Category: Recommended

Aspirin has a long history, dating back nearly 4,000 years when Sumerians wrote of using willow bark for pain relief.1 The ancient Egyptians used willow bark to reduce body temperature and inflammation, and the Greek physician Hippocrates used it to help relieve pain and fever. By the early 1800s Europeans were researching the effects of salicylic acid and how to determine a correct dosage of it.2
In 1899, Bayer begin distributing the powder, and it was sold as tablets over the counter in 1915. Doctors gave aspirin to Alexi Nicholaevich Romanov of Russia, who had hemophilia. The aspirin likely made the bleeding worse. When the family’s mystic Grigori Rasputin advised the family to stop modern treatments and rely on spiritual healing, the bleeding improved.
In an article published in 2010 in CNN, one physician from Harvard Medical School recommended reducing the risk of stomach bleeding associated with aspirin by taking a second medication — Prilosec.
By 2012, the U.S. Food and Drug Administration reversed their recommendation, concluding data did not support aspirin as a preventive medication for those who had not had a heart attack, stroke or cardiovascular problems.3 In this population, not only had benefit not been established, but “dangerous bleeding into the brain or stomach” was a significant risk.
Salicylates Found Naturally in Some Foods

In the same year the FDA withdrew their recommendation for daily aspirin intake to reduce cardiovascular risk, one meta-analysis was published showing a reduction and cancer mortality in those taking daily low-dose aspirin.4 The researchers hypothesized the effect was the result of inhibition “of cox-2 in preneoplastic lesions.”
Their results were supported by a second meta-analysis5 published in the same year finding a reduction in nonvascular deaths and cancer with low dose aspirin. In another study published in 2018,6 researchers found data suggesting aspirin is associated with a lower risk of developing several types of cancer, including colorectal, esophageal, pancreatic, ovarian and endometrial.
As New York Times best seller author and nutrition expert Dr. Michael Greger writes,7 animal products made up 5% or less of their diet before Japanese citizens began adopting a Western diet.8 During the same period, there was a vast difference in cancer deaths between the U.S. and Japan.
The age-adjusted death rates for colon, breast, ovary and prostate were five to 10 times lower in Japan, and leukemia, lymphoma and pancreatic cancer death rates were three to four times lower. In part, this protection may have been the result of phytonutrients found in the plant-based diet, including salicylic acid, the active ingredient in aspirin.
The highest concentrations in plants is found in herbs and spices with the greatest amount in cumin. Researchers have found eating a teaspoon of cumin will spike your blood levels of salicylic acid to the same degree that taking a baby aspirin does. Greger9 quotes one study describing the lower incidence of colorectal cancer in areas where people eat diets rich in salicylic acid:10 

“The population of rural India, with an incidence of colorectal cancer which is one of the lowest in the world, has a diet that could be extremely rich in salicylic acid. It contains substantial amounts of fruits, vegetables, and cereals flavored with large quantities of herbs and spices.”

In another analysis11 comparing organic versus nonorganic vegetables, scientists found soup made with organic vegetables contained more salicylic acid. Salicylic acid is produced by plants in response to stress, such as when they’re being bitten by bugs. Plants treated with pesticides do not undergo this type of stress, and studies show they contain six times less salicylic acid than those grown organically.
Is Aspirin Overrated?

Evidence supports the assertion that a plant-rich diet offers protection against certain cancers. Aspirin used to be recommended to reduce clotting time and the risk of heart attack and ischemic stroke, triggered by a clot to the brain. However, long-term use of aspirin has been associated with harmful effects, including hemorrhagic stroke, or bleeding in the brain when a clot doesn’t form.
In addition to aspirin side effects, results from a trio of studies published in the New England Journal of Medicine demonstrated daily low-dose aspirin had no measurably significant health benefits for healthy older adults. Instead, the data demonstrated it did not prolong disability-free survival and contributed to the risk of major bleeding.
In one study the authors found those with helicobacter pylori (H. pylori) infection who used low dose aspirin had a higher risk of upper gastrointestinal bleeding then those who took aspirin without the infection.
In another study12 researchers found those who used aspirin regularly, which they defined as at least once a week for one year, experienced an increased risk of neovascular age-related macular degeneration (AMD). Results from a separate study13 also point to a connection between frequent aspirin use and AMD, linking increasing frequency of use to higher risk.
Nattokinase: Aspirin Alternative Without the Side-Effects

Cardiovascular disease is the leading cause of death14 in people of most racial and ethnic groups in America. The Centers for Disease Control and Prevention reports one person dies every 37 seconds from heart disease and cardiovascular deaths account for 25% of all deaths reported.
Using aspirin to reduce the risk of clot formation comes with significant risk. A better alternative is nattokinase, produced by the bacteria bacillus subtilis when soybeans are being fermented to produce natto. This is a fermented soybean product that has been a traditional food in Japan for thousands of years.
Without using conventional drugs, nattokinase has demonstrated the ability to reduce chronic rhinosinusitis and dissolve excess fibrin in blood vessels, which improves circulation and reduces the risk of serious clotting. Another benefit is the ability to decrease blood viscosity and improve flow, which consequently lowers blood pressure.
Data also showed consuming nattokinase decreased systolic and diastolic blood pressure and demonstrated effectiveness in reducing deep vein thrombosis in those who were on long-haul flights or vehicle travel. Studies have demonstrated administration of a single-dose can enhance clot breakdown and anticoagulation.
Each of these factors affects your long-term cardiovascular health and risk for heart disease. In one study,15 researchers wrote nattokinase is a “unique natural compound that possesses several key cardiovascular beneficial effects for patients with CVD and is therefore an ideal drug candidate for the prevention and treatment of CVD.”
Could Earthworms Hold One Key to Heart Health?

One of the drawbacks of pharmaceutical interventions, including thrombolytics, antiplatelets and anticoagulants, is that they interfere with the anticoagulation system and carry a risk of major bleeding.16 Lumbrokinase is a secondary option that works as a fibrinolytic enzyme, activating the plasminogen system and direct fibrinolysis.
The compound also indirectly achieves anticoagulation through inhibition of platelet function. Additionally, lumbrokinase has an enzyme opposing the coagulation system. Research has demonstrated it promotes fibrinolysis but also fibrinogenesis, meaning it may have a built-in balance system that contributes to the safety record.
Interestingly, this complex enzyme is extracted from earthworms and is sometimes referred to as earthworm powder enzymes. Eastern medicine has used earthworms for thousands of years, and Chinese medicine practitioners believe they possess properties to “invigorate blood, resolve stasis and unblock the body’s meridians and channels.”
They are commonly found in a traditional herbal formula used to treat ischemic or thromboembolic conditions. To date, those producing lumbrokinase cannot make any therapeutic claims. Available studies have demonstrated safety and effectiveness in the treatment of acute ischemic stroke and impressive results in the treatment of coronary arterial disease including those with unstable angina.
Lumbrokinase has also been evaluated as an antimetastatic and antitumor agent, with evidence demonstrating a potential use in anticoagulation to limit cancer growth and metastasis. The authors of two review papers found adverse rates to be 0.7% to 3% with most symptoms being a mild headache, nausea, dizziness and constipation, which resolved when the enzyme was discontinued.
Neither of the reviews found the enzyme triggered bleeding or adverse effects in the kidney or liver. Both nattokinase and lumbrokinase have a lower side effect profile than aspirin and provide much of the same benefits to the cardiovascular system. While aspirin is no longer universally recommended, consider speaking with your physician to include nattokinase or lumbrokinase in your heart health regimen.

The New York Times1 reports that the average person in their mid- to late 60s today is taking 15 prescription drugs a year — and that doesn’t even count the number of over-the-counter products they may be taking.
That’s a lot of medications, especially when you consider that a survey released by the American Association of Retired Persons (AARP)2 not quite four years ago, in 2016, indicated that 75% of the respondents — all over age 50 — said they take at least one prescription medication on a regular basis.
In that AARP survey, more than 80% reported taking at least two, and more than 50% took four or more. Compared to a 2005 Gallup survey,3 which showed 52% of all Americans said they were taking at least one prescription medication, it’s obvious that seniors are taking more drugs than they did in the past.
Specifically, from 1988 to 2010, adults over age 65 doubled the number of prescriptions they took from two to four.4 The proportion of adults taking five or more tripled in that same time period. Yet, despite the rising number of prescriptions, more drugs don’t add up to better health.
According to the researchers, “Contemporary older adults on multiple medications have worse health status compared to those on fewer medications, and appear to be a vulnerable population.” This translates to a negative effect on activities of everyday living as well as increased confusion and memory problems.
The term used to describe a condition in which a person takes multiple medications, drugs, supplements and over-the-counter remedies is polypharmacy. As evidenced by the quoted research, the clinical relevance and consequences of polypharmacy — of seniors taking fistfuls of medications each day — are far-reaching as the aging population across the world continues to grow.
Polypharmacy Raises Safety Risk

Polypharmacy is common among the elderly, especially for those who reside in nursing homes. Some end up in a nursing home because of adverse drug reactions, which places financial and emotional burdens on communities and families. They also may result in a significant number of hospitalizations with a high number of complications, increased rates of death and excessive health care costs.5
What’s worse, you may believe the federal government, medical associations or pharmaceutical companies have tested the effects that combinations of drug chemicals would have in your body but, unfortunately, this doesn’t always happen.
Researchers report these adverse drug reactions are responsible for up to 12% of all hospital admissions of seniors. Yet, even being in the hospital doesn’t ensure against, or reduce, polypharmacy.
In one study,6 a team in Italy evaluated 1,332 inpatients who were at least 65 years old and who took at least five medications. They found polypharmacy was present in 51.9% of the patients when they arrived at the hospital; this increased to 67% by the time they left.

Taking One Drug to Offset Side Effects of Another Drug
One of the hidden dangers of polypharmacy is the chemical interactions that occur in the body when medications are mixed. Another problem is the number of times one drug is prescribed to take care of the side effects of another. This has become known as a “prescribing cascade.” The New York Times writes:7

“One common example is the use of anti-Parkinson therapy for symptoms caused by antipsychotic drugs, with the anti-Parkinson drugs in turn causing new symptoms like a precipitous drop in blood pressure or delirium that result in yet another prescription.”

To that end, drug interactions can cause hospitalizations in and of themselves — and sometimes these interactions can even lead to death. The authors of one study8 noted a 50% increase in this problem when seniors are taking five to nine medications.
Dr. Michael Stern, geriatric emergency medicine specialist at New York Presbyterian Hospital, told a New York Times reporter that polypharmacy accounts for more than one-fourth of all admissions to the hospital and that it would be considered the fifth leading cause of death if it were categorized that way.9
Antidepressant Use Has Doubled in Seniors

In a study10 published in 2013, scientists looked at participants who were prescribed antidepressants by their physicians. Of those who were over age 65, only 14.3% met the DSM-4 criteria for having had a major depressive episode — indicating they most likely were overprescribed or not necessary. The authors noted the importance of providing better diagnoses to patients as well as more appropriate treatments of their symptoms.
And again, statistics show more prescriptions don’t translate into fewer depressive illnesses. For example, in a 2017 study,11 researchers reviewed data from 1990 to 2015 that had been gathered in England, Canada, the U.S. and Australia and found the incidence of symptoms had not decreased despite an increase in the number of prescriptions of antidepressants.
This is important because the risks associated with depression in seniors include cognitive decline, dementia and poor medical outcomes. Those suffering from depression in any age group also experience higher rates of suicide and mortality.
This is one reason the American Psychiatric Association writes that in some cases, treatment for the elderly “should parallel that used in younger age groups.”12 Unfortunately, even though therapy for depression can include psychotherapy and alternative treatments, such as addressing vitamin deficiencies, good sleep habits, proper nutrition and exercise, too often, seniors are only prescribed medication — and that only adds to the multiple prescriptions they’re probably already taking.
Studies Link Depression to Inflammation

In related studies, researchers have found that inflammation contributes to many chronic diseases including heart disease and dementia.13 They also have found a link between inflammation and depression. The authors of one literature review14 included results from 30 randomized control trials with a total of 1,610 participants. Data analysis showed anti-inflammatory agents could reduce depressive disorder when compared to a placebo.
Results from another large meta-analysis15 revealed similar findings: Anti-inflammatory medications were helpful for those dealing with depression.
Yet another group of researchers16 found that those treated with immunotherapy for an inflammatory disorder experienced symptomatic relief of depressive symptoms. All of this points toward other ways of addressing depression than resorting to a prescription antidepressant. For a discussion of how to reduce inflammation naturally, see the articles below and consider optimizing your melatonin, adding fiber to your diet and grounding.
Seek Out the Root of the Health Condition

Before adding one more prescription medication or over-the-counter drug to your daily regimen, consider seeking the help of a natural health physician who can help get to the root of the problem. Too often medications mask symptoms but do not address the underlying condition. A vicious cycle may begin when the first medication triggers a side effect that a second medication will be prescribed to treat.
While your pharmacy computer may flag some drug interactions, the chemical complexity involved when more than three drugs are prescribed make it unnecessarily challenging to avoid adverse reactions. The real solution is to take control of your health and introduce foundational strategies to improve your overall health.
There is no magic pill that will fix symptoms, remove your illness and restore the vigor of youth. However, there are lifestyle choices you can make that will go a long way toward achieving your health goals. Consider starting with the strategies in the following articles to move toward better health:

