B Well

The B vitamins are a group or complex of water-soluble vitamins that play critical roles in cell metabolism by acting as co-factors for innumerable enzymatic reactions and thus helping with fatigue and the processing of many other nutrients.

B vitamins are primarily found in whole unprocessed foods (B it ever so humble, there’s no place like home… cooking). Processed carbohydrates such as sugar and white flour have a lower B vitamin content than their unprocessed counterparts. All B vitamins are particularly concentrated in meat, including turkey, tuna, liver and other meat products. Good sources for some of the B vitamins include whole grains, potatoes, bananas, lentils, chili peppers, tempeh, beans, and molasses.

B12 is critically important to help prevent macrocytic anemia and to reduce the risks of adult sudden death syndrome (dropping dead from a heart attack), peripheral neuropathy, memory loss and other cognitive deficits. Absolute deficiency is most likely to occur among elderly people, as absorption through the gut declines with age; but a relative deficiency is common in children with Autism and related spectrum disorders.

This is important to know because B12 is not available from plant products, making B12 deficiency a very real concern for vegans or children who are on a self-imposed limited diet. Sneaky manufacturers of plant-based foods will sometimes mislead you by reporting the “B12 content” in their food product. This will create confusion because the standard US Pharmacopeia (USP) method for measuring the B12 content does not measure the B12 directly. Instead, it measures a bacterial response to the food. The bio-chemical cousins of the B12 vitamin that are found in plant sources are great for bacteria, but cannot be used by the human body. So a good B-complex supplement by mouth is just what the doctor recommends.

For a variety of reasons, type 2 diabetes has become much more common and along with it your risk of developing kidney disease. However, recently a research team found that you can protect yourself with high doses of vitamin B1, thiamine. In their study, they gave participants 300 mg daily (100 mg, three times daily).

To determine how well the nutrient worked, they measured how much protein, microalbumin, the patients lost in their urine during the three-month study. Their results were fantastic! The thiamine reduced protein loss by 41%. What's more, 35% of the patients stopped losing protein altogether.

So here’s the beef, it takes more than spinach to be strong.

B well.

Let The Sunshine In

You may have read the recent news and heard the reports on vitamin D (Total 25-hydroxyvitamin D (D₂ + D₃)). The prestigious Institute of Medicine just upped their vitamin D recommendation from a mere 400 IU per day to a still-paltry 600 IU per day. WOW… not. And they didn't stop there. They claim most people get enough vitamin D each day. They say no one should take more than 4,000 IU each day.  

I've told my patients for decades that everyone needs to take at least 5,000 IU daily. Now this report says I'm wrong. So what should you believe?

Well, I take a scientific approach to things. So if you do a little research on Medline or Vitasearch, you will find literally hundreds of studies that show the health benefits of mid normal ranges of vitamin D. Amongst a myriad of other positive health effects, mid normal ranges of vitamin D build strong bones, support your eyes and heart, boost your immune system, and help relieve joint discomfort. The mid normal range part is important, if you haven’t had your Vitamin D level tested, then you should - just to know where you stand.

Normally, when clad in a bikini, or similar attire, your body produces 5,000-10,000 IU just from being outside for an hour on a sunny summer day. So why would taking that much in the cold, dark winter do you any harm? It doesn't. No doctor I know has seen any harmful effects from that amount. In fact, I routinely recommend my cancer patients take 10,000 IUs daily, or even 50,000 IU twice weekly or more, with no toxicity.

You see, there's a simple blood test to measure the level of vitamin D in your blood. Everyone — even the Institute of Medicine — agrees that levels below 20 nanograms per milliliter indicate a "serious deficiency."  Yet, in the same breath, they said that the too-low level of 20 ng/mL is enough for good health. That's just sheer lunacy. This group is so confused, it's sad. But it's also very dangerous. This report will end up harming a lot of people.

