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Precision medicine: lessons learned

By Connie Dello Buono , motherhealth@gmail.com

I learned many care practices/protocols/collaborations and advance health IT and medicines in the area of precision medicine during the last conference.

FDA (Health Insurance companies and FDA are not present in the conference)

  • Regulations around cloud and internet are onerous.
  • Regulations and health insurance companies not aligned to ensure pharmacogenetic tests is a standard of care for all doctors at a reasonable costs for doctors, labs, health consumers and health insurance companies
  • Real problem: International, privacy rules are not the same

Collaborations

Collaboration among bio-pharma, cancer organizations and life science centers, hospitals and clinicians in the area of precision medicine is starting to form during the last two years to better understand cancer related health data in clinical space.

  • Precision medicine must use health data insights with actionable data points.
  • Plural anecdotes does not equal good data.
  • From Clinical outcomes to value outcomes , which is not the present scenario.
  • We have to scale the big data and derive health data insights. How?
  • There is a gap in health care practice, in balancing costs, tribal fashion of clinical practice ; ~80% softer, inferential, tribal
  • Curated health data to clinical decision is not translated.
  • Data warehouse to data mart to data cube for consumer oriented data, curated and reduced processing and search.  New, faster data access: score atomically from one metadata ; one single copy of data and apply link to it for easy access.
  • Complete DNA sequencing allows  discovery of new biomarkers based on output DNA data where utilized data ; 95% , shown in 5 continental population, to shown complex disease, 95% of casual variants identified by GWAS are multi-ethnic

Disease phenotypes

  • Disease phenotypes in different ethnic population ; statistical significance higher in 5 continental population
  • Strong evidence for clinical associations, to establish new functionalities
  • 22,483 variants known clinical associations

Individual protocol

  1. Pathogenic annotated GSA variant
  2. Annotate/cross reference clinvar
  3. Confirm clinical lab criteria
  4. Based on evidence report

Population

  • Application areas: sample stratification and QC, early detection and intervention, participant selection for clinical trials, biomarker discovery (drug target ID)
  • Sample stratification and QC: population of increasing sample size, use SNP variance, epigenetics, gen or physical traits,
  • Epidemiology: 1 out of 5 with risk variance has kidney failure
  • Early detection: 70% present in African americans, a protective mutation against __ disease
  • Intervention: genetic counseling from test results for lifestyle modifications
  • Wilson Disease: gene ATP7B; high in Japan and Slovenia; body retains too much copper ; deposited in liver; undiagnosed organ failure to death
  • Warfarin Treatment: based on genetic profile, tailor dose
  • Biomarker discovery: 7000 SNPs are associated with 400 disease

Precision medicine with select hospitals for cancer patients, targeted based on DNA sequence and drugs

Contradiction of Precision Medicine Drugs

860 billion interactions in a single cell each day, 210 cells types and 78 organs and 100-300 Trillion microbes.

Issues with clinical data:

  1. Randomized controlled clinical trial: too expensive, too long
  2. Existing data sources: very valuable with many data insights; not structured; not specific to a patient cohort;
  3. Registries; traditional site-based; track patients over time; data mining to search for particular study data; very expensive; longer time to collect; more patient-centered;

Data scientists:

  • Give patients service, manage their medical records, organize and distribute them among their doctors
  • Structure and normalize patient data
  • Give patient a timeline of their health information
  • Together with other clinicians and doctors, provide data insights and actionable health data

precision

Important considerations for a successful precision medicine standard of care

  • Institutions: Collaboration between hospitals, doctors, labs for complete DNA sequence and bio-pharma allowed the delivery of precision medicine
  • Doctors: Alignment of doctors with patient and his/her care team in implementation of precision medicine
  • Legacy system: Providing care teams transparent access to array of precision medicine from legacy systems
  • Data Science: Allow over-ride in variance matching with whole genome variants and cancer drugs
  • Clinical operations have access to wide array of precision medicine
  • Actionable results: stripping raw data to arrive at actionable results from data , using pattern generation
  •  

    In genomics: See the patient in context.

