Anxiety and Sleep Medications

Anxiety and sleep medications can be dangerous, especially when used inappropriately. Zolpidem (Ambien) is a very common one that many people take to get to sleep at night. Alprazolam (Xanax) and clonazepam (Valium) are also fairly common drugs that are seen in the pharmacies and in the cupboards of many people. They are taken whenever a person feels anxious, which these days seems like all the time.

Zolpidem is classified as a sedative-hypnotic. It puts you to sleep and that is why so many people like it. Take one sometime before bed and it’s lights out for the next few hours. So what’s the problem?

Zolpidem affects a specific omega-subtype of the GABA receptor in the central nervous system. This subtype is what puts you to sleep but doesn’t seem to affect muscle tone and doesn’t show anxiolytic properties (anti-anxiety). This also may be why so many people have reported all kinds of crazy incidences of sleep walking or other activities without remembering a thing. You can read about some of those here:

http://www.peoplespharmacy.com/2013/01/10/fda-lowers-dose-of-popular-sleeping-pill-ambien-zolpidem/

As with many receptors it’s also likely that since they are being activated so often by meds like zolpidem they get down regulated with time and people don’t get the benefit of the drug. I’ve talked with several people in the pharmacy about this. They are so frustrated that they can’t get sleep. Some take double the dose that is normally prescribed and still only sleep a couple of hours.

This quite honestly scares me. I’m worried that some people are going to take it too far one day for that one night of sleep and then not wake up. We Americans especially forget that more isn’t better to a problem that actually requires less.

Another problems that scares me is the sharing of these types of meds between family and friends. This is especially true among teenagers. A recent article talks about this:

http://www.foxnews.com/health/2014/11/24/abuse-sleep-anti-anxiety-drugs-growing-issue-among-teenagers-study-shows/

SAMSHA (Substance Abuse and Mental Health Administration) reported that “the estimated number of emergency department visits involving zolpidem overmedication (taking more than the prescribed amount) nearly doubled from 21,824 visits in 2005-2006 to 42,274 visits in 2009-2010” [1]. By comparison they report that in 2010 there were a total of 4,916,328 drug-related visits to emergency departments throughout the nation.

It’s not the most abused drug in the country but it is on the rise.

Drugs like clonazepam mentioned earlier aren’t so selective as zolpidem and can cause other problems. Originally they were developed for people with seizure disorders and they work well for that. People now take them primarily for finding relief from anxiety and stress.

Like zolpidem, people can become tolerant to them over time and require higher and higher doses to get the desired effect. It’s no different from a person on pain medications. These are more likely to cause a euphoric effect on a person than the zolpidem and many become psychologically dependant. It’s very important to note that people wishing to discontinue these after having been on them for some time must do so slowly. The withdrawal symptoms in people on high enough doses can actually land them in the hospital and cause death. While going cold turkey off narcotics isn’t recommended it typically doesn’t cause death like the benzodiazepines (clonazepam, alprazolam) can.

What can a person do to help with sleep?

insomnia

Exercise seems to be beneficial to those who have insomnia. In a study with insomniacs, researchers looked at walking on the treadmill for 50 minutes at a time, 3 days a week for 6 months. What they found was that participants were able to fall asleep faster and had decreased amounts of wakefulness during the night. [2] The effect was seen in both the morning and evening groups.

Another study found similar results but the best were achieved in those performing moderate amounts of activity and not all out, balls to the wall type of stuff. It was also done on the treadmill for 50 minute intervals.[3]

In another analysis done in diabetics, the loss of belly fat with diet or exercise or a combination of both resulted in better sleep. [4]

There are other things that can help. Getting into a sleep schedule and actually going to sleep at the same time every day. I know that seems impossible or at best unlikely but it does help.

Managing a proper diet and exercise/activity level also decreases anxiety and symptoms of depression. I realize the catch-22 of people with depression. They don’t want to do anything, especially exercise. They don’t have the energy to do it and even if it makes sense logically that it will help, emotionally they are too drained to even think about it. If that’s you I encourage you to do whatever you can, even if it is walk to the mailbox. Any start is better than nothing.

