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No-Bake Blueberry Almond Whole 30 Snack Bars

No-Bake Blueberry Almond Whole 30 Snack Bars

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

If you have been through the Total30 diet plan, you know sweets are off-limits. You are not allowed to eat sugar, honey, agave nectar, maple syrup, or any other sugar substitute. This includes Equal, NutraSweet, Stevia, Splenda, etc. After doing some research, I found that dates are about as sweet as you can get. If you add different kinds of nuts, some dried fruit, and a little sunflower seed butter for moisture, you can make snack bars that are very satisfying. I made several versions of these during my 30-day party.

Only five initial ingredients

No Cooking Necessary

You read that right. You don’t need to cook these in any way. All you need is the five ingredients pictured above, a food processor, a pan lined with parchment paper and a little time. The first step in all of my recipes is gathering ingredients. I have started preparing too many meals only to find out I was missing a key ingredient. This frustration has taught me to set all ingredients out before beginning.

Prepare the Pan

Set the pan (I used a cake pan) down on a piece of parchment paper. Draw an outline around the pan. Cut the parchment paper along the line drawn to form a circle that fits into the pan as shown above.

White Mulberry Leaf Blend Works by Suppressing Appetite

Add Ingredients to Food Processor

To be honest, the hardest part of this recipe is being sure all your ingredients are Whole30 compliant. Be sure the dried fruit does not contain any added sugar or sulfites. Whole Foods has dried fruit that has no added ingredients. Do the same with the dates. The next thing to do is to measure out the dry ingredients and add them to the food processor as shown above.

Next just pulse the nuts dates and dried fruit until well mixed. Add 2 tablespoonfuls of sunflower seed butter (or almond butter) . This adds moisture and makes it possible to press into your pan.

Press mixture into your pan and refrigerate. I told you this was easy. Sweet, healthy, yummy blueberry bars.

No-Bake Blueberry Almond Whole 30 Snack Bars

This is a super simple, Whole30 compliant healthy snack bar recipe.
Prep Time20 mins
Cook Time0 mins
Course: Snack
Cuisine: American
Keyword: Blueberry bar, healthy snack, Larabar, Whole30
Servings: 10
Calories: 144kcal
Author: Michael Brown
Cost: $15

Equipment

  • Food processor
  • Cake Pan
  • Parchment paper

Ingredients

  • 1 cup Raw Almonds
  • 1 cup Raw cashews
  • 1 cup Pitted dates
  • 1 cup Dried blueberries May use any dried fruit that DOES NOT contain added sweeteners or sulfites. Read labels closely
  • 2 tbsp sunflower seed butter could substitute almond better

Instructions

  • Place cake pan on parchment paper and draw circle around bottom of pan.
  • Cut out circle and place into the bottom of the cake pan and set aside.
  • Add Nuts, pitted dates, and dried fruit to the food processor.
  • Pulse until well mixed.
  • Add sunflower seed butter and mix until moist.
  • Press into the lined cake pan and refrigerate.
  • Slice into wedges and serve.
My new Best Friend “Ginger”

Five Amazing Organic Ceylon Cinnamon Benefits

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Cinnamon comes in two varieties. 

  • Cinnamomum zeylanicum (CZ): Also known as Ceylon cinnamon or “true cinnamon.”  This is the version we will be exploring in this post.
  • Cinnamomum aromaticum (CC): Also known as Cinnamon cassia, or “Chinese cinnamon.”

Ceylon cinnamon is a spice is made from the bark of the tropical evergreen tree Cinnamomum verum.  This tree is indigenous to southern India, Madagascar and Sri Lanka with eighty percent of the world’s supply being provided by the latter 1

Almost every part of this tree including the leaves, bark, flowers, roots and fruit has some use either as an ingredient in cooking or a medicinal agent.

Ceylon cinnamon has a lower coumarin content than Chinese cinnamon.2

This is an important difference because coumarins are known to be strong anticoagulants, are carcinogenic and toxic to the liver.  Consuming large quantities of CC over a long period of time could pose health risks whereas CZ does not carry these risks.3

Many studies have been performed demonstrating the benefits of Ceylon cinnamon.  Some of these will be summarized below.

 

Ceylon Cinnamon in Diabetes and Hyperlipidemia

A systemic review and meta-analysis on the use of cinnamon in type 2 diabetes was published in 2013.  This review included ten randomized controlled trials involving 543 patients.  Cinnamon doses ranged from 120 mg per day to 6 grams per day for four to eighteen weeks. 

This review found the consumption of cinnamon to be associated with a statistically significant decrease in:

  • Fasting plasma glucose
  • Total cholesterol
  • LDL-C
  • Triglyceride levels

An increase in HDL-C levels was also significant.  There was not a significant effect on hemoglobin A1c found.  The researchers concluded that “The high degree of heterogeneity may limit the ability to apply these results to patient care, because the preferred dose and duration of therapy are unclear.”4

The fact that cinnamon had a positive effect on five out of six diabetes and blood lipid parameters in this review suggests it may be a positive supplement to add for patients who have hypertriglyceridemia or suffer from type 2 diabetes. 

Other studies have shown no improvement in fasting blood glucose with Ceylon cinnamon compared to placebo or a control group.5

 

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In animal models, the following benefits of cinnamon on diabetes and hyperlipidemia were shown in a study published in Diabetic Medicine in 2012:

  • Attenuation of diabetes associated weight loss
  • Reduction of fasting blood glucose (FBG)
  • Reduction in LDL (bad fat)
  • Increase in HDL (good fat)
  • Reduction in HbA1c
  • Increased circulating insulin levels
  • Beneficial effects against diabetic neuropathy and nephropathy
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Ceylon Cinnamon and Hypertension

Acute intravenous administration of Ceylon cinnamon extract administered to hypertensive rats resulted in a long-lasting decrease in blood pressure.  This study also resulted in a significant decrease in plasma triglycerides (-38.1%), total cholesterol (-32.1%) and LDL-cholesterol (-75.3%).  HDL-cholesterol in this study showed a 58.4% increase.9

Ceylon Cinnamon Antioxidant Properties

Ceylon cinnamon possesses strong antioxidant properties.  This spice is rich in polyphenols.10

 

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A study published in 2005 quantified the antioxidant capacity (TEAC) and phenolic content of 26 common spice extracts from twelve botanical families.  This is important because prior to this study, many different assay methods were used to determine antioxidant capacity.  This study showed a mean TEAC value of 31.7 mmol/100g.  The strongest antioxidant based on radical scavenging activity was clove at 168.7 mmol/100g. 

Cinnamomum zeylanicum had the second highest radical scavenging activity at 107.69 mmol/100g.  This study confirmed the high antioxidant activity of Ceylon cinnamon.14

Antioxidant effects are important because they may reduce the risk of developing many diseases including heart disease and some cancers.  This is accomplished by preventing or limiting the damage caused to cells from free radicals.

Antimicrobial Effects of Ceylon Cinnamon

Ceylon cinnamon has shown antimicrobial activity against many bacterial strains.  CZ oil was beneficial in protecting mice against cryptosporidiosis.15

Another study showed chewing gum containing cinnamic aldehyde and natural flavors from CZ led to significant reductions in salivary anaerobes twenty minutes after gum was chewed.16

There are many more studies and outcomes listed referring to the antimicrobial effects of CZ in the research article “Medicinal properties of ‘true’ cinnamon (Cinnamomum zeylanicum): a systemic review.”

https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/1472-6882-13-275

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It is thought that CZ’s antimicrobial action is due to cinnamaldehyde.18

Anti-Inflammatory Actions of Ceylon Cinnamon

Extracts of cinnamon are known to increase Tristetrapolin mRNA and protein levels.  These have anti-inflammatory effects.  This may be why anti-inflammatory actions have been observed with the use of CZ.19

This effect can help the body fight infection and repair tissue damage.  Studies have shown that Ceylon cinnamon has potent anti-inflammatory properties.  If therapeutic concentrations reach the tissues, this substance may be used in the treatment of age-related inflammatory conditions.20 

A study published in 2012 determined “cinnamic aldehyde may be used in the prevention or treatment of disease where free radical formation is a pathological factor.”21

Ceylon Cinnamon Side Effects

This spice is generally well tolerated and adverse effects are uncommon.  Some side effects reported areHeartburn

  • Nausea
  • Bloating
  • Dyspepsia
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Cinnamon oil can cause burning and contact dermatitis when it comes into contact with the skin.  There has also been a case report of a 7 year-old child developing signs of toxicity (vomiting, dizziness, sedation and loss of consciousness) after ingesting 60 ml of cinnamon oil.23

Ceylon Cinnamon Drug Interactions

Antidiabetic agents:  Ceylon cinnamon can decrease blood sugar so combining it with antidiabetic agents may lead to hypoglycemia.  Frequent monitoring of blood sugars is recommended if combining Ceylon cinnamon with these agents.