The truth is that there's an epidemic of vitamin D deficiency in this country. Nearly every SICK patient I test is low. I see levels less than 40 in almost every known osteoporosis patient. I see levels in this range with cancer patients as well. Without adequate levels of vitamin D, your body can’t mount a good defense.

Consider this: There's not enough sunlight in Riverhead during the winter months to make barely ANY vitamin D. How are these folks supposed to make up the shortfall? What's more, being outdoors is no assurance you're making enough vitamin D on your own. I was pleased that the news reports included "respected" dissenters from major medical centers across the country, including Harvard, UC San Diego, and Johns Hopkins. Some of these experts are calling for up to 4,000 IU daily, not too far from my 5,000 IU recommendation.

Dr. John Cannell, of the non-profit Vitamin D Council, is in the thick of all the emerging research. He believes that a level of 70ng/mL is optimal. I push my patients to that level.

So follow me and ignore the new warnings. I'm sticking with my daily 5,000 IU dose, especially in winter. I suggest that you do so as well and get your vitamin D blood level checked.

--Jesse Stoff, M.D.

Of Limes, Brits and Vitamin C

Here's a quiz. Can you tell me how the British got the notorious nickname of "Limey?" Most of us probably don't have a clue, but the story is actually quite fascinating. Many, many years ago when the Royal British Navy sent their sailors on long voyages, they found that their sailors developed poor nutrition. As a result they often developed a disease known as scurvy. Suffering from swelling and bleeding gums, hair and teeth loss, wounds that wouldn't heal, vision difficulties and fatigue and digestive problems, the sailors had a hard time surviving, let alone completing their missions. Fortunately, however, someone astutely observed that if the sailors ate more fresh fruit, the symptoms would not occur. Unfortunately, fruit did not travel well on the high seas.

The British began experimenting to find a fruit that would not spoil when stored in a barrel in the lower hold of the ship for long periods of time. The most beneficial fruit they discovered was, of course, limes! In fact, they found that limes were still good several months into the ocean voyage, allowing the sailors to ward off scurvy and better fight the pirates of the New World who were raiding their cargo ships and throwing their tea into Boston Harbor. Hence, the expression “limey” came to refer to a British sailor.

So, what do Brits, limes and vitamin C have in common? What the British didn't learn until many years later was that the "preventative" agent found in limes is actually vitamin C. Since the first vitamin was isolated 90 years ago, scientists have been studying the link between nutrition and a healthy body. Vitamin pioneers, for example, demonstrated that too little vitamin A brought on a long list of deficiency symp¬toms, including hard lumpy skin, hair loss, liver and muscle problems. And, as more vitamins were discovered, it became clear that other vitamin deficiencies affected the skin as well.

Approximately 100 years after the Brits' "lime discovery," doctors actually isolated the active component in limes, and vitamin C has only continued to draw medical interest since that time. Perhaps one of vitamin C's most famous advocates was the two-time Nobel prize winner, Linus Pauling, who devoted the last decades of his life to researching this vitamin and finding new ways of applying it for treatment of many different disorders, including the common cold, various forms of gum disease, cancer and heart disease.!

Today we know that vitamin C is a very powerful antioxidant. But it is also a water soluble vitamin, which means that your body does not store it in any appreciable amount. If vitamin C is not available, the body does without it the best it can. If the vitamin C is available, however, it is used for a long list of biochemical reactions including many that are implicated in wound healing and in the normal functioning of our immune system. It is a very critical co-factor for the normal structure and function of our bodies.

Perhaps better than any other, this vitamin absorbs free radicals from our blood. Free radicals are biologically active compounds that destroy tissue structure, thus accelerating the aging process. In addition, increased levels of free radicals in our blood are associated with an increased risk of cancer, arteriosclerotic heart disease and cataract development. Recent studies have shown that if someone takes 1,000 mg of vitamin C twice a day, it can cut their risk of heart disease significantly. And taking antioxidant vitamins and supplements, including vitamin C, has been shown to decrease the incidence, development and progression of cataracts.

