, a couple of months ago, tested some herbal products right off the market at GNC, Walgreens, Target. I don't remember all of them and the headlines read that these herbal supplements don't have the active ingredients. There's some extra stuff thrown in there. They're not safe.

    Then, we heard this whole thing go on and on and on. We now know, though, when we investigated how this guy from New York tested these products, he did the wrong test. He did what is called "DNA bar coding" which is a test you do for raw materials, not the final product. So, he used the wrong material. As a matter of fact, some very outspoken anti-supplement researchers even admitted he did the wrong test. And, GNC brought this out. GNC fought him and now they came out with this agreement.

    Basically, the agreement, from what I understand, is that the Attorney General has to admit, which he's done in public already, but I think he has to do it like in a paper—formal paper—that the herbs, because of the way he tested, his results are not valid and that these herbs are in compliance following the FDA regulation of GMP manufacturing. So, he has to admit that these products he pulled off, he tested them wrong and these products actually were manufactured the exact way the United States Government says they should be manufactured. The caveat, though, for him was that further testing would have to be done and that testing, of course, would have to be the appropriate way to test a final product and, of course, GNC said, "Sure. Let's do some extra testing," and that's where we're at, I think, at this point in the agreement. So, ultimately, to summarize: the herbs are in compliance. New testing required.

    So, to answer Sylvia's question about, "Do you think the damage has been done?" No, I don't. Personally, Sylvia, this is my take on this. Supplement users understood the problems with this kind of testing. They understood the biasness. It doesn't stop people from taking their supplements, especially people who are serious about quality. They stick with good companies, companies that product certificates of analysis for their products. I mean, that didn't change anybody's mind. The only people that may have been influenced by this guy in this report were people who were already against supplements in the first place and they're not our consumers anyway. I wish they were, but they're not. So, I think that this is just a wash out.That's my opinion.

    This is Health Talk on RadioMD. I'm Dr. Mike.
  • Length (mins) 10
  • Waiver Received No
  • Internal Notes NO GUEST
  • Host Mike Smith, MD
A new pill promises, yet again, to aid in your weight loss goals.

Additional Info

  • Segment Number 3
  • Audio File healthy_talk/1515ht5c.mp3
  • Transcription RadioMD Presents: Healthy Talk | Original Air Date: April 10, 2015
    Host: Michael Smith, MD

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

    DR. MIKE: What if I were to tell you that I could---Well, not me, but a certain chemical. A pill could trick your body into thinking you ate a meal. Hmm. Interesting, isn't it? This comes from a paper published in Nature Medicine just this past January. Now, this is complicated so I'm going to take my time in trying to explain what's going on here. Let me begin by saying this. We've talked about, for a long time, the importance of when you are dieting not to overdo it because if you eliminate a lot of calories in a day—too many—it actually can have the opposite effect you want. If, all of a sudden your body is saying to itself, "Wow. I'm missing a lot of food all of a sudden." You know, if you're dieting and you decrease your calorie intake 15%, 20%, 25%, even beyond that.

    Some of these extreme fad diets really cut calories big. If you do that right away, definitely, your body senses that you're missing food and it starts to think, "Oh, my gosh. There's like a famine going on. We're starving." And it will kick in anti-starvation mechanisms. I mean, the human body, because we've gone through so many famines in our human existence, we've developed some really amazing mechanisms to make sure we can make it through that famine and not starve to death. Our bodies can do some amazing things, specifically through the liver.

    The take home message to all this is that the body never wastes the calorie. Every calorie you bring in is either burned or stored. So, if you start to decrease calories too much, your body actually does the reverse of what you wanted to do. It starts to store everything up, even if you eat a little bit, it stores it as fat and, eventually, you'll plateau and even start gaining some of that weight back.

    I wanted to begin with that because what this study highlighted was the fact that when you do consume calories—when you bring calories into your system, there are two physiological mechanisms that kick in. The first one—and this is the easy one, I think, for most people to understand. If there's anything in your gut, it needs to be moved out to make room for the new food that you're eating. So, the first thing that happens when you consume something is it stimulates the "peristalsis" which is the contraction of the bowels to move anything that's just sitting there, out. That's the first thing. But what we've learned, though, is that's not the only thing that happens. That peristalsis, that movement of the digestive system, is highly controlled between hormones and neurotransmitters. The brain's involved, certain gut reflexes are involved. I mean, it's very complex.

