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Thursday, January 10, 2013

Evolving insights into FIP virulence

Terada Y, Shiozaki Y, Shimoda H, et al. Feline infectious peritonitis virus with a large deletion in the 5'-terminal region of the spike gene retains its virulence for cats. The Journal of general virology. 2012; 93: 1930-4. 

The acquisition of macrophage tropism appears to be an essential step in the transformation of feline enteric corona virus (FECV) to feline infectious peritonitis virus (FIPV).This is a transformation from a largely non-pathogenic and localized enterocyte pathogen to a highly virulent and systemic monocyte/macrophage pathogen. Therefore, determining the critical genetic mutation(s) leading a change in tropism is required for understanding the pathogenic phenomena of feline coronavirus (FCoV) infections. Although various viral proteins such as 3c and 7b have been considered to be involved in the transformation, the spike (S) protein may also play a role in a switch toward macrophage tropism and enhanced virulence. 

In coronaviruses, the S protein functions in cell entry and is responsible for receptor attachment and membrane fusion. While the receptor-binding site is located in the N-terminal part of the protein, fusion is mediated by its membrane proximal part. Surprisingly, previous studies have suggested virulence mutation(s) in the S protein occur in the membrane-proximal domain of the protein and not in the N-terminal region. 

In the present study, a type I FCoV strain, C3663, was found to have a large deletion of 735 bp within the gene encoding for the S protein, resulting in an estimated 245 amino acid loss in the N-terminal region of the protein. FIP developed in three out of four cats that were infected with strain C3663, suggesting that the 5’-terminal region of the S gene is not essential for pathogenic transformation. If the S protein is indeed involved in the transformation and development of FIP, then this result is consistent with the localization of the determinant for macrophage tropism lying in the domain responsible for membrane fusion suggesting a role for fusion function rather than for receptor binding. [GO]

See also: Rottier PJ, Nakamura K, Schellen P, Volders H and Haijema BJ. Acquisition of macrophage tropism during the pathogenesis of feline infectious peritonitis is determined by mutations in the feline coronavirus spike protein. J Virol. 2005; 79: 14122-30. 

Related blog articles:
Understanding FIP virulence (October 2012)
Development of new therapies for FIP (March 2012)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+
Terada Y, Shiozaki Y, Shimoda H, et al. Feline infectious peritonitis virus with a large deletion in the 5'-terminal region of the spike gene retains its virulence for cats. The Journal of general virology. 2012; 93: 1930-4. 

The acquisition of macrophage tropism appears to be an essential step in the transformation of feline enteric corona virus (FECV) to feline infectious peritonitis virus (FIPV).This is a transformation from a largely non-pathogenic and localized enterocyte pathogen to a highly virulent and systemic monocyte/macrophage pathogen. Therefore, determining the critical genetic mutation(s) leading a change in tropism is required for understanding the pathogenic phenomena of feline coronavirus (FCoV) infections. Although various viral proteins such as 3c and 7b have been considered to be involved in the transformation, the spike (S) protein may also play a role in a switch toward macrophage tropism and enhanced virulence. 

In coronaviruses, the S protein functions in cell entry and is responsible for receptor attachment and membrane fusion. While the receptor-binding site is located in the N-terminal part of the protein, fusion is mediated by its membrane proximal part. Surprisingly, previous studies have suggested virulence mutation(s) in the S protein occur in the membrane-proximal domain of the protein and not in the N-terminal region. 

In the present study, a type I FCoV strain, C3663, was found to have a large deletion of 735 bp within the gene encoding for the S protein, resulting in an estimated 245 amino acid loss in the N-terminal region of the protein. FIP developed in three out of four cats that were infected with strain C3663, suggesting that the 5’-terminal region of the S gene is not essential for pathogenic transformation. If the S protein is indeed involved in the transformation and development of FIP, then this result is consistent with the localization of the determinant for macrophage tropism lying in the domain responsible for membrane fusion suggesting a role for fusion function rather than for receptor binding. [GO]

See also: Rottier PJ, Nakamura K, Schellen P, Volders H and Haijema BJ. Acquisition of macrophage tropism during the pathogenesis of feline infectious peritonitis is determined by mutations in the feline coronavirus spike protein. J Virol. 2005; 79: 14122-30. 

