Gout Patients Should Be Screened for Erectile Dysfunction

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Erectile dysfunction (ED) is common and often severe in men suffering from gout, according to the results of a cross-sectional survey of men who presented to a rheumatology clinic.

“These results strongly support the proposal to screen all men with gout for the presence of ED. Increasing awareness should in turn lead to earlier medical attention and treatment for this distressing condition,” said lead author Naomi Schlesinger, MD, chief, Division of Rheumatology, and professor of medicine at Rutgers–Robert Wood Johnson Medical School, in New Brunswick, New Jersey.

The results of the study were presented here at the European League Against Rheumatism (EULAR) Congress 2014.

The most common inflammatory arthritis in men older than 40 years, gout is caused by deposits of urate crystals in the joints and is associated with uricemia. The crystals cause inflammation, pain, and swelling, and the inflammatory component of the disease is linked to risk factors for cardiovascular disease and coronary artery disease.

The cross-sectional study included 201 men aged 18 to 89 years who presented at a rheumatology clinic between August 2010 and May 2013. Of these, 83 had gout.

Participants filled out a Sexual Health Inventory in Men (SHIM) questionnaire, which evaluates the ability to have an erection, the firmness of the erection, the ability to penetrate sufficiently for sexual intercourse, and sexual satisfaction. A score of ≤21 indicates ED; a score of ≤10 indicates severe ED.

“Men don’t usually volunteer sexual complaints,” said Dr. Schlesinger. “The gout patients in our study were generally delighted and grateful that someone finally asked them about ED.”

The mean SHIM score for all participants was 16.88. Patients with gout had a mean SHIM score of 14.38 compared with 18.53 in patients without gout (P < .0001).

A significantly greater percentage of patients with gout had ED compared with patients without gout (76% vs 52%, P = .0007). Also, significantly more men with gout had severe ED vs men without gout (43% vs 30%, P = .007).

The presence of ED was significantly more frequent in gout patients aged 65 years or older, compared with men of the same age without gout (P = .0001), and was significantly more likely to be severe (P = .0002).

A multivariate analysis adjusted for age, hypertension, low-density cholesterol level, glomerular filtration rate, obesity, and depression found that the association between gout and ED was statistically significant (P = .0096).

Silent Coronary Artery Disease

 “It is estimated that 1 in 5 men who present with ED have silent coronary artery disease. A man with ED, even with no cardiac symptoms, is a cardiac patient until proven otherwise,” said Dr. Schlesinger. “Perhaps we could say that the 3 ‘EDs’ are related: endothelial dysfunction leads to erectile dysfunction leads to early death.

“Gout patients who present with ED have an increased rate of cardiovascular risk factors and concomitant silent coronary artery disease and should be evaluated,” she added.

 Maya Buch, MD, from the Leeds Institute of Rheumatology and Musculoskeletal Medicine, at the University of Leeds, United Kingdom, praised the authors of this study for providing new information on these conditions with overlapping risk factor — gout and cardiovascular disease.
 “These patients are at risk for cardiomyopathies, and there is no literature on ED and gout. We know that patients with gout have multiple comorbidities, and it’s clear that rheumatologists need to address that,” she explained.

“I was surprised at how many patients with gout have ED. In addition to treating hyperuricemia in our patients with gout, we need to pay attention to cardiovascular risk factors. I hope that this study makes doctors more receptive to evaluating patients for ED,” she added.

Dr. Schlesinger has disclosed no relevant financial relationships. Dr. Buch has received honoraria and consulting fees from AbbVie, Bristol-Myers Squibb, and Roche-Chugai and has a research grant from Pfizer, Inc.

 European League Against Rheumatism (EULAR) Congress 2014: Abstract OP0135. Presented June 13, 2014.

Written By: Alice Goodman

Article Source: http://www.medscape.com/viewarticle/826773

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Understanding Inflammation

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Inflammation has been found to be an underlying cause in many diseases, making it a hot topic in the health media. But what do we really know about chronic inflammation and its effects on the body?

As scientists have searched for the mysteries behind the diseases most likely to afflict us, they have alighted on one factor common to virtually all of them: inflammation. Chronic inflammation, headlines now regularly state, has a role in a host of common and often deadly diseases, including Alzheimer’s, arthritis, cancer, diabetes, heart disease, and possibly even depression.

Unsurprisingly, this news brings with it a raft of self-proclaimed remedies purporting to fight inflammation. Diets, herbs, supplements, and exercise regimens have flooded the market with promises to keep inflammation in check and improve overall health.

But is there evidence that over-the-counter products or sweeping lifestyle changes will reduce inflammation’s damaging effects? Scientists caution that despite its current high profile, inflammation remains a mystery. “Basic science hasn’t yet answered the major questions about inflammation,” says Michelle Petri, a rheumatologist and a director of the Johns Hopkins Lupus Center. Researchers like Petri have been studying low-level inflammation as a culprit in a number of diseases for decades. What they have discovered has led to an emerging understanding of how lifestyle choices—like diet, dental health, and exercise—may influence inflammation and its potentially damaging downsides.

Despite its current high profile, Petri says, inflammation remains a mystery.

