That’s a simple answer for a simple question. Frankly speaking, since poor nutrition is the leading cause of death in the United States, my theory to believe behind it: doctors are not trained on nutrition because there’s no money to profit from it.
The chemicals to blame for our reproductive crisis are found everywhere and in everything ~ 10:23 UTC Thursday, 18 March 2021
The end of humankind? It may be coming sooner than we think, thanks to hormone-disrupting chemicals that are decimating fertility at an alarming rate around the globe. A new book called Countdown, by Shanna Swan, an environmental and reproductive epidemiologist at Icahn School of Medicine at Mount Sinai in New York, finds that sperm counts have dropped almost 60% since 1973. Following the trajectory we are on, Swan’s research suggests sperm counts could reach zero by 2045. Zero. Let that sink in. That would mean no babies. No reproduction. No more humans. Forgive me for asking: why isn’t the UN calling an emergency meeting on this right now?
The chemicals to blame for this crisis are found in everything from plastic containers and food wrapping, to waterproof clothes and fragrances in cleaning products, to soaps and shampoos, to electronics and carpeting. Some of them, called PFAS, are known as “forever chemicals”, because they don’t breakdown in the environment or the human body. They just accumulate and accumulate – doing more and more damage, minute by minute, hour by hour, day by day. Now, it seems, humanity is reaching a breaking point.
Swan’s book is staggering in its findings. “In some parts of the world, the average twentysomething woman today is less fertile than her grandmother was at 35,” Swan writes. In addition to that, Swan finds that, on average, a man today will have half of the sperm his grandfather had. “The current state of reproductive affairs can’t continue much longer without threatening human survival,” writes Swan, adding: “It’s a global existential crisis.” That’s not hyperbole. That’s just science.
As if this wasn’t terrifying enough, Swan’s research finds that these chemicals aren’t just dramatically reducing semen quality, they are also shrinking penis size and volume of the testes. This is nothing short of a full-scale emergency for humanity.
Swan’s book echoes previous research, which has found that PFAS harms sperm production, disrupts the male hormone and is correlated to a “reduction of semen quality, testicular volume and penile length”. These chemicals are literally confusing our bodies, making them send mix messages and go haywire.
Given everything we know about these chemicals, why isn’t more being done? Right now, there is a paltry patchwork of inadequate legislation responding to this threat. Laws and regulations vary from country to country, region to region, and, in the United States, state to state. The European Union, for example, has restricted several phthalates in toys and sets limits on phthalates considered “reprotoxic” – meaning they harm the human reproductive capacities – in food production.
In the United States, a scientific study found phthalate exposure “widespread” in infants, and that the chemicals were found in the urine of babies who came into contact with baby shampoos, lotions and powders. Still, aggressive regulation is lacking, not least because of lobbying by chemical industry giants.
In the state of Washington, lawmakers managed to pass the Pollution Prevention for Our Future Act, which “directs state agencies to address classes of chemicals and moves away from a chemical by chemical approach, which has historically resulted in companies switching to equally bad or worse substitutes. The first chemical classes to be addressed in products include phthalates, PFAS, PCBs, alkyphenol ethoxylate and bisphenol compounds, and organohalogen flame retardants.” The state has taken important steps to address the extent of chemical pollution, but by and large, the United States, like many other countries, is fighting a losing battle because of weak, inadequate legislation.
In the United States today, for example, you can’t eat the deer meat caught in in Oscoda, Michigan, as the health department there issued a “do not eat” advisory for deer caught near the former air force base because of staggeringly high PFOS levels in the muscle of one deer.
And, just the other week, hundreds of residents who live near Luke air force base in Arizona were advised not to drink their water, when tests detected high levels of toxic chemicals. Scientists have found these substances in the blood of nearly all the people they tested in the US. No country or region on earth is untouched by PFAS contamination. It is a global problem. PFAS has been found in every corner of the globe. It is virtually present in the bodies of every human. It’s found in fish deep in the sea, and birds flying high in the sky.
And it’s killing us, literally, by harming and attacking the very source of life: our reproductive capacities. The rapid death and decline of sperm must be addressed, and it must be addressed now. There simply is no time to lose.
