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“Catching Things Early” Supplementing Perfectly

Jan 19, 2016

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“Catching Things Early” Supplementing Perfectly. John Whitcomb, MD Green Bay Business Forum March 2nd, 2011. Objective. Explain the 50,000 foot picture of what modern medicine does What we really want from health care How this “Changes Everything” in Primary Care - PowerPoint PPT Presentation

  • Catching Things Early Supplementing PerfectlyJohn Whitcomb, MDGreen Bay Business ForumMarch 2nd, 2011

  • ObjectiveExplain the 50,000 foot picture of what modern medicine doesWhat we really want from health careHow this Changes Everything in Primary CareA couple of practical tips for yourself

  • What We Really WantTo never get sickTo live to be a healthy hundredTo operate at optimal levels of functioningTo reduce the cost of health care to ourselves personally and corporatelyGradual decline into senility is not acceptable

  • Its the JourneyGoing back to the source of infectious diseaseWe started living longer: 46 in 1900 to 78-87 in 2000Now we have chronic diseaseWere still treating with the same paradigm of infectious disease: fix you when you get sickAnd do it in 10 days (thats the core fallacy that modern medicine is now trying to do)

  • MODERN MEDICINES ADDICTIONWe get paid for procedures: appendicitis, open heart surgeryWe get rewarded for doing big dramatic things that fix you all in a hurryWe come to believe that we can fix many things with a quick bulletOpen heart surgery does not reverse vascular diseaseThere is no surgery/pill for Alzheimers

  • But, we now have Chronic Disease as our ChallengeSame journeyLets get back to the sourceWhats the real cause of chronic diseaseFact: the treatment of chronic illness, once its entrenched is expensive, toxic and debilitatingAwareness: MUCH BETTER fend off earlyWhat causes Alzheimers (78% less on India)

  • Western DiseasesCancer, Heart Disease, Neurological Degenerative Diseases (50% of us will have Alzheimers by 90)Arthritis, Autoimmune (40% of American women carry an autoantibody) Save my eyes, my knees and my brain!Many parts of the less developed world have very rare cancerDistricts in China go decades between heart attacks

  • HypothesisChronic diseases are caused by long latency conditionsUnderlying physiology is out of balance for years or decades prior to diseaseAutoimmune illnesses: typically have 20 years of antibody, 5 years of vague symptoms, then horrible diseaseWe need to get to core imbalances

  • 4070100120BirthGrowth HormoneInflammationLong Latency Disease

  • Our Big GoalAddress the mechanisms of chronic long latency diseaseMaintain optimal health (not treat disease)Rectangularize optimal health keep your healthy and vibrant the longest possibleThat means addressing inflammation Delay long latency diseaseMust address the Antecedents to Chronic Illness

  • Jan 15th, 2008, Wisconsin Medical Journal1. Whats the Problem in Wisconsin?

  • Using 30 ng as sufficient59% of Caucasian Elderly women in WI are insufficient

  • 2. What is Vitamin D? A Hormone Based on CholesterolLike a hormone, effects the expression of genesDoes not work like a vitamin as a cofactor in metabolismAffects over 2000 genes in 1400 cell typesComes from SUN: NOT from foodEvolution is frugal: uses cholesterol for other hormone functions: but Dwas likely the first

  • 20:20:20:20 Rule20 year old with 50% of skin exposed20 minutes of mid day sun: with skin type III (typical Caucasian-American) On JUNE 20th(height of summer)Not enough sun to tanWill make about 20,000 U over the next 24 hours: the 20:20:20 Rule on June 20Typical African-American: needs 4-5 times as much sun-light because of skin pigmentElderly: age 70 make only 25%

  • This means one glass of milk a dayWill raise your D level about 1 ng, or 2.5 nmoles.

  • Note: After20 min, CA dont make any more D

  • (Vieth, AJCN 1999:69, 842-56)4. Whats Enough?

    Chart1

    42

    54

    65

    59

    Vitamin D Levels in Sun Rich Environments

    Sheet1

    Puerto Rico Nurses (26)Puerto Rico Farmers (18)St. Louis Lifeguards (9)Israeli Lifeguards (34)

    42546559

    Sheet1

    Vitamin D Levels in Sun Rich Environments

    Sheet2

    Sheet3

  • Published Literature on Intentional UVB Treatment and D Levels(Vieth AJCN 1999 : 69 p 842-56)

    Chart4

    924

    22.436.8

    1245.2

    847.2

    2150

    2651.6

    2360

    2155

    Before

    After UVB

    Sheet1

    Puerto Rico Nurses (26)Puerto Rico Farmers (18)St. Louis Lifeguards (9)Israeli Lifeguards (34)

