I put together this blog post to educate my readers about the influenza vaccine, specifically the flu shot. It is essentially a compilation of relevant facts. I will follow-up with a blog about naturopathic flu prevention and treatment options next week. The 'flu shot' you're being offered by doctors and pharmacists is the 'inactivated' version (the live version is 'FluMist').
The Cochrane Library is an extremely highly-regarded database company that regularly reviews the current scientific studies on a particular subject and releases what is referred to as a 'plain language summary' (along with a detailed report) so that anyone can understand the results of their work. They do this so that we can all benefit from, and practice, evidence-based medicine.
In 2010 they released a report on 'Vaccines for preventing influenza in healthy adults.' What follows (in green) is what they refer to as their 'plain language summary'. Please remember, this pertains to healthy adults aged 16 to 65 years of age:
"Over 200 viruses cause influenza and influenza-like illness which produce the same symptoms (fever, headache, aches and pains, cough and runny noses). Without laboratory tests, doctors cannot tell the two illnesses apart. Both last for days and rarely lead to death or serious illness. At best, vaccines might be effective against only influenza A and B, which represent about 10% of all circulating viruses. Each year, the World Health Organization recommends which viral strains should be included in vaccinations for the forthcoming season.
Authors of this review assessed all trials that compared vaccinated people with unvaccinated people. The combined results of these trials showed that under ideal conditions (vaccine completely matching circulating viral configuration) 33 healthy adults need to be vaccinated to avoid one set of influenza symptoms. In average conditions (partially matching vaccine) 100 people need to be vaccinated to avoid one set of influenza symptoms. Vaccine use did not affect the number of people hospitalised or working days lost but caused one case of Guillian-Barré syndrome (a major neurological condition leading to paralysis) for every one million vaccinations. Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions and because the harms evidence base is limited." [http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001269.pub4/abstract]
I completely understand this review runs counter to what you're being told by the government. For example, this infographic says that 60 to 80% of healthy adults and children can 'prevent the flu with the flu shot' :
One reason for this discrepancy is because the efficacy of the vaccine is extremely dependent on how well-matched the vaccine is to the strain that actually circulates that year. For example, the CDC released this report in 2008 which stated (in green):
"... vaccine effectiveness (VE) against culture-confirmed influenza ranged from 71% to 79% when the vaccine and circulating strains were suboptimally matched to 74% to 79% when the matches were well matched... In contrast, a 2-year study of....influenza vaccine among healthy adults aged 18--64 years found no measurable VE during a year when a poorly matched strain circulated"
The flu shot is less effective in the elderly, and those with compromised immune function.
How Well Does it Work in Children?
This 2008 study released by a Rochester, New York, hospital was unable to demonstrate vaccine effectiveness (VE) in children in New York state, Ohio, and Tennessee. They compared kids who had been treated for influenza to kids who were patients of doctors participating in the study. An excerpt (in green):
"However, significant influenza VE could not be demonstrated for any season, age, or setting after adjusting for county, sex, insurance, chronic conditions recommended for influenza vaccination, and timing of influenza vaccination (VE estimates ranged from 7%-52% across settings and seasons for fully vaccinated 6- to 59-month-olds)"
This is just one study! However, it did indicate the current state of affairs when I reviewed the research. The CDC has a fabulous webpage giving details about how effective vaccines are here. In regards to children, they say:
"Children In a four-year randomized, placebo-controlled study of inactivated and live influenza vaccines among children aged 1–15 years, vaccine efficacy was estimated at 77% against influenza A (H3N2) and 91% against influenza A (H1N1) virus infection (Neuzil et al., 2001). A two-year study of children aged 6–24 months found that the vaccine was 66% effective in preventing laboratory-confirmed influenza in one year of the study (Hoberman et al., 2003)."
Notice, these results pertain only to particular strains of Influenza A. The first study (Neuzil) talked about kids in 1990, and the second study (Hoberman) actually found that although the vaccines were effective in terms of reducing infection rates, also,:
".... in neither cohort were there any statistically significant differences between the vaccine group and the placebo group during ensuing respiratory seasons regarding utilization of selected health care resources. During the second year of the study the rate of hospitalization was actually higher in the vaccine group than in the placebo group."
Last but not least, FluMist is fast becoming the go-to choice for children older than 24 months of age.
The flu shot in Canada can contain thimerosal (mercury), formaldehyde, and egg.
