The Validity of Saliva Cortisol Testing

For 30 years saliva has been used as a reliable, cheap and effective way to measure the body's major stress hormone, cortisol.

Although use of saliva cortisol is by no means limited to natural or "functional medicine," that is probably where it has been used the most. Natural health care practitioners will often give patients saliva test kits to measure cortisol and hence their stress response.

Nonetheless, if a patient happens to then go to a medical doctor with the results, they may be told that there is no validity to saliva tests.

I want to make these points very clear:

1) If a medical doctor says there is no validity or reliable way to measure cortisol through saliva that doctor is ignorant. 

In such a case what that doctor really should do, is tell their patient that they are not familiar with saliva cortisol testing.

2) The debate on saliva cortisol testing has nothing to do with differences between functional medicine/ holistic medicine/ naturopathy / eastern medicine or anything else you'd like to call it and conventional mainstream medicine.

In reality, such lab testing is far within the scope of anything that can be called "western medicine." Not only that, it has been accepted by mainstream western medicine.

The use of saliva cortisol testing is actually a guideline in the practice of mainstream endocrinology! See link to Journal of Endocrinology and Metabolism abstract

Among the many studies done on saliva cortisol in the last 30 years, this one also stands out as well.

Melatonin and cortisol assessment of circadian shifts in astronauts before flight.

 3) Most medical doctors don't understand cortisol, stress and the circadian rhythm

Many times medical doctors tell patients things which are just simply not scientific with regards to such testing. This includes:

• "Cortisol doesn't affect your health."

In truth cortisol is the body's stress hormone. If this true then stress itself doesn't affect health. At this point, the fact that stress greatly impacts health is accepted by everyone in health and proven over and over in countless research studies.

• "Timing of testing cortisol doesn't matter"

In truth cortisol is closely linked to our circadian rhythm. In a healthy person it will be about 10 times higher upon waking then at night. Cortisol may even be normal one time of the day, but wildly out of reference range another time. Cortisol must be tested multiple times during the day, and at the correct time. (the above article citing use of saliva cortisol to test for Cushing's disease, is very clear to tests it late at night, not morning or afternoon, as people have blood cortisol tested then.)

• "There is no science behind this"

There is overwhelming scientific support for saliva cortisol testing (and other saliva tests as well). A cursory glance at clinical studies will show that. I have linked to two studies in this blog article, but it would not be difficult to link to dozens. 

Great Video on Causes of Depression

Causes of Depression

Psychetruth on youtube recently posted an excellent video: 

What Causes Depression and Suicide? Brain Chemical or Human Needs? Psychology & Self Esteem

 Often, one of the most difficult parts of even discussing a problem such as "depression" is how the field of psychiatry has redefined it as some kind of physical illness. 

But depression is not a physical illness like cancer or the flu. You can not see it, or touch it. There are no lab tests for it. Depression is a feeling. Depression is also caused by something else. The feeling depression can not be caused by the disease depression. That does not make any sense.

The cause of feeling depressed is either going to be psychological or physiological. Also, we have to keep in mind that we are one unit, the psychological and physiological do affect each other. 

This video by Psychetruth does a great job at going over the psychological causes of feeling depressed. The truth is more complicated then simple trains of thought that come from drug companies that one "has depression," or has a "chemical imbalance." 

However, once the truth is understood, actions can be taken to help someone who feels depressed.

Statins May Be Linked to Fatigue

A new study shows that cholesterol lowering statin drugs may be linked to fatigue.

As stated in the article:

"People who were taking statin drugs were more likely to experience decreased energy, fatigue upon exertion, or both, when compared with those who were not taking statins. The effects were more pronounced among women.
This fatigue during exercise reported in the study is different than a rare and potentially fatal side effect associated with statins. Rhabdomyolysis can cause severe muscle pain, liver damage, kidney failure, and death. "Fatigue is still quite important in and of itself," Golomb says."

Commentary:

This should not be surprising to anyone, as statin drugs inhibit the body's production of Coq10. Coq10 is needed for the mitochondria inside our cells to produce energy. So it makes sense that a drug which lowers Coq10, can lead to fatigue. This very obvious cause of fatigue was not mentioned in the article.

In addition, there are very popular drugs and have been used for a long time now. Patients reporting fatigue as a common side effect should be very apparent.

Popcorn packed with anti-oxidants - commentary

A new study has come out that popcorn is full of anti-oxidants!

So what's wrong with this study?

How about the fact that popcorn is a food which just about should NEVER be eaten.

Don't get me wrong, a small amount of organic popcorn is ok, but what goes into most popcorn?

1. Puffed corn. Basically, this is simple carbohydrate.

2. "Butter" and other additives.