Related blog articles:
Understanding FIP virulence (October 2012)
Development of new therapies for FIP (March 2012)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+
Read More


Wednesday, January 9, 2013

Coalition of health groups launches two-week ad campaign to drum up support for a statewide smoking ban

A geographically targeted newspaper and online advertising campaign calling for "a comprehensive, statewide smoke-free law" is hitting Kentucky media outlets this week, as the legislature convenes, and next week. The campaign was launched by Smoke-Free Kentucky Coalition, the Campaign for Tobacco-Free Kids and the Robert Wood Johnson Foundation. The newspaper ad can viewed here.

Twenty-nine percent of Kentucky adults are smokers, giving the state the highest smoking rate in the U.S., and ranks very high in youth smoking, according to the Centers for Disease Control. Kentucky also has the nation's highest lung cancer death rates, 87 percent of which are caused by smoking, according to the National Cancer Institute. The state also "lags behind other states in enacting a comprehensive, statewide smoke-free law that covers all indoor workplaces, including bars and restaurants," a press release about the ad campaign says. Twenty-four states have smoking bans. A fall poll for the Foundation for a Healthy Kentucky showed that 59 percent of Kentucky adults support a smoking ban in workplaces, restaurants and bars. For a story on the poll, click here.

Tobacco-Free Kids communications manager Catherine Butsch said the ad is running in the Lexington Herald-Leader, the Messenger-Inquirer of Owensboro, the Daily Independent of Ashland, the Commonwealth Journal of Somerset, the Kentucky New Era of Hopkinsville, the Glasgow Daily Times, the Paducah Sun, the Paducah-based West Kentucky News, the Sentinel-Echo of London, the Lebanon Enterprise, the Jessamine Journal, the Tompkinsville News, the Carlisle Weekly of Bardwell, the Fulton Leader, the Marshall County Tribune Courier, and the Kentucky Gazette, a government-oriented twice-monthly in Frankfort. The online ad will run on websites of the Herald-Leader, Business Lexington, The Lane Report and CN2, a cable news service. The campaign will cost $93,000, Butsch said.
A geographically targeted newspaper and online advertising campaign calling for "a comprehensive, statewide smoke-free law" is hitting Kentucky media outlets this week, as the legislature convenes, and next week. The campaign was launched by Smoke-Free Kentucky Coalition, the Campaign for Tobacco-Free Kids and the Robert Wood Johnson Foundation. The newspaper ad can viewed here.

Twenty-nine percent of Kentucky adults are smokers, giving the state the highest smoking rate in the U.S., and ranks very high in youth smoking, according to the Centers for Disease Control. Kentucky also has the nation's highest lung cancer death rates, 87 percent of which are caused by smoking, according to the National Cancer Institute. The state also "lags behind other states in enacting a comprehensive, statewide smoke-free law that covers all indoor workplaces, including bars and restaurants," a press release about the ad campaign says. Twenty-four states have smoking bans. A fall poll for the Foundation for a Healthy Kentucky showed that 59 percent of Kentucky adults support a smoking ban in workplaces, restaurants and bars. For a story on the poll, click here.

Tobacco-Free Kids communications manager Catherine Butsch said the ad is running in the Lexington Herald-Leader, the Messenger-Inquirer of Owensboro, the Daily Independent of Ashland, the Commonwealth Journal of Somerset, the Kentucky New Era of Hopkinsville, the Glasgow Daily Times, the Paducah Sun, the Paducah-based West Kentucky News, the Sentinel-Echo of London, the Lebanon Enterprise, the Jessamine Journal, the Tompkinsville News, the Carlisle Weekly of Bardwell, the Fulton Leader, the Marshall County Tribune Courier, and the Kentucky Gazette, a government-oriented twice-monthly in Frankfort. The online ad will run on websites of the Herald-Leader, Business Lexington, The Lane Report and CN2, a cable news service. The campaign will cost $93,000, Butsch said.
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Republicans moving to gain a say over Beshear's decisions about insurance exchange, Medicaid expansion; Democrat dismissive

Kentucky Senate Health and Welfare Committee Chair Julie Denton, R-Louisville, left, said yesterday that she would file legislation that would block Democratic Gov. Steve Beshear from setting up a health-insurance exchange or expanding Medicaid coverage without legislative approval, Joseph Gerth of The Courier-Journal reports. Beshear has already established an exchange under the federal health reform, but hasn't announced whether he will expand Medicaid.

Denton said the exchanges and Medicaid expansion would be too costly for the state and shouldn't be something Beshear can set up unilaterally. But her effort will likely face opposition in the Democrat-controlled House, Gerth writes. Liberal Rep. Tom Burch, D-Louisville, said Denton "should save the ink that it would take to print the bills," and House Democrats would not receive the bill favorably. Burch has been in the legislature longer than any other current member.

