By Dr. Al Sears

Even before I went to medical school, I worked with college athletes. And by far, the biggest complaint was joint pain.

While everyone else was using non-steroidal anti-inflammatory drugs (NSAIDs) like Motrin, Advil and Aleve, I was giving my athletes real hope with an ancient secret. And now, modern scientists are catching on.

A new study in Italy gathered 52 otherwise healthy young rugby players. They all had acute knee pain and inflammation. The players were given either a placebo or an extract of Indian frankincense (Boswellia serrata). Ed: For more information, please click here, here, and here.

After just four weeks, the players taking the Boswellia had a significant reduction in pain and inflammation compared to standard treatments. They could walk farther without pain. They had less damage to their joints, tendons and muscles. And they needed fewer drugs or doctor’s visits.1

But this natural painkiller isn’t only for athletes. Joint pain can be just as debilitating for you and me. And, these days, orthopedic surgeons are quick to cut for joint injuries. More than a million Americans have joint replacement surgery every year.

And Big Pharma’s opioid drugs are dangerous. They have a very high risk of addiction and abuse. Even Ibuprofen has a black box warning about increased risks of heart attack and stroke.

As you know, I use nature’s remedies, like frankincense to relieve the pain and inflammation of any joint aches or injuries. It’s an ancient remedy that goes back 5,000 years.

In Biblical times, it was more highly prized than gold. You probably know it as one of the gifts the three Magi brought to the infant Jesus on the first Christmas.

This resin comes from a tree native to India. It’s one of the most effective treatments I’ve found for arthritis and joint pain. And it doesn’t have the adverse side effects of drugs.

In another large study, researchers followed 440 arthritis patients for six months. They found that frankincense relieved pain as effectively as painkiller drugs. It also significantly improved knee function.2

Boswellia works in many different ways. It contains enzymes that block prostaglandin e2 (PGe2). This hormone-like chemical is produced by the body in response to an injury. It makes blood vessels dilate and expand. This causes the injured area to become swollen and arthritic.

But by directly attacking PGe2, frankincense stops inflammation before it starts.

Frankincense also contains boswellic acid. This compound is a potent inhibitor of 5-lipoxygenase (5-LOX), an enzyme responsible for inflammation. Knocking out 5-LOX enzymes helps prevent inflammation and pain.

Look for a Boswellia serrata supplement standardized to at least 65% boswellic acids. I recommend taking 400 mg three times a day.

Frankincense is also available as an essential oil. You can place a drop or two under your tongue. Or dilute a drop in a glass of water or a teaspoon of honey. I also like to mix frankincense oil with coconut oil and rub it right onto a sore joint.

Boswellia is not the only painkiller in nature’s medicine cabinet. There are additional natural ways to relieve joint pain and inflammation.

Protect Your Joints with These 3 Natural Painkillers

1. First, try holy basil (Ocimum sanctum linn). This herb has a long and ancient history of treating arthritis pain. It contains dozens of nutrients that reduce inflammation.3 One of the most powerful is called ursolic acid. It inhibits the inflammatory COX-2 enzyme. Clinical studies prove holy basil relieves pain and reduces inflammation.
2. You can buy holy basil tea at most health food stores or on the Internet. Holy basil capsules are also for sale online. Make sure the product you’re buying has at least 2.5% ursolic acid to get the anti-inflammatory effect. I suggest 150 mg three or four times a day.
3. If that doesn’t work, take white willow bark. This plant contains salicin, the same compound found in aspirin. Hippocrates had his patients chew on white willow bark to reduce inflammation. Studies show it relieves arthritis pain as well as lower back pain.4
4. White willow bark won’t upset your stomach like aspirin might. You can find it in health food stores or online. I recommend 240 mg per day.
5. And for arthritis, try ashwagandha. This “smart plant” is also called Indian ginseng and winter cherry. In a recent study, researchers gave 60 arthritis patients ashwagandha or a placebo. After 12 weeks, those taking the herb had significantly less pain according to three different pain-score tests.5
6. I recommend 300 mg to 500 mg twice a day. Or you can buy dried ashwagandha root powder. Look for a product that’s 100% organic with no artificial flavors or colors. I like to add one teaspoon to a cup of boiling organic milk. I let it simmer for five minutes. Then I add a little honey to taste.

Aim to get at least 600 mg of DHA and 400 mg of its cousin EPA every day. And make sure you take them with meals so these omega-3 fats can be digested properly.

Al Sears, MD

1. Franceschi F, et al. “A novel lecithin based delivery form of Boswellic acids (Casperome®) for the management of osteo-muscular pain: A registry study in young rugby players.” Eur Rev Med Pharmacol Sci. 2016; 20(19): 4156-4161.
2. Chopra A, et al. “Ayurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: A randomized, double-blind, controlled equivalence drug trial.” Rheumatology (Oxford). 2013;52(8):1408-1417.
3. Cohen MM. “Tulsi – Ocimum sanctum: A herb for all reasons.” J Ayurveda Integr Med. 2014; 5(4): 251–259.
4. Chrubasik S, et al. “Treatment of low back pain exacerbations with willow bark extract: A randomized double-blind study.” Am J Med. 2000;109:(1): 9-14.
5. Chopra A, et al. “Ayurveda–modern medicine interface: A critical appraisal of studies of Ayurvedic medicines to treat osteoarthritis and rheumatoid arthritis.” J Ayurveda Integr Med. 2010;1(3):190–198.

Killing Jiminy: Stress, Fear, and Cortisol

For those of you that have been following our bi-monthly E-letter, Northwest Senior News, you may remember our series of reviews and digests from Dr. Stephen Sinatra’s book, The Great Cholesterol Myth. Sinatra listed the four leading causes of heart disease. Here they are.

• Sugar
• Inflammation
• Oxidation
• Stress

In Chapter 4, Dr. Lustig also references a connection between stress and sugar. Cortisol also gets thrown into the mix. What we can learn from various experts in their respective fields is that their messages, while slightly different and approaching issues from somewhat different vantage points, end up saying some very similar things. Sinatra focused on the myth of the cholesterol problem. Lustig has focused the problem of sugar addiction.

