All Things Omega Fish oil is one of the topics I like to write about the most because it is so crucial to overall health. The word omega comes from the last or 24th letter of the Greek alphabet. The definition is the end or extreme and final part. When thinking about omega and omega 3 in particular, I wouldn't put it at the end of the supplements I take but at the beginning, as it is part of our core four nutrients for foundational nutrition. Omega-3, omega-6, and omega-9 fatty acids are fats that are super important for your body . You might have heard about or seen them on food labels, but what makes them different? Let's break it down simply by looking at what they are, where you find them, and how they help (or sometimes harm) your health. Omega-3s are a type of fat called polyunsaturated, which means they have a unique chemical structure with multiple double bonds. Your body can't make omega-3s on its own, and that is why we refer to them as an essential fatty acid; you need to get them from food. There are three main kinds: ALA (found in plants like flaxseeds, chia seeds, and walnuts), and EPA and DHA (found in fatty fish like salmon, tuna, and sardines). Omega-3s are like superheroes for your body. They help reduce inflammation, essentially calming down swelling or irritation inside you. They're great for your heart, helping to lower bad fats in your blood and keep your blood pressure in check. Omega-3s also support your brain, helping you think clearly, and they're essential for healthy eyes. Eating foods like fish or adding flaxseeds to your smoothie can boost your omega-3s. Omega-6s are also polyunsaturated fats; like omega-3s, your body needs them from food because it can't make them. The primary omega-6 is called linoleic acid, and you find it in vegetable oils (like corn, soybean, or sunflower oil), nuts, seeds, red meat, and lots of processed foods like chips and fast food. Omega-6s are important for healthy skin, hair, and bones and help your body use energy . But here's the catch: too many omega-6s can cause inflammation, which might lead to problems like heart disease if you overdo it. Most people eat way more omega-6s than omega-3s (like 20 times more!), but a healthier balance is closer to 4 times more or less. Reducing junk food and eating more fish or veggies can help fix this. Omega-9s are different because they're monounsaturated, meaning they have just one double bond in their structure . Your body can make omega-9s, so they're not "essential" like omega-3s or omega-6s. You find them in foods like olive oil, avocados, and almonds. Omega-9s are great for your heart. They can raise your "good" cholesterol (HDL) and lower the "bad" cholesterol (LDL), which helps keep your blood vessels healthy. They also reduce inflammation and might make your body better at using sugar, which is good for preventing diabetes. Adding olive oil to your salad or snacking on avocados is a tasty way to get omega-9s. The significant differences are that omega-3s and omega-6s are essential (you need to eat them), while omega-9s aren't. Omega-3s fight inflammation, omega-6s can increase it if you overeat, and omega-9s support your heart. To stay healthy, eat more omega-3 foods (like fish or flaxseeds), cut back on omega-6-heavy proc essed foods, and include omega-9s from things like olive oil. A balanced diet keeps these fats working together to keep you strong! Fish oil is famous for its omega-3 fatty acids, but it also contains small amounts of lesser-known nutrients that are beneficial for your body. These are some of the additional nutrients contained in fish oil. One key ingredient in fish oil is vitamin D . This vitamin acts like a hormone and helps your body absorb calcium, keeping your bones strong and healthy. It also supports your immune system, allowing you to fight off colds and other bugs. Most people don't get enough vitamin D, especially in winter when sunlight is low so that fish oil can be a significant boost. Another critical component is vitamin A, found in some fish oils, especially those from cod liver. Vitamin A is fantastic for your vision, helping you see better in low light. It also keeps your skin healthy and supports your immune system so you stay strong against infections. Fish oil also contains antioxidants , like astaxanthin in some types, which protect your cells from damage caused by free radicals (think of them as tiny troublemakers in your body). Antioxidants may reduce inflammation and keep your skin and heart healthier. Lastly, fish oil has small amounts of minerals like selenium , which supports your thyroid and immune system. These nutrients work together to make fish oil a powerful supplement. Adding fish oil to your diet, through capsules or foods like salmon, can give you these extra benefits beyond omega fatty acids, helping you stay healthy and energized! Fish oil is well-known for its health benefits, especially for the heart and brain. However, many people don't know about the benefits of pro-resolving mediators (PRMs) . This nutrient is essential in reducing inflammation and keeping our bodies healthy. PRMs are unique molecules that help the body end inflammation after it has done its job. When we get hurt or sick, inflammation helps us heal—but too much can be harmful. PRMs help calm things down and restore balance, which can protect against chronic diseases like arthritis or heart problems. PRMs can be taken separately or in combination with a product that combines them with omega-3s and other ingredients. A high-quality fish oil supplement that includes PRMs can support better health, especially for people with inflammation-related conditions. Omega 3 and 6 testing can easily be done with a finger stick at home. You have heard me talk about testing the oil in our cars, but we seldom test the oil in our bodies. This is a great opportunity to check these oils and make sure the products we are taking are providing the benefits we hope for. I hope you find this information helpful in your health journey. If you would like help or more information about fish oil and testing, do not hesitate to contact the pharmacy, as we would be more than willing to help you at 701-483-4858. All my articles can be found online at our website, www.irsfeldpharmacy.com . My podcast, "The Irsfeld Pharmacy Optimal You Podcast," can also be accessed through the website. Until next time, be vigilant about your health!!

