Benign prostatic hyperplasia (BPH). latest advances.


Definition

Prostate gland enlargement is a common condition as men get older. Also called benign prostatic hyperplasia (BPH), prostate gland enlargement can cause bothersome urinary symptoms. Untreated, prostate gland enlargement can block the flow of urine out of the bladder and cause bladder, urinary tract or kidney problems.

There are several effective treatments for prostate gland enlargement, including medications, minimally invasive therapies and surgery. To choose the best option, you and your doctor will consider your symptoms, the size of your prostate, other health conditions you might have and your preferences.

Symptoms

The severity of symptoms in people who have prostate gland enlargement varies, but symptoms tend to gradually worsen over time. Common signs and symptoms of BPH include:

  • Frequent or urgent need to urinate
  • Increased frequency of urination at night (nocturia)
  • Difficulty starting urination
  • Weak urine stream or a stream that stops and starts
  • Dribbling at the end of urination
  • Straining while urinating
  • Inability to completely empty the bladder

Less common signs and symptoms include:

  • Urinary tract infection
  • Inability to urinate
  • Blood in the urine

The size of your prostate doesn’t necessarily mean your symptoms will be worse. Some men with only slightly enlarged prostates can have significant symptoms, while other men with very enlarged prostates can have only minor urinary symptoms.

In some men, symptoms eventually stabilize and might even improve over time.

Other possible causes of urinary symptoms

Conditions that can lead to symptoms similar to those caused by enlarged prostate include:

  • Urinary tract infection
  • Inflammation of the prostate (prostatitis)
  • Narrowing of the urethra (urethral stricture)
  • Scarring in the bladder neck as a result of previous surgery
  • Bladder or kidney stones
  • Problems with nerves that control the bladder
  • Cancer of the prostate or bladder

When to see a doctor

If you’re having urinary problems, discuss them with your doctor. Even if you don’t find urinary symptoms bothersome, it’s important to identify or rule out any underlying causes. Untreated, urinary problems might lead to obstruction of the urinary tract.

If you’re unable to pass any urine, seek immediate medical attention.

Causes

The prostate gland is located beneath your bladder. The tube that transports urine from the bladder out of your penis (urethra) passes through the center of the prostate. When the prostate enlarges, it begins to block urine flow.

Most men have continued prostate growth throughout life. In many men, this continued growth enlarges the prostate enough to cause urinary symptoms or to significantly block urine flow.

It isn’t entirely clear what causes the prostate to enlarge. However, it might be due to changes in the balance of sex hormones as men grow older.

Comparing normal and enlarged prostate glands
At normal size, the prostate gland is about the size and shape of a walnut or golf ball. When enlarged, the prostate may obstruct urine flow from the bladder and out the urethra.

Risk factors

Risk factors for prostate gland enlargement include:

  • Aging. Prostate gland enlargement rarely causes signs and symptoms in men younger than age 40. About one-third of men experience moderate to severe symptoms by age 60, and about half do so by age 80.
  • Family history. Having a blood relative, such as a father or brother, with prostate problems means you’re more likely to have problems.
  • Ethnic background. Prostate enlargement is less common in Asian men than in white and black men. Black men might experience symptoms at a younger age than white men.
  • Diabetes and heart disease. Studies show that diabetes, as well as heart disease and use of beta blockers, might increase the risk of BPH.
  • Lifestyle. Obesity increases the risk of BPH, while exercise can lower your risk.

Complications

Complications of enlarged prostate can include:

  • Sudden inability to urinate (urinary retention). You might need to have a tube (catheter) inserted into your bladder to drain the urine. Some men with an enlarged prostate need surgery to relieve urinary retention.
  • Urinary tract infections (UTIs). Inability to fully empty the bladder can increase the risk of infection in your urinary tract. If UTIs occur frequently, you might need surgery to remove part of the prostate.
  • Bladder stones. These are generally caused by an inability to completely empty the bladder. Bladder stones can cause infection, bladder irritation, blood in the urine and obstruction of urine flow.
  • Bladder damage. A bladder that hasn’t emptied completely can stretch and weaken over time. As a result, the muscular wall of the bladder no longer contracts properly, making it harder to fully empty your bladder.
  • Kidney damage. Pressure in the bladder from urinary retention can directly damage the kidneys or allow bladder infections to reach the kidneys.

Most men with an enlarged prostate don’t develop these complications. However, acute urinary retention and kidney damage can be serious health threats.

Having an enlarged prostate doesn’t affect your risk of developing prostate cancer.

Preparing for your appointment

You might be referred directly to a doctor who specializes in urinary issues (urologist).

What you can do

  • Make a list of your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Keep track of how often and when you urinate, whether you feel you’re completely emptying your bladder, and how much liquid you drink.
  • Make a list of your key medical information, including other conditions you might have.
  • Make a list of all medications, vitamins or supplements that you’re currently taking.
  • Write down a list of questions to ask your doctor.

Questions to ask your doctor

  • Is an enlarged prostate or something else likely causing my symptoms?
  • What kinds of tests do I need?
  • What are my treatment options?
  • How can I manage other health conditions along with an enlarged prostate?
  • Are there any restrictions on sexual activity?

Don’t hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them might give you more time to address any concerns. You might be asked:

  • When did you first begin experiencing urinary symptoms? Have they been continuous or occasional? Have they gradually worsened over time, or did they come on suddenly?
  • How often do you urinate during the day, and how often do you need to get up at night to urinate?
  • Have you ever leaked urine? Do you have a frequent or urgent need to urinate?
  • Is it difficult for you to begin urinating? Do you start and stop when urinating, or feel like you have to strain to urinate? Does it ever feel like you haven’t completely emptied your bladder?
  • Is there any burning when you urinate, pain in your bladder area or blood in your urine? Have you had urinary tract infections?
  • Do you have a family history of enlarged prostate, prostate cancer or kidney stones?
  • Have you ever had any trouble getting and maintaining an erection (erectile dysfunction), or other sexual problems?
  • Have you ever had surgery or another procedure that involved insertion of an instrument through the tip of your penis into your urethra?
  • Are you taking any blood thinners, such as aspirin, warfarin (Coumadin) or clopidogrel (Plavix)?
  • How much caffeine do you consume? What is your fluid intake?

Tests and diagnosis

Your doctor will start by asking detailed questions about your symptoms and doing a physical exam. This initial exam is likely to include:

  • Digital rectal exam. The doctor inserts a finger into the rectum to check your prostate for enlargement.
  • Urine test. Analyzing a sample of your urine can help rule out an infection or other conditions that can cause similar symptoms.
  • Blood test. The results can indicate kidney problems.
  • Prostate-specific antigen (PSA) blood test. PSA is a substance produced in your prostate. PSA levels increase when you have an enlarged prostate. However, elevated PSA levels can also be due to recent procedures, infection, surgery or prostate cancer.
  • Neurological exam. This brief evaluation of your mental functioning and nervous system can help identify causes of urinary problems other than enlarged prostate.

After that, your doctor might recommend additional tests to help confirm an enlarged prostate and to rule out other conditions. These additional tests might include:

  • Urinary flow test. You urinate into a receptacle attached to a machine that measures the strength and amount of your urine flow. Test results help determine over time if your condition is getting better or worse.
  • Postvoid residual volume test. This test measures whether you can empty your bladder completely. The test can be done using ultrasound or by inserting a catheter into your bladder after you urinate to measure how much urine is left in your bladder.
  • 24-hour voiding diary. Recording the frequency and amount of urine might be especially helpful if more than one-third of your daily urinary output occurs at night.

If your condition is more complex, your doctor may recommend:

  • Transrectal ultrasound. An ultrasound probe is inserted into your rectum to measure and evaluate your prostate.
  • Prostate biopsy. Transrectal ultrasound guides needles used to take tissue samples (biopsies) of the prostate. Examining the tissue can help your doctor diagnose or rule out prostate cancer.
  • Urodynamic and pressure flow studies. A catheter is threaded through your urethra into your bladder. Water — or, less commonly, air — is slowly injected into your bladder. Your doctor can then measure bladder pressure and determine how well your bladder muscles are working.
  • Cystoscopy. A lighted, flexible cystoscope is inserted into your urethra, allowing your doctor to see inside your urethra and bladder. You will be given a local anesthetic before this test.
  • Intravenous pyelogram or CT urogram. A tracer is injected into a vein. X-rays or CT scans are then taken of your kidneys, bladder and the tubes that connect your kidneys to your bladder (ureters). These tests can help detect urinary tract stones, tumors or blockages above the bladder.