  • Data Fidelity: Clinician reviews raw data from feedback loop.  Change workflow routine on data collection, use of natural Language processing, SW solutions around data mapping, human curation of data elements
  • Consolidate databases:
    1. No clear annotated database for easy data mining; we reference back to the original raw data; which one to choose; drill down to clinical database evidence
    2. Updating DB and having the latest data

Other notes

  • Confidentiality of data: use an army of lawyers to maintain privacy of all (institution and consumers); finding balance enough liquidity, shareable while still conforming with regulatory environment
  • Real problem: International, privacy rules are not the same
  • Regulations around cloud and internet are onerous.
  • How do you prioritize data? Laser focus on goals , increasing data capture with focus on data elements that will allow to fire a large number of health data measures as quality loop for clinicians
  • Identify to make positive change is in the standardization of care.
  • Achievable scaling costs, level of trusts/granularity/specificity

Big Data

  • N of millions ; characterize as fast as you can and then create your big data asset ; under the complexity, you derive data insights ; Millions of N = 1S

    Make informed clinical decision

How to nurture big data enterprise in clinical cancer space?

There is a coalition building to pool resource knowledge to leverage novel cancer insights for cancer care.  Institute of Medicine, of the national academes has a system to set into motion to be able to use emerging science, informatics to improve cancer care and reduce suffering.

What if we can bring all electronic health data into one space ; share health data that is not financially injurious but drives science into creation of clinical knowledge

  • This is true in clinical science where we can see from genotypes, with proper computing power and scientific rigor
  • There 7 molecular drivers (HER,etc) – drives cancer

For health care provider: Use knowledge base, oncology database, derive what truth is (pain model, care guideline, population at risk)

  • Only 3% of the population are entered into a clinical trial
  • Everyday patients tend to be older, less healthy and more diverse
  • We are treating a more skewed view of the population

Challenge: how do we disseminate knowledge into actionable points and how to make people keep up with exploding knowledge base

  • Our ability to analyze disease (to sequence genes) outstrips our ability to know what it means

New diagnostics, new care, cancer biomarkers

  • We need too learn from patients, take data from backend, not to increase the burden, to rationalize information from various sources into a common understanding as to how care is rendered into clinical outcomes into wide variety of care in the US, use of modern computing skills to mine data and get data insights; fearless collaboration; to change incentives on how to mine data insights; reward institutions and clinicians for contributing to a common knowledge source – health data insights

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Digital Health Avatar

Advanced technology has been incorporated into all aspects of daily living. The health consumer is the master of her own personal health and the Health Advocate Avatar or Digital Health Avatar is her faithful assistant. This digital knowledge entity works through a compelling interactive “personality” to provide continuous monitoring, coaching, advice and support to serve the unique needs of its master. It learns to help the master comply with therapies, reminds him to take medicines, and uses persuasion to encourage healthy behavior.

The avatar has access to its master’s comprehensive personal health record, knowledge of his needs and preferences, and the accumulated wisdom of health databases, evidence-based knowledge and consolidated opinions of the world’s experts.

Biosensors worn on the body or embedded in the environment continuously track the master’s physiological and psychological health status and behaviors. This data provide a comprehensive ongoing picture of all aspects of health and allows detection of minute changes in disease risk.

The avatar proactively investigates any abnormality and takes automatic action within parameters determined by the master and his care team. (Actions are also assessed by the avatar’s fail-safe monitor to ensure that no harm is done.)

The avatar provides information to the health home and sets up virtual encounters or interventions as required.


 

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Billionaires who created the most jobs

By Keren Blankfeld

Following is a ranking of the top American billionaires behind the most jobs:

1. Bernard Marcus & Arthur Blank, The Home Depot

Total employees: 385,000 (24,000 salaried, remainder compensated on an hourly or temp basis)

Forbes 400 2016 Net worth: Marcus, $3.6 billion; Blank, $3.1 billion

2. Warren Buffett, Berkshire Hathaway

Total employees: 331,000 (25 at headquarters, remainder at consolidated subsidiaries)

Forbes 400 2016 Net worth: $65.5 billion

3. Frederick Smith, Fedex

Total employees: 323,035 (149,000 full-time employees in US)

