Red yeast rice and cholesterol

Saw an interesting article on Medscape that involved a comparison between the medication group “statins” (i.e. Crestor, Lipitor) and their effectiveness in lowering cholesterol versus red yeast rice. The name of the study was Red Yeast Rice and Hyperlipidemia: How strong is the Evidence?  by author, Charles P. Vega, MD.  The author discusses both the benefits and drawbacks of statin therapy. Myopathy (muscle pain and breakdown) and rhabdomyolysis (the toxic product of muscle breakdown that will damage kidneys) are the most severe complications of statin therapy. However, these complications must be weighed against the benefits of reducing both cardiovascular events and arterial plaque.

 Red yeast rice was initially compared to placebo treatment in those patients who could not tolerate statin therapy. It was administered over a period of 24 weeks, with only 4 patients leaving the treatment group. After the treatment term ended, the researchers  found that the group taking the red yeast rice had a reduction in LDL cholesterol (bad cholesterol) by -27.3% versus the placebo group. In addition, a separate trial of 5000 patients with a history of heart attack demonstrated that red yeast rice reduced the risk of another heart attack by 62% and death due to cardiovascular disease by 31%. Although more research is needed, , red yeast rice certainly holds promise for the future without the toxic side effects.

 On the same front, also released today was a large study comparing Zetia/Vytorin versus Niaspan (Niacin is a B vitamin). The study revealed that niaspan was well more effective than Zetia in increasing HDL (good cholesterol) and modestly lowering the LDL.

 It is nice to see a more natural  line of effective treatments coming into vogue for the near future. I will anxiously await the outcome of further studies and report back.

 

Our trip to Erie

Halloween, what a time to drag the kids from home.  However, the Celiac Sprue Association’s National Convention was held on just that weekend in Erie, PA. Erie is a quaint town that sits right on the shore of Lake Erie. The people are very friendly and gluten-free knowledgable. The convention was held at the Bayside Convention Center, right on the water.  Inside, there were two large ballrooms dedicated to lectures. In a third, we had the pleasure of an exhibit hall filled with samples of all the best gluten-free foods, flours, cookbooks and amenities one could wish to find. Our children made quick work of all the samples offered. When surveyed, all four agreed that the brownies and numerous brands of cupcakes were their favorites!

The Celiac Sprue Association does a wonderful job at many things, not the least of which is arranging this conference every year. We heard superb lectures from the likes of Dr. Peter Greene(Columbia University NY,NY), Dr. Rodney Ford ( New Zealand), Dr. Fransisco Leon( Alba Therapeutics), Dr. Dennis Vidmar( dermatology) and many more. They were kind enough to allow my husband and me to present as well. Bill spoke on the medicolegal aspects of Celiac Disease and I did a brief lecture on associated conditions that cause diarrhea in celiac patients after going gluten-free . The reception was very warm and we really enjoyed our chance to touch more lives.

While in Erie, we had the pleasure of meeting some of the people who make the CSA work. Pictured above, with me, is Mary Schluckebier, MA( reader’s left). Mary is the executive director of the CSA.  Along with Bill Ehl, the president of the Celiac Sprue Association, they reach out all over the country to spread the word about celiac disease , raise money for research and education and closely monitor the labeling laws that guide all food intolerant individuals. What a great job they do. If you have not already done so and you are a person living with celiac disease, please go ahead and join the CSA. It is worth the $20 you will pay for it!

Lastly, I would like to take a moment and give a special thanks to Mike and Deb Mailand. Every year, this couple comes and designs a 3-day program for the children of those attending the conference. Their children are already grown so this is done purely out of the goodness of their hearts. I would like to say to them “What a great job you both did!!” Our children were included in several field trips. The kids went to a large chain supermarket, Wegman’s, for a tour of the gluten-free choices offered and a talk on nutrition. They had a trip to the zoo, carving pumpkins, a homemade haunted house, gluten-free cooking lessons, a Halloween party brimming with more than 12 different treats made by the children themselves and more. The cleaning was endless and the sleep not enough for the Mailands, yet they were at the convention center every morning by 7am ready and willing to go again. Bill and I were most impressed!

Next years conference will be in Kansas City, Kansas. I implore all that can to please make the trek down. It is well worth the trip, even if just for the camaraderie alone. You will realize just how many of us are fighting the same fight.I am also pulling for Chicago for 2011. Hope you can all join me in the Chicago push. I would love to see all of you here in our grand city that is so supportive of celiac disease!