Inflammation is a vital part of the human immune system. When harmful bacteria or viruses enter your body, when you scrape or twist your knee, the body’s defense system kicks into high gear. Chemicals ramp up the body to fight, bathing the damaged area with blood, fluid, and proteins; creating swelling and heat to protect and repair damaged tissue; and setting the stage for healing.

Sentinel cells first alert the immune system to the presence of invaders. Another set of cells releases chemicals that signal the capillaries to leak blood plasma, which surrounds and slows down trespassers. Another group of sentinels, called macrophages, releases cytokines, which are specialized germ fighters. Immunizing B- and T-cells join in, destroying both the pathogens and the tissues they have damaged. Finally, a last wave of cytokines is released to end the job and signal the immune system that its work is done. Its mission completed, the immune system calls off its dogs.

When our body’s powers of correction go wrong, however, they can work against us. Think of the acute heat and swelling that protect us during a normal immune response—a fever, or the redness and pain that surround a new injury, for example—and you can get a hint of what chronic inflammation is. Unlike the inflammation that follows a sudden infection or injury, the chronic kind produces a steady, low level of inflammation within the body that can contribute to the development of disease. It’s the result, in part, of an overfiring immune system. Low levels of inflammation can get triggered in the body even when there’s no disease to fight or injury to heal, and sometimes the system can’t shut itself off. Arteries and organs break down under the pressure, leading to other diseases, including cancer and diabetes.

Scientists don’t fully understand how the immune system becomes short-circuited, but they have long known that some diseases, such as lupus and rheumatoid arthritis, emerge after the immune system has gone awry and attacked healthy tissue. Increasingly, as Americans and other Westerners live longer and get larger (35 percent of Americans are obese), researchers have also found that low-level immune responses triggered by extra weight and a lack of exercise can contribute to the development of other illnesses.

“For a long time, we had the idea that inflammation was involved in certain autoimmune diseases, but now we’re seeing this lower level of inflammation in people who are obese and people who are sedentary,” says Kimberly Gudzune, a physician at Johns Hopkins and a clinical researcher who focuses on obesity. “We see a link between obesity and some diagnostic markers for inflammation, but we don’t know what causes them. We worry that there’s something brewing for these people, that they are at higher risk for heart disease, cancer, and diabetes.”

‘We see a link between obesity and some diagnostic markers for inflammation, but we don’t know what causes them. We worry that there’s something brewing for these people, that they are at higher risk for heart disease, cancer, and diabetes.’

Researchers have discovered that fat cells can trigger the release of a steady, low hum of cytokines that, in lieu of an invader to attack, go after healthy nerves, organs, or tissues. As we gain weight, the release becomes prolific, affecting our body’s ability to use insulin, sometimes leading to type 2 diabetes.

They have also learned that inflammatory cells can have an effect elsewhere in the body—for example, chronically infected and inflamed gums in the mouth can cause damage that leads to heart attack and stroke. And they know that inflammation contributes to congestive heart failure and uncontrolled hypertension, and that it somehow has a role in the tangled cells that are the hallmarks of Alzheimer’s disease.

Researchers continue to find answers about how inflammation contributes to cancer. Inflammatory cells produce free radicals that destroy genetic material, including DNA, leading to mutations that cause cells to endlessly grow and divide. More immune cells are then called in, creating inflammation that feeds the growth of tumors.

The link between inflammation and cancer can sometimes be direct. When too much stomach acid—a feature of the immune system that evolved to fight foodborne bacteria—creeps up the esophagus, it causes inflammation and chronic heartburn. Extended exposure to this acid changes the nature of the cells lining the esophagus, increasing the risk of cancer.

In colon cancer patients, certain communities of bacteria associated with diarrhea can create cancer with help from inflammatory cytokines. Cells protected by mucus can become inflamed when that mucus wall is breached by bacteria, says Cynthia Sears, a doctor who specializes in infectious disease research at Johns Hopkins. “The lining in the colon makes peptides”—short chains of amino acids that act to protect the lining of the organ—“to thwart bacteria. If there aren’t enough peptides, bacteria can get a foothold, which means even more bacteria,” Sears says. As inflammation ramps up to fight it, so does the risk of cancer.

If inflammation is the behind-the-curtain factor in so many diseases, what can we do to keep it at bay? Researchers admit that they’re still figuring this out.

Petri has studied lupus for more than three decades and has been investigating the effects of chronic inflammation. “Lupus is basically friendly fire,” Petri explains. “We can’t get the immune system to calm itself down.”

Treating chronic inflammation, whether for lupus or other chronic ailments, is a challenge. Researchers have an idea that inflammation exists as part of a self-reinforcing loop system. If they could figure out how to interrupt or reverse one stage in that loop, then they might be able to develop drugs to stop it. But how do you tone down the immune response enough to control the inflammation but not so much that a body can’t fight disease?  “We’ve done 20 to 25 years of clinical trials on lupus drugs,” Petri says, by way of example. “We’ve had maybe one success and 30 failures.”

Finding a drug that both interrupts the immune cycle and maintains a healthy immune response is important not just for people battling illness but for all of us as we age.

