Minimalist Transition

I’m going to write a short series of posts on my experience and research into minimalist and “barefoot” styles. Today I’ll talk a bit about the transition to minimalist footwear.

The first minimalist shoes I tried were a pair of martial art shoes I already had. They fit the definition for “minimalist” since the sole was very flexible and only a 4 mm “rise” from toe to heel. They worked fine to begin with. Of course I’m on my feet for several hours a day. After 2 hours no problem. After 4 hours my feet were getting a little sore. After about 6 yours my feet were on *fire*. Fortunately, I had brought my regular shoes and changed into them, much to the relief of my poor feet.

I realized that my foot plantar muscles were probably very atrophied (wimpy) from all that great support my feet were getting from “good” shoes and orthodics. My foot muscles had very little to do and got real lazy. Over the next few days I switched back and forth between my martial art shoes (Tiger claws, available for $25-50) and my dress shoes. I have been able to wear the minimalist shoes for longer and longer periods as my muscles developed. Now I can wear them all day long.

The lesson here is to ease into this kind of change, especially if you’re putting extra stress on your feet by being in them all day or running.

The other interesting thing is that I probably have been weakening my feet by giving them too much support. I’m still deciding whether minimalist or barefoot footwear will be the best approach for most people but I’m becoming convinced that we all should spend some time every day walking barefoot or with minimal shoe support. This will allow our foot and other muscles to get some exercise as well as more proprioceptive stimulation to our foot receptors.

Get Some Sun!

It’s Summer and we finally have a few days of sun! This is our chance to get outside, expose some skin and experience our own brand of photosynthesis. You may think that photosynthesis is something only plants do but we humans do it too. The difference is that, instead of making glucose and other sugars, humans make vitamin D.

I really think the sun has gotten a bad rap of late. Everyone is concerned about the possibility that exposing skin to sun will cause skin cancer. This is understandable since the incidence of skin cancer per capita has been rising over the last decade or so. This, *despite* more people staying indoors, watching TV, playing video games etc and staying covered with clothing, hats and sun screen when they do venture outside.

Something many people are not aware of is that vitamin D deficiency causes a lot of problems beyond weak bones and teeth. It’s important for a strong immune system, for preventing diabetes, obesity, cardiovascular disease, autoimmune diseases like MS and Hashimoto’s thyroiditis, and depression.

It’s also important for preventing several types of cancer, including skin cancer! While people are busy protecting themselves from the “dangerous” effects of the sun they may actually be increasing their chances of skin cancer as well as all the problems above!

Like a lot of things, moderation is the key to good health when it comes to sun exposure. Getting repeated burns will cause skin damage that increases your risk of skin cancer. Avoiding any significant sun exposure will increase your risk of skin cancer (and a lot of other problems) by leaving you vitamin D deficient. My recommendation is to get out in the sun for 20-40 minutes 2-4 times/week with as much skin exposed as possible. Check your shadow. If it’s longer than you are tall, the sun is too low in the sky to stimulate much vitamin D production.

If you’re going to be out in the sun for several hours then, by all means, protect yourself with hats, sun screen etc. You might want to wait 20 minutes or so before covering up.

If you have a problem that truly requires you to stay out of the sun, you’ll need to take a vitamin D supplement. There is also a big difference in how well different people make vitamin D. As we get older, we tend to lose some ability. Darker skinned people have more protection from the sun but also make vitamin D less well. On the other hand, I’ve seen some light skinned people in their 30s and 40s who are not making vitamin D well. If you need to take oral vitamin D (this is almost everyone in this part of the country during the Winter) make sure it’s vitamin D3 not D2. The D in milk is not enough and is usually D2.

Usually, your body won’t make more vitamin D than you need but you can get too much taking it orally. Because there is also a big difference in how people absorb vitamin D in orally, the only sure way to tell how much D is in your system is with a blood test. Because you can also get too much D, resulting in kidney damage, I don’t feel muscle testing is adequate when using the amount of vitamin D (3000-10,000 iu/day) needed to get us into the “optimal health range”.

The lab level for vitamin D is 30 – 100 ng/ml. This is a level that will prevent diseases like rickets but most modern authorities suggest a level of at least 50 – 100 ng/ml. I like my patients to test at least 50 for general good health and 60-80 for those with auto-immune conditions, diabetes, depression or other disease states that are affected by vitamin D. Again, over 100 could cause vitamin D toxicity. When I first got serious about vitamin D, my blood levels went to 120! I happen to be one of the people who produce D well from sun exposure despite being in my 60s and need to stop taking D from May through September. Fortunately, I didn’t have any detrimental effects from briefly excessive vitamin D levels but this shows how easy it can be to get too much of a good thing!