Forbes 400 2016 Net worth: $3.7 billion

4. Howard Schultz, Starbucks

Total employees: 300,000

Forbes 400 2016 Net worth: $2.9 billion

5. Thomas Frist, HCA

Total employees: 233,000 (includes hospitals operated by HCA and subsidiaries)

Forbes 400 2016 Net worth: $7.9 billion

6. Jeff Bezos, Amazon

Total employees: 230,800

Forbes 400 2016 Net worth: $67 billion

7. Doris Fisher, Gap

Total employees: 141,000

Forbes 400 2016 Net worth: $2.6 billion

8. Larry Ellison, Oracle

Total employees: 136,000 (all full-time)

Forbes 400 2016 Net worth: $49.3 billion

9. Richard Schulze, Best Buy

Total employees: 125,000

Forbes 400 2016 Net Worth: $2.8 billion

10. Bill Gates & Paul Allen, Microsoft

Total employees: 114,000 (all full-time)

Forbes 400 Net worth: Gates, $81 billion; Paul Allen $18.9 billion

Arthur Blank and Bernard Marcus were fired from their jobs at hardware store Handy Dan in 1978 before deciding to open The Home Depot, their own competing hardware retailer, in two gigantic Atlanta, Ga warehouses. Among their first employees were their kids, who they sent to the streets to hand out $1 bills to anyone willing to walk inside. Today, The Home Depot, which they left in 2002 and 2001, respectively, boasts more than 385,000 workers in the United States, Canada and Mexico.

That’s enough to put Marcus and Blank at the top of FORBES’ first ever list of American billionaires who have helped create the most jobs. While these moguls have made themselves enormous fortunes, they’re also responsible for creating employment for hundreds of thousands. The top 12 billionaire job creators — all together worth more than $308 billion — have generated at least 2.3 million jobs globally. Those include both full-time and part-time employees directly linked to the company created or managed by the billionaire.

While Internet darlings like Facebook and Google-parent Alphabet have amassed huge stock value, they’ve created relatively few jobs (40,000 jobs at Google, which has a market cap of $546 billion, and 14,495 jobs at Facebook, which has a market cap of $366 billion. Home Depot created 385,000 jobs and has a market cap of $155 billion). Some economists have pointed to robots and automation for being partly to blame for taking human jobs at technology companies.

Still, three of the top job creators hail from the technology sector. Amazon founder Jeff Bezos famously started selling books online from his Seattle garage in 1994. These days Amazon, which has since expanded to grocery, furniture and restaurant delivery, employs 230,800 workers around the world. (Amazon doesn’t disclose how many of those are full-time employees.) Larry Ellison cofounded Oracle in 1977 with two coworkers from database company Ampex, where he’d been working as a programmer. Today Oracle is both a hardware and a software firm, having acquired quite a few companies over the years, including PeopleSoft and Sun Microsystems, and it employs 136,000 people — all of them full-time. Ellison may be worth billions less than his sometimes arch nemesis, Microsoft cofounder Bill Gates, but he has bragging rights when it comes to employing more people. Since Gates and his friend Paul Allen founded Microsoft in 1975, the software firm has acquired a slew of companies, including video and calling application Skype and Nokia’s device and services business. Altogether, Microsoft now has more than 114,000 full-time workers. These do not include employees of professional network company LinkedIn, which Microsoft announced in June that it has agreed to acquire; once that acquisition is complete, it will add another 9,900 full-time employees to Microsoft’s roster, bringing its total employment closer to Oracle’s.

Two of the top job creators almost failed out of the gate. FedEx founder Frederick Smith, a Vietnam vet, started his shipping company in 1971. After an initial loss of $29 million during FedEx’s first 26 months, he took to the blackjack tables in Las Vegas to earn money to keep the fledgling business afloat. Today FedEx employs 323,035 workers worldwide — 149,000 of whom work full-time in the United States, making Smith the third biggest job creator Meanwhile, Best Buy founder Richard Schulze took out a second mortgage in his home in 1966 to open a stereo equipment shop called the Sound of Music, the predecessor to Best Buy. Since then the business has been transformed into a chain with 125,000 employees in 1,600 technology superstores.

