Dr. Mark Hyman's 10-Episode Broken Brain Series

[Rufous McKinney]

I don't know about you, but a 4 mg/dl decrease after 1 month, 10 mg/dl decrease after 2 month, does for me show some effectiveness, even increasing with time of use.

These data show high variance (the plus/minus numbers) and rather show a not very good result (altho no probability is provided). (probability the result due to chance needs to be reasonably low).

There are actually different kinds of cinnamon....while i have heard that it helps with lowering blood sugar , it generates heat in the body and is therefore an herb I chose to not use as I have go cool down.

There is a Mexican cinnamon and its less heating...

Just thinking about herbs generally and studies generally: there was considerable discussion of Kava Kava in another post, and it seems differing strains, species and/or sources contain differing qualities.

So: maybe it actually matters which cinnamon, what source, and other subtleties.

 

[Rufous McKinney]

A famous story: they found ONE individual Yew tree, in a forest in Siskyou County CA that was tested genetically and found to produce 400 TIMES the taxol levels of other Yew trees nearby.

Yew are viewed as a Trash Tree. This beautiful understory tree is removed in clear cuts and burned in piles. Forest Abuse.

so in this example: that tree's Genetic uniqueness got noticed.

I think these types of REAL variations in the world: can really matter and affect research results.

 

[pamojja]

So: maybe it actually matters which cinnamon, what source, and other subtleties.

And only a cheap glucose meter at hand would tell.

 

[Rufous McKinney]

None-medical info on Mexican Cinnamon (which is from Sri Lanka).

its milder: it might work better for blood sugar and be less heat generating...

 

[Rufous McKinney]

sorry: link to info on Mexican cinnamon

https://culinarylore.com/spices:what-is-mexican-cinnamon/

 

[Rufous McKinney]

And only a cheap glucose meter at hand would tell.

Definately with you on this and intending to get one. Doing alot of blood sugar management.

Long long ago: it became evident to me I could not assign health care to the responsibility of somebody else. Perhaps I have flunked the self-assignment. But keep going and at it because: obviously nobody else is gonna fix it.

It started one day, when one decides to buy a can of fake Turkey at the Seventh Day Adventist store in 1968.

 

[Hip]

A good example to show

I only provided a link to a randomly-chosen supplement study, the cinnamon treatment of diabetes, as an example. Not actually to change the conversation to diabetes.

I used it as an example to demonstrate that numerous treatments, including supplement treatments, are tested in proper RCT studies without there being any profit incentive or pharma funding. Thus if someone refuses the opportunity to test their therapy, to me it suggests they know their therapy is not very effective, so perhaps they prefer not to have it tested.

But anyway, since you started examining the cinnamon treatment, you might lik this systematic review of eight cinnamon studies found that this spice does have some benefit for T2D.

 

[pamojja]

Thus if someone refuses the opportunity to test their therapy, to me it suggests they know their therapy is not very effective, so perhaps they prefer not to have it tested.

But anyway, since you started examining the cinnamon treatment, you might lik this systematic review of eight cinnamon studies found that this spice does have some benefit for T2D.

It wasn't my intention to examine cinnamon's effectiveness at all (for which there would have been a link to a review in that quote from labtestanalyzer.com too), but that the functional approach can't be tested with RCT's. I don't know how I further could emphasis that, for you to understand?

How on earth could anyone ever control for all the possible confounders, as in the glucose control example? Where cinnamon is just a tiny 1.

A functional approach would address any of 17 possibly underlying chronic conditions also in other bodily systems, if present. The 10 other factors which can contribute, the 10 classes of drugs possibly raising glucose, employ some of the 11 lifestyle interventions, and the 15 spices/supplements mentioned. Naturally all tailored to individual differences. And therefore no 2 treatments exactly the same.

Spoiler: considered variables

Some chronic conditions that can lead to elevated fasting glucose levels include:

1. Insulin resistance [R, R]
2. Glucose intolerance [R]
3. Metabolic syndrome [R]
4. Type 1 and type 2 diabetes [R, R]
5. Pregnancy and gestational diabetes [R, R]
6. Fatty liver and other liver disease [R, R, R]
7. Hyperthyroidism [R]
8. Cushing’s disease (too much cortisol) [R]
9. Acromegaly (excess growth hormone) [R]
10. Pheochromocytoma (benign tumors of the adrenal gland) [R]
11. Pituitary tumors [R]
12. Myocardial infarction [R]
13. Pancreatitis [R]
14. Pancreatic adenoma [R]
15. Cystic fibrosis [R]
16. Head injury/brain damage [R]
17. Kidney disease [R]

The following factors can also lead to high blood sugar levels:

1. Acute and chronic stress [R, R, R]
2. Poor sleep quality or not enough sleep [R, R, R]
3. Obesity [R]
4. Smoking, but also quitting smoking [R, R, R]
5. Chronic exposure to toxins such as polychlorinated biphenyls (PCB) and organochlorine pesticides (OCP) [R]
6. Low hematocrit [R]
7. Estrogen [R]
8. Oral contraceptives [R]
9. Epinephrine/adrenalin [R]
10. Glucocorticoids [R, R]