We recently did a serialized transcription of Gary Taubes’ YouTube video, The Case Against Sugar. Taubes’ focus is that sugar consumption leads to insulin resistance. His central theme is that hypertension, heart disease, diabetes, strokes, obesity, etc. are all a subset of insulin resistance. Again, we see these similar themes of hypertension, stroke, and obesity.

Lustig examines the interrelationship between pleasure and happiness and what happens when there is too much pleasure (addiction) and not enough happiness (depression). He very astutely zeros in on what are the drivers of sugar addiction. That is exactly what he does in Chapter 4, Killing Jiminy: Stress, Fear and Cortisol.

The big pictures of these authors (and certainly many others) is how to stay as healthy as possible. And that, of, course, is one of the reasons why we produce Northwest Senior News.

Background: For those that remember Pinocchio, Jiminy Cricket was Pinocchio’s conscience, reminding him of good and bad. Lustig says that the chemical changes that occur when a person is under chronic stress can contribute to a reduction of a person’s constraining forces not to do bad things (Ed: or even evil things).

Our review and digest of Chapter 4 begins.

Lusting tells us that stress is a normal part of life. If there is an immediate threat to our personal safety such as a lion in our path, our blood sugar and blood pressure will rise to prepare us for action. This stress (or fear) causes the release of a necessary hormone called cortisol from the adrenals, which are located on top of our kidneys.

Acute, short term cortisol release is both necessary for survival and is actually good for you. It increases vigilance, improves memory and immune function, and redirects blood flow to fuel the muscles, heart and brain. Your body is designed for cortisol to be released in any given stressful situation, but in small doses in short bursts.

Lustig suggests that modern conveniences such as electricity, air conditioning, and plenty of food have decreased stress in our lives. However, chronic stresses have “gone through the roof.” He says that these chronic stresses are taking a toll on people’s lives.

Chronic stress leads to constant cortisol releases which will slowly kill a person.

Evidence of the association of job stress, psychological distress, and disease is extremely compelling. Psychological stress in adolescence is directly linked to the risk of heart attack and diabetes in adulthood. Chronic stress also directly impacts the reward pathway as described in Chapter 3, and it has been shown that chronic stress can speed the onset of dementia.

My comments: We have a family acquaintance that worked on the staff of a leading orthopedic clinic in North Central Idaho for nine months. She had to quit her job because working for the doctors was too stressful. How many people have to endure stressful jobs because they can’t afford to quit?

Continuing: Lustig reminds us that people in lower socioeconomic or minority groups often have more stress, and because of that they suffer from higher rates of morbidity (sickness).

Stress breeds more cortisol.

. . . the more stress, the more breakdown of the endocannabinoid CBI receptor agonist and anti-anxiety compound anandamide, and the more anxiety.

Lustig references the connection with marijuana and states that its use can help a person “mellow out.” He also cautions that long term marijuana use can lead to a cognitive decline to the tune of eight IQ points. At that point, Lustig quips that those people may be less stressed about reality anyway.

My Comments: Cognitive decline all by itself is a potential aging issue. Why would anyone want to engage in a behavior that could hasten his/her mental decline? If there is a medical reason for using marijuana, that’s one thing. As far as keeping your mental faculties sharp, using pot recreationally doesn’t seem like a very smart idea.

A Bucket of Nerves

Continuing: Lustig explains that your body’s reaction to stress is the result of a cascade of responses.  The amygdala is the part of your brain that regulates this. When you encounter a threat such as a vicious dog or being contacted by nasty creditors, the amygdala activates the sympathetic nervous system. This raises your blood sugar and blood pressure to prepare you for the acute stress. The hypothalamus is the part of the brain that controls hormones. That tells the pituitary gland to tell the adrenal glands to release cortisol.

Occasional releases of cortisol are one thing, but continued exposure over the long term can exact a toll on your arteries and your heart, leading to hypertension and stroke. When everything is working well, you remember what caused a particular stress. For example, if you got freaked out by a snarling pit bull on a street you’re walking on, you’ll remember that and not walk down that street again if you can possibly help it.

Lusting explains that the hippocampus might be the most vulnerable part of the brain to cell death.

Almost any brain insult you can imagine (low blood glucose, energy deprivation or starvation, radiation) can knock off the neurons of the hippocampus. And one of the serial killers that attacks the neurons of the hippocampus is cortisol. The longer your cortisol stays elevated, the smaller and more vulnerable your hippocampus gets, which puts you at the risk for depression.

Lustig tells us that this is the likely reason why chronic stress leads to memory loss. Put more bluntly, he posits that chronic stress literally fries your brain, and it gets worse.

He continues by explaining that chronic stress impairs your ability to reason. The prefrontal cortex (PFC) is your high order or executive function part of your brain. Lustig uses the Jiminy Cricket analogy. Put another way, this is what tells us the difference between right and wrong and keeps us from going off the deep end, or what keeps us from indulging in bad behavior and keeps our baser desires in check.

A bad guy rapes Bill Smith’s daughter, and Bill finds out who the perp is. Bill is so angry at what happened that he feels like going over and taking the guy out. However, his rational side of his brain kicks in and tells himself that 1) he has no right to commit murder and 2) if he gets caught, tried and convicted of pre-meditated murder, he goes to the pen for a long time. His Jiminy Cricket says, “Okay, that’s your thought, but stop right there and get it out of your mind. You don’t want to be as bad as the other guy.”

In an uncontrollable, stressful situation, the amygdala-HPA trio (hypothalamus-pituitary gland-adrenal glands) axis commands the release of neurotransmitters including dopamine (yep, that again). These flood the prefrontal cortex (PFC), silencing Jiminy, which disinhibit you from doing some wild and crazy things. When your PFC is under fire by cortisol, your rational decision-making ability is toast.

My Comments: In the past few years we have heard of some things that people have done that are absolutely crazy. The woman in San Diego loses some YouTube revenue, so she drives up to the Bay Area and shoots some YouTube employees. Joe Blokes gets fired from his Post Office job, so he returns with a gun and shoots his boss. As I read this section of the text, I thought of these and other similar situations. You wonder, did these people just lose it without being aware of the consequences of what they were doing?

Continuing: Lusting explains that the more cortisol the amygdala is exposed to, the less it is dampened down by . . . the law of mass action.

More cortisol means fewer cortisol receptors in the amygdala, and the more likely your amygdala will do the talking from here on. Chronic stress day by day weakens your inner Jiminy.