Doctor’s Death After Covid Vaccine Is Being Investigated
How scary is that title? It worries me to know that the Coronavirus Pfizer vaccine that was created to save lives, are killing people all around the world.
Dr. Gregory Michael, 56-year-old obstetrician and gynecologist in Miami Beach, received the vaccine at Mount Sinai Medical Center on Dec. 18 and died 16 days later from a brain hemorrhage. Then in Norway, 23 people died after receiving the first dose of Pfizer COVID-19 vaccine, 13 were nursing home patients. Steinar Madden, Medical director said, it is quite clear that these vaccines have very little risk, with a small exception for the frailest patients. Doctors must now carefully consider who should be vaccinated. Although these deaths are low, they are still significantly important because there’s clearly something wrong with the Pfizer vaccine. People need to understand, vaccines are not a ones-size-fits-all.
Agreeing to take the vaccine regardless of which drug company manufactured it, there is a high risk of side effects or possibly dying. When these drug companies, such as Moderna, Pfizer, Johnson & Johnson, Merck, and AstraZeneca (to name of few), created the COVID-19 vaccine they applied for an Emergency Use Authorization (EUA) for distribution.
What is an Emergency Use Authorization (EUA)?
An Emergency Use Authorization (EUA) is a mechanism to facilitate the availability and use of medical countermeasures, including vaccines, during public health emergencies, such as the current COVID-19 pandemic. Under an EUA, FDA may allow the use of unapproved medical products, or unapproved uses of approved medical products in an emergency to diagnose, treat, or prevent serious or life-threatening diseases or conditions when certain statutory criteria have been met, including that there are no adequate, approved, and available alternatives. Taking into consideration input from the FDA, manufacturers decide whether and when to submit an EUA request to FDA.
Once submitted, FDA will evaluate an EUA request and determine whether the relevant statutory criteria are met, taking into account the totality of the scientific evidence about the vaccine that is available to FDA. This emergency use allows drug companies to skip many steps. Steps that would usually include many years of research studies on the efficacy and validity of the vaccine on various different variables. The population of people in the United States consists of so many variables to study. For example:
The effects on people with high blood pressure
The effects on breast cancer, blood cancer, prostate cancer, brain cancer patients and so on.
The effects on diabetics
Psychological and mental disorders
Allergies, pregnancy, infants, elderly, teenagers and so on
That list can go on and on because there are so many underline health conditions to consider when studying the effects on people. I’m not one hundred percent sold on the Emergency Use Authorization for these vaccines because the data is still pending. Everyone that opted-in now to be vaccinated are being studied and monitored closely.
In the months and years to come, that data may be used to adjust or even change the ingredients in the vaccines to address side effects and deaths that people have experienced. The more data on hand, the better the outcome. These first individuals will pave the way for concrete information to be used to create the most effective vaccine. Please be careful because there are fake vaccines and treatments out on the market as well.
Unfortunately, there are people and companies trying to profit from this pandemic by selling unproven and illegally marketed products that make false claims, such as being effective against the coronavirus. These fraudulent products that claim to cure, treat, or prevent COVID-19 haven’t been evaluated by the FDA for safety and effectiveness and might be dangerous to you and your family.
Always consult with your healthcare professionals before taking or thinking of buying any form of drug, tests, treatments, vaccines, or vitamins for the treatment of COVID-19 or any other ailments.
The research suggests that children clear the infection much faster than adults and may help explain why many don’t become seriously ill.
Children infected with the coronavirus produce weaker antibodies and fewer types of them than adults do, suggesting they clear their infection much faster, according to a new study published Thursday.
Other studies have suggested that an overly strong immune response may be to blame in people who get severely ill or die from Covid-19. A weaker immune response in children may paradoxically indicate that they vanquish the virus before it has had a chance to wreak havoc in the body, and may help explain why children are mostly spared severe symptoms of Covid, the disease caused by the coronavirus. It may also show why they are less likely to spread the virus to others.
“They may be infectious for a shorter time,” said Donna Farber, an immunologist at Columbia University in New York who led the study reported in the journal Nature Immunology.
Having weaker and fewer antibodies does not mean that children would be more at risk of re-infections, other experts said.
“You don’t really need a huge, overly robust immune response to maintain protections over some period of time,” said Deepta Bhattacharya, an immunologist at the University of Arizona in Tucson. “I don’t know that I would be especially worried that kids have a little bit lower antibody response.”