Antihypertensives:  Some research has shown Ceylon cinnamon can decrease blood pressure in rat models.  Blood pressure should be monitored when combining Ceylon cinnamon with antihypertensive agents to prevent hypotension.

Cinnamon comes in two different varieties.  Ceylon cinnamon is the preferred type to use for medicinal purposes.  This spice may be useful for several indications.  Cinnamon can lower blood sugar, improve blood lipid levels and reduce blood pressure.  It has also been shown to be effective in preventing and fighting several types of bacterial infections. 

Cinnamon has strong antioxidant properties that may help prevent heart disease and some types of cancer.  It may also be useful in several inflammatory conditions related to the ageing process. 

Ceylon cinnamon is well tolerated when consumed at recommended dosages.  It is important to consume the correct form of cinnamon.  The cinnamon used in cooking (Chinese cinnamon) is not the same as Ceylon cinnamon.  It has many of the same effects but contains high levels of coumarin compounds which may lead to bleeding.  Coumarins are also carcinogenic and toxic to the liver.  Consuming small amounts of Chinese cinnamon in food is safe but you wouldn’t want to consume large quantities for its health benefits.

Sunshine Nutraceuticals has a Ceylon cinnamon supplement available for purchase.  Please let us know if you have any questions regarding this product or any item we offer for sale.  We are always happy to answer any questions regarding happy, healthy living as well.

Have a great week and be safe!  Remember to follow all guidelines regarding COVID-19.  We need to get through this!

 

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Crohn’s Disease Dietary Restrictions and Natural Remedies

Crohn’s disease is an inflammatory bowel disease (IBD) resulting in chronic inflammation of the gastrointestinal tract.  IBD encompasses Crohn’s disease and ulcerative colitis.   Crohn’s disease is associated with distinct granulomas and inflammation which may also affect lymph nodes.1

Ulcerative colitis is a milder disease that is characterized by continuous inflammation affecting the colon.  Both of these conditions lead to extensive epithelial damage.

Inflammatory bowel disease may cause a variety of symptoms including:

  • Loss of appetite
  • Fever
  • Weight loss
  • Diarrhea which may contain blood
  • Abdominal pain and cramping
  • Anemia due to blood loss
  • Urgency to defecate

I thought I would write a post on ways to combat this disease other than the traditional medication therapy. 

Remember, if you suffer from IBD, it is important to visit your physician on a regular basis.  Since bleeding and GI blockages are possible, tests may need to be performed by a professional to keep you as healthy as possible. 

You may require medication depending on how severe your symptoms are.  This disease may also cause a decrease in the absorption of vital vitamins and nutrients the body needs for proper functioning. 

The recommendations in this article should only be considered in combination with the advice of a physician.  I am a strong advocate of yearly check-ups.  Preventative medicine is vital to health.

What Foods Cause Crohn's Disease Flare-ups

Although there is no particular diet that has been scientifically proven to prevent inflammatory bowel disease, there are some trigger foods that may cause flare-ups.  My advice is to keep a food journal and this should help you determine which foods tend to cause problems.  If you find a certain food or food group appearing often before flare-ups, you may consider eliminating that item from your diet.  Some of the possible “problem items” include:

  • Corn, including popcorn
  • Dairy products – if lactose intolerant- consider supplementing with lactase or eliminating
  • Foods that cause increased gas production in the gut (onions, broccoli, cabbage, beans, legumes, lentils, etc.)
  • High fiber foods (chia seeds, avocado, pasta, chickpeas, quinoa, oats, almonds etc.)
  • Fried foods
  • Nuts and seeds, including peanut butter
  • Some raw fruits
  • Coffee and tea
  • Chocolate
  • Fats (butter, mayonnaise, cooking oils)
  • Alcoholic beverages
  • Red meat
  • Pork
  • Spicy foods

As you can see, there are many foods on this list, and others may also cause irritation and flare-ups.  This is why a food journal is essential.  It is worth the effort!

Another strategy is to try an elimination diet.  The way this works is you start by eliminating many foods and if your symptoms improve, you begin to add foods back one at a time.  This can help identify which foods should be avoided in the future. 

There are several elimination diets available today.  The Whole30 is a diet my family and I tried last October.  I have written about this in a separate post if you are interested in the specifics.  I highly recommend trying it.

I was also able to locate a specific diet and cookbook on Amazon written by Patty Catsos, MS, RD, LD.  I have not tried this diet yet, and don’t suffer from IBS, but this book has great reviews.  I do not have any association with this product but will list the link below for your convenience.

https://www.amazon.com/IBS-Elimination-Diet-Cookbook-Low-FODMAP/dp/0451497724

FODMAPs

Fermentable oligo-, di-, mono-saccharides and polyols (FODMAPs) are short-chained carbohydrates.  These make their way to the end of the intestinal tract where large amounts of bacteria reside.  The bacteria break these substances down causing the release of gas which may lead to digestive issues in some individuals.  These FODMAPs also draw liquid into the intestines which can lead to diarrhea.  Most individuals with IBS are sensitive to FODMAPs and these substances can lead the flare-ups.  Examples of FODMAPs include:

Lactose – Milk sugar contained in dairy products.

Galactans – Legumes have large quantities of these.

Fructose – This is the sugar contained in fruits and vegetables.  You also find this in many packaged products.

Fructans – These are found in many grains including wheat, spelt, barley and rye.

Polyols – These are sugar alcohols and are also used in processed foods as a sweetener.  Examples include sorbitol, mannitol, xylitol and maltitol.

These substances are resistant to digestion and are passed through the intestinal tract unchanged.  FODMAPs cause an increased hydrogen concentration in the intestines of those with IBS.  They also influence the quantity of methane gas and may cause gastrointestinal symptoms in IBS patients.2

Curcumin for IBS

One of the most effective and popular herbal medicines available is turmeric.  This herb contains curcumin which has many beneficial properties.  Curcumin is known to have a wide range of effects on the gastrointestinal system.  This substance has been shown to inhibit the growth of H. pylori in both mice and on agar plates.3

Curcumin is thought to kill bacteria by inhibiting cell division.4

A study by Niamsa and Sittiwet in 2009, demonstrated the antimicrobial activity of curcumin several commonly encountered pathogenic Gram-negative and Gram-positive bacteria.5

Curcumin has also been shown to regulate the gut microbiota.  This is important because inflammatory bowel disease is partially defined by an altered, pathogenic microbiome.6

 

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One of the changes that occur in the gut is the increase in adherent invasive E. Coli (AIEC) which can promote gut inflammation.9

 

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Curcumin has also been shown to inhibit signaling that initiates the inflammatory process in the intestinal tract.11

A study published in 2006 found the addition of curcumin, 1 gram after breakfast and 1 gram after dinner, plus sulfasalazine or mesalamine was more effective than placebo combined with one of these two medications.  The mesalamine group had a 4.65% relapse rate (2/43), whereas the placebo group had a relapse rate of 20.51% (8/39).  A six month follow-up found eight more patients relapsed in the curcumin group and six additional patients relapsed in the placebo group.12

For additional information on curcumin, please refer to my blog post on turmeric below.

Plantago Ovata

Plantago ovata, also known as Desert Indian wheat or psyllim husk has been used as a medicinal plant.  Psyllium is often used as a bulk forming laxative to support normal bowel movements.  Psyllium is marketed as Metamucil.   We also have this product available in capsule form in the Sunshine Store.  There have been studies showing psyllium to be useful in the treatment of UC.13

Probiotics in Inflammatory Bowel Disease

Probiotics would seem to be helpful in IBD.  Ingesting “good” bacterial should fend off some of the “bad” gas-producing bacteria.  At the present time, the studies show that probiotic supplementation is a promising adjuvant treatment in ulcerative colitis.  It is best to use a combination Probiotic such as Probiotic-40 available below.   There is not enough clinical evidence to support the use of probiotics for Crohn’s disease at the present time.14

Inflammatory bowel disease can be a debilitating illness and may be dangerous in some cases.  This condition may lead to a decrease in the absorption of critical nutrients and can also lead to bleeding and/or intestinal obstructions.  I suggest visiting your physician on a regular basis, keeping a food journal, and consider adding nutritional supplements to your medication regimen.  Your physician can tell you if you are deficient in vitamin B-12 or other necessary vitamins or minerals.  I strongly recommend a turmeric supplement.  This is one of the healthiest natural herbs available today.  Psyllium may also be beneficial but caution should be observed as large fiber loads can increase IBS symptoms in some individuals.  Be sure to check with your physician before starting this or any other supplement. 

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

L-Arginine and Cardiovascular Disease, IVF, PCOS, and More..

What is L-Arginine

L-Arginine is an amino acid made naturally by our bodies and is used in protein biosynthesis.  It is also found in foods such as fish, poultry, red meat, and dairy products. L-Arginine is vital to overall health.  It is associated with the Krebs Cycle and is a part of the urea cycle where it carries nitrogenous waste.   This amino acid also causes vasodilation by its conversion to nitric oxide (NO).1

It is important in maintaining the acid-base balance of the body as the urea cycle is a significant consumer of bicarbonate.