Treatments and drugs

A wide variety of treatments are available for enlarged prostate, including medication, minimally invasive therapies and surgery. The best treatment choice for you depends on several factors, including:

  • The size of your prostate
  • Your age
  • Your overall health
  • The amount of discomfort or bother you are experiencing

If your symptoms are tolerable, you might decide to postpone treatment and simply monitor your symptoms. For some men, symptoms can ease without treatment.

Medication

Medication is the most common treatment for mild to moderate symptoms of prostate enlargement. The options include:

  • Alpha blockers. These medications relax bladder neck muscles and muscle fibers in the prostate, making urination easier. Alpha blockers — which include alfuzosin (Uroxatral), doxazosin (Cardura), tamsulosin (Flomax), and silodosin (Rapaflo) — usually work quickly in men with relatively small prostates. Side effects might include dizziness and a harmless condition in which semen goes back into the bladder instead of out the tip of the penis (retrograde ejaculation).
  • 5-alpha reductase inhibitors. These medications shrink your prostate by preventing hormonal changes that cause prostate growth. These medications — which include finasteride (Proscar) and dutasteride (Avodart) — might take up to six months to be effective. Side effects include retrograde ejaculation.
  • Combination drug therapy. Your doctor might recommend taking an alpha blocker and a 5-alpha reductase inhibitor at the same time if either medication alone isn’t effective.
  • Tadalafil (Cialis). Studies suggest this medication, which is often used to treat erectile dysfunction, can also treat prostate enlargement. However, this medication is not routinely used for BPH and is generally prescribed only to men who also experience erectile dysfunction.

Minimally invasive or surgical therapy

Minimally invasive or surgical therapy might be recommended if:

  • Your symptoms are moderate to severe
  • Medication hasn’t relieved your symptoms
  • You have a urinary tract obstruction, bladder stones, blood in your urine or kidney problems
  • You prefer definitive treatment

Minimally invasive or surgical therapy might not be an option if you have:

  • An untreated urinary tract infection
  • Urethral stricture disease
  • A history of prostate radiation therapy or urinary tract surgery
  • A neurological disorder, such as Parkinson’s disease or multiple sclerosis

Any type of prostate procedure can cause side effects. Depending on the procedure you choose, complications might include:

  • Semen flowing backward into the bladder instead of out through the penis during ejaculation
  • Temporary difficulty with urination
  • Urinary tract infection
  • Bleeding
  • Erectile dysfunction
  • Very rarely, loss of bladder control (incontinence)

There are several types of minimally invasive or surgical therapy.

Transurethral resection of the prostate (TURP)

A lighted scope is inserted into your urethra, and the surgeon removes all but the outer part of the prostate. TURP generally relieves symptoms quickly, and most men have a stronger urine flow soon after the procedure. After TURP you might temporarily need a catheter to drain your bladder, and you’ll be able to do only light activity until you’ve healed.

Transurethral incision of the prostate (TUIP)

A lighted scope is inserted into your urethra, and the surgeon makes one or two small cuts in the prostate gland — making it easier for urine to pass through the urethra. This surgery might be an option if you have a small or moderately enlarged prostate gland, especially if you have health problems that make other surgeries too risky.

Transurethral microwave thermotherapy (TUMT)

Your doctor inserts a special electrode through your urethra into your prostate area. Microwave energy from the electrode destroys the inner portion of the enlarged prostate gland, shrinking it and easing urine flow. This surgery is generally used only on small prostates in special circumstances because re-treatment might be necessary.

Transurethral needle ablation (TUNA)

In this outpatient procedure, a scope is passed into your urethra, allowing your doctor to place needles into your prostate gland. Radio waves pass through the needles, heating and destroying excess prostate tissue that’s blocking urine flow.

This procedure might be a good choice if you bleed easily or have certain other health problems. However, like TUMT, TUNA might only partially relieve your symptoms and it might take some time before you notice results.

Laser therapy

A high-energy laser destroys or removes overgrown prostate tissue. Laser therapy generally relieves symptoms right away and has a lower risk of side effects than does nonlaser surgery. Laser therapy might be used in men who shouldn’t have other prostate procedures because they take blood-thinning medications.

The options for laser therapy include:

  • Ablative procedures. These procedures vaporize obstructive prostate tissue to increase urine flow. Examples include photoselective vaporization of the prostate (PVP) and holmium laser ablation of the prostate (HoLAP). Ablative procedures can cause irritating urinary symptoms after surgery, so in rare situations another resection procedure might be needed at some point.
  • Enucleative procedures. Enucleative procedures, such as holmium laser enucleation of the prostate (HoLEP), generally remove all the prostate tissue blocking urine flow and prevent regrowth of tissue. The removed tissue can be examined for prostate cancer and other conditions. These procedures are similar to open prostatectomy.

Prostate lift

In this experimental transurethral procedure, special tags are used to compress the sides of the prostate to increase the flow of urine. Long-term data on the effectiveness of this procedure aren’t available.

Embolization

In this experimental procedure, the blood supply to or from the prostate is selectively blocked, causing the prostate to decrease in size. Long-term data on the effectiveness of this procedure aren’t available.

Open or robot-assisted prostatectomy

The surgeon makes an incision in your lower abdomen to reach the prostate and remove tissue. Open prostatectomy is generally done if you have a very large prostate, bladder damage or other complicating factors. The surgery usually requires a short hospital stay and is associated with a higher risk of needing a blood transfusion.

Follow-up care

Your follow-up care will depend on the specific technique used to treat your enlarged prostate.

Your doctor might recommend limiting heavy lifting and excessive exercise for seven days if you have laser ablation, transurethral needle ablation or transurethral microwave therapy. If you have open or robot-assisted prostatectomy, you might need to restrict activity for six weeks.

Whichever procedure you have, your doctor likely will suggest that you drink plenty of fluids afterward.

Lifestyle and home remedies

To help control the symptoms of an enlarged prostate, try to:

  • Limit beverages in the evening. Don’t drink anything for an hour or two before bedtime to avoid middle-of-the-night trips to the toilet.
  • Limit caffeine and alcohol. They can increase urine production, irritate the bladder and worsen symptoms.
  • Limit decongestants or antihistamines. These drugs tighten the band of muscles around the urethra that control urine flow, making it harder to urinate.
  • Go when you first feel the urge. Waiting too long might overstretch the bladder muscle and cause damage.
  • Schedule bathroom visits. Try to urinate at regular times — such as every four to six hours during the day — to “retrain” the bladder. This can be especially useful if you have severe frequency and urgency.
  • Follow a healthy diet. Obesity is associated with enlarged prostate.
  • Stay active. Inactivity contributes to urine retention. Even a small amount of exercise can help reduce urinary problems caused by an enlarged prostate.
  • Urinate — and then urinate again a few moments later. This practice is known as double voiding.
  • Keep warm. Colder temperatures can cause urine retention and increase the urgency to urinate.

Alternative medicine

The Food and Drug Administration hasn’t approved any herbal medications for treatment of an enlarged prostate.

Studies on herbal therapies as a treatment for enlarged prostate have had mixed results. One study found that saw palmetto extract was as effective as finasteride in relieving symptoms of BPH, although prostate volumes weren’t reduced. But a subsequent placebo-controlled trial found no evidence that saw palmetto is better than a placebo.

Other herbal treatments — including beta-sitosterol extracts, pygeum and rye grass — have been suggested as helpful for reducing enlarged prostate symptoms. But the safety and efficacy of these treatments hasn’t been proved.

If you take any herbal remedies, tell your doctor. Certain herbal products might increase the risk of bleeding or interfere with other medications you’re taking.

11 Fascinating Facts About the Human Heart.


Your heart is the center of your cardiovascular system. It is responsible for pumping blood through your body, carrying nutrients in and taking waste out. Having good cardiovascular health is an important factor of optimal wellness.

Sadly, many people do not pay enough attention to their cardiovascular system. According to a study published in the Journal of the American Heart Association (JAHA), one in 10 adult Americans has poor cardiovascular health.i This is often caused by a nutritionally-deficient processed food diet, a sedentary lifestyle, and chronic stress.

I truly believe that achieving optimal heart health is not difficult, as long as you follow a healthy diet and  lifestyle.*

The Structure of the Human Heartii

Your heart works as a “pump” to keep your blood moving inside of you, delivering nutrients and oxygen to all areas of your body while carrying away waste products and carbon dioxide. When your heart muscle contracts or “beats,” it pushes blood through your heart and all over your body.