The Science of Sleep and Sleep Deprivation

Autophagy — How Your Body Detoxifies and Repairs Itself

How to Make Fasting Easier, Safer and More Effective

Incorporate the Nitric Oxide Dump

In recent years, the devastating effects of wanton opioid use have become unmistakable, with opioid overdoses killing 47,600 Americans in 2017 alone.1 As of June 2017, opioids became the leading cause of death among Americans under the age of 50,2 and President Trump declared the opioid crisis a public health emergency that year in October.3
I’ve written many previous articles detailing the background of how the U.S. ended up here. While the opioid crisis was largely manufactured by drug companies hell-bent on maximizing profits, leading to exaggerated and even fraudulent claims about the drugs’ safety profile, the increased availability of opioids isn’t the sole cause.
A Perfect Storm of Poverty, Trauma, Availability and Pain

As noted in a January 2020 article4 in The Atlantic, “researchers … say opioid addiction looks like the result of a perfect storm of poverty, trauma, availability and pain.”
Commenting on some of the research cited in that article, David Powell, senior economist at Rand, told The Atlantic that to produce the most lethal drug epidemic America has ever seen “you need a huge rise in opioid access, in a way that misuse is easy, but you also need demand to misuse the product.”5
Poverty and pain, both physical and emotional, fuel misuse. If economic stress or physical pain (or both) is a factor in your own situation, please be mindful that seeking escape through opioid use can easily lead to a lethal overdose. The risk of death is magnified fivefold if you’re also using benzodiazepine-containing drugs.
The Hidden Influence of Poverty and Trauma

Several investigations seeking to gain insight into the causes fueling the opioid epidemic have been conducted in recent years. The findings reveal common trends where emotional, physical and societal factors have conspired to bring us to the point where we are today.
Among them is a 2019 study6 in the Medical Care Research Review journal, which looked at the effects of state-level economic conditions — unemployment rates, median house prices, median household income, insurance coverage and average hours of weekly work — on drug overdose deaths between 1999 and 2014. According to the authors:7

“Drug overdose deaths significantly declined with higher house prices … by nearly 0.17 deaths per 100,000 (~4%) with a $10,000 increase in median house price. House price effects were more pronounced and only significant among males, non-Hispanic Whites, and individuals younger 45 years.
Other economic indicators had insignificant effects. Our findings suggest that economic downturns that substantially reduce house prices such as the Great Recession can increase opioid-related deaths, suggesting that efforts to control access to such drugs should especially intensify during these periods.”

Similarly, an earlier investigation, published in the International Journal of Drug Policy in 2017,8 connected economic recessions and unemployment with rises in illegal drug use among adults.
Twenty-eight studies published between 1990 and 2015 were included in the review, 17 of which found that the psychological distress associated with economic recessions and unemployment was a significant factor. According to the authors:9

“The current evidence is in line with the hypothesis that drug use increases in times of recession because unemployment increases psychological distress which increases drug use. During times of recession, psychological support for those who lost their job and are vulnerable to drug use (relapse) is likely to be important.”

Abuse-related trauma is also linked to unemployment and financial stress, and that too can increase your risk of drug use and addiction. As noted in The Atlantic,10 when the coal mining industry in northeastern Pennsylvania collapsed, leaving many locals without job prospects, alcohol use increased, as did child abuse. Many of these traumatized children, in turn, sought relief from the turmoil and ended up becoming addicted to opioids.
Free Trade Effects Implicated in Opioid Crisis

Another 2019 study11 published in Population Health reviewed the links between free trade and deaths from opioid use between 1999 and 2015, finding that “Job loss due to international trade is positively associated with opioid overdose mortality at the county level,” and that this association was most significant in areas where fentanyl was present in the heroin supply.
Overall, for each 1,000 people who lost their jobs due to international trade — commonly due to factory shutdowns — there was a 2.7% increase in opioid-related deaths. Where fentanyl was available, that percentage rose to 11.3%. The study “contributes to debates in the social sciences concerning the negative consequences of free trade,” the authors note, adding:

“Scholars have long focused on the positive effect of international trade on the overall economy, while also noting that it causes layoffs and bankruptcy for some groups.
Recent influential work by Autor, Dorn, and Hanson demonstrates that these negative impacts of trade are actually highly localized, with layoffs, unemployment, and lower wages concentrated in specific labor markets.
This study furthers our understanding of the local consequences of international trade by looking beyond wages and employment levels to the potential impact on opioid-related overdose death.”

Opioid Makers Have Had a Direct Impact
The National Bureau of Economic Research has also contributed to the discussion with the working paper12 “Origins of the Opioid Crisis and Its Enduring Impacts,” issued November 2019.

In it, they highlight “the role of the 1996 introduction and marketing of OxyContin as a potential leading cause of the opioid crisis,” showing that in states where triplicate prescription programs were implemented, OxyContin distribution rates were half that of states that did not have such programs.

“Triplicate prescription programs” refers to a drug-monitoring program requiring doctors to use a special prescription pad whenever they prescribed controlled substances. One of the copies of each prescription written had to be submitted to a state monitoring agency.

Since it involved additional work, many doctors avoided prescribing drugs requiring the use of triplicates, and as a consequence, Purdue (the maker of OxyContin), did not market its opioid as aggressively in those states.

The fact that triplicate prescription states had lower rates of lethal overdoses led the authors to conclude “that the introduction and marketing of OxyContin explain a substantial share of overdose deaths over the last two decades.”

According to this paper, death rates from opioid overdoses could have been reduced by 44% between 1996 and 2017 had triplicate prescriptions been implemented in nontriplicate states.

Importantly, the relationship between triplicate prescription programs and opioid overdose deaths held true even when economic conditions were taken into account, which shows that poverty alone did not contribute to the opioid crisis — aggressive marketing to doctors and the ease with which patients could get the drugs were an inescapable part of the problem.
Pain as a Source of Addiction
Naturally, physical pain is also a driving force behind the opioid epidemic, especially the inappropriate treatment of back pain with opioids and dentists’ habit of prescribing narcotics after wisdom tooth extractions.13,14
(While American family doctors prescribe an estimated 15% of all immediate-release opioids — the type most likely to be abused — dentists are not far behind, being responsible for 12% of prescriptions, according to a 2011 paper15 in the Journal of the American Dental Association.)
Statistics16 suggest 8 in 10 American adults will be affected by back pain at some point in their life, and low-back pain is one of the most common reasons for an opioid prescription.17 This despite the fact that there’s no evidence supporting their use for this kind of pain. On the contrary, non-opioid treatment for back pain has been shown to be more effective.18
Research19 published in 2018 found opioids (including morphine, Vicodin, oxycodone and fentanyl) fail to control moderate to severe pain any better than over-the-counter (OTC) drugs such as acetaminophen, ibuprofen and naproxen, yet most insurance companies still favor opioids when it comes to reimbursement, which makes them culpable for sustaining the opioid crisis, even as doctors and patients try to navigate away from them.
As noted by Dave Chase, author of “The Opioid Crisis Wake-Up Call: Health Care Is Stealing the American Dream. Here’s How to Take It Back,” in an article for Stat:20

“Our entire health care system is built on a vast web of incentives that push patients down the wrong paths. And in most cases it’s the entities that manage the money — insurance carriers — that benefit from doing so …
An estimated 700,000 people are likely to die from opioid overdoses between 2015 and 2025,21 making it absolutely essential to understand the connections between insurance carriers, health plans, employers, the public, and the opioid crisis.
We will never get out of this mess unless we stop addiction before it starts … the opioid crisis isn’t an anomaly. It’s a side effect of our health care system.”

According to the American College of Physicians’ guidelines,22 heat, massage, acupuncture or chiropractic adjustments should be used as first-line treatments for back pain. Other key treatments for back pain include exercise, multidisciplinary rehabilitation, mindfulness-based stress reduction, tai chi, yoga, relaxation, biofeedback, low-level laser therapy and cognitive behavioral therapy.

When drugs are desired, nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants should be used. Opioids “should only be considered if other treatments are unsuccessful and when the potential benefits outweigh the risks for an individual patient,” according to the American College of Physicians’ guideline.23
Struggling With Opioid Addiction? Please Seek Help

It’s vitally important to realize that opioids are extremely addictive drugs that are not meant for long-term use for nonfatal conditions. Chemically, opioids are similar to heroin, so if you wouldn’t consider using heroin for a toothache or backache, seriously reconsider taking an opioid to relieve these types of pain.
If you’ve been on an opioid for more than two months, or if you find yourself taking a higher dosage, or taking the drug more often, you may already be addicted. Resources where you can find help include the following. You can also learn more in “How to Wean Off Opioids.”

Your workplace Employee Assistance Program
The Substance Abuse Mental Health Service Administration24 can be contacted 24 hours a day at 1-800-622-HELP

Nondrug Pain Relief
The good news is that many types of pain can be treated entirely without drugs. Recommendations by Harvard Medical School25,26 and the British National Health Service27 include the following. You can find more detailed information about most of these techniques in “13 Mind-Body Techniques That Can Help Ease Pain and Depression.”

Gentle exercise

Physical therapy or occupational therapy

Hypnotherapy

Distracting yourself with an enjoyable activity

Maintaining a regular sleep schedule

Mind-body techniques such as controlled breathing, meditation, guided imagery and mindfulness practice that encourage relaxation. One of my personal favorites is the Emotional Freedom Techniques (EFT)

Yoga and tai chi

Practicing gratitude and positive thinking

Hot or cold packs

Biofeedback

Music therapy

Therapeutic massage

In “Billionaire Opioid Executive Stands to Make Millions More on Patent for Addiction Treatment,” I discuss several additional approaches — including helpful supplements and dietary changes — that can be used separately or in combination with the strategies listed above to control both acute and chronic pain.

In decades past, a daily low-dose aspirin regimen was frequently recommended as a primary prevention strategy against heart disease. However, the evidence in support of it was rather weak, and kept getting weaker as time went on.

I stopped recommending daily “baby aspirin” use for the prevention of heart disease over two decades ago, due to the growing evidence of harmful side effects.

The primary justification for a daily aspirin regimen has been that it inhibits prostaglandin production,1 thereby decreasing your blood’s ability to form dangerous clots. However, in more recent years, most public health authorities have reversed their stance on the practice of using aspirin for primary prevention.
‘Baby’ Aspirin No Longer Recommended as Primary Prevention

The U.S. Food and Drug Administration reversed its position on daily low-dose aspirin as primary prevention for heart disease in 2014,2 citing clearly established side effects — including dangerous brain and stomach bleeding — and a lack of clear benefit for patients who have never had a heart attack, stroke or cardiovascular disease.
In 2019, the American Heart Association (AHA) and American College of Cardiology updated their clinical guidelines on the primary prevention of cardiovascular disease,3 spelling out many of the controversial findings on prophylactic aspirin use.
Importantly, studies have found that prophylactic aspirin use in adults over the age of 70 is potentially harmful, primarily due to the increased risk of bleeding in this age group. As noted in one 2009 paper,4 long-term low-dose aspirin therapy nearly doubles your risk for gastrointestinal bleeding.

Older people are, of course, more likely to be at high risk for heart disease, and thus more likely to be put on aspirin therapy. In younger adults, the risks are less clear-cut.

As noted in the AHA guideline, in adults younger than 40, “there is insufficient evidence to judge the risk-benefit ratio of routine aspirin for the primary prevention of atherosclerotic cardiovascular disease.”5

That said, the conventional recommendation to avoid a daily aspirin regimen only applies to primary prevention of heart disease in those with no history of heart problems, or those with low or moderate risk for heart disease. As reported by the AHA:6

“The new recommendation doesn’t apply to people who already have had a stroke or heart attack, or who have undergone bypass surgery or a procedure to insert a stent in their coronary arteries.
These individuals already have cardiovascular disease and should continue to take low-dose aspirin daily, or as recommended by their health care provider, to prevent another occurrence …”

Is Aspirin Regimen Safe for Heart Disease Patients?
While daily low-dose aspirin continues to be recommended for patients who already have heart disease, there’s evidence suggesting it may not be an ideal solution for them either. 

For example, the WASH (warfarin/aspirin study in heart failure) study7 published in 2004 — which assessed the risks and benefits of aspirin and the blood thinner warfarin in heart failure patients — found those who received aspirin treatment (300 mg/day) actually had the worst cardiac outcomes, including worsening heart failure. According to the authors, there was “no evidence that aspirin is effective or safe in patients with heart failure.”

Similarly, a 2010 study8 found older heart disease patients who had a prior history of aspirin use had more comorbidities and a higher risk of recurrent heart attack than those who had not been on aspirin therapy.

Aspirin has also not been proven safe or effective for diabetics, who are at increased risk for heart disease and therefore likely to be put on an aspirin regimen.

For example, a 2009 meta-analysis9 of six studies found no clear evidence that aspirin is effective in preventing cardiovascular events in people with diabetes, although men may derive some benefit.

Another 2009 study10 that examined the effects of aspirin therapy in diabetic patients found it “significantly increased mortality in diabetic patients without cardiovascular disease from 17% at age 50 years to 29% at age 85 years.”
On the other hand, it did lower mortality in elderly diabetic patients who also had cardiovascular disease. A meta-analysis11 published in 2010 also concluded aspirin did not reduce the heart attack risk in diabetic individuals.
Why Phlebotomy May Be a Better Option Than Aspirin Therapy
While the benefits of low-dose aspirin may outweigh the risks for some people, I believe you may be able to achieve similar cardiovascular protection by doing therapeutic phlebotomies.
There’s evidence to suggest that the bleeding caused by aspirin may in fact be part of why it lowers your risk of heart attack and stroke, as bleeding will lower your iron level. Aspirin’s ability to lower inflammation may be another factor at play.
As shown in a 2001 study,12 people taking seven aspirins per week had 25% lower mean serum ferritin than nonusers. The effect was most marked in diseased subjects, compared to healthy ones. As explained by the authors:

“Atherosclerosis, a primary cause of myocardial infarction (MI), is an inflammatory disease. Aspirin use lowers risk of MI, probably through antithrombotic and anti-inflammatory effects.
Because serum ferritin (SF) can be elevated spuriously by inflammation, reported associations between elevated SF, used as an indicator of iron stores, and heart disease could be confounded by occult inflammation and aspirin use if they affect SF independently of iron status …
Aspirin use is associated with lower SF. We suggest this effect results from possible increased occult blood loss and a cytokine-mediated effect on SF in subjects with inflammation, infection, or liver disease.”