We have recently added this supplement to our product line mostly to be used by athletes.  I will cover this, as well as some uses of L-Arginine in this post. 

L-Arginine and in vitro fertilization (IVF)

In vitro fertilization has become increasingly popular for couples who struggle to become pregnant.  This is often attempted during the later child-bearing years after the woman has failed to become pregnant.  There is some research to suggest L-Arginine can increase the number of oocytes collected in women attempting IVF.  This, however, has yet to be shown to improve the viable pregnancy rate.2

L-Arginine and Polycystic Ovary Syndrome (PCOS)

A small study of eight patients with polycystic ovary syndrome was published in December of 2009.  This study showed that a combination of L-arginine 1600 mg daily combined with N-acetylcysteine 1200 mg daily for a period of six months resulted in moderate improvement of menstrual function and decreased insulin resistance.3

L-Theanine Effects on Cardiovascular Disease and Exercise

L-Arginine may lessen angina symptoms and improve exercise and quality of life in angina patients according to a study published in 2002.4

Another randomized, double-blind cross-over study published in September of 2000, found that, although L-arginine supplementation did not affect exercise-induced changes in QT interval, QT dispersion, or the magnitude of ST segment depression, it significantly improved exercise tolerance.  This is most likely the result of improved peripheral vasomotion.5

Many studies have found L-arginine to be effective and decreasing both systolic and diastolic blood pressure.  This has been shown in healthy individuals, those with pulmonary hypertension, as well as patients with type 2 diabetes.6

 

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L-arginine also appears to have an additive vasodilation effect when combined with angiotensin converting enzyme (ACE) inhibitors and nitrate vasodilators when used for the treatment of hypertension.10

 

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Intermittent claudication associated with peripheral arterial disease symptoms have also been shown to improve with the administration of oral or intravenous L-arginine for short term periods (up to eight weeks). 15

 

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Although this is promising, walking speed, walking distance, or absolute claudication distance does not seem to improve with long-term (up to six months) administration of L-arginine. 18

 

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L-Arginine and Erectile Dysfunction (ED)

L-arginine has shown some promise in the treatment of erectile dysfunction.  A double-blind, placebo-controlled study of 50 men with organic ED showed significant improvement in sexual function in 9/29 (31%) of the treatment group but only 2/17 (11.8%) of the placebo group.  The nine patients in the treatment group that showed improvement all had initially low NOx but this level doubled by the end of the study.20

L-arginine seems to be effective in men with mixed-type impotence when combined with Pycogenol at 1.7 grams daily or when combined with both Pycogenol and aspartic acid when dosed at 0.69 grams daily.21

 

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L-Arginine and Statins

The combination of L-arginine and atorvastatin (Lipitor) has been shown to have a significant positive effect on the progression of atherosclerosis.  A study utilizing rabbits found this combination to achieve a 21% decrease in the total area of lesions and a 44% reduction in the area of abdominal lesions compared to the control group.23

A two-arm, randomized, double-blind study on 33 hypertriglyceridemic patients reported that L-arginine alone had no effect on serum lipids compared to placebo. When combined with simvastatin, however, led to a significantly larger reduction in triglycerides compared to placebo plus simvastatin.  This study also found L-arginine attenuated simvastatin-induced increases in aspartate transaminase and fibrinogen.24

L-Arginine and Body Building

L-arginine is popular with body builders because it helps in the synthesis of proteins.  As muscle mass increases, L-arginine helps signal muscle cells and encourages growth hormone release and the metabolism of fat.  This leads to a more defined, stronger, well-defined physique.  L-arginine can also improve endurance and muscle conditioning due to its vasodilation effects.  This increases blood flow to muscle during workout periods.

L-Arginine Drug Interactions

ACE inhibitors, Angiotensin Receptor Blockers (ARBs) and other antihypertensive agents The combination of L-arginine and ACE inhibitors may lead to increased vasodilation and a larger decrease in blood pressure.  When combined, the risk of hypotension exists. Examples include benazepril, captopril, Ramipril, losartan, valsartan, diltiazem, amlodipine, and many more.

Anticoagulants and Antiplatelet DrugsL-arginine may decrease platelet aggregation in humans.  Caution should be exercised when combining L-arginine with medications that increase bleeding risk.  Some examples are warfarin, apixaban, rivaroxaban, enoxaparin, clopidigrel, ticlodipine and others.

Isoproterenol and NitratesL-arginine may lead to increased vasodilation when combined with vasodilators leading to hypotension and dizziness.

Sildenafil (Viagra) – Although not reported in humans, combining L-Arginine with sildenafil may lead to increased vasodilation and dizziness as well.

Potassium-sparing diuretics – There have been some reports of L-arginine causing hyperkalemia in some patients.  Combining L-arginine with these medications may increase the risk of hyperkalemia.  Examples of these medications include amiloride, spironolactone, and triamterene.

Adverse Effects of L-Arginine

L-Arginine is generally well tolerated.  The most common side effects reported for this supplement are:

  • Abdominal pain
  • Bloating
  • Diarrhea
  • Nausea
  • Gout
  • Allergic reactions
  • Exacerbation of airway inflammation in asthmatic patients

L-arginine is an amino acid which helps in the synthesis of proteins.  It also leads to vasodilation and, in doing so, can be beneficial for relieving chest pain.  When combined with a statin, L-arginine leads to a decrease in atherosclerosis which may help prevent heart attacks.  It has also been shown to decrease both systolic and diastolic blood pressures.  Due to its vasodilation properties, L-arginine may help with the symptoms of erectile dysfunction. It may also help with some of the symptoms of polycystic ovary syndrome when combined with N-acetylcysteine.

We recently added L-arginine as a dietary supplement to our product line with the thought of making it available to body builders.  It can increase exercise tolerance and help create a sculpted, muscular body.  As it turns out, many other uses are possible with this substance. 

L-arginine is relatively safe and well tolerated as it is an amino acid found in the human body.  As with any other medication or supplement, allergic reactions are always a possibility.  These reactions are often due to fillers and other substances used to produce the dosage form rather than the active chemical.  Gastrointestinal side effects are always a possibility as well.

If you have any questions about L-arginine or any other medication or supplement, please feel free to send me an email.  I have spent over half of my life working with medications and supplements.   As I have expressed in the past, if I do not know the answer to your question, I will find it.  Have a great week and live a happy, healthy life.  Get plenty of exercise, drink adequate amounts of water, and eat whole foods.  You are worth it.

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Intermittent Fasting and Artificial Sweeteners, Bulletproof Coffee, Weight Loss, and More…

Is intermittent fasting (IF) good for you?

Does it work?

What are some tips for success?

My readers are aware that I have written about diets and nutrition in the past. Our family completed the Whole30 diet in October of 2019 and my wife and I were successful in sticking to the rules for the entire month. The kids couldn’t stick with it. They needed more carbohydrates and got very tired of stir fry’s and curry. Although we aren’t currently eating such a restrictive diet, much was learned during that month with regards to eating and how your body can feel differently when only whole foods are consumed.

Intermittent fasting (IF) was introduced to me by a pharmacist colleague a couple of years ago. He sent me some information via email and I decided to give it a try.

IF is a pattern of normal food intake combined with extended periods where little to no food is consumed. Restricting food intake to a time window of eight hours or less per day is also known as time-restricted feeding (TRF). As you can probably imagine, there are many ways to achieve this.

Alternate Day Fasting

During this plan, you can eat normally on even days and fast on odd days. During your fasting days you may drink non-calorie beverages such as coffee, tea or water. There are many books explaining this method. Probably the most popular is “The Every Other Day Diet” by Krista Varaday. The premise is you can eat all you want, half the time, and lose weight.

The 5:2 Diet

The 5:2 method involves eating normally for five days of the week and consuming only 500-600 calories on two consecutive days after that. I am unable to do this. Eating a few calories makes me hungry.

Lean Gains Protocol

This is also called the 16/8 method. This plan involves restricting your calorie intake to an eight hour period. In my opinion, this is a great place to start. Just pick an eight hour period during the day where you are allowed to eat, and fast for the rest of the day. You could eat from noon until 8:00 PM, for example.

The 20:4 Plan

This is the plan I follow. It is the most restrictive single day fast. This regimen allows for one meal per day. Many find this best for weight loss, ketone production, and mental sharpness. I do not recommend starting here, but you can work your way towards this goal. I suggest starting with the 16/8 method as mentioned above.

There are many more possibilities to choose from. Just google “intermittent fasting” and you will find many ideas. There are also several apps available for the iPhone to help you. Some of these include:

  • BodyFast Intermittent Fasting
  • Zero-Fasting Tracker
  • Simple: Fasting & Meal Tracker
  •  MyFast Intermittent Fasting

If you own an iPhone and want to try IF, I strongly suggest downloading one of these apps. It makes the process much easier. These apps also contain a ton of useful information on the subject.