There are three layers that make up your heart:

  • Pericardium – the thin outer protective sack
  • Myocardium – composed of specialized cells that make up the thick muscular wall
  • Endocardium – the thin inner lining of the heart

Inside your heart are four chambers: two on the left side and two on the right. The two small upper chambers are called the atria, and the two larger lower chambers are called the ventricles. The left and right side of your heart are divided by the septum, a muscular wall.

The human heart has four valves. The ones on the right side of your heart are called the tricuspid valve and the pulmonary valve, while the ones on the left are the mitral valve and the aortic valve. These valves act as gates that open and close, ensuring that your blood travels in one direction through your heart.

The heart gets its blood supply from the coronary arteries, which branch off from the aorta, the main artery. The coronary arteries spread across the outside of the myocardium and provide it with blood.

Although the two sides of your heart are separated, they still work together. The right side receives dark, de-oxygenated blood that has already circulated around your body. This blood is then pumped to your lungs, where it receives a fresh supply of oxygen and turns bright red again.

Try These Natural Heart-Healthy Strategies

When your heart and/or other parts of your cardiovascular system, such as your blood vessels, are not properly cared for, they will fail to function properly, which may lead to certain health issues.*

But the good news is you can maintain normal cardiovascular function by eating a healthy diet and exercising correctly. Here are some of my top recommendations:

  • Consume a well-balanced diet. Choose whole, organic foods rich in vitamins, minerals, and other nutrients, like l-arginine. Some heart-friendly foods you can eat include:
      • Olive oil
      • Coconuts and coconut oil
      • Organic raw dairy products and eggs
      • Avocados
      • Raw nuts and seeds
      • Organic grass-fed meats

    It is best to eat a good portion of your foods raw. Also, be sure to severely limit or eliminate grains and sugar, which are mostly found in processed foods, from your diet.

  • Get plenty of high-quality, animal-based omega 3 fats, such as krill oil.
  • Drink plenty of fresh, pure water every day.
  • Optimize your vitamin D levels through appropriate sun exposure. Many studies have proven the numerous benefits of vitamin D. However, you must first know what your current vitamin D level is. The optimal range is between 50-70 ng/ml, but if you have less-than-optimal heart health, I would recommend 70-100 ng/ml.
  • Get enough exercise. It improves not only your blood circulation, but your overall health as well. However, I do not advise doing prolonged, strenuous cardio such as marathon running, as it puts too much strain on your heart. Instead, opt for short-burst, high-intensity exercises like Peak Fitness, which also optimize your human growth hormone (HGH) production.
  • Maintain a healthy weight.
  • Get plenty of high-quality, restorative sleep.
  • Manage your stress.
  • Avoid smoking or drinking alcohol excessively.

human heart facts

FDA approves larger capacity Humalog insulin pen


The FDA recently approved a 200 units/mL Humalog KwikPen, a pre-filled, rapid-acting insulin pen designed to improve glycemic control in people with type 1 and type 2 diabetes, Eli Lilly and Company announced in a press release.

The Humalog KwikPen (insulin lispro 200 units/mL; U-200), the first concentrated mealtime insulin analogue in the U.S., holds twice as many units of insulin (600 units vs. 300 units) as the U-100 formulation in the same 3-mm cartridge, offering a longer-lasting option for people with diabetes. The U.S. approval follows the European Union approval of Humalog 200 units/mL KwikPen in Oct. 2014.

Humalog U-200 KwikPen delivers the same dose in half the volume of Humalog U-100 KwikPen with no dose conversions required, and can be dialed in one-unit increments to a maximum of 60 units per injection.

David Kendall , M.D., vice president of medical affairs for Lilly Diabetes, called the drug a new treatment option for those requiring increasing levels of insulin.

“Diabetes is a progressive disease that often requires increased doses of insulin over time to better control a patient’s blood sugar levels,” Kendall said in a statement. “Fewer pen changes per month may help people who require higher daily doses of mealtime insulin better fit their treatment in their daily lives.”

Approval was based on a demonstration of the bioequivalence of Humalog 200 units/mL relative to Humalog 100 units/mL in a pharmacokinetic/pharmacodynamic study.

Humalog is a rapid-acting human insulin analogue indicated to improve glycemic control in adults and children. The most common side effect of Humalog is hypoglycemia that may be severe and cause unconsciousness, seizures and death.

“We are proud to advance our commitment to supporting people with diabetes,” Mike Mason, vice president, U.S., Lilly Diabetes, said in a statement. “Humalog U-200 KwikPen is an example of our work to improve the patient experience. This product is the newest addition to Lilly’s growing portfolio of diabetes treatment options for people in the United States.”

Brain malformations common cause of pediatric central diabetes insipidus


Pediatric central diabetes insipidus is more commonly caused by brain malformations than previously thought, according to recent study findings published in The Journal of Endocrinology & Metabolism.

David Werny, MD, MPH, of the University of Washington and Seattle Children’s Hospital, and colleagues evaluated 147 children (mean age at diagnosis, 7 years; mean follow-up, 6.2 years) with central diabetes insipidus from 2000 to 2013 to determine the different causes of the condition.

Overall, the most common diagnosis was craniopharyngioma (25.2%), followed by septo-optic dysplasia (14.3%) and Langerhans cell histiocytosis (12.2%). A brain malformation was the underlying cause of central diabetes insipidus in 24% of patients. After age 2 years, 33% of patients with a congenital anatomic cause were diagnosed with central diabetes insipidus.

The most common causes of central diabetes insipidus were acquired infiltrative and tumor etiologies (56.7%). Familial central diabetes insipidus or a presumed genetic cause was identified in 7% of patients.

Central diabetes insipidus was diagnosed in 29 patients without any medical conditions known to be associated with it. Abnormal initial MRI or clinical evaluation suggesting an underlying cause was present in 24% of these patients.

Twenty-two patients had no known cause for central diabetes insipidus and were considered initially idiopathic.

No initial cause of central diabetes insipidus could be identified in 12 patients, and they had normal pituitary stalk thickness on the initial MRI.

Similar rates of anterior pituitary hormone deficiencies in patients with anatomic malformations as patients with tumor/infiltrative forms of central diabetes insipidus were found (P = .09). Patients with genetic/familial central diabetes insipidus had no anterior pituitary hormone deficiencies compared with 39% of those with idiopathic central diabetes insipidus.

Throughout the whole patient group, 60% had GH deficiency, 59% has thyroid-stimulating hormone deficiency and 57% had adrenocorticotropic hormone deficiency. Normal posterior pituitary bright spot was identified in 13% of patients despite having central diabetes insipidus.

“We have confirmed our suspicion that idiopathic [central diabetes insipidus] is relatively rare and anatomic brain malformations are a more common cause of pediatric [central diabetes insipidus],” the researchers wrote. “Patients with anatomic brain malformations have a high rate of [anterior pituitary deficiencies], and many have persistence of the [posterior pituitary bright spot]. Our follow-up of patients with idiopathic [central diabetes insipidus] shows that providers can consider less frequent MR imaging after 3 years from diagnosis, and that having a standardized assessment of the infundibulum on the initial MRI may help predict later development of [Langerhans cell histiocytosis] or germinoma.” – by Amber Cox

What Happens to Your Body When You Drink Too Much Alcohol


alcohol poisoning

Story at-a-glance

  • Generally, women are more vulnerable to alcohol poisoning. They feel the effects of alcohol faster than men of the same size. Unfortunately, they’re also more predisposed to suffer from long-term alcohol-induced damage in the body
  • Blood alcohol content (BAC), also called blood alcohol concentration, refers to the amount of alcohol in your bloodstream. It is expressed as the weight of ethanol measured in grams in 100 milliliters of blood or 210 liters of breath. BAC can be measured either through a breathalyzer test, a blood test, or a urine test
  • As a rule of thumb, darker and bitter beers have higher alcohol content. Red wines, on the other hand, have higher alcohol content than white wines, except for chardonnay. Also, sweeter wines have less alcohol content. Meanwhile, all clear liquors have 40 percent alcohol content except for grain alcohol. While darker liquors have more alcohol content, like red wine, sweeter variants have less
  • The Standard Dietary Guidelines for Americans 2010 consider having no more than one drink per day for women and no more than two drinks per day for men as moderate drinking

Some people believe that an occasional glass of red wine can benefit your health. Regardless of the merits of this view, too much red wine is a recipe for disaster.

Alcohol can impair decision-making abilities and motor skills. It is frequently a factor in vehicular accidents, violent behaviors, unplanned pregnancy, and sexually transmitted diseases. Excessive alcohol consumption can lead to the lethal danger of alcohol poisoning, too, which negatively impacts your health and may even cost you your life if it’s not properly addressed.