While neither Warren Buffett nor Howard Schultz founded the companies that made them into multi-billionaires, they both reinvented what were initially small businesses and were responsible for making them into powerhouse firms behind thousands of jobs. Buffett, America’s third richest man, transformed Berkshire Hathaway from a failed textile company into a sprawling conglomerate responsible for more than 331,000 jobs. While only 25 of those jobs are based at Berkshire Hathaway’s Omaha, Neb. headquarters, the remainder span various subsidiaries, including Geico Auto Insurance, Duracell batteries and See’s Candies, among many others that Berkshire Hathaway bought throughout the five decades Buffett’s led it. Schultz bought Starbucks in 1987, two years after working as a director of retail operations and marketing at what was initially a coffee-bean store. Over the years he rapidly added stores, expanded into new ventures through acquisitions such as tea company Tazo Tea, San Francisco-based music company Hear Music and Ethos Water. Today Starbucks has more than 300,000 employees in 74 countries (that number includes part-time workers).

The list of top job creators does not include investors who do not have an active hand in managing the companies that made them wealthy. That is why billionaire Peter Buck, who in 1965 gave 17-year old Fred DeLuca a $1,000 loan to start a sandwich shop called SUBWAY, isn’t included in the list, despite SUBWAY having created at least 450,000 jobs through its worldwide restaurant franchises.

At least one of the biggest billionaire job creators is not longer around. If Wal-Mart founder Sam Walton were alive today, he’d not only be America’s richest man, but he would top this list of biggest billionaire employers. The multinational retailer has 2.3 million employees worldwide — as many as the complete list of the top 10 billionaire job creators combined.


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$340B health care costs from plastics, EDC – endocrine disruptive chemicals

“These findings speak to the large health and economic benefits to regulating endocrine-disrupting chemicals,” said senior study author Dr. Leonardo Trasande, a researcher at New York U…

Source: $340B health care costs from plastics, EDC – endocrine disruptive chemicals

$340B health care costs from plastics, EDC – endocrine disruptive chemicals

“These findings speak to the large health and economic benefits to regulating endocrine-disrupting chemicals,” said senior study author Dr. Leonardo Trasande, a researcher at New York University Langone Medical Center in New York City.

For the current study, researchers reviewed blood sample and urine analyses that documented the presence of endocrine disruptors among U.S. participants in the National Health and Nutrition Examination Survey (NHANES).

They estimated total costs linked to these chemicals based on both the direct cost of treatment and the indirect cost of lost productivity or earnings. Then, they compared the U.S. results to findings from a previous study done in Europe.

Costs are higher in the U.S. in large part due to widespread use of a chemical mixture applied to furniture to make it less flammable that has been restricted in Europe since 2008.

This chemical blend, polybrominated diphenyl ethers (PBDEs), is responsible for about 43,000 cases of intellectual disability in the U.S. each year, compared with 3,290 cases in Europe, the researchers estimate.


Dr Mercola wrote:

Top 10 EDC  – endocrine-disrupting chemicals

According to Thomas Zoeller, a biology professor at the University of Massachusetts Amherst who specializes in how chemicals affect the endocrine system, there are an estimated 800-1,000 endocrine-disrupting chemicals on the market.

Epoch Times recently compiled 10 common sources of endocrine disruptors, as well as what you can do about them.8

1. Personal Care Products

Shampoo, conditioner, moisturizer, cosmetics, and other personal care products often contain endocrine disruptors, including (but certainly not limited to) phthalates. Phthalates are a group of “gender-bending” chemicals causing males of many species to become more female.

These chemicals have disrupted the endocrine systems of wildlife, causing testicular cancer, genital deformations, low sperm counts, and infertility in a number of species, including polar bears, deer, whales, and otters, just to name a few.

One 2002 study by the Environmental Working Group detected phthalates in nearly three-quarters of personal care products tested, noting:9

“Major loopholes in federal law allow the… cosmetics industry to put unlimited amounts of phthalates into many personal care products with no required testing, no required monitoring of health effects, and no required labeling.”