I have been an “intermittent faster” my whole life. I very rarely eat breakfast because it tends to make me sluggish and hungry, and I find it causes unwanted GI symptoms, dizziness and increases my sugar cravings.

I have always read that you shouldn’t skip breakfast, but this strategy has never worked for my body. I have started using the intermittent fasting plan during the last couple of years where I only eat during a four hour window on weekdays. I do not do this on weekends because I find it too hard to accomplish.

I decided to write a post about the IFD because I wanted to report the available research to my readers. There are many benefits to this diet and I find it to be an effective method to keep my weight stable.

The Basis For Intermittent Fasting

It is no secret that, as a society, we overeat. Most of us eat at least three meals per day and snacks in between. This often leads to the consumption of too many calories predisposing our bodies to metabolic complications such as excessive visceral fat accumulation and insulin resistance. Lack of exercise makes these conditions even worse. The truth is, we are perfectly capable of surviving by eating less food, less often. There are many ways to practice IF. The benefits of these diets include:

  • Depletion or reduction of glycogen stores.
  • Mobilization of fatty acids.
  • Maintaining blood glucose levels in the low-normal range.
  • Reduced leptin and elevation of adiponectin levels.
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Behavioral effects are also possible and include increased alertness and improved mental acuity.4

Intermittent Fasting and Diabetes

The popularity of IF has revolved around losing or maintaining weight. This is what initially piqued my interest. It makes sense that if you eat for only a small portion of the day, you will likely consume less calories. Less calories means less weight. There are other benefits, however, which I have listed above. What do the studies say about IF and weight loss?

Most of the studies performed on intermittent fasting and weight loss are done during Ramadan. One such study, published in 2019, looked at the effects of intermittent fasting on individuals with metabolic syndrome (MetS).5

Metabolic syndrome is characterized by insulin resistance, hypertension, abdominal obesity, and poor lipid profiles. Most countries have a 20-30% prevalence of MetS among their adult population.6

It is important to point out that there are three general approaches most commonly investigated in studies of fasting.

  • Dietary restriction – One or more macronutrients are restricted with or without a total calorie reduction.
  • Intermittent fasting – Whole-day fasting or time-restricted feeding (TRF).
  • Daily caloric restriction – cutting 20-40% of daily caloric intake.

The 2019 study cited above showed a significant positive association between weight loss and the number of fasting days. The reduction of fat and body weight were achieved during the Ramadan fast while retaining lean mass. The non-fasting group showed no changes in weight. The fasting group experienced a decrease in both daily calorie intake, and physical activity. This led to a weight loss of 1.5 kg. This loss was 76% fat mass, 17% body fluid loss, and only 6% protein loss. The loss of body fat occurring in this study is higher than that reported from calorie restriction alone.7

A meta-analysis was published in February of 2018 reviewing intermittent fasting interventions for treatment of overweight and obese adults.8

This analysis included 400 subjects ranging in age from 37 years to 49 years. All participants were overweight or obese with a BMI range of (26.0 kg/m2 to 35.6 kg/m2). The studies contained in this analysis used different methods of IF. All but one study used self-reporting through food diaries to monitor compliance to the various protocols.

This meta-analysis found that intermittent fasting is as effective as the current clinical practice utilized for weight loss in overweight and obese individuals. Only a few studies met criteria to be included in this analysis, and most participants were women. These studies were of short duration and follow-up was very poor. Compliance was measured almost exclusively by diaries obtained by the subjects. Due to these issues, the researchers concluded that there was insufficient evidence at this time to recommend routine use of IF for weight loss in overweight and obese individuals. I did consult my personal physician and his take was that IF likely not cause harm and may indeed lead to weight loss. He stated that many of his patients utilize IF, especially athletes.

What to Drink During Fasting Periods

A common question people ask is “what can I drink during the fasting period?” My suggestions are listed below. If you ask several people about this, you will get many different answers. Always remember that no two people are the same. Find a plan that works for you and stick to it!

1. Water – This is my number one choice. Water is very good for your body and you need to remain hydrated. You should drink plenty of water daily whether or not you are fasting. You may add lemon slices to the water if you desire.

2. Bulletproof Coffee – This is one of my favorites. There are different ways to make this but I just use black coffee and add MCT oil to it. Others use butter and some add butter and MCT oil. The MCT oil I use is pictured below. I only drink one cup of coffee per day that contains one tablespoonful of MCT oil because the oil contains saturated fat. This special coffee helps curb hunger. You can also try one of our keto supplements if you find you are getting hungry or are low on energy.

3. Apple Cider Vinegar – I occasionally add 1-2 tablespoons of apple cider vinegar to my water for taste and health reasons. I wrote an entire article on this. Click the link above to read more about the benefits.

4. Tea – Tea is fair game as long as you don’t add sugar. I also advise against artificial sweeteners (see below.)

Intermittent Fasting and Artificial Sweeteners

I do not recommend using any artificial sweeteners during IF. These products are not good for your body and, in many cases, can cause sugar cravings. This means no diet sodas or sweet coffee. At least one study showed that these substances actually lead to glucose intolerance by altering the intestinal micro biota.9

If you must utilize artificial sweeteners, I recommend Stevia. I just prefer the brand you use does not contain glucose or sugar alcohols.

Risks of Intermittent Fasting

  1. Dehydration.  Be sure to hydrate especially during your fasting periods10

2. Increased afternoon urine osmolality.

This can also be avoided by adequate hydration. Remember to drink plenty of water during the day.11

3. Increased cortisol levels.

Fasting causes stress to our bodies. This leads to a release of cortisol which is our primary stress hormone. This may lead to an increase in fat storage although, as stated above, studies show that IF actually decreases fat.12

4. Increased guilt.

Inability to stick to the fasting regimen may cause one to feel guilty. I don’t put much stake in this as any diet may have this effect.

5. Decreased alertness.

Even though IF is known to improve alertness and concentration in the short term, it is possible that if enough calories are not consumed, one may actually become less alert and fatigued. Dizziness may also result. This can be easily rectified by simply eating more calories during your eating window.

I have been using the 20:4 intermittent fasting plan off and on for a couple of years. For me it was a fairly easy transition as I rarely eat breakfast. I just had to train myself to skip lunch. It was difficult at first, but I found the bulletproof coffee and drinking a lot of water helped me get through the day. I also only do this during the work week so I eat whatever I desire on weekends. I do not lose weight on this diet unless I am exercising regularly, but I don’t gain weight, either. It is a perfect solution for me.

My recommendation is to also check with a physician prior to initiating a diet, especially if you have diabetes or take medications. You should have routine check-ups with your physician and you may discuss diets at that time. Although IF is not for everyone, I do believe it can help most people achieve weight loss safely.

Some other pointers are:

  • Be sure to have healthy food available to eat during your feeding period. You do not want to fill up on junk food and empty calories.
  • Stay hydrated. Drinking plenty of water will help you feel less hungry and keep you from getting headaches and becoming lethargic.
  • Have a plan. Try different approaches to IF and pick the one that is right for you. Remember, we are all different.
  • Utilize an iPhone IF app. There are many to choose from. These apps are great for tracking your food intake, weight, and they contain valuable information to help you succeed.

I hope you have gained something positive from this post. My goal is always to help my readers live a happy, healthy life. If you have any topics you would like covered or have any questions for me, please reach out by email. I am always here to help.

Have a great week!

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Bipolar Depression Treatment – Seroquel, Latuda, and Others

The first line medication treatments for bipolar depression are explored along with signs and symptoms of mania and depression.

Ornish vs Mediterranean Diet, Which is Better

What is the healthiest diet?

 

How can I achieve sustainable weight loss?

 

Is it possible to prevent, reverse or control type 2 diabetes with diet?

 

Those who have been following my blog know that I believe in the following key strategies to live a happy, healthy, healing lifestyle:

 

  • Eat whole foods
  • Exercise
  • Drink plenty of water
  • Get 7-8 hours of sleep per night
  • Control stress and anxiety
  • Spend as much time as possible with your happiness elements

 

This post will focus on the best diet to achieve weight loss and keep your body as healthy as possible.  Our family tried the Whole30 diet in October.  It was challenging for us all, but some major lessons were learned from the experience.  First, it is amazing how good you feel when crappy foods are eliminated from your diet.  Your thoughts are clear, your energy level improves, and you feel better in general.  Secondly, your skin improves, you look healthier, and sugar cravings disappear.  Although this diet is hard to continue indefinitely based on its restrictions, I do recommend trying it to get an idea of how the food you eat effects your life.

 

Let’s look at two different diets that may help you.