Most people, physicians included, fail to appreciate that — aside from blood loss, including menstruation — the body has no significant way to excrete excess iron. There are very minor amounts lost through normal bodily processes, but not enough to move the needle on overall iron levels.

Between supplementation, fortification and the iron that occurs naturally in foods, it’s very easy to end up with excessive levels. In fact, most adult men and postmenopausal women are at risk for excess iron and need regular blood testing for ferritin.

Excessive iron causes significant oxidative stress, catalyzing the formation of excessive free radicals that damage your cellular and mitochondrial membranes, proteins and DNA. It is a potent contributor to increased risks of cancers, heart disease and neurodegenerative diseases. You can learn more about the ins and outs of excess iron in “Why Managing Your Iron Level Is Crucial to Your Health.”
While dangerous, iron overload is easy and inexpensive to treat. All you really need to do is monitor your serum ferritin and/or gamma-glutamyl transpeptidase (GGT) levels, avoid iron supplements, and be sure to donate blood on a regular basis.
By doing this, you can avoid serious health problems, and donating blood is a far safer way to lower your iron stores than taking aspirin and losing blood via internal bleeding.
Aspirin Linked to Lower Risk of Death

Interestingly, a 2019 study13 found prophylactic aspirin use may lower the risk of all-cause cancer, gastrointestinal (GI) cancer and colorectal cancer mortality among older adults.
The study included 146,152 individuals with a mean age of 66.3 years who participated in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. The median follow-up time was 12.5 years. Those taking aspirin at least three times a week had a:

19% lower risk of death from all causes
15% lower risk of death from any cancer
25% lower risk of death from GI cancer
29% lower risk of death from colorectal cancer 

Having a higher body mass index (BMI between 25 and 29.9) lowered these percentages by 1%, with the exception of colorectal cancer. In this group, colorectal cancer death decreased by 34%.
No observable benefit of aspirin use was found in underweight individuals (BMI below 20), which led the researchers to hypothesize that “the efficacy of aspirin as a cancer preventive agent may be associated with BMI,”14 although this theory needs to be confirmed in future studies. The authors also warn that prophylactic aspirin therapy for cancer prevention would need to be weighed against the increased risk of bleeding. 
Other Health Risks Associated With Long-Term Aspirin Use

Overall, there’s a lot of evidence against long-term daily aspirin therapy. The risk of internal bleeding is one significant concern, which is further magnified if you’re taking antidepressants or blood thinning medications such as Plavix.
Using aspirin in combination with SSRI antidepressants has been shown to increase your risk of abnormal bleeding by 42%, compared to those taking aspirin alone,15 and taking aspirin (325 mg/day) with Plavix has been shown to nearly double your risk of major hemorrhage and significantly increase your risk of death, while not affecting your risk of recurrent stroke to any significant degree.16
Aside from damaging your gastrointestinal tract,17,18 routine aspirin use has also been linked to an increased risk for cataracts,19 neovascular (wet) macular degeneration,20 tinnitus21 and hearing loss in men.22
Nattokinase Reduces Clot Formation Without Side Effects

Aside from donating blood to lower your iron level (provided it’s elevated), nattokinase is another far safer alternative to a daily aspirin regimen. Nattokinase, produced by the bacteria Bacillus subtilis during the fermentation of soybeans to produce natto,23 is a strong thrombolytic,24 comparable to aspirin without the serious side effects.

It’s been shown to break down blood clots and reduce the risk of serious clotting25 by dissolving excess fibrin in your blood vessels,26 improving circulation and decreasing blood viscosity. These effects can also help reduce high blood pressure.27

As noted in a 2018 paper,28 nattokinase appears to be a promising alternative in the prevention and treatment of cardiovascular diseases, and has been linked to a reduction in cardiovascular disease mortality.
Lumbrokinase Is Even Better Than Nattokinase
Yet another alternative is lumbrokinase, a complex fibrinolytic enzyme extracted from earthworms. Like nattokinase, lumbrokinase boosts circulatory health by reducing blood viscosity, reducing blood clotting factor activity and degrading fibrin, which is a key factor in clot formation.29,30

Some researchers have suggested lumbrokinase could be used “as secondary prevention after acute thrombosis,” such as heart attacks and stroke.31 A 2008 study32 that explored “the mechanisms involved in the anti-ischemic action of lumbrokinase (LK) in the brain,” found it protected against cerebral ischemia via several mechanisms and pathways. As explained by the authors:

“These data indicated that the anti-ischemic activity of LK was due to its anti-platelet activity by elevating cAMP level and attenuating the calcium release from calcium stores, the anti-thrombosis action due to inhibiting of ICAM-1 expression, and the anti-apoptotic effect due to the activation of JAK1/STAT1 pathway.”

A 2009 pilot study33 that used lumbrokinase in patients with coronary artery disease and stable angina found it improved angina symptoms in 40% of patients and lowered the summed stress score by 29% (the summed stress score is a risk indicator for a cardiac event over the next 12 months34). According to the authors, “Oral lumbrokinase improves regional myocardial perfusion in patients with stable angina.”

Millions of people take acetaminophen, commonly known as the brand name drug Tylenol, frequently. People use acetaminophen for treating everything from fevers and muscle aches to headaches, hangovers and other pain. Because acetaminophen is available over the counter and is an ingredient found in many other preparations such as those for cold and flu, few people think twice about taking it. They should.
Acetaminophen is the top cause of acute liver failure in the U.S.1 and overdoses are a leading cause of emergency department visits and hospitalizations.2 According to UT Southwestern Medical Center, more than 200 people a year die from acetaminophen poisoning in the U.S. and there are 15,000 hospital visits due to accidentally taking too much.3
Acetaminophen is also correlated with serious side effects4 such as certain skin conditions, abdominal and gastrointestinal problems and allergic reactions. As I mention later in this article, it also could be dangerous for pregnant women. And, if California state regulators are correct, the latest risk to be associated with acetaminophen may be cancer. The regulators are in the process of determining whether to classify acetaminophen as a carcinogen on the Proposition 65 list.
Public Hearing on Carcinogenicity May Be in Spring 2020

California’s Proposition 65, enacted in 1986, requires the state to maintain a list of chemicals known to cause cancer or reproductive toxicity. Businesses are required to provide a warning if the products they sell or use expose the public to chemicals on the Proposition 65 list.5,6
California state regulators reviewed 133 acetaminophen studies in peer-reviewed journals and are considering whether to classify the drug as a carcinogen. They will hold a public hearing in spring 2020. According to The Associated Press, acetaminophen is:7

” … known outside the U.S. as paracetamol and used to treat pain and fevers. It is the basis for more than 600 prescription and over-the-counter medications for adults and children, found in well-known brands like Tylenol, Excedrin, Sudafed, Robitussin and Theraflu. Acetaminophen has been available in the U.S. without a prescription since 1955.

Concerns about its potential link to cancer come from its relationship to another drug: phenacetin. That drug, once a common treatment for headaches and other ailments, was banned by the FDA in 1983 because it caused cancer.”

Since the drug is so popular, some fear that a warning will unnecessarily worry the public but Thomas Mack, chairman of the Carcinogen Identification Committee, the group appointed by the governor to identify chemicals linked to cancer,8 dismisses the fears. “That’s not what our mandate is,” he says.9
In addition to the tremendous popularity of acetaminophen, inclusion of a chemical on the Proposition 65 list can pave the way for lawsuits, so industry is resisting the classification.10 For example, reports The Associated Press:

“After the state listed glyphosate — widely known as the weed killer Roundup — as a carcinogen in 2017, a jury ordered the company that makes Roundup to pay a California couple with cancer more than $2 billion. A judge later reduced that award to $87 million.”

What Are the Possible Cancer Links to Acetaminophen?

Suspicion of acetaminophen’s carcinogenic potential stems from the fact that it is a major metabolite of phenacetin, a drug connected with cancer more than three decades ago. In 2001, researchers in the International Journal of Cancer wrote:11

“Concern has been raised about the carcinogenic potential of paracetamol (acetaminophen) because it is the major metabolite of phenacetin, which was classified as a human carcinogen by the International Agency for Research on Cancer (IARC) in 1987 and has been withdrawn from the market in most countries …

Because of the established link between phenacetin and malignant tumors of the urinary tract, most epidemiologic studies of paracetamol and cancer have focused on these tumors.

Some of these have reported slightly elevated risks of renal cell cancer or transitional cell cancers of the renal pelvis, ureter or urinary bladder with regular or long-term use of paracetamol, whereas other studies have failed to demonstrate such associations.”

Still, the researchers added that they did not find what you would interpret as very strong cancer links with acetaminophen:12

“We found no evidence of an association between use of paracetamol and risk of urinary bladder cancer, but some evidence of an association with upper urinary tract cancers, including cancers of the renal parenchyma, renal pelvis and ureter.”

Nearly 20 years later, in January 2020, the Los Angeles Times weighed in on the possible risks and downplayed them, saying the “standards for inclusion” for the Proposition 65 list are so low, even coffee was put on it.13
Acetaminophen Can Cause Liver Damage

As I wrote before, acetaminophen is the top cause of acute liver failure in the U.S. It can even be toxic to your liver at recommended doses when taken daily for just a couple of weeks.14 Part of the reason for the risk is that acetaminophen’s recommended dose and the amount of the drug that causes an overdose are very close. There is not much margin of safety.
In fact, studies reveal that taking just a little more acetaminophen than the recommended dose over a few days or weeks (referred to as “staggered overdosing”) can be deadlier than one large overdose.15 Research in the Journal of Clinical and Translational Hepatology found:16

“Hepatic injury and subsequent hepatic failure due to both intentional and non-intentional overdose of acetaminophen (APAP) has affected patients for decades, and … it accounts for more than 50% of overdose-related acute liver failure and approximately 20% of the liver transplant cases.

… Although APAP hepatotoxicity follows a predictable timeline of hepatic failure, its clinical presentation might vary. N-acetylcysteine (NAC) therapy is considered as the mainstay therapy, but liver transplantation might represent a life-saving procedure for selected patients.”

Acetaminophen Is Linked to Fatal Skin Reactions

Few people have heard of three serious skin reactions linked to acetaminophen, but they are concerning enough that the FDA issued a warning in 2013:17

“Reddening of the skin, rash, blisters, and detachment of the upper surface of the skin can occur with the use of drug products that contain acetaminophen. These reactions can occur with first-time use of acetaminophen or at any time while it is being taken …

Anyone who develops a skin rash or reaction while using acetaminophen or any other pain reliever/fever reducer should stop the drug and seek medical attention right away.”

The three skin conditions that the FDA warns of are very rare but also life-threatening:

Stevens Johnson Syndrome (SJS) — This reaction begins with flu-like symptoms that progress into a painful rash that blisters and causes the top layer of the skin to slough off. This can lead to serious infections, blindness, damage to internal organs, permanent skin damage and death.
Toxic Epidermal Necrolysis (TEN) — TEN also typically begins with flu-like symptoms (cough, headache, aches and fever) and progresses into a blistering rash. Layers of the skin may peel away in sheets and hair and nails may fall out. TENS is often fatal.
Acute Generalized Exanthematous Pustulosis (AGEP) — This skin eruption causes numerous pustules to appear on the skin, often accompanied by fever. This condition typically resolves within two weeks once the acetaminophen is stopped.