An interesting kitchen experiment can help you visualize the antioxidant effect of vitamin C. Take an apple and cut it in half. Than dissolve a vitamin C pill in some water and coat one half of the apple with it. Leave the other half alone. After putting the two halves next to each other on the kitchen counter and leaving them for a few minutes, you will notice a difference. The half that does not have the vitamin C coating will begin to oxidize and turn brown. As the hours pass it will become soft and "mushy" and will begin to shrivel like a prune. The vitamin C coated half will still look as good as it was when it was part of the intact apple.

Interestingly enough, most animals can synthesize vitamin C. But, owing to a quirk of evolution, man has lost this capacity and has become dependent upon taking it in, either through foods or by way of supplementation. So, what's the moral of the story? Should we all follow the example of British sailors of old and begin consuming limes in order to gain the benefits of vitamin C?

Well, that's one way of doing it. But fortunately, due to advances in modern medicine, we now know that vitamin C can be found in a variety of sources. For instance, it is found plentifully in nature and on our vitamin store shelves. Common sources include; rose hips, lemongrass, corn, hibiscus, Sago Palm, and tapioca, for example. Although these sources of the vitamin are equally beneficial in respect to potency, it is important, to take into consideration any known allergies you may have. For example, if you have an allergy to rose, then you don't want to take vitamin C that is extracted from rose hips. Although vitamin C is also synthesized these days, the synthetic version may be associated with an increased risk of kidney stones. It is therefore better to take vitamin C that has been extracted from natural sources. It is also best to take it in combination with other bioflavonoids such as rutin and hesperdin. Because vitamin C is very acidic, it can, in minor ways, temporarily alter the pH in the digestive tract and create some irritation. For most people, taking six or eight grams of vitamin C can cause diarrhea and sometimes stomach cramping and mucous in the stool. This is not a toxic effect nor is this a dangerous side effect, it is merely a biochemical effect of the concentrated vitamin. Newer preparations of vitamin C, such as Bio En’R-G’y C, are designed as a high dose supplement and prepared so as not to cause stomach upset.

Other than limes, there are many foods that contain appreciable sources of vitamin C. Perhaps the most notorious is orange juice. However, it is important to note that because of how quickly it reacts with oxygen and free radicals, vitamin C has a very short life. For example, if you were to make some fresh squeezed orange juice and leave it on the counter for even a half hour, as much as 75 percent of the vitamin C that was originally in there would be destroyed because of its reaction with oxygen. Other nutritious and delicious sources of the vitamin include broccoli, Brussels sprouts, cantaloupe, grapefruit, mustard greens, pineapple, spinach, strawberries and turnip greens. Although, cabbage contains a fairly large amount of vitamin C, much of it is often lost because it tends to be overcooked.

So, that's the tale of Brits, limes and vitamin C. And, no, we don't have to become a "limey" to reap this vitamin's gains. But it is interesting to think about the connection… just think of the health benefits we may have missed if the British never gatecrashed our tea party.

Resisting Arrest: Antibiotic Resistant Bacteria are Gaining Ground

Germs! They're all around us, they can spread quickly and they can be deadly and, with the increase in air travel, they easily cross borders. But what is most alarming is that new strains of bacteria are resistant to some of the most powerful drugs available. This is causing great concern among the medical community.

This emergence of drug-resistant bacteria has the potential to become a much more serious global threat. Because of the increasing population density and indiscretions in the area of public sanitation (i.e. garbage strikes, refuse on the street, people mindlessly secreting and excreting on our sidewalks, etc.), we are seeing a resurgence of many infectious diseases.

In Seattle, a strain of the common E. coli bacteria was found at a fast-food restaurant. It killed three children and left scores of others hospitalized. In New York City, an outbreak of an unusual type of strep bacteria that is capable of almost dissolving flesh has appeared. Part of the problem is sanitation, but part of the problem is personal awareness and hygiene. For example, when I used to work as a school physician, it was amazing to me how often children who were obviously ill, were still being sent to school by their parents. Kids with obvious fever, strep throat, rashes, and more were showing up and spreading germs among their classmates.