The study looked at children’s antibody levels at a single point in time, and was too small to provide insights into how the levels may vary with age. But it could pose questions for certain antibody tests that may be missing children who have been infected.
Dr. Farber and her colleagues analyzed antibodies to the coronavirus in four groups of patients: 19 adult convalescent plasma donors who had recovered from Covid without being hospitalized; 13 adults hospitalized with acute respiratory distress syndrome resulting from severe Covid; 16 children hospitalized with multi-system inflammatory syndrome, the rare condition affecting some infected children; and 31 infected children who did not have the syndrome. About half of this last group of children had no symptoms at all.
Individuals in each group had antibodies, consistent with other studies showing that the vast majority of people infected with the coronavirus mount a robust immune response.
“This further emphasizes that this viral infection in itself, and the immune response to this virus, is not that different from what we would expect” from any virus, said Petter Brodin, an immunologist at Karolinska Institutet in Stockholm.
But the range of antibodies differed between children and adults. The children made primarily one type of antibody, called IgG, that recognizes the spike protein on the surface of the virus. Adults, by contrast, made several types of antibodies to the spike and other viral proteins, and these antibodies were more powerful at neutralizing the virus.
Children had “less of a protective response, but they also had less of a breadth of an antibody response,” Dr. Farber said. “It’s because those kids are just not getting infected as severely.”
Neither group of children had antibodies to a viral protein called the nucleocapsid, or N, that is entangled with the genetic material of the virus. Because this protein is found within the virus and not on its surface, the immune system would only see it and make antibodies to it if the virus were widely disseminated in the body, she said.
“You don’t really see any of that in the children, and that suggests that there’s really a reduced infection course if these kids are getting infected,” she explained.
The finding could undermine the results from tests designed to pick up antibodies to the N protein of the virus. Many antibody tests, including those made by Abbott and Roche and offered by Quest Diagnostics and LabCorp, are specific to the N antibodies and so may miss children who have successfully cleared the virus. “That’s absolutely an interesting implication of that finding,” Dr. Brodin said.
Lower levels of virus in the body would also explain why children seem generally to transmit the virus less efficiently than adults do. But experts urged some caution in interpreting the results because they represent samples taken from people at a single point in time. Samples from the more severely affected children and adults were collected within 24 to 36 hours of being admitted or intubated for respiratory failure; those from children with mild or no symptoms were banked after medical procedures.
The type of antibodies produced by the body varies over the time course of an infection. This was a limitation of this study because the researchers may have been comparing people at different points in their infection, Dr. Brodin said. “You risk comparing apples and oranges.”
Other experts cautioned that the study was too small to draw conclusions about how the immune response may vary in children of different ages. The children in the study ranged in age from 3 to 18 years, with a median age of 11. But some studies have suggested that teenagers may be just as much at risk from the coronavirus as adults.
“It’s very important to understand what happens in children,” to understand the nature of their illness, but also how they contribute to spread of the virus in the community, said Dr. Maria L. Gennaro, an immunologist at Rutgers University. But “to try and stratify by age, it’s a little bit of a stretch in the analysis,” she said.
The researchers were also not able to explain why children have a more limited antibody response. Having fewer types of antibodies may seem like a bad thing, but “having a ton of antibody isn’t necessarily a marker of a good thing,” said Dr. Bhattacharya. “It usually means that something went wrong early in the response.”
At least one other study has suggested that children have a powerful inborn immune system, intended to combat the many new pathogens they encounter, and that this first line of defense may clear the infection early without needing to rely on later antibodies.
Another possibility is that the children have some protection — in the form of immune cells called memory T cells — from previous encounters with common cold coronaviruses.
“Is it all innate? Or could there actually be some pre-existing memory?” Dr. Bhattacharya said. “I think those are both possible.”
At my house, dinner is not a three-course meal every night. More likely, it’s a main course and a green salad. Sometimes, it is a one-pot main course, though not always. (I find that even when cooking a simple meal, at least two pots and pans are often involved.) And, quite frequently, dinner is meatless.
While I consider myself a carnivore, my first love will always be vegetables. I’m quite happy to have a vegetarian meal several times a week.