Currently, there are no prescription drugs that specifically target chronic inflammation. (There are, of course, over-the-counter medications that treat the minor and temporary inflammation and accompanying pain caused by injuries or procedures, such as surgery. These are not meant to treat chronic inflammation.) Some drugs, such as hydroxychloroquine, once used to battle malaria, are useful in treating some lupus patients, but they don’t cure the disease. Aspirin and statins have shown promise in reducing inflammation in some people, but researchers aren’t sure how broadly useful such drugs are in that role. With the exception of far-from-perfect anti-inflammatory drugs, such as prednisone, a corticosteroid that brings with it a slew of side effects, scientists are still researching how best to contain inflammation. “We need something that can work broadly and quickly, and without a lot of side effects,” says Petri.

Finding a drug that both interrupts the immune cycle and maintains a healthy immune response is important not just for people battling illness but for all of us, because as we age, inflammation increases in the body. Scientists aren’t sure how and why, but interestingly, the study of HIV is offering some insight.

HIV triggers chronic inflammation in the body, even after medications have rendered levels of the virus undetectable in blood tests. Certain cytokines involved in that inflammation process can profoundly decrease testosterone levels, leading to muscle loss. “It’s possible that the chronic inflammation in people with HIV is similar to the chronic inflammation we see in aging,” says Todd Brown, an endocrinologist who researches the link between bodily markers for inflammation and chronic diseases found in people with HIV. If researchers can understand that process and create treatments to disrupt it in people with HIV, they could potentially translate their findings into treatments for similar muscle loss in aging.

Jeremy Walston is a Johns Hopkins geriatrician who investigates immune system response and muscle function in the elderly. He has been searching for markers that highlight the early signs of inflammation. Some blood tests for inflammation markers exist, but the researchers have uncovered two new markers that they believe may predict mortality and mark signs of late-in-life decline. “These are powerful inflammatory molecules that, when chronically expressed, lead to declines in stem cells and a remodulation of the immune system,” says Walston. “They also contribute to cell death,” particularly in the elderly, he says.

As the quest for diagnostic measures and therapies continues, researchers point to simple lifestyle measures we can all take to help prevent chronic inflammation. Scientists are skeptical of cure-all claims found in the new crop of anti-inflammation diet books, but they do recommend dropping pounds (and the harmful fat cells that come with obesity) and avoiding the now common American diet high in fats and sugars.

“Losing weight can have profound effects on lowering inflammation,” says Brown, who adds that eating a diet rich in fruits and vegetables and low in fats, processed foods, and sugars is generally a good idea, though more study needs to be done to determine how it might affect inflammation. Exercising, which causes an acute inflammatory response in the short term, but an anti-inflammatory one when we regularly get moving, is another strong step to take, he adds.

For most of us, keeping inflammation in check comes down to common sense basics: eat well, don’t smoke, get moving, get more rest, and see your doctor for regular physicals, which could help stop chronic inflammation before it becomes rampant.

Other researchers advise getting plenty of sleep, lowering stress levels, and seeking out treatment for inflammation-inducing culprits, such as gum disease and high cholesterol levels. Avoid contact with heavy metals such as mercury, which is found in dangerous amounts in some large fish, and limit exposure to substances, such as diesel exhaust and cigarette smoke, that can set off the immune system. Additional studies by Brown and his colleagues have also shown some advantage in increasing our intake of omega-3 fatty acids and vitamin D, though more research is needed.

Walston and others caution against popping dietary supplements touted as anti-inflammatory cures. Some so-called remedies, such as turmeric, taken in large amounts, may actually be toxic to the liver and other organs.

For most of us, keeping inflammation in check comes down to common sense basics: eat well, don’t smoke, get moving, get more rest, and see your doctor for regular physicals, which could help stop chronic inflammation before it becomes rampant. “All of the things our grandmothers told us were good for us are actually good for us,” says Brown. “Until we have a more nuanced understanding of what inflammation does, that’s what we have to fall back on.”

Written By: Michael Anft

Article Source: http://www.johnshopkinshealthreview.com/issues/spring-summer-2016/articles/understanding-inflammation


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The Big Picture: 5 Fundamentals of Lifetime Health

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Discover what you can start doing now to prepare for your healthiest, most vibrant future.

Elaine Hooker was a trailblazer. As a newspaper reporter and editor in the 1960s, she excelled in a challenging field dominated by men. What’s more, she shouldered the added pressure of caring for four children at a time when there was little institutional or cultural support for working women.

“There was no tolerance for staying home with sick kids,” recalls Hooker, now 70. “I didn’t even dare keep photos of my children on my desk for fear I’d be considered not as serious as the guys.”

Still, even as Hooker was going through one of the most stressful times of her life, she took good care of herself. Exercise and meditation were part of her routine. And she is now enjoying a healthy and active retirement.

More of us would do well to follow Hooker’s example, looking beyond momentary circumstances and time pressures to see the bigger picture — namely, how the daily habits we form now can dictate our health for a lifetime.

When functional-medicine gynecologist Sara Gottfried, MD, met Hooker a few years ago for a checkup, Gottfried witnessed Hooker’s hardiness at a cellular level.

Gottfried checked Hooker’s telomeres — the protective tips on the chromosomes that keep them from fraying and sticking to each other. Functional physicians often examine the length of telomeres to assess how well a patient is aging.