In the United States alone, there are estimatedly 88,000 deaths and 2.5 million years of potential life lost (YPLL) reported yearly from 2006 to 2010 due to alcohol poisoning, hacking off an average of 30 years on the lives of those who died. 1

What Is Alcohol Poisoning?

Alcohol poisoning impairs the body and eventually can shut down the areas of the brain that control basic life-support functions like breathing, heart rate, and temperature control.2

You become more susceptible to alcohol poisoning when you:

  • Binge drink, or consume four or more (women) or 5 or more (men) alcoholic beverages in a single occasion.
  • Drink heavily, or consume eight or more (women) or 15 or more (men) alcoholic beverages per week.
  • Drink during pregnancy. No amount of alcohol is safe to drink during pregnancy due to risks of passing alcohol toxicity through the placenta to your unborn child, which can cause severe damages at any stage of pregnancy.
  • Drink under the age of 21. Underage drinkers are more vulnerable to alcohol poisoning as studies have shown that they typically consume about five drinks in a single occasion.

Alcohol Poisoning Symptoms

Alcohol poisoning comes with very serious health penalties, which is why it’s very important to be well-informed about what symptoms you need to watch out for. Below are some of the most common telltale signs of alcohol poisoning:3

Loss of coordination Cold, clammy hands, and bluish skin due to hypothermia
Vomiting repeatedly and/or uncontrollably Irregular or slow breathing (less than eight breaths per minute or more than 10 seconds between breaths)
Seizures Confusion, unconsciousness, stupor (or conscious but unresponsive), and sometimes coma

If you notice any of these symptoms, call 911 for help immediately.

Alcohol Poisoning Risk Factors

Generally, women are more vulnerable to alcohol poisoning. They feel the effects of alcohol faster than men of the same size. Unfortunately, they’re also more predisposed to suffer from long-term alcohol-induced damage in the body. This is due to several physiological reasons, such as: 4

  • Poor ability to dilute alcohol because they have lower body water percentage in the body. The average female only has 52 percent while the average male has 61 percent.
  • Poor ability to metabolize alcohol because they have less dehydrogenase, a liver enzyme designed to break down alcohol in the body, than men.
  • Hormones. Premenstrual hormone changes tend to make women get intoxicated more rapidly during the days before their period. Birth control pills and other estrogen-containing medications, on the other hand, slow down the excretion of alcohol from the body.

Nevertheless, this does not mean that men are completely safe from the dangers of alcohol poisoning. Below are a number of other factors that affect your body’s response to alcohol, regardless if you’re male or female:

Food The peak blood alcohol concentration level can be three times higher in people who drink with an empty stomach than in those who had a decent meal before drinking. Food plays a significant role in alcohol absorption in the body because it dilutes the alcohol while slowing down the emptying of the stomach into the small intestine where alcohol is absorbed.
Asian ethnicity Approximately 50 percent of Asians have trouble metabolizing alcohol due to a missing liver enzyme needed to process the substance.
Existing health conditions People with diabetes should be wary of alcohol because it can cause a sudden surge and a dangerous drop in their blood sugar levels. Drinking alcohol may also prevent diabetes prescription drugs from working properly.
Prescription drugs Medications can potentially dull the effects of alcohol, which in turn causes you to drink more than what your body can truly handle.

How much water you drink, how often you drink, your age, and your family history are potential risk factors as well.

Blood Alcohol Content: How Much Is Too Much?

Blood alcohol content (BAC), also called blood alcohol concentration, refers to the amount of alcohol in your bloodstream. It is expressed as the weight of ethanol measured in grams in 100 milliliters of blood or 210 liters of breath. BAC can be measured either through a breathalyzer test, a blood test, or a urine test.

For example, a BAC of 0.10 means that 0.10% (one-tenth of one percent) of your blood, by volume, is alcohol. All 50 states have now set .08% BAC as the legal limit for Driving Under the Influence (DUI). For commercial drivers, a BAC of .04% can result in a DUI conviction nationwide. For those under age 21, there is a zero tolerance limit―any amount of alcohol is grounds for a DUI arrest.5

To calculate your current blood alcohol content, there are free online sites and apps you can try like BloodCalculator.org and iDrinkSmarter. BAC results may vary depending on several variables, which include your gender, personal alcohol tolerance, body weight, and body fat percentage.6

How Much Alcohol Is in Your Drink?

As far as the Standard Dietary Guidelines for Americans 2010 is concerned, moderate drinking is having no more than one drink per day for women and no more than two drinks per day for men.

Basically, a standard drink contains 0.6 ounces of pure alcohol, which is usually found in:7

  • 12 ounces of beer (five percent alcohol)
  • Eight ounces of malt liquor (seven percent alcohol)
  • Five ounces of wine (12 percent alcohol)
  • 1.5 ounces of 80-proof distilled spirits or liquor like gin, rum, vodka, and whiskey (40 percent alcohol)

Various brands and types of alcoholic beverages come with different alcohol content levels. To have an idea how much alcohol your favorite drink contains, check out this chart below: 8

TYPE OF DRINK AVERAGE ALCOHOL PERCENTAGE BY VOLUME
LAGERS:
LIGHT 4.2 percent
REGULAR 4.5 percent
ICE 5.5 percent
ALES 4.5 percent
PORTER/STOUTS 6.5 percent
WINES:
CHARDONNAY 12.5 percent
OTHER WHITE WINES 10 percent
RED WINE 13 percent
VODKA 40 percent
GIN 42.5 percent
RUM 45 percent
TEQUILA 45 percent
BRANDY 42 percent
WHISKEY 50 percent

As a rule of thumb, darker and bitter beers have higher alcohol content. Red wines, on the other hand, have higher alcohol content than white wines, except for chardonnay. Also, sweeter wines have less alcohol content. Meanwhile, all clear liquors have 40 percent alcohol content except for grain alcohol. While darker liquors have more alcohol content, like red wine, sweeter variants have less.

Possible Complications

If left untreated, a person suffering from alcohol poisoning can:9

  • Choke on his/her own vomit
  • Be severely dehydrated, which can cause seizures, permanent brain damage, and even death
  • Have slow and irregular breathing, which can eventually stop
  • Have irregular heartbeats, which can eventually stop
  • Have hypothermia
  • Have hypoglycemia (extremely low blood sugar), which can lead to seizures

Long-Term Effects of Alcohol in Women

Because a woman’s body has less tolerance for alcohol compared to men, it’s more susceptible to the damaging effects of alcohol poisoning. Numerous studies have linked these health consequences to excessive drinking in women, which include:

  • Disrupted menstrual cycle10
  • Increased risk of infertility, miscarriage, stillbirth, and premature delivery11
  • Higher risk of liver cirrhosis and other alcohol-related liver diseases compared to men12
  • Memory loss and brain shrinkage13
  • Increased risk  of mouth, throat, esophagus, liver, colon, and breast cancer14

Alcohol is also a common risk factor in many cases of sexual assault, particularly among young women. About 1 in 20 college women are sexually assaulted each year, and research suggests that there is a higher likelihood of rape or sexual assault when both the victim and the attacker are under the influence of alcohol before the incident.15,16

Dos and Don’ts for Someone Suspected with Alcohol Poisoning

It is not something to be ignored in belief that it will pass and go away the following day. If you believe that someone you know could be suffering from alcohol poisoning, here are some steps that you can do and avoid doing to comfort them while waiting for help:

Do:

  • Make sure they remain conscious
  • Keep them hydrated by giving them water
  • Keep them warm
  • Stay with them and never leave them alone
  • Monitor their symptoms
  • Ensure they lie on their side so they won’t choke  on their own vomit

Don’t:

  • Tell them to sleep it off. The blood alcohol content can continue to rise even when they’re not drinking.
  • Give them coffee. This will further dehydrate the person.
  • Instruct them to walk around. This may only cause falls and bumps, which may result in serious injuries, given the brain’s unfit condition.
  • Ask them to take a cold shower. Alcohol lowers your body temperature, and making them feel colder than they already feel could lead to hypothermia.

Lastly, don’t wait for all the symptoms of alcohol poisoning to show up and don’t hesitate to call for emergency medical help immediately. Remember, BAC levels can rise rapidly, and time is of the essence in this situation. Being a minute too late could mean irreversible damage or even death.