State health-insurance exchanges will allow the uninsured to buy insurance from private companies and perhaps get government subsidies to help pay for it. If Medicaid were expanded in Kentucky, hundreds of thousands of more people would be covered, with the fedreal government paying all the extra cost in 2014-16, decreasing to 90 percent by 2020. Gerth reports that Senate Republicans said they will make it a priority "to rein in Beshear on Medicaid," which they fear would be unsustainable if it were expanded. Denton said requiring legislative approval of these parts of "Obamacare" would give Kentucky citizens a greater voice in the process. (Read more)
Kentucky Senate Health and Welfare Committee Chair Julie Denton, R-Louisville, left, said yesterday that she would file legislation that would block Democratic Gov. Steve Beshear from setting up a health-insurance exchange or expanding Medicaid coverage without legislative approval, Joseph Gerth of The Courier-Journal reports. Beshear has already established an exchange under the federal health reform, but hasn't announced whether he will expand Medicaid.

Denton said the exchanges and Medicaid expansion would be too costly for the state and shouldn't be something Beshear can set up unilaterally. But her effort will likely face opposition in the Democrat-controlled House, Gerth writes. Liberal Rep. Tom Burch, D-Louisville, said Denton "should save the ink that it would take to print the bills," and House Democrats would not receive the bill favorably. Burch has been in the legislature longer than any other current member.

State health-insurance exchanges will allow the uninsured to buy insurance from private companies and perhaps get government subsidies to help pay for it. If Medicaid were expanded in Kentucky, hundreds of thousands of more people would be covered, with the fedreal government paying all the extra cost in 2014-16, decreasing to 90 percent by 2020. Gerth reports that Senate Republicans said they will make it a priority "to rein in Beshear on Medicaid," which they fear would be unsustainable if it were expanded. Denton said requiring legislative approval of these parts of "Obamacare" would give Kentucky citizens a greater voice in the process. (Read more)
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Tuesday, January 8, 2013

Evaluating disinfection methods for viruses and bacteria

Tuladhar E, Hazeleger WC, Koopmans M, Zwietering MH, Beumer RR and Duizer E. Residual viral and bacterial contamination of surfaces after cleaning and disinfection. Applied and environmental microbiology. 2012; 78: 7769-75.
 
Cleaning and disinfection are important facets of animal care and critical for multi-cat settings, such as veterinary clinics, breeding catteries, and shelters. These investigators examined the ability of various methods to disinfect surfaces of a multitude of viruses (e.g., norovirus, rotavirus, and others) and bacteria (e.g., Staphylococcus, Salmonella, and others) that vary in environmental stability. A single wipe with water, liquid soap, or free chlorine solution led to reduction in contamination but not total elimination of the pathogens. A second wipe with chlorine solution led to significantly more reduction in contamination. However, a single wipe with liquid soap followed by a single wipe with chlorine solution reduced contaminant levels significantly for most pathogens tested. [MK]

See also: Murphy CP, Reid-Smith RJ, Weese JS and McEwen SA. Evaluation of specific infection control practices used by companion animal veterinarians in community Veterinary practices in southern Ontario. Zoonoses Public Health. 2010; 57: 429-38.

Related blog articles:
Disease control in animal shelters (May 2011)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+
Tuladhar E, Hazeleger WC, Koopmans M, Zwietering MH, Beumer RR and Duizer E. Residual viral and bacterial contamination of surfaces after cleaning and disinfection. Applied and environmental microbiology. 2012; 78: 7769-75.
 
Cleaning and disinfection are important facets of animal care and critical for multi-cat settings, such as veterinary clinics, breeding catteries, and shelters. These investigators examined the ability of various methods to disinfect surfaces of a multitude of viruses (e.g., norovirus, rotavirus, and others) and bacteria (e.g., Staphylococcus, Salmonella, and others) that vary in environmental stability. A single wipe with water, liquid soap, or free chlorine solution led to reduction in contamination but not total elimination of the pathogens. A second wipe with chlorine solution led to significantly more reduction in contamination. However, a single wipe with liquid soap followed by a single wipe with chlorine solution reduced contaminant levels significantly for most pathogens tested. [MK]

See also: Murphy CP, Reid-Smith RJ, Weese JS and McEwen SA. Evaluation of specific infection control practices used by companion animal veterinarians in community Veterinary practices in southern Ontario. Zoonoses Public Health. 2010; 57: 429-38.

Related blog articles:
Disease control in animal shelters (May 2011)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+
Read More


Monday, January 7, 2013

Increased Risk Of Stroke for Thyroid and Diabetes Patients!