These drugs can increase glucose levels:

1. Phenytoin (Dilantin), used to treat seizures [R]
2. Antipsychotics [R, R]
3. Thiazide diuretics, used to treat high blood pressure [R]
4. Beta blockers, drugs that reduce blood pressure and manage irregular heart rhythms [R]
5. Antidepressants [R]
6. Lithium [R]

1. Improve your diet. A healthy diet will help control your blood sugar levels. An example of a good, balanced diet is the Mediterranean diet, which is rich in plant-based foods such as fruits and vegetables, whole grains, legumes, nuts, herbs, and spices. It is also high in monounsaturated fats found in olive oil [R, R].
2. Eat regularly, and especially take care not to skip breakfast. Starting your day without breakfast can lead to increased blood glucose [R].
3. On the other hand, you may want to refrain from nighttime snacks. Studies show that these are associated with obesity and high blood sugar levels [R].
4. Exercise is a great way to manage your blood glucose levels. Find something fun that you will enjoy doing regularly [R, R, R, R, R].
5. Drink plenty of water [R].
6. Lose some weight if overweight. This will improve the ability of your body to use and respond to glucose more efficiently [R].
7. Get adequate rest. Sleep deprivation and poor sleep quality decrease the ability of cells to react to insulin, and over time causes increases in blood sugar levels [R, R, R].
8. Manage stress. Stress can increase blood sugar levels, by increasing hormones such as cortisol and inflammatory molecules in your body [R, R, R, R].
9. Reduce red meat consumption. It is associated with higher blood sugar [R].
10. Avoid artificial sweeteners. These may cause glucose intolerance [R].
11. Studies show that moderate alcohol consumption can lower blood glucose levels and prevent diabetes and heart disease [R, R, R, R]. However, heavy consumption has a negative effect, and increases the risk of type 2 diabetes.

Supplements that can help:

1. Fenugreek [R, R]
2. Cinnamon [R, R]
3. Garlic [R, R]
4. Green tea [R]
5. Thiamine (vitamin B1) - high blood sugar increases the excretion of this vitamin. Diabetics are often deficient and benefit from thiamine supplementation [R, R, R]
6. Vitamin D [R, R]
7. Zinc [R]
8. Magnesium [R, R]
9. Chromium [R, R]
10. Mango [R]
11. Vinegar [R]
12. Beta-glucans (a type of fiber found in cereals, mushrooms, yeasts, seaweed, and algae) [R]
13. Pistachios [R]
14. Alpha-lipoic acid [R, R]
15. Multispecies probiotics [R]

About 60 variables all considered IS the functional approach. What on earth - compared to that comprehensive knowledge - could constitute a placebo? - where the patient couldn't know he is on placebo? - Ignorance about the therapeutic, where placebo can be controlled for, is the very antithesis to the informed functional approach. Therefore there can't ever be a RCT for the functional approach at this point in time.

Thus if someone refuses the opportunity to test their therapy, to me it suggests they know their therapy is not very effective, so perhaps they prefer not to have it tested.

Someone like Dr. Dale Bredesen, because of the complete non-appropriateness of any RCT for this approach, choose case studies instead, the maximum possible study design for the functional approach in this point of time. To ask for RCT's from the functional approach is like asking to test for anything else, but the comprehensive functional approach itself.

To imply again, because the functional medicine approach can't do RCTs without negating it's very own approach, would be due to being in the known of its ineffectiveness, is an untenable assertion.

Or else you would have to come up with a good idea what could constitute a placebo, compared to considering countless variables all backed-up by lab-testing.

 

[Hip]

It wasn't my intention to examine cinnamon's effectiveness at all (for which there would have been a link to a review in that quote from labtestanalyzer.com too), but that the functional approach can't be tested with RCT's. I don't know how I further could emphasis that, for you to understand?

How on earth could anyone ever control for all the possible confounders, as in the glucose control example? Where cinnamon is just a tiny 1.

I understood what you were trying to say, but your comments about cinnamon are a non sequitur in relation to what we were discussing. As you know, we were discussing your earlier comment here:

You certainly do understand that almost all clinical trials to get a pharmaceutical approved does cost about 30 millions, which really no investor would want to waste on compounds which can't be patented and which would be totally lost.

In the above comment you are trying to suggest it is not possible to test alternative treatments unless you have millions of dollars of pharma backing. That's not true, because if you search PubMed you will find thousands if not millions of studies which examine alternative treatments. I gave cinnamon for diabetes as just one example of these millions of studies on alternative treatments.

So it is clear from PubMed that you can easily scientifically test alternative medicine treatments for efficacy. You do not need pharma budgets of multi-millions to perform a simple RCT study of the efficacy of alternative treatments.

So that's the end of that particular discussion, about whether you can test alternative medicine without pharma funding. You can.