How to Prevent Alcohol Poisoning

It does not take rocket science to know how you can prevent yourself or your friends from suffering from alcohol poisoning. I believe the first step, and probably the most important one, that you can take is to practice self-control. Avoid and discourage your friends from participating in  any alcohol drinking challenge, which is a surefire way to get alcohol poisoning.

However, if you really must have a few drinks, I personally recommend taking this natural protocol beforehand to pretox your body:

N-acetyl cysteine (NAC) Take at least 200 milligrams of NAC 30 minutes before you drink to help lessen alcohol’s toxic effects. NAC increases glutathione and reducesacetaldehyde toxicity that causes many hangover symptoms.
B vitamins Alcohol depletes essential B vitamins, which help to eliminate it from the body. NAC is thought to work even better when combined with thiamine, or vitamin B1.
Milk thistle Milk thistle contains silymarin and silybin, antioxidants that are known to help protect the liver from toxins, including the effects of alcohol. Not only has silymarin been found to increase glutathione, but it also may help to regenerate liver cells.
Vitamin C Alcohol may deplete your body of vitamin C, which is important for reducing alcohol-induced oxidative stress in your liver. Make sure you’re getting adequate amounts of vitamin C, either through supplements or citrus fruits, before taking any alcoholic beverage.
Magnesium Magnesium is another nutrient depleted by alcohol, and it’s one that many are already deficient in. Plus, magnesium has anti-inflammatory properties that may help to reduce some hangover symptoms. If you don’t eat a lot of magnesium-rich foods, taking a magnesium supplement before an evening involving drinking may be helpful.

These pretox measures are imperative for supplying your body with the vitamins, antioxidants, and other nutrients to protect your liver and assist in the breakdown and removal of alcohol from your system.

Other practical measures that may help include:

  • Staying hydrated – Drink a glass of water along with each alcoholic beverage to help prevent dehydration. At bedtime, drink another large glass of water or two to help stave off hangover symptoms in the morning.
  • Eating before and during drinking – If your stomach is empty, it will speed up the alcohol’s rate of absorption into your body. It may also cause severe stomach irritation. Make it a point to eat a meal before you drink alcohol and nibble on satisfying snacks (such as cheese) while you drink. At the very least, try this old piece of wisdom from the Mediterranean region: take a spoonful of olive oil before drinking alcohol to help prevent a hangover.
  • Replenishing electrolytes – Try drinking coconut water before you go to bed to help reduce hangover symptoms in the morning.
  • Sticking with clear alcohol – Generally, clear liquors (vodka, gin, or white wine) will contain fewer congeners than darker varieties (brandy or whiskey).
  • Stopping once you feel buzzed – When you feel buzzed, it’s a sign that your body’s detoxification pathways are becoming overwhelmed. Take a break from drinking, or quit for the day entirely, to allow your body to metabolize the alcohol effectively.

In addition, I also advise against drinking when you’re feeling down, or worse, depressed, as this can only lead to unconscious and uncontrolled alcohol consumption. Note that alcohol can actually alter your brain chemistry and lower the levels of serotonin, a mood-regulating chemical in your brain, increasing your anxiety and stress instead of reducing it.

Rather than falling into the vicious cycle of alcohol abuse, I recommend addressing your emotional health as soon as possible. Try Emotional Freedom Technique (EFT), which is one of the most effective energy psychology tools for me.

50 Years On, NASA’s First Spacewalk Still Resonates


Ed White’s first foray into the vacuum of space on June 3, 1965, set the stage for future spacewalks to assemble stations and repair telescopes

Astronaut Ed White floats in the microgravity of space outside the Gemini IV spacecraft.
NASA/Jim McDivitt

The United States first stepped out into the void of space 50 years ago today (June 3).

On June 3, 1965, NASA astronaut Ed White left the safety of his Gemini 4 spacecraft equipped with a spacesuit, a tether and a small gas gun for maneuvering. Video of that first American spacewalk shows White enjoying the excursion, even as he made spaceflight history.

For about 23 minutes, White floated near the spacecraft with Earth backdropped behind him. His tumbling movements—captured in photos by his commander, Jim McDivitt—are still widely published today. White has described his return to the spacecraft as one of the saddest moments of his life. [The First American Spacewalk in Photos]

Hundreds of spacewalks (also known as extravehicular activities, or EVAs) have been done since White’s time. While the first NASA EVA—which came just three months after the world’s first spacewalk, performed by cosmonaut Alexei Leonov—was brief, with no major tasks accomplished aside from getting used to the sensation, it marked a change in the thinking for space work, historian Jennifer Levasseur told Space.com.

“There is a turning point between learning how to do things and actually starting to carry out some of the activities we know are going to be required to perform tasks in space,” said Levasseur, a museum specialist at the Smithsonian National Air and Space Museum in Washington, D.C. [Video: Astronaut Recounts 50 Years of Spacewalks]

Specifically, White’s spacewalk previewed challenges that the Gemini program would later have to overcome, Levasseur said. Fogging in White’s visor pointed to problems with the spacesuit overheating. His difficulties in maneuvering, combined with reports from other astronauts, eventually prompted NASA to install more handrails and anchor points on spacecraft.

Parts of White’s spacesuit, such as his helmet and gloves, are on display at a temporary museum exhibit Levasseur is curating, called “Outside the Spacecraft: 50 Years of Extra-Vehicular Activity.” The exhibit closes Monday (June 8).

Saving Skylab
EVAs were considered necessary in the 1960s just in case a spaceship docking failed, said Robert Pearlman, the founder of space history site (andSpace.com partner) collectSPACE.com. For example, spacewalking to the other vehicle was one of many backup procedures for an Apollo lunar lander returning to its orbiting mate after a moon mission.

But in some ways, Pearlman pointed out, White’s spacewalk made things look too easy. Later Gemini EVAs were designed with the assumption that astronauts could move without challenges, but as tasks were added, several spacewalkers had difficulty holding on to the spacecraft to do their work. [The Evolution of the Spacesuit in Photos]

“In the large sense of history,” Pearlman said, “spacewalking became much more important after Apollo. It literally saved the Skylab space station.”

“Had we not been able to perform spacewalks and do them reliably, then there would have been no way to repair the station from the damages, and that entire program would have been a loss,” Pearlman said.

Future of spacewalks
Spacewalks advanced even further during NASA’s space shuttle program, which began flying in the 1980s, with astronauts using manned maneuvering units (jetpacks) to retrieve satellites for repair.

While this practice ceased due to safety concerns following the Challenger shuttle explosion in 1986, spacewalking still was key to how space exploration developed. Among other milestones, astronauts performed EVAs to repair and upgrade NASA’s Hubble Space Telescope, as well as construct and repair the International Space Station.

Best practices from other programs were also discussed, as the United States began working more closely with international partners, Pearlman added.

For example, cameras were included on the Russian Orlan suit after that country saw how Americans monitored astronaut activities in real time. Later, the United States began using GoPro cameras after seeing how much the Russians liked doing so.

With the United States now working to get astronauts to an asteroid and Mars, changes to spacewalking techniques and spacesuits will be needed, both Levasseur and Pearlman said.

For example, artificial handholds or ways of attaching to an asteroid may be required since, unlike a station, space rocks don’t come equipped with built-in spots for tethers. And if an astronaut plans to walk on Mars in the same spacesuit as that used during a free-floating spacewalk, the suit will need to have better joint flexibility.

Bad Bacteria Thrive on Unhealthy Tissue and Cells


The bacteria in your body, once thought to be more of a nuisance than an asset, are integral to your very survival. Your body is in fact a complex ecosystem made up of more than 100 trillion microbes that must be properly balanced and cared for if you are to be healthy.

This system of bacteria, fungi, viruses, and protozoa living on your skin and in your mouth, nose, throat, lungs, gut, and urogenital tract, is unique to you. It varies from person to person based on factors such as diet, lifestyle, health history, geographic location, and even ancestry – and it’s vulnerable to your daily lifestyle decisions.

Junk Foods and Unhealthy Meat Allow ‘Bad’ Bacteria to Thrive

While today 80 percent of processed foods are made up of genetically modified (GM) corn and soy, wheat, and meat, 15,000 years ago people ate about 150 different ingredients each week, according to Tim Spector, professor of genetic epidemiology at King’s College London and author of The Diet Myth.1

Spector wanted to find out what happens to your gut if you eat only fast food, specifically McDonald’s, for 10 solid days. His son, Tom, became the willing guinea pig and reported his symptoms, as well as sent stool samples to different labs, throughout the 10-day trial.