“She had the telomeres of a woman 20 years younger,” Gottfried says. “Despite a very stressful life, she had practices in place that are associated with a better health span.”

We’d all like to have a “health span” that equals our life span. And the new science of epigenetics confirms that we have a significant say in how long we stay in fighting shape.

Epigenetics shows that lifestyle choices (like nutrition, activity, and how we manage stress) can trump our genetic heritage by controlling which of our genes actually turn on.

There are also new tools that can track tiny alterations in cellular function — such as the test Gottfried used to check Hooker’s telomeres — to help doctors evaluate how well our bodies are withstanding the test of time.

“These biomarker tools help us better understand and optimize the health of the cells throughout our body,” says Jeffrey Bland, PhD, FACN, CNS, cofounder of the Institute for Functional Medicine.

These tools are also definitively showing what we’ve suspected all along: that the choices we make on a daily basis He— about our food, exercise, sleep, and stress — all make a huge difference in how well we age at a biochemical, structural, and neurological level.

Read on to discover the factors that are affecting your rate of aging now and how some simple adjustments can help set the stage for a healthier, more vital, more vibrant future.


We tend to think of inflammation as the angry red swelling around a splinter or mosquito bite. Indeed, that acute inflammatory response is a critical part of the body’s healing process — a good thing. “If we didn’t have an inflammatory response, we could die from a minor injury such as a paper cut,” says Robert Rountree, MD, a functional-medicine practitioner at Boulder Wellcare in Colorado and the chief medical officer of Thorne Research.

Chronic inflammation, which can be caused by “injuries” to the body like poor nutrition and excessive stress, is something else entirely: It’s a slow-boil systematic disturbance that affects many parts of the body and injures cells. Over time, it can play a huge role in major afflictions like heart disease, type 2 diabetes, dementia, cancer, and more.

Here’s how it works: Inflammation creates atoms called free radicals. These carry at least one unpaired electron that damages cells in its reckless pursuit of another electron with which to pair. Free radicals traumatize tissues throughout the body and can even harm DNA, leaving cells to malfunction or die.

We might feel the effects of systemwide inflammation when it causes ongoing pain in a knee, for instance, but are less likely to notice when that same inflammatory process wreaks silent havoc in other areas, such as the brain. We may detect some fogginess and forgetfulness, but we don’t connect it to inflammation.

“We don’t have pain receptors in the brain and we certainly can’t tell that it’s turning red like that area around the mosquito bite, but it’s the same exact process,” says neurologist David Perlmutter, MD, author of Brain Maker. “We measure inflammatory markers in the brains of individuals with things like Parkinson’s, Alzheimer’s, multiple sclerosis, and a variety of brain-related disorders, and we can see that these are the same markers of inflammation that are elevated in your arthritic knee.”


Embrace an anti-inflammatory lifestyle, and be proactive about addressing inflammatory health conditions.

Your doctor can assess your inflammation level with a blood test for high-sensitivity C-reactive protein (hs-CRP), a substance the body produces when inflammation is present.

A high reading could indicate that your lifestyle is contributing to bodywide inflammation, or that a more localized problem -— such as gum disease or leaky gut — is triggering an inflammatory cascade.

“You want to get that hs-CRP lower,” says Bland, “because it’s a marker for biological aging and it’s increasing your risk for a variety of chronic illnesses.” One key area of focus is the intestinal tract, he says, because over 50 percent of the immune system is clustered around our intestines: “An unfriendly intestinal tract activates the immune system and that produces hs-CRP in your liver.”


“Genes play an absolutely pivotal role in human health,” states Perlmutter. “But 99 percent of the genes and 99 percent of the DNA in our body are not ours.”

The majority of genes in the body belong to the microbiota in our guts — and they have a big influence on how we age, he explains.

“In terms of healthy aging, the bacterial DNA carries the biggest sword,” Perlmutter says, noting that, in his view, Alzheimer’s, Parkinson’s, and other aging-related diseases are influenced to some degree by negative changes to the bacterial population in our guts. (For more on the gut-brain connection, see “Healthy Gut, Healthy Brain“.)

Indeed, one of the most revolutionary  areas of health research — carried on  notably by the National Institutes of Health’s Human Microbiome Project — has to do with our microbiome, that -collection of tiny organisms living in and on our body that are our essential partners in good health.

According to the Human Microbiome Project, these microbes “produce some vitamins that we do not have the genes to make, break down our food to extract nutrients we need to survive, teach our immune systems how to recognize dangerous invaders, and even produce helpful anti-inflammatory compounds that fight off other disease-causing microbes.”

Growing numbers of studies have linked changes in the composition of our microbiomes to various diseases. Perlmutter points to a 2015 study in the Journal of Neuroinflammation showing that chronic inflammation of the gut causes a decrease in the formation of new brain cells in the hippocampus, a process that normally continues throughout adulthood and is linked to cognition and mood.