This is a tricky subject. There is a lot of anecdotal evidence out there that vaccines can cause some pretty serious side effects ('anecdotal evidence' means that a lot of people like you and me report it, but it has never been thoroughly scientifically studied or proven). I would direct my readers to check out The Vaccination Risk Awareness Network for more information at http://vran.org/about-vaccines/specific-vaccines/influenza-vaccine-flu-shot/
I often hear patients tell me they got sick after they got the flu shot. You can't get the flu from the flu shot, but it can have an effect on your immune system function.
When to Seek Help:
The following (in green) is an excerpt from the Ontario Ministry of Health website.
Call 911 right away or take your child to the nearest hospital emergency department if your child has new onset or worsening of the following symptoms:
If You Get the Flu Shot:
[Image courtesy of 'cooldesign' / freedigitalphotos.net]
I have a lot of my patients ask about which oils they should be using. I, too, find myself a little uneasy when I'm standing in front of the oil section in the grocery store. It's a difficult topic to research, there are a lot of contradictory 'facts' and 'figures' out there. I've attempted to do your research for you, and have put together this simple guide.
There are three main factors to consider when choosing an oil:
To keep it simple, we get way too much Omega-6 and not enough Omega-3 in our diet. Omega-6 is significantly more inflammatory in the body. To make things worse, it edges out what little Omega-3 we have. Anyone who tells you that you need more Omega-6 is wrong (and, yes, I know I'm contradicting Dr. Udo here). The only exception to this rule is a form of Omega-6 called GLA (gamma linolenic acid), found most commonly in borage oil and evening primrose oil, which sometimes helps with particular conditions such as eczema and premenstrual syndrone. Omega-9 oils have been proven to have beneficial effects on such things as heart health and blood pressure, which has partly lead to the popularity of olive oil. Please note, your body can make its own Omega-9, the only thing you need to worry about increasing is Omega-3.
(Saturated vs. Unsatured)
Polyunsaturated fatty acids are unstable. They begin to go rancid the moment you open the bottle, and aren't able to withstand heat well at all. Monounsatured fatty acids are much more stable and it looks like they have some great health benefits. Saturated fatty acids are not evil! It turns out there probably wasn't anything wrong with grandma frying her eggs in bacon grease. They are very stable oils (including butter, tallow, ghee, etc.). The ratio of Omega's in animal fat is determined by what the animal ate during its life. For example, grass-fed beef is significantly higher in Omega-3. (Note - coconut oil is also largely saturated fat) All that said, I don't generally recommend cooking with dairy fats because if I had a dollar for every patient of mine who was intolerant of dairy, well, I'd be able to go to Starbucks for a loooooong time.
2) Smoke Point
This refers to the point at which the oil begins to smoke when exposed to heat, signifying that it has started to break down into a form that is not good for you.
Oils made from genetically-modified plants and subjected to chemical solvents just don't make health sense.
MY OIL RECOMMENDATIONS
Reasons - proven health benefits, mostly Omega-9, high in monounsaturated fats
Reasons - taste, high antioxidant content, generally well-balanced oil
Reasons - smoke point of 400°F (204°C) (extra virgin), high monounsaturated fatty acid content, not high in Omega-6
Reasons - smoke point of 350°F (177°C) (extra virgin), high saturated fatty acid content, speculative health benefits (such as raising good cholesterol or antiviral properties), not high in Omega-6
Reasons - high monounsaturated fatty acid content, smoke point of 413°F (210°C), not high in Omega-6
Reasons - not proven to be a form of omega-3 we can actually use, oxidizes rapidly (which can cause cancer), and better absorbed in its whole form (freshly ground)
Reasons - (generally) genetically-modified, (generally) chemically extracted, high in polyunsaturated fat
rice bran oil
Reasons - difficult to find cold-pressed (though it is well-balanced with a high smoke point)
Fish, fish, fish (ideally, small fish like anchovies and sardines)! Please see this blog entry for more details. All that said, seek the advice of a healthcare practitioner to determine the right medical-grade oil for YOU.
Last pieces of advice:
NEVER buy oils in bulk. Unless you're going to go through it extremely quickly, buy the smallest bottle possible and keep it is as cold as possible without it solidifying (such that you can't pour it). Oxidized oil is just not good for you.