Spring is one of my favorite seasons as it is like the rebirthing of plants that have been dormant during our cold winter. Every day brings something new in the yard and gardens from perennials popping up all over the place to the beautiful green leaves filling in the barren trees. Spring is also the time pollen counts are on the rise prompting me to write and article about allergies and how to treat them so buckle up and enjoy the ride and hopefully I can help you get to a better place in your allergy battle. There are two reasons for addressing allergies. First is that I want to help patients achieve some level of relief by developing lifelong strategies. The second is to address the way we often go about dealing with allergies which is by playing catch-up, while only treating symptoms, essentially blocking the body’s natural response, without looking to strengthen the body’s response to the allergens. Therefore, I have to wonder if we go about “treating” allergies all wrong? Many people are looking for natural alternatives out of personal preference, as well as the side-effects that common over the counter allergy medicines can cause such as drowsiness, dry mouth, feeling jittery, difficulty sleeping, rebound congestion, and even raising blood pressure. Conventional treatments only calm symptoms . Antihistamines are used to block histamine at the receptor site. Histamine is released in response to exposure to an allergen and which stimulates the histamine receptor causing the symptoms of swelling, runny nose, itchy eyes, and hives, just a few reactions. Decongestants shrink blood vessels decreasing swelling and congestion but can also lead to unnaturally stimulating the body, kind of like running your car on a high idle. If this is not good for your car, what could it do to your body after prolonged and continual stimulation? Nasal decongestants are the worst as they work incredibly well for a couple of days but then your body gets used to them and once that happens, they cause increased congestion. We refer to this as rebound congestion which requires more frequent use to get an ever-weakening benefit. If you learn anything from this article, please avoid decongestant nasal sprays. What if we were able to support and strengthen these pathways, allowing the body to operate in its natural state? Could this be a better approach? When looking for natural relief during allergy season, I like to focus on four main areas: (1) the health of the immune system, (2) how the body responds to allergens and environmental factors, (3) supporting healthy mucosal linings such as nasal passages, and (4) stabilizing the mast cells to help prevent excessive histamine release before it ever happens. If you can avoid allergens, that is often the best solution, however, we know that quarantining can get old in a hurry so staying indoors forever is not an option but keeping your windows closed will help decrease your exposure to allergens. You might also consider an air purifier which can remove allergens in your home. Nasal irrigations are a mechanical solution and involves something most people find offensive, shooting water up your nose. There are several options to consider: Neti Pot, NeilMed Rinse bottle, and nasal nebulizers. They are listed in order from the least amount of pressure used to the most. These products will physically wash the sinus mucosa and rinse away the allergens. Performing this procedure twice a day can provide great benefits for patients. As a side note, for the patient with chronic sinus infections, we can compound capsules with antibiotics, antifungals, and steroids that can be added to the rinses to help treat those infections. Sinus infections are one of the most difficult infections to treat due to lack of blood flow so by taking the treatment directly to the infection, the patient often has had better results without wreaking havoc on the bacteria lining the intestinal tract. This compound requires a prescription from your provider if it is an option you would like to pursue. Here are some of my favorite natural ingredients to help during allergy season . Quercetin has strong antioxidant activity and has been shown to support immune health by decreasing the release of inflammatory compounds including leukotrienes and prostaglandins. Quercetin is known for its ability to stabilize mast cells, diminishing the release of histamine, the compound known to cause hypersensitivity reactions during seasonal changes. Stinging nettles leaf is a plant that has been shown to balance immune response, specifically in the airways and nasal passages. Studies have shown that the extract of stinging nettles leaf balances a variety of inflammatory activities that affect respiratory health. Bromelain is a plant enzyme naturally found on the stem and fruit of the pineapple plant. Bromelain is a proteolytic (protein-digesting) enzyme that aids in the breakdown