3. Genetically modified franken foods. Most corn is genetically modified.
I usually refer people to the Institute for Responsible Technology for information about genetically modified foods.

So popcorn is not healthy, unless it's from organic corn, eaten in moderation, and not full of all sorts of additives. However, a big bag of movie theater popcorn is not healthy.

But this study isn't just about popcorn. It's about how researches can take a complex question (such as if a food healthy) and use reductionist thinking to focus on only one aspect of it, ignore lots of other information, and come to a misleading conclusion.

Although to be honest - it's not even the researcher's fault. I blame WebMD for taking this paper and giving it an intentionally misleading headline. Of course this is a big problem in health today. Both from conventional and natural health. Any little factoid can turn into a misconstrued headline.

What is truly misleading, is many more people with read the headline, than the article. And how many people will read the article and consider the other side of the story?

A few years ago there was a research study that showed GMO corn can lead to organ failure. What if that was given a headline such as "Popcorn causes organ failure and death." Would that be honest.

Often, the truth about nutrition is much more boring than any headlines. Eat real food, not too much, mostly plants. Of all the nutrition books, dietary advice, seminars, lectures, radio shows and everything I've heard about nutrition, 90% of it can be summed up in just that.

Raw Food Made Easy Book Review

When going through my library for great health books to recommend, Raw Food Made Easy for 1 or 2 people, by Jennifer Cornbleet is on the top of the list.

What makes this a great book?

1. Not preachy and over the top telling you that you must only eat raw food. Eating raw food is important. Generally, most people need to get more raw food into their diet. However, eating raw food should not be turned into a cult. Unlike some other raw food books, this doesn't do that.
   
2. The recipes are easy to make. Many raw food books have rather time consuming recipes. This book truly is raw food made easy and will not just sit on the bookcase unused, because the recipes are too time consuming.
   
3. Lots of expensive, raw food "cooking" equipment is not needed. A food processor with S blade and blender will be helpful. But you will not find the majority of recipes demanding you first go out and spend hundreds on fancy juicers and dehydrators.

Any negatives with this book?

None. This is a great book to help busy people incorporate more health, raw foods into their diet. 

Study Finds SSRIs May Cause Babies To Have Smaller Heads

Researchers found an association between SSRIs such as Paxin and Prozac and preterm birth. “We found prenatal exposure to SSRIs was associated with decreed growth of the head, but not decreased growth of the body,” said head researcher Hana El Marroun.

Although this does become more complicated.

They also found that depressed women, who were not taking SSRIs, babies had both smaller heads and smaller bodies.

The researchers also point out that anti-depressants are only one possible treatment, and that psychological treatment could be used instead.

Comments:

No one really knows what SSRIs do, or how they affect the whole body. The idea that SSRIs work by affecting brain serotonin is not just unproven theory. It's a bad theory. Anytime you hear a doctor or medical researcher talk about how SSRI produce certain effects by working on serotonin, they are basically just speculating.

What we do know, is that SSRIs affect the brain, and the rest of the body in numerous ways, creating long lists of “side effects.” Medical doctors and psychiatrists often do not warm patients about these numerous side effects, which include horrible withdrawal symptoms that force patients to remain on these toxic medications.

It would not be easy to calculate the amount of harm done (to mothers and their babies), by giving pregnant women SSIRs, instead of proper health care.

In case of depression, I recommend a full medical history be taken, followed by steps to treat the person. What treatment might be depends upon individual circumstances. There is no cookie cutter protocol in natural health. The following list is some common problems and treatments. This is not a complete comprehensive list.

• Therapy for psychological issues.
• Hormonal imbalance (low/high cortisol, hypothyroidism)
• Poor nutrition, including low protein, amino acid deficiency, low vitamins B6, B12, folate, magnesium or generally poor nutrition
• Inflammation
• Infection
• Toxicity
• Eliminating allergenic foods
• Poor digestive function, including but not limited to poor absorption of nutrients, or candida
  
  
  
  
  SOURCES: Hanan El Marroun, Ph.D., department of child and adolescent psychiatry, Sophia Children’s Hospital, Rotterdam, the Netherlands; Michael O’Hara, Ph.D., professor, psychology, University of Iowa, Iowa City; March 5, 2012, Archives of General Psychiatry, online

Statin drugs, cholesterol, depression and reductionism.

Statin Drugs = Less Depression?

A recent study found that of 965 heartdisease patients, those who were taking statin drugs where less likely to be depressed.

The study then follow the 776 of those patients who were not depressed.

18.5% of the 520 patients on statins became depressed by follow up.

28% of of the 256 not on statins became depressed by follow up.

This was translated into a 38% reduced risk of developing depression.