Look for 'cold-pressed' or 'expeller-pressed' oils. Expeller pressed oils are produced by manual compression, as opposed to chemical solvents. 'Cold-pressed' means that the expeller pressing was done in a temperature controlled environment, because the process can naturally generate very high heat. 'Extra virgin' should mean that oil was produced by mechanical means without chemical solvents.
If you'd like to research these topics further, here are two great sites:
[Image courtesy of m_bartosch / FreeDigitalPhotos.net]
The way I see it, there are a few ways to motivate yourself to exercise, including:
2) social pressure (for example, you told everyone you were running a marathon in September and you can't stand the shame of not following through)
3) you paid someone, such as a personal trainer, to be accountable to (and, as an added bonus, that person might even make sure you're doing it right)
4) vanity (the classic example being trying to fit into a wedding dress)
5) fear (of illness, often of one you've let get a little too close for comfort)
7) for the joy of it!
I used to live in Seattle. I have a good friend (see photo of us above) who was my climbing, snowboarding, camping, hiking, biking, kayaking, and running buddy while I lived there. Sometimes, he would just show up at my house and suggest we go for a run. I used to jokingly refer to him as 'my personal trainer.' We had some amazing adventures, and I was in the best shape of my life. He pretty much kicked my ass at everything we did. Sometimes he would, literally, run circles around me. He taught me a very important lesson. One day, he suggested I try running simply for the joy of it; instead of thinking about the distance I'd covered, how fast I was going, or the muscle cramp I was developing. I tried to focus on being grateful that I could run, and I was amazed by how much better my performance and experience was...instantly! Focusing on a positive emotion created a thoroughly positive experience.
My patients often wait until they have to do things....eat well, exercise, take time to be calm, etc. It's so much more fun to learn and grow through joy instead of pain. I encourage you to find your joy. Everyone has the capacity to make good choices, it can often be as simple as 'checking in' as you're about to sit down in front of the TV or reaching for a bag of chips, and asking 'is this really what is going to make me happy?' [And sometimes, yes, that TV show IS what it going to make you happy!] The process of making sustainable choices can be exhilarating and tremendously empowering! Choose the carrot instead of the stick!
Happy New Year!
My thanks to each and every one of you for your support in my first year practicing here in North Bay. It's been a fantastic year! The highlight of 2012, for me, is how often I've been blown away by the dramatic improvements in my patients. I believe in what I recommend, but it still takes me by surprise sometimes how beautifully it all works!
I've had a number of patients ask me how they can fire their current medical doctor so that they can find a new one. In an under-serviced area like North Bay a new medical doctor or nurse practitioner will most likely refuse to take you on as a patient if you already have a medical doctor. To be clear, I'm not advocating for firing medical doctors! It's usually best to let someone know what you're dissatisfied with, and give them a chance to explain and/or improve. However, I'd also like for everyone to feel like they have some control over their own medical care.
If you would like to fire your doctor, the best way to do so is to call the Service Ontario Info Line at 1-866-532-3161 and tell them the name of your medical doctor or nurse practitioner and that you would like to remove your name from their roster. Service Ontario tells me they will remove you from the roster within 48 hours, and mail you a letter confirming that they have done so. If need be, you can show that letter to the new medical doctor or nurse practitioner you would like to see.
Last but not least, you can call 'Health Care Connect' at 1-800-445-1822, and they can help you find a family doctor or nurse practitioner in your area that is accepting patients.(www.ontario.ca/healthcareconnect)
This study found that obese women who were served three large meals instead of six small meals per day had much lower postprandial (after eating) levels of triglycerides in their blood, which may reduce the risk for cardiovascular disease.
One of the authors of the study (Heden) was quoted as saying "The mass media and many health care practitioners often advocate eating several small meals throughout the day. However, when we examined the literature, we didn't find many studies examining or supporting this popular claim. This lack of research led to our study, which is one of the first to examine how meal frequency affects insulin and blood-fat levels in obese women during an entire day of eating."
Our body needs to secrete bile from the liver/gallbladder, acid from the stomach, and digestive enzymes from the pancreas in order to properly digest food. Building up an "appetite" includes preparing all these digestive components. If your digestive tract is being constantly bombarded by small quantities of food; how can it know when to secrete, when to digest, and when to relax the sphincter at the bottom of the stomach and release the partially digested food into the intestines?