Increased Risk Of Stroke for Thyroid and Diabetes Patients!

Attention: If you or someone you know is stricken with diabetes along with low thyroid, known as hypothyroidism, then you MUST read this article.  Your life may already be hanging on by a thread, a thread that your doctor doesn’t even know may be unraveling quickly.
Research has shown that diabetic patients are commonly found to have concurrent thyroid disorders.
In comparison to the normal population, diabetics have over 30% more hypothyroid disease, an 11% increase in postpartum diabetes and studies have shown that diabetics have over 5 times the incidence of sub-clinical hypothyroid disease compared with the normal population!
An autoimmune disease known as Hashimoto’s Thyroiditis accounts for between 70%-80% of all hypothyroid disease cases in American adults.  It is the most common cause of hypothyroid in the adult population. In people with hypothyroidism caused by autoimmune disease it has been found that they have, as a group, multiple other conditions along with the hypothyroidism.
It is known that patients with one organ-specific autoimmune disease are at risk of developing other autoimmune disorders, and because thyroid disorders are more common in females, it is not surprising that so many female diabetes patients have thyroid disease.
One problem that arises with having these two conditions together is that, due to the diabetic state of glucose dysregulation, glucose is inefficiently transported to the cells and the metabolism of glucose is diminished. This results in an increase of glucose in the blood stream.
As a result, the body will convert the excess sugar to triglycerides to be stored in adipose tissue for use as energy when it may be needed.
Because hypothyroidism decreases the overall rate at which you burn calories (Think of the thyroid as your body's furnace) and low thyroid also slows down hormone production, your triglycerides are more likely to remain in your fat cells because of the lowered energy needs of the body, this is one reason many people with low thyroid have cold hands and / or feet because the byproduct of energy production is heat, so if the bodies “furnace”, is functioning below what is required, one symptom could be those cold hands and feet.
Hypothyroidism may also increase your LDL levels (low density lipoproteins, which are wrongly called our “bad” cholesterol) by increasing the absorption of cholesterol through your liver, preventing it from effectively eliminating excess cholesterol.
So you see, diabetes causes you to make more triglycerides and then hypothyroidism helps you to keep them around, either stored as fat because you don’t utilize them for energy or within the bloodstream.
High triglyceride blood plasma levels are one marker used to show increased risk factor for heart disease, atherosclerosis, metabolic syndrome, transient ischemic attacks (TIA) and stroke. 
In fact two studies found that increased triglycerides were a more reliable marker for future strokes that LDL or that so called “bad cholesterol”.
Prior to these two studies elevated LDL levels were always deemed the prime suspect in the development of stroke.
In the first study that was done, spanning over 4 years, researchers at UCLA collected data on more than 1,000 patients who were admitted to the medical center for TIA’s.
All of the study patients had fasting lipid panels drawn the day following admission to the hospital. After comparing the lipid panels, researchers found that patients with the highest triglyceride levels were 2.7 times more likely to suffer a stroke than those with low triglyceride levels.  
LDL levels, however, showed no correlation to stroke risk.
A 2001 study reported similar results. An Israeli team of scientists’ analyzed more than 11,000 patients, all of whom had coronary heart disease but had never suffered a stroke. 
During an 8-year follow-up period, 487 of those study patients had a TIA or full-blown stroke.
In studying these patients’ findings along with those whom had high triglycerides, researchers determined that diabetics with thyroid conditions who had triglyceride levels of 200 mg/dL or more had a 30% greater risk of having a stroke than patients with normal triglyceride levels.
This information has been around for over 10 years, and if your triglycerides have always been an issue in your blood panels, has your doctor ever explained this to you?
If the doctor does any reading of research at all they should know this connection between Diabetes, Hypothyroidism, Glucose, Triglycerides, Heart Disease and Strokes.
If they don’t acknowledge this and, instead continue to prescribe you statins for your supposed high cholesterol, then maybe it’s time for you to find a doctor that does actively search out the newest, life saving research.
You deserve to have a health care provider that actually provides “health improving care”, not just  “keep you from dying care”. 
Think about the definition of medicine: The prevention, alleviation, or cure of disease.
Knowing that definition would you say that, in your opinion, the doctors you see for your health, have they prevented any of your diseases? Have they cured you of any of these disease conditions?
 I bet the your answers to those 2 questions is a profound “No!”.  In fact, when you have your blood chemistry tested and a blood chemistry result comes back on your test that is out of range the doctor probably tells you "We'll watch it.", not giving any explanation or a limited explanation at best about what they are watching and waiting for.
Well let me clue you in, this “watch and wait” is really a code for “We need for your health to become worse because, in reality, you aren’t sick enough for the type of care that we provide.”   
That's Not Health Care, That's Sick Care!
This is why you continue to deteriorate as the years go by because no one is trying hard enough for you! They aren't getting to the root cause of your problems.
You need a health provider who is willing to investigate your health in order to find what the cause of all these problems you are saddled with. A health-rejuvenating clinician that doesn’t blame your "Bad Luck" for what you are going through.
Saying a person with your health is just unlucky is a cop-out. It is a lazy doctor’s excuse to be incompetent. It's their way of dealing with their inadequate and falsely labeled “health care” treatment.