 

CSA Lectures

Our lecture handouts didn’t make it into the CSA handout that was distributed for attendees at the conference.

We promised to make the handouts available for everyone and I have included both my lecture and my husband’s lecture below.

Gluten Free and Still Symptomatic
Legal Aspects Celiac Disease

 

Celiac Sprue Association’s National Convention

In just a few days I leave for Erie, PA for the Celiac Sprue Assocation’s national convention. My husband, Bill, and I were honored with an invitation to speak at the gathering. We are included amongst some of the most influential in the celiac community such as Dr. Peter Greene out of Columbia University Hospital in New York City. Dr. Greene is responsible for a large amount of research and books on the subject of Celiac Disease. It is very humbling for us to be sharing the same stage. Bill and I are looking forwad to mingling with other people living with celiac disease  from around the country. Once I return, I will update everyone on what I saw, the people I met and the things that I learned.

 Hope everyone has a happy, healthy, gluten-free Halloween!

 

A Thank You

I want to thank everyone who came to visit our open house this past Saturday. It was a great success. I met many interesting people and shared a wonderful array of gluten free foods with both gluten intolerant as well as gluten tolerant individuals. Amy, from Be Well 365, worked her fingers to the bone giving massages, almost continuously, for 5 hours. Those whom Amy worked on agreed whole-heartedly that she is very good at what she does.

I want to take this opportunity to thank DaLuciano’s, Health Nutz in Mokena, and Natural Choices in New Lenox for their food donations. Amy and I truly appreciated your generosity.

We are planning to have another gluten-free open house in a few months. Here’s hoping that more of you reading this will come and stop by for a visit!

 

An Invitation

I recently mentioned about the new addition to my office. Be Well 365 is up and running.  Amy Novotny is a certified massage therapist who looks forward to helping the masses with all that ails them. Having said that, I would like to invite everyone to an open house we are having at our office. The date is Saturday, October 10th. The time is from 11-3. The place is 9475 Bormet Drive in Mokena, Illinois. Amy will be present giving free, 5-minute sample massages to anyone interested. I will be present with a load of gluten-free food to taste and comment on. Places such as DaLuciano’s, Free From Market, Health Nutz, Natural Choices, Guardi’s Pizza  and my kitchen will be represented.

 I really hope everyone will take a minute and stop by.

 

Another bit about swine flu

Recently, I have had several patients tell me that they do not want to receive the swine flu vaccine. They offer many reasons such as they “have never received the flu shot in the past and they have been just fine” and “the vaccination has not been out long enough to know the side effects”. I have even heard that some people believe this uproar over the H1N1 virus is all propaganda by the pharmaceutical companies (see comment section) created to increase vaccine profits.

I am here to tell you that the risk with this virus is very real!

H1N1 is proposed to kill between 90,000 and 100,000 patients in this country over the coming winter months. Although it is a new vaccine, it is safe. Tens of thousands of doses have already been dispensed to both adults and pediatric patients with no overwhelming side effects. In this case, the benefit strongly outweighs the risk. The unfortunate fact about this virus, in particular, is that the young healthy individuals are more likely to die from the disease. We have no immunity, as we have never lived through a pandemic such as this current swine flu.  We have been given the opportunity to protect ourselves and I suggest that we all take it. I believe so strongly in this coverage that my four children, my husband and I will be receiving the vaccination as early as possible.

Lastly, I do want to make the point that taking the seasonal influenza vaccine is still very important. Upward of 35,000 people die each year from seasonal flu. The H1N1 virus is entirely different from the viruses contained in the seasonal flu vaccine. Seasonal flu vaccine will NOT cover H1N1 and the H1N1 vaccine will NOT cover seasonal influenza. The CDC strongly recommends receiving both vaccines.

So, please take a proactive approach to your own health care and take both vaccines!

 

Increased Risk of Death in Celiac Disease

Many of my patients with celiac disease ask whether it is OK to “cheat” on their gluten free diet.

This study titled “Small Intestinal Histopathology and Mortality Risk in Celiac Disease” just published in the Journal of the American Medical Association shows that patients may be gambling with their lives if they do so.