Grapefruit inhibits the ability of the body to break down some prescriptions drugs, which can increase the concentration of those medications in the body. There isn't much information out there about how long the effect of grapefruit juice lasts after it has been consumed. However, we do know that taking certain prescription drugs and grapefruit at the same time is a bad idea. (From the article below) "For example, simvastatin, when taken with about a 7-ounce glass of grapefruit juice once a day for three days, produced a 330% greater concentration of the drug compared to taking it with water"
Common prescription drugs that interact with grapefruit in this manner include:
This is NOT an exhaustive list. Additionally, grapefruit only has this effect on drugs that are taken orally.
Medscape Medical News > Oncology
Study: 1.3 Million Overdiagnosed Breast Cancers in 30 Years - Nick Mulcahy
This article nicely summarizes a lot of controversy lately regarding breast cancer screening. Long-term studies in Scandinavia and the States are causing quite a paradigm shift. Key points include:
-' "overdiagnosed,"...means their screening-detected tumors would never have led to clinical symptoms'
-'the advent of widespread mammography screening in the United States led to a "substantial increase" in early-stage breast cancer, but only "marginally reduced" the rate of advanced cancers detected. "The imbalance suggests that there is substantial overdiagnosis." '
-'only 8 of the 122 [per 100,000 women] additional early-stage cancers diagnosed were expected to progress to advanced disease'
-'screening is having, at best, only a small effect on the rate of death from breast cancer'
The Canadian Task Force on Preventative Health Care (composed primarily of MDs) has made the following recommendations to health care professionals:
For women aged 40–49 we recommend not routinely screening with mammography. (Weak recommendation; moderate quality evidence)
For women aged 50–69 years we recommend routinely screening with mammography every 2 to 3 years. (Weak recommendation; moderate quality evidence)
For women aged 70–74 we recommend routinely screening with mammography every 2 to 3 years. (Weak recommendation; low quality evidence)
Magnetic Resonance Imaging
We recommend not routinely screening with magnetic resonance imaging. (Weak recommendation; no evidence)
Clinical Breast Exam
We recommend not routinely performing clinical breast exam alone or in conjunction with mammography to screen for breast cancer. (Weak recommendation; low quality evidence)
Breast Self Exam
We recommend not advising women to routinely practice breast self exam. (Weak recommendation; moderate quality evidence)
Here is the link for the Patient FAQ document http://canadiantaskforce.ca/guidelines/2011-breast-cancer/breast-cancer-screening-patient-faq/
It takes time for information like this to be evaluated, absorbed and implemented; but don't be surprised if the recommendations you receive regarding breast cancer screening begin to change in the next few years.
Please don't allow the CBC to ruin fish oil supplements for you! I've looked over all the articles and research referenced in the story below, and there are so many flaws, including:
-the study in the article below evaluates the effects of a very short period of fish oil supplementation on irregular heart beat (arrhythmia) after a specific surgical procedure. Obviously, this very specific scenario can't translate into the general value of fish oil
-many of the studies referenced don't differentiate between fish and plant sources of omega-3. It has not been proven that plant sources of omega-3 are in a form our body can utilize.
-fish oil is generally called EFA (Essential Fatty Acids) and then it is further divided into EPA and DHA content. 1000 mg of 'EFA' does not guarantee a therapeutic dose of EPA and/or DHA.
-fish oils don't (always) work rapidly. You shouldn't expect to a shorten a hospital stay by suddenly starting a fish oil supplement when you check in.
-the article references a Cochrane review which actually said 'There is not enough evidence to say that people should stop taking rich sources of omega 3 fats...' AND some of the research they were reviewing was for a margarine spread!
I could go on and on. I guess what it comes down to is that the news these days is filled with sensational stores. There must be some combination of reporters intentionally skewing the facts and/or just not understanding the science. There is no 'wonder supplement' out there, but there are many that are extremely good. I would encourage you to speak to a health care practitioner you trust when the news raises questions for you.
As a final note, we are starting to discover some wonderful non-fish sources of omega-3 essential fatty acids that hold great promise of being in a form our body can properly use.
This Australian study's preliminary findings were that "On average, every single hour of TV viewed after the age of 25 reduces the viewer's life expectancy by 21.8... min[utes]" Wow!