Tom said that for three days he felt ok, but then started to become more lethargic and turned a slight gray color according to his friends. He reported feeling bad the last few days and says he also experienced some withdrawal symptoms,” TIME reported.2

After 10 days of fast food about 40 percent of his bacteria species were lost, which amounted to about 1,400 different types. Losses of microbial diversity such as this have been linked to diabetes and obesity.3

As you continue to subsist on junk food, your gut microbes respond and “bad” bacteria may proliferate, furthering your cravings for more unhealthy foods. As Spector told Food Navigator:4

“Each species of microbe has a preference for certain food sources, which allows them to feed and reproduce. They therefore have their own evolutionary drive to maintain their ecological niche and will do anything to ensure their survival. This includes sending signals to the hosting human that they want more of the same junk food that they thrive on.”

Swapping Your Diet Quickly Alters Your Microflora – For Good or For Bad

A separate study swapped the typical Western diet of a group of African-Americans with that of rural Africans (which meant swapping processed, low-fiber foods with beans and vegetables). In just two weeks, the groups took on the other’s biomarkers of cancer risk such as bacterial activity, fiber fermentation, and intestinal inflammation.5,6

In another study, the hunter-gatherer Yanomami tribe—which had never come in contact with outsiders prior to the researchers’ arrival and had never been exposed to antibiotics—had about 50 percent greater microbial diversity than American subjects.

They also had 30 percent to 40 percent more diversity than the Guahibo and the Malawian tribes, the latter two of which have adopted some Western lifestyle components, such as living indoors and using antibiotics.7 According to one of the authors:8

“As cultures around the world become more ‘Western,’ they lose bacteria species in their guts… At the same time, they start having higher incidences of chronic illnesses connected to the immune system, such as allergies, Crohn’s disease, autoimmune disorders, and multiple sclerosis.

When you eat too many grains, sugars, and processed foods, these foods serve as “fertilizer” for pathogenic microorganisms and yeast, causing them to rapidly multiply. The best way to support microbial diversity is to instead eat a varied diet, including plenty of fiber-rich vegetables and fermented foods while avoiding antibiotics.

In the not-too-distant future, however, it may not be unusual to have your individual gut microbes tested and consume a personalized probiotic product, with four or five different strains tailored to your unique microbial needs, as a result.

Processed Foods Interfere with the Microbes in Your Gastrointestinal Tract

Aside from the sugar and lack of diversity in ingredients, emulsifiers found in processed foods also have a detrimental effect on your microbiome. As reported by Time:9

“Ingredients such as polysorbate 80, carrageenan, polyglycerols, and xanthan and other ‘gums,’ all of which keep ingredients—often oils and fats—from separating.

They are also used to improve the texture and shelf-life of many foods found on supermarket shelves, from ice cream and baked goods, to salad dressings, veggie burgers, non-dairy milks, and hamburger patties.

Now, a new study… suggests these ingredients may also be contributing to the rising incidence of obesity, metabolic syndrome, and inflammatory bowel disease by interfering with microbes in the gastrointestinal tract.”10

In this study, widely used food additives caused chronic colitis in mice with already abnormal immune systems. In mice with healthy immune function, they resulted in mild intestinal inflammation and subsequent metabolic dysfunction that led to obesity, hyperglycemia, and insulin resistance.

Most notably, the emulsifiers were fed at levels that an average person would be exposed to if eating a lot of processed foods, suggesting these additives may indeed affect the health of many Americans.

In addition, the majority of processed foods contain GM ingredients, which are heavily sprayed with Monsanto’s Roundup. The active ingredient in Roundup,glyphosate, is toxic in its own right and causes extreme disruption of microbes’ function and lifecycle.

What’s worse, glyphosate preferentially affects beneficial bacteria, allowing pathogens to overgrow and take over, including the highly toxic Clostridium botulinum. So whenever you eat processed foods, you’re subjecting your microbiome to a number of assaults…

CAFO Meats Harbor Low Doses of Antibiotics and, Often, Antibiotic-Resistant Disease

Animals raised in CAFOs (concentrated animal feeding operations) are routinely given low doses of antibiotics to promote growth and prevent diseases resulting from the crowded and unsanitary conditions of these facilities. Eighty percent of all antibiotics sold in the US are fed to livestock, so eating CAFO-raised foods is likely to be the greatest source of antibiotics for many people.

Not only may this low-dose ingestion of antibiotics have an adverse effect on the composition of your microbiome, thereby affecting your health, but also about half of all meats sold in American grocery stores have also been found to harbor drug-resistant bacteria that can cause severe food-borne illness.

Remember, pathogenic bacteria thrive in unhealthy tissues – whether that be in a plant, animal, or human. It’s nature’s way of taking out the weak and, ultimately, promotes balance in ecosystems. Of course, you don’t want to be one of the weak, which is why caring for the health of your microbiome is so important.

This is one of the reasons why I recommend eating only organically raised, grass-fed or pastured meats and other animal products, such as dairy and eggs, as organic standards do not permit non-medical use of antibiotics.

Bacteria ‘Signaling’ May Detect Disease

Bacteria in your body might one day be used as a method to detect diseases like cancer and diabetes. Research published in the journal Science Translational Medicine found bacteria could be modified to change color in the presence of sugar, which could reveal diabetes (as people with diabetes may have sugar in their urine).11

Additional tests showed bacteria could be altered to change color in the presence of liver tumors, changing the color of urine, or even causing it to give off light, as a result.

The study shows a complex signaling system is at work between your microbes and your body… and your microbes may be able to detect disease before you do. More research is needed before this approach can be harnessed in people, but one day it could lead to in-home testing kits for a variety of diseases, courtesy of your microbial “sensors.”

How Healthy Is Your Microbiome?

All of this information should really drive home the point that optimizing your gut flora is of critical importance for disease prevention and optimal health. Reseeding your gut with beneficial bacteria is essential for maintaining proper balance here. In light of this, here are my recommendations for optimizing your microbial self:

    • Fermented foods are one of the best routes to optimal microbial health, as long as you eat the traditionally made, unpasteurized versions. Healthy choices include lassi (an Indian yoghurt drink, traditionally enjoyed before dinner), fermented grass-fed organic milk such as kefir, various pickled fermentations of cabbage, turnips, eggplant, cucumbers, onions, squash, and carrots, and natto (fermented soy).

Some of the beneficial bacteria found in fermented foods are also excellent chelators of heavy metals and pesticides, which will also have a beneficial health effect by reducing your toxic load.

Fermented vegetables are an excellent way to supply beneficial bacteria back into your gut. Most high-quality probiotic supplements will only supply you with a fraction of the beneficial bacteria found in homemade fermented veggies, so it’s your most economical route to optimal gut health as well.

  • Probiotic supplement. Although I’m not a major proponent of taking many supplements (as I believe the majority of your nutrients should come from food), probiotics are an exception, especially if you don’t eat fermented foods on a regular basis or if you’re taking antibiotics.

In addition to knowing what to add to your diet and lifestyle, it’s equally important to know what to avoid, and this includes:

Antibiotics, unless absolutely necessary (and when you do, make sure to reseed your gut with fermented foods and/or a probiotic supplement) Conventionally-raised meats and other animal products, as CAFO animals are routinely fed low-dose antibiotics, plus genetically modified grains, which have been implicated in the destruction of gut flora Processed foods (as the excessive sugars, along with otherwise “dead” nutrients, feed pathogenic bacteria)
Chlorinated and/or fluoridated water Antibacterial soap Agricultural chemicals, glyphosate (Roundup) in particular

Neurosurgeon Reflects on the Awe and Mystery of the Brain


Who better to explore the mysteries of the brain than a neurosurgeon, a person who has delved into the jelly-like matter of the organ itself using forceps, suctions and a scalpel.

As British neurosurgeon Henry Marsh wrote in his book Do No Harm: Stories of Life, Death, and Brain Surgery, I often have to cut into the brain and it is something I hate doing.”1 His dislike stems from the fact that brain surgery is so dangerous.

Even under the best circumstances, there is a risk of leaving a person severely disabled if even a small area of the brain becomes unintentionally damaged. As technology has improved, surgeons now have a sort of GPS for the brain known as computer navigation.

This involves a brain scan taken just before the surgery, which allows the surgeon to see where his instruments are located in the person’s brain. The patient may even be awake at the time of surgery, performing simple tasks to ensure no damage is caused as the operation progresses. Marsh wrote:2

“Despite all this technology neurosurgery is still dangerous, skill and experience are still required as my instruments sink into the brain or spinal cord, and I must know when to stop.

Often it is better to leave the patient’s disease to run its natural course and not to operate at all. And then there is luck, both good luck and bad luck, and as I become more and more experienced it seems that luck becomes ever more important.”