In addition to fresh vegetables, whole grains and dried legumes are usually part of the picture. I’m a big fan of every type of bean, whether cannellini or garbanzo, with a cupboard full of them to choose from. Lately, it is lentils that most strike my fancy. Aside from being delicious, they have the advantage of being quick-cooking. It usually takes no more than 30 minutes to simmer a pot, so they are perfect for a relatively fast meal.
For most uses, any kind will work, but even among lentils, there are lots of types to choose from. If the meal is leaning in a Spanish direction, I might go with Pardina lentils, a small brown variety good for stews, soups or salads. For an Italianate dish, I like Castelluccio lentils from Umbria. When I want to veer toward Turkish flavors, I choose split red lentils. What follows are three lentil dinners I highly recommend. They are all vegetarian, and all have the advantage of tasting good, perhaps better, when prepared in advance. Lastly, each of these dishes can benefit from a drizzle of fruity extra-virgin olive oil as a final flourish, to make them that much more luscious.
This rustic stew improves after a day in the fridge. At the very least, try to cook it an hour or two ahead of the meal, so the elements have time to meld. (You can also make it to eat over several days, or to freeze for later.) Any size green or brown lentil will work here, if you can’t get the small Spanish Pardina lentils (or French lentilles du Puy). But the smoky pimentón is vital: Along with extra-virgin olive oil, it provides real depth of flavor.
There are many versions of pasta with lentils, a multitude of which are thick and stewlike, more lentil than pasta. This one emphasizes the pasta. The saucy lentil topping is similar to a traditional Bolognese ragù. The addition of fennel — seeds, bulb and chopped green fronds — gives it a surprising brightness and zest. For even more flavor, put your saved-up Parmesan rinds to use in the sauce. (Meat eaters: Add a little chopped anchovy or Italian fennel sausage.)
You may have encountered the kind of vegetarian lentil loaf that masquerades as something else. With its brownish-grey color and a red ketchup glaze, it tries to emulate the homespun comfort of meatloaf. Most recipes call for Worcestershire and barbecue sauce to make it taste beefy. This delicate red lentil loaf is worlds away from that. It’s all about the undisguised flavor of the lentil: sweet and vegetal. The seasoning is a little bit Turkish, with lemon, cumin, cilantro, dill and yogurt. It is delicious served at room temperature or warm. The loaf is easier to cut if cooled, with slices heated through in the oven. Even better is to griddle the slices with a little oil in a nonstick or cast-iron pan until crisp and golden on both sides.
Johnson & Johnson on Friday recalled a single batch of its baby powder as a precaution after government testing found trace amounts of asbestos in one bottle bought online.
The regulator found trace levels of chrysotile asbestos in samples taken from a bottle of baby powder purchased from an online retailer,Johnson & Johnsonsaid. The company has, for years, denied that the carcinogen is, or ever was, present in its talc-based products.
This is the first time Johnson & Johnson has ever pulled baby powder from the market over asbestos concerns, a spokesman for the company said, and comes as Johnson & Johnson is battling thousands of lawsuits brought by people who say that baby powder and other talc-based products caused them to develop cancer. Some have mesothelioma, an aggressive cancer that is considered the signature disease of asbestos exposure, while others have ovarian cancer, which has also been linked to asbestos.
The recall will undermine defense claims against those suits, and could lead to the company having to pay more or to settle cases, said Erik Gordon, a University of Michigan business professor who studies corporate governance. Shares of the company fell 5 percent in early afternoon trading on Friday.
But in announcing the recall, the company also repeated part of its long-running defense against cancer claims, saying that “thousands of tests over the past 40 years repeatedly confirm that our consumer talc products do not contain asbestos.” The company said it was recalling the shipment out of an “abundance of caution.”
Though Johnson & Johnson said it has started “a rigorous, thorough investigation into the matter” it also appeared to question the testing process, saying in a statement that it is working with the F.D.A. to “determine the integrity of the tested sample and the validity of the test results.”
The recalled baby powder was produced and shipped last year. The recalled lot, #22318RB, involves 33,000 bottles sold by a retailer, which sold products online but may have shipped powder to stores, the spokesman, Ernie Knewitz, said. The F.D.A. has not responded to questions about the identity of the retailer.