Now if you want to introduce a new discussion about there being too many variables to test the efficacy of the approach of functional medicine doctors, let's then talk about that concept.

Yes it is true that there may be more variables that a functional medicine doctor may consider, and may attempt to address. However, if we take the case of diabetes, the bottom line is your blood sugar level. That's what you are trying to correct. That is a single variable that you can measure in a study.

So it would be quite feasible to compare the blood sugar levels of diabetic patients who were treated by normal doctors, and diabetic patients who were treated by functional medicine doctors. Then you could see if the functional medicine doctors do a better job of controlling blood sugar.

Another example: multiple sclerosis. The worsening of MS can be objectively measured by a single variable: the number of new brain lesions that are detected on an MRI.

So why not compare MS patients treated by normal doctors to MS patients treated by functional medicine doctors, and see if there is any difference in the appearance of new brain lesions. That should be a straightforward means of assessing the efficacy of the functional approach.


I understand that functional medicine doctors may work with more parameters and variables. But the bottom line is whether these doctors get better results in treating diseases compared to regular doctors.

 

[pamojja]

So that's the end of that particular discussion, about whether you can test alternative medicine without pharma funding. You can.

Small RCTs usually done by research institutions are something completely different from getting a substance approved through 4 phases of clinical trials as a treatment for a particular disease. Neither me, nor you, nor any of the functional practitioner have that kind of funding. To imply that this kind of money (millions) wouldn't be spent on the side of the functional practitioners, because then it would show it doesn't work is implying bad intentions on side of these practitioners for no other reason than your depreciation.

Thus if someone refuses the opportunity to test their therapy, to me it suggests they know their therapy is not very effective, so perhaps they prefer not to have it tested.

Yes, end of that unfruitful discussion.

So it would be quite feasible to compare the blood sugar levels of diabetic patients who were treated by normal doctors, and diabetic patients who were treated by functional medicine doctors.

Of course. I don't know about you, but I talk to my GP. And in his practice no-one treated by him ever experienced remission from PAD, COPD or T2D, as I did. However, this isn't and wouldn't ever be a randomized placebo controlled trial, a RCT you till now insisted as the only evidence for any treatment to show it would work.

 

[Hip]

@pamojja, I really do not see why you are making excuses for functional medicine's shirking of its scientific responsibilities.

Look at someone like Dr Martin Lerner. He was just a single doctor who pursued the theory that herpesviruses are a cause of ME/CFS, and that antiviral treatment can improve ME/CFS. Even just as a doctor, he was able to conduct and publish several clinical trials examining the efficacy of his antiviral treatments.


It is a valid criticism to point out that the evidence base for function medicine is very, very poor, and that they have not attempted to conduct any studies to prove the efficacy of their approach. This is not a damning criticism, but a constructive criticism, pointing to what functional medicine needs to do in order gain scientific credibility. It is your duty as a scientist to provide empirical evidence.

 

[pamojja]

It is your duty as a scientist to provide empirical evidence.

That I agree with. As long as it doesn't necessitates placebo controlled trials, which would kill the study subject at hand from the outset.

However, in my experience with Cardiologists, Internists, Pulmologists, or any General Practitioner, young or old.. I had to learn that none of them had learned to read studies and verify them for themselves. In discussions they exhibited that they don't understand such simple concepts even every chronic disease patient should know about, for being enabled in making informed decisions. Like what's the difference between relative and absolute risk reduction, primary or secondary prevention, number needed to treat or harm, etc. Therefore I must assume the training to become an MD is very far from that of becoming a scientist, unless she or he had that particular inclination already in youth.

Now such a MD himself might get disabled in the middle of life, and because of the shortcoming of his training as MD, turns to the functional medicine approach instead to recover oneself. Being glad having overcome one's disability, she or he shares the few last years as an MD with his patients with all the enthusiasm about what was learned additional to the training as MD.

Now you expect from such a person like Mark Hyman at age 59 short before retirement - or at any other age - to start a career as a scientist?

I don't think that's anywhere realistic. Nor should anyone feel above any other and entitled to demand what she or he should pursue in life. Or depreciate an others vocation because it doesn't fits with one's own needs.

I personally try to have a livelihood where I at least do not harm anyone. Repeatedly I had to refuse treatments offered by MDs because of possible harms, of which I had to inform myself elsewhere. They seem to have forgotten: 'First, do no harm!'. Any MD who remembers that through whatever tire circumstances in my eyes has gone full circle, and deserves all my respect.

The average burned-out middle-aged MD isn't a scientist to begin with. Take Dale Bredesen or Martin Lerner as examples who perused a scientific career from the start.

@pamojja, I really do not see why you are making excuses for functional medicine's shirking of its scientific responsibilities.

Scientifically inclined youngsters will show up in the future. You have to grant any individual, who out of disappointment with conventional medicine turns to functional medicine, the same right of choosing one's vocation, as everyone grants to you. Appreciation of individuals is a better motivator than depreciation.