Increased stress can turn a small desire into a big dopamine drive, which can be quenched by either drugs or food, or both. This is how the pizza and beer scenario typifies the American food experience.

My comments: There is a move afoot to absolve people of responsibility for their actions. Some suggest that we should have sympathy for the murderer or rapist because he had a bad childhood. This is along the lines of “he Devil made him do it.” The flip side here is that everyone has issues in his/her life, and everyone has to deal with various stresses. Maybe we have some events that are adding more stress compared to 20, 30, or 40 years ago. The key questions are, “What are the stresses I face and how can I minimize their effect on me?

Continuing: Lustig continues by saying that stress-induced dopamine has the capacity to remodel the prefrontal cortex so that it doesn’t work as well as before. Poor Jiminy Cricket has been squashed like a bug.

These neurons (the ones that house the dopamine receptors) are fewer and farther between. . . You need even more to get less. By driving the stimulation of the amygdala and decreasing your cognitive control centers, stress and cortisol make it much more likely that you will succumb to temptations.

Lustig poses a rhetorical question. Do you take three deep breaths or eat three doughnuts? Now it gets even scarier.

When cognitive control is lost, the ability to inhibit the drive to seek pleasure is lost. Stress promotes faster addiction to drugs of abuse and is likely the reason why drug addicts find it difficult to quit. Chronic stress kills off neurons in the PFC . . .

He reminds us that the preferred drug of choice when dealing with stress is, yes, yes, it’s SUGAR. Gary Taubes in his YouTube video The Case Against Sugar says essentially the same thing. It’s cheap, socially acceptable, and doesn’t appear to have immediate consequences. This sets up a vicious circle.

With chronic stress, eating is the preferred coping behavior of the individual. The person seeks energy dense food, usually loaded with sugar, which may become addictive. Since cortisol is an appetite stimulant, the infusion of cortisol into a person rapidly increases his/her food intake.

It gets even worse. Cortisol actually kills neurons that help inhibit food intake. Now a person eats even more food, usually sugar. The cycle continues.

If Only I Could Sleep at the Switch

Lustig tells us that another outcome of stress is reduced sleep. Reduced sleep also contributes to obesity. Short sleepers generally have an increased body moss index (BMI). Those deprived of sleep may consume up to 300 additional calories per day. The vicious circle gets worse and worse.

Dopamine makes you more likely to eat. The more you eat, the more likely you are to become obese. Obesity leads to sleep deprivation.

Lustig finishes the chapter by explaining that the impact of stress on children is even worse compared to adults. He says that this stress can lead to unhealthy snacking during adolescence. The result of that is overweight teens.

Lustig closes the chapter with:

The more chocolate cake you eat in response to stress, the less pleasure you will get and the sicker you will start to feel, which will drive even more stress. Those dopamine receptors need more but deliver less. You’ll become more tolerant or worse yet, addicted.

End

Why Your Pharmacist Can’t Tell You That a $20 Prescription Could Cost Only $8

WASHINGTON — As consumers face rapidly rising drug costs, states across the country are moving to block “gag clauses” that prohibit pharmacists from telling customers that they could save money by paying cash for prescription drugs rather than using their health insurance.

Many pharmacists have expressed frustration about such provisions in their contracts with the powerful companies that manage drug benefits for insurers and employers. The clauses force the pharmacists to remain silent as, for example, a consumer pays $125 under her insurance plan for an influenza drug that would have cost $100 if purchased with cash.

Much of the difference often goes to the drug benefit managers.

Federal and state officials say they share the pharmacists’ concerns, and they have started taking action. At least five states have adopted laws to make sure pharmacists can inform patients about less costly ways to obtain their medicines, and at least a dozen others are considering legislation to prohibit gag clauses, according to the National Conference of State Legislatures.

Senator Susan Collins, Republican of Maine, said that after meeting recently with a group of pharmacists in her state, she was “outraged” to learn about the gag orders.

Click here to continue reading on the New York Times Website.

10 Things to Know About Your New Medicare Card

Background: As dictated by 2015 legislation, the Social Security Administration (SSA) will begin the roll-out of new Medicare cards without the use of Social Security numbers. This is help prevent identity theft as Medicare has used Social Security numbers since its inception on your Medicare cards.

The following list is from Centers for Medicare and Medicaid services (CMS).

1. Mailing takes time. Your card may arrive at a different time than your friend’s or neighbor’s.
2. Destroy your old Medicare card: Once you get your new Medicare card, destroy you old Medicare card and start using your new card right away.
3. Guard you card: Only give your new Medicare number to doctors, pharmacists, other health care providers, your insurers, or people you trust to work with Medicare on you behalf.

Our comments: For some reason the CMS in its publication avoids mentioning insurance agents. When filling out an application for a Medicare supplement, Medicare advantage, or a Part D Rx plan, we must put down your Medicare number on the application.

4. Your Medicare number in unique: Your care has a new number instead of your Social Security number. This new number is unique to you.
5. Your new card is paper: Paper cards are easier for many providers to use and copy, and they save taxpayers a lot of money. Plus, you can print your own replacement card if your need one.

Our comments: Some people laminate their card. Technically, that may be a no-no, but obviously people do it anyway. For sure, make a photocopy of your new Medicare card. You could carry the copy with you and keep your government issued one safely at home.

6. Keep you new care with you: Carry your new card and show it to your health care providers when you need care.

Our comments: The same as number five. We have seen some old paper cards so worn that they were virtually unreadable. There’s the wisdom in making a copy.

7. Your doctor knows it’s coming: Doctors, other health care providers and facilities will ask you for your new Medicare care when you need care.
8. You can find your number: If you forget your new card, you, your doctor or other health care provider may be able to look up you Medicare number online.

Our comments: Again, carry a copy or even multiple copies. Keep one in your car or other backup location. Since there is no SS# on the card, it will be virtually useless to an identity thief.

9. Keep you Medicare advantage card: If you’re in a Medicare advantage Plan (like an HMO or PPO, your Medicare advantage Plan ID card is you main card for Medicate—you should still keep and use it whenever you need care. However, you also may be asked to show your new Medicare card, so you should carry this card, too.