Statistical Manipulation?

Medical studies do not need to lie to be misleading. Statistics can be manipulated in all sorts of ways. In this case, the 38% reduced risk of developing depression sounds impressive. But lets look at this study using another statistic, the number to treat (NNT).

The NNT is the number of patients who need to be treated in order to prevent one additional bad outcome.
In this case the NNT is 10.5.

So according to this study, 10 ½ people would need to be treated with a statin drug, in order to prevent one incidence of depression.

But Don't Statin's Cause Many Side Effects?

Yes they do! Side effects such as liver damage, elevated liver enzymes, rhabdomyolysis, diabetes and much more! In fact, and reasonable review of the negative effects of statin drugs would be quite lengthy, and beyond the scope of what I wish to write about in this post.

Why might statins lower depression?

Inflammation can divert tryptophan and 5-HTP into inflammatory cytokines instead of serotonin. Therefore, taking anti-inflammatory medications or supplements may improve mood in some people. I don't know if statins make anyone feel better, but this is at least a possible explanation.

However, considering the numerous side effects of statin drugs, and the fact that over 10 people needed to be treated in this study to see one positive outcome, plus the negative effects statins do have on cognitive function, and a plethora of natural anti-inflammatory supplements, using statins in this way would be simply foolish.

Even the study itself says, that this does not mean statins should be used solely as anti-depressants. However, headlines and a few statistics can be taken out of context, to make statin drugs seem like better options when treating high cholesterol.

What is wrong with this approach to medical research?

This study is an example of the extreme reductionism in medicine. A large population is selected, along with a few variables, and then some general result is given.

However, feeling “depressed” is a mulch-factorial phenomena. Contributing factors include psychology, toxicity, infection, inflammation, nutritional statues, and even musculo-skeletal problems. Mufti-factorial problems demand individualized solutions. Even a study showing improvement of 90% of patients, does not necessarily tell a physicians if that treatment will help the patient in-front of them.

You can only treat people, not feelings

Depression is not a disease per se, it is a feeling. It makes no sense to treat a feeling.

You can only treat a person who has those feelings. I'm not saying this to belittle "depression" as if it's a non problem. In fact I take mental symptoms very seriously. My point is, if we really want to develop successful treatment plans then we need to start out by being honest about what we are dealing with.

If one person is depressed due to metal toxicity, and another due to psychological abuse, then very different treatments are needed. Not a generic drug (or supplement) that treats depression.

But this is what psychiatry does, when it calls the feeling "depression" a disease in and of itself and throws mind altering drugs at the feeling.

Language and the distortion of reality

The very thought of "treating" a feeling per se, is mind boggling nonsensical.

Terms such as ""treating depression" become imbedded into language, and changes how we think.

Language is not just a means of communication and thought, but actually sets the boundaries in which thought can take place. If vocabulary assumes a false paradigm, then it may become almost impossible to see the truth.

The distorted idea of treating a feeling, instead of the person who has the feeling, is handed down to us by psychiatry. For example, psychiatrists call DSM labels diagnoses. In truth, the DSM explicitly states that none of its labels is a diagnosis. Psychiatrists know these are not real medical diagnoses. Nonetheless, they use such terms manipulate language and how people understand reality.

This is why I often put terms such as “depression” and “anxiety” in quotes. I do not wish to add to the confusion.

People tell me they have "depression" or "anxiety" all the time. Those terms are mostly useless by themselves. I have to dig deeper. I Ask them to describe these feelings? Is it in the mind? Is it physical? What systems is it related to? What was going on when all this began?

I need things to be clear, that I am helping them, not their "anxiety" or "depression."

Reductionism

Reductionism is the belief that complex systems can be understood as the sum of all their parts. Reductionism works well in many fields. However, it does not work for complex, dynamics, emergent systems such as the human body. To put it quite simply, we are much more than the sum of all our parts. Feeling depressed can not be reduced down to something so simple as serotonin (although both psychiatry and many people in natural health seem to believe that). I do not wish to dismiss the importance of the 5-Htp > serotonin pathway.  It is simply not the entire story.

The “gold standard” double blind placebo controlled study, is based on a reductionist model. This doesn't make such studies worthless. However, these studies do not have the final say in what specific treatments are needed for a specific individual. Especially since such studies only look at symptoms which large groups of people have in common. The "strange and peculiar" symptoms that we see on an individual basis are ignored. But often it is these other symptoms which show what the individual patent actually needs. 

Instead of reductionist models of "mental illness," we need dynamic models. Models that consider all the multi-factorial conditions that may lead an individual to feel depressed. In the real world, the real question is, "what does this individual patient need." Not what random drug or supplement will have a 30% chance of improving symptoms.