of large protein complexes, including antigenic compounds, and has been shown to enhance the absorption of quercetin. Bromelain has been shown to reduce circulating allergenic protein complexes associated with hyper-immune sensitivity and seasonal discomfort. N-acetyl cysteine (NAC ) is an amino acid precursor to one of the most important antioxidants in the body, glutathione. Both glutathione and NAC help reduce the viscosity of the mucus allowing for clearing of the airways and improved respiratory health. Vitamin C cannot be synthesized by humans and is, therefore, an essential nutrient that must be consumed in the diet. Among its numerous health-promoting properties, vitamin C is an essential vitamin that supports the immune system and is also a potent antioxidant. When the body is under a significant amount of stress, vitamin C is excreted rapidly. Vitamin C has many immune-boosting properties but is distinctively beneficial for individuals with seasonal discomfort because of its ability to deactivate histamine. And lastly, Deglycyrrhizinated Licorice Root (DGL) which is the root of the licorice plant has been shown to have expectorant (mucus-loosening) properties in humans, thus providing healthy respiratory support. It also acts as a demulcent by soothing irritation in mucous membranes. The beauty of working with these natural ingredients is that you can get them all in one product, AllerPro so you don't have to source them individually. These ingredients work great for seasonal allergies, but they are also effective against environmental allergens inside and out of the home, so you are covered from season to season. Seasonal allergies are a common occurrence and are often resolved with a strategy like the one discussed however, there is a group of patients who have excessive allergy symptoms. This group of patients have a super twitchy immune response to allergens, often year around, and sometimes quite debilitating. For this group with have other options to tame down the immune response. If you would like help or more information about natural treatment option for seasonal allergies, do not hesitate to contact my pharmacy staff, as they would be more than willing to help you at 701-483-4858. All my articles can be found online at our website, www.irsfeldpharmacy.com . My podcast, "The Irsfeld Pharmacy Optimal You Podcast," can also be accessed through the website. Until next time, be vigilant about your health!!

Welcome back to all things Leaky Gut . Last week I went over what it is, some of the symptoms, and lastly the causes of leaky gut. The testing of leaky gut was also reviewed and as promised, I will dig deeper into the test and what the results mean. Lastly, we will discuss the treatment of leaky gut and possible retesting. Hippocrates in around 400BC stated, “all disease begins in the gut”. Gastroenterologist and the person who discovered zonulin, a leaky gut marker, Dr Alessio Fasano in 2020 took this concept a little further in a paper looking at zonulin and leaky gut and stated, “all disease begins in the leaky gut”. The leaky gut test I like to use is from a company called KBMO, it is called the Gut Barrier test and tests for occludin, zonulin, and lipopolysaccharides and a bonus marker for candida. If these are present in our blood, which is where they shouldn’t be, our body develops a defense against them, in the form of antibodies, to protect our bodies. Additionally, food sensitivity testing can be added to this test which is another important test to see which foods are potentially causing inflammation in your system. All the markers being tested are important in the gut barrier test, but one marker stand out, lipopolysaccharide or LPS because it is a signal for systemic inflammation. Some of the concerning characteristics of LPS include: • It is an endotoxin – a toxic substance found in the outer membrane of Gram- negative bacteria • Acts as extremely strong stimulator of the innate immune system • Triggers release of vast number of inflammatory cytokines • Crosses the blood brain barrier – LPS gets into the central nervous system potentially causing brain issues • Can create damage to the gut, joints, heart, liver, thyroid and lungs along with affecting metabolic and immune systems The huge takeaway from having LPS enter your system is that LPS is a trigger to inflammation and potential autoimmunity. If you have inflammation, getting a gut barrier test done may be the key to finding and addressing the root cause of the inflammation After performing the gut barrier test and finding out that you have a leaky gut, what are the treatment options? The 5-R protocol is the most comprehensive gut overhaul to consider if you are looking to get back on track. Here is the explanation of what this protocol looks like: 1. Remove all dietary triggers such as gluten, dairy, sugar, artificial sweeteners, soy, and alcohol. All processed foods and beverages should be eliminated along with unnecessary medications. Stop eating any foods you suspect you are allergic to or cannot tolerate or do a food sensitivity test to make sure you know which ones these are. This is also the place where killing agents can be used to tame opportunistic bacteria and fungus, so herbs like berberine, oregano, and garlic play a part in the removal process. 