The Wonder of the Human Brain

Beyond the fear and uncertainty that comes with brain surgery is also a sense of excitement and wonder. Marsh is honest in his assessment of how little is actually known about the brain and how it coordinates what is the essence of being human: breathing, movement, memory, thoughts, feelings, consciousness…

He admitted that even after decades of work as a neurosurgeon, much of the brain is still beyond his grasp:3

“The idea that my sucker is moving through thought itself, through emotion and reason, that memories, dreams and reflections should consist of jelly, is simply too strange to understand.”

In an interview with NPR,4 which you can listen to above, Marsh also shared how, oftentimes, what we think is “real” is actually an illusion. He used pain as an example, because when you feel pain in your hand, for instance, it’s not actually in your hand at all …

“If I got pain in my hand the pain is not actually in the hand, the pain is my brain.

My brain creates a three-dimensional model of the world and associates the nerve impulses coming from the pain receptors in my hand with pain in the hand and it create this illusion that the pain is actually in the hand itself, and it isn’t. The more you look into neuroscience the more strange and confusing it becomes.”5

We ‘Can’t Even Begin to Explain’ How Consciousness Works

Your body is capable of generating electricity, and this allows your nervous system to send signals to your brain. These signals are actually electrical charges that are delivered from cell to cell, allowing for nearly instantaneous communication.

The messages conducted via electrical signals in your body are responsible for controlling the rhythm of your heartbeat, the movement of blood around your body, and much more. So it’s not a stretch to consider yourself an electrical being.

Marsh even describes his thoughts as “electric chemistry,” but even though we understand cells are transmitting electrical charges and signals back and forth… we’re nowhere near understanding the complexities of human brain function. Marsh told NPR:6

“I find it quite a consoling thought that our modern scientific view of the world which has explained so much, we can’t even begin to explain how consciousness, how sensation arises out of electric chemistry, but the fact of the matter is it does…

The sense of awe and mystery, for some reason, has gotten greater as I’ve got older. I’m not sure why.Maybe because many of us, as we get older, we start thinking more about the fact our life is going to come to an end, and we become a bit more religious and philosophical. 

If you don’t have conventional religious belief, as I don’t, I think in a way thinking about the mystery of one’s own consciousness and the universe is a sort of compensation for that in some ways.”

Top 5 Mysteries of the Mind

Your brain contains billions of neurons. No one knows exactly how many, but it’s estimated there may be about 86 billion (for comparison’s sake, there are thought to be 200-400 billion stars in the Milky Way). About half of those neurons are located in your brain’s cerebellum, which is about half the volume of your central nervous system.7

How these neurons interact with each other, forming trillions of connections, forms the basis for how your brain works, but there are more questions than answers. Some of the biggest unsolved mysteries of the mind include:8

  1. Consciousness: You are aware of your surroundings, capable of self-evaluation, thoughts, emotions, and other experiences. How consciousness works, in particular how the brain leads to subjective experiences that are unique to each of us, is a mystery.
  2. Personality: How do personalities develop? Are they a result of your environment or are you born with one? Personalities can be drastically altered by brain surgery or trauma, but the brain’s role in personality is poorly understood.
  3. Memories: How your brain creates, stores, and retrieves memories is largely a mystery, particularly how you’re able to recall a memory at will.
  4. Intelligence: How your brain’s neurons work together to solve problems, and why people have different levels of intelligence and styles of learning is another mystery.
  5. Sleep and dreams: Sleep loss results in the loss of neurons, and proper sleep is important for brain detoxification. During sleep, your brain cells actually shrink by about 60 percent, which allows for more efficient waste removal. However, what exactly occurs in your brain while you sleep, and why you have dreams, is not well understood.

There is so much yet to be discovered about the mind that the US government launched the BRAIN Initiative in 2013 to “revolutionize our understanding of the human mind.”9 Among the goals of this program are to help:

  • Uncover patterns of neural activity that produce cognition
  • Understand how brain activity leads to perception, decision-making and ultimately action
  • Understand how information is stored and processed in neural networks
  • Unlock the mysteries of normal and abnormal brain function
  • Uncover the mysteries of brain disorders such as Alzheimer’s and Parkinson’s diseases, depression, post-traumatic stress disorder (PTSD), and traumatic brain injury

It’s Now Known Your Brain Is Malleable and Constantly Changing

It used to be thought that your brain was static, except during some critical developmental periods, but today, we know this isn’t true. This is one area of brain research that has come a long way in recent decades. This concept is calledneuroplasticity, or brain plasticity—meaning, you are literally reforming your brain with each passing day. Your brain possesses the remarkable ability to reorganize pathways, create new connections and, in some cases, even create new neurons throughout your entire lifetime.

There are two types of brain plasticity—functional plasticity (your brain’s ability to function moves from a damaged area to undamaged areas) and structural plasticity (its ability to actually change its physical structure as a result of learning).10Think about what happens when you’re learning a new skill. The more you focus and practice something, the better you become, and this is a result of new neural pathways that form in response to your learning efforts.

At the same time, your brain is undergoing “synaptic pruning”—elimination of the pathways you no longer need. Until recently, it was believed the human brain could not generate new neurons. The old model assumed that you were born with a finite number of brain cells, and when a cell died, no new cell grew in its place. This old model is no longer relevant, as it’s been proven that certain areas of your brain can generate new cells (neurogenesis), as well as creating new neural pathways.

Environment plays an essential role in the process, but genetics can also have an influence. These neural processes have been well documented in people recovering from stroke-related brain damage, for instance. This phenomenon even applies to emotional states. For example, if you have a history of anxiety, your neural pathways become wired for anxiety. If you develop tools to feel calm and peaceful more of the time, those anxiety pathways are pruned away from lack of activity—“use it or lose it” really applies here. As explained by neurologist David Perlmutter:

“We interact with our genome every moment of our lives, and we can do so very, very positively. Keeping your blood sugar low is very positive in terms of allowing the genes to express reduced inflammation, which increase the production of life-giving antioxidants. So that’s rule number one: You can change your genetic destiny. Rule number two: you can change your genetic destiny to grow new brain cells… You are constantly growing new brain cells into your 50s, 60s, 80s, and 90s – throughout your lifetime – through a process called neurogenesis.”

Brain ‘Hacks’ to Keep Your Mind Strong

While much of your brain remains a mystery, there are some factors that are known to be good for brain health. If you want to learn more about the mysteries of your mind, check out “The English Surgeon” documentary, which goes into even more detail about Henry Marsh’s fascinating career. However, if you’re wondering what you can do, starting to day, to make the most of your brainpower and mind, use the tips below:

Stimulate Your Mind

In a study of people aged 85 and older, those who engaged in artistic, craft, and social activities in mid- and late life, and who used a computer late in life, had a lower risk of mild cognitive impairment (MCI).11 Another study, published in 2014, found that taking part in “cognitively demanding” activities was also beneficial. This would include learning to quilt or take digital photography, which researchers found enhance memory function in older adults.12

Get Regular Exercise

During exercise, nerve cells release proteins known as neurotrophic factors. One in particular, called brain-derived neurotrophic factor (BDNF), triggers numerous other chemicals that promote neural health, and directly benefits cognitive functions, including learning. A 2010 study on primates published in Neuroscience also revealed that regular exercise not only improved blood flow to the brain, but also helped the monkeys learn new tasks twice as quickly as non-exercising monkeys.13

This is a benefit the researchers believe would hold true for people as well. In a separate one year-long study, individuals who engaged in exercise were actually growing and expanding the brain’s memory center 1 percent to 2 percent per year, where typically that center would have continued to decline in size. To get the most out of your workouts, I recommend a comprehensive program that includes high-intensity interval exercise, strength training (especially super slow workouts), stretching, and core work, along with walking about 10,000 steps a day.

Eat a Proper Diet

The foods you eat – and don’t eat – play a crucial role in your memory. Fresh vegetables are essential, as are healthy fats and avoiding sugar and grain carbohydrates. You can find detailed information about nine foods for brainpower here. Increasing your animal-based omega-3 fat intake and reducing consumption of damaged omega-6 fats (think processed vegetable oils) in order to balance your omega-3 to omega-6 ratio is important.

In addition, there is a close connection between abnormal gut flora and abnormal brain development, and just as you have neurons in your brain, you also have neurons in your gut — including neurons that produce neurotransmitters like serotonin, which is also found in your brain and is linked to mood. Along with avoiding sugar, one of the best ways to support gut health is to consume beneficial bacteria. You can use a probiotic supplement for this, but I’m particularly fond of using fermented vegetables, because they can deliver extraordinarily high levels of beneficial bacteria.