The best that you get from the medical doctor is an attempt to alleviate your symptoms, but even then they are ignoring this huge elephant in the room that I just went over with you, which is:  
Triglycerides, Not Cholesterol, Is How You Assess The Risk Factor Of A Future Stroke In Those Patients With Both Hypothyroid Disease And Diabetes!
You are invaluable to your family, friends and loved ones, don’t you think you are deserving of a doctor who’s life mission it is to contribute to his patients allowing them the opportunity to achieve the most optimal health imaginable?
A doctor who will look at your health as a whole so that you are afforded the very best care by using his knowledge of the human body and all it's systems to find the common cause of your multiple health system issues! That doctor would then need to know what to do for you so that you are no longer burdened with that always present fear that comes with the uncertainty of not knowing when the next “health crisis” shoe will drop causing you to become even more ill.
To live is to be able to enjoy your life as it was meant to be, it's not just going through the motions of the day unable to do the things that you love because of your poor health. Isn't it time to stop beating your head against the wall and change the direction of your life? Well then you are going to have to find someone that knows how to look at hypothyroidism and diabetes from a functional perspective.
Has your doctor even tested you for an autoimmune thyroid? If not, how does that doctor know what in the world is really going on in your body?
The doctor you entrust your health, and ultimately your life with needs to look beyond the labels of hypothyroidism and/ or diabetes so that they are able to do some real, health improving detective work to find the root cause(s) of your specific issue(s).
Do you get blood work results that are out of range and yet your doctor doesn’t seem to concerned with those pathological findings, telling you that we’ll just watch those results and see how they are on the next follow-up and when that time comes the doctor does the same thing again?  Worse yet, does your doctor not even acknowledge the negative results and instead tells you that your blood work is fine, making up some lame excuse like it’s ok for your age and weight?
If that's the case it is imperative that you find someone who understands the interaction between Hypothyroidism, Diabetes and the rest of your body's systems.
The combination of these two diseases in one individual is a deadly serious problem that cannot be swept under the rug and ignored, you must find a doctor that fully understands the gravity of this situation and will give it the attention it deserves by analyzing all the facts from a functional medical perspective.
Fortunately, I have spent many countless hours on these specific disease processes. I have the background, knowledge and desire it takes to get to the root of your problems so that you don’t become a statistic of an ever increasingly cold and incompetent health care system.
Patients often times are forced to blindly travel down the path of poor health as it meanders along due to a doctor that is either far too busy, too lazy or just too damn stubborn to stay up to date with the most current scientific research.
Chronic health conditions such as these are given the most inadequate of care in our current health care system and a huge reason is the health insurance companies. You see, they are the controller of the money and they dictate what care a patient will receive; many times a doctor is unable to exercise their full clinical skills due to the fact that they wouldn't be reimbursed by the insurance company as well as they dare not go against what has been set as the "Standard Of Care" for a particular health condition even though that Care is generic in that it is based on the diagnosed condition and not based upon an individual patient's uniqueness.
Unfortunately our health care system for the chronically ill patient is broken and patient care is no longer based on the individual but instead, it is has become an assembly line of “cookie cutter” treatment protocols that do not deviate much from patient to patient within the same diagnosis.
If you have been in the medical system for any length of time, you know this to be the case.
You are expected to wait, sometimes hours after your appointment time to see the doctor, then, when you finally get into your exam room, the doctor asks you a few questions, may or may not order blood work and then write you a couple of prescriptions for Synthroid®to cover the hypothyroid and Metformin® for your diabetes.
They can’t take the time to explain why your blood work is the way it is, nor will they have an answer as to why you continue to feel as you did before beginning your thyroid replacement hormones and the diabetes support medications.
Don’t you think you deserve better than what you have been getting in regards to your healthcare?  
Isn’t your life as important as anyone else’s?
Shouldn’t the doctor you employ to recover your lost health make it his fundamental duty to do all that is within his God given talent and power so that you no longer continue on the downward spiral of decreasing health in which you find yourself now?
If you are finally sick and tired of being sick and tired and you want to find someone that cares as much about your health as you do, then call my office at 281-812-8101 and set up a free, no obligation Health Recovery Workshop so you may see for yourself that there is hope and you are not destined to live a life of misery.
My door is open for those that want to take responsibility for their own health and stop relying on some profit driven, corporate health insurance company with their doctors that feed into this international profit driven machine at the expense of their patients’ health and many times the patient pays the ultimate cost by losing that same health and life that they and entrusted with the doctor to protect, nurture and improve.
If you have any questions or just want to sit down and talk about the possible solutions to your health issues, then please give my office a call at: 281-812-8101.
If you want to learn more please go to my website at:
In Health,
Dr. Walter K. Crooks DM (P), DC, CCCN