A New York Times investigation last year found that Johnson & Johnson executives were aware for decades of the risks of asbestos contamination in talc but did not warn consumers. Internal memos and reports made public during litigation against the company document executives’ concerns about potential contamination that date back 50 years.
Earlier this year, Johnson & Johnson disclosed that it isbeing investigatedby the Justice Department and Securities and Exchange Commission over concerns about possible asbestos contamination of its talc-based products.
The company is now entangled in litigation on multiple fronts. On Thursday, it agreed to pay$117 millionto settle claims that it deceptively marketed transvaginal pelvic mesh implants. Earlier this month, a jury in Philadelphia ordered Johnson & Johnson to pay$8 billionto a Maryland man who accused the company of downplaying the risks associated with the anti-psychotic drug Risperdal. The company has also agreed tosettleclaimsinvolving its role in the nationwide opioid crisis.
Lee Hambright, an analyst with Bernstein, wrote in a note to clients last week that Johnson & Johnson could face $5 billion in legal liability over the talc litigation. Of the 15,500 talc lawsuits the company has disclosed, Mr. Hambright estimated that 1,000 involved mesothelioma cases.
Talc is a natural mineral that is mined from underground deposits, but asbestos can form under the same geological conditions that form talc, and geologists say veins of asbestos can intermingle with talc in underground mines.Johnson & Johnson officials emphasized that the level of asbestos detected was very low, the amount being “two ten-thousands of a percent” of the sample. U.S. health agencies, however, say there is no known safe level of exposure when it comes to asbestos.
While health risks increase with heavier and longer exposure times to asbestos, the overall evidence suggests no level of asbestos exposure is safe, and disease has been found in people with only brief exposures, according to theNational Cancer Institute.
For generations, urinary tract infections, one of the world’s most common ailments, have been easily and quickly cured with a simple course of antibiotics. But there is growing evidence that the infections, which afflict millions of Americans a year, mostly women, are increasingly resistant to these medicines, turning a once-routine diagnosis into one that is leading to more hospitalizations, graver illnesses and prolonged discomfort from the excruciating burning sensation that the infection brings.
The New York City Department of Health has become so concerned about drug-resistant U.T.I.s, as they are widely known, that it introduced a new mobile phone app this month that gives doctors and nurses access to a list of strains of urinary tract infections and which drugs they are resistant to. The department’s research found that a third of uncomplicated urinary tract infections caused by E. coli — the most common type now — were resistant to Bactrim, one of the most widely used drugs, and at least one fifth of them were resistant to five other common treatments. “This is crazy. This is shocking,” said Lance Price, director of the Antibiotic Resistance Action Center at George Washington University, who was not involved in the research.
The drug ampicillin, once a mainstay for treating the infections, has been abandoned as a gold standard because multiple strains of U.T.I.s are resistant to it. Some urinary tract infections now require treatment with heavy-duty intravenous antibiotics. Researchers last year reported in astudythat a third of all U.T.I.s in Britain are resistant to “key antibiotics.” Certainly, the day-to-day experience of having a U.T.I. is growing less routine for many women. Carolina Barcelos, 38, a postdoctoral researcher in Berkeley, Calif., said she had several U.T.I.s as a teenager, all successfully treated with Bactrim. When she got one in February, her doctor also prescribed Bactrim, but this time it didn’t work.
Four days later, she returned and got a new prescription, for a drug called nitrofurantoin. It didn’t work either. Her pain worsened, and several days later, there was blood in her urine. Her doctor prescribed a third drug, ciproflaxacin, the last of the three major front-line medicines, and cultured her urine. The culture showed her infection was susceptible to the new drug, but not the other two. “Next time,” Dr. Barcelos said, “I’m going to ask them to do a culture right away. For eight days I was taking antibiotics that weren’t working for me.” Usually, it is people with weakened immune systems or chronic medical conditions who are most vulnerable to drug-resistant infections, but U.T.I.s have a dubious distinction: They are the single biggest risk to healthy people from drug-resistant germs.
Resistance to antibiotics has become one of the world’s most pressing health issues. Overuse of the drugs in humans and livestock has caused germs to develop defenses to survive, rendering a growing number of medicines ineffective in treating a wide range of illnesses — a phenomenon that is playing out worldwide with U.T.I.s.