So, for good health, come in and let me set you up for a vitamin D blood test and get some sun!

What is the Best Shoe?

I’m currently investigating this question and the answer may turn out, surprisingly, to be: “none”.

I’ve been aware, for about 10 years, of research showing that athletes had higher injury rates with the expensive, state of the art, built up shoes than they did with cheaper, simpler shoes. Now a number of athletes are moving toward “minimalist” or “barefoot” approaches to footwear.

There was a very interesting presentation at our last ICAK meeting in June showing that shoes that are inflexible or have a “rise” (the difference between the sole thickness at the ball of the foot and the heel) of more than 7mm (about 1/4 inch) would cause problems with gait mechanism. The arm and leg and wrist and ankle muscles work together to give us a smooth, healthy walking or running motion. It seems that the wrong kind of footwear interferes with this normal “teamwork” between the upper and lower body.

Since I got back from the meeting, I’ve been reviewing the literature and research on this issue. I’ve also been experimenting on myself and my family with minimalist or barefoot styles. I’ll have more as we go along.

One thing I can tell you is that, if you’re used to a lot of support, the muscles in your feet may have atrophied and, if you try to go minimalist or barefoot, you need to do it slowly. This is also true if you’re used to a large “rise” between the toe and the heel. All your muscles work differently when your heel is on the level your were born with. With heels over about 1/2 inch, muscles in the back of your legs may shorten and may need to be stretched out for barefoot styles to be comfortable. This is especially true if if you want to run in barefoot styles and injury can result from too quick a transition to barefoot or minimalist running.

In future posts I’ll talk more about my own experiences and different shoes I’ve tried both “high end” and “low end” price-wise.

Garlic Therapy Update

Since I posted the “garlic cough medicine” recipe, I’ve gotten some feedback from patients that have prompted this update. Some have reported that too much garlic gave them gas. Karen also suggested that I had over-estimated how much garlic I had given her. It turns out that what I was giving her (I just eyeballed it) was more like 1/4 to 1/2 of a tsp with a TBS of yogurt, not a full tsp of garlic!

I have also done some research and found that more is not necessarily better. Long term use of large amounts of raw garlic can be irritating to the GI tract and can even cause temporary hemolytic anemia. It turns out that raw onions, once again in large amounts, are even higher in the compounds that cause this. Taking 1/8 to 1/2 tsp with yogurt (yogurt makes it less irritating) 3-4 times/day for a week or so should be fine but I suggest that raw garlic be saved for when you’re actually sick.

Homemade Herbal Cough Medicine

Spring is coming and, hopefully, the severe cold and flu season we’ve been having this year will end as the weather improves. In the meantime though a new discovery I made last night may come in handy.

Karen rarely gets sick. This year has been an exception and she’s been sick twice this year. She seems especially susceptible to catching things from our adorable granddaughter who always wants to kiss us whether she’s sick or not. Recently Evie got a cold which she processed through pretty quick. Karen, however, wasn’t doing so well. She has had a severe cough the last couple of days.

Unfortunately (or perhaps fortunately) she cannot take most cough medicines or expectorants like mucinex because they contain ingredients that aggravate gut problems for those needing the SCD diet (more info on our web page). Last night the cough was so severe she was hurting herself and could not sleep. I was more than a little concerned, which prompted me to do some research on www.pfaf.org, an incredible database of over 7000 edible and medicinal plants.

Looking for expectorants, I found that garlic was not only one of the best expectorants but was also a good anti-spasmodic. Of course I knew about the anti-viral and anti-bacterial qualities of garlic but the expectorant and anti-spasmodic properties were news. I minced up about a teaspoon of fresh garlic and mixed it with a tablespoon of homemade yogurt and had her just swallow it without chewing.

Within 20 minutes the horrible hacking cough was reduced to almost nothing! Karen got a good night’s sleep with almost no coughing and she is dramatically better this morning. She has decided to make the garlic and yogurt “cough medicine” and take it every hour until she’s well.

BTW, garlic is also an excellent anti-inflammatory so may be good for aches and pains associated with colds and flu.

So, the formula is: 1 tsp minced fresh garlic (not the stuff in the jars) mixed with 1 Tbs of yogurt. Swallow it down without chewing and you won’t have much garlic breath. Take as often as needed for a natural, non-toxic cough medicine that also boosts your immune system and is anti-inflammatory!