    42546559

    Sheet1

    Vitamin D Levels in Sun Rich Environments

    Sheet2

    German Men (24) Two weeksMedical Students (6) One sessionPsoriasis (8) Three weeksLondoners (7) Three weeksNew Yorkers (7) 10 sessionsKidney Stone (11) 10 sessionsHBP (9) 3 times a weekGerman Men (5) 3 times a week

    Before922.412821262321

    After UVB2436.845.247.25051.66055

    Sheet2

    Before

    After UVB

    Sheet3

    British Submariners (26) 2 monthsImmigrant Pakastanis (24) 12 monthsAmerican Submariners (30) 2.25 months

    Before142031

    After83.219

    Sheet3

    Before

    After

  • When you are deprived of sunshine, your D level drops(Vieth AJCN 1999: 69, 842-56)

    Chart3

    148

    203.2

    3119

    Before

    After

    Sheet1

    Puerto Rico Nurses (26)Puerto Rico Farmers (18)St. Louis Lifeguards (9)Israeli Lifeguards (34)

    42546559

    Sheet1

    Vitamin D Levels in Sun Rich Environments

    Sheet2

    German Men 24)Medical Students (6)Psoriasis (8)Londoners (7)New Yorkers (7)Kidney Stone (11)HBP (9)German Men (5)

    Before922.412821262321

    After UVB2436.845.247.25051.66055

    Sheet2

    Before

    After UVB

    Sheet3

    British Submariners (26) 2 monthsImmigrant Pakastanis (24) 12 monthsAmerican Submariners (30) 2.25 months

    Before142031

    After83.219

    Sheet3

    Before

    After

    *This is self evident. Its a shot across the bow. We have an epidemic. And it should be corrected. Note, thats very different than continuing to observe the population and see if a tiny bit of intervention helps. Its time to correct the epidemic. Research should be around trying to see if we improve when we are normalized. You will notice that most current research is involved in adding a small amount of extra D to see if it makes a difference, instead of supplementing you with enough to get you to a safe level. Most national type studies looking at the whole country havent taken into account the northern nature of Wisconsin and how that is much more risky than southern areas.Taking 30 ng as sufficient, 59% of folks in Wisconsin are insufficient. But this was on elderly Caucasian women in Madison. Personal communications in Milwaukee shows that African Americans have levels around 14 ng average, with little seasonal variation. Caucasian women in Wisconsin have levels that vary by season. 30 ng is considered sufficient because Parathyroid hormone stops falling around 32 ng. PTH is essentially the counterbalancing hormone to D in keeping Calcium levels normal. We dont know about the internal cellular optimal level, though many experts suggest that the better level to take as sufficient is what humans naturally get to in full sun.**The key point here is the simple step from cholesterol to D3 is just one step. Just one chemical bond gets opened and there you have it. All cells have cholesterol in their membranes.*In the summer, you get the full spectrum. The colors just beyond the purple, the sun goes down and we end up losing some of the colors in the sky. We cant see them but the UV light is gone. You go into a Vit D winter.*Anything above Atlanta starts having some time in Winter when you cant make D, no matter how much time you spend outdoors. Regardless of how cold. The further north, the longer that time period is. Considering that the half life of D is about a month, you can easily coast through in Atlanta. But once you get to the 5 months of inadequate sunshine in Milwaukee, you have too long a time for your body stores of D to last.

    *This is a handy tool. Use it. It gives people a simple way of calculating how much D they need. How much sunshine they need. But it applies only to Caucasians. Critical to note that folks with pigment need proportionately more sunshine. You must be culturally appropriate to your audience. The modified rule of 20s for Elderly and AA: One HUNDRED and TWENTY minutes of sun, on June 20th, makes 20,000 IU of D in a 20 year old.*A glass of milk will raise your blood level by 2.5 nanomoles, or 1 ng. . To get to a blood level of 60 ngms, you would have to take 10 multivitamins or 4000 IU of D. (Starting from a level of 15 ng, which many of us have in mid winter, 1000 IU will raise you 10 ng to 25. Another 1000 will raise you to 35 ng. Another 1000 to 45 ng. Another thousand to 55 ng. Thats 4000 total, a day.) 10 multivits would give you 4000 IU a day but would give you toxic levels of A. Not of D.*We evolved in the red circle and migrated from there. We moved to places where we got much less sunshine*Adequate sun for a Caucasian is 20 minutes: 120 for dark skin African Americans. Middle Easterners, east Asian**Here is what people who work in the sun have as normal blood levels of Vit D. Living in Puerto Rico, a farmer gets to a blood level of about 60 ng (or 150 nmoles) To convert ng to nm, you divide or multiple by 2.5. 150 nmoles = 60 ng. Aurora uses nanograms abbreviated as ng. Notice, a nurse working in PR is indoors and only gets to a level of about 100 nmoles = 40 ng. Working indoors is a problem. Young Caucasian lifeguards, in the sun all day long, get to a level of 160 nanomoles or 65 ng. So, our body will naturally make 60 ng with lots of sun.

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