2. Replace the eliminated foods with fresh fruits and vegetables, high-quality protein, and healthy fats. Add fermented foods (sauerkraut, kimchi, kombucha) to your daily diet. If you struggle in this area, a good diet to look at would the Mediterranean diet which incorporates all the listed ingredients. Digestive enzymes to help with digesting food along with betaine hydrochloride when there is an issue with low stomach acid can be incorporated. Patients with stress issues are often unable to produce these when they are in state of “fight and flight” which is the opposite of the stress free “rest and digest” state. 3. Reinoculate your GI tract with beneficial bacteria to help restore and rebalance the microflora. A probiotic supplement containing L. acidophilus and B. lactis strains, in addition to akkermansia, these are all types of bacteria that should be added to your daily diet in addition to at least one serving of a fermented food. 4. Repair your GI tract with targeted supplements and lifestyle modifications intended to promote healthy inflammatory markers and accelerate healing. Repairing the gut can incorporate products containing zinc carnosine, glutamine, colostrum, and ingredients that are mucus like so okra, slippery elm, marshmallow, aloe vera, and licorice root. 5. Retain the gains . Gut health is an ongoing process. Adopt the eating, exercise, and stress management strategies you have been incorporating as part of your new lifestyle. Continue to eliminate dietary triggers, follow a clean eating plan, and take any nutritional supplements recommended by your healthcare practitioner. The 5R protocol also incorporates macronutrients such as omega 3 fatty acids and prebiotic/fermentable fibers are helpful in closing the tight junctions. Micronutrients such as Vitamin A and D have data to support the healing of tight junctions so optimizing those levels can be helpful. The 5R program can be a little daunting as it incorporates lifestyle modifications along with a few dietary supplements however, for patients who have been struggling with gut issues for long periods of time, the protocol can be a huge benefit to those individuals. Leaky gut is a big deal and one that is not spoken about in traditional medicine. The ability to test for markers which would indicate a patient has a leaky gut is a huge advancement in gut health. If a patient’s test comes back indicating they have a leaky gut, we have protocols that can help heal and then retest to make sure we are successful in this process. So many of the topics I discuss in this weekly article feed back to the concept that inflammation is the cause of many of our health issues and leaky gut can be a key component in this battle against inflammation. Stop by the pharmacy or call 701-483-4858 to schedule a consultation to explore testing and treatment of leaky gut. Please visit my website at www.irsfeldpharmacy.com to view this and other health related articles in the blog section. Until next time, be vigilant about your health!!

This week’s article will cover Leaky Gut , a topic discussed previously but now has some new developments especially in the form of testing. Why does so much of my focus revolve around the gut? Hippocrates stated in the 460AD, “All disease begins in the gut”. If this is true, which I believe it is, it is critical that we work hard as we can to make our intestinal tract happy and healthy. Before diving into leaky gut, we need to look at our immune system and how our gut is an important part of our immune system. One part of our immune system has to do with structure, so think skin, lungs, and gut or gastro-intestinal tract. If these areas are compromised, we can let things get into our system that don’t belong there and can eventually cause issues. Leaky gut is also referred to as hyper-permeable gut and the concept is surprisingly quite simple. Our intestinal tract is a tube that runs through our bodies from our mouth all the way to our backside. This tract, or tube is a closed system where when it is healthy, only the things that our bodies are designed to let in get in. It is a barrier to protect our bodies from things like bacteria, virus’, toxins and undigested food. When intact, it is one cell thick and these cells are packed tightly together allowing only small particles or nutrients to be absorbed through and between the cells. When the lining of our gut becomes damaged, it becomes more permeable or porous, developing gaps between these cells and our gut becomes leaky. Think