Dean Ornish’s Spectrum Diet

Dr. Dean Ornish has created a program which is similar to what I believe will lead to a healthier you.  His program claims to be able to reverse heart disease, diabetes, prostate cancer, and lead to weight loss.  Dr. Ornish believes that foods are neither good nor bad, but some are healthier than others.  He believes eating more of the healthy foods such as

 

  • Fruits
  • Vegetables
  • Whole grains
  • Nonfat dairy
  • Fats that contain omega 3 fatty acids
  • Legumes
  • Soy products
  • Egg whites

 

can have anti-aging, anti-cancer, and anti-heart disease effects.  Like me, Dr. Ornish emphasizes whole foods.  Processed foods should be limited.  He believes eating mostly plants in their natural form will lead to better health.

 

Ornish’s diet does not restrict calories unless weight loss is a goal.  He believes in small frequent meals throughout the day which maintain energy levels and controls hunger.

Carbohydrates

This diet limits the following “bad” carbs

 

  • Sugar
  • Concentrated sweeteners
  • White flour
  • White rice
  • Refined carbohydrates

 

Added sugars such as agave, honey, white or brown sugar, maple syrup and refined carbohydrates are limited to 2 servings per day. 

 

Alcohol can be consumed in limited quantities, but is not encouraged and is limited to one serving per day or

 

  • 5 ounces liquor
  • 4 ounces wine
  • 12 ounces beer

Fats

The Ornish diet recommends 4 grams of good fats daily.  These include

 

  • Fish oil
  • Flax seed oil
  • Nuts
  • Seeds
  • Plankton based omega-3 fatty acids

 

Limit calories from fats to 10% or less.  This diet achieves this by not adding fats, oils, avocados, coconut, or olives to the mostly plant-based diet.  The fat will come naturally from grains, vegetables, soy, fruit, legumes, and beans.

 

Cholesterol is limited to 10 mg or less per day.  Non-fat dairy products are optional but should be limited to 2 servings per day.  Alternatives such as soy milk are preferred as they are rich in healthy nutrients and are cholesterol-free.

 

Since nuts contain large amounts of fat, serving sizes are limited.  Three servings of the following types of nuts are recommended.  These specific types contain antioxidants, phytochemicals, and polyphenols which convey cardiovascular benefits.

 

  • 5 tsp pumpkin seeds
  • 6 peanuts
  • 3 pecan halves
  • 1 whole walnut
  • 5 almonds
  • 9 pistachios
  • 2 cashews
  • 5 tsp flax seeds, ground
  • 2 tsp chia seeds or sunflower seeds

 

Low fat packaged foods are not encouraged, but optional.  Remember, whole foods are preferred.

 

 

Protein

Protein, obtained mostly from plants, is encouraged by the Ornish diet.  Examples include.

  • Beans
  • Legumes
  • Tofu
  • Tempeh
  • Egg Whites
  • Non-fat yogurt
  • Non-fat cheese

Other Recommendations

Flavoring foods with herbs, spices, vinegar, and citrus fruits is preferred over salt.  If you are a coffee drinker, limit coffee to one cup per day, or two cups decaf or black or green tea.  Supplements may be taken as well.  Dr. Ornish recommends a low-dose multivitamin and mineral supplement with vitamin B-12, fish oil, and calcium supplements if directed by a physician.

All information regarding the Ornish diet was obtained directly from his website at:

https://www.ornish.com/proven-program/nutrition/

 

The Mediterranean Diet

The Mediterranean Diet is a way of eating in countries that surround the Mediterranean.  The basic guidelines are as follows.

Foods to eat daily:

  • Whole grains
  • Beans
  • Spices
  • Healthy fats
  • Herbs
  • Fruits
  • Vegetables
  • Nuts

To be consumed twice a week:

  • Fish
  • Seafood

Moderate portions of:

  • Dairy products
  • Eggs
  • Poultry (occasional)

Foods to consume infrequently:

  • Red meats
  • Sweets

There are many websites devoted to a Mediterranean diet and lifestyle.  One of my favorites is http://www.oldwayspt.org

This pyramid is found on that site.  This gives a visual explanation of what I have written above.

Why the Mediterranean Diet?

Studies have shown that this diet achieves better results than other diets in many areas:

  1. A 50% lower risk of type 2 diabetes compared to low fat diets.1

 

  1. Lower blood sugars in type 3 diabetics compared to other diets.2

3
  1. More effective for sustainable weight loss.4

5
  1. Lower rates of cancer, dementia, heart disease, stroke, and overall dementia.6

  1. More favorable cholesterol, blood sugar and inflammation levels compared to low fat diets.7

It is important to realize that what you actually eat depends on your situation and what you are trying to achieve.  The above Mediterranean diet pyramid shows what to eat in general. 

Since most are likely reading this because they want to lose weight, here are some pointers.  Remember, if you are at your goal weight, just eat according to the pyramid above.

Try to stop eating and drinking sweet foods and beverages

This includes those with artificial sweeteners.  Even fruit juices should be avoided.  These items are high in empty calories and can spike insulin levels.  If you refrain from eating sweets, your cravings for them will decrease.  I noticed when on the Whole30 diet that fruits will also start to taste much sweeter and become more enjoyable to consume.

Avoid grains, even whole grains. 

If you want to lose weight, or are having trouble controlling blood sugar, avoiding all grains is important.  Grains contain high levels of carbohydrates.  Grains fit into three broad categories.

     Highly-refined grains

Any foods made with white, wheat or enriched flour.  Some examples include bagels, focaccia bread, pizza, pancakes, pastries, donuts, cookies, chips, pretzels etc.  White rice, tortillas, most granola bars, and ready-to-eat breakfast cereals also fit into this category.  Highly refined grains should ALWAYS be avoided.

     Moderately-processed whole grains

These foods are not as processed as the highly refined carbs but contain rapidly-metabolized starches which spike blood sugar levels much like their highly-refined counterparts. Examples in this category include whole grain versions of pastas, crackers, breads, couscous, brown rice cakes, puffed grain cereals, muesli, and granola.  People at goal weight without diabetes, high triglycerides, or insulin resistance can eat moderately-processed whole grains in limited quantities.

     Intact whole grains

These are grain products that have not been processed.  Examples include whole unpearled barley, wheat and rye berries, oat groats, brown rice and millet.  These are the healthiest grains available but, again, should only be eaten by those who are at goal weight, don’t suffer from diabetes, insulin resistance, or high triglyceridemia.

Eat nine servings of whole fruits and vegetables daily but eat the vegetables first

Most frozen vegetables are almost as good as the fresh variety.  Be sure to eat more vegetables than fruit and eat vegetables with every meal, even breakfast.  Eat the vegetables whole instead of juicing them.  Steer away from starchy vegetables such as potatoes.  Keep serving sizes of yams, carrots and sweet potatoes small.

All fruit is not created equal.

The best fruits to eat are apples, pears, berries and citrus fruits.  Dried fruits should be avoided as they contain concentrated sugars.  The only exception is dried prunes which have a lower glycemic load.  Higher sugar fruits such as bananas, pineapple, grapes and mangoes should be consumed in moderation.

Eat beans and legumes regularly

These are best prepared from the dry versions.  Be careful when using canned beans.  Many contain added sugars and fat.  Beans and legumes add vegetable protein to the diet and have less of an impact on weight gain and blood sugar than whole grains.

Try to eat good fat, protein and fiber with each meal and snack

This has a couple of benefits.  First, blood sugar will rise more slowly and increase satisfaction.  Secondly, combining these leads to a longer digestion time which curbs hunger. 

Don’t skip meals. 

I know intermittent fasting is currently popular and I like to practice it myself.  Eating a good breakfast and small, frequent meals has been shown to help with weight loss.

Eat unsweetened cultured dairy products. 

Some studies have shown that eating dairy reduces diabetes and obesity risk.  It is also better to choose whole or 2% milk products instead of the low-fat or non-fat variety.  Eating aged cheeses is preferable to drinking milk.  Kefir and yogurt can be a great source of microorganisms (probiotics), calcium and protein.  It is always best to consume plain yogurt and sweeten it yourself.  I like to use blueberries, raspberries and blackberries for this purpose.

Always read food labels. 

Don’t fall for marketing slogans such as “healthy” or “low-fat.”  Avoid packaged foods that contain added sugar, refined grains and bad fats.  Remember, it is always best to eat whole foods whenever possible.  If it doesn’t come with a label, it is probably much healthier for your body.

Plan ahead. 

Often we make poor choices when in a hurry or when we haven’t purchased the correct ingredients for healthy meals.  Stay away from fast food and limit trips to restaurants. 

Exercise!  

My readers are probably tired of hearing this but it is probably the most important key to health, happiness and weight loss.  Be active, take the stairs, park further from your destination and walk.  There are many ways to get exercise, you don’t necessarily have to live at the gym to accomplish this.

Get enough sleep. 

This is another thing that comes up over and over in my posts.  Lack of sleep puts you at a higher risk for type 2 diabetes.

Let's Compare the Two Diets

Now that we have explored these two diets, we can compare them.  They are actually not that much different.  They both rely on fruits and vegetables as the primary food source and both prefer you eat the “whole” versions of these.  They both restrict refined sugars, processed foods, and unhealthy carbohydrates.