The World Health Organization, while noting that data on urinary tract infections and drug resistance is “scarce,” said the fact the infections were so common strongly suggested that increasing resistance would lead to more severe illnesses and fatalities. The solution, researchers and clinicians say, includes a continued push for more judicious use of antibiotics worldwide. But more immediately, a partial solution would be the development of quick, cheap diagnostic tools that would allow an instant urine culture so that a doctor could prescribe the right drug for U.T.I.s.
But whether to wait the several days it usually takes to get lab results before prescribing presents a tough dilemma for doctors and patients, who frequently are desperate for relief. Plus, depending on a person’s insurance, getting a culture can be expensive. Generally doctors still do not order a urine culture before prescribing an antibiotic.
“In the old days, the list of antibiotic options was short but by and large they would all work,” said Dr. James Johnson, an infectious disease professor and leading researcher on urinary tract infections at the University of Minnesota. Some women have U.T.I.s that the body fights off on its own without using antibiotics, while other women may have a different low-level ailment that feels like a U.T.I., but isn’t. The safest course is to see a doctor and make an informed decision that includes a judicious determination of whether antibiotics are warranted. The science does not support the efficacy of some popular remedies like cranberry juice or cranberry pills.
Officials from the federal Centers for Disease Control and Prevention said that U.T.I.s acquired by otherwise healthy people were a growing concern and one poorly studied. They are not tracked nationally. In older people, urinary tract infections can be deadly, but tracking in the United States is so weak that there are no reliable estimates on the numbers of deaths related to the infections. The C.D.C. published an estimate of 13,000 per year, but that figure comes froma paper looking at 2002 dataand refers only to U.T.I.s acquired in hospitals. Dr. Clifford McDonald, associate director for science in the division of health care quality promotion at the C.D.C., said the government planned to expand its research.
“If we don’t do something soon,” Dr. McDonald said, “it’s going to push all our treatments to more advanced antibiotics that finally put a lot of pressure on the last-line treatments.”
What makes these infections so dangerous, and commonplace, is human anatomy. In women, the urethra — the gateway to the urinary tract — is in proximity to the rectum. This can lead to easy transfer of bacteria in fecal residue that otherwise resides harmlessly in the gut.
In reproductive years, women are 50 times for likely than men to have a urinary tract infection; later in life, the ratio drops to 2 to 1, as men wind up having surgical procedures on their prostate, or catheters, that more easily expose their urinary tracts to infection.
There are multiple germs that cause U.T.I.s, and their resistance levels to drugs vary both by strain and by where a patient lives. By far the most common cause of U.T.I.s today is E. coli, and, in general, those infections have seensharp rises in resistanceto gold standard treatments over the past decade and a half.
New research shows that one crucial path of transfer of germs that cause U.T.I.s is food, most often poultry. The consumed poultry winds up in a person’s gut and can get transferred through fecal residue to the urethra.
A study published last year by the American Society of Microbiology, funded partly by the C.D.C., found 12 strains of E. coli in poultry that matched widely circulating urinary tract infection strains. One of the study’s authors, Dr. Lee Riley, a professor of epidemiology and infectious diseases at the University of California, Berkeley, said he was working on a C.D.C.-funded project to determine whether the urinary tract infection needs to be classified and reported as a food-borne illness.
Dr. Brad Frazee, an emergency room doctor at Highland Hospital in Oakland, Calif., has been a co-author ofresearchthat adds another troubling wrinkle: Increasingly, E. coli is proving resistant not just to individual antibiotics, but also to a broad group of drugs known as beta-lactam antibiotics. These drugs share a way of attacking infection, and when a germ develops resistance to this method of attack, it eliminates several key treatment options all at once.
Recently, a woman carrying such resistance showed up at Dr. Frazee’s hospital, he said. She wound up with pyelonephritis, an infection in the kidney, and had to be treated in the hospital intravenously with a drug called ertapenem that can cost $1,000 a dose. A study found that around 5 percent of U.T.I.s at the hospital carried this resistance.
Doctors are now confronting cases of resistant urinary tract infections in their practices. Dr. Eva Raphael, a primary care physician in San Francisco, recently received notice that one of her patients, a healthy woman in her mid-30s, was back in the emergency room with another U.T.I. that was resistant to multiple antibiotics.