Among other roles, our friendly gut bacteria maintain the lining of the gut — only a single cell thick — and keep dangerous compounds from circulating throughout the body. Factors like poor diet, stress, toxins, and infections can damage the gut lining. And when the intestinal wall is breached, inflammatory compounds seep into the rest of the body, promoting a variety of premature-aging and chronic-disease factors. (For more on leaky-gut syndrome, check out “How to Heal a Leaky Gut“.)


Be on the lookout for the symptoms of microbiome imbalance and leaky gut, including diarrhea, constipation, intestinal pain and bloating, chronic joint pain, psoriasis, and headaches.

When gut distress is suspected, many progressive physicians recommend their patients try an elimination diet. (For more on elimination diets, see “The Institute for Functional Medicine’s Elimination Diet Comprehensive Guide and Food Plan“.) Getting rid of allergenic foods is often enough to quell the disturbance and restore balance in the gut.

When it’s not, practitioners can order a stool analysis to help clarify what else might be disrupting intestinal bacteria, like yeast overgrowth, parasites, or viruses.

To support the microbiome over time, Perlmutter recommends a diet rich in probiotic foods like yogurt, kefir, kimchi, kombucha, and sauerkraut, all of which are full of microbial life.

In addition, he recommends consuming plenty of prebiotic foods that contain the fibers our microbes love to eat. These include onions, jicama, raw dandelion greens, bananas, and Jerusalem artichokes.


“None of the interventions that we talk about in the anti-aging field work unless you exercise,” says Rountree. He is especially impressed by the impact of exercise on our cells’ mitochondria, those powerhouses that generate the cells’ energy and are involved in other vital functions.

We inherit all our mitochondria and can’t make new ones from scratch, but those that we possess can split and make copies of themselves. This intracellular revitalization is called mitochondrial biogenesis, and recent research indicates that one way to stimulate it is through vigorous exercise. (For more on mitochondria, see “The Care and Feeding of Your Mitochondria“.)

Exercise also helps mitigate the aging effects of stress. “If we don’t have activity as a regular part of life, those stress hormones can’t get properly metabolized and they build up,” says Bland. “When you get regular exercise, your hormones improve, your energy improves, and your cell viability improves.”

On the other hand, a sedentary lifestyle can promote the production of inflammatory cytokines, which accelerate aging and endanger bone health. “There are bone cells that break down bone,” says Rick Mayfield, DC, a faculty staff doctor at the Institute for Functional Medicine, and these get activated when the body experiences systemwide inflammation.

But note: While regular exercise is essential, exercising too often or aggressively without adequate recovery can actually cause you to age faster.


Rountree says the best exercise for mitochondrial biogenesis is high-intensity interval training (HIIT), in which you push really hard for a short while, recover, then push hard again. (For details on HIIT workouts, see “HIIT It“.)

Still, any exercise you do -regularly, whether that’s yoga, strength training, or cycling, will help you metabolize stress -hormones, maintain better energy, and offset chronic inflammation.


As we age, our hormones shift. For men, testosterone tends to drop 1 to 2 percent every year after age 30, though research shows this can be related to lifestyle factors (typically weight gain) rather than aging alone.

Women, meanwhile, see decreases in estrogen and fluctuations in thyroid hormones during and after menopause. They may be 10 times as likely as men to have thyroid problems, with a resulting impact on their energy, mood, and weight. And everyone’s cortisol patterns tend to shift over time, which can be linked to disrupted sleep, shorter telomeres, and accelerated aging.

Keeping stress in check supports the health of the adrenal glands, and vice versa. “Imbalance in your adrenal function can accelerate aging,” says Gottfried, “so it’s important to keep cortisol in the optimal range.”

Gottfried uses a blood test to evaluate all of her patients’ cortisol, estrogen, and thyroid levels, and then works with her patients on lifestyle and treatment plans to get their levels within an optimal range.


Adjust your eating, exercise, stress management, and sleep cycles in ways that help optimize your hormone levels. And if you suspect your hormones might be out of whack, ask your doctor for a hormone panel. Just keep in mind that most imbalances are best addressed by lifestyle adjustments.

For example, while overconsuming carbs spikes insulin, avoiding them altogether can increase cortisol production, Gottfried notes. She recommends focusing on protein, fat, and nonstarchy vegetables for breakfast and lunch, and enjoying some quality carbohydrates at dinner. “Cycling” carbohydrates this way helps rein in cortisol at night, when it’s most likely to disrupt sleep.

And don’t underestimate the role stress might be playing in your hormonal fluctuations. “High perceived stress -— that overwhelmed feeling that you’re a victim and it’s all just happening to you — can be disastrous for your hormonal balance,” she explains. “Things like yoga, meditation, mindfulness, and exercise can really help us adjust our mindset.”

Sleep helps, too, but many people find it more elusive as they age because of disrupted cortisol patterns. Gottfried recommends moderating circadian rhythms by dimming lights in the evening and timing carbohydrate consumption.


Some of the best predictors of a good health span may not sound especially scientific. They involve words like “community” and “passion,” says Nortin Hadler, MD, professor of microbiology/immunology at the University of North Carolina at Chapel Hill. But they have a real and measurable effect on how long and how well you live.

Hadler has spent years as a medical iconoclast, arguing that while certain drugs and procedures may be indispensable for treating diseases, community and social engagement are equally crucial for maintaining overall good health. And there’s plenty of science to back him up.