of a bowl that has now become a sieve. These gaps allow foreign substances to be absorbed and our bodies begin to develop antibodies to these substances. This is the start of an inflammatory process. It is in this process where the problem becomes amplified with repeated exposure to certain foods, which can make the immune response go crazy. One such food is gluten a protein complex found in wheat, barley, spelt and rye. Many people believe that gluten sensitivity and gluten free diets are is just a fad or a health craze that will soon go away. Gluten sensitivity is a IgG response to gluten. It is not an anaphylactic reaction but a low-level inflammatory response this is often times not immediate. When embarking on a gluten free diet, it takes some time for your system to purge itself of gluten and then to have the inflammation subside after the gluten has been removed. The process takes 3 weeks and even a small amount of gluten exposure resets the clock. If there is not complete removal of gluten or any food, it will be hard to correlate a food sensitivity as the cause of their illness. Gluten, unfortunately, is in almost every meal that is in the Standard American Diet and if you don’t remove it over a period of time, you will never rid yourself of the inflammation. I recommend that patients go on a modified elimination diet if they have a chronic disease. This diet is designed to remove the most allergenic foods: gluten, dairy, eggs, corn and sugar . Many of those patients who adhere to the diet for 2-3 weeks find themselves feeling better that when they were not on the diet. What are the signs or symptoms of leaky gut? • Digestive issues such as gas, bloating, diarrhea or irritable bowel syndrome. • Diagnosis of candida overgrowth. • Seasonal allergies or asthma. • Diagnosis of chronic fatigue or fibromyalgia. • Hormonal imbalances such as PMS or PCOS. • Diagnosis of an autoimmune disease such as rheumatoid arthritis, Hashimoto’s thyroiditis, lupus, psoriasis, or celiac disease. • Mood and mind issues such as depression, anxiety, ADD or ADHD. • Skin issues such as acne, rosacea, or eczema. • Food allergies or food intolerances. One of the reasons leaky gut is hard to pin down is that it can be hard to correlate skin issues, fatigue and seasonal allergies or any of the other symptoms as coming from the same source. Cause of leaky gut can be lumped into 4 main areas: foods, infections, toxins, and stress . For most cases it is not one individual thing but the sum of many factors. • Toxic foods provide little nutritional value, can deplete nutrients and slow the gut down causing it to produce more toxins. Processed foods invariably are low in nutrients and fiber, with high levels of food additives, chemically modified fats, and sugar. These foods promote inflammation of the GI tract. • The most common infectious causes are candida or yeast overgrowth, intestinal parasites, and small intestine bacterial overgrowth. Taking antibiotics can affect the balance and nature of bacteria on our gut. • Toxins come in the form of medications like ibuprofen and naproxen, steroids, antibiotics, and acid-reducing drugs, and environmental toxins like mercury, pesticides and BPA from plastics. Toxins stress our immune system and the body's ability to repair itself. • It seems like stress is a recurring theme in many chronic conditions . It is tough to see the correlation between stress and our GI system but it is ongoing but in the presence of stress our body’s immune response is diminished. How can we tell if we have a leaky gut? The best way is to find out if you have antibodies in your blood of things that shouldn’t be in your blood. The test I like to use is from a company called KBMO, it is called the Gut Barrier test and tests for occludin, zonulin, and lipopolysaccharides and a bonus marker for candida. If these are present in our blood, which is where they shouldn’t be, our body develops a defense against them, in the form of antibodies, to protect our bodies. You will be pleasantly surprised by the cost of the test in relation to the information it provides. In next week’s article, I will further discuss the results of the KBMO test and what it means along with treatment options to help heal a leaky gut and ultimately, take control of your health. Stop by the pharmacy or call 701-483-4858 to schedule a consultation to explore testing and treatment of leaky gut. Please visit my website at www.irsfeldpharmacy.com to view this and other health related articles in the blog section. Until next time, be vigilant about your health!!

The body content of your post goes here. To edit this text, click on it and delete this default text and start typing your own or paste your own from a different source.

The body content of your post goes here. To edit this text, click on it and delete this default text and start typing your own or paste your own from a different source.