[Br J Sports Med. 2012;46(13):927-930]
(photo by Nadia Meslem, http://3d.nu)
This is an interesting finding (article copied from Medscape), reminding us that everything is generally best in moderation. To summarize - although vitamin D has been found to assist with bone growth, proper immune cell function, and some elements of cancer control; it has recently been found that people who live longer seem to have lower vitamin D levels. This is an initial finding, meaning more work needs to be done to determine whether vitamin D levels are just a bio marker for some other physiologic process, or directly associated with longevity.
Low Vitamin D Levels Linked to Longer Life
Laurie Barclay, MD
Nov 05, 2012
New genetic findings in those predisposed to longevity cast doubt on whether low levels of vitamin D cause age-related diseases and mortality, according to an analysis from the Leiden Longevity Study published online November 5 in the Canadian Medical Association Journal.
"Vitamin D plays a critical role in bone formation, immune cell differentiation, and in the inhibition of proliferation and angiogenesis in cancer," write Raymond Noordam, MSc, from the Department of Gerontology and Geriatrics at Leiden University Medical Center in the Netherlands, and coauthors. "Low serum levels of 25-hydroxyvitamin D3 (25[OH] vitamin D) are associated with increased mortality, cardiovascular disease, diabetes mellitus, cancer, multiple sclerosis, allergy, asthma, infection, depression, mental illness and musculoskeletal pain. However, because of design limitations, previous studies have not been able to infer causality."
The goal of this study was to examine a possible causal association between low levels of 25(OH) vitamin D and various age-related diseases and mortality. The Leiden Longevity Study allowed assessment of vitamin D levels in the middle-aged offspring of nonagenarians who had 1 or more nonagenarian siblings, using a sample of 380 white families with 2 or more siblings at least 89 years of age for men or 91 years of age for women. This was useful because the prevalence of age-related diseases is lower in these offspring than in the general population, and they are more likely to survive to old age.
Control patients (n = 461) were the partners of the offspring (n =1038) and were of similar age and had similar environmental exposures that could affect vitamin D levels. In addition to anthropometric measurements, 25(OH) vitamin D levels, parathyroid hormone levels, and dietary vitamin D intake, the investigators studied single nucleotide polymorphisms (SNPs) in 3 genes known to be associated with vitamin D levels.
Compared with the control participants, the offspring had significantly lower levels of vitamin D (64.3 nmol/L vs 68.4 nmol/L; P= .002). These findings were independent of possible confounding factors (age, sex, body mass index, month of blood sampling, tanning bed use, dietary and supplemental vitamin D intake, and creatinine levels). Levels of parathyroid hormone did not differ between groups.
The rs2060793 genetic variant in the CYP2R1 gene occurred less frequently in the offspring than in the control participants (P= .04). Across the 2 most prevalent genotypes of this SNP, there was a persistent difference in vitamin D levels between offspring and control patients.
"Compared with controls, the offspring of nonagenarians who had at least one nonagenarian sibling had a reduced frequency of a common variant in the CYP2R1 gene, which predisposes people to high vitamin D levels; they also had lower levels of vitamin D that persisted over the 2 most prevalent genotypes," the study authors write. "These results cast doubt on the causal nature of previously reported associations between low levels of vitamin D and age-related diseases and mortality."
Limitations of this study include the availability of data on tanning bed use and sun exposure for only a small, but random, subpopulation of participants. In addition, the analyses excluded 36% of participants because of missing data on possible confounding factors. However, the excluded participants also showed similar differences in vitamin D levels between offspring and control patients, suggesting they were representative of the total study group.
The investigators put forth a theory that the offspring of nonagenarians may have increased expression of the klotho protein, which is thought to be an "aging suppressor" protein.
"We found that familial longevity was associated with lower levels of vitamin D and a lower frequency of allelic variation in theCYP2R1 gene, which was associated with higher levels of vitamin D," the study authors conclude. "Future research should focus on elucidating the mechanisms that explain the lower 25(OH) vitamin D levels in familial longevity and other genetic variants associated with vitamin D metabolism, such as the vitamin D receptor."
The study was supported by the Innovation Oriented Research Program on Genomics, the Center for Medical Systems Biology, and the Netherlands Genomics Initiative/Netherlands Organisation for Scientific Research. The study authors have disclosed no relevant financial relationships.
CMAJ. Published online November 5, 2012. Abstract
Medscape Medical News © 2012 WebMD, LLC
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Cite this article: Low Vitamin D Levels Linked to Longer Life. Medscape. Nov 05, 2012.
Dr. Dielle Raymond, ND