Another endocrine-disrupting chemical, triclosan, can even be found in certain brands of toothpaste. Switching to natural and/or homemade personal care products will help you avoid such exposures. You can also try to cut down on the number of personal care products you use every day.

2. Drinking Water

Your drinking water may be contaminated with atrazine, arsenic, and perchlorate, all of which may disrupt your endocrine system. Filtering your water, both at your tap and your shower/bath, using a highquality water filtration system can help protect you and your family.

3. Canned Foods

In an analysis of 252 canned food brands, 78 are still using bisphenol-A (BPA) in their canned goods, even though it’s a known endocrine disruptor.10 BPA has been linked to a number of health concerns, particularly in pregnant women, fetuses and young children, but also in adults, including:

Structural damage to your brain Changes in gender-specific behavior and abnormal sexual behavior
Hyperactivity, increased aggressiveness, and impaired learning Early puberty, stimulation of mammary gland development, disrupted reproductive cycles, ovarian dysfunction, and infertility
Increased fat formation and risk of obesity Stimulation of prostate cancer cells
Altered immune function Increased prostate size and decreased sperm production

BPA coats about 75 percent of cans in North America, which means if you eat canned foods, it’s likely a major source of BPA exposure for you. Even BPA-free cans may not be safe, as they’re often coated with a similar chemical known as BPS. Ideally, buy products that come in glass bottles and jars rather than plastic or cans.

4. Conventionally Grown Produce

Pesticides, herbicides, and industrial runoff may coat your conventionally grown fruits and vegetables in endocrine-disrupting chemicals. As much as possible, buy and eat organic produce and free-range, organic foods to reduce your exposure to endocrine-disrupting pesticides and fertilizers.

5. CAFO Meat, Poultry, and Dairy Products

Animals raised on concentrated animal feeding operations (CAFOs) also typically contain antibiotics, hormones, and other industrial chemicals that may disrupt your endocrine system. Look for animal products that are free-range, organic and raised on small, local farms that avoid the use of such chemicals.

6. High-Mercury Fish

Fish contaminated with high levels of mercury and other heavy metals are problematic because such metals also disrupt hormonal balance. Shark, swordfish, king mackerel, marlin, and tilefish are among the worst offenders here, but even tuna has been found to be contaminated with dangerously high levels. Farmed fish (the “CAFOS of the sea”) also tend to be higher in contaminants and are better off avoided. When eating seafood, smaller fish like sardines, anchovies, and herring tend to be low in contaminants and high in omega-3 fats.

7. Kitchen Products

Plastic containers and non-stick cookware common in many kitchens are another type of hazards. The plastic containers may contain BPA or other endocrine-disrupting chemicals that can leach into your food, especially if the plastic is heated. Poly- and perfluoroalkyl substances (PFAS) used to create non-stick, stain-resistant, and water-repellant surfaces are also toxic and highly persistent, both in your body and in the environment.

When heated, non-stick cookware releases perfluorooctanoic acid (PFOA), linked to thyroid disease, infertility, and developmental and reproductive problems. Healthier options include ceramic and enameled cast iron cookware, both of which are durable, easy to clean (even the toughest cooked-on foods can be wiped away after soaking it in warm water), and completely inert, which means they won’t release any harmful chemicals into your home.

8. Cleaning Products

Commercial solutions used to clean your floors, toilets, oven, windows, and more typically contain industrial chemicals that may throw your hormones out of whack. For instance, nonylphenol ethoxylates (NPEs), a common ingredient in laundry detergents and all-purpose cleaners, is banned in Europe and known to be a potent endocrine disrupter,11causing male fish to transform into females. It’s surprisingly easy to create your own cleaning products at home using different combinations of vinegar, baking soda, essential oils, and even coconut oil. Find simple tips for greener cleaning here.

9. Office Products

Ink cartridges, toner, and other solvents common in office environments are another common source of endocrine-disrupting chemicals. Handle such products with care and minimize your exposure as much as possible.