  The Ornish diet allows 2 servings of “bad carbs” daily whereas the Mediterranean diet advocates consuming them as a treat or on special occasions. 

Fat consumption in the Ornish diet is only 10% of the daily caloric intake whereas the Mediteranean diet allows for approximately 29% fat on a daily basis. 

Every physician I have consulted regarding diets has recommended the Mediterranean diet over all others.  The primary reason for this is the large quantity of clinical data available to support it for heart disease, diabetes treatment and prevention as well as the prevention of neurodegenerative disorders such as Parkinson’s disease and Dementia.  The prevention of dementia is of upmost importance to me as I work on a hospital unit that cares for these patients.  This disease is devastating for both the patient as well as the family and care-givers.  Anything I can do to prevent this disease is worth the effort.

U.S. News and World Report ranked 35 diets and ranked the Mediteranean diet #1 and the Ornish diet #9. 

https://health.usnews.com/best-diet/best-diets-overall

This isn’t surprising considering the evidence available.  The main complaint surrounding the Ornish diet was the finding that the fat limitation made the diet hard to adhere to.  Nevertheless, this diet is very good for your heart and is also supported by quality evidence.  I see no problem following this diet if you are able to stick to it.  You will likely lose weight and feel great.  It follows all of my “rules” which are explained at the beginning of this post. 

I plan to stick with the Mediterranean diet for now.  My main reason for this is the evidence supporting its effect on the progression of neurodegenerative diseases.  I have no problem recommending the Ornish diet as well.  I have researched it and find it to be a great alternative for weight loss.  I recommend you take a look at both and make your decision based on what you can maintain.  A diet only works if you are able to stay on it.

As always, if you have any questions or comments positive or negative, please let me know.  I would also love to hear topics you are interested in reading about.  The goal is to keep you informed about anything that supports a happy, healthy, healing lifestyle! 

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Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

14 Surprising Berberine Uses

The newest supplement available in the Sunshine Store is berberine. We chose to add this product based on the evidence available on its usefulness. As you will learn from this article, berberine may be useful for a variety of health-related conditions. It is one of the few herbal supplements that can have similar effects on the body as prescription medications.

Berberine has been used in Chinese and Ayurvedic medicine for thousands of years. This yellow, bitter alkaloid is found in the roots, bark, and rhizomes of plants such as Oregon grape, goldenseal, European barberry, and tree turmeric, among others.  

What is berberine used for?

Is it safe?

Are there drug interactions?

As mentioned above, berberine has a variety of uses. Some of the most popular are listed below.

Berberine for Diabetes

Berberine has been shown to have a positive effect on diabetes in several studies. 

Some of these effects are listed below.

Taking 500mg of berberine twice daily for three months in patients with type 2 diabetes may reduce glycated hemoglobin (HbA1c), post-prandial glucose (PPG), and fasting plasma glucose (FPG).1

Taking berberine 500mg two to three times daily for two to three months works as well as metformin two to three times a day or rosiglitazone 4mg daily in the regulation of glucose metabolism in type 2 diabetics.

2

 

Berberine for Hypertension

Hypertension is a growing problem. Approximately one million visits to emergency departments listed hypertension as the primary diagnosis in 2016.

3

 

This condition often does not have symptoms associated with it and can go unnoticed for years. 

Hypertension can damage your arteries, heart, kidneys, eyes, and brain. It may lead to stroke, dementia, kidney failure, and blindness.

A meta-analysis showed that combining berberine with amlodipine is more effective at reducing blood pressure than taking amlodipine alone.

4

Source: 5

Berberine for Polycystic Ovary Syndrome (PCOS)

There have been studies examining the use of berberine in women with PCOS who were attempting to become pregnant. Although there are mixed results, one study showed that 500mg of oral berberine taken three times daily for three months before IVF increased pregnancy and live birth rate. These results were similar to those obtained when taking oral metformin 500mg three times daily for three months before IVF.

6

Berberine for Hyperlipidemia

Meta-analyses show that berberine may reduce total cholesterol (TC), triglycerides (TG), and LDL (bad) cholesterol. 

It can also increase HDL (good) cholesterol levels. It also leads to a more significant reduction in TC and LDL when combined with lipid-lowering medications.

7

 

8

 

9

 

Berberine may also be useful for the following conditions, although less quality evidence is available to support its use for these.

Congestive heart failure (CHF) – May reduce premature ventricular contractions and lower mortality.

Burns – As an ointment in combination with beta-sitosterol.

10

Cholera

Coronary heart disease (CHD) – See hyperlipidemia above.

Diarrhea – May be effective for diarrhea caused by E. coli.

11

Glaucoma – As eyedrops in combination with tetrahydrozoline.

12

Hepatitis B and C – Berberine decreases triglycerides and blood glucose. It also reduces markers of liver damage, including aspartate aminotransferase (AST) and alanine aminotransferase (ALT).

13

Irritable bowel syndrome (IBS) – May reduce the frequency of abdominal pain, diarrhea, and defecation frequency when compared to placebo.

14

Symptoms of menopause – When taking berberine along with soy isoflavones, vasomotor symptoms in menopausal women may be decreased when compared to calcium plus vitamin D administration.

15

Obesity – Berberine has been shown to decrease weight by 2.3 kg (~5 lbs) in obese patients compared with a control group when ingested for twelve weeks.

16

Berberine interactions with Drugs:

Drugs used to treat diabetes – Do not use berberine with antidiabetic medications. There is substantial clinical evidence suggesting this combination increases the risk of hypoglycemia. Berberine should not be used with any drug that lowers blood sugar. 

This includes insulin as well as other oral and injectable diabetes medications.

17

 

18

 

19

Amlodipine and other drugs for high blood pressure – Combining berberine with amlodipine may result in a decrease in both systolic and diastolic blood pressure.

20

This effect may also occur with other antihypertensive medications.

Anticoagulants – Since berberine may inhibit platelet aggregation, caution should be used when combining it with antiplatelet or anticoagulant medications. 

The risk of bleeding may be increased.

21

 

22

Cyclosporine – Do not combine berberine with cyclosporine. This combination may result in an increased level and increased adverse effects of cyclosporine.

23

 

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Drugs that may cause sedation – Use caution when combining berberine with medications that produce sedation. 

This combination may lead to an increase in sedative effects. Some examples of sedative agents include.

  • Benzodiazepines
  • Narcotics
  • Barbiturates
  • Sedating antihistamines such as diphenhydramine and hydroxyzine
  • Anticonvulsants

There are other sedating medications, please contact your physician or pharmacist or send me a message to me for clarification.

Medications metabolized by Cytochrome P450 – There are several agents in this category. Below is a shortlist but again, if you have questions about what you are taking, please consult a physician or pharmacist, or simply shoot me an email.

26

Ibuprofen (Motrin) – May increase ibuprofen levels.

Losartan (Cozaar) – May decrease therapeutic effects of losartan.

Dextromethorphan (Robitussin DM, Delsym, others) – May increase dextromethorphan levels leading to drowsiness, irritability, and confusion.

Lovastatin (Mevacor) – May increase lovastatin levels.

Sildenafil (Viagra) – May increase sildenafil levels.

Tacrolimus – There has been at least one case report of berberine, causing an increased serum creatinine and tacrolimus level in a 16-year-old patient with idiopathic nephrotic syndrome.

27

Patients who take berberine along with tacrolimus should have drug levels checked as tacrolimus dose adjustment may be necessary.

Safety of Berberine in Pregnancy and Lactation

Berberine should NOT be used in pregnant or lactating women. Berberine is believed to cross the placenta and may cause kernicterus and harm the fetus. Berberine may also be secreted into breast milk when taken orally, so it should not be used by breastfeeding mothers.

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Side Effects of Berberine

Although berberine is generally well tolerated, the following side effects were the most commonly reported during research studies.

  • diarrhea
  • constipation
  • abdominal pain
  • abdominal distention
  • vomiting
  • flatulence

Berberine is a substance that has been used in other countries for its health benefits for thousands of years. I became interested in it while reading a book I recently purchased on nutraceutical preparation. This herbal product has the best evidence for its use in diabetes, hyperlipidemia, hypertension, and polycystic ovary syndrome. It can also be effective for several other ailments described above.

 

Berberine should never be used in children or pregnant or breast-feeding mothers. There is some evidence that it may be harmful to the fetus as well as small children. As a pharmacist, I believe in using herbs and medications in pregnancy or children only when absolutely necessary. The risk is just too substantial.

 

Berberine, along with turmeric and ashwagandha, has effects on the body that can rival prescription medications. It can be beneficial for those who have diabetes, PCOS, or obesity. It is generally well-tolerated and is now available in the Sunshine Store for purchase. 

 

Give it a try and let me know what you think.

Always remember to take care of yourself, eat whole foods, drink plenty of water, exercise, and get adequate sleep. These can significantly help in your quest for happiness.

 

 

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Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Abnormal Condition of Dry or Scaly Skin in Older Individuals

What can be done to prevent dry skin as you age?