CIAO

 

1.http://www.samhsa.gov/newsroom/press-announcements/201408111015

2.Passos, Giselle Soares, et al. “Effects of moderate aerobic exercise training on chronic primary insomnia.” Sleep medicine 12.10 (2011): 1018-1027.

3.Passos, Giselle S., et al. “Effect of acute physical exercise on patients with chronic primary insomnia.” Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine 6.3 (2010): 270.

4.http://www.hopkinsmedicine.org/news/media/releases/losing_weight_especially_in_the_belly_improves_sleep_quality_according_to_a_johns_hopkins_study

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Is Xylitol Safe?

xylitolWe continue on our journey of looking at different sweeteners today. Xylitol is on the menu today and so lets take a look at this substance and see what we discover. Xylitol is becoming popular in many foods and snacks. It’s a sweetener that is about as sweet as sucrose. It is found in nature but produced commercially chemically. On a personal note I think xylitol has what I can only describe as a “cooling” taste in my mouth, but that’s just me. So what else can we learn about xylitol. Study time!

Insulin and GI

In dogs after administration of xylitol and insulin response was seen. 1,2,3 Insulin did raise more with xylitol than with glucose. It is important to remember two big things from these studies; first is that these are dogs, second is these were infusions of xylitol rather than being ingested. Would ingested xylitol cause a greater response than glucose? I don’t know but it does appear to raise insulin.

After administration of xylitol, researchers measured a significant increase of insulin in the portal veins in man. 4

In another study 5 subjects were given 30gm glucose and 30mg xylitol (months apart) and their insulin responses as well as GIP and motilin. GIP (glucose-dependent insulinotropic peptide) is a hormone that increases insulin secretion. This action is greater when glucose is ingested rather than infused. Motilin does a number of things including stimulation of the motility of the gut. So in this study a solution of xylitol or glucose was given and they measured these factors. Insulin rose in both solutions but more so in glucose. In fact it was a very small increase with xylitol. GIP was not affected by xylitol but was by glucose. Glucose increased motilin and caused faster stomach emptying than xylitol. So what did the xylitol do you ask? Cause diarrhea. Yup it gave 3 of the 5 subjects the runs. The researchers attributed this to an osmotic difference. This is consistent with many reports that xylitol causes Montezuma’s revenge. The good part though is that it only happened that one time and after bowel evacuation the 3 volunteers had no more problems. 5 Very similar effects were seen in both men and rat subjects. 6

Another effect of xylitol, as mentioned above is that it can slow gastric emptying. This may be helpful to help a person feel full longer. A study looking at this gave subjects 25gm xylitol in solution at 10 AM. Others were given other sweet solutions such as fructose and sucrose. At 11 they were given a meal of eggs. The xylitol group maintained the food in their stomach for roughly 30min longer than the others groups. In another part of the study the same preloads were given and 1 hour later the subjects were allowed to eat at an “attractive buffet” (according to the researchers). Calorie intake was measured and the group that had 25gm preload of xylitol ate significantly less calories (690 +/- 45 with 25g xylitol vs 920 +/- 60 with water). 7

It think it’s important to keep this in context. These people were consuming 60 kcal before a meal to consume on average 230 kcal less. Now this would be a net reduction for the people in this study of 170kcal/meal. Not bad but the potential for diarrhea I’m sure would increase with that kind of dose if taken regularly.

So it appears that xylitol does have a very small impact on insulin and definitely the potential for an impact on your porcelain throne. It may also help you eat less when consumed about an hour before meals. What else can xylitol do?

Dental

Xylitol is touted as having beneficial properties on dental health, most especially with caries (cavities). One reviewer of articles believes this is due to increased saliva production from xylitol gum and candies rather than preventing bacteria from being able to metabolize the xylitol. 8 Saliva has chemicals that are responsible for tooth remineralization and health. Elderly folks who have chronic dry mouth are at increased risk of having caries. Some believe that streptococcus mutans (the bug responsible for laying down plaques and excreting acid) are responsible for caries and xylitol has been shown to stop this bug from doing it’s nasty deeds. 9,10 It’s possible that xylitol doesn’t interfere with the internal nutrient system in the individual teeth like sucrose does, but that is the topic of an entire article.