10. Cash Register Receipts

Thermal paper has a coating that turns black when heat is applied (the printer in a cash register applies heat to the paper, allowing it to print numbers and letters). It also contains BPA, and research shows that handling this type of paper is enough to increase your bodily levels. A study in Analytical and Bioanalytical Chemistry found that of 13 thermal printing papers analyzed, 11 contained BPA.12

Holding the paper for just five seconds was enough to transfer BPA onto a person’s skin, and the amount of BPA transferred increased by about 10 times if the fingers were wet or greasy (such as if you’ve just applied lotion or eaten greasy food).

Finally, because receipts are often stored next to paper currency in people’s wallets, paper currency may also be contaminated with BPA. In a study published in Environmental Science and Technology, researchers analyzed paper currencies from 21 countries for the presence of BPA, and the chemical was detected in every sample.13

So, seek to limit or avoid carrying receipts in your wallet or purse, as it appears the chemical is transferring onto other surfaces it touches. It would also be wise to wash your hands after handling receipts and currency, and avoid handling them particularly if you’ve just put on lotion or have any other greasy substance on your hands, as this may increase your exposure). If you’re a cashier or bank teller who handles such papers often, you may want to wear gloves, especially if you’re pregnant or of child-bearing age.

19 More Tips to Reduce Your Chemical Exposure at Home

Implementing the following measures will help you avoid the worst endocrine-disrupting culprits as well as other chemicals from a wide variety of sources. To sum it up, try to stick with whole foods and natural products around your home. The fewer ingredients a product contains, the better, and try to make sure anything you put on or in your body – or use around your home – contains only substances you’re familiar with. If you can’t pronounce it, you probably don’t want it anywhere near your family.

  1. As much as possible, buy and eat organic produce and free-range, organic meats to reduce your exposure to added hormones, pesticides, and fertilizers. Also avoid milk and other dairy products that contain the genetically engineered recombinant bovine growth hormone (rBGH or rBST).
  2. Rather than eating conventional or farm-raised fish, which are often heavily contaminated with PCBs and mercury, supplement with a high-quality purified krill oil, or eat smaller fish or fish that is wild-caught and lab tested for purity. Wild caught Alaskan salmon is about the only fish I eat for these reasons.
  3. Buy products that come in glass bottles or jars rather than plastic or canned, since chemicals can leach out of plastics and into the contents.
  4. Store your food and beverages in glass rather than plastic, and avoid using plastic wrap.
  5. Use glass baby bottles and avoid plastic sippy cups for your little ones.
  6. Eat mostly raw, fresh foods. Processed, prepackaged foods (of all kinds) are a common source of chemicals such as BPA and phthalates.
  7. Replace your non-stick pots and pans with ceramic or glass cookware.
  8. Filter your tap water—both for drinking and bathing. If you can only afford to do one, filtering your bathing water may be more important, as your skin absorbs contaminants. To remove the endocrine-disrupting herbicide Atrazine, make sure the filter is certified to remove it. According to the Environmental Working Group (EWG), perchlorate can be filtered out using a reverse osmosis filter.
  9. Look for products that are made by companies that are earth-friendly, animal-friendly, green, non-toxic, and/or 100% organic. This applies to everything from food and personal care products to building materials, carpeting, paint, baby items, upholstery, and more.
  10. Use a vacuum cleaner with a HEPA filter to remove house dust, which is often contaminated with traces of chemicals.
  11. When buying new products such as furniture, mattresses or carpet padding, ask what type of fire retardant it contains. Be mindful of and/or avoid items containing PBDEs, antimony, formaldehyde, boric acid, and other brominated chemicals. As you replace these toxic items around your home, select those that contain naturally less flammable materials, such as leather, wool, and cotton.
  12. Avoid stain- and water-resistant clothing, furniture, and carpets to avoid perfluorinated chemicals (PFCs).
  13. Minimize your use of plastic baby and child toys, opting for those made of natural wood or fabric instead.
  14. Only use natural cleaning products in your home or make your own. Avoid products that contain 2-butoxyethanol (EGBE) and methoxydiglycol (DEGME) — two toxic glycol ethers that can damage fertility and cause fetal harm.14
  15. Switch over to organic brands of toiletries such as shampoo, toothpaste, antiperspirants, and cosmetics. You can replace many different products with coconut oil and baking soda, for example. EWG has a great database15 to help you
    1. find personal care products that are free of phthalates and other potentially dangerous chemicals. I also offer one of the highest quality organic skin care lines, shampoo and conditioner, and body butter that are completely natural and safe.
    2. Replace feminine hygiene products like tampons and sanitary pads with safer alternatives.
    3. Avoid artificial air fresheners, dryer sheets, fabric softeners, or other synthetic fragrances.
    4. Look for products that are fragrance-free. One artificial fragrance can contain hundreds – even thousands – of potentially toxic chemicals.
    5. Replace your vinyl shower curtain with one made of fabric.