In 2014, University of Chicago researchers reported that feelings of loneliness represent a major health risk for older adults and can increase their risk of premature death by 14 percent. They also referenced a 2010 meta-analysis that found that loneliness has twice the impact on early death as obesity does. But you don’t have to be old to have your health negatively affected by a lack of social support and connection.

Numerous studies have shown that feeling a strong sense of social and emotional connection helps reduce the biochemical markers of stress, lowers inflammation, improves immunity, supports healthy hormonal balance,
and can even affect gene expression.

In his best-selling book The Blue Zones, National Geographic explorer Dan Buettner named having a strong sense of community as one of the top factors dictating not just one’s chances of living to 100, but of living to 100 as a reasonably healthy and happy person.

And in the big picture, that’s really what aging well is all about: enjoying a high-vitality, rewarding life both now and later. Starting wherever you are, right here, today.


Make some space for real, live human interaction and significant relationships. Start by looking at your calendar. Do you have plans for social activities that feel rich, rewarding, and fun? Are you visiting with friends and family, volunteering on projects, participating in group activities, going on dates?

All of these things make a big difference in how connected you feel, and that feeling of connection keeps you vital at all levels. “You want to be engaged, you want to feel valued, you want to have a community,” says Hadler. “If you don’t, it will take years off your life.”

What foods can help fight the risk of chronic inflammation?

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A new study by the University of Liverpool’s Institute of Ageing and Chronic Disease has identified food stuffs that can help prevent chronic inflammation that contributes to many leading causes of death.

Inflammation occurs naturally in the body but when it goes wrong or goes on too long, it can trigger disease processes. Uncontrolled inflammation plays a role in many major diseases, including cancer, heart disease, diabetes and Alzheimer’s disease.

Diets rich in fruits and vegetables, which contain polyphenols, protect against age-related inflammation and chronic diseases.

Cell-to-cell communication

Polyphenols are abundant micronutrients in our diet, and evidence for their role in the prevention of degenerative diseases such as cancer and cardiovascular diseases is already emerging. The health effects of polyphenols depend on the amount consumed and on their bioavailability.

T-cells, or T-lymphocytes, are a type of white blood cell that circulate around our bodies, scanning for cellular abnormalities and infections. They contribute to cell signalling molecules (cytokines) that aid cell-to-cell communication in immune responses and stimulate the movement of cells towards sites of inflammation, infection and trauma. Cytokines are modulated by fruit and vegetable intake.

Little is known about the relative potency of different (poly)phenols in modulating cytokine release by lymphocytes.

Pro-inflammatory mediators

The study, conducted by Sian Richardson and Dr Chris Ford from the University’s Institute of Ageing and Chronic Disease, examined the different potencies of the polyphenols.

Sian Richardson, said: “The results of our study suggest that (poly)phenols derived from onions, turmeric, red grapes, green tea and açai berries may help reduce the release of pro-inflammatory mediators in people at risk of chronic inflammation.

“Older people are more susceptible to chronic inflammation and as such they may benefit from supplementing their diets with isorhamnetin, resveratrol, curcumin and vanillic acid or with food sources that yield these bioactive molecules.”

The study, entitled ‘Identification of (poly)phenol treatments that modulates the release of pro-inflammatory cytokines by human lymphocytes’, has been published in the British Journal of Nutrition and can be found here http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4836295/

Article Source: http://www.eurekalert.org/pub_releases/2016-05/uol-wfc051616.php

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Low Testosterone levels in Men Linked to Whole Body Inflammation

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Low testosterone levels have been linked to a marker of whole body inflammation, C Reactive Protein.  When germs, high levels of fat in blood or high blood pressure are present they cause cellular injury, resulting in inflammation of the body.  Harboring inflammation over an extended period of time can lead to tissue destruction and a variety of health problems such as allergies, cancer, arthritis and autoimmune diseases.

A recent study has found a link that was very strong in overweight men as well as those with the risk factors of heart disease, such as low testosterone.  High blood pressure, obesity, diabetes, smoking and high blood fats were positively linked to increased C Reactive Protein, therefore inflammation.

Very importantly, higher levels of total testosterone (TT, β = −0·114, 95%CI, −0·162 to −0·065), free testosterone (β = −0·059, 95%CI, −0·106 to −0·012) and SHBG (β = −0·116, 95%CI, −0·169 to −0·063) were statistically significantly related to lower levels of C Reactive Protein  (Clinical Endocrinology, 78: 60-66, 2013).

The clinical studies surrounding the associated dangers of low testosterone (LOW T) in men are staggering.

If you are a man of 30 years of age and feel you may be suffering from Low Testosterone, Hypogonadism or Andropause, contact Boston Testosterone Partners today for a consult on how you can get tested.

Boston Testosterone is a Testosterone Replacement, Wellness and Preventative Medicine Medical Center that treats and prevents the signs and symptoms associated with Andropause and hormone imbalances.  With affiliates nationally, Boston Testosterone offers hormone replacement therapy, weight loss protocols, erectile dysfunction (ED), Sermorelin-GHRP2 therapy and neutraceutical injectable therapies for men and women.  Their medical facilities offer physician examinations and treatment programs that incorporate the latest in medical science.