No one knows why acetaminophen can cause these extreme skin conditions and there is no way to predict who may be at risk before they take the drug. Even more concerning, as the FDA points out in its warning, the reactions can occur in someone who has safely taken acetaminophen before.
Acetaminophen Not Safe During Pregnancy

Acetaminophen is likely not safe to take for women who are pregnant. A study in JAMA Pediatrics found disturbing links between hyperkinetic disorders (HKD), a severe form of attention-deficit/hyperactivity disorder (ADHD), and ADHD itself.18 The study found a 29% increased risk for ADHD in the children whose mothers had used acetaminophen during pregnancy in the first seven years of their lives and a 37% increased risk of being diagnosed with HKD.19
In a 2015 communication, the FDA cited the JAMA Pediatrics ADHD study. It also cited research that found a possible connection between the use of acetaminophen and other drugs called nonsteroidal anti-inflammatories (NSAIDs) and miscarriage but found the evidence inconclusive.20
The fetal exposure of mothers taking acetaminophen during pregnancy may also increase a child’s chances of developing asthma.21 Researchers analyzed data from the Norwegian Mother and Child Cohort Study, which includes many mother/child pairs, and found that prenatal acetaminophen exposure was associated with an increased risk of asthma in offspring.22
Finally, use of acetaminophen during pregnancy may cut levels of testosterone in the womb, negatively affecting males, according to research in mice.23 It’s possible that this apparent testosterone reduction interferes with the development of the male reproductive system and explains genital birth defects, infertility and testicular cancer, according to other research.24
In addition to harm to male fetuses, a rat study found that the use of acetaminophen or NSAIDs in pregnancy could reduce the size of ovaries and follicles, and if applied to humans, might indicate that it could affect fertility of resulting daughters and granddaughters.25
Other Acetaminophen Risks

Acetaminophen may not be safe to take when you are drinking alcohol. Research suggests it can greatly increase your risk of kidney dysfunction — even if the amount of alcohol is small.26 Combining alcohol with acetaminophen was found to raise the risk of kidney damage by 123% compared to taking either of them individually.
Besides alcoholics, young adults are particularly at risk of kidney harm as they’re more likely to consume both alcohol and acetaminophen.27
Acetaminophen can also affect the immune system. According to a study in Human Vaccines & Immunotherapeutics,28 infants who received acetaminophen right after getting a vaccination experienced lowered immune response and developed significantly fewer antibodies against the disease they were vaccinated against.
Acetaminophen’s anti-inflammatory activity might explain the apparent effects by interfering with the body’s immune system antibody response, say the researchers.
Other risks that have been associated with the use of acetaminophen include chronic obstructive pulmonary disease (COPD) and reduced lung function, brain damage, increased blood pressure and hearing loss. Finally, acetaminophen may have psychiatric effects, according to research conducted by University of British Columbia researchers in 2016.29
The researchers found that use of acetaminophen may both lessen the ability of people to recognize errors that they make and their concern about whether or not they have made an error.30
Past research has also revealed subtle cognitive effects associated with acetaminophen use, like a 2010 study that indicated acetaminophen may reduce the pain of social rejection.31 Research also showed that acetaminophen had the ability to blunt both positive and negative emotions.32
Regardless of whether acetaminophen is added to California’s Proposition 65 as a carcinogen, there are many reasons to avoid this drug when possible and use it cautiously. Further, there are many pain-relieving herbs and practices that you can use to replace acetaminophen for natural relief.

Aside from causing a wide variety of side effects in those who take medications, the widespread routine use of pharmaceuticals also pose a serious risk to children who get their hands on them.
As of 2016, nearly half of the U.S. population were on at least one medication.1,2 Twenty-four percent used three or more drugs, and 12.6% were on more than five different medications.3 According to the 2016 National Ambulatory Medical Care Survey, 73.9% of all doctor’s visits also involved drug therapy.4
As one would expect, drug use dramatically increases with age. As of 2016, 18% of children under 12 were on prescription medication, compared to 85% of adults over the age of 60. While this trend is troubling enough, with prescription drugs now being a staple in most homes, the number of children suffering accidental poisoning is also on the rise.
Medications Pose Serious Risks to Young Children

According to a 2012 article5,6 in The Journal of Pediatrics that reviewed patient records from the National Poison Data System of the American Association of Poison Control Centers, 453,559 children aged 5 or younger were admitted to a health care facility following exposure to a potentially toxic dose of a pharmaceutical drug between 2001 and 2008.
In that time, drug poisonings rose 22%. Ninety-five percent of cases were due to self-exposure, meaning the children got into the medication and took it themselves, opposed to being given an excessive dose by error.
Forty-three percent of all children admitted to the hospital after accidentally ingesting medication ended up in the intensive care unit, and prescription (opposed to over-the-counter) medications were responsible for 71% of serious injuries, with opioids, sedative-hypnotics and cardiovascular drugs topping the list of drugs causing serious harm. As noted by the authors:7

“Prevention efforts have proved to be inadequate in the face of rising availability of prescription medications, particularly more dangerous medications.”

Keep All Drugs in Childproof Containers

If you’re older, you may recall your parents or grandparents would have a lockable medicine cabinet where drugs were stored. Few people keep their medications in locked cabinets or boxes these days, failing to realize the serious risk they pose to young children.
The hazard is further magnified if you sort your medications into easy-open daily pill organizers rather than keeping each drug in its original childproof container.
A 2020 paper8,9 in The Journal of Pediatrics, which sought to “identify types of containers from which young children accessed solid dose medications during unsupervised medication exposures” found 51.5% involved drugs accessed as a result of having been removed from its original childproof packaging.
Remarkably, in 49.3% of cases involving attention deficit hyperactivity disorder medications and 42.6% of cases involving an opioid, the drug was not in any container at all when accessed. In other words, the child found the pill or pills just laying out in the open. In 30.7% of all cases where a child ingested a drug, the exposure involved a grandparent’s medication. As noted by the authors:

“Efforts to reduce pediatric SDM [solid dose medication] exposures should also address exposures in which adults, rather than children, remove medications from child-resistant packaging.
Packaging/storage innovations designed to encourage adults to keep products within child-resistant packaging and specific educational messages could be targeted based on common exposure circumstances, medication classes, and medication intended recipients.”

Teen Drug Overdoses Are Also on the Rise
While infants are notorious for putting anything and everything in their mouth, making them particularly vulnerable to accidental drug exposures, drug overdoses, particularly those involving opioids and benzodiazepines, are also becoming more prevalent among teens with access to these drugs.
According to a 2019 study10 published in the journal Clinical Toxicology, 296,838 children under the age of 18 were exposed to benzodiazepines between January 2000 and December 2015. Over that time, benzodiazepine exposure in this age group increased by 54%. According to the authors:11

“The severity of medical outcomes also increased, as did the prevalence of co-ingestion of multiple drugs, especially in children ages 12 to <18 years. Nearly half of all reported exposures in 2015 were documented as intentional abuse, misuse, or attempted suicide, reflecting a change from prior years … Medical providers and caretakers should be cognizant of this growing epidemic to avoid preventable harm to adolescents, young children, and infants.” A similar trend has been found with opioids. A 2017 study12 looking at prescription opioid exposures among children and adolescents in the U.S. between 2000 and 2015 found: “Poison control centers received reports of 188,468 prescription opioid exposures among children aged<20 years old from 2000 through 2015 … Hydrocodone accounted for the largest proportion of exposures (28.7%), and 47.1% of children exposed to buprenorphine were admitted to a health care facility (HCF). The odds of being admitted to an HCF were higher for teenagers than for children aged 0 to 5 years or children aged 6 to 12 years. Teenagers also had greater odds of serious medical outcomes … The rate of prescription opioid-related suspected suicides among teenagers increased by 52.7% during the study period.” Commonsense Precautions The U.S. Centers for Disease Control and Prevention promotes and supports the Up and Away and Out of Sight campaign, which centers “around several simple, data-driven actions that parents and caregivers can take to prevent medication overdoses in the children they care about and care for.”13 These commonsense precautions include the following:14 Store your medications (and supplements) in their original packaging in a place your child cannot reach. Don't store medications in your nightstand, purse or end table where little hands are likely to explore and find them. Any medication stored in the refrigerator should be in childproof packaging. Also make sure drugs are safely stored in areas your child visits frequently, such as a grandparent’s house or a baby sitter. Put all medications away after each use. Make sure to relock the safety cap after each use. Teach your children about medicine safety; never tell them medicine is “like candy” in order to get them to take it. Remind guests to place bags, purses and coats that have medicine in them in a safe place while visiting. What to Do in Case of Accidental Drug Exposure Be sure to keep the Poison Help number in your phone, and make sure your baby sitter or caregiver has it. In the U.S., the Poison Help number is 800-222-1222. If you suspect your child has taken a prescription or OTC medication, even if he or she is not yet exhibiting symptoms, call the Poison Help line immediately. If you’re unsure what medication your child may have taken, call 911 or the emergency number in your area for transportation to the nearest medical facility. Although your child may appear fine in the initial minutes, this can rapidly change. You want to start treatment as soon as possible to reduce the risk of permanent damage or potential death. Remember to bring with you the names of any medications your child may have accidentally ingested, as well as any medications your child has taken in the past 24 hours as prescribed by their doctor, any allergies they have, and any changes or symptoms you may have observed. Unfortunately, symptoms of a medication overdose can vary widely, depending on the drug, dosage and age of the child. That said, symptoms of an overdose may include:15 Nausea Vomiting or diarrhea Drooling or dry mouth Convulsions Pupils that grow larger or shrink Sweating Loss of coordination and/or slurred speech Extreme fatigue Yellow skin or eyes Flu-like symptoms Unusual bleeding or bruising Abdominal pain Numbness Rapid heartbeat Should your child exhibit any of the following symptoms, call 911 (in the U.S.) immediately:16 Won’t wake up Can’t breathe Twitches or shakes uncontrollably Displays extremely strange behavior Has trouble swallowing Develops a rapidly spreading rash Swells up in the face, including around the lips and tongue Opioid Epidemic Takes Toll on Pediatric Population It’s crucial to realize that many drugs can be life threatening to a young child, even in low doses. This is particularly true for opioids and buprenorphine, a drug used to treat opioid dependence. As noted in a 2005 paper17 on opioid exposure in toddlers: “Ingestions of opioid analgesics by children may lead to significant toxicity as a result of depression of the respiratory and central nervous systems. A review of the medical literature was performed to determine whether low doses of opioids are dangerous in the pediatric population under 6 years old. Methadone was found to be the most toxic of the opioids; doses as low as a single tablet can lead to death. All children who have ingested any amount of methadone need to be observed in an Emergency Department (ED) for at least 6 h and considered for hospital admission. Most other opioids are better tolerated in ingestions as small as one or two tablets. Based on the limited data available for these opioids, we conclude that equianalgesic doses of 5 mg/kg of codeine or greater require 4 to 6 h of observation in the ED. Data for propoxyphene and all extended-release preparations are limited; their prolonged half-lives would suggest the need for longer observation periods. All opioid ingestions leading to respiratory depression or significant central nervous system depression require admission to an intensive care unit.” Similarly, a 2006 paper18 on the adverse effects of unintentional buprenorphine exposure in children noted that: “Buprenorphine in sublingual formulation was recently introduced to the American market for treatment of opioid dependence. We report a series of 5 toddlers with respiratory and mental-status depression after unintentional buprenorphine exposure. Despite buprenorphine's partial agonist activity and ceiling effect on respiratory depression, all children required hospital admission and either opioid-antagonist therapy or mechanical ventilation … The increasing use of buprenorphine as a home-based therapy for opioid addiction in the United States raises public health concerns for the pediatric population.” The take-home message here is that as drug treatment increases and becomes ever-more prevalent among all age groups, the risk of unintentional exposure increases as well. Toddlers will stick just about anything in their mouth, and young children will often not recognize there’s a difference between pills and candy. As parents and caregivers, we simply must take the necessary precautions to keep all medications in a safe place, well out of reach of curious hands. Failure to safeguard your medications can have profoundly tragic consequences, so please, do not take this matter lightly.

Earlier this year, I reported that carcinogenic N-nitrosodimethylamine (NDMA) had been found in certain blood pressure, heartburn and diabetes medications. As of February 2020, drugs recalled due to contamination with this poison included:1

Valsartan, losartan and irbesartan (high blood pressure medications)
Zantac2 and Axid (heartburn medications)
Metformin (diabetes medication)

In the case of valsartan, the three companies whose drugs were recalled in 2018 had all purchased the active ingredient from a Chinese company called Zhejiang Huahai Pharmaceutical Co. It’s one of China’s largest manufacturers of generics.3
Since 2018, the recall has been expanded dozens of times to also include losartan and irbesartan, made by more than 10 different companies with distribution in some 30 countries.4
As reported5 by Bloomberg in December 2019, the U.S. Food and Drug Administration checks less than 1% of imported drugs for impurities (or potency for that matter). Clearly, the regulatory system, which is meant to safeguard patients, is broken, and trust in drug manufacturers is often misplaced.
Disturbingly, Bloomberg’s report6 suggests the NDMA contamination at Huahai may have been intentional, at least in the sense that profitability was prioritized over thorough quality testing and perfecting of novel manufacturing methods.
What Is NDMA?

NDMA is a water-soluble chemical known to cause cancer in animals. In humans, it’s classified7 as a probable carcinogen and causes serious liver damage and liver failure.8
According to the Environmental Protection Agency’s technical fact sheet,9 NDMA, which can form in both industrial and natural chemical processes, is a member of N-ni-trosamines, a family of potent carcinogens.

“Potential industrial sources include byproducts from tanneries, pesticide manufacturing plants, rubber and tire manufacturers, alkylamine manufacture and use sites, fish processing facilities, foundries and dye manufacturers,” the EPA notes. However, we now know the chemical can also be produced during the manufacturing of drugs.

Historically, there are several cases10 in which NDMA was used as a poison. In 1978, a German teacher’s wife died after he put NDMA in her jam and a Nebraska man was sentenced to death that same year for spiking lemonade with it, killing two people.
In 2013, a Chinese medical student died as a result of an April Fool’s prank when NDMA was put into the water cooler, and in 2018, a Canadian graduate student poisoned a post-doctoral fellow by injecting it into an apple pie. Meanwhile, hundreds of millions of patients around the world have been taking drugs contaminated with this poison, oftentimes daily, for years on end.
Can FDA Ensure Drug Safety?
Bloomberg’s report11 reviews the history of how carcinogens like NDMA have crept into the generic drug supply, and raises serious questions about the FDA’s ability to ensure drug safety.

The article features the story of Karen Brackman, who after taking generic valsartan for two years suddenly found herself with a diagnosis of a rare and aggressive liver cancer, despite having no family history of cancer, and no specific risk factors for it.

As reported by Bloomberg,12 some of the contaminated valsartan pills contained as much as 17 micrograms of NDMA per pill, an amount estimated by European health regulators to give 1 in 3,390 people cancer. Brackman suspects she’s one of the unlucky ones.

