Calcium supplements are safe

Calcium supplements do not increase the risk of heart disease.

Until recently the only side-effect of calcium supplementation was a very small increase in kidney stones, but in recent years there has been a suggestion from a small number of researchers that calcium supplementation may increase the risk of heart attacks.

Because calcium and vitamin D are extremely important in bone health and many other bodily functions, people have been encouraged to stop taking supplements and rely on their diet for calcium. In most cases this is usually insufficient, particularly in the elderly.

A study recently presented at the world Congress of Osteoporosis and Musculoskeletal medicine, (April 2016) the authors reviewed the effect of both calcium and vitamin D supplements in over 500,000 people over 7 years in the United Kingdom. This showed no effect of calcium supplements or vitamin D on the incidence of heart disease in either men or women.

The UK Biobank is a large study of men and women (502,664) with a mean age of 58 years, they recorded the baseline intake of calcium and vitamin D supplements and link this to hospital admissions for any cardiovascular event and death through the 7 years of follow-up. 34,890 participants were taking calcium supplements and 20,004 vitamin D. The incidence of heart disease and death were no different from those people taking no supplements.

Hopefully, this will put to bed any suggestion that taking these supplements which are essential particularly as we age does anything other than good. Osteoporosis and falls (particularly hip fractures) are a major cause of both morbidity and death in the older population, and these people can now confidently take the supplements knowing it will do them no harm.

Medicine in 2016 - a Happy New Year?

2016 looks like becoming a very important year in the development of medicine. Over the last few years people have been looking more critically at the direction of modern medicine, at the way in which it has been driven by procedures and drugs, and questioning whether the cost of modern medicine is sustainable and is providing the benefits that are claimed.

 I can see huge changes in the two major killers in today's world – cancer and heart disease.

Cancer – in the past chemotherapy has been blunderbuss essentially damaging the most rapidly dividing cells which are assumed to be the cancer cells but at the same time knocking off any rapidly dividing normal cells in the body as well – giving the well-known side-effects. In recent years however much more selective chemotherapies have been developed which target the cancer cells specifically, giving much fewer side-effects, but more importantly a much better outlook. Unfortunately because the selective drugs are only applicable to selective cancers, the number of patients receiving them are relatively small, and thus it is difficult for the drug firms to recoup their research costs. This makes them extremely expensive, and insurance companies and Governments are going to have to decide which ones to fund, and for how long. While this is a real problem, it does give a real opportunity for quality and increased duration of life for many cancer patients. Example of these drugs include treatments for melanoma, myeloma, lung cancer, prostate cancer, pancreatic cancer and others.
Thus the diagnosis of even widespread cancer no longer needs be seen as a death sentence as it has in the past.

Heart disease – this has tended to be the pinup boy of medicine over the last couple of decades, as doctors have discovered bypass surgery, angioplasty and stenting. The same time the pharmaceutical industry has come up with a variety of drugs both to treat symptoms and to try and reduce the incidence of heart disease.  .

There has been a very strong emphasis on lowering cholesterol, and even though only one of the cholesterol-lowering drugs that have ever been shown to reduce heart disease (the statins),
The emphasis on cholesterol has continued, but more and more conventional doctors are looking critically at the evidence and the advice we have been giving to our patients in the past. By telling people not to eat fat, we have forced them into eating food containing lots of carbohydrates, which is led to an obesity epidemic. Doctors are now looking at whether we should be giving statins as frequently as we are recommending -for most doctors there is no debate - patients with definite heart disease should be on statins, their value in other situations is very debatable, in fact dubious.
People are also looking at the benefits of angioplasty which is being done every time doctors see what appears to be a significant lesion in a coronary artery. The evidence appears that only lesions that are symptomatic should be treated, and there is very little evidence that stenting any
lesion actually reduces the risk of heart attack or death. Over the forthcoming years, I suspect the number of angioplasty procedures will drop significantly.

Because of the increased cost of effective cancer treatments, I suspect that governments and insurance bodies may well be looking more closely at all other procedures, and confirm that they are value before funding them.

But perhaps the most frightening aspect of health which has the prospects of returning us to the Middle Ages is the development of drug resistant bacteria which could render most of our antibiotics impotent. Because of the speed of development of resistance, and the cost of developing new forms of antibiotics, the drug industry is unlikely to be spending a great deal of money on this problem.

What is Modern Medicine?

What is Modern Medicine?

In the 18 and 19th centuries, blood letting, leeches and purging were considered state of the art.

