Browsing Tag When politics and medicine collide

The Food and Drug Administration (FDA) issued a warning a few years ago that pregnant women taking the selective serotonin reuptake inhibitor (SSRI) antidepressant paroxetine risk giving birth to infants with major birth defects, including heart abnormalities Now comes word that the same drug (sold as Paxil, Paxil CR, Seroxat, Pexeva, and generic paroxetine hydrochloride) carries another danger that could keep babies from being born in the first place. A new study just published in the online edition of the journal Fertility and Sterility concludes as many as fifty percent of all men taking the antidepressant could have damaged sperm and compromised fertility.

New York Presbyterian Hospital and Weill Cornell Medical Center researchers followed 35 healthy male volunteers who took paroxetine for five weeks. Then sperm samples from the men were studied using an assay called terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) to evaluate whether there were missing pieces of genetic code in the sperm DNA. This condition, know as DNA fragmentation, is associated with reproductive problems.

The results? The percentage of men with abnormal DNA fragmentation soared from less than 10 percent to 50 percent while taking the antidepressant. This is a crucial finding because DNA fragmentation has long been known to correlate with an increased risk of birth defects, poor fertility and unsuccessful pregnancy outcomes — even when high tech, extraordinarily expensive fertility enhancing techniques such as in vitro fertilization and intracytoplasmic sperm injection are used.

The study, one of the first scientific investigations into the effect of SSRIs on sperm quality, also confirmed that paroxetine impairs sexual function. More than a third of the research subjects reported significant changes in erectile function and about half had difficulty ejaculating.

“It’s fairly well known that SSRI antidepressants negatively impact erectile function and ejaculation. This study goes one step further, demonstrating that they can cause a major increase in genetic damage to sperm,” Dr. Peter Schlegel, the study’s senior author and chairman of the Department of Urology and professor of reproductive medicine at Weill Cornell Medical College, explained in a statement to the media. “Although this study doesn’t look directly at fertility, we can infer that as many as half of men taking SSRIs have a reduced ability to conceive. These men should talk with their physician about their treatment options, including non-SSRI depression medications.”

The scientists could not identify the exact way the SSRI caused the DNA fragmentation, but the evidence strongly suggests the drug slows sperm as it moves through the male reproductive tract from the testis to the ejaculatory ducts. When this happens, the sluggish sperm grows old and its DNA becomes damaged. “This is a new concept for how drugs can affect fertility and sperm. In most cases, it was previously assumed that a drug damaged sperm production, so the concept that sperm transport could be affected is novel,” Dr. Schlegel stated.

The study contains some good news for men currently on Paxil and related drugs who may be concerned about their fertility. All the changes the researchers found appeared to be totally reversible. Specifically, normal levels of sexual function and DNA fragmentation both returned to normal one month after discontinuation of the drug.

A higher dietary intake of omega-3 fatty acids may protect men from prostate cancer even if they have a genetic predisposition to the disease, researchers have found.

“We detected strong protective associations between increasing intake of long-chain omega-3 polyunsaturated fatty acids and more advanced prostate cancer,” said lead researcher John S. Witte. “These fatty acids are primarily from dark fish such as salmon.”

“And the decrease in risk may be even more pronounced if one has a high-risk genetic variant,” he said.

In a study published in the journal Clinical Cancer Research, Witte and colleagues compared the diets and genetic profiles of 466 men suffering from aggressive prostate cancer with those of 478 healthy men of similar age and ethnic distribution. Average participant age was 65, and cancer patients were recruited an average of 4.7 months after diagnosis. Healthy controls were recruited from among men undergoing standard annual health checkups.

The researchers focused only on aggressive tumors because these represent the most dangerous form of the disease. Many men with non-aggressive, slow-growing tumors die of other causes before ever experiencing any cancer symptoms.

Researchers had all participants fill out food frequency questionnaires, classifying their intake of various kinds of fish as “never,” “one to three times per month,” or “one or more times per week.” All men were screened for nine different mutations of the cox-2 gene. These variables were then analyzed for their relationship with prostate cancer, adjusting for other known risk factors such as smoking, obesity, family cancer history and prior prostate screening results.

The study was conducted by researchers from the Institute for Human Genetics, University of California and University of Southern California, and funded by the National Institute of Health and a dean’s grant from Laval University McLaughlin.

The researchers found that men with cancer had a significantly higher intake of calories, fat and linoleic acid (an omega-6) than healthy men. They had a significantly lower intake of omega-3s, shellfish and dark fish.

Men who ate dark fish one to three times a month had a 36 percent lower chance of developing an aggressive prostate cancer than those who ate it rarely or never, while those who ate such fish once a week or more had a 63 percent lower risk.

“The strongest effect was seen from eating dark fish such as salmon one or more times per week,” Witte said.

The researchers found that men with a particular cox-2 gene variant, rs4647310, had 5.5-times the risk of aggressive prostate cancer as men without that variant. This elevated risk was not seen, however, among men with a high omega-3 intake.