Our comments: Back in 2006 when Medicare advantage plans ramped up, the companies were insistent that you SS numbers NOT be used on their ID cards.

10. Help is available: If you don’t get your new Medicare card by April 2019, call 1-800-Medicare (1-800-633-4227). TTY users can call 1-877-486-2078. End of the CMS document

Avoid the Scammers: We have reprinted some of the tips from Ron Iverson concerning scammers. They are as follows:

First, scammers are calling Medicare recipients, sometimes identifying themselves as Medicare or “government” officials and telling them that the new cards are coming out, but that they will have to send $30-50 to get the new cards.  That is bogus—there is no charge for the new cards—and CMS/Medicare does not call people—it only uses the U.S. Postal Service to communicate.

The second technique is for the scammer to say that he has a Medicare Advantage Prescription Drug Plan available, but then request personal Medicare information so that the new plan can be utilized.  This is also bogus.  Whatever you do, do not fall for this.  Medicare information is personal, and the scammers simply use it for other nefarious activities.

So, we don’t know when or how the scammers will spring into operation in your area, but if you receive one of these calls, just hang up and report the activity with a call to 1-800-Medicare (800-633-4227).  And…above all, do not feel pressured to respond to any of these calls—the scammers are well-trained in intimidation and persistency.  Don’t fall for it. End

The Hacking of the American Mind—Report Number 3

by Robert H Lustig, MD, MSL

Synopsis of Report #2

Two quotes from Lustig well sums up his account so far.

No pleasure means no happiness. Pleasure is the straw that stirs the drink. Happiness is the drink. Anxiety melts the ice cubes. We all need reward, because reward keep anxiety at bay . . . for a short time.

When taken to the extreme, these two pathways can take you to the highest mountain or the lowest valley—addiction, depression, and just plain misery. The science in Part 2 and 3 says so.

Pleasure and happiness are interrelated, and there has to be a proper balance. If all pleasure is removed from a person’s living, his/her zest for life is gone.

Chapter 3: Desire and Dopamine, Pleasure and Opioids

Lustig is a university trained medical doctor. He’s also an endocrinologist, and his writing is on a university level with almost the expectation that his reader can grasp the technical terminology that he uses. As I mentioned before, understanding some of his technical stuff is stretching my brain. I will do my best to interpret it for you.

Lustig starts out by reminding us that reward is a strong driver of human emotion. He uses several paragraphs to explain this in greater detail. His summation is as follows:

Reward is first and foremost. Reward is the end. And sometimes reward literally becomes your end. Because one reward is never enough. When one reward becomes the primary goal, overwhelming all else, the end consequence is addiction—perhaps the nadir (the lowest point) of unhappiness. Therefore, understanding the inner working of reward is paramount to any discussion of personal or societal benefit or detriment.

My Comments: Lustig is spot on when he says, “becomes your end.” I have two cousins that predeceased their parents due to booze and drugs. Their reward was their end.

I have witnessed several people so addicted to their refined carbohydrates that they are dying a slow death of degenerative diseases, meaning obesity, diabetes, heart attacks and strokes. They’re still consuming their sweets, and gradually losing the battle with ever increasing doses of insulin. It’s akin to the person with emphysema that continues to smoke.

Continuing: Lustig says that the reward pathway is basic to survival. If our parents hadn’t enjoyed sex, we might not have been reading this text. He says that scientists have now learned how the reward pathways work and how they can be manipulated for both good and bad.

From hereon out, the chapter gets very technical. Please feel free to read it in its entirety if you care to delve into the intricate details.

Lustig says that we can distill the discussion down to the trigger of the pathway: dopamine:

…Virtually all pleasurable activities (sex, drugs, alcohol, food, gambling, shopping, the internet) employ the dopamine pathway in the brain to generate the motivation. But too much dopamine starts the downward spiral toward misery (my emphasis). If you can put “-aholic” on the end of the word (alcoholic, shopaholic, chocaholic, sexaholic) then the dopamine pathway is in play.

My Comments: I emphasized “misery” in that Lustig is so right with his analysis of too much dopamine. When he mentioned food, he didn’t elaborate, but you can bet your last dollar that he is referring to refined carbohydrates, meaning white flour and rice, sugars, and high fructose corn syrup, etc. I have a relative that is miserable because her choices of consuming alcohol and junk food have led her to type 2 diabetes, obesity, amputated toes, having a stroke, and now being confined to a wheelchair. All of this is for a person in her fifties!

Continuing: Lusting explains that our dopamine levels can be graded on a bell-shaped curve.  If a person doesn’t have enough dopamine, she will be lethargic and have little motivation for reward.

But if you’re already at the top of your bell-shaped curve, and you get that same dopamine boast, it can result in a transitional state that can quite unpleasant. Moreover, your current position on that bell-shaped curve can be changed by your experience with many forces, including stress and medicines.

Lustig cites two examples of being moved the wrong way on this bell curve. Number one is obesity. In a nutshell, obesity plays havoc with your dopamine system in very consistent ways. The obese person is already skewed to the right on the bell-shaped curve. An advertisement for Oreos, for example, can trigger a dopamine release, and now the person is overloaded with dopamine and has nowhere to go but down.

Worse, leptin is the hormone that tells our brains that we have had enough. It can get totally fouled up in the obese person’s brain* resulting in eating the second, third, and fourth pint of ice cream. The dopamine satisfaction continues to dwindle so he gets less and less reward from eating the ice cream. *Rather than referring the anatomical terminology for various parts of our brains, I’ll keep it simple and only use the word “brain.”

For a deeper understanding of how leptin works, Lustig references his book Fat Chance: Beating the odds against Sugar, Processed Food, and Disease. He also explains that some people have a genetic disposition for their obesity. Part of their brain can light up faster and quicker when they see a food commercial compared to people with normal weight.

My Comment: Lustig brings up the subject of food commercials. Where do you see most of these commercials? Of course, it’s on television. Please permit me to explain the power of advertising and how it plays around with our minds.

Let’s say Wilma Nesmeyer is 30 years old and has never touched alcohol in her life. She has her first taste of wine, only a few ounces, and she is already in a swooning state from the effects of what little alcohol was in that wine. It had an extraordinarily powerful effect on her. Just a small dose sent her reeling.