Don't let this be the result of poor dental health

Don’t let this be the result of poor dental health

An entire article looking at data has concluded that xylitol chewing gum is beneficial in preventing dental caries. 11 It should be noted it has to be done 3-5 times per day after meals and for at least 5 minutes. Chewing on one piece for 2 hours once a day might not do a thing. Another study done over 40 months in Belize showed that children who chewed xylitol gum had a significant reduction in caries over those who had xylitol-sorbitol combo and most definitely over sugar base gums. 12

Calories

Xylitol isn’t calorie free like some people may think. While sugar has close to 4kcal/gram, xylitol has 2.4kcal/gram. So if you’re using xylitol in cooking be aware that while you aren’t putting as many calories in that dish as sugar, you’re still putting calories into the food. So really you can only say that it is a lower calorie alternative to sugar, not a no calorie option.

Antibacterial

There are actually nose sprays that one can use to help treat sinus problem and maybe even help resolve sinus and ear infections. Xlear is one company that makes such products. Because the xylitol helps disrupt bacterial plaques it is thought that they can help balance in the nose and ear. I’ve never tried them but if you have and had success I’d love to hear about it.

Negatives

Some people have had problems with the gut after ingesting xylitol. As mentioned above xylitol can cause diarrhea and maybe fermentation can arise because it arrives to the colon pretty much untouched. There are no large trials that I know of showing adverse effects. Lack of evidence isn’t an indictment but for me xylitol goes into my book as once in a while probably ok but not regularly. This is a natural substance but you don’t get a lot of it naturally and there’s probably a reason for that. Sugar is also natural but really you don’t get a ton of it in nature all in one spot, at least in most areas. We humans condense it down and create abundance. If you are having ill effects but think you’re doing good for say your teeth, then you should reconsider using it. It’s never good to sacrifice one organ system for the other. Try to treat the whole system. Also, xylitol is toxic to your dog. Do not give xylitol to your dog!

If anyone has had any experience with xylitol please share down below. I love hearing anecdotal stories about how they affect different people.

CIAO

1.Kuzuya, Takeshi, Yasunori Kanazawa, and Kinori Kosaka. “Stimulation of insulin secretion by xylitol in dogs.” Endocrinology 84.2 (1969): 200-207.

2.Kuzuya, Takeshi, Yasunori Kanazawa, and Kinori Kosaka. “Plasma insulin response to intravenously administered xylitol in dogs.” Metabolism 15.12 (1966): 1149-1152.

3.Hirata, Yukimasa, et al. “Blood glucose and plasma insulin responses to xylitol administrated intravenously in dogs.” Biochemical and Biophysical Research Communications 24.3 (1966): 471-475.

4.Berger, W., et al. “Insulin concentrations in portal venous and peripheral venous blood in man following administration of glucose, galactose, xylitol and tolbutamide.” Hormone and Metabolic Research 5.01 (1973): 4-8.

5.Salminen, Eeva K., et al. “Xylitol vs glucose: effect on the rate of gastric emptying and motilin, insulin, and gastric inhibitory polypeptide release.” The American journal of clinical nutrition 49.6 (1989): 1228-1232.

6.Salminen, Eeva K., et al. “Xylitol vs glucose: effect on the rate of gastric emptying and motilin, insulin, and gastric inhibitory polypeptide release.” The American journal of clinical nutrition 49.6 (1989): 1228-1232.

7.Shafer, Rex B., et al. “Effects of xylitol on gastric emptying and food intake.” The American journal of clinical nutrition 45.4 (1987): 744-747.

8.Alanen, Pentti. “Does chewing explain the caries-preventive results with xylitol?.” Journal of dental research 80.7 (2001): 1600-1601.

9.Beckers HJ. Influence of xylitol on growth, establishment, and cariogenicity of Streptococcus mutans in dental plaque of rats. CariesRes 1988;22(3):166-73.

10. Grenby TH, Phillips A, Mistry M. Studies of the dental properties of lactitol compared with five other bulk sweeteners in vitro. Caries Res 1989;23:315-9.