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New research adds spice to curcumin’s health-promoting benefits

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The health benefits of over-the-counter curcumin supplements might not get past your gut, but new research shows that a modified formulation of the spice releases its anti-inflammatory goodness throughout the body.

Curcumin is a naturally occurring compound found in the spice turmeric that has been used for centuries as an Ayurvedic medicine treatment for such ailments as allergies, diabetes and ulcers.

Anecdotal and scientific evidence suggests curcumin promotes health because it lowers inflammation, but it is not absorbed well by the body. Most curcumin in food or supplements stays in the gastrointestinal tract, and any portion that’s absorbed is metabolized quickly.

Many research groups are testing the compound’s effects on disorders ranging from colon cancer to osteoarthritis. Others, like these Ohio State University scientists, are investigating whether enabling widespread availability of curcumin’s biological effects to the entire body could make it useful both therapeutically and as a daily supplement to combat disease.

“There’s a reason why this compound has been used for hundreds of years in Eastern medicine. And this study suggests that we have identified a better and more effective way to deliver curcumin and know what diseases to use it for so that we can take advantage of its anti-inflammatory power,” said Nicholas Young, a postdoctoral researcher in rheumatology and immunology at Ohio State and lead author of the study.

The research is published in the Nov. 4, 2014, issue of the journal PLOS ONE.

Curcumin powder was mixed with castor oil and polyethylene glycol in a process called nano-emulsion (think vinaigrette salad dressing), creating fluid teeming with microvesicles that contain curcumin. This process allows the compound to dissolve and be more easily absorbed by the gut to enter the bloodstream and tissues.

Feeding mice this curcumin-based drug shut down an acute inflammatory reaction by blocking activation of a key protein that triggers the immune response. The researchers were also the first to show that curcumin stops recruitment of specific immune cells that, when overactive, are linked to such problems as heart disease and obesity.

Young and his colleagues, including co-senior authors Lai-Chu Wu and Wael Jarjour of the Division of Rheumatology and Immunology at Ohio State’s Wexner Medical Center, now want to know if curcumin in this form can counter the chronic inflammation that is linked to sickness and age-related frailty. They have started with animal studies testing nano-emulsified curcumin’s ability to prevent or control inflammation in a lupus model.

“We envision that this nutraceutical could be used one day both as a daily supplement to help prevent certain diseases and as a therapeutic drug to help combat the bad inflammation observed in many diseases,” Young said. “The distinction will then be in the amount given – perhaps a low dose for daily prevention and higher doses for disease suppression.”

The term nutraceutical refers to foods or nutrients that provide medical or health benefits.

The curcumin delivery system was created in Ohio State’s College of Pharmacy, and these researchers previously showed that concentrations of the emulsified curcumin in blood were more than 10 times higher than of curcumin powder suspended in water. From there, the researchers launched experiments in mice and cell cultures, generating artificial inflammation and comparing the effects of the nano-emulsified curcumin with the effects of curcumin powder in water or no treatment at all.

The researchers injected mice with lipopolysaccharide, a bacteria cell wall extract that stimulates an immune reaction in animals. Curcumin can target many molecules, but the research team zeroed in on NF-kB, a protein that is known to play an important role in the immune response.

In a specialized imaging machine, mice receiving plain curcumin lit up with bioluminescent signals indicating that NF-kB was actively triggering an immune response, while mice receiving nano-emulsified curcumin showed minimal signs – a 22-fold reduction – that the protein had been activated at all.

Knowing that curcumin delivered in this way could shut down NF-kB activation throughout the animals’ bodies, researchers looked for further details about the compound’s effects on inflammation. They found that nano-emulsified curcumin halted the recruitment of immune cells called macrophages that “eat” invading pathogens but also contribute to inflammation by secreting pro-inflammatory chemicals. And in cells isolated from human blood samples, macrophages were stopped in their tracks.

“This macrophage-specific effect of curcumin had not been described before,” Young said. “Because of that finding, we propose nano-emulsified curcumin has the best potential against macrophage-associated inflammation.”

Inflammation triggered by overactive macrophages has been linked to cardiovascular disease, disorders that accompany obesity, Crohn’s disease, rheumatoid arthritis, inflammatory bowel disease, diabetes and lupus-related nephritis.


This work was supported by The Ohio State University Wexner Medical Center and Comprehensive Cancer Center Support (CORE) grant from the National Institutes of Health/National Cancer Institute and funding for Ohio State’s Center for Clinical and Translational Science provided by the National Center for Advancing Translational Sciences.

Additional co-authors are Michael Bruss, Mark Gardner, William Willis and Giancarlo Valiente of the Division of Rheumatology and Immunology; Xiaokui Mo of the Center for Biostatistics; and Yu Cao and Zhongfa Liu of the College of Pharmacy, all at Ohio State.

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Weight loss plus vitamin D reduces inflammation linked to cancer, chronic disease

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For the first time, researchers at Fred Hutchinson Cancer Research Center have found that weight loss, in combination with vitamin D supplementation, has a greater effect on reducing chronic inflammation than weight loss alone. Chronic inflammation is known to contribute to the development and progression of several diseases, including some cancers.