I don’t watch television, and I don’t have a TV in my home as my time is too valuable to passively sit and watch the screen. I’d rather be doing something more productive.

However, when I visit my sister-in-law who lives out-of-state, I’m exposed to the TV and its advertising. She’s a widow and has it on all the time. I ask her to turn it down or even off when I’m interacting with her. However, sometimes I’m forced to watch some of it.

I’m like Wilma. I literally feel the effects of how the advertising is working on my mind. One or two doses of it sends me reeling. It’s like, “Wow, what hit me; what’s pulling at my brain?” It like an assault on my mind. I certainly don’t like allowing someone to subliminally screw around with my emotions. I used to love eating Oreos, and seeing an Oreos commercial wants to trigger my dopamine response. In another era, it could have been the motivation to buy some. It’s incredibly powerful!

If you are trying to overcome your addiction to sugary, refined and processed foods, exposing yourself to advertising is like trying to put out the fire while at the same time fueling the flames. If you know you have a weakness here (most of us do), it’s best to minimize our exposure to advertising as much as possible.

Continuing: The second example that Lustig cites is estrogen. Simply put, rising estrogen means rising dopamine. He gives examples of how this can affect a woman’s moods.  She can be either focused and motivated, checking things off her to-do-lists, or on the verge of maiming her family member for forgetting to pick up the ice cream. For complete details, please refer to pages 50-51.

Get a Hit, Get a Rush

Lustig explains that there are three separate modes for the regulations of our dopamine levels.

(1) Synthesis: Dopamine is made in neurons of the ventral tegmental area (VTA) from the amino acid tyrosine, found in many foods. Ed: Examples are high-protein foods such as chicken, turkey, fish, milk, yogurt, cottage cheese, cheese, peanuts, almonds, pumpkin seeds, sesame seeds, lima beans, and avocados.

Lustig continues with a brief discussion of drugs that have been used to either decrease or increase dopamine levels.

(2) Action: This gets very technical. There are receptors for the dopamine that is produced our brains. If a person has fewer receptors, in part due to genetic reasons, it takes more dopamine to arrive at one’s optimal level. If a person has fewer receptors, then it takes more food intake to generate the reward, and that, of course, leads to weight gain. Put another way, this person needs more of a fix to generate the same level of reward as people without this particular genetic variation.

Lustig describes some of the uses for pharmaceutical drugs such as Risperdal, Zyprexa, and Abilify. They are used to enhance the effects of a person’s anti-depressant prescription. These drugs may be also used to treat ADHD, but they have their own side effects. These can be lack of motivation, walking around in a personality daze, and induce insulin resistance in the liver which leads to weight gain.

(3) Clearance: Remember, the synapses are the connecters between our nerves. The dopamine is like the electricity (electrons) flowing through the wires. The dopamine needs to be cleared out of the synapse, which occurs from one of two mechanisms.

The dopamine molecules can be recycled and used again. The dopamine transporter (DAT) transports and sucks dopamine back into the nerve terminal, removing it from the synapse and readying it for the next stimulus.

Lustig points out that cocaine and methamphetamine, in essence, fool the DATs into keeping more dopamine in the system. Now you know why they’re called uppers.

Dopamine molecules can be deactivated. The very technical explanation is on page 55.

Too Much of a Good Thing

Lustig cuts to the chase:

Recreational drugs such as cocaine are the quickest way to boost your dopamine. But drugs aren’t the only way to access reward, and drug use isn’t the only manifestation of a disordered reward pathway.

He explains that other behaviors can quickly can become addictive and specifically cites gambling. He mentions the excitement of the Kentucky Derby.

It generates the same dopamine rush, to different extents, as a ski run down a steep slope, a shopping spree . . . or a line of cocaine.

Lustig explains that dopamine is the just the gateway neurotransmitter or the trigger. He likens dopamine to sexual foreplay.

. . . the euphoria, the pleasure is mediated through another set of chemicals, the endogenous opioid peptides (EOPs) whose cell bodies are in the hypothalamus, the brain area that controls emotions. The most famous of these is beta-endorphin, the brain peptide with properties similar to morphine. It binds to the same opioid receptor as does morphine or heroin, generating the pleasure signal in the nucleus accumbens.

He explains that you can get there through the use of opioid drugs such as hydrocodone or OxyContin. Another way to get there is through your own beta-endorphin by vigorous exercise. This is known as the runner’s high.

There’s a problem here, just as there is with the over use of dopamine.

. . . [T]hose EOP receptors are also down-regulated with chronic exposure . . . although we’re not sure what happens to runners. . . . and when the opioid receptors down regulate, you go from wanting to needing. That’s the neuro-chemical equivalent of addiction.

If You Scratch You’ll Keep Itching

Lusting concludes this chapter by saying that the goal of reward is not in the motivation but rather it’s in the consummation. He says that activating these opioid receptors is where the action is.

Pleasure is the goal. Desire is the driver. Motivation drives the outward behavior, consummation is the inward expression of reward.

He recounts an incident when holed up in an old hot, muggy hotel in Paris when he had an itch for ice cream, and he satisfied that itch.

Reward comes in two phases. Motivation or desire triggers the dopamine. Consummation or pleasure comes from the endogenous opioid peptides (EOPs) delivered from parts of our brains.

Dopamine is the trigger and the EOPs are the bullets. You need both to fire the gun, unless someone fires the gun for you, like taking Demerol in the emergency room . .  . EOPs are designed to shut down further dopamine production.

If there is chronic over-stimulation, there is a reduction of dopamine receptors in the key area in our brains. This leads to needing more and more dopamine to get less and less of an effect. Lustig closes the chapter by saying that chronic stress impacts our dopamine more than anything else.

My Comments: Everything that Lustig has described in this chapter is how we are wired. It’s the human condition. What he hasn’t discussed, at least not yet, is how we can overcome this condition and not be controlled and driven by it. I’ll delve into this in the future. End.

The following is a reprint of a letter of the Editor from Ron Iverson, President of the National Association of Medicare Supplement and Medicare Advantage Producers.

Background: As dictated by 2015 legislation, the Social Security Administration (SSA) will begin the roll-out of new Medicare cards without the use of social Security numbers. Sadly, the scamsters are always looking to take advantage of a new script.