    When that peristalsis starts to kick in, there's a second thing that happens. As you're making room for the food you just ate, something else happens. Fat cells get a signal to start to burn. Why would they do that? Well, because they want to make room for more storage. More fresh storage of fat, if you will. They're trying to also supply some energy to that peristaltic motion in the gut. So, all of this time that people like myself and other weight loss experts have been saying, "You've got to eat if you want to lose weight," we were right. We're just learning about what's really going on and we always knew that if you eat smaller meals throughout the day, that helps in weight loss. Starving yourself doesn't help down the line.

    Now, we're kind of starting to understand the physiology involved. So, let me just explain this one more time to make sure, because it's hard to understand what this new drug is doing without understanding everything I just said. So, cutting out calories increases anti-starvation mechanisms. So, even if you eat a little bit of something, you're going to turn it into fat. So, that's why we don't want to starve. Number two, when you do bring in calories, it stimulates what's called peristalsis which is very complex in the body. It contracts the gut and moves food out, but that process also leads to fat burning, probably to supply the energy for peristalsis as you start to mobilize the sugars and stuff like that for food, you've got to supply the peristalsis before all that food gets in.

    So, those fat cells that have been burned are now used for fuel to do the peristalsis. So, yes. You've got to eat to lose weight. So, that's important to understand. This is a conclusion from one of the researchers in this paper: Dr. Evans said that once you start to bring calories in and you initiate this peristaltic hormonal relay, the fat tissue needs to anticipate food before it's there and it starts to burn itself to supply energy and make room for new fat storage. It's pretty awesome, isn't it? So, let's go back.

    So, how are we going to do this? Remember at the beginning of this, I said, "What if there were a way for a drug to kind of initiate all of this?" All of this peristaltic kind of motion, the fat burning motion, to make room for new fat to supply energy for peristalsis? What if we could initiate that without eating? What if we could help somebody who is obese who really can't do the several meals? I mean, they're just eating huge meals consistently throughout the day and that's not going to work. What if we could replace some of those meals with a pill that acted like food and kind of initiated this complex peristalsis and fat burning thing? Wouldn't that be awesome? It would be very helpful, at least for people who are morbidly obese.

    So, here we have this pill. The drug is called Fexaramine. It was developed by Ronald Evans, Director of the Gene Expression Laboratory at the Salk Institute for Biological Studies in California. Again, this was published in January 2015 in Nature Medicine. They found that this Fexaramine could reduce weight gain, ease inflammation and help turn white fat, which stores calories, into brown fat which burns it in overweight mice compared to a controlled group.

    Remember, food itself can also do that. Not to a huge degree, but when you bring in calories, you kick in peristalsis. You've got to supply energy for that. So, you take white fat, you turn it into brown fat. You burn that fat and now you have fuel for peristalsis. Now, what they have found is a drug, Fexaramine, that could mimic that process without eating the food. Fexaramine is a food that activates a receptor that's linked to the release of bioacids. This is how it works or what they, in this study, called "digestive juices". My listeners know digestive juices, for the most part, mean digestive enzymes and bioacids. That's important because that's what, especially with the fatty meal, helps you emulsify fat so you can absorb those nutrients.

    These digestive juices and bioacids are produced in the liver. They go to the gallbladder before being released in the intestine. All of this is the beginning part of the digestion process before you really start kicking in peristalsis and needing that energy, this is all that happens when you take in a bolus of food. Turns out, this Fexaramine can bind to the same receptors that some food sources do, mimicking the food source.

    We realize the release of bioacids flips on a series of genetic programs that control intestinal activity. The gut gets a signal in there which mobilizes blood flow to gather nutrients and prepares fat tissue to behave in a particular way, which is to burn itself. So, Fexaramine is mimicking a bolus of food, initiating peristalsis and the burning of fat so you can provide fuel for that peristalsis. So, Fexaramine is a pill that maybe somebody that's morbidly obese can take at certain times and not eat, but you get that same feeling, get that same process going and get some additional fat burning.

    Fexaramine. Is this the new weight loss trick? Maybe so. Fexaramine.

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