Increased Risk Of Stroke for Thyroid and Diabetes Patients!

Attention: If you or someone you know is stricken with diabetes along with low thyroid, known as hypothyroidism, then you MUST read this article.  Your life may already be hanging on by a thread, a thread that your doctor doesn’t even know may be unraveling quickly.
Research has shown that diabetic patients are commonly found to have concurrent thyroid disorders.
In comparison to the normal population, diabetics have over 30% more hypothyroid disease, an 11% increase in postpartum diabetes and studies have shown that diabetics have over 5 times the incidence of sub-clinical hypothyroid disease compared with the normal population!
An autoimmune disease known as Hashimoto’s Thyroiditis accounts for between 70%-80% of all hypothyroid disease cases in American adults.  It is the most common cause of hypothyroid in the adult population. In people with hypothyroidism caused by autoimmune disease it has been found that they have, as a group, multiple other conditions along with the hypothyroidism.
It is known that patients with one organ-specific autoimmune disease are at risk of developing other autoimmune disorders, and because thyroid disorders are more common in females, it is not surprising that so many female diabetes patients have thyroid disease.
One problem that arises with having these two conditions together is that, due to the diabetic state of glucose dysregulation, glucose is inefficiently transported to the cells and the metabolism of glucose is diminished. This results in an increase of glucose in the blood stream.
As a result, the body will convert the excess sugar to triglycerides to be stored in adipose tissue for use as energy when it may be needed.
Because hypothyroidism decreases the overall rate at which you burn calories (Think of the thyroid as your body's furnace) and low thyroid also slows down hormone production, your triglycerides are more likely to remain in your fat cells because of the lowered energy needs of the body, this is one reason many people with low thyroid have cold hands and / or feet because the byproduct of energy production is heat, so if the bodies “furnace”, is functioning below what is required, one symptom could be those cold hands and feet.
Hypothyroidism may also increase your LDL levels (low density lipoproteins, which are wrongly called our “bad” cholesterol) by increasing the absorption of cholesterol through your liver, preventing it from effectively eliminating excess cholesterol.
So you see, diabetes causes you to make more triglycerides and then hypothyroidism helps you to keep them around, either stored as fat because you don’t utilize them for energy or within the bloodstream.
High triglyceride blood plasma levels are one marker used to show increased risk factor for heart disease, atherosclerosis, metabolic syndrome, transient ischemic attacks (TIA) and stroke. 
In fact two studies found that increased triglycerides were a more reliable marker for future strokes that LDL or that so called “bad cholesterol”.
Prior to these two studies elevated LDL levels were always deemed the prime suspect in the development of stroke.
In the first study that was done, spanning over 4 years, researchers at UCLA collected data on more than 1,000 patients who were admitted to the medical center for TIA’s.
All of the study patients had fasting lipid panels drawn the day following admission to the hospital. After comparing the lipid panels, researchers found that patients with the highest triglyceride levels were 2.7 times more likely to suffer a stroke than those with low triglyceride levels.  
LDL levels, however, showed no correlation to stroke risk.
A 2001 study reported similar results. An Israeli team of scientists’ analyzed more than 11,000 patients, all of whom had coronary heart disease but had never suffered a stroke. 
During an 8-year follow-up period, 487 of those study patients had a TIA or full-blown stroke.
In studying these patients’ findings along with those whom had high triglycerides, researchers determined that diabetics with thyroid conditions who had triglyceride levels of 200 mg/dL or more had a 30% greater risk of having a stroke than patients with normal triglyceride levels.
This information has been around for over 10 years, and if your triglycerides have always been an issue in your blood panels, has your doctor ever explained this to you?
If the doctor does any reading of research at all they should know this connection between Diabetes, Hypothyroidism, Glucose, Triglycerides, Heart Disease and Strokes.
If they don’t acknowledge this and, instead continue to prescribe you statins for your supposed high cholesterol, then maybe it’s time for you to find a doctor that does actively search out the newest, life saving research.
You deserve to have a health care provider that actually provides “health improving care”, not just  “keep you from dying care”. 
Think about the definition of medicine: The prevention, alleviation, or cure of disease.
Knowing that definition would you say that, in your opinion, the doctors you see for your health, have they prevented any of your diseases? Have they cured you of any of these disease conditions?
 I bet the your answers to those 2 questions is a profound “No!”.  In fact, when you have your blood chemistry tested and a blood chemistry result comes back on your test that is out of range the doctor probably tells you "We'll watch it.", not giving any explanation or a limited explanation at best about what they are watching and waiting for.
Well let me clue you in, this “watch and wait” is really a code for “We need for your health to become worse because, in reality, you aren’t sick enough for the type of care that we provide.”   
That's Not Health Care, That's Sick Care!
This is why you continue to deteriorate as the years go by because no one is trying hard enough for you! They aren't getting to the root cause of your problems.
You need a health provider who is willing to investigate your health in order to find what the cause of all these problems you are saddled with. A health-rejuvenating clinician that doesn’t blame your "Bad Luck" for what you are going through.
Saying a person with your health is just unlucky is a cop-out. It is a lazy doctor’s excuse to be incompetent. It's their way of dealing with their inadequate and falsely labeled “health care” treatment.