Consider Intermittent Fasting

If you really want to jumpstart your brain health, you might want to also try intermittent fasting. Contrary to popular belief, the ideal fuel for your brain is not glucose but ketones, which is the fat that your body mobilizes when you stop feeding it carbs and introduce coconut oil and other sources of healthy fats into your diet. A one-day fast can help your body to “reset” itself and start to burn fat instead of sugar. Further, it will help you to reduce your overall calorie consumption, which promotes brain cell growth and connectivity.

Get Proper Sleep

Sleep and sleep loss modify the expression of several genes and gene products that may be important for synaptic plasticity. Furthermore, certain forms of long-term potentiation, a neural process associated with the laying down of learning and memory, can be elicited in sleep, suggesting synaptic connections are strengthened while you slumber. Among adults, a mid-day nap was even found to dramatically boost and restore brainpower.14

As with most aspects of health, it’s not one factor but many that create or destroy a healthy brain. Just like your physical health, your mental health will flourish with a balanced healthy lifestyle of eating right, exercising, tending to stress, stimulating your mind and, last but not least, sleeping well. For the latter, you can find 33 tips to help you get the shut-eye you need here.

Lithium Linked to Renal, Endocrine Function


Lithium, the cornerstone treatment for bipolar disorder, is associated with a decline in renal function, hypothyroidism, and hypercalcemia, new research suggests.

“Lithium is a widely used and highly effective treatment for mood disorders, but causes poorly characterized adverse effects in kidney and endocrine systems,” write investigators, led by Brian Shine, MD, from John Radcliffe Hospital, Oxford, United Kingdom. “We aimed to analyze laboratory information system data to determine the incidence of renal, thyroid, and parathyroid dysfunction associated with lithium use.”

The findings were published online May 20 in the Lancet.

For the study, the investigators extracted routinely collected data from the laboratory information system of the Clinical Biochemistry Department, Oxford University Hospitals National Health Service Trust.

The laboratory performs routine tests for primary and secondary care for about 650,000 people in Oxfordshire, United Kingdom, and surrounding counties and has been in continuous operation since 1985.

The study cohort included all patients aged 18 years or older who had had at least two creatinine, thyrotropin, calcium, glycated hemoglobin, or lithium measurements taken between October 1, 1985, and March 31, 2014.

The main exposure was lithium therapy, defined as more than two serum measurements in which lithium was detected. A total of 4678 patients had serum lithium concentrations measured once, and 60% of these (2795) had more than one measurement.

The remaining 689,228 patients in the cohort were matched for sex and age and served as nonexposed control participants.
The analysis showed that the presence of lithium in serum was strongly associated with a decline in renal function (estimated glomerular filtration rate <60 mL/min per 1.73 m2), hypothyroidism, and increased total serum calcium concentration, but not with hyperthyroidism or increased adjusted calcium concentration.

Table. Effects of Lithium on Renal and Endocrine Function

Function Hazard Ratio 95% Confidence Interval P-value
Stage 3 chronic kidney disease 1.93 1.76 – 2.12 < 0.0001
Hypothyroidism 2.31 2.05 – 2.60 < 0.0001
Increased total serum calcium concentration 1.43 1.21 – 1.69 < 0.0001
Hyperthyroidism 1.22 0.96 – 1.55 0.1
Increased adjusted calcium concentration 1.08 0.88 – 1.34 0.46

Rapid Effect

Young women had higher hazard ratios than other groups, which suggests they have the greatest risk for kidney disease and hypothyroidism.

The results also showed that the adverse effects occurred early in treatment and lessened with length of treatment (HR <1 for length of treatment with lithium). Higher than median lithium concentrations were associated with increased risk for all adverse outcomes.

The finding that length of lithium treatment has a negative association suggests that the onset of effects is rapid once patients start taking lithium, the authors write.

“All patients taking lithium therapy should have regular monitoring of renal function. The low risk of serious renal dysfunction should be balanced against the risks of the mood disorder and those of other mood stabilizers,” they add.

Because data for lithium dosing and renal risk are scarce, a “sensible” approach would be to minimize the dose of lithium used in general.

Patients receiving lithium should also undergo regular thyroid testing and have calcium levels measured at baseline and once a year thereafter, the authors advise.

They note that the strengths of their study are the large number of individuals and the length of follow-up, which, in many cases, was longer than 20 years.

The main limitations are the heterogeneity of the study population, the limited information on patients’ clinical features, not knowing why the specimens were taken, not knowing what proportion of patients taking lithium had bipolar vs unipolar disorder, and the lack of any information about the doses of lithium that were taken.

Balancing Act

In an accompanying editorial, Gin S. Malhi, MD, from the University of Sydney, in Australia, writes that lithium is “without doubt the best treatment for many patients with bipolar disorder because it confers long-term mood stability and prophylaxi…reduces the risk of suicide and is possibly neuroprotective.”

Dr Malhi agrees with Dr Shine and colleagues that patients receiving lithium therapy should have their renal and thyroid function and blood calcium levels checked at the start of therapy and monitored closely thereafter.

“Maintenance of lithium concentrations at the lower end of the therapeutic range (ie, 0.6 mmol/L) can reduce the adverse outcomes associated with lithium treatment,” Dr Malhi writes.

However, acheiving blood concentrations of lithium high enough to be efficacious but low enough to avoid toxicity is a “delicate balance,” he writes.

“The dilemma of lithium therapy arises because, if poorly managed, lithium can compromise renal function, sometimes irreversibly, and severely disrupt endocrine homoeostasis — ultimately limiting its usefulness. Therefore, lithium therapy remains a challenge that will benefit from a better understanding of its therapeutic properties,” Dr Malhi writes.

More Benefit Than Harm From Mammography: IARC Update


Women between 50 and 69 years of age who participate in screening mammography have about a 40% reduction in the risk for death from breast cancer, an update from the International Agency for Research on Cancer (IARC) Working Group concludes.

The updated report was published online June 3 in the New England Journal of Medicine.

If all women in the same age group who are invited to participate in screening mammography are considered, the average reduction in the risk for mortality from breast cancer is 23%.

There is also a “substantial” reduction in the risk for death from breast cancer in women between 70 and 74 years of age who either attend or who are invited to attend a screening mammography program.

In contrast, evidence supporting the benefit of screening mammography in women younger than 50 years was limited, so the IARC Working Group did not find overt benefit from screening mammography in younger women.
These new conclusions extend those issued in 2002, when the IARC Working Group last considered the evidence. At that time, the IACR concluded that “the efficacy of screening by mammography as the sole means of screening in reducing mortality from breast cancer was sufficient for women 50 to 69 years of age, limited for women 40 to 49 years of age and inadequate for women younger than 40 or older than 69 years of age.”

“Recent improvements in treatment outcomes for late-stage breast cancer and concerns regarding overdiagnosis called for reconsideration,” the current Working Group writes.

Recent years have seen a huge public debate about the value of screening mammography, as reported by Medscape Medical News on numerous occasions, with an increasing focus on potential harms.

The IARC Analysis

The IARC brought together a working group of 29 international experts from 16 countries to assess the benefits and harms associated with breast cancer screening with mammography.
Results from 40 case-control and cohort studies from high-income countries were analyzed for the benefits vs the harms of screening mammography in different age groups.

“The most important harms associated with early detection of breast cancer through mammographic screening are false positive results, overdiagnosis and possibly radiation-induced cancer,” the authors observe.

Estimates of the cumulative risk for false positive results differ between organized programs, but the group estimates that it is approximately 20% for a woman who has undergone 10 mammographic screenings between age 50 and 70 years.

On the other hand, fewer than 5% of all false positive test results lead to an invasive procedure, the group points out.

Estimates of overdiagnosis of breast cancer from screening mammography based on several calculations range from between 1% to 10%, the group adds.

The estimated cumulative risk for death from breast cancer attributable to radiation from mammographic screening is from 1 to 10 per 100,000 women, depending on age and the frequency and duration of screening.

Echoing the finding of others, the Working Group concluded that data from available studies generally did not show a reduction in breast cancer–related mortality when breast self-examination was either taught or practiced competently and regularly.

“Screening for breast cancer aims to reduce mortality from this cancer as well as the morbidity associated with advanced stages of the disease through early detection in asymptomatic women,” the Working Group notes.

“And the key to achieving the greatest potential effects from this screening is providing early access to effective diagnostic and treatment services,” they conclude.