When I graduated from Medical School in 1967 - the major cause of heart attacks, strokes, cerebral haemorrhage, kidney failure, blindness and death was - believe it or not - high blood pressure (hypertension).  Since then BP lowering drugs have been developed so there are now very few people who suffer from this problem - drugs do save lives. We have antibiotics which kill bacteria and have again made feared diseases like puerperal sepsis (sepsis at birth), pneumonia, TB etc problems of the past.  However with the widespread use of antibiotics in medicine and veterinary practice, many of these are beginning to reappear in drug resistant forms. 
We still have no answers to cancer, immune diseases, virus diseases, neurological diseases - both in their prevention and cure, and most of modern medicine involves treating symptoms without necessarily improving survival or outcomes. 
Gene therapy, targeting cancer cells with immune therapy and similar techniques are probably the next step in the advancing march of medicine, but again all of this concentration is closing the gate after the horse has bolted.   Much much better, prevent the diseases from developing in the first place.
We have forgotten the wonder of the human body and also nature which has kept  us sustained and healthy for  hundreds of thousands of years - as far as we know, cancer, coronary disease, Alzheimer's, immune diseases were rare until the last century.   We need to look also  at our world - pollution and toxins which we put in and around our bodies, poor nutrition and lack of exercise are all creating bodies ripe for the development of today's diseases. 

This Pharmacists map from the 1930's click here (for full size)gives a fascinating commentary on how health is changing.  In modern medicine only approved drugs made by the pharmaceutical industry are considered appropriate to administer to our patients.  Natural, complementary or alternative therapies are discouraged or  even banned because they may  interfere with our  'proven' therapies -  even though the third  cause of death in the USA is pharmaceutical drugs.  But here we have evidence from the 1930's that many of today's  so called  'snake oils' were being used by doctors and health practitioners very effectively.   Why effectively -  well because many of them contained  drugs which we use today ( aspirin, quinine, local anaesthetics, caster oil, psyllium, cafergot, ipecac, morphine...the map is quite fascinating, and how many more of these early remedies may possibly be beneficial?   For example there is good evidence that cannabis oil,  CBD the non psychoactive ingredient of cannabis can help with epilepsy, other neurological diseases and even cancer.)


It will be many years before we reach the stage of having a wand that diagnoses and cures like Doc
in Star Trek, diseases, bacteria and viruses do have a cunning ability to change and become resistant to whatever therapy humankind can develop.   Concentrating on prevention, supporting and protecting our bodies, and looking more at what nature has provided will really become a Modern Medicine which will not need to change.

Informed consent before angioplasty

Most patients are not given informed consent.

Less than 2% of angioplasty patient are properly informed!

Before taking any prescribed drugs, or undergoing any form of elective treatment, in today's medical world it is assumed that the patient is informed about the need for the procedure, and also its risks and benefits. One of the most frequently performed

procedures in the Western world is coronary artery angioplasty, usually for patients with angina.  A recent study in the JAMA Internal Medicine makes horrifying reading.(click here).  In this paper 59 patients listed for coronary angioplasty had the discussion between themselves and their cardiologist concerning informed consent, recorded. (One would have thought the cardiologist knowing that he or she was being recorded would do better than usual).
There are seven basic elements to informed consent:
1. The patient knows they have a role of the decision.
2. Discussion of the issues and decisions at hand.
3. Discussion of the alternatives.
4. Discussions of the pros and cons of the alternatives.
5. Discussion of the uncertainties.
6. An assessment of the patient's understanding.
7. Exploration of the patient's preference.

Most patients believed that the procedure (angioplasty) reduces the risk of heart attacks and death, but in fact this is not correct. Angioplasty merely reduces the symptoms.

The findings of the study were very sobering – only 3% of the discussions included all elements of informed consent, and just 14% met a more limited definition of the procedure, alternatives and risks. 97% were good at discussing the procedure, but alternative procedures were offered only to 25% of cases. Also the majority of patients were not aware that they had a role in the decision-making process.

There is a real concern worldwide that coronary angioplasty is being performed a great deal more than it should be. There is no evidence, other than reducing symptoms that it does any benefit, and this is not what the general public believe. Even the conservative medical bodies and journals are beginning to discuss this, as not only is the procedure expensive, but it also does have significant risks, and there are other alternatives.

Make absolutely certain that any drug or procedure that you are about to undertake does more good than harm!

Why do we still circumcise boys?

Why are we still circumcising boys?

I have just finished reading a superb blog by Spoony Quinn (click here) and a video by John Geisheker (click here) on the history and current status of circumcision in boys.  
Some religious faiths require this practice, but the majority of boys circumcised in the last 150 years were not for this, but in the belief that it protected against STDs and other diseases, and also to discourage boys from playing with themselves by making masturbation less pleasurable. (To quote the ancient Jewish scholar Maimonides: "circumcision is good because it decreases sexual pleasure for the man and the woman, so that they will keep their minds on God rather than the unclean flesh.")
However there is almost no good evidence that circumcision reduces STDs and more recently HIV, which was strongly advocated until recently.   The Cochrane review on the subject concluded that there was no evidence that this genital mutilation had any effect. 
It certainly did reduce sexual pleasure, especially when performed on teenage boys and older, not only in the shorter term but also for life.   The Spoony Quinn blog goes into this topic in fascinating detail. 
So it does not reduce STDs and makes sex less pleasurable for men - so why do we still do it on little babies?   It is almost always performed without anaesthetic on the assumption that they don't feel pain - says who???? 
( Typical pain responses include an extremely fast heart rate, very high levels of cortisol (stress hormone), and high-pitched screaming, sometimes until the infant turns blue from lack of oxygen. The fragile newborn's heart, lungs, and other organs can be damaged or ruptured from being overworked.  Although some parents may believe that their own son "slept through" his circumcision, this is what they are told when their baby goes into shock and doesn't respond to any stimulus.) One reason given by parents is "so he doesn't look different from the other boys".
Routine circumcision was stopped in New Zealand 40 years ago, and there the incidence of infections is less than the USA and other circumcising countries. 
Before you consider genital mutilation and punishing your son for life, I would recommend you read the Quinn  bolg and watch the Geisheker video - then make an informed decision. 