“Men with low intake of dark fish and the high-risk variant had a substantially increased risk of more advanced prostate cancer,” Witte said.

Omega-3s are believed to decrease the risk of cardiovascular disease, cancer, and autoimmune disorders, and to improve cognitive health. The mechanisms for these benefits are not well understood, but are believed, in some cases, to be linked to reduced inflammation.

The cox-2 gene is known to play a role in prostate inflammation, a risk factor for prostate cancer.

For many years, we have been doing a Natural Fertility Program for couples who are delighted with the results.

Be well

Dr Sundardas

http://www.naturaltherapies.com/nfp.htm

On a daily basis when I work with my clients and I have to present to them information that upsets their mental models, I get a variety of responses. These responses range from

1) Are you sure about this? (mildly skeptical)
2) Why did my doctor or dentist not tell me this?
3) How come the FDA passed this?
4) Why isn’t the government doing anything about this?

For the mildly skeptical responses (its only mildly skeptical now because those who come to me know about my somewhat unorthodox views), I simply give them the facts and let them decide. They are of course shocked that the precious antibiotics that the doctor gave them for their viral influenza was quite useless and it was in the best (or worst) case scenario (depending on your perspective) meant to protect against the possibility of a secondary bacterial infection (if it occurred). Most people believe however that the cold got better because of the antibiotics. It is because of the indiscriminate use of the antibiotics we now have “flesh eating bacteria” proliferating and
the development of antibiotic resistant bacterial species.

The next scenario is that of “Why did my doctor or dentist not tell me this”. I have a good friend of mine who is a general practitioner who regularly tells his patients when they have a cold that they do not need antibiotics. Some of his patients love him. His relatives when they see him professionally for a cold and are told they do not need antibiotics go away disgruntled grumbling under their breath, “What kind of doctor are you?” This is one reason doctors do this. They do not want to lose patients. If a patient feels he needs antibiotics and nearly everyone else is doing it, than “I must do it as well’.

On the subjects of mercury fillings, I can wax lyrical but I won’t. I will simply say that in many countries until quite recently, a dentist could lose his license for suggesting that mercury was not a suitable material to be used in the teeth. Now there are states in the US outlawing the use of mercury. One wag once said that

1) If they used the same standard of double blind studies on mercury as a dental filling that they do on drugs, it would never have cleared clinical trials

2) If the US government were to openly ban mercury as a dental product, it would go bankrupt under the weight of the lawsuits filed by its military serviceman

In Singapore, dentist are advised not to use mercury for pregnant mothers by the Ministry of Health. Makes you wonder doesn’t it? Is it not safe for pregnant mothers or is it not safe for the babies? If its not safe for mothers and babies, how about the rest of us poor mortals?

One of the other major issues is that of vaccines and its safety. A certain percentage of the cost of the vaccines goes towards legal fees. There are legal companies in the good old USA who specialize in cases of vaccine damage in children. They take these companies to court and win. I will let you ponder on the meaning of a purported medical procedure that is supposed to protect children but leaves 2 % of the children handicapped and brain damaged and autistic some way. Before the serious advent of modern vaccines, the incident of autistic features was 0.1% to 0.2 % . Ahh…the wonders of modern medical science.

For the longest time, the FDA has been held up as the bastion of medical safety and reliability. I have already written about the makeup of the FDA committees when they sit in deliberation. However let me add a new piece to the puzzle.
In what may be among the longest-running and widest-ranging cases of academic fraud, one of the most prolific researchers in anesthesiology fabricated much of the data underlying his research, said a spokeswoman for the hospital where he works.
The researcher, Dr. Scott S. Reuben, an anesthesiologist in Springfield, Mass., who practiced at Baystate Medical Center, fabricated data in some or all of the 21 journal articles dating from at least 1996, said Jane Albert, a spokeswoman for Baystate Health.

The reliability of dozens more articles he wrote is uncertain, and the common practice — supported by his studies — of giving patients aspirinlike drugs and neuropathic pain medicines after surgery instead of narcotics is now being questioned.

The drug giant Pfizer underwrote much of Dr. Reuben’s research from 2002 to 2007. Many of his trials found that Celebrex and Lyrica, Pfizer drugs, were effective against postoperative pain.
“Independent clinical research advances disease treatments and improves the lives of patients,” said Raymond F. Kerins Jr., a Pfizer spokesman. “As part of such research, we count on independent researchers to be truthful and motivated by a desire to advance care for patients. It is very disappointing to learn about Dr. Scott Reuben’s alleged actions.”
Last but not least, the government of any country is the last resort in the chain of medical responsibility. When all else fails and there is a epidemic, pandemic or global financial meltdown than the government steps in.

My question to you my dear reader is, how responsible are you going to be for the health care of you and your family?

Be well
Dr Sundardas