Letter of the Editor by Ron Iverson

There is great news for Medicare enrollees, and a bit of caution regarding scammers.  The good news is that Medicare will be sending out new Medicare cards to each recipient.  The cards will arrive sometime between April 1st of this year and will be completed by April 1st of next year.

The new cards will not have the enrollee’s Social Security number on them, as they do now.  This is a major accomplishment for Medicare and is being done to help put a stop to identity theft via Social Security identification numbers.  This problem has been rampant nationally and is very serious business for Medicare enrollees who have had their cards compromised by internet bandits.

The new cards will have an 11-digit number that will have no relation to your Social Security number. So that is good news.  I understand that Montana will be in the second wave of states being sent the new cards, and that delivery is scheduled to begin May 1st.

But, along with the good news, bad news sometimes seems to follow.  The bad news is that Medicare scammers have already jumped into the game.  There is more than one technique involved, but these are the two most used.

First, scammers are calling Medicare recipients, sometimes identifying themselves as Medicare or “government” officials and telling them that the new cards are coming out, but that they will have to send $30-50 to get the new cards.  That is bogus—there is no charge for the new cards—and CMS/Medicare does not call people—it only uses the US Postal Service to communicate.

The second technique is for the scammer to say that they have a Medicare Advantage Prescription Drug Plan available, but then request personal Medicare information so that the new plan can be utilized.  This is also bogus.  Whatever you do, do not fall for this.  Medicare information is personal, and the scammers simply use it for other nefarious activities.

So, we don’t know when or how the scammers will spring into operation in your area, but if you receive one of these calls, just hang up and report the activity with a call to 1-800-Medicare (800-633-4227).  And…above all, do not feel pressured to respond to any of these calls—the scammers are well-trained in intimidation and persistency.  Don’t fall for it.

My Comments: Thank you Ron for your timely letter and information about the new Medicare card rollout. Let’s review some common techniques used by scammers and how to avoid becoming a victim.

1. Governmental agencies such as the SSA, IRS, and CMS always communicate with you via U.S. Mail. They do not phone you nor do they email you. You can automatically assume that any purported “governmental” communication from these sources are either scam or phishing schemes. Hang up to any such phone calls and do NOT open any suspicious emails. Hit the “delete” key.
2. In a similar vein, your credit card company, cable company, or tel-com company will never ask you to provide your user and passwords to them so they can ”update” their information. Delete such suspicious emails.
3. Passwords: Use complex passwords with 12 or 16 characters. Use a mix of upper case, lower case, numbers and symbols. I highly recommend using a password manager such as Last Pass, KeePass, or 1Password. For more information, please click here.
4. Use second factor authentication for critical accounts.
5. Be careful about what you post on social media.
6. Ron Iverson sent an email to our members warning us about a new phony email touting “TrumpMedicare.” Keep your delete key in good working order

End

by Robert H Lustig, MD, MSL

Synopsis of Report #1

Lustig’s central thesis is that corporations and governments are purposely conflating (mixing up two opposite concepts) pleasure and happiness. This is being done for their gain and at the expense of the person that is left confused by the conflating of these two distinctly different but related concepts.

Pleasure: Enjoyment or satisfaction derived from what is to one’s liking; gratification. While pleasure has a multitube of synonyms, it has a specific, well understood “reward pathway” in our brain.

Happiness: The quality of being happy or contentment. I’ll skip over the philosophy of Aristotle that he cites to further explain happiness. Contentment says that I’m satisfied; it’s not necessary to seek more.

 

Chapter 1: The Garden of Earthly Delights

Chapter 1 to a large extent reiterates the concepts that Lustig proposes in his introduction. Let’s see what we can gleam, however, from this chapter.

Lustig poses the question, why are so many people miserable? He also points out that many rich people are unhappy. Additionally, he points out that some people claim that the argument between pleasure and happiness is a “straw man.” He asserts that it does matter and that the differences between these two otherwise positive emotions forms the narrative arc of this book.

He explains that pleasure is the “reward pathway” and happiness is the “contentment” pathway. Lustig also concedes that the definition of happiness has changed over time.

He spends page 19-20 discussing how various religious traditions have dealt with the concepts of pleasure and happiness. He says that the definitions of these words are a moving target.

Because people want to learn how to be happier, numerous pop psychology books have appeared in recent decades, ostensibly leading people on the way to the happiness that they seek. However, most of these books confuse pleasure with happiness.

Until you can distinguish the difference between these two emotions, you can’t recognize either one as unique and you can’t understand, let alone fix, the problem for yourself and for your family.

One Origin of the Confusion

Lustig says that if you “google” happiness you will find definitions such as pleasure, joy, bliss, contentedness, etc. He points out to the reader that this is a classic example of conflating pleasure and happiness. I’ll skip past his references to Aristotle. He shows how academics such as those at Stanford University have conflated pleasure and happiness. He quotes from the Stanford Encyclopedia of Philosophy:

 Happiness: Hedonism (maximization of pleasure) …

Lustig is not happy about Stanford’s conflating his two key concepts that drive his book. He spends the reminder of page 24 discussing some philosophical nuances of pleasure and happiness.

Lustig concludes chapter one:

And as corporations have profited big from increased consumption of virtually everything with a price tag promising happiness, we have lost big-time. America has devolved from the aspirational, achievement oriented “city on a hill” we once were, into the addicted and depressed society that we’ve now become. Because we abdicated happiness for pleasure. Because pleasure got cheap.

My comments: All through school I struggled with abstract concepts, and I’m struggling again. I’m fully sympathetic with anyone who thinks the following as he/she reads this summary: “I’m not sure that I understand all of this. Let’s see if this helps.

As a pre-adolescent emerging into adolescence, I loved drinking soda pop. It was sweet, fizzy, and tasted good. Back in those days soda pop was marketed in returnable bottles with deposits. I marveled with a friend when we bought a bottle of Royal Crown Cola. Why? The Royal Crown came in a 16-ounce bottle instead of the standard 12-ounce bottle. Coke was still being sold in 8-ounce bottles.

That extra 4 ounces of pop delivered more pleasure that lasted longer as I drank it down. As it fed my sugar addiction, it certainly didn’t add to my long-term happiness. In fact, because the massive sugar fix that I was imbibing contributed to weight gain, which contributed to me becoming more depressed.