Have you ever been told that something easy and it turned out to be hard? The topic of this article has some easy ways to decrease the risk of getting cancer. So where does the “easy” button come in? When I go to my accountant’s office, they have this huge button with the word EASY on it. When you push the button a computerized voice says, “that was easy”, based on the current tax laws, I question how often that button gets pushed. I think we can all agree that reducing the risk of cancer is a topic that should pique our interest as cancer has affected so many people personally and in their families. Today’s article will look at some simple, EASY, and inexpensive ways to lower your cancer risk. Most of the reading I do revolves around health and wellness, but every once in a while, I sneak in a Jack Reacher or Gray Man book to mix it up. The reason I read health related topics is twofold, first, I’m always looking for a topic to write for this weekly article and secondly, I really enjoy the subject and am always wanting to learn more information on how to be healthier. In a recent social media dive, I came across a study titled “Combined Vitamin D, Omega-3 Fatty Acids, and a Simple Home Exercise Program May Reduce Cancer Risk Among Active Adults Aged 70 and Older”. The study was published in 2022 in the publication Frontiers in Aging and must not have gotten much uptake especially in the media which was quite shocking. As people get older, their risk of developing cancer naturally increases. Scientists have been looking for safe, simple ways to lower this risk, especially for older adults. A recent study titled “Combined Vitamin D, Omega-3 Fatty Acids, and a Simple Home Exercise Program May Reduce Cancer Risk Among Active Adults Aged 70 and Older” explored whether combining three easy-to-follow health habits could help prevent cancer in people aged 70 and above. The study wanted to find out if taking vitamin D supplements, omega-3 fatty acids, and doing a simple home exercise program could work together to lower the chances of getting cancer. Researchers already knew that each of these things — vitamin D, omega-3s, and exercise — might have some benefits on their own. But no one had tested what would happen if older adults did all three at the same time. The study included over 2,100 healthy adults aged 70 and older from five different European countries: Switzerland, Germany, Austria, France, and Portugal. These participants were all still active and living independently when the study began. The average age was around 74 years old. The researchers randomly divided the participants into eight different groups. This was so they could test different combinations of the three treatments (vitamin D, omega-3, and exercise) to see how they worked separately and together. • Some participants took a vitamin D supplement (2000 IU per day) • Some took omega-3 fatty acid capsules (1 gram per day) • Some followed a simple home strength exercise program (3 times per week) • Others took placebos (fake pills with no real effect) or didn’t do the exercise program The exercise program was designed to be easy and safe for older people to do at home. It included basic movements like standing up from a chair, balancing exercises, and light strength training using body weight. The study lasted for three years, during which the researchers tracked who developed cancer and who didn’t. The results were very interesting. On their own, taking vitamin D, omega-3 fatty acids, or doing the exercise program slightly reduced cancer risk, but the changes weren’t very big. However, when participants combined all three interventions together — taking vitamin D, omega-3 supplements, and doing the simple exercise program — the results were much more impressive. The group that did all three saw a 60% reduction in the risk of developing cancer compared to the group that did none of them. This means that doing these three simple things together may have a powerful effect in lowering cancer risk in healthy, older adults. Each of these three habits helps the body in different ways: • Vitamin D helps keep bones strong and may support the immune system, which is the body’s natural defense against diseases like cancer. • Omega-3 fatty acids are healthy fats often found in fish. They can reduce inflammation and may help cells stay healthy. • Exercise improves overall health by strengthening muscles, improving balance, increasing energy, and possibly boosting the immune system. • When combined, these three healthy habits may work together to make the body stronger and better at preventing cancer cells from growing. This study is important because it shows that simple, everyday actions can have a big impact on health — especially for older adults. None of these treatments were expensive or difficult to do. Vitamin D and omega-3 supplements are easy to take, and the exercise program could be done at home without needing to go to a gym. Also, this study involved a large number of people across several countries, making the results more reliable. While these results are very promising, the researchers say that more studies are needed to confirm the findings and see if the benefits continue over a longer time. But for now, it gives hope that older adults can take easy steps to lower their cancer risk and stay healthy. If you are reading this article and are under the age of 70, it is not guaranteed that the benefits will extend to individuals of younger ages. However, incorporating these items into your daily routine should be straightforward. If you are questioning whether you need to take these nutrients, we can always test for vitamin D and Omega 3’s with simple at home tests to find out if you are deficient. Circling back to the EASY button , it’s time to press it today and get started on a program that can decrease your cancer risk easily. My staff and I would like to help you with questions regarding lowering your cancer risk, so call or stop to schedule a consultation. Please visit my website at www.irsfeldpharmacy.com to see this and other archived articles in the blog section. Until next time, be vigilant about your health!!