Cholesterol, Part 2

Yesterday I wrote that, although my cholesterol has been high for a number of years, I wasn’t surprised to find that it hasn’t caused any plaque formation on my carotid arteries. This is because of a number of factors that are important to consider along with the total cholesterol number. BTW, there are some studies that suggest health benefits to high cholesterol but more on that later.

First, one of the primary factors that cause buildup of arterial plaque is inflammation. Inflammation causes irritation to the arterial wall, essentially “roughing it up”. Just like we might sand a surface we want to paint or varnish to make things adhere better, this roughening of the arterial wall makes platelets, cholesterol and other material adhere to the wall of the artery, eventually building up enough to restrict blood flow to vital organs like the heart and brain. There are lifestyle factors that have a lot to do with our levels of inflammation (more later). I feel that I’ve been doing a good job of living an anti-inflammatory lifestyle.

This feeling has been borne out in my blood tests for many years. Tests that indicate inflammation are C reactive protein and fasting serum insulin. My blood levels of these markers have been very good.

Another important consideration is the triglyceride/HDL ratio. We all know there is “good” cholesterol (HDL which actually cleans the arteries) and “bad” cholesterol (LDL) which is thought to stick to the arteries. It turns out that there is “bad” LDL and “neutral” LDL. The neutral LDL will not clean your arteries but won’t stick to them either. The way to tell how much of each you have is with the Triglyceride/HDL ratio. Divide your total triglyceride number by your HDL number. A ratio result of 1 is good, 2 fair. Above 3 indicates that most of the LDL is the “sticky” kind and there are definite problems. Above 3 can also be a marker for inflammation. My T/H ratio has been 1 or less since I first started tracking it.

It was very gratifying to get confirmation that my numbers meant what I thought they meant and that my lifestyle choices have paid off! Future emails will talk about what those lifestyle choices have been as well as some concerns about statin drugs, the most common class of medication used to treat high cholesterol.

Does High Cholesterol Cause Cardiovascular Disease? Part 1

I have to warn everyone that this email will probably be surprising and also a teaser!

Something not many of you are likely to know is that I’ve had high cholesterol for many years. In the last two years it’s been around 300. Of course the common medical opinion is that high cholesterol (over 200) is dangerous and causes plaque to build up on your arteries, eventually causing heart attack or stroke as the blood vessels get so clogged that the heart or brain become starved for oxygen and nutrients.

Did you know that you can get a doppler ultrasound of your carotid arteries (the main arteries carrying blood to your brain and head)? I just had one done. My arteries are pristine, no plaque at all! This puts me at *much lower* risk of cardiovascular disease, stroke or heart attack than most other 61 year old men. Please note: I’m not saying that high cholesterol might not be dangerous but the danger depends on other factors often ignored by mainstream medicine, IMO.

While this news was welcome, it was really no surprise but about what I expected. Why?

More to come……..

 

For some reason, the link to “Part 2” just won’t work, so I cut and pasted it below.

Yesterday I wrote that, although my cholesterol has been high for a number of years, I wasn’t surprised to find that it hasn’t caused any plaque formation on my carotid arteries. This is because of a number of factors that are important to consider along with the total cholesterol number. BTW, there are some studies that suggest health benefits to high cholesterol but more on that later.

First, one of the primary factors that cause buildup of arterial plaque is inflammation. Inflammation causes irritation to the arterial wall, essentially “roughing it up”. Just like we might sand a surface we want to paint or varnish to make things adhere better, this roughening of the arterial wall makes platelets, cholesterol and other material adhere to the wall of the artery, eventually building up enough to restrict blood flow to vital organs like the heart and brain. There are lifestyle factors that have a lot to do with our levels of inflammation (more later). I feel that I’ve been doing a good job of living an anti-inflammatory lifestyle.

This feeling has been borne out in my blood tests for many years. Tests that indicate inflammation are C reactive protein and fasting serum insulin. My blood levels of these markers have been very good.

Another important consideration is the triglyceride/HDL ratio. We all know there is “good” cholesterol (HDL which actually cleans the arteries) and “bad” cholesterol (LDL) which is thought to stick to the arteries. It turns out that there is “bad” LDL and “neutral” LDL. The neutral LDL will not clean your arteries but won’t stick to them either. The way to tell how much of each you have is with the Triglyceride/HDL ratio. Divide your total triglyceride number by your HDL number. A ratio result of 1 is good, 2 fair. Above 3 indicates that most of the LDL is the “sticky” kind and there are definite problems. Above 3 can also be a marker for inflammation. My T/H ratio has been 1 or less since I first started tracking it.