11.Burt, Brian A. “The use of sorbitol-and xylitol-sweetened chewing gum in caries control.” J Am Dent Assoc 137.2 (2006): 190-6.

12.Makinen, K. K., et al. “Xylitol chewing gums and caries rates: a 40-month cohort study.” Journal of Dental Research 74.12 (1995): 1904-1913.

Artificially Sweet Seductions – Saccharin

sugar lipsIn the last post we looked at sucralose and it’s effect (or lack of) on insulin. It also has an effect on gut microbes. But sucralose isn’t the only artificial sweetener. Today lets look at saccharin and see what it can do.

Saccharin was discovered in 1878 by a chemist who when sitting down for dinner and noticed a sweet taste after a day at the lab. After tasting the substance he went back to the lab and began tasting everything to find the source. Serendipity led to the “discovery” of saccharin. And it was sweet.

It didn’t take a genius to figure out the implications and soon it began to be added to make things sweet. So the question is how does it affect blood sugar or insulin.

In one study participants, while fasting “sipped, and washed out their mouths with eight taste solutions (sucrose, saccharin, acetic acid, sodium chloride, quinine hydrochloride, distilled water, starch, and sodium glutamate) for 45 s and spat them out again”. 1 Insulin levels raised significantly with the sucrose and the saccharin solutions, but not the others. Blood glucose was not affected during any of the solutions. This study says that there is a potential to raise insulin with saccharin.

In another study different drinks were given to participants with either saccharin, aspartame or non-sweetened drinks and researchers looked at insulin levels.2 No significant difference in insulin levels were seen.

In another study similar to the first one listed, no differences were seen in any case with insulin. 3

In another study researchers gave sucrose or starch sweetened with saccharin in equal caloric amounts and measured insulin levels, glucose levels, triglycerides and glucose excretion. After 6 weeks and crossover for the two groups of another 6 weeks there was no difference. 4

It doesn’t look as though saccharin has a lot of influence on insulin, at least in these human studies. Again it would be good to have a long term study to really look at the impact on insulin and blood sugar. What about weight?

In a study with rats, when added to the diet, saccharin and aspartame increased weight gain. 6 But what about in humans?

To be honest I can’t find randomized controlled trials that show saccharin ingestion and weight increase. There are epidemiological studies that show associations but we all know these do not equal causation. There are many studies in rats that seem to show weight gain like the one I just mentioned above but I don’t always transpose what happens in rats to what happens in humans.

What has saccharin been found to do? In rats it appears to inhibit some digestive enzymes. 6 It also makes stomachs hemorrhage and causes iron deficiency anemia in rodents. 7 It should be noted these affects are in high doses, levels we humans probably wouldn’t get. Another study shows that saccharin reduces good bacteria in rats. 8 This is similar to what was reported with sucralose. This could be very problematic. While I haven’t seen any experiments in humans for this phenomenon I don’t doubt this is something that could translate over into humans.

The problem with most of these studies is that they’re short term. Long term nutritional studies are hard to do. A significant decrease in good gut bacteria probably won’t show up as anything over a 6 week period. Over a 6 year period or longer though that could be problematic. The gut is definitely a crucial part of overall health and disrupting good bacteria may lead to many problems from digestive to autoimmunity.

People have reported nausea and other gut dysfunction and have anecdotally correlated that with saccharin ingestion. It’s important to note that saccharin has a sulfa component to it, which is a major cause of drug allergies in many people. This could be part of the reason why nausea seems to be a problem. It could be a low level intolerance or allergy to this sulfa component. If you have a known sulfa allergy it would be good to avoid saccharin.

The FDA almost got a ban on saccharin back in the 70’s but it got defeated. They were concerned with bladder cancer in rodents. While a little saccharin here and there probably isn’t at all a problem for many, many others might feel its effects quickly. Ultimately the only way to know is to experiment with yourself but my advice is overall stay away from artificial sweeteners. Saccharin has a nasty aftertaste anyway.

CIAO

1.Just, Tino, et al. “Cephalic phase insulin release in healthy humans after taste stimulation?.” Appetite 51.3 (2008): 622-627.