The skin is the largest organ of the body. It serves as a barrier and protects us from bacteria. 

Skin also helps to regulate body temperature and allows us to respond to heat, cold, and touch. There are three layers that compose the skin.

  • Epidermis – This is the outer layer that serves as a barrier. The epidermis keeps pathogens from entering the body and regulated water being released from the body.
  • Dermis – The layer below the epidermis is called the dermis. This layer contains blood vessels, nerve endings, sweat glands, and hair follicles.
  • Hypodermis – This layer contains fat and connective tissue, and provides cushioning and insulation to the body.

Dermatologists are specialized physicians who diagnose and treat various conditions of the skin. This post will explore dry skin, its causes, treatments, and effects on the aging population.

Effects of Age on the Skin

As we age, our skin becomes thinner. The number of blood vessels, nerve endings, and the amount of connective tissue also decrease. These changes lead to a reduced ability to retain moisture, control body temperature, and sense the environment.

1

 

Pruritis, or itching, is the most common complaint involving the skin in older individuals. Short-term itching, less than six weeks, may protect us, but pruritis lasting more than six weeks can be bothersome. Pruritis can effect the quality of life and, in some cases, patients would rather live a shorter life without symptoms than live longer with pruritis.

2

 

Dry skin (xerosis) is more common in older individuals and those living in colder climates. Heating homes in the winter months leads to decreased humidity that can dry the skin.

Prevention of Dry, Itchy Skin

The best treatment for most anything is prevention. 

Dry, itchy skin is no exception. 

The first step is to monitor the health of the skin regularly. This can be done by scanning the body for problem areas. A physician may also perform skin monitoring during a routine physical exam. 

Some causes of dry skin include:

  • Cold, dry air during the winter months
  • Skin damage from the sun
  • Use of soaps and detergents that damage the skin
  • Excessive immersion in water (taking long baths)
  • Some diseases such as lymphoma, malnutrition, hypothyroidism, eczema, and others
  • Direct exposure to fan heaters3

     

    One of the best ways to prevent dry to skin is to eat an adequate amount of protein, vitamins, and fatty acids.

    4

Best Foods to Eat for Healthy Skin

What should you eat to help keep your skin healthy? In general, fresh fruits and vegetables are a good choice because of the vitamins and antioxidants. Below are some great suggestions.

  1. Salmon – Fatty fish, such as salmon, contain omega-3 fatty acids which reduce inflammation and keep the skin moisturized.5
  1. Bell Peppers – Bell peppers are an excellent source of beta-carotene, especially the red and yellow variety. Green bell peppers are picked before they turn color and do not contain as much beta-carotene, which is converted to vitamin A in the body. Bell peppers are also high in vitamin C, which helps keeps the skin healthy by helping form collagen.6

3. Broccoli –

7

Probably my favorite vegetable, broccoli, contains many vitamins and minerals necessary for good skin health, including:

  • Vitamin A
  • Vitamin C
  • Zinc

Broccoli, as well as cabbage, cauliflower, and kale, also contains sulforaphane. This substance may protect the skin from the sun’s damage, thus decreasing photoaging.

8
  1. Avocados – Packed with healthy fats, this guacamole ingredient can improve skin health by moisturizing and improving flexibility.9

Avocados also contain vitamins C and E, which act as antioxidants. One symptom of vitamin C deficiency is dry, scaly skin. Vitamin C also is needed to make collagen that helps keep skin healthy and strong.

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  1. Tomatoes – Another favorite of mine, tomatoes contain vitamin C, lycopene, and beta-carotene. 

These substances can protect skin from the sun and help prevent wrinkles.

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  1. Soy – Isoflavones are contained in soy. These have been shown to improve skin elasticity and decrease fine wrinkles in at least one study.13

Isoflavones can also protect the skin from the sun’s harmful rays.  

  1. Sweet potatoes – We started eating more sweet potatoes when consuming the Whole30 diet. These are an excellent beta-carotene source that can protect the skin from the sun. Sweet potatoes are a better option than white or yellow potatoes. Give them a try.
  1. Green leafy vegetables – spinach, kale, and collard greens contain vitamins A, C and E. They are also a good source of protein and spinach contains selenium which can protect the skin from UV rays.
  1. Eggs – These are a good source of protein, selenium, zinc, vitamin A and vitamin C.  

10. Healthy oils –  Extra virgin olive oil and fish oil can help with keeping the skin moist and pliable.

Dietary supplements may be necessary if you cannot get enough nutrients from the foods you eat. 

Some of these can be found in the Sunshine Store. The supplements listed below are the same as those contained in the foods above.  

  • Fish Oil
  • Vitamin A
  • Vitamin C
  • Vitamin E
  • Zinc
  • Selenium

Topical Agents for Dry Skin

Daily use of moisturizers that hydrate the skin is important. Some examples of ingredients that can help are:

 

Topical Urea – This is a molecule produced by our body that is naturally found in the skin. It is generated from the metabolism of proteins and other compounds. 

Urea is excreted in the urine and through sweating.

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Urea is one of the best moisturizing agents available to dermatologists today. It has been used safely for over a century and can be utilized for several skin conditions. Urea has different effects on the skin, depending on the concentration employed. At lower concentrations (~10% or less), it acts as a moisturizer, while at concentrations greater than 10%, it has an emollient/keratolytic action. Urea can also enhance the penetration of other molecules through the skin and is used in combination therapies.

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Other skin moisturizers available include glycerin, lactic acid, and petrolatum.

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Other Ways to Help Dry Skin

  • Avoid traditional soaps – regular soap can alkalinize the skin damaging the moisture barrier. Synthetic cleansers such as Dove, Olay, and Cetaphil are preferred.
  • Avoid excessive washing – This can worsen dry skin, especially if very hot water is used. 
  • Avoid aggressive scrubbing and use luke-warm water.
  • Use a Humidifier – Increasing humidity can help decrease skin drying, especially in the winter months.

 

 As we age, our bodies go through many transformations. Energy levels decrease, our kidneys and liver don’t work as well, and we have a higher percentage of body fat. Our skin also changes and becomes thinner, less pliable, and dry. If we don’t care for our skin, it can crack, leading to pain and possible infection.  

 

One of the best things you can do for your body at any age is to eat fresh, whole foods. If you eat a healthy, balanced diet, you are likely to help your skin stay strong and healthy. Always stay hydrated, exercise, and use high-quality moisturizing lotions. 

 

If you live in the northern part of the country where it is cold in the winter, consider using a humidifier to help decrease the effects of dry air on your skin.  

 

Avoid excessive bathing, especially with very hot water, as this may dry your skin. Stick with high-quality synthetic cleansers, and be sure to monitor your skin for dry, scaly areas. If you find problems with your skin, see your doctor. There are medicated creams and lotions available to help relieve the various skin conditions you may be suffering from.

Skin integrity is vital to our overall health. If you have any questions regarding this topic, or any other health or fitness related subject, feel free to contact us. If you have ideas for future blog posts, let me know. My goal is to keep you entertained and informed. Have a great day; be happy, healthy, and keep smiling.

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Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Female Pattern Hair Loss, PCOS Alopecia Treatment, What Works?

Female pattern hair loss (FPHL), also called female androgenic alopecia is a diffuse, non-scarring loss of hair.  The hair loss is most apparent in the frontal, central, and parietal scalp regions.  This condition is most common in adult females and its incidence increases with age.  Unfortunately, this disease shows variable responses to treatment.

1

Not surprisingly, FPHL can lead to low self-esteem, poor body image, depression, and a lower over-all quality of life.

We know that the hair follicle changes in alopecia are similar for men and women, but the presentation and response to therapy is different. 

FPHL normally occurs during the reproductive years.  The second peak occurs at menopause (50-60 years of age).  A study conducted in 2001 found a 3% incidence of FPHL among 1008 Caucasian women in their 30’s.  This prevalence increased slowly with age and was 32% in the ninth decade of life.  The combined prevalence was 19%.

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Minoxidil

The first line of treatment for FPHL is Minoxidil (Rogaine).  Many are familiar with Rogaine as it has been approved for use in men’s hair-loss since 2006.

We are not completely sure how minoxidil works but it is thought to promote the growth phase of the hair follicle, shorten the resting phase, and enlarge miniaturized follicles.

3

 In 2014, 5% minoxidil was approved for FPHL.  Before this, only 2% minoxidil solution was approved for use in women.  Studies have shown that once daily application of a 5% foam is as effective as twice daily application of a 2% solution.  This is important because once daily application is more convenient for the patient. 

There are side effects associated with the use of minoxidil.  During the Rogaine clinical trials conducted by Johnson and Johnson, the following side effects were reported in at least 2% of the study participants.

  • Weight Gain
  • Headache
  • Itching
  • Nasal and upper respiratory tract infections        4

    5

One of the common concerns among women using hair growth products is the worry of hair growing in the wrong places.  Hypertrichosis has been reported with both strengths of minoxidil but is significantly less with the 5% foam.