Vitamin C and infections

Vitamin C is one of the most powerful weapons in treating disease – from scurvy, to infections and cancer. It is almost completely ignored by the conventional medical profession - which is a tragedy.
Most of us know about scurvy and how it killed more sailors than other diseases and battles, and was simply cured by giving sailors lemons or limes.
When the vitamin C level in many patients in hospital, particularly those who are seriously ill is measured, it is often near scurvy levels, and because vitamin C is essential for holding the cells together, maintaining the immune system, fighting infections and cancer, and many other functions, one wonders how many patients in intensive

care and hospital beds do not recover simply because of low vitamin C levels. (In hospital they regularly measure electrolytes, kidney and liver function etc – but never vitamin C levels!)

I have had personal experience and seen the benefit of intravenous vitamin C, or even high dose oral vitamin C in patients with infection and cancer, it provides enormous hope for people with cancer, especially advanced disease. I will write about this in a later blog, but I felt the article below written by one of the world authorities on vitamin C (Dr Thomas Levy) is worth sharing with the rest of the world. The more people who know about the value of this essential vitamin and its potential use in many diseases, the more rapidly conventional medicine and doctors will start introducing into their treatment regimes.

Is the healing power of Vitamin C too good to be true? Can this inexpensive and convenient vitamin improve and heal the toughest of ailments? 

by Thomas E. Levy, MD, JD

My ongoing relationship with vitamin C now spans a full 20 years, when I first

What to do when you have a heart attack

What to do when you have a heart attack

What happens:
One in three of us will die of heart disease, and although becoming slightly less common, a heart attack remains the major cause of death.With a heart attack a fat laden plaque in a coronary artery ruptures, causing a clot which blocks the artery. This can lead to a number of consequences:
1. Chest pain – a tight heavy feeling in the chest, throat, left or right arm,

2. Breathlessness, sweating, faintness and a feeling of being generally unwell frequently happen.
3. The heart can sometimes beat irregularly, causing palpitations, sometimes it can stop or beat in an uncoordinated fashion (ventricular fibrillation), leading to sudden death.

Speed is of the essence - both to reduce the amount of heart damage long term, and also reduce the risk of sudden death.   In the cardiology literature - "minutes mean muscle', ie the longer the delay, the more heart damage occurs. 
If we can dissolve the clot in the artery rapidly (less than 30 minutes) no damage is done at all. However there is benefit up to 6 hours, some believed 12 hours. However at any stage a cardiac arrest can occur, which is why the patient needs to be in a cardiac unit or close to a defibrillator as fast as possible.

While doctors can do –
1. Dissolve the clot with drugs given intravenously (thrombolysis). 

2. Remove the clot and open up the arteries in the cardiac catheter lab – angioplasty and stenting.
3. If the heart goes into fibrillation, this can easily be reversed with a defibrillator. These are routinely present in ambulances, places where people congregate (sports stadium, airports, shopping malls) and of course cardiac units.

What you can do –
1. Get to a cardiac unit (or ambulance) as soon as possible.

Call the ambulance using the emergency number (111, 999, 911) and say you have chest pain.
2. Sit down quietly and relax, if you feel faint lie down flat.
3. Chew one aspirin tablet (300 mg) slosh it round the mouth and then swallow it. This prevents the clot in the artery getting bigger.
4. If you have one, use your Nitrolingual spray one or two puffs every five minutes.
5. If you have some available, take some chewable magnesium or liquid magnesium (500 – 1000 mg), and 1000 mg of omega-3 fish oil. Both of these can  reduce the risk of cardiac arrest.

8 year survival curves, shortest delay (top) to slowest (bottom)

A recent study from the Netherlands has shown that in 3000 patients with a heart attack, the 30 day mortality was 2.6% in those with the shortest delay in reaching hospital catheter lab (mean 72 minutes), compared to 7.4% in those with the longer delay (160 minutes).   Five year mortality was also reduced from 22.6% in those with the longer delay to 12.8% in the shortest delay. 

So - getting to hospital as fast as possible saves lives in both the short and longer term.  DO NOT DELAY, don't worry about a false alarm or being a nuisance, any chest pain lasting more than 10 minutes, call an ambulance!