All of these factors contribute to the possibility of outbreaks. However , one of the major problems is that antibiotics have been used with fairly little discretion over the last couple of decades. Years ago, while working as an emergency room physician, if a child had a sore throat, swollen glands, a low-grade fever, aches and chills, and I did not offer a prescription for antibiotics, the parents would threaten to complain to the hospital authorities. Even though antibiotics are totally ineffective in treating the viral diseases that show these symptoms, people still expected them to be dispensed just in case.

Antibiotics have long been inappropriately prescribed for patients with common colds and other minor non-bacterial infections. The problem with that is twofold. On the one hand the antibiotics work as an evolutionary force, selecting for resistant bacteria and on the other hand many antibiotics are actually immunosuppressive. So what we wind up with are superbugs facing off against a population of people with weakened defenses, the results aren’t pretty!

Another problem occurs when patients prematurely stop taking their medication because the symptoms of their illness have disappeared. The disappearance of symptoms does not necessarily mean that the infection is cleared up. Therefore, stopping medication allows microbes not initially killed by the drugs to survive and develop resistance to the drugs.

This use, misuse and overuse of drugs have lead to the development of resistant strains of many common bacteria that used to be easily controlled. Bacteria are continually adapting and finding ways of resisting antibiotics. As a result, they can cause life-threatening diseases and show little, if any, response to even our most recent generation of antibacterial drugs. According to the Centers for Disease Control, 19,000 hospital patients die annually from antibiotic resistant infections, while another 58,000 die from complications caused by these infections. We see organisms causing life-threatening rashes, while tuberculosis and many other bacteria that used to be controlled are now running rampant through our schools, streets and places of business. Antibiotic-resistant bacteria are also causing an increase in the number of cases of diarrheal illnesses, sexually transmitted diseases and respiratory infections. This trend is a very dangerous one. Unfortunately, now that the ball is in motion, there is no easy way to stop it using the same technology that caused the problem. We develop more and more powerful antibiotics which ultimately lead to more complex and more resistant strains of these organisms, and more esoteric manifestations of their diseases.

While virtually no sector of society is blameless, the biggest consumer of these antibiotics; by far, is the livestock industry. Most commercially raised animals are routinely fed antibiotics to fight infections. Some livestock, like chickens, are also given "sub-therapeutic doses" of antibiotics as a growth stimulant. Sadly, this means that many of these drugs wind up in our foods while they are still in an active form. Milk, for example, is allowed to contain eighty different antibiotics while still being labeled as fit for human consumption. These low doses of antibiotics allow for the breeding of resistant strains of bacteria in animals and humans.

How can we get out of this cycle? One possible way is through the use of immuno modulators and natural medicines that strengthen a person's immune defenses. This helps to both battle the bacteria successfully once it has attempted to establish an infection as well as to prevent these bugs from getting into our system to begin with.

In our cities, with their major congestion, people with compromised immune systems often carry many of these organisms with them and often spread them to other people. So, we must include a rise in public awareness and consciousness as part of any plan of action. We can do what the Japanese do and wear a mask when we have a cold or flu. This prevents the spread of germs to friends or loved ones. You should also avoid taking antibiotics for minor illnesses and infections, minimize your consumption of food that is high in antibiotics (red meat, chicken, dairy) and look for organically raised foods. It is also good to try to do things that naturally raise the functioning of your own immune system by reducing stress and adding immune system building nutrients to your diet (i.e. vitamin c, zinc, beta-carotene, garlic) will also help. Last but not least you must be aware of your environment. At home, you should keep meat cold until cooking it, and then cook it well. Watch expiration dates on food containers and discard any canned goods if the can starts to bulge. Finally, when you are acutely ill - stay at home!!!!