Last week's article covered the basics of uric acid, what happens when it is elevated, the causes of the elevation, and how to decrease uric acid in your system. Today's article will cover another the dark side of uric acid from the book Drop Acid by Dr. David Perlmutter, looking at the evolution of uric acid and some surprising influences that affect its level. May the force be with you, as you venture into more information!! Uric acid has been downplayed as a little know metabolic waste product that has little to do with our overall health unless it becomes so high that gout and renal stones occur, as discussed last week. Based on that statement, that is many providers today have been educated on the effects of uric acid in our bodies, including my pharmacy education. We are going to take a step backward and look at the inner workings of our bodies and the formation of uric acid, and what happens when it starts to increase. Purines are directly converted into uric acid , our body naturally produces about 2/3 of them, and the other 1/3 is obtained externally in our diet. Purines alone are not bad, but when they become elevated, they become a concern. A study looking at heart disease found that elevated uric acid correlated with increased blood pressure. The high uric acid causes oxidative stress, constricts blood vessels, and constant elevation of uric acid causes lasting injury and inflammation in the kidneys, making them unable to ride our bodies of excessive salt, causing increased blood pressure. They found that 90% of patients with newly diagnosed high blood pressure had high uric acid and when treated with allopurinol, 85% of the patient's blood pressure normalized. The study and ongoing research prove that high uric acid is a problem for all of us. Our bodies have evolved, and most mammals have an enzyme called uricase which breaks down uric acid so that elevations don't occur. Humans do not have that enzyme, and here is the reason why. Thousands of years ago, when food was not always available like today's, man would eat as much as possible when food was plentiful. During times when fruit and meat were abundant, they would gorge themselves. Meat contains purines, and the fructose in fruit is converted to purines as well, elevating our uric acid. Without uricase to break down uric acid, our bodies would start to store the excess calories from fructose into fat. This excess fat would allow us to survive during lean times. A yearly cycle of increased fat, then fat is used for survival, and the cycle continues. Herein lies the concern, we do not have times when food is unavailable for us to eat. There are no lean times where we need to draw on our fat stores because food is always plentiful, so our bodies continue to pack on fat that never gets tapped into unless we consciously try to eliminate the fat. A major hit to our dietary habits was the increased consumption of high fructose corn syrup from 1970 to 1990, which increased by 1000% during this period. This surge coincided with increased obesity and other health conditions aggravated by elevated uric acid levels. Consuming fructose is associated with impaired glucose tolerance, insulin resistance, high blood fats, and high blood pressure. Fructose does not trigger the production of insulin and leptin, and these two hormones are responsible for regulating our metabolism; therefore, diets containing high amounts of fructose lead to obesity and the metabolic backlash that follows. Fructose also increases uric acid, which leads to other health issues. Studies show that men with a uric acid above 7mg/dl and women above 5mg/dl significantly increased all-cause mortality and cardiovascular mortality, meaning those with increased uric acid are more likely to die from diseases than those with a lower uric acid level. However, the optimal level seems to be less than 5.5mg/dl. Elevated uric acid = inflammation, and as you know, inflammation is a driver for most diseases and illnesses, from cardiovascular disease to Alzheimer's disease. What do we do with this information? The first thing would be to measure our uric acid and find out if you are a person that has elevated uric acid without the typical gout symptom. Testing can be done in your doctor's office with a blood test. They now have at-home uric acid monitors like those used to test blood glucose. Simple steps that apply to anyone, not just those with high uric acid, include exercising, getting adequate sleep, staying hydrated by drinking ½ your body weight in ounces of water per day, reducing stress, and decreasing sugar and processed food consumption. Last week I talked about using allopurinol and febuxostat, prescription medications, to lower uric acid. There are natural products that can also help reduce levels. Quercetin is a polyphenol with an antioxidant and anti-inflammatory benefit that is helpful in the fight against inflammation. Quercetin can be used as a natural xanthine oxidase inhibitor, like allopurinol. Any product inhibitor of xanthine oxidase will naturally lower uric acid levels. A dose of 500mg of Quercetin daily should get the job done. Luteolin is another natural xanthine oxidase inhibitor; additionally, it has been shown to prevent the dysfunction of beta cells in the pancreas. If the effects of the beta cells diminish, your body's ability to produce insulin helps with blood sugar regulation. Taking 100mg daily seems to be a good dose for luteolin. You all know of my love for omega 3 fatty acids, and DHA or docosahexaenoic acid is the omega 3 that can be beneficial for patients with elevated uric acid. DHA has anti-inflammatory benefits and is especially helpful in treating the brain. Fructose can harm the brain, and it appears that DHA is protective for the brain and offsets the destructive effects of fructose. A dose of 1000mg per day is recommended. Vitamin C at a small dose of 500mg per day helps lower uric acid levels by increasing urinary excretion and decreasing kidney reabsorption. Because it is a potent antioxidant, it can help lower the tissue damage caused by high uric acid. In summary, elevated uric acid is a huge health concern, you need to get it tested, high fructose corn syrup should be avoided at all costs, and there are ways to lower the uric acid burden and gain back your health. My staff and I would like to help you with questions regarding uric acid and inflammation, finding suitable treatment options to lower the burden, so call or stop to schedule a consultation. Please visit my website at www.irsfeldpharmacy.com to see this and other archived articles in the blog section. Until next time, be vigilant about your health!!