It was very gratifying to get confirmation that my numbers meant what I thought they meant and that my lifestyle choices have paid off! Future emails will talk about what those lifestyle choices have been as well as some concerns about statin drugs, the most common class of medication used to treat high cholesterol.

Help for Plantar Fasciitis and Other Foot Problems

As I woke up this morning to my NPR (National Public Radio) alarm clock, I heard they were doing a story on plantar fasciitis (pain in the heel or bottom of the foot). My ears perked up because I treat many people with this problem and only get good results about 90% of the time. Another 5-8% get some improvement but still have pain and a few I don’t seem to be able to help at all!

I was interested to hear that it’s estimated that about 33% of older (over 45) adults have trouble with foot pain. Proper foot wear and custom orthodic foot supports were discussed, pretty much as I use them in my practice.

What I found especially interesting was a new treatment called “Shock Wave Therapy”. This uses a device that generates powerful sound waves to pound on the heel “like a little baseball bat”. The foot has to be numbed with novocaine first which gives us an idea of how hard the heel is being hit. The theory is that, by injuring the foot, the shock wave therapy will stimulate a healing response that may heal the original problem. The cost was quoted as being from five hundred to several thousand dollars. I was thinking that this sounded pretty extreme! Then the story went on to state that up to 25% of shock wave therapy patients experienced complete pain relief.

I’m always amazed when there is excitement over this kind of results. If I only got resolution with 25% of my patients (plantar faciitis or anything else) I’d be pretty upset and start looking for something that worked better!

The story continued, stating that podiatrists used to think that plantar fasciitis was caused by heel spurs (actually, in my opinion, heel spurs are the result of chronic plantar fasciitis that has not been resolved) or inflammation but not anymore. Surgery often made people worse so is not used much anymore (thank goodness!).

The story concluded with the observation that the cause of plantar fasciitis is not clear but that many people eventually got over it.

At this point I started feeling even better about my results with plantar fasciitis. As I said, I get complete resolution of pain and symptoms with 85-90% of my patients with some improvement in most of the rest. I have a pretty good idea about the cause, which is probably why I get such good results.

The job of the plantar fascia is to help support the longitudinal arch of the foot. There are also muscles that help in this process. I see plantar faciitis occur when either the bones that plantar fascia attach to misalign, putting abnormal pressure on the fascia or when the supporting muscles turn off, leaving the fascia to do all the work, or both.

In most cases, realigning the bones and getting the supporting muscles to stay turned on takes pressure off the plantar fascia and allow it to heal. Proper footwear is important to provide support (women’s shoe fashions are often big offenders). Fortunately I can test to see if your shoes are stressing your feet, legs or back. Sometimes I need to cast patients feet for custom orthodics or use specific nutrition or laser therapy to get the best results. Other factors such as being more than 50 lbs overweight or ergonomic (work conditions) may also play a roll.

In the past, I haven’t talked much about plantar fasciitis, I have just treated it and moved on. After hearing this story however, I thought I needed to speak up and let folks know that there are more successful, less expensive methods to resolve this common problem than pounding your heels “with a little baseball bat”!

As always, questions and comments can be sent to me at: drhogg@drhogg.com or call me at 563-386-9494

Are Nexium and Prilosec Too Popular?

As you may know, I’m not a fan of this family of drugs. There are all kinds of problems that arise from interfering with normal acid production in the stomach, including osteoporosis, anemia poor healing of wounds, low protein problems like hormone and immune system problems and intestinal infections.

I was pleased to see that CBS news reported on some of the problems these drugs caused. My thanks to Rebecca on the front desk for pointing out this story. Even I wasn’t aware that these drugs caused an increased risk of pneumonia!

There’s some good advice for natural prevention in the story. Ask me about applied kinesiology methods I’ve used for years to help with acid reflux without drugs.

Here’s the link to the CBS story
http://www.cbsnews.com/stories/2010/05/10/eveningnews/main6471233.shtml

Osteoporosis Drugs Like Fosamax May Increase Your Chances of Broken Bones!

I’ve had concerns about drugs like fosamax for years. Reports of facial bone atrophy and the tendency for bones to become more brittle with these drugs have made me question the wisedom of their use, especially since there are more natural approaches that I have seen work for many women in my practice. Now this concern is getting more attention as outlined in an email I got today from Dr. Williams. His short article is below with my comments in blue.