While generics are a boon to patients in that they’re far less expensive while still providing the same benefits, there’s more room for error as they also receive far less scrutiny by regulators, and manufacturers are trusted to regulate themselves.
Most Active Ingredients Are Manufactured in China and India
An estimated 80% of all active drug ingredients are manufactured in China and India, and overseas plants are rarely inspected by U.S. authorities. At present, the U.S. has just one FDA inspector’s office in China. In the case of valsartan, even when a plant is inspected and found wanting, it can take years before problems are addressed — if ever.

“Huahai, the first manufacturer found to have NDMA in its valsartan, is also the one whose product had the highest concentration,” Bloomberg reports.13
”When an FDA inspector visited in May 2017, he was alarmed by what he saw: aging, rusty machinery; customer complaints dismissed without reason; testing anomalies that were never looked into.
He reported that the company was ignoring signs its products were contaminated. Senior FDA officials didn’t reprimand Huahai; they expected the company to resolve the problem on its own. Huahai didn’t …
It wasn’t until a year later that another company … found an impurity in Huahai’s valsartan and identified it as NDMA. That was when the FDA demanded drugmakers begin looking for NDMA in their valsartan. They found it again and again.”

As David Gortler, a drug safety consultant and former FDA medical officer, told Bloomberg, “Valsartan is just the one we caught. Who knows how many more [tainted drugs] are out there?” Well, we now know the NDMA contamination affects many other drugs as well, including metformin, used by more than 78.6 million Americans as of 2017.14
Huahai’s Mistake
Bloomberg goes on to recount some of the historical details of Huahei, from its inception in 1989 to its current status as one of the largest generic’s companies in China, and the first Chinese company to gain FDA approval to export finished drugs to the U.S. — a generic HIV medication.

When Novartis’ patent on Diovan (the brand name for its valsartan drug) expired in 2011, Huahai became one of the companies to manufacture valsartan for generic drug companies. Valsartan, being a simple compound to make and used daily by millions, looked like it could be just what Huahai needed to grow and improve its bottom line.

Now, as explained by Bloomberg, if a company like Huahai wants to create its own version of a generic drug and then export it to the U.S., they must first get FDA approval. However, if they’re just manufacturing and supplying the active ingredient to a U.S. company that then produces the finished product, then FDA approval is not required. All they have to do is inform the FDA if there are any changes to the manufacturing process.

In the case of Huahai’s valsartan, the company did make a change to its manufacturing process, but downplayed its significance. In November 2011, Huahai stopped using the solvent used by Novartis in the manufacturing of the brand name drug, and started using another called dimethylformamide (DMF).

This turns out to have been a massive mistake, as side reactions ended up producing NDMA, which could not be removed from the drug. “The chemists at Huahai either didn’t realize that or didn’t consider it a potential hazard,” Bloomberg writes, adding that, in 2018, after the recall began, vice chairman of Huahai, Jun Du, told an FDA inspector that “The purpose of the change was to save money,” thus increasing their profits.

The cost-savings were so substantial, it allowed Huahai to dominate the global market share for valsartan. Making matters worse, since Huahai’s patent was public, other generic companies copied the new, toxic, process. According to Bloomberg,15 this is “one reason so much of the world’s valsartan supply is now contaminated.”
Incompetence or Intentional Poisoning?
It’s hard to justify a defense of ignorance, though, seeing how the 2017 FDA inspector’s report noted multiple problems at the plant, including suspicious contaminants showing up in quality tests.

Du claimed the tests showed “ghost peaks … from time to time for undetermined reasons.” In another instance, he referred to the residual spike showing in testing as “noise.” Huahai never investigated to determine what the contaminants might be, or how they got there. Instead, they simply omitted the incriminating tests from official reports.

The FDA inspector recommended the agency issue a warning letter, which would have meant Huahai would have to pass another inspection before continuing its manufacturing. But the FDA didn’t send a warning letter. Instead, they urged Huahai to resolve the issues on their own — which they didn’t.

Disturbingly, a lax FDA approach to inspections that reveal faked quality testing is not unusual. Bloomberg spoke to Michael de la Torre, who runs a database of FDA inspections. According to Torre, in the five years up to 2019, the FDA issued warning letters in response to faked data just 25% of the time.

The only element who cares in this whole global supply chain is patients. ~ David Light, CEO Valisure LLC

Bloomberg also recounts a number of quality problems discovered at Indian drug manufacturing plants. Clearly, FDA is failing in its mission to regulate the generics industry overseas.

The industry is expected to regulate itself, and profit wins over quality concerns most of the time when no one is around to hold the companies accountable. A company is only as ethical and conscientious as the people running it.

Quality problems are really not uncommon. The New Haven, Connecticut-based online pharmacy Valisure LLC tests every drug it orders, and reports rejecting more than 10% of all batches it receives — in some cases due to inaccurate amounts of active ingredient, in others due to contaminants or other inconsistencies in quality.16

Kevin Schug, analytical chemistry professor at the University of Texas, told Bloomberg17 Huahai “certainly should have caught” the NMDA contamination, and “should have modified the procedure to correct it.” Former FDA medical officer Gortler agreed, saying, “Any well-trained analytical chemist would know to check. If it’s not intentional, it’s incompetence. At some point, those are the same.”

Valisure CEO David Light told Bloomberg that while people in the industry are well aware of the problems, the overwhelming consensus is that it’s not “their” problem. “There’s no liability at any one point,” he said. “The only element who cares in this whole global supply chain is patients.”

The FDA didn’t send a warning letter18 to Huahai until November 2018, stating the obvious: The company should have anticipated the possibility that changing the process to use DMF solvent might cause problems, and when testing revealed anomalies, they should have identified the impurity.

Brackman filed a lawsuit against Huahai in April 2019. About 140 others have also sued Huahai and other drugmakers involved in the valsartan recall, and lawyers are reviewing several hundred additional cases, Bloomberg reports.
Bottom Line
This devastating and pervasive toxic exposure results largely from people’s reliance on using drugs as symptomatic bandages that in no way, shape or form treat the cause of the disease. They trust their physicians to help them but sadly they have been captured by the drug industry and are nearly universally clueless on how to identify and address the underlying cause of most diseases.

That is why it is crucial to understand that YOU are responsible for your own health and need to use physicians as your consultants, and not implicitly trust them. If you provide your body with what it needs, it typically tends to self-correct and get better so you can avoid these dangerous medications which, rarely, if ever, resolve the foundational cause.

Fortunately, this COVID-19 crisis has shown us the two most important physical strategies to optimize your health: vitamin D and metabolic flexibility. The ability to eliminate insulin resistance is a strategy that addresses the majority of illnesses that you will ever encounter in your lifetime.

This is why time-restricted eating, eliminating industrially processed seed oils like soy, corn and canola oils, eating a cyclical ketogenic diet, exercising and sleeping well can improve, if not eliminate, most conditions that you would need to take medications for. As you can see, drugs can harm you just because they were made with shortcuts to increase company profits.

When you follow these health principles you will decrease, if not eliminate, your need for these dangerous medications. You will also enjoy a high degree of health and freedom from the pain, disability and suffering associated with these conditions.

The featured 2019 BBC documentary, “Addicted: America’s Opioid Crisis,” explores the depth of the nation’s addiction to opioid painkillers and the role played by Purdue Pharma and other makers of the drug.
As noted in the film, opioids kill more people than any other drug on the market, and it’s the only type of drug that can condemn a person to a life of addiction after a single week of use.
According to the BBC, “1 in 8 American children live with a parent who suffers from a substance abuse disorder,” and “every 15 minutes, a baby in America is born suffering from opioid withdrawal.” Middle school-aged children interviewed also say they have easy access to drugs, should they want them.
Many now blame the drug companies that make these drugs and have falsely promoted them as safe and nonaddictive for patients of all kinds, including children.
That includes one of the former addicts followed in the film, who says he thinks the drug companies need to be held responsible for their role in creating this epidemic, and made to help pay for the solution.
Purdue Pharma Pleads Guilty and Folds
One of the most prominent drug companies involved in the creation of this opioid addiction crisis is Purdue Pharma, the maker of OxyContin. At the end of October 2020, Purdue Pharma agreed to plead guilty to three federal criminal charges relating to its role in the opioid crisis, including violating a federal anti-kickback law, conspiracy to defraud the U.S. government and violating the Food, Drug and Cosmetic Act.1,2
To settle the charges, Purdue is supposed to pay $8.3 billion in fines, forfeiture of past profits and civil liability payments,3 but because it doesn’t have the cash, the company will instead be dissolved and its assets used to erect a “public benefit company” that both makes opioids and pays for addiction treatment.
Legal Painkillers Now the Gateway Drug to Heroin

While marijuana was long known as the gateway drug to other illicit drug use, that distinction now belongs to prescription opioids. According to data4 from the National Institute on Drug Abuse, prescription opioid use is a significant risk factor for subsequent heroin use.
1 in 3 people who misused opioids during their high school years ended up using heroin by age 35.
The incidence of heroin use is 19 times higher among those who have used opioids nonmedically than among those who have no history of opioid use, and 86% of young, urban injection drug users report using opioid pain relievers nonmedically before starting heroin. Overall, nearly 80% of heroin users now report using prescription opioids prior to heroin.
Similarly, data5 from the University of Michigan shows just under 1 in 3 people (31.8%) who misused opioids during their high school years ended up using heroin by age 35.
When it comes to children and teens, a major source of opioids are dentists, who wrote a staggering 18.1 million prescriptions for opioids in 2017.6 Opioids are frequently prescribed when extracting wisdom teeth, even though there’s no evidence to support this strategy.
This is especially true if you see a biological dentist who knows what they are doing. Earlier this year I had a periapical abscess and had to have the tooth extracted. I saw one of the best dentists in Florida, Dr. Carl Litano, just south of Tampa. He used platelet rich plasma (PRP) at the extraction site and I had zero pain and no swelling without any medication. Afterward, no one could tell I had an extraction the previous day.
Children are also recklessly prescribed addictive opioids for minor surgical procedures. For example, insurance claims data from 2016 and 2017 reveal 60% of children between the ages of 1 and 18 with private insurance filled one or more opioid prescriptions after surgical tonsil removal.7,8
Meanwhile, research9 shows opioids (including morphine, Vicodin, oxycodone and fentanyl) fail to control moderate to severe pain any better than over-the-counter drugs such as acetaminophen, ibuprofen and naproxen.
An Epidemic Caused by Greed

As noted in the film, this is an epidemic caused by greed within the medical system. Purdue Pharma was exceptionally skilled at marketing its product, cleverly disguising its advertisements as educational material. (The same can clearly be said about many other drug companies and their wares today.)
There can be no doubt that false advertising played a central role in the opioid epidemic,10 and for doctors, it highlights the importance of staying on top of published research rather than relying on drug company sales reps for their education.
The fraud has its roots in a short letter to the editor11,12 published in The New England Journal of Medicine in 1980. The letter — which was simply commenting on a cursory examination of patient files in a Boston hospital — stated that narcotic addiction in patients with no history of addiction was very rare.
Purdue built its marketing of OxyContin on this letter, for years falsely claiming that opioid addiction affects less than 1% of patients treated with the drugs. According to Purdue’s marketing material, featured in the film, “the most serious risk with opioids is respiratory depression.”
In reality, opioids have a very high rate of addiction and have not been proven effective for long-term use.13 A number of court cases in recent years have demonstrated how Purdue systematically misled doctors about OxyContin’s addictiveness to drive up sales.
As noted by David Powell, a senior economist at Rand, to produce the most lethal drug epidemic America has ever seen “you need a huge rise in opioid access, in a way that misuse is easy, but you also need demand to misuse the product.”14
According to the documentary, Purdue made more than $1 billion a year from its sales of OxyContin. OxyContin’s success also quickly led to other drug companies mimicking Purdue’s tactics. Other companies being called to account include Allergan, Cephalon, Endo International, Egalet Corporation, Insys Therapeutics, Johnson & Johnson, Janssen Pharmaceuticals, Mallinckrodt plc and Teva Pharmaceutical Industries.
In the final analysis, it’s clear that unconscionably deceitful marketing tactics have resulted in the death of hundreds of thousands of Americans; 46,802 Americans died from opioid overdoses in 2018 alone.15 As of June 2017, opioids became the leading cause of death among Americans under the age of 50.16
That said, the BBC also rightfully points out that we need stronger regulations and more effective checks and balances to prevent this kind of situation from happening again in the future. Merely making drug companies pay is not enough. 
Purdue Lured in, Then Abandoned Doctors

Steven May, a former Purdue sales rep, also highlights yet another scandal. The company came up with a plan to help doctors to better document their treatment of pain. Sales reps were taught how to instruct doctors to use these tools.
When those same doctors eventually got in trouble for overprescribing opioids, using Purdue’s tools, the company walked away and offered no support. Many doctors lost their medical licenses. Some ended up doing jail sentences and some committed suicide. “And they were doing exactly what [Purdue] taught us to teach them to do,” May says.
No Remorse

Adding insult to injury, when it became clear that people were dying in droves from opioid overdoses, Purdue launched an extensive damage-control operation that included the suggestion that those dying from opioids were already addicts, and that this wouldn’t happen to patients who were not already addicted to drugs. It was basically just a variation on the original lie.
According to lawsuits filed against Purdue, the company knew as early as the 1990s that OxyContin was one of the most abused drugs in the country, yet they did nothing to change their marketing and sales strategies.
That the Sacklers, the owners of Purdue, had no remorse and didn’t care about the societal effects that overprescription of their drug was having is illustrated in a 2001 email exchange between then-Purdue president Richard Sackler and an acquaintance.
In the documentary, Connecticut Attorney General William Tong reads this exchange, which begins with the unnamed acquaintance stating: “[Drug] abusers die, well that is the choice they made. I doubt a single one didn’t know the risks,” to which Sackler replied, “Abusers aren’t victims; they are the victimizers.”