Fast forward from the 1950s to today. Pop is still marketed and sold in 12-ounce cans. However, the 20-ounce plastic bottle has now become the new norm. That 20-ounce bottle has 67% more bad stuff compared to the old, 12-ounce can. And don’t think you’re getting off the hook if you consume “diet.” It’s all bad.

If the 20 ounce “new” serving size wasn’t big enough, the liquid candy purveyors are now marketing 24 ounce and 1-liter single serving sizes. However, the sales in recent years has been lagging for these super-sized servings, so the liquid candy folks have originated a clever new marketing gambit.

The liquid-candy-in-a-can folks are now marketing a 7.5-ounce can that sells for more than 12-ounce cans! This is something like $0.50 per can versus the $0.31 for a 12 ounce can. Or put another way, the liquid candy drinker now pays more for his/her smaller sized fix compared to a larger size.

A couple of years ago I attended an insurance meeting in Denver, and as a treat for the attendees, the sponsoring agency bussed us to a Colorado Rockies baseball game at Coors Stadium. The last major league baseball game I attended was around 50 years ago at Dodger Stadium in Los Angeles. Was I in for a rude shock.

During every inning break we were bombarded with a plethora of advertising, especially for soda pop, on the brightly lit, monster outdoor screens. I vividly remember one of the scenes of the HAPPY young adults romping around and having fun while guzzling down their liquid candy. Their heads were tipped back with their pop bottles tipped upside down at a 60-degree angle. The close-up shots showed the imbibers’ throats flexing as they swallowed their caffeinated candy. I don’t think it’s a stretch to suggest that the scenes had sexual overtones.

I can’t think of a better example of Lustig’s narrative of the conflating of pleasure and happiness. He also repeatedly hammers at the theme that the corporations’ conflating of pleasure and happiness is done at the expense of the consumer, or more accurately, the unwitting victim. That could be you!

Warren Buffet’s Berkshire Hathaway collects around $500 million dollars per year in dividends from the Coca Cola stock that he purchased around 30 years ago.  On December 1, 2012 the value of one Class A share of Berkshire Hathaway’s stock (BRK-A) was around $152,000. BRK-A hit $325,000 plus on January 22, 2018. That’s a doubling of wealth in a little over five years!

Every consumer that purchases Coke products (or any other liquid candy brand for that matter) has contributed to that explosion in wealth. It’s a they win, and you lose proposition. Meanwhile we hear on the news that America’s middle class in shrinking. We hear reports of the startling high percentage of seniors that are living at or below the poverty line. An exhaustive study of the causes of this occurrence is way beyond the scope of this chapter summary.

However, here is what Lustig is trying to get across to his readers. Drinking that liquid candy offers temporary pleasure, but let’s look at what happens for all too many people. That after effects include but are not limited to the following:

1. Weight gain and obesity
2. Please remember that the “diet” form of liquid candy introduces toxic substances such as aspartame or sucralose (Splenda) into your body. The evidence is clear that “diet” increases your appetite and is totally counter-productive as far as losing weight goes.
3. Type 2 diabetes
4. Heart disease
5. Stroke
6. Cancer
7. Increased dental costs due to the phosphoric acid in colas eating away the enamel on your teeth. I have received many calls from people needing thousands of dollars with of crowns, implants or other expensive dental work.
8. Financial ruin. The money spent on soda pop might as well be money flushed down the toilet. Worse yet, for those whose health has been damaged by the consumption of pop, there are increased medical costs that somebody is paying for. I have heard many people anguishing over the copays for their insulins (especially when packaged in pens) such as Lantus, Humalog and Novolog. Additionally, major pharmaceutical companies have developed expensive new diabetic drugs such as Januvia, Victoza, Onglyza, Byetta, and Trajenta. The costs for some of these are so high that some people simply cannot afford them.
9. Depression caused by a combination of the above occurrences.

I think Dr. Lustig would whole-heartedly agree that the drinking of soda pop may give temporary pleasure, but not only does it not lead to long-term happiness, but it contributes to depression when the negative results begin to occur. Please remember that too much pleasure leads to addiction and not enough happiness leads to depression.

Continuing:

Chapter 2: Looking for Love in all the Wrong Places

I thought Chapter 1 was a little on the technical side, but Chapter 2 is even worse. Lustig delves into the physiology of how the reward pathways work in our brains. For details, please read pages 26-32. He summarizes his commentary by stating:

These three pathways generate virtually all human emotion, and in particular, those of reward and contentment.

Because of how dopamine works on the reward pathways, virtually any stimulus that generates reward can lead to addiction. These addictions can include drug addiction, but they can also include behavior such as gambling or internet use. Sugar along with high fructose corn syrup sweetened foods or beverages are also highly addictive.

Happiness depends on serotonin, but the brain’s interpretation of these signals isn’t as simple as the pleasure signal.

Lustig explains that when the THC in marijuana binds to our CBI receptors it heightens mood and alleviates anxiety, which is partially why people become so giddy when they smoke pot…in those who toke, anxiety is thrown to the wind, leaving plenty of room for pleasure.

He discusses the drug Rimonabant which suppresses pleasure receptors. This drug was supposed to help people curb their eating as they received less pleasure from eating. The only problem was that when a person loses motivation for reward, he/she also lost motivation for life. Some suicides were the end result.

No pleasure means no happiness. Pleasure is the straw that stirs the drink. Happiness is the drink. Anxiety melts the ice cubes. We all need reward, because reward keep anxiety at bay . . . for a short time.

Lustig discusses the reward-contentment paradigm in relationships. Infatuation is the spark that may start a relationship, but for the long-term run, here is what he says:

Studies of married people show that the contentment derived from the commitment of an interpersonal union generates added individual benefit; people within such unions tend to live longer and develop fewer diseases then those who never married or those that are previously divorced.

Lustig points out that romance novels run on infatuation (reward) while love (contentment) is boring. Infatuation leads to alteration in the brain chemistry that resembles drug addiction, almost assuredly due to dopamine.

He concludes Chapter 2 by mentioning how the neurotransmitters dopamine and serotonin physiologically work in our brains. He explains that these two pathways influence each other.

When taken to the extreme, these two pathways can take you to the highest mountain or the lowest valley—addiction, depression, and just plain misery. The science in Part 2 and 3 says so.