———

  1. Join 25,000 people in helping redefine health with health concierge and precision medicine.

    https://clubalthea.com/2016/10/14/your-complete-dna-sequence-will-help-shape-the-future-of-medicine/

Curing a disease, see your doctor first

curing

See a doctor or a second doctor to get more doctors examining your health issues as they have seen others with same health issues or read other similar health issues.


 

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Mental fatigue and adrenal gland dysfunction

mental-fatigue

Symptoms of Chronic Fatigue Syndrome (CFS) include malaise after exertion; unrefreshing sleep, widespread muscle and joint pain, sore throat, headaches of a type not previously experienced, cognitive difficulties, chronic and severe mental and physical exhaustion. … Symptoms vary in number, type, and severity from person to person.

The main symptom of CFS is persistent physical and mental fatigue (exhaustion). This doesn’t go away with sleep or rest and limits your usual activities.

Most people with CFS describe this fatigue as overwhelming and a different type of tiredness from what they’ve experienced before.

Exercising can make symptoms worse. This is called post-exertional malaise, or “payback”. The effect of this is sometimes delayed – for example, if you were to play a game of sport, the resulting fatigue may not develop until a few hours afterwards, or even the next day.

People with severe CFS are unable to do any activities themselves or can only carry out simple daily tasks, such as brushing their teeth. They’re sometimes confined to their bed and are often unable to leave their house.

Other symptoms

There are other common symptoms as well as fatigue, although most people don’t have all of them. They include:

  • muscular pain, joint pain and severe headaches
  • poor short-term memory and concentration, and difficulty organising thoughts and finding the right words (“brain fog”)
  • painful lymph nodes (small glands of the immune system)
  • stomach pain and other problems similar to irritable bowel syndrome, such as bloating, constipationdiarrhoea and nausea
  • sore throat
  • sleeping problems, such as insomnia and feeling that sleep isn’t refreshing
  • sensitivity or intolerance to light, loud noise, alcohol and certain foods
  • psychological difficulties, such as depression, irritability and panic attacks
  • less common symptoms, such as dizziness, excess sweating, balance problems and difficulty controlling body temperature

What is the Connection Between Chronic Fatigue Syndrome and Adrenal Fatigue?

While CFS and adrenal fatigue are not the same, adrenal function may play a role in it. Those with CFS are often found to produce a low amount of the hormone cortisol, which is produced by the adrenal glands. Furthermore, CFS is a malfunction of the pituitary, a pea-sized gland at the base of the skull, which regulates all our hormones. The pituitary, hypothalamus and adrenals all work together as part of the HPA axis to regulate our health and hormones. Analysis of the data in over 50 studies that assessed adrenal function in CFS and fibromyalgia patients demonstrates that the majority of these patients have abnormal adrenal function due to hypothalamic-pituitary dysfunction.

Deficiencies in hormones like cortisol, DHEA, aldosterone, pregnenolone, estradiol, progesterone, testosterone and growth hormone are often missed or poorly treated because doctors have come to rely on standard blood tests that require an intact pituitary and hypothalamus for diagnosis and dosing of hormone levels. There is, however, severe hypothalamic and pituitary dysfunction with CFS, making the standard blood tests inadequate. Evaluating hormone function, not just hormone levels, can help diagnose CFS and adrenal fatigue; and when properly treated and balanced, tremendous results can be achieved.