The best that you get from the medical doctor is an attempt to alleviate your symptoms, but even then they are ignoring this huge elephant in the room that I just went over with you, which is:  
Triglycerides, Not Cholesterol, Is How You Assess The Risk Factor Of A Future Stroke In Those Patients With Both Hypothyroid Disease And Diabetes!
You are invaluable to your family, friends and loved ones, don’t you think you are deserving of a doctor who’s life mission it is to contribute to his patients allowing them the opportunity to achieve the most optimal health imaginable?
A doctor who will look at your health as a whole so that you are afforded the very best care by using his knowledge of the human body and all it's systems to find the common cause of your multiple health system issues! That doctor would then need to know what to do for you so that you are no longer burdened with that always present fear that comes with the uncertainty of not knowing when the next “health crisis” shoe will drop causing you to become even more ill.
To live is to be able to enjoy your life as it was meant to be, it's not just going through the motions of the day unable to do the things that you love because of your poor health. Isn't it time to stop beating your head against the wall and change the direction of your life? Well then you are going to have to find someone that knows how to look at hypothyroidism and diabetes from a functional perspective.
Has your doctor even tested you for an autoimmune thyroid? If not, how does that doctor know what in the world is really going on in your body?
The doctor you entrust your health, and ultimately your life with needs to look beyond the labels of hypothyroidism and/ or diabetes so that they are able to do some real, health improving detective work to find the root cause(s) of your specific issue(s).
Do you get blood work results that are out of range and yet your doctor doesn’t seem to concerned with those pathological findings, telling you that we’ll just watch those results and see how they are on the next follow-up and when that time comes the doctor does the same thing again?  Worse yet, does your doctor not even acknowledge the negative results and instead tells you that your blood work is fine, making up some lame excuse like it’s ok for your age and weight?
If that's the case it is imperative that you find someone who understands the interaction between Hypothyroidism, Diabetes and the rest of your body's systems.
The combination of these two diseases in one individual is a deadly serious problem that cannot be swept under the rug and ignored, you must find a doctor that fully understands the gravity of this situation and will give it the attention it deserves by analyzing all the facts from a functional medical perspective.
Fortunately, I have spent many countless hours on these specific disease processes. I have the background, knowledge and desire it takes to get to the root of your problems so that you don’t become a statistic of an ever increasingly cold and incompetent health care system.
Patients often times are forced to blindly travel down the path of poor health as it meanders along due to a doctor that is either far too busy, too lazy or just too damn stubborn to stay up to date with the most current scientific research.
Chronic health conditions such as these are given the most inadequate of care in our current health care system and a huge reason is the health insurance companies. You see, they are the controller of the money and they dictate what care a patient will receive; many times a doctor is unable to exercise their full clinical skills due to the fact that they wouldn't be reimbursed by the insurance company as well as they dare not go against what has been set as the "Standard Of Care" for a particular health condition even though that Care is generic in that it is based on the diagnosed condition and not based upon an individual patient's uniqueness.
Unfortunately our health care system for the chronically ill patient is broken and patient care is no longer based on the individual but instead, it is has become an assembly line of “cookie cutter” treatment protocols that do not deviate much from patient to patient within the same diagnosis.
If you have been in the medical system for any length of time, you know this to be the case.
You are expected to wait, sometimes hours after your appointment time to see the doctor, then, when you finally get into your exam room, the doctor asks you a few questions, may or may not order blood work and then write you a couple of prescriptions for Synthroid®to cover the hypothyroid and Metformin® for your diabetes.
They can’t take the time to explain why your blood work is the way it is, nor will they have an answer as to why you continue to feel as you did before beginning your thyroid replacement hormones and the diabetes support medications.
Don’t you think you deserve better than what you have been getting in regards to your healthcare?  
Isn’t your life as important as anyone else’s?
Shouldn’t the doctor you employ to recover your lost health make it his fundamental duty to do all that is within his God given talent and power so that you no longer continue on the downward spiral of decreasing health in which you find yourself now?
If you are finally sick and tired of being sick and tired and you want to find someone that cares as much about your health as you do, then call my office at 281-812-8101 and set up a free, no obligation Health Recovery Workshop so you may see for yourself that there is hope and you are not destined to live a life of misery.
My door is open for those that want to take responsibility for their own health and stop relying on some profit driven, corporate health insurance company with their doctors that feed into this international profit driven machine at the expense of their patients’ health and many times the patient pays the ultimate cost by losing that same health and life that they and entrusted with the doctor to protect, nurture and improve.
If you have any questions or just want to sit down and talk about the possible solutions to your health issues, then please give my office a call at: 281-812-8101.
If you want to learn more please go to my website at:
In Health,
Dr. Walter K. Crooks DM (P), DC, CCCN