End

Note from Lance: This is a reprint of an article by Dr. Sears with my comments after.

by Al Sears, MD

You’ve probably heard the expression that something important is “worth its weight in salt” and that a person who’s decent and good is the “salt of the earth.”

These expressions have their origin in the fact that up until about only a hundred years ago or so, salt was one of the most valuable and sought-after commodities in the world.

Today, it’s one of the most vilified. In fact, the American Heart Association (AHA) recently made a shocking announcement in the journal, Hypertension. They claimed that one in 10 Americans dies from eating too much salt.¹

I’m sure you’ve heard the dire warnings about salt from your own doctor, the media, the FDA and just about everyone else. It makes great attention-grabbing headlines. But these recommendations are not just misleading; they’re downright dangerous.

Current FDA and AHA guidelines recommend that to lower blood pressure and reduce your risk of heart disease, you should consume no more than 1,500 mg of salt per day.

Their hypothesis goes like this… You eat salt and get thirsty, so you drink more water. The excess salt causes your body to retain that water. And retaining excess water increases your blood volume, which leads to higher blood pressure… and therefore to heart disease and stroke.

It seems to make sense in theory. But there’s a big problem. The facts don’t back it up. Repeated studies have failed to show a causal link between salt intake and high blood pressure. In fact, a lot of research even points in the opposite direction.²

Most doctors will never tell you that multiple peer-reviewed studies published over the last 10 years reveal that when your daily sodium intake drops below 3,500 mg, your body reacts with a rapid rise in the hormones renin, angiotensin and aldosterone.³

This can lead to insulin resistance and trigger chronic diseases, like diabetes, metabolic syndrome and heart disease — precisely what salt restriction is supposed to prevent.^4,5

Let me explain…  In a 2016 Harvard study — involving 130,000 people across 49 countries — researchers put healthy people on a low-salt diet. Within just 7 days, these previously healthy participants developed insulin resistance! In fact, the researchers found that low salt intake raised their risk of heart attack, stroke and death, compared with an average salt intake.⁶

I’m all for better labeling and your right to choose how much salt you consume. But if you were to slash your salt consumption by 30% or more, as the FDA and AHA recommend, the chances are we’d be struck by a major health crisis.

Decades of pushing a low-salt diet may even be partly responsible for the epidemic in insulin-resistance and diabetes faced by millions of Americans today.

Salt craving is normal. It’s a biological need, just like your thirst for water. The truth is, you can’t live without salt.

Salt carries nutrients across cell membranes and into your cells. Your heart, kidneys, liver and other organs need it to function. It helps regulate fluid balance and muscle contraction. You can’t digest food without it. And humans are salty people. We cry and sweat salt. Even our blood is salty.

Studies show that when people are allowed to use as much salt as they like, they tend to settle at about a teaspoon-and-a-half a day — around 3,500 mg of sodium. This is true all over the world, across all cultures, climates and social backgrounds.⁷

The real question you should be asking is not, should you eat salt or not — but what kind of salt should you eat? Because not all salt is created equal…

Don’t Buy Into the Big Salt Lie

Here’s what I tell my patients who are worried about their salt intake: Toss the processed table salt. The salt you find on supermarket shelves is refined table salt. And table salt is not even anywhere close to the kind of salt Mother Nature intended. Table salt is superheated and bleached until it’s devoid of nutrients and minerals.

Stop eating fake foods. Americans get almost 80% of their salt intake from processed foods. And these fake foods are loaded with sodium — even if they aren’t traditionally “salty” foods. It acts as a food preserver and works by removing water from the food so bacteria can’t survive.

Salt has been used to preserve food for thousands of years. But the salt Big Agra uses is loaded with chemicals and can be listed in the ingredients under names like sodium ascorbate and sodium lactate.

Choose natural salt alternatives. Here are two of my favorites:

Sea Salt: Natural sea salt is unrefined. It contains sodium chloride like ordinary salt, but also has 50 other minerals, with all the co-factors and trace elements nature intended real salt to have. Sadly, most sea salt around the world has been contaminated by plastics pollution. But it’s still better for you than processed table salt.

Himalayan Crystal Salt: Himalayan salt is mined from ancient salt beds in the Himalayas. Since these salt beds are ancient and dried, they don’t have a risk of contamination. They also contain many trace minerals. For example, 500 mg of Himalayan salt has 250 mcg of iodine. Its pinkness comes from its rich iron content.

To Your Good Health,

Al Sears, MD

Lance’s Comments: The website for the brand Himalayan Crystal Salt contains some excellent information as to the why’s of this type of natural salt. They list “Five Factors that differentiate the different types of salt:

1. The amount of trace minerals in each salt.
2. The ratio of those minerals.
3. The particle size and structure of those minerals.
4. The level of contamination with additives, chemicals or pollution.
5. The research on that specific salt showing its health benefits.

They next list a useful spread sheet that shows why their brand of salt is superior compared to others.

There is another brand of unrefined salt called Real Salt. It is mined from an underground salt deposit in central Utah. Their website does not get into the detailed specifics as does the one for Himalayan Crystal Salt.

Another entry in the healthy salt lineup is Celtic Sea Salt. Again, this salt is mined from ancient sea beds. End

 

References

1. “Sodium and Salt.” American Heart Association.
2. Brownstein D. “Salt Your Way to Health.” A Grain of Salt Winter. 2006 issue.
3. Graudal NA., Hubeck-Graudal T., et al. “Effects of Low-Sodium Diet Vs. High-Sodium Diet on Blood Pressure, Renin, Aldosterone, Catecholamines, Cholesterol and Triglyceride [Cochrane Review].” Am J Hypertens. 2012 Jan.
4. Alderman MH., Madhavan S., et al. “Association of the Renin-Sodium Profile With the Risk of Myocardial Infarction in Patients With Hypertension.” N. Engl. J. Med. 1991.
5. Ruivo GF., Leandro SM., et al. “Insulin Resistance Due to Chronic Salt Restriction is Corrected by α and β Blockade and by l-arginine.” Physiology and Behavior. 2006.
6. Mente A., et al. “Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies.” Lancet. 2016 Jul 30.
7. Alderman MH. “Dietary salt and cardiovascular disease.” Hillel Cohen. Published: 10 Dec 2011.