2.Horwitz, David L., Michael McLane, and Peter Kobe. “Response to single dose of aspartame or saccharin by NIDDM patients.” Diabetes Care 11.3 (1988): 230-234.

3.Teff, Karen L., John Devine, and Karl Engelman. “Sweet taste: effect on cephalic phase insulin release in men.” Physiology & behavior 57.6 (1995): 1089-1095.

4.Cooper, P. L., M. L. Wahlqvist, and R. W. Simpson. “Sucrose Versus Saccharin as an Added Sweetener in Non‐insulin‐dependent Diabetes: Short‐and Medium‐term Metabolic Effects.” Diabetic medicine 5.7 (1988): 676-680.

5.Feijó, Fernanda de Matos, et al. “Saccharin and aspartame, compared with sucrose, induce greater weight gain in adult Wistar rats, at similar total caloric intake levels.” Appetite (2012).

6.Lok, Eric, Frank Iverson, and David B. Clayson. “The inhibition of urease and proteases by sodium saccharin.” Cancer letters 16.2 (1982): 163-169.

7.Okamura, T., E. M. Garland, and S. M. Cohen. “Glandular stomach hemorrhage induced by high dose saccharin in young rodents.” Toxicology letters 74.2 (1994): 129-140.

8.Mallett, Anthony K., Ian R. Rowland, and Carol A. Bearne. “Modification of rat caecal microbial biotransformation activities by dietary saccharin.” Toxicology 36.2 (1985): 253-262.

Disclaimer: All info on this website is for education purposes only. Any dietary or lifestyle changes that readers want to make should be done with the guidance of a competent medical practitioner. The author assumes no responsibility nor liability  for the use or dissemination of this information. Anyone who chooses to apply this information for their own personal use does so at their own risk.

FDA Says Down with HCG

Here is one of many links you can look at: http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM281457.pdf

Here is the last paragraph from the above site;

FDA advises consumers who have purchased homeopathic HCG for weight loss to stop using it, throw it out, and stop following the dieting instructions. Harmful effects should be reported online to FDA’s MedWatch (www.fda.gov/Safety/MedWatch) program or by phone at 800-FDA-1088 (800-332-1088) and to the consumer’s health care provider.

Finally some common sense. Granted it appears that the FDA is looking at it more from a legal standpoint than an actual efficacy standpoint, they are pointing out that the HCG part of the program does absolutely nothing to help reduce weight. As I mentioned in another recent post, anyone who eats only 500 Calories/day is going to lose weight. It’s just going to happen.

If you have been fed the HCG propaganda by your doctor or the internet please get a new doctor (unless he/she can admit he/she was wrong and know why and apologizes to you) and quit looking at every product with some hot picture of some hot fitness model. Those pics are doctored up and they are made that way to sell product. If you want some more evidence, watch the documentary Bigger, Stronger, Faster by Chris Bell. In the following pic he shows just how deceptive altering a pic can be.

Getting shredded in 6 weeks is easier than you think...NOT!

Chris describes in his documentary that it is common for the photographers to photoshop the pics. In the pic above, Chris shows what they can do. Both pics are of him…on the same day. They waxed him, had him shave, gave him a fake tan, took in his gut and added some light 6 pack lines while telling him to act depressed for the first pic and happy for the second. Good work.

Drug companies do this all the time with their commercials. It’s really almost like the beer commercials with the hot babes in bikinis and parties. Only for drugs it’s living that perfect dream life where everything, but your cholesterol is wonderful and if you take that statin, you will be even more wonderful. Uh huh.

Don’t do drugs to lose weight, do exercise and change some dietary habits. Stay away from sugar. Eat fewer Calories than you utilize in a day. Above all else remember, if you see something like this

yeah she has a hot bod, but she didn't get it with what she's about to sell you

Walk away from the computer and go for a jog. It will do your wallet and you thighs some good.

CIAO

The Brute

Disclaimer: All info on this website is for education purposes only. Any dietary or lifestyle changes that readers want to make should be done with the guidance of a competent medical practitioner. The author assumes no responsibility nor liability  for the use or dissemination of this information. Anyone who chooses to apply this information for their own personal use does so at their own risk.