“It’s hard to stomach that someone would write that about people who are suffering, people who are in real distress and people who have died,” Tong says, “and that is the kind of thing that powered this company during a period and led to deceptive, fraudulent, misleading product development and marketing … [They] made money off people’s misery and I think that is what these emails show.”

Unemployment and Poverty Fuel Addiction
Many of the opioid and heroin abusers featured in “Addicted” live on the streets. Desperation and despair are evident in all. Several investigations seeking to gain insight into the causes fueling the opioid epidemic have been conducted in recent years.
Among them is a 2019 study17 in the Medical Care Research Review journal, which looked at the effects of state-level economic conditions — unemployment rates, median house prices, median household income, insurance coverage and average hours of weekly work — on drug overdose deaths between 1999 and 2014. According to the authors:18

“Drug overdose deaths significantly declined with higher house prices … by nearly 0.17 deaths per 100,000 (~4%) with a $10,000 increase in median house price. House price effects were … only significant among males, non-Hispanic Whites, and individuals younger 45 years …

Our findings suggest that economic downturns that substantially reduce house prices such as the Great Recession can increase opioid-related deaths, suggesting that efforts to control access to such drugs should especially intensify during these periods.”

Similarly, an investigation published in the International Journal of Drug Policy19 in 2017 connected economic recessions and unemployment with rises in illegal drug use among adults. Seventeen of the 28 studies included in the review found that the psychological distress associated with economic recessions and unemployment was a significant factor:20

“The current evidence is in line with the hypothesis that drug use increases in times of recession because unemployment increases psychological distress which increases drug use. During times of recession, psychological support for those who lost their job and are vulnerable to drug use (relapse) is likely to be important.”

Another 2019 study21 published in Population Health reviewed the links between free trade and deaths from opioid use between 1999 and 2015, finding that “Job loss due to international trade is positively associated with opioid overdose mortality at the county level.” Overall, for each 1,000 people who lost their jobs due to international trade — commonly due to factory shutdowns — there was a 2.7% increase in opioid-related deaths.
Trauma Raises Addiction Risk

Abuse-related trauma is also linked to unemployment and financial stress, and that too can increase your risk of drug use and addiction. As noted in The Atlantic,22 when the coal mining industry in northeastern Pennsylvania collapsed, leaving many locals without job prospects, alcohol use increased, as did child abuse.
Many of these traumatized children, in turn, sought relief from the turmoil and ended up becoming addicted to opioids. All of this is particularly pertinent today, as many parts of the U.S. have been shut down for extended periods of time over fears of COVID-19.
Not being allowed to work, being forced to stay at home for weeks or months on end, maintaining an unnatural distance even to your loved ones and not being able to see people’s faces when out in public — all of these things can contribute to fear, anxiety and, ultimately, despair that fuels addiction. Indeed, reports23 warn that substance abuse is on the rise as a result of pandemic measures, as is domestic violence.24
Struggling With Opioid Addiction? Please Seek Help

It’s vitally important to realize that opioids are extremely addictive drugs that are not meant for long-term use for nonfatal conditions. If you’ve been on an opioid for more than two months, or if you find yourself taking a higher dosage, or taking the drug more often, you may already be addicted. Resources where you can find help include the following. You can also learn more in “How to Wean Off Opioids.”

Your workplace Employee Assistance Program
The Substance Abuse Mental Health Service Administration25 can be contacted 24 hours a day at 1-800-622-HELP

I also urge you to listen to my interview with Dr. Sarah Zielsdorf, which is being published in tomorrow’s newsletter. In it, she explains how low-dose naltrexone (LDN), used in microdoses, can help you help combat opioid addiction and aid in your recovery.26
Using microdoses of 0.001 milligrams (1 microgram), long-term users of opioids who have developed a tolerance to the drug are able to, over time, lower their opioid dose and avoid withdrawal symptoms as the LDN makes the opioid more effective.
For opioid dependence, the typical starting dose is 1 microgram twice a day, which will allow them to lower their opioid dose by about 60%. When the opioid is taken for pain, the LDN must be taken four to six hours apart from the opioid in order to not displace the opioid’s effects.
Nondrug Pain Relief

Many types of pain can be treated entirely without drugs. Recommendations by Harvard Medical School27,28 and the British National Health Service29 include the following. You can find more detailed information about most of these techniques in “13 Mind-Body Techniques That Can Help Ease Pain and Depression.”

Gentle exercise
Physical therapy or occupational therapy

Hypnotherapy
Distracting yourself with an enjoyable activity

Maintaining a regular sleep schedule
Mind-body techniques such as controlled breathing, meditation, guided imagery and mindfulness practice that encourage relaxation. One of my personal favorites is the Emotional Freedom Techniques (EFT)

Yoga and tai chi
Practicing gratitude and positive thinking

Hot or cold packs
Biofeedback

Music therapy
Therapeutic massage

In “Billionaire Opioid Executive Stands to Make Millions More on Patent for Addiction Treatment,” I discuss several additional approaches — including helpful supplements and dietary changes — that can be used separately or in combination with the strategies listed above to control both acute and chronic pain.

Journalist Gary Taubes has written several books on diet, including “Good Calories, Bad Calories,” “The Diet Delusion,” “Why We Get Fat: And What to Do About It,” and most recently, “The Case for Keto: Rethinking Weight Control and the Science and Practice of Low-Carb/High-Fat Eating,” which is the topic of this interview.
For his most recent book, Taubes interviewed more than 120 physicians, plus a few dieticians and chiropractors and a dentist — about 140 medical practitioners in all — to understand the challenges that clinicians and patients face when trying to implement a ketogenic diet and lose weight.
The first half of the book explains how carbs and fats affect your body, and why replacing carbs with healthy fats is so important if you’re trying to control your weight and/or blood sugar. The second half of the book is a review of the lessons he’s learned along the way.
The Real Cause of Obesity
As noted by Taubes, on a global scale, the obesity epidemic can be linked back to a Western diet rich in refined sugars and grains. Whenever sugar and white flour are added to a population’s diet, regardless of what their baseline disease rate is, you eventually end up with an epidemic of obesity and diabetes.
The idea that you get fat because your caloric intake exceeds your expenditure is naïve, Taubes says. “That’s not the cause of obesity. That’s like saying we get rich because we make more money than we spend.” He also takes issue with the idea that obesity is a hormonal regulatory disorder.

“There are a lot of hormones that play a role in fat accumulation. Sex hormones primarily. But the hormones that link our diets to obesity are our insulin and glucagon,” he says. “I pretty much left glucagon out of the story because I don’t think we need to discuss it to know what the dietary treatment is.

So, when you’re talking about the influence of diet on obesity, it’s not because we eat too much. It’s not because we eat too much energy dense food. It’s [about] the glycemic index of the carbohydrates — how quickly can we digest the carbohydrates in our diet? And then the fructose content, the sugar content.”

Uphill Battle Remains Despite Strong Scientific Evidence

Unfortunately, Taubes estimates some 98% of conventional nutrition and obesity research community still approach obesity as an energy balance disorder. “They’ve been trained over their entire professional careers to think of obesity as caused by this imbalance in intake and expenditure,” he says.

“They believe it’s a direct consequence of the laws of thermodynamics. When they do research on this, they’re often not studying why people accumulate excess fat. They’re studying appetite and satiety and eating behavior, because they think that the reason why they accumulate fat can be explained if you can explain why they eat so much.”

On the upside, many physicians are now starting to understand the role of diet, processed grains and sugar in particular. Interestingly, the U.S. Department of Agriculture Dietary Guidelines Advisory Committee’s 2020 report claims there’s an insufficient amount of low-carb and ketogenic diet trials to suggest that this kind of diet would be beneficial for the American public at large.

This, despite the fact that hundreds of studies over the past two decades have consistently shown a ketogenic diet to be beneficial. “Name a disease state at the moment from Alzheimer’s to traumatic brain injury, and you’ll find somebody studying whether or not ketogenic or a low-carb/high-fat diet could be beneficial,” Taubes says.

When you spend your whole life believing something to be true and proselytizing about the truth of that supposed fact, it’s very hard to think otherwise, no matter what the research shows.
In 2018, the American Diabetes Association Nutrition Committee published a consensus report1 saying there was more consistent evidence for a low-carb or very low-carb diet being beneficial for Type 2 diabetes than any other diet tested, particularly ones that have been advocated by mainstream medical authorities, such as the Mediterranean diet and the DASH diet.

“So, clearly, the studies are out there,” Taubes says. “I think what we’re faced with is a sort of classic combination of cognitive dissonance and groupthink. When you spend your whole life believing something to be true and proselytizing about the truth of that supposed fact, it’s very hard to think otherwise, no matter what the research shows.
The literature of cognitive behavioral psychology is full of studies and texts discussing this phenomenon. Cognitive dissonance … is what happens when a brain is confronted with evidence that something that brain has believed indisputably is wrong.”

Not All Fats Are Equal Metabolically

An important side note here is that while processed sugars and grains are certainly a significant contributor to obesity and ill health, the types of fats you eat play an important role. Many are eating far too much omega-6 linoleic acid (LA), which appears to be even worse than excess sugar.
In fact, I now believe an excess of LA in general is responsible for a vast majority of the damage and ill health we see in response to diet. I’ve reviewed this in several recent articles, including “How Linoleic Acid Wrecks Your Health.”
Now, while most people will experience a significant improvement in their health when they cut down on processed carbs, replacing them with fats, the improvement is not universal. This paradox, I believe, is because they’re eating too much LA.
Similarly, I think those who successfully use high-carb, low-fat diets to treat obesity, diabetes and coronary artery disease may be achieving these beneficial effects largely because they’re avoiding excess LA. Taubes is not entirely convinced, however, and goes into some of the details of his objections in the interview.

“Here’s what we need: We need to know how the LA changes in other populations, not just ours. Can we find populations that ate relatively large quantities of it but did not have obesity and diabetes and heart disease epidemics? Because if we do, that’s a bad sign. Do we have clinical trials? We have a whole host of clinical trials poorly done, uncontrolled, but can we look at those and see what the levels are?” Taubes says.

The Importance of Self-Experimentation

As noted in Taubes’ book, at some point, you’ll need to be willing to self-experiment to determine your own dietary triggers and what works best for you. At the end of the day, it’s about how you feel, not how well you follow any given diet. Taubes recommends starting off rigidly abstaining from carbohydrate-rich foods, and then assessing what other problems you might have and make additional changes from there.

“At the end of the book I talk about the lessons I learned from these 120 plus physicians I interviewed,” Taubes says. “I have one section in which the opening quote is from a wonderful spine surgeon in Ohio, who’s a vegan. She cannot tolerate animal products.
She has a family history of obesity. She used to be obese … she’s now a Type 1 diabetic, yet she sustains her health on a vegan ketogenic diet. And she says ‘It’s not a religion, it’s about how I feel.’ What she learned over the years is that her body couldn’t tolerate animal products.
Whether it’s the fat content, or the protein, or some other element of the animal-sourced foods, she can’t do it. And then I compare her to Dr. Georgia Ede, a psychologist who’s now working in western Massachusetts. She has slowly progressed to a carnivore diet, because she found that her body doesn’t seem to tolerate plant-based foods. Again, it’s not a religion, it’s just about how she feels.
My book originally was called ‘How to Think About How to Eat’ … One of the problems in this field is knowing who to believe. But I really thought about it as a process of self-experimentation. You fix the big things, which we can all agree on, and even the low-fat proponents and the vegan proponents would define their diets as healthy if they don’t include sugar and sugary beverages and white bread.
And then you start manipulating the smaller things to find out what your body can tolerate and what it can’t. That’s part of the process of learning how to think about how to eat. We learned over our youth what we liked and what we didn’t like. Then when we became adults we refined our tastes … and changed how we ate again.
Now, rather than doing it based on taste, we’re going to do it based on how it makes our bodies feel and perform. That’s the one advice we can give everyone to help them get healthier.”

Why Restrict Carbs?
So, just why is carb restriction such a key component? I was surprised to find that Taubes has not yet embraced cyclical keto (eating low-carb on some days and relatively higher amounts of carbs, maybe 200% to 300% more on others). Instead, he advises a more regimented and consistent carb restriction, i.e., a ketogenic diet that remains low in carbs continuously.

The primary justification for this is because most obese and chronically ill people have an addiction to carbs. They are addicted to a certain way of eating, and the concern is that if you allow carbohydrates back into their diet they can trigger eating carbs without discipline.

“If you’re doing a carbohydrate addiction program, any addiction program, moderation is one of the worst messages you could give. Nobody tells smokers to smoke in moderation, or alcoholics to drink in moderation, because we know it’s going to fail.
So, what worries me about cyclical programs is that ultimately, it’s advocating consumption of a product that these individuals are going to want to always eat more of. Sometimes rigid abstinence is easier. That’s the only issue.”

That said, I, and nearly all of my clinical associates who see patients, especially those who are athletes, now personally use and recommend cyclical ketosis. Personally, I will eat 30 to 50 grams of carbs one day and then 100 to 150 grams the next day. I’ll alternate back and forth. To make sure you’re moving in the right direction, you can measure and monitor your ketones and blood sugar.
The problem I’ve seen consistently is that if you restrict carbs continuously, your blood sugar tends to rise. The reason for this is because your body requires a certain amount of carbohydrates (glucose) to function. If you’re not getting it from your diet, your body makes more of it in your liver to supply your needs.
I hopefully catalyzed Taubes to seriously reevaluate his position as to one that is more consistent with our ancestral consumption of carbs. He responded:

“I’m taking in what you’re saying and I’m thinking [about] my own experience. I’ve found that over the 20 years I’ve been eating a very low-carb diet, there are fewer and fewer things that I can eat because my body responds to them.
Maybe had I been doing cyclical keto I’d not have that issue. Maybe I’d be at the same sort of general weight and health status but my body would be more tolerant of the foods I’m not eating. I don’t know what the answer is, other than self-experimentation, ultimately.”