One of her prior U.T.I.s had failed to respond to two commonly used treatments and had spread to her kidney, requiring hospitalization to receive intravenous antibiotics. This time Dr. Raphael consulted with infectious disease specialists. “It can be quite dangerous in this age where there is more and more resistance,” she said, noting that without effective treatment the infection can get into the blood. “It can be fatal.”
A study published in the journalJAMA Internal Medicineon Monday suggests that the link is strongest for certain classes of anticholinergic drugs — particularly antidepressants such as paroxetine or amitriptyline, bladder antimuscarinics such as oxybutynin or tolterodine, antipsychotics such as chlorpromazine or olanzapine and antiepileptic drugs such as oxcarbazepine or carbamazepine.
Researchers wrote in the study that “there was nearly a 50% increased odds of dementia” associated with a total anticholinergic exposure of more than 1,095 daily doses within a 10-year period, which is equivalent to an older adult taking a stronganticholinergic medication daily for at least three years, compared with no exposure.
“The study is important because it strengthens a growing body of evidence showing that strong anticholinergic drugs have long term associations with dementia risk,” said Carol Coupland, professor of medical statistics in primary care at theUniversity of Nottinghamin the United Kingdom and first author of the study.
“It also highlights which types of anticholinergic drugs have the strongest associations. This is important information for physicians to know when considering whether to prescribe these drugs,” she said, adding “this is an observational study so no firm conclusions can be drawn about whether these anticholinergic drugs cause dementia.”
She said that people taking these medications are advised not to stop them without consulting with their doctor first, as that could be harmful. The study involved analyzing data on 284,343 adults in the United Kingdom, aged 55 and older, between 2004 and 2016. The data came fromQResearch, a large database of anonymized health records.
The researchers identified each adult’s anticholinergic exposure based on details of their prescriptions. The researchers found the most frequently prescribed anticholinergic drugs were antidepressants, drugs to treat vertigo, motion sickness or vomiting and bladder antimuscarinic drugs, such as to treat overactive bladder. The researchers also took a close look at who was diagnosed with dementia and found that 58,769 of the patients had a dementia diagnosis.
The researchers found no significant increases in dementia risk associated with antihistamines, skeletal muscle relaxants, gastrointestinal antispasmodics, antiarrhythmics, or antimuscarinic bronchodilators, according to the data, but associations were found among other classes of anticholinergic drugs. The researchers found that the odds of dementia increased from 1.06 among those with the lowest anticholinergic exposure to 1.49 among those with the highest exposure, compared with having no prescriptions for anticholinergic drugs.
The study had some limitations, including that some patients may not have taken their prescribed medication as directed, so anticholinergic exposure levels could have been misclassified. The researchers found only an association between anticholinergic drugs and dementia risk, not a causal relationship.
“However, if this association is causal, the population-attributable fractions indicate that around 10% of dementia diagnoses are attributable to anticholinergic drug exposure, which would equate, for example, to around 20,000 of the 209,600 new cases of dementia per year in the United Kingdom,” the researchers wrote in the study.Since the study shows only an association, more research is needed to “clarify whether anticholinergic medications truly represent a reversible risk factor” for dementia, wrote expertsNoll Campbell,Richard HoldenandDr. Malaz Boustaniin an editorial that published alongside the new study in JAMA Internal Medicine.
“Additionally, deprescribing trials can evaluate potential harms of stopping anticholinergic medications, such as worsening symptoms of depression, incontinence, or pain, as well as the potential unintended increase in acute health care utilization,” Campbell, Holden and Boustani wrote in the editorial.”With little evidence of causation, the next steps for research on anticholinergic medications in older adults must improve knowledge of the effect of deprescribing interventions on cognitive outcomes and important safety outcomes such as symptom control, quality of life, and health care utilization,” they wrote. “We propose deprescribing research as a high priority.”
It has been well known that anticholinergic agents and confusion or memory issues are linked, but the new study investigated this association over a long period of time, said Dr. Douglas Scharre, director of the division of cognitive neurology at theOhio State University Wexner Medical Centerin Columbus, who was not involved in the study.