Dispensing medications in our pharmacy for gout attacks isn't common, but we do dispense a fair amount for prevention. One of the talking points I like to discuss with patients is what gout has been referred to over the years, "the rich man's disease" or "the disease of kings." The response from patients is usually one of denying that they are rich or even a king. Gout got these names because it can be attributed to a diet heavy in meat, fish, and alcohol, which were only affordable to wealthy people during specific historical periods. In today's day, many people have access to a diet that could possibly set them up to have an increase in uric acid-causing gout. If you could discuss gout with a person who has gone through a gout attack, they will not speak fondly of the condition as it is extremely painful. Gout is a form of inflammatory arthritis characterized by excessive uric acid in the synovial fluid , which fills the space between our joints. When the concentration of uric acid gets too high, crystals start forming in the joint, and if you can imagine, having a crystal grinding into the bones of your joint will be very painful. The joint most often affected is the big toe, but it is not specific to that joint. Another medical condition caused by elevated uric acid levels is renal stones. Uric Acid renal stones form from the build-up of uric acid in the kidneys, and if the condition is chronic, small stones can develop from the excess. Uric acid is one of four different types of kidney stones. Our bodies get rid of uric acid via our kidneys, so small stones start to form if we have an excess amount. These stones, if small, are readily excreted in our urine, but if they grow to a large size, they can pose quite a problem for removal. Research shows that about 1 in 10 people may develop a kidney stone, with males more likely than females to develop one. Hyperuricemia is the medical term for high uric acid levels, and a study done in 2015-2016 showed that about 20% of the US population suffers from this condition. The incidence of patients with gout from the 1960s to the 1990s has doubled in our country during that time. The increase in gout coincides with the increased consumption of high fructose corn syrup over that same period, which I will discuss later in this article. There are a couple of ways to treat an elevated uric acid level. The first is to decrease the consumption of foods rich in purines and increase the consumption of low-purine foods. Purines are amino acids or building blocks that convert into uric acid; therefore, reducing exposure to foods containing purines can solve the problem in many instances. The most common purine-rich foods include animal proteins, such as beef, poultry, pork, eggs, shellfish, and organ meat. Some vegetables contain purines, but eating too many is impossible to cause a problem. Drinking adequate amounts of water is essential for diluting urine ; it reduces the concentration of waste products. You will want to drink enough fluids so your urine is pale yellow. Alcohol and soda can increase uric acid levels in the blood and should be avoided. Beverages sweetened with high fructose corn syrup can make it difficult for uric acid to be excreted through the kidneys. Another option is to take a medication that blocks the formation of uric acid. Medications that lower uric acid are referred to as xanthine oxidase inhibitors. The most common one that has been around for over 50 years is called allopurinol. A newer one is febuxostat, also known as Uloric. Both medications successfully lower high uric acid levels. I f you get gout, you must take an anti-inflammatory medication to reduce the swelling and address the pain. The two most common medications for this inflammation are colchicine and indomethacin. Both drugs have been around for many years and have been the standard of care in treating pain. They are, however, very potent and can be hard on the stomach, limiting their duration of use. As discussed above, once the pain and swelling are under control, patients are transitioned to the xanthine oxidase inhibitors for prevention. The treatment for decreasing uric acid in kidney stones is the same. The best way to prevent uric acid stones is to stay hydrated. Drinking plenty of water will help reduce the concentration of uric acid in your urine, preventing stone formation. A common question in the pharmacy is, how can I treat my gout naturally? If you were going to treat gout from a natural angle, the most common way is to take a product containing tart cherry extract or drink unsweetened tart cherry juice. Studies show that eating ½ cup of cherries daily can reduce the risk of a gout flare by 35%. Cherries contain anthocyanins and quercetin, which are anti-inflammatory and fight oxidative stress. Eating cherries or taking a product with cherry extract is preferred due to the potential added sugar in the tart cherry juice. Uric acid is being looked at differently these days, with its potential to be an alarm for concerns around metabolic health. Author and neurologist Dr. David Perlmutter wrote a book called "Drop Acid," which examines the health problem that accompanies a person having an elevated uric acid level. Uric acid has been downplayed as a little-known metabolic waste product that has little to do with our overall health unless it becomes so high that gout and renal stones occur, as discussed above. That is the concept I learned in pharmacy school and most others in health care. Next week's article will continue to unfold the metabolic effects of elevated uric acid levels, how to monitor uric acid, and some additional natural ways to address the excess levels before high levels further degrade your health. Please read my next article to receive the rest of the story. My staff and I would like to help you with questions regarding uric acid and finding suitable treatment options to lower the burden, so call or stop to schedule a consultation. Please visit my website at www.irsfeldpharmacy.com to see this and other archived articles in the blog section. Until next time, be vigilant about your health!!