6

It is recommended that minoxidil be applied at least 2-4 hours prior to bedtime with hands thoroughly washed after application to limit unwanted hair growth on the face.

Although I do own stock in Johnson and Johnson, I currently am not paid for promoting their products.  I have included the link to the Rogaine site below as a convenience to my readers.  Both 2% solution and 5% unscented foam are available at:

https://www.rogaine.com/products/womens-hair-regrowth-solutions#women

Other Treatment Options

If Minoxidil is ineffective, other medications may be tried.  It is important to note that although these secondary treatments may be tried, no conclusive evidence supporting their effectiveness is available.  In fact, a Cochrane Review including 47 trials with 5290 subjects, found only minoxidil to be effective for FPHL.

7

Although evidence is lacking, these systemic treatments are still utilized in some situations.  They will be briefly discussed here.

Spironolactone

Spironolactone is an aldosterone antagonist.  It works by blocking androgen receptors and has some inhibition of androgen synthesis.

8

It is usually the initial second-line agent employed for FPHL because it is often used in women for other indications such as acne, hirsutism, and polycystic ovarian syndrome.  This gives providers more confidence in regards to side effects and tolerability.  Spironolactone has limited positive data available for its use in FPHL.  One open-label study treated patients with either spironolactone or cyproterone.  The average duration of treatment in this study was 16 months.  There was not difference between the groups.  Forty-four percent of the patients experienced regrowth of hair, forty-four percent showed no change, and twelve percent had continued hair loss.

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Finasteride

Finasteride is often used to treat baldness in men.  It works by inhibiting the conversion of testosterone to dihydrotestosterone.  This medication is usually well tolerated in females and because of the limited options for women who fail minoxidil, it may be another option.

10

Flutamide

Flutamide has a few studies supporting its usefulness in FPHL.  In one prospective cohort study of 101 premenopausal women, flutamide was associated with an average of 15% improvement of hair thickness at six months and 28% at two years.

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Another case study found flutamide reversed hair loss in a patient who had failed treatment with a combination of spironolactone and topical minoxidil.

12

Flutamide is associated with side effects such as decreased libido, GI distress and rarely liver failure.  The threat of liver failure has limited flutamide’s use in FPML.

Low-Level Laser Light Therapy (LLLT)

Photobiomodulation therapy, or low-level laser light therapy has also been used to treat FPHL.  A study published in 2014 in The American Journal of Clinical Dermatology found a clinically significant difference in terminal hair density between an FDA approved low-level laser product (Lasercomb) and a sham device.  This was a randomized, double-blind sham device controlled study of 128 male and 141 female subjects. 

The patients who used the Lasercomb also reported an improvement in hair thickness and an overall improvement of their hair loss condition as compared to the sham treated patients. 

There were no serious adverse effects reported with the use of the Lasercomb.  This device may be a good alternative for hair-loss patients who either do not respond to medications or have adverse effects or contraindications to available treatments.

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More information on the Ultima 9 Classic LaserComb can be found at:

https://hairmax.com/products/ultima-9-classic-lasercomb?variant=30328901664886&currency=USD&gclid=Cj0KCQiApt_xBRDxARIsAAMUMu_CUgG6KDzv5d4DMnuOrpiGeL5NHVb0edgODpcXETrwB8E1rGCknE8aArzhEALw_wcB

Surgery

When all other treatments fail, hair transplantation surgery is an option.  Unfortunately, this is not always effective as transplant failure is possible.  This procedure is also costly and time-consuming for the patient.  There may also be an increased amount of hair loss early on and pain and infection is also a risk.

 

PCOS Alopecia Treatment

Polycystic ovarian syndrome (PCOS) alopecia is caused by an increase in male hormones.  Treatments for this are the same as those listed above.  In addition, birth control pills may be used to help decrease androgen levels.  Oral contraceptives not only help with hair loss but also can be effective for the treatment of other PCOS symptoms such as acne and irregular menstruation.  

There is evidence that weight loss in women with PCOS can also decrease androgen levels.  Even a loss of five to ten percent of body weight can have a significant effect on PCOS symptoms.14

Female pattern hair loss is an unfortunate ailment that increases in prevalence with age.  This condition leads to poor self-esteem, a distorted body image, and may even lead to depression.  Unfortunately, the treatments available for this disorder are scarce.  The only scientifically proven method is topical minoxidil, or Rogaine.  Other treatments have been used with some success but are not well supported by the clinical literature. 

Please leave any questions or comments below.  Thanks for reading, and have a great day!

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

The 2019 Novel Coronavirus – What You Need to Know

Coronaviruses are a group of viruses that can be transmitted between animals and humans.

These viruses can cause mild ailments such as the common cold as well as more severe infections requiring hospitalization.

The latest outbreak initiated in China has already killed 427 people worldwide, as reported by NBC News on February 4th, 2020. This is alarming since this virus has only recently been identified as 2019-nCoV on January 7th, 2020.

How is this virus spread?

What can you do to protect yourself?

How Does This Virus Spread?

Since this is a new virus, we can only speculate on how it is transmitted.  It can be assumed that its spread is similar to other coronaviruses.  These viruses are normally spread by close physical contact (usually six feet or less). 

Droplet transmission is the most likely culprit. 

When an infected patient coughs or sneezes, droplets may be inhaled by others or land in their mouths or noses.  It may also be transmitted by touching a surface contaminated with these droplets and then touching the mouth, eyes, or nose, but this is not currently confirmed.

There is no vaccine against this virus at the current time.

Coronavirus Symptoms

The symptoms of the new 2019-nCoV virus are as follows

  • Fever over 100.4 degrees
  • Muscle aches
  • Breathing problems
  • Malaise
  • Cough

Some people with this virus will show no symptoms but may still spread the virus to others.  Some patients may have severe symptoms such as pneumonia, hypoxia, and even death.

The risk of death is higher in those who are immunocompromised, prone to pneumonia, elderly or frail.

Coronavirus Treatment

There is currently no treatment for this virus other than supportive measures.  Viruses are difficult to treat with medications.  A hospital stay may be necessary to keep the patient comfortable and prevent the condition from deteriorating.  In severe cases, being treated in the ICU to support breathing may be necessary. 

The FDA has approved the use of hydroxychoroquine (Plaquenil) on 3/30/2020 for the treatment of COVID-19.  This drug helps dry secretions in the lungs.  One of the main causes of death from this virus is respiratory failure.

Prevention of Coronavirus

The best way to prevent this infection is to stay away from others who have it, wash your hands often, and clean work surfaces used by others frequently.  Since it is not possible to know who has the virus, the recommendation is to stay six feet away from everyone.  It is also mandated that people in the USA stay home unless they must shop for food or are in critical positions and must go to work.  The social distancing guidelines are in effect until April 30, 2020.

If you are not familiar with the correct hand-washing technique, please refer to:

 https://www.cdc.gov/handwashing/

  • Hand washing is extremely important for optimal health.
  • If you don’t need to travel to China, don’t. 
  • Avoid touching your eyes, nose, or mouth with unwashed hands.
  • Cough or sneeze into a tissue and promptly throw the tissue in the trash.

If you are living with someone who you think may be infected with coronavirus, do the following:

  • Stay in a separate room and use a different bathroom if possible
  • Clean all surfaces the infected person may have had contact with well!
  • Wear disposable gloves, a disposable gown, and a face mask when caring for them, be sure to wash your hands thoroughly after providing care.
  • Have the infected person wear a mask if possible. If this causes breathing problems, others in the same room as the patient should wear a mask.
  • Keep all surfaces very clean, especially ones the patient comes into contact with.

What if I Get Infected?

If you believe you have contracted this virus, see your doctor.  This is especially important if you have a high fever or trouble breathing.  Do not go to highly populated areas as this may cause the disease to spread.  Stay home from work.  If you are severely ill, go straight to the emergency room. 

The hospital or doctor will test you to confirm you are infected with 2019-nCoV.

It is important to stay away from elderly patients, those who are immuno-compromised, small children and anyone who is susceptible to pneumonia if you suspect you may have this virus. 

Protecting yourself against the coronavirus is much the same as avoiding other illnesses.

Stay away from other infected individuals.

Wash your hands often.

Do not travel to destinations where the disease is prevalent.

Wear protective clothing (masks, gowns, gloves) when caring for others with the condition, and keep yourself in good physical condition.

This virus is more dangerous in those with pre-existing respiratory problems, those who are immunocompromised, and the elderly and frail.

If you have any questions, feel free to contact me.

UPDATE

 As of 03/30/2020, there have been over 143,000 deaths attributed to this virus in the USA.  This has turned out to be much worse than originally thought.  The best resource I have been able to find for updated information can be found at the link below.

https://coronavirus.jhu.edu/

Stay safe, and always remember to be happy and healthy.  Please follow the guidelines issued by the government regarding this virus.  Many lives depend on it!

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.