Although a concept that is sometimes uncomfortable and foreign to traditional medical styles of thinking, the need for multiple interventions is required for effective treatment of such complex illnesses like CFS and adrenal fatigue. The HPA axis works as the body’s energy and hormone regulator. An imbalance between any part of the axis can affect the entire body system and treatment for such disorders requires a well-rounded approach to restore function. Therefore, adrenal and pituitary dysfunction often require treatment with several hormones. When treatment is received, individuals with devastating syndromes like CFS, adrenal fatigue and fibromylagia can “get their lives back” despite the fact that they were previously told, “there is nothing that can be done.”

Watch this short video with Dr. Kent Holtorf explaining the symptoms, diagnose and treatment of chronic fatigue syndrome:

– Holtorf Medical Group


Dr Mercola wrote:

  • When your adrenal glands are overtaxed, a condition known as adrenal fatigue or adrenal exhaustion sets in, which in turn can set a cascade of disease processes into motion. One tell-tale sign of adrenal burnout is feeling chronically fatigued
  • Four most common reasons for adrenal fatigue and dysfunction are intense emotional stress, poor diet, chronic inflammation, and underactive thyroid
  • The Kalish Method normalizes dysfunctional adrenals and restores normal adrenal function. It’s a clinically validated method that’s been used for a long time, yet most physicians are still not aware of it
  • The adrenal protocol calls for carefully replacing just a small portion of the exact level of the missing adrenal hormones including DHEA and the precursor to cortisol called pregnenolone, which instigates your body to begin producing it more naturally

The basis of adrenal fatigue or burnout is stress, which over time can tax your adrenal glands to the point of causing other health problems, such as:

  • Sleep disorders
  • Weight gain
  • Fatigue
  • Depression

Four Causes of Adrenal Dysfunction

There are three main reasons for adrenal fatigue and dysfunction:

    1. Emotional stress, typically related to grief or loss
    2. Poor diet: Eating too many carbs can disrupt cortisol and a certain group of corticosteroids (a blood pressure-stabilizing hormone), and the Standard American Diet is “a perfect recipe for destroying your adrenal glands,” Dr. Kalish warns.

One of the most important things that cortisol does is regulating secretory IgA in your gut. What this means is that the immune response in your gut is controlled by cortisol. Hence, if you’re stressed, the immune response in your gut suffers, the gut tissue becomes damaged, and good bacteria give way to bad bacteria, causing immune dysregulation that is centered in and around your gut.

Two important components to address this problem are to 1) regularly eat fermented foods, which will dramatically increase the beneficial bacteria in your body (which automatically will help decrease pathogenic bacteria), and 2) to eat a diet low in sugars and carbs, as that will also promote a healthy gut flora.

    1. Chronic inflammation in your body: Inflammation is the hallmark of virtually every disease you can think of, from diabetes to cancer, and when chronic, it stresses your system, including your adrenals.

One little-known strategy to counter inflammation is grounding or earthing, which requires nothing more than taking off your shoes and walking barefoot outside, ideally on dewy grass or on the beach. Connecting your soles to the earth will massively increase the influx of free electrons into your body, which helps dissipate inflammation due to their potent anti-inflammatory action.

Another common hormonal cause of adrenal fatigue is hypothyroidism or underactive thyroid. Thyroid function is diagnosed by a blood test, but there’s some controversy over what is normal and what’s not. Many alternative doctors feel the conventional reference ranges are far too broad, and opt to treat people exhibiting sub-clinical thyroid symptoms.

“What’s interesting about the thyroid and the adrenals is that as the cortisol levels go up, one of the normal body mechanisms is to downregulate thyroid,” Dr. Kalish says. “So, most everybody with high cortisol is going to have lower than ideal thyroid hormone levels. At that point, it becomes a decision as to if you want to work on the adrenals, work on thyroid, or work on both together…

More than 90 percent of the time, the adrenal program is enough to restore thyroid function. The biggest reason [for doing] the adrenals first is that when you start taking thyroid hormones your internal production of thyroid hormones drop. With the adrenal glands, it’s the opposite. When you start to take these adrenal-support products, your internal production of adrenal hormones comes back. If you can restore adrenal function, you can save the person from having to be on thyroid medications potentially for the rest of their life.” 


 

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