Results of the randomized, controlled clinical trial — which involved more than 200 overweight, postmenopausal women who had insufficient levels of vitamin D at the beginning of the study — are published online ahead of the July print issue of Cancer Prevention Research, a journal of the American Association for Cancer Research.

“We know from our previous studies that by losing weight, people can reduce their overall levels of inflammation, and there is some evidence suggesting that taking vitamin D supplements can have a similar effect if one has insufficient levels of the nutrient,” said lead and corresponding author Catherine Duggan, Ph.D., a principal staff scientist in the Public Health Sciences Division at Fred Hutch. However, it has not been known whether combining the two — weight loss and vitamin D — would further boost this effect. “It’s the first study to test whether adding vitamin D augments the considerable effect of weight loss on inflammatory biomarkers,” she said.

To explore this question, Duggan and colleagues recruited 218 healthy, overweight older women who had lower-than-recommended levels of vitamin D (less than 32 ng/mL). The women then took part in a 12-month diet and exercise program (including 45 minutes of moderate-to-vigorous exercise five days a week). Half of the study participants were randomly selected to receive 2,000 IU of vitamin D daily for the duration of the year-long trial, and the other half received an identical-appearing placebo, or dummy vitamin. Biomarkers of inflammation were measured at the beginning and end of the study. The researchers then compared changes in these levels between the two groups.

At the end of the study, all of the participants had reduced levels of inflammation, regardless of whether they took vitamin D, “which highlights the importance of weight loss in reducing inflammation,” Duggan said. However, those who saw the most significant decline in markers of inflammation were those who took vitamin D and lost 5 to 10 percent of their baseline weight. These study participants had a 37 percent reduction in a pro-inflammatory cytokine called interleukin-6, or IL-6, as compared to those in the placebo group, who saw a 17.2 percent reduction in IL-6. The researchers found similar results among women in the vitamin D group who lost more than 10 percent of their starting weight. While IL-6 has normal functions in the body, elevated levels are associated with an increased risk of developing certain cancers and diabetes and may be implicated as a cause of depression, Duggan said.

“We were quite surprised to see that vitamin D had an effect on an inflammation biomarker only among women who lost at least 5 percent of their baseline weight,” Duggan said. “That suggests vitamin D can augment the effect of weight loss on inflammation.”

Vitamin D is a steroid hormone that has multiple functions beyond its widely recognized role in regulating calcium levels and bone metabolism. Vitamin D receptors are found in more than 30 cell types and the research focus around this nutrient recently has shifted from bone health to vitamin D’s effect on cancer, cardiovascular health and weight loss, among other health issues.

Inflammation occurs when the body is exposed to pathogens, such as bacteria or viruses, which puts the immune system in overdrive until the “attack” ceases and the inflammatory response abates. Overweight or obese people, however, exist in a state of chronic inflammation. This sustained upregulation of the inflammatory response occurs because fat tissue continually produces cytokines, molecules that are usually only present for a short time, while the body is fighting infection, for example.

“It is thought that this state of chronic inflammation is pro-tumorigenic, that is, it encourages the growth of cancer cells,” she said. There is also some evidence that increased body mass “dilutes” vitamin D, possibly by sequestering it in fat tissue.

“Weight loss reduces inflammation, and thus represents another mechanism for reducing cancer risk,” Duggan said. “If ensuring that vitamin D levels are replete, or at an optimum level, can decrease inflammation over and above that of weight loss alone, that can be an important addition to the tools people can use to reduce their cancer risk.”

Duggan encourages women to speak to their health care providers about measuring their levels of vitamin D to determine the most appropriate dosage.


The Breast Cancer Research Foundation, Susan G. Komen for the Cure, National Institutes of Health, Seattle Cancer Consortium Breast Cancer Specialized Program in Research Excellence, Fred Hutchinson/University of Washington Cancer Consortium and Safeway Foundation funded the research.

Editor’s note: To obtain a copy of the Cancer Prevention Research paper, “Effect of vitamin D3 supplementation in combination with weight loss on inflammatory biomarkers in postmenopausal women: a randomized controlled trial,” or to arrange an interview with corresponding author Catherine Duggan, please contact: Kristen Woodward in Fred Hutch media relations, kwoodwar@fredhutch.org or 206-667-5095.

Fred Hutch: 40 years of cures 1975-2015

At Fred Hutchinson Cancer Research Center, home to three Nobel laureates, interdisciplinary teams of world-renowned scientists seek new and innovative ways to prevent, diagnose and treat cancer, HIV/AIDS and other life-threatening diseases. Fred Hutch’s pioneering work in bone marrow transplantation led to the development of immunotherapy, which harnesses the power of the immune system to treat cancer with minimal side effects. An independent, nonprofit research institute based in Seattle, Fred Hutch houses the nation’s first and largest cancer prevention research program, as well as the clinical coordinating center of the Women’s Health Initiative and the international headquarters of the HIV Vaccine Trials Network. Private contributions are essential for enabling Fred Hutch scientists to explore novel research opportunities that lead to important medical breakthroughs. For more information visit fredhutch.org or follow Fred Hutch on Facebook, Twitter or YouTube.