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3 in 5 Kentucky adults favor a statewide smoking ban, according to an independent poll that may have oversampled smokers

By Al Cross
Kentucky Health News

Kentuckians now favor a statewide smoking ban by a margin of 3 to 2, according to the latest Kentucky Health Issues Poll conducted last fall for the Foundation for a Healthy Kentucky. Interestingly, 38 percent of the Kentucky adults polled said they were smokers, much more than the 29 percent found by a year-long federal survey. Among those identified as smokers, 37 percent favored such a law, while it was favored by 68 percent of former smokers and 75 percent of those who said they had never smoked.

Overall, 59 percent of those polled said they supported a state law that would prohibit smoking in most public places, including workplaces, public buildings, offices, restaurants and bars, while 38 percent said they opposed it and 4 percent said they had no opinion. The figures showed a 5-point shift toward support since the last poll, in 2011. The gain was among smokers and former smokers.

Support for the law was higher among registered voters than non-voters, perhaps a consideration for legislators considering the proposal. Among voters, 62 percent favored it while 36 percent opposed it. Only 50 percent of nonvoters supported it. Support was slightly higher among Republicans (64 percent) than among Democrats (59 percent; only 44 percent of independents, who comprise about 7 percent of Kentucky voters, said they supported it. The poll also found that support for the law increases as age and income increase.

As for the apparent oversampling of smokers, pollster Eric Rademacher said self-reporting of such habits is known to vary according to time, and the differences in his poll and the federal survey "are likely due to the different time frames in which they were conducted and the different methodology employed by each study." He added, "For example, a person who regularly smokes might openly disclose that information at one point in the year. However, at another point in the year, that same person might be directly exposed to news or advertising that paints smoking in a negative light from a societal perspective. Hearing that information could make the person more reluctant to discuss their smoking behavior with researchers soon after they have seen or heard it.”

Rademacher is co-director of the Institute for Policy Research at the University of Cincinnati, which did the poll for the foundation and the Health Foundation of Greater Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by telephone from Sept. 20 to Oct. 14. This included 1,360 landline interviews and 320 interviews with cell phone users. In 19 of 20 cases, each statewide figure will be accurate to plus or minus 2.5 percentage points. Smaller samples, such as those of smokers and non-smokers, have larger margins of error. There are other sources of variation inherent in public opinion studies, such as non-response, question wording, or context effects that can introduce error or bias. For a copy of the poll's full questionnaire and guidance to interviewers, click here. For more information, go to www.healthy-ky.org
or www.healthfoundation.org/kentucky-health-issues-poll.

The Foundation for a Healthy Kentucky noted the health implications that a smoke-free law would address: "Secondhand smoke poses serious health risks. Smoke-free environments are the only way to fully protect nonsmokers from these hazards. To reduce these risks, many Kentucky communities have adopted smoke-free