Dr. Williams:

Some popular osteoporosis drugs may actually increase your risk of breaking your leg, as recently reported on ABC’s Good Morning America.

The good news here is that the word about these drugs is finally getting out to a wider audience. The bad news is that it took so long to happen.

In 2008, the FDA alerted Merck, the manufacturer of the osteoporosis drug Fosamax, that there were reports of what’s called “subtrochanteric fracture of the femur.” In simple terms, this refers to a break in the thigh bone at a point somewhere below the hip. It took Merck more than a year to finally say, essentially, “We’re looking into it.”

I Hate to Say It, But “I Told You So”

I first wrote about the perils of these osteoporosis drugs in 2002. At that time, I warned readers of my Alternatives newsletter about studies showing that drugs like Fosamax, a group called bisphosphonates, increase bone strength over the first few years of use, but eventually the bone becomes brittle and more susceptible to fracture.

That appears to be exactly what’s happening here. Women who have taken Fosamax for longer than five years appear to be suffering the thigh fractures after doing such commonplace activities as walking down stairs.

Fortunately, women who took my advice back in 2002 stopped taking these drugs, and have saved themselves from years of worry-and possible fracture and disability. I didn’t leave these women in the lurch, however. Over the years in Alternatives I’ve provided many other safe, natural ways to keep your bones healthy and strong. Here’s a quick summary.

My 3-Point Plan to Keep Your Bones Healthy and Strong

Exercise. Your bones are living tissue, and they need a healthy degree of stress to stay healthy and vibrant. Weight-bearing exercise such as walking or dancing provides appropriate stress. As your bones respond to this stress, they renew themselves and become stronger.

Whenever you can, get your activity outdoors. For much of the year, exposure to the sun will form vitamin D, which is necessary for good bone health. If bad weather prevents you from getting outside, or you’re not able to be very physically active for some reason, an alternative for good bone health is vibration therapy. Simply standing on the vibrating platform of a device such as the Power Plate will provide your bones with a good dose of healthy stress. Diet. Bones are more than just a coatrack for your skin and muscle to hang on. They also act as a store of minerals to keep your body’s pH in balance. The modern American diet is loaded with foods that push your pH out of the healthy range, so for better bone health you must make the switch back. Cut down on bone-unfriendly foods such as white bread and rice, most grains, and most meat. Eat more bone-friendly foods such as fruits and vegetables, flax and chia, and even dairy foods.

Supplements.You need more than just calcium tablets to keep your bones in good shape. Your bones also contain large amounts of magnesium, and smaller amounts of minerals such as boron. In addition, your body needs vitamin D and vitamin K to get that calcium and magnesium moved into position. I recommend the following amounts daily for bone health:

* 500 mg of magnesium (from a combination of diet and supplements),

* 1,000 mcg of boron,

* 2,000 IU daily of vitamin D (in the form of vitamin D3), and (Dr Hogg: I recommend up to 5000 IU or more/day depending on your blood tests)

* 150 mcg of vitamin K (in the form of vitamin K2).

(Dr Hogg: We have a great supplement, Oscap Plus, that includes all of the above plus a nutrient called “Iproflavone” which specifically supports the cells that build new bone. We also have a good, plant based, hormone cream that helps with menopausal symptoms as well as bone density without the risks associated with common hormone replacement drugs like premarin.

In addition, be sure to ask me to check you for Hydrochlororic acid (HCl) production in your stomach which is essential for calcium absorption. Proton pump inhibitors like nexium and prilosec, used for heartburn or acid reflux, are designed to interfere with natural HCl production and studies have shown that they increase the risk of hip fracture with long-term use. Anti-acids like Tums and Rolaids neutralize HCl and create similar problems but not as severely as proton pump inhibitors. If your are using any of these drugs, check with me to see if I can eliminate the actual cause of the reflux and eliminate the need for these drugs.)

Dr. Williams:

What to Do If You’re Taking the Drugs Now

The FDA has issued a patient advisory. In it, they address the recent ABC report, and tell patients to “talk to your doctor.” That would be the same doctor who advised you to begin the drug in the first place, even though the dangers have been known since 2002.

I do recommend that you talk to your doctor. But the conversation shouldn’t begin with, “Can I stop taking the drug?” Instead, start with, “I want off. What should I do instead?” When your doctor shrugs, or insists that drugs are your best option, show him or her this e-mail. Then start on the 3-point plan I gave you earlier.

Whatever you do, get out of the bone-drug trap as quickly as you can.

Take care,

David Williams