He encouraged any patients who might have questions about this association to talk to their physicians. “I spend a lot of my time in the memory disorder clinic seeing geriatric patients and taking people off medications, mostly ones that have anticholinergic properties, and many times there can be another drug out there that has less anticholinergic impact or is non-anticholinergic that may work,” Scharre said.
“Some of the medications that they list in the study may be quite critical and important and are well worth the person taking for their seizures or their psychosis, and so it’s a risk-benefit discussion,” he added. “So have a conversation with your doctor.”
I’m journeying on a new path to learn how to meditate. I need to bring calm, stillness, and peacefulness to my mind. I’ve heard and read about the many amazing benefits on practicing meditation, and I’m at the right stage in my life where I need it the most. With a full time career, three children, husband, and a dog; it’s a time much needed. I chose The Headspace Guide to Meditation and Mindfulness by Andy Puddicombe to kick start my journey because it came highly recommended by Bill Gates. No, I don’t know him personally, although I wish! I follow his blog, gatesnotes. If you don’t, you should. He’s brilliant, Google him. Bill is the reason why I researched Andy in the first place. Andy is 47 with many years of training in monasteries in India, Nepal, Myanmar, Thailand, Australia, Russia, and Scotland. He’s even an ordained Buddhist monk.
Andy’s approach to meditation is clear and easy to understand. He teaches amazing techniques, and they’re easy to apply to your everyday busy lifestyle. Andy also believes all you need is 10 minutes a day. Obviously, if you have the ability and time to meditate longer, by all means meditate. When you think of 10 minutes, it’s actually not that long; however, it’s hard for the average person to sit still with a clear mind. More importantly, the practice of meditation is about much more than simply sitting down for a set period of time each day. Andy says, “it’s about training in awareness and understanding how and why you think and feel the way you do, and getting a healthy sense of perspective in the process.” His book also looks deeper in the differences between understanding mindfulness and headspace. He even have an app called, Headspace available on IOS. I haven’t downloaded it yet, but I intend to. Let’s take a look at mindfulness, Andy explains it as the temptation to judge whatever emotion that comes up, and therefore neither opposing or getting carried away with a feeling. And headspace is the result of applying this approach. Headspace delivers a sense of ease with whatever emotion is present.
How many times you’ve been in a situation where someone pissed you off? It angers you, and you feel like you just want to explode. Then you move through your day retelling that scenario over and over to everyone you possibly can share it with. Instead of moving forward productively with your day, you dwell and relive that situation over and over again transferring that negative energy to your friends, love ones, and even into your workplace. This behavior is toxic and becomes debilitating to your mind, body and soul. Who wants to go through life this way? Surely not me! Knowing how to let go and release these toxic thoughts and energy is my goal.
Andy’s book offers four steps to help you achieve meditation. His Take10 summary is recommended to follow each and every time before you meditate.
Focusing the mind
The book explains in detail what you need to do in each step to get your mind and body ready. I’m almost midway finish reading the book. I feel more confident than ever. This book has already taught me about the layers of my thoughts, dealing with my emotions, and how to tackle each one as they come to mind. I’ve re-read many chapters and made side notes. It’s definitely a page turner. If you’re interested in learning how to meditate, this book may help you. I would love to hear about your journey or any suggestions on meditation.
What do you start your day off with? For me it’s sometimes a green smoothie, an almond butter toast with flaxseeds and chia seed toppings. Today, it’s my oatmeal. Midway through devouring my breakfast, I just had to snap a picture and blog about it. This was so simple to make. It didn’t require any frying. I literally just added hot water and waited 10 minutes. Then I topped it with cinnamon, ground up flaxseeds, blueberries, blackberries and half of a banana. This is what a healthy breakfast should look like. People often say, “oatmeal is boring!” I could see that, but then you should jazz it up. Be creative! Add cocoa nibs, which are cocoa bean pieces with nothing added to them. This would be for those chocolate lovers. Shredded coconuts and raisins are delicious too, or even some nuts. I added bananas for some sweetness because I don’t use sugars.
I think oatmeal is one of the healthiest most nutritious meal you can start your day off with. It’s packed with so many vitamins, fiber, and minerals. It’s also cheap, and easy to prepare. If you were to have a cup of basic quick oats everyday, it would cost you $.043. Can’t beat that!