The study compiled all small bowel biopsies taken in Swedish patients between July 1969 and February 2008. The researchers divided patients into several groups – those with villous atrophy, those with intestinal inflammation (which the study says is equivalent to intraepithelial lymphocytes in Sweden), and those with normal mucosa. Out of 287,586 unique patients who had biopsies, celiac disease was found in 29,148, inflammation was found in 13,446, and the mucosa was normal in 244,992. The researchers also found 3,736 patients with “latent celiac disease” – meaning that they had normal intestinal biopsies and positive celiac disease serology (blood tests).

The researchers then compared death rates between these different groups of patients with death rates from the general population.

For patients with celiac disease (atrophy on biopsy), the risk of death was 39% more than the general population. Patients with inflammatory changes on their biopsies had a 72% increased risk of death, and patients with latent celiac disease had a 35% increase in risk of death.
Patients with celiac disease had a 19% greater likelihood of dying from heart disease, 55% greater likelihood of dying from cancer, 36% greater likelihood of dying from lung problems, and 65% greater likelihood of dying from other causes.
Patients with inflammatory changes on their biopsies were 35% more likely to die from heart disease, 232% more likely to die from cancer, 46% more likely to die from lung problems, and 201% more likely to die from other causes.
There were not enough patients with latent celiac disease (normal biopsies with positive blood tests) to predict cause of death in several categories, but patients with latent disease were almost three times more likely than the general population to die from respiratory problems. Cause of death was also higher in all the other categories, but did not reach statistical significance.

One other interesting thing noted in the study is that risk of death was much higher in the first year after celiac disease was diagnosed and then tended to level off with time. In fact, those with inflammatory changes on their biopsies had a risk of death almost 5 times greater than the general population in the first year after diagnosis. Those with celiac disease had a risk of death almost 3 times greater than the general population in the first year after diagnosis. The researchers believed that this discrepancy may be because the patients were likely to be more ill and have more severe symptoms leading to the diagnosis of celiac disease. Once a gluten free diet is initiated, it can take 1-2 years for the changes to resolve.

There were several interesting things I noted about the study findings.

First, if we add up all the categories, the incidence of celiac disease for patients undergoing intestinal biopsy was 29,148 + 13,446 + 3,736 out of 287,586 total patients. That totals more than 16% of patients undergoing intestinal biopsies in Sweden who had either biopsy or serologic findings consistent with celiac disease.

Second, 1.3% of patients had normal small bowel biopsies, considered the standard for diagnosis in the US, but still had positive serologic tests for celiac disease.

Third, the study shows that celiac disease is more than just a bad reaction to food. Uncontrolled celiac disease causes changes in the body that increase the risk of death. The better that we follow a gluten free diet, the more likely we are to live long healthy lives.

Finally, celiac disease awareness is increasing! See news stories about this study in:
The Los Angeles Times
Medscape
Medpage Today

A .pdf copy of the study can be found here.

 

An Announcement

I would like to welcome Be Well 365 to my office. Although not part of Sullivan Medical, Amy Novotny LMT, AMTA is a certified massage therapist who will be sharing my office space with me on a part-time basis. Amy has a strong belief in a holistic approach to patient care. She takes the time to develop a wellness plan with each patient that includes massage, reflexology and other modalities to provide total care. She will be accepting both cash payment as well as insurance, if the patient has covered benefits.

As a welcome to my new office and to Amy, we will be having an open house on October 10th, from 11am to 2 pm. We will be serving a load of gluten-free goodies as well as 5-minute sample massages. Please come and join us for the festivities. We will look forward to seeing you there!

 

Don’t believe everything you hear

A patient with both celiac disease and diabetes (see here for a US News article about the link between celiac disease and diabetes) recently visited me in my office. While I help manage her celiac disease, she also sees an endocrinologist to help manage her diabetes. The patient shared with her endocrinologist that she has had several episodes of contamination which lead to a breakout of Dermatitis Herpetiformis. The endocrinologist told her that if she stays on a small dose of prednisone every day, she can not only prevent her breakouts but completely cure her celiac disease.

For anyone who has heard similar statements, I am writing to tell you that this is not true. There is no medicine to treat or cure celiac disease. The only “cure” to celiac disease is a strict gluten-free lifestyle, so please do not believe otherwise. All celiac patients (including myself) have had episodes of contamination. We treat the symptoms and move on, trying twice as hard to be strict with our diets in the future.

My family and I are awaiting word on any sort of treatment for celiac disease. There are studies ongoing.

I will let you know when I get that word!