How Excess LA Breaks Your Metabolism

If you’re like Taubes and are concerned about starting cyclical integration of carbs into your diet, I would recommend using a continuous glucose monitor like the Nutrisense device that allows you to measure and record your blood glucose every five to 10 minutes.
This will allow you to determine whether chronic low carb dieting is working optimally, or whether cycling higher and lower carb intakes might be better. Continuous blood glucose monitoring can immediately tell you how various foods affect your system.

Cycling back to the issue of LA again, it’s important to recognize that excessive LA in your diet can cause extreme reverse electron transport flow through complex I in your mitochondria with the production of high quantities of superoxide and H2O2, which actually causes you to become insulin resistant. So, insulin resistance is not restricted to excessive carb intake.
Limiting LA will also help reduce oxidative LA metabolites, which are the most pernicious sources of oxidative stress in your body. These oxidized LA metabolites (OXLAMs) prematurely destroy mitochondria and limit your ability to efficiently create ATP.
When you eat an excessive amount of LA, the disruption it causes in your mitochondrial electron transport chain causes your fat cells to become insulin sensitive. This is the last thing you want. While you want your somatic cells to be insulin sensitive, your fat cells need to be insulin resistant.2 As explained by Dr. Paul Saladino in “The Case Against Processed Vegetable Oils”:

“You are supposed to be insulin resistant in ketosis. That’s how your body partitions glucose to the cells that need it. [When] you have a ketogenic diet based on canola oil, safflower oil or soybean oil, you see people remain insulin sensitive when they’re in ketosis.
This is clear evidence that polyunsaturated fats are breaking your metabolism. Glucose is lower because it’s going into your cells; it’s making bigger cells. You’re getting fat.”

The take-home message here is that a proper ketogenic diet must be based on healthy saturated fats, not destructive vegetable seed oils or other common foods that are loaded with LA. Eating a high-fat diet, when the fats are primarily LA, is far worse than eating a chronic high-carb diet. The type of fat is of crucial importance, as it impacts your mitochondrial, cellular and metabolic functioning.

I realize that this information likely leads many of you to many questions. The good news is I’m co-writing a new book on all of this with Chris Knobbe, who is a leading expert. We hope to have the book out by the summer of 2021.
More Information
To learn more about how carb restriction can improve your weight and health, be sure to pick up a copy of Taubes’ book, “The Case for Keto: Rethinking Weight Control and the Science and Practice of Low-Carb/High-Fat Eating.”

While I believe most people would benefit from additional dietary changes, such as implementing a cyclical ketogenic diet and limiting LA, the basic premise of carbohydrate restriction is certainly sound, and is likely to improve the health of virtually everyone.

Then, as mentioned earlier, you may need to continue to fine-tuning and tweaking your nutritional choices to find just the right fit. You may also find that your body’s needs change with age. This is completely normal, and to be expected, so there’s no need to be dismayed if what you’ve done for a number of years no longer is working.

Dr. Mercola Interviews the Experts
This article is part of a weekly series in which Dr. Mercola interviews various experts on a variety of health issues. To see more expert interviews, click here.

In this interview, Tucker Goodrich and I discuss what will be the topic of my next book, namely linoleic acid (LA), which I believe is likely the leading contributing cause of virtually all chronic diseases we’ve encountered over the last century. Unfortunately, this is a topic that most clinicians and health care practitioners who focus on natural medicine have only a superficial understanding of.
Goodrich has a business background as a stockbroker and asset manager, and developed an IT risk management system used by two of the largest hedge funds in the world. A string of health crises in his late 30s and early 40s prompted him to apply his research and troubleshooting skills to medical research.
As noted by Goodrich, “It was a very upsetting time in my life and medical professionals really weren’t any help at all in trying to figure out what caused things.” After a lot of reading and researching, he decided to cut out seed oils from his diet, and in just two days, his 16-year-long bout with irritable bowel disease started to dramatically improve.
“I started immediately feeling better,” he says. He also lost a significant amount of weight over the next two months. After that, he stopped eating carbs and realized he must have had a severe case of gluten intolerance.

“Being an engineer by trade, I did a lot of experimenting. What can I eat? What brings back the symptoms? What do I have to avoid to keep the symptoms away? And it was a transformation that made everybody I worked with comment on what a difference they saw in me. It was a very quick change,” he says.

Avoiding Omega-6 Fats Is Key for Good Health

While considered an essential fat, when consumed in excessive amounts, which over 99% of people do, LA (an omega-6 polyunsaturated fat or PUFA) acts as a metabolic poison.

Most clinicians who value nutritional interventions to optimize health understand that vegetable oils, which are loaded with omega-6 PUFAs, are something to be avoided. What most fail to appreciate is that even if you eliminate the vegetable oils and avoid them like the plague, you may still be missing the mark.
Chances are you’re still getting too much of this dangerous fat from supposedly healthy food sources such as olive oil and chicken (which are fed LA-rich grains) — a topic covered in “Why Chicken Is Killing You and Saturated Fat Is Your Friend.”
Another common mistake is to simply increase the amount of omega-3 that you eat. Many are now aware that the omega-3 to omega-6 ratio is very important, and should be about equal, but simply increasing omega-3 can be a dangerous strategy. You really need to minimize the omega-6. As explained by Goodrich:

“The ratio is not really what’s important. What’s important is avoiding the omega-6 fats. There are disease models, like age-related macular degeneration (AMD), where that’s starting to be clearly understood, and you can find papers saying explicitly that the important intervention that prevents AMD from progressing is reduction of omega-6 fats, and you can’t prevent it by increasing your omega-3 fats.
I’ve got papers that show, in animal models, very nasty outcomes, such as liver failure, with a lower omega-6 to omega-3 ratio, but high absolute levels of both fats still allows pathology to progress.”

LA Is a Primary Contributor to Chronic Disease
When we talk about omega-6, we’re really referring to LA. They’re largely synonymous, as LA makes up the bulk — about 60% to 80% — of omega-6 and is the primary contributor to disease. Broadly speaking, there are three types of fats:

Saturated fats, which have a full complement of hydrogen atoms
Monounsaturated fats, which are missing a single hydrogen atom
PUFAs, which are missing multiple hydrogen atoms

The missing hydrogen atoms make PUFAs highly susceptible to oxidation, which means the fat breaks down into harmful metabolites. OXLAMS (oxidized LA metabolites) are what have a profoundly negative impact on human health. While excess sugar is certainly bad for your health and should be limited to 25 grams per day or less, it doesn’t oxidize like LA does so it’s nowhere near as damaging.
Over the last century, thanks to fatally flawed research suggesting saturated animal fat caused heart disease, the LA in the human diet has dramatically increased, from about 2 to 3 grams a day 150 years ago, to 30 or 40 grams a day. Goodrich cites research showing LA used to make up 1% to 3% of the energy in the human diet and now it makes up 15% to 20%.
In my mind, this radical change has had the most catastrophic impact on human health in the history of the human race, as it is the complete opposite of what you need for optimal health. This dietary change has undoubtedly killed millions, probably hundreds of millions, prematurely and still continues to do so because people don’t understand this.

“I’m a speed reader and I love reading medical journals … but what nobody’s really done is connect all the dots. There are a lot of people who understand little sections of [the science], but they haven’t gone on to coalesce everything into a common explanation for these pathologies across different disease states.
I think that’s what I’ve been able to do, and I think that’s the key insight that makes this message really compelling,” Goodrich says.

On a side note, do not confuse LA with conjugated linoleic acid (CLA). While most think CLA and LA are interchangeable, they’re not. CLA has many potent health benefits and will not cause the problems that LA does.
How Excess LA Consumption Damages Your Health

At a molecular level, excess LA consumption damages your metabolism and impedes your body’s ability to generate energy in your mitochondria. There is a particular fat only located in your mitochondria — most of it is found in the inner mitochondrial membrane — called cardiolipin.
Cardiolipin is made up of four fatty acids, unlike triglycerides which have three, but the individual fats can vary. Examples include LA, palmitic acid and the fatty acids found in fish oil, DHA and EPA. Each of these have a different effect on mitochondrial function, and depending on the organ, the mitochondria work better with particular kinds of fatty acids.
For example, your heart preferentially builds cardiolipin with LA, while your brain dislikes LA and preferentially builds cardiolipin in the mitochondria with fats like DHA. Goodrich further explains:

“To give you an idea of how important this is, 20% of the fat in your entire body is contained in cardiolipin. So, for anybody who doesn’t understand mitochondria, mitochondria are what distinguish us from bacteria. It’s what allows us to be a multi-cellular creature. They are what produce the energy in your body, what’s known as ATP, which is a chemical carrier of energy.
To give you an example of how important it is, cyanide, which we all know is highly toxic, breaks your mitochondria, and that’s why it kills you so fast. It prevents mitochondrial respiration and therefore your entire body shuts down almost instantly.
So, [mitochondria are] something we want to take good care of because they’re everywhere, in almost every tissue except for red blood cells … There are studies showing that cardiolipin is directly controlled by dietary intake of fats. That is, to an extent, true. Obviously, different tissues build cardiolipin in the mitochondria out of different fats.
But they can vary that composition in fairly short order through changing the diet in rat models, like in the order of weeks. So, you can see changes pretty quickly. I notice things happening in days. What’s unique about LA is that it is very susceptible to oxidation when it is in the cardiolipin molecule.
Two LAs that are adjacent to each other can oxidize each other. They’re also attached to proteins in the mitochondria that contain iron, and that iron can catalyze the oxidation of cardiolipin. This is a pretty fundamental process in the body.”

Oxidation of Cardiolipin Controls Autophagy

Oxidation of cardiolipin is one of the things that controls autophagy. In other words, it’s one of the signals that your body uses when there’s something wrong with a cell, triggering the destruction and rebuilding of that cell. Your cells know that they’re broken when they have too many damaged mitochondria, and the process that controls this is largely the oxidation of omega-6 fats contained within cardiolipin.

Animals typically develop cancer once the LA in their diet reaches 4% to 10% of their energy intake, depending on the cancer.
So, by altering the composition of cardiolipin in your mitochondria to one that’s richer in omega-6 fats, you make it far more susceptible to oxidative damage. Goodrich cites research showing that when the LA in cardiolipin is replaced with oleic acid, another fat found in olive oil, the cardiolipin molecules become highly resistant to oxidative damage.

“That is basically what I think we need to go back to,” he says. “We evolved with low levels of LA in our diet and therefore in our cardiolipin. One of the neatest papers I’ve ever seen looking at this, something that encapsulated this whole model that I’m talking about, fed rats either a regular high carbohydrate diet, or they added PUFAs to their diet.
Just adding the omega-6 fats to the diet caused the mice to become diabetic. They became insulin resistant, leptin resistant, obese, and the differences are pretty stark between the fat mice and the skinny mice on the high carbohydrate rat diet …
The high-PUFA diet caused a breakdown in the cardiolipin content in the mitochondria in their hearts. So just adding seed oils caused heart damage through a change in the cardiolipin composition.”

As mentioned, the primary problem is the OXLAMS, the oxidized byproducts. One of them is 4HNE, which is relatively easy to measure. Studies have shown there’s a definite correlation between elevated levels of 4HNE and heart failure. LA is broken down into 4HNE even faster when the oil is heated, which is why cardiologists recommend avoiding fried foods.
OXLAMS Trigger Cancer

Heart disease isn’t the only condition triggered by excessive LA intake and the subsequent OXLAMS produced. It also plays a significant role in cancer. As noted by Goodrich, to induce cancer in animal models, you actually have to feed them seed oils. “So, this is a really fundamental process that we’re talking about here,” he says.
Animals typically develop cancer once the LA in their diet reaches 4% to 10% of their energy intake, depending on the cancer. In the breast cancer model, cancer incidents increase once 4% of calories are in the form of seed oils. Disturbingly, most Americans get approximately 8% of their calories from seed oils. “So, we’re way over what these thresholds in the lab would suggest is a safe level of these fats based on the laboratory work in animals,” Goodrich says, adding:

“We’ve got this huge disconnect between what the lab science tells us we should be doing and what our dietary guidelines tell us we should be doing. The scientists are saying, ‘Oh, look, it’s poison. It causes all the chronic diseases,’ and the government’s saying, ‘Eat lots of it.’ That’s not a good thing.”

4HNE is a mutagen, in other words, a toxin that causes DNA damage. One of the primary genes it damages is the P53 anticancer gene. Mutations in the P53 gene is found in 15% of cancers, making it one of the most common. As noted by Goodrich, “P53 is literally a cancer prevention gene. It’s how your body regulates cancer. You can all draw your own conclusions about the wisdom of eating something that can cause that to break.”
On a side note, one of the major jobs of glutathione is to detoxify 4HNE. You can often tell that you have excess 4HNE if your glutathione levels are low, as this means it’s being used up detoxifying 4HNE.

LA and Obesity
High-LA diets also cause obesity. “If you feed mice lots of saturated fat, they don’t get fat and they don’t get sick. It’s only when you increase the LA in the diet from 1% to 8% that they become obese,” Goodrich says. Now, mice and rats are not exactly like humans, so how do we know all of this applies to us? Goodrich explains:

“What Alheim and Ramston observed is that, back in 2006, there was a drug introduced called Rimonabant, which was an anti-obesity drug. It was a bit of a miracle drug. I want to quote this exactly because it’s so important to understand the effects that this drug had on humans.
‘Large randomized trials with Rimonabant have demonstrated efficacy in treatment of overweight and obese individuals with weight loss significantly greater than a reduced calorie diet alone.
In addition, multiple other cardiometabolic parameters were improved in the treatment groups, including increased levels of HDL, reduced triglycerides, reduced weight circumference, improved insulin sensitivity, decreased insulin levels. And in diabetic patients, improvements in HBA1C.’
This paper was released in 2007. Unfortunately, Rimonabant had a side effect that it caused people to want to kill themselves. So, it was withdrawn from the market and it largely killed research for several years into that area.
But what Alheim did in 2012 was demonstrate that the mechanism behind Rimonabant is to block the metabolism of seed oils into the chemicals in your body and the endocannabinoid system that cause overeating. My experience when I stopped eating seed oils was that I forgot to eat carbohydrates.
The effect of Rimonabant in these mouse models is to make them crave carbohydrates and to stimulate them to eat sweet foods and carbohydrates. Everybody’s familiar with this effect. It’s called the munchies. And it’s what you get after you smoke pot, because the endocannabinoid system is the system that marijuana affects and the chemical that Rimonabant blocks is your body’s homologue to the THC in marijuana.
So essentially what we’ve done to ourselves is given ourselves a chronic case of the munchies, which is blocked by this unfortunately very harmful drug. This is as open and closed a case for causation as you’re going to find in the medical literature.
We have a human drug that treats this, and as I just read, it treats all these different aspects of this disease. And it works through this one pathway that we have a clear demonstration of in animal models. In this case, the drug is completely pointless because the dietary fix is well known and is simple.”

Increased LA Also Increases Your Risk of Sunburn
So, to summarize, the dramatic increase in LA — and the oxidative end products that cause the damage — is the primary cause behind the increase in chronic diseases such as obesity, diabetes, heart disease and cancer.

Simply lowering your LA intake to what your great-great grandparents used to eat, you can essentially eliminate almost every single one of the diseases that is now prematurely killing us.

Interestingly enough, there’s even evidence showing eliminating seed oils from your diet will dramatically reduce your risk of sunburn, which is something Goodrich experienced first-hand. “Susceptibility to UV radiation damage is controlled by how much PUFAs are in your diet,” he says. “It’s like a dial. They can control how fast it happens, and how fast you get skin cancer.”
Seed Oils Raise Risk of ARDS and COVID-19
Considering the metabolic and mitochondrial damage caused by LA, there’s reason to suspect LA may also play a role in COVID-19, as some white blood cells convert LA into leukotoxin. Essentially, LA contributes to the inflammatory domino effect that eventually kills. Goodrich explains:

“Yes. That’s certainly what the conclusion that I drew. I did an enormous post on this, looking at the effects of LA in SARS COV-2 and SARS in general. SARS is a severe acute respiratory syndrome. SARS kills you by giving you acute respiratory distress syndrome (ARDS).
ARDS can be caused by lots of different things, not just these viruses. You can get it from influenza. You can get it from inhaling acid into your lungs. What’s fascinating is the human literature is quite clear that you can induce ARDS through feeding seed oils.
Very sick people who can’t eat are fed intravenously. It’s called total parenteral nutrition (TPN). Generally, this is used through a product called Intralipid, which is made out of soybean oil and sugar. When you start to understand all this stuff, it’s just mind boggling. Doctors did an experiment after they noticed that a lot of their patients who came into the ICU and got TPN then subsequently got ARDS.
So, they started playing with what they were feeding them, and what they discovered was this soybean oil formula increased the patient’s rate of getting ARDS. The fatality rate from ARDS is 30% to 60%. Feeding seed oils increased the rate of ARDS by seven times.”

As explained by Goodrich, the key toxin that produce the symptoms of ARDS is called leukotoxin, and leukotoxin is made from LA by white blood cells to kill pathogens. It’s toxic enough to where if you inject high-enough amounts of it into animals, it kills them in minutes. Leukocytes incubated with LA convert all of the LA into this toxin until there’s none left, so, a major part of the disease process in ARDS is the conversion of LA into leukotoxin. That is what ends up killing patients.

“It is often noted in the popular press that what kills people is this cytokine storm. What I’m describing is the mechanism of the cytokine storm. Leukotoxin is uniquely what causes the symptoms of ARDS, as has been clearly demonstrated in the animal models,” Goodrich says. “So, it seems to me that a sensible thing to do would be [to] change your diet. Why wouldn’t you want to do that?”

How LA Triggers Heart Disease

Goodrich also explains how high LA levels causes heart disease. One of the first things that happens in atherosclerosis is your macrophages, another type of leukocyte, turns into a foam cell, essentially a macrophage stuffed with fat and cholesterol. Atherosclerotic plaque is basically dead macrophages and other types of cells loaded with cholesterol and fat. This is why heart disease is blamed on dietary cholesterol and fat.
However, researchers have found that in order for foam cells to form, the LDL must be modified through oxidation, and seed oils do just this. Seed oils cause the LDL to oxidize, thereby forming foam cells. LDL in and of itself does not initiate atherosclerosis. LDL’s susceptibility to this oxidative process is controlled by the LA content of your diet.

“That’s a result that’s been repeated several times, so subsequently, the definition of an atherogenic lipid in your blood is one that contains oxidized omega-6 fats. That’s the definition,” Goodrich says.
“The standard explanation of why you get heart disease and why it progresses the way it does is because the omega-6 fats in your blood get oxidized and become toxic, and progress you all the way through atherosclerosis until it finally kills you.
That’s the standard explanation for what causes heart disease. I can’t tell you how many cardiologists I have talked to who don’t understand that that’s what the medical literature says is causing this disease.

Now, it’s worse if you’re also on a high carbohydrate diet. A ketogenic diet is somewhat protective against the negative effects of this, but I can’t stress enough that this is the standard explanation for cardiovascular disease in the medical literature — that seed oils oxidize and that’s what causes the pathology.”

Understanding Olive Oil
As mentioned, olive oil also contains LA, but it also has other healthy fats. This makes olive oil a bit tricky. The main fat in olive oil is oleic acid, which is one of your body’s favorite fats. Your body actually makes, it, which is why it’s not considered an essential fat. Oleic acid is much more resistant to oxidation than LA, which is why olive oil is a pretty decent cooking oil.
According to Goodrich, oleic acid is protective against both cardiolipin oxidation and LDL oxidation. Interestingly, oleic acid can also replace LA in LDL. Other fats, such as palmitic acid, cannot do that. The problem with olive oil is that it also has a fair amount of LA.
“The percentages that I’ve seen quoted in literature range from 2%, which is awesome, to 22%, which is not good,” Goodrich says. The other problem is the olive oil market is hugely corrupt and fraught with fraud. Many olive oils are cut with cheaper seed oils, which raises the LA content.
So, in summary, if you’re using olive oil, I strongly recommend keeping close track of your total LA intake. Anything over 10 grams a day is likely to be problematic (although the exact cutoff is still unknown, so this is merely an educated guess).
If you really want to be on the safe side, consider cutting LA down to 2 or 3 grams per day, to match what our ancestors used to get before all of these chronic health conditions became widespread. If olive oil puts you over the limit, consider cooking with tallow or lard instead. Beef tallow is 46% oleic acid and lard is 36% oleic acid.
High-LA Sources to Avoid

As Goodrich suggests, if you want to protect your health, you’d be wise to avoid all concentrated sources of LA. Top sources include chips fried in vegetable oil, commercial salad dressings, virtually all processed foods and any fried fast food, such as french fries.

“What amazes me is people who go to all these measures and I’ll hold up my girlfriend as an example. She was a vegan when we got together, had a farm and grew organic food and went to extremes to avoid toxins in food and then went home and cooked with seed oils,” Goodrich says.
“There are so many people who are like this, who are genuinely trying to do their best to have a healthy diet and then they’re chugging down LA that turns into a metabolic toxin in your body, and they wonder why they can’t lose weight.
By the way, after I told her, what I just said here: Avoid seed oils, avoid refined carbohydrates, eat animal food and animal fats, she lost 56 pounds in two and a half months and her autoimmune disease, fibromyalgia, went into complete remission.”

The Importance of Carnosine

Beef, even conventional grain-finished beef, has low LA. Grass fed beef has higher DHA and CLA, which makes it a healthier option. Beef is also the primary source of carnosine, which has been shown to be anti-atherogenic.
Carnosine is also a mitochondrial stimulant, a sacrificial scavenger of advanced lipooxidation end products (ALEs), which is very similar to advanced glycation end products (AGEs). AGEs is another name for HNE and all the other reactive oxygen species generated from oxidizing LA.
Carnosine is the most effective scavenger for HNE. Carbonylation of proteins is basically the process through which proteins in your body get damaged and become ineffective. HNE damages 24% of the proteins in your cells, so carnosine can go a long way toward warding off this cellular damage. As explained by Goodrich:

“In heart failure, Alzheimer’s and in AMD, one of the things they see is an inability of the cell to produce enough energy. The mitochondria are getting damaged. HNE does that damage. It damages 24% of the proteins in the cell, primarily around energy production.
One of the worst cancers is glioblastoma, a brain cancer. A researcher up in Boston, [Thomas Seyfried], decided to try and figure out why the mitochondria are getting damaged in glioblastoma, and found they all have oxidized cardiolipin. Every single cancer cell he looked at had damaged cardiolipin in it.
One of the ways your cells produce energy is they basically ferment glucose into pyruvate outside of the mitochondria This is a perfectly normal part of metabolism and they produce something called pyruvate. A molecule called pyruvate dehydrogenase takes pyruvate into the mitochondria and converts it to acetyl-CoA so the mitochondria can burn it very efficiently for fuel.
Well, one of the things HNE does is it breaks pyruvate dehydrogenase, and they see this in Alzheimer’s where their cells are no longer able to produce enough energy. This is why your cells are dying in Alzheimer’s. The beta amyloid plaques in Alzheimer’s disease are induced by HNE. There’s a great model that came out of Harvard a couple of years ago showing that.
And in cancer, if you can’t get pyruvate out of the cell, out of the cytosol, the part of the cell surrounding the mitochondria, it has to ferment there and turn it into energy, which is what we call the Warburg effect, where you start shifting over to this damaged primitive fuel system. The evidence seems to be that that’s because you’ve broken your mitochondria.
Even the critical, the most important part of the mitochondria, complex 5ADP synthase — which is what takes all the energy coming from your mitochondria and turns it into ATP, which is what fuels the rest of your body — is damaged by HNE. This is a huge issue. There’s no more fundamental problem in aging and health than protein damage.”

Take Control of Your Health by Lowering Your LA Intake
As you can see, the evidence strongly suggests excessive LA is driving all the killer diseases today. The solution is simple though. Just lower your LA intake. There’s an easy way to do this. You don’t have to send all your food out for analysis. Simply use an online nutritional calculator such as Chronometer to calculate your daily intake.

Chronometer will tell you how much omega-6 you’re getting from your food down to the 10th of a gram, and you can assume 90% of that is LA. Again, anything over 10 grams is likely to cause problems. Since there’s no downside to limiting your LA, you’ll want to keep it as low as possible, which you do by avoiding high-LA foods.
Keep in mind you’ll never be able to get to zero, and you wouldn’t want to do that either. So, just what should you eat to keep your LA intake low? Goodrich summarizes his own diet:

“I eat mostly beef. I eat vegetables. I cook mostly in butter. I eat a little bit of fruit. I eat occasional grains. Occasionally I’ll have corn, a little bit of rice and potatoes. I’m mostly on a cyclical keto diet. Once you fix your metabolic system, then you can go back and forth a lot easier and I don’t see any reason to be on strict keto long term. I think [cyclical keto] is healthier.
They looked at a ketogenic diet in rodents and found they were protected. The reason they were protected is because they were able to burn HNE as fuel. But if you add a little bit more insulin into the system, then it turns off fat-burning and HNE goes out of the mitochondria and does more damage.”

This is yet another reason for working out in a fasted state, which Goodrich also recommends. “I think working on a fasted state is one of the most important health things that you can do, without question,” he says. Goodrich also points out that the reason a strict ketogenic diet can cause liver failure is due to the omega-6 fats in the diet. It’s crucial to make sure the fats you eat are actually healthy.

Goodrich is currently in the process of writing a book about this, as am I, in which all of this information will be laid out in even greater detail. In the meantime, you can learn more by visiting Goodrich’s blog, Yelling-Stop, or follow him on Twitter. In closing:

“I can’t say anything that you haven’t already said in this talk, honestly,” Goodrich says. “You want to eat like your ancestors ate because your ancestors were healthier and they were not eating industrial seed oils. They were not eating industrial processed carbs in high quantities.
They were making sure that they got lots of animal meat and animal fat and they were getting exercise. I mean, it doesn’t really matter what kind of exercise you’re doing, just as long as you’re doing it.
I think I have helped many people in many different ways by telling people this. And it’s typically a short conversation, like my girlfriend who cured her autoimmune disease, fibromyalgia. She’d been in constant pain for almost 30 years and it went away in a couple of weeks. I mean, that’s amazing, and it’s so simple to do.
This is, I believe, the fundamental problem with our modern health — this issue of LA. There are lots of other things that play into it. There’s no doubt about that, but that’s the fundamental thing. If you fix that, you can get away with doing a lot of other things that aren’t exactly optimal, but still be healthy.”