Tag Archives: Opinion

DR. C’S MEDICINE CABINET: LITHIUM OROTATE

Lithium’s big claim to medical fame is it’s beneficial effect on manic depressive disorders in approximately 1/3 of the cases. It seems to benefit the manic phase more than the depressive phase, and its effect  on isolated depression is uncertain.

A recent report states that lithium works by increasing CRMP 2, which has an effect on tubulin in nerve cells. This report has not yet been confirmed.

When lithium is effective, it must be given in a dose that is almost toxic. People taking this drug should have lithium levels on a regular basis, and be alert to its numerous side effects, diarrhea, lethargy, and the like. It may also have an adverse effect on thyroid function.

I started taking low doses of lithium orotate a while back because of the touted effects on memory, mitochondrial function, and the like. I thought that our hunter gatherer ancestors probably had some exposure to lithium from the Hot Springs present in many areas, and that maybe lithium was a physiologic necessity.  Sodium and potassium are highly regulated ions in the cell membrane of all cells, I thought, so why should not lithium, a kindred element, have some effect there.

Lithium carbonate is the form that is used for treatment of manic depressive disease, and lithium orotate has not been well studied.
When one starts taking a dietary supplement, it is hard to tell whether or not it has any effect. Our bodies are complicated, and even if something does have an effect, the bodies corrective mechanisms can nullify that effect, or even cause  a reverse effect,

After further thought, I plan to start phasing out my lithium orotate. Maybe once a week would be a reasonable dosage, if at all. With irregular dosages, if I notice that I feel better on a day when I take lithium orotate, I might change my mind.

—Dr. C.

DR. C’S JOURNAL: PROTEIN-BASED MEDICATIONS

Proteins, the very structure of life itself, are currently being understood with increasing precision. This will undoubtedly lead to a new generation of medications useful in treating a wide variety of diseases. Such proteins could be coded by DNA or RNA, and churned out by veritable protein factories, yeasts.

This could drastically lower the cost of such medications, which are more stable than RNA, allowing easier distribution and storage. DNA and RNA advances are currently getting all the press, with CRSPR  advances in manipulating their structure. Indeed, the RNA vaccines by Moderna and Pfizer have been a rapidly deployed life saver with the COVID-19 epidemic. Correction of genetic disease is also possible in rare instances, if only one gene causes the disease.

PROTEINS, the result of DNA and RNA activity, form the basis of a vast array of signaling molecules, offering many possible treatments of disease.

The reason why advances in protein chemistry has been slow, is that protein is a very large molecule that exercises its effects by its three dimensional structure.This is formed by the loops,foldings, twists, and bunchings of its amino acid string. A molecule’s three-dimensional structure is very expensive to determine at the present time,

Encouraging scientists to attempt predicting  the structure by knowing  the  electric charges and other sticky characteristics of different parts of that amino acid string. Recently, artificial intelligence has come to the rescue, and the field is advancing rapidly.

Novel vaccines are being developed, using small protein pieces of the COVID-19 antibody combining site. Pieces of proteins are being designed that can stick to that antibody combining side and prevent it from attaching. Novel signaling blockers, or even agonists,  are looking increasingly possible.

I thought you would like to know about this little island of optimism in the midst of all the gloom. My interest in PROTEINOMICS was fueled by an excellent article in the Scientific American July 2021 issue, by science journalist Rowan Jacobson, who presents the story in a very interesting fashion. I would very much recommend the reading of this article.

–Dr. C

Read Scientific American article

DR. C’S JOURNAL: CAUSES & SYMTPOMS OF INSOMNIA

Sleep has many functions, among which are clearing the body of toxins and consolidating memory. The exact amount we need is determined by age, and genetics among another things. From what I’ve read, eight hours is required, plus or minus an hour.

That being said, there are a few  among us who are super sleepers. Going back in history this probably included Mozart and Thomas Edison: They could live healthy, productive lives with as few as three or four hours of sleep. Genetic mutations, including changes to the Orexin Gene receptor account for true super-sleepers.

Familial fatal insomnia is a genetic disease operating through prion proteins, and does not illuminate the problem of insomnia. In most people  there are two major forces which determine the onset of sleep, the circadian rhythm, and sleep pressure.

The TIMING of the sleep varies from morning larks to night owls. These shifts in the circadian rhythm is also genetic, involving many genes, including PER and CRY. Diurnal rhythm can apparently be changed, But with difficulty.

The sleep pressure is caused by the gradual daily accumulation of adenosine in the system, apparently resulting from the stripping away of the phosphate groups from the energy currency, ATP.  This can be assuaged by caffeine containing drinks, such as tea or coffee. Caffeine temporally blocks the effect of adenosine, but when it wears off, you usually go right back to your fatigue state.

INSOMNIA occurs when you do not get as much sleep as you need, and are tired in the daytime. This is a major problem for a lot of people.

Insomnia has many causes. Stress will cause an increase in Cortisone in the bloodstream which interferes with sleep. Caffeinated drinks nicotine and other stimulants can cause you to have difficulty falling asleep, and alcohol will help you fall asleep but will often result in awakening in the middle of the night when the alcohol is metabolized.

Depression, Parkinson’s, chronic pain, gastroesophageal reflux and any other medical conditions can interfere with sleep. Sleep apnea, often associated with overweight and heavy snoring, is a special problem that sometimes needs the help of a sleep specialist.

Some poor habits such as reading in bed, doing work in bed, eating at bedtime, and heavy exercise just before bed can also be a problem.
A regular routine of Preparing for sleep, such as brushing and flossing and taking a warm shower are also helpful; you can get more details by looking up “sleep hygiene”.

A lot of people take a nap, but this can cause some difficulty in going to sleep. Among things you can do to prevent insomnia include living an active life, making your bedroom comfortable for sleep, and using your bedroom ONLY for sex and sleep.

Please refer to the accompanying Mayo clinic article for more organized information.

—Dr. C.

Mayo Clinic articlehttps://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes/syc-20355167


VIEWS: IS U.S. HEALTHCARE SYSTEM BROKEN? (HARVARD)

Here’s a question that’s been on my mind and perhaps yours: Is the US healthcare system expensive, complicated, dysfunctional, or broken? The simple answer is yes to all.

Below are 10 of the most convincing arguments I’ve heard that our system needs a major overhaul. And that’s just the tip of the iceberg. Remember, an entire industry has evolved in the US just to help people navigate the maddeningly complex task of choosing a health insurance plan.

The cost is enormous

  • High cost, not highest quality. Despite spending far more on healthcare than other high-income nations, the US scores poorly on many key health measures, including life expectancy, preventable hospital admissions, suicide, and maternal mortality. And for all that expense, satisfaction with the current healthcare system is relatively low in the US.
  • Financial burden. High costs combined with high numbers of underinsured or uninsured means many people risk bankruptcy if they develop a serious illness. Prices vary widely, and it’s nearly impossible to compare the quality or cost of your healthcare options — or even to know how big a bill to expect. And even when you ask lots of questions ahead of time and stick with recommended doctors in your health insurance network, you may still wind up getting a surprise bill. My neighbor did after knee surgery: even though the hospital and his surgeon were in his insurance network, the anesthesiologist was not.

Access is uneven

  • Health insurance tied to employment. During World War II, healthcare was offered as a way to attract workers since employers had few other options. Few people had private insurance then, but now a layoff can jeopardize your access to healthcare.
  • Healthcare disparities. The current US healthcare system has a cruel tendency to delay or deny high-quality care to those who are most in need of it but can least afford its high cost. This contributes to avoidable healthcare disparities for people of color and other disadvantaged groups.
  • Health insurers may discourage care to hold down costs. Many health insurance companies restrict expensive medications, tests, and other services by declining coverage until forms are filled out to justify the service to the insurer. True, this can prevent unnecessary expense to the healthcare system — and to the insurance company. Yet it also discourages care deemed appropriate by your physician.

Read full article

Dr. C Commentary:

Please refer to the DWWR Posting on “concierge doctors” for my rant on the current healthcare system, which I will not repeat.

The truth is more nuanced. All countries are having trouble of one sort or another with their healthcare systems. This is due to the inherent expense of today’s top flight medicine. The very best care requires costly high technology and drugs that are intrinsically hard to produce. And you have to know where to look. I am very thankful for my medical degree, and that I have kept up with current advances.

You would probably need a Government entirely of physicians to develop the willpower to do something for health, which always starts with PREVENTATIVE MEDICINE, A hard sell, given that you must spend money and effort to block something which will probably, but may not always, occur.

There is low hanging fruit. Why are sugary drinks not heavily taxed, since they produce obesity which causes a lot of costly medical disorders, such as diabetes, inflammatory diseases, and cancer, but not everybody all the time?

Why is efficiency of telehealth not more widely embraced, but stymied by moneymaking lobbiests and lawyer powered difficulties, in addition to Patient’s and doctor’s old habits?

And then there are the jealously guarded  American freedoms to do stupid things, such as avoid vaccines and masks, even in a prodigiously expensive and dangerous Covid  epidemic.

Given human nature, a complete solution would seem to be impossible, and we should content ourselves with minor victories wherever they can be attained.

Embrace sleep, diet, and exercise, and KEEP HEALTHY.

–Dr. C

DR. C’S JOURNAL: BENEFITS OF PARATHYROID HORMONE

Hormones, Vitamins, and minerals all have extensive interactions in the give-and-take of the bodies’ ballet of homeostasis. No where is this more clear-cut than the interplay of parathyroid hormone, vitamin D, and calcium.

Although it has many other actions in the body, calcium is best known as the prime component of our bones. It is essential for making them healthy and strong. The bones act as a storehouse or vault for the bodies calcium. The parathyroid hormone is the key that unlocks the vault to release the calcium so it can perform its many other roles in the body. An elevation of the calcium in the blood stream shuts down the parathyroid Glands.

Parathyroid hormone also acts to instruct the body to absorb more vitamin D, just as the vitamin D causes the intestinal tract to absorb more calcium. The parathyroid glands are in the upper poles of the thyroid which as we mentioned before sits astride the windpipe.
Sometimes the parathyroid gland develops an adenoma which causes too much secretion of parathyroid hormone.

This results in an excess of calcium in the body and a variety of symptoms, such as joint pain muscle weakness, fatigue, nausea and vomiting. One of the technicians in my medical practice developed hyperparathyroidism. It was detected by a metabolic panel, which showed an elevation of serum calcium.

This discovery, early in my practice, made me a big fan of metabolic panels when patients have general symptoms. Her condition, a parathyroid adenoma, was cured by surgery. Conversely, surgery for an overactive thyroid can sometimes accidentally remove the parathyroid glands if the surgeon isn’t careful. The parathyroid glands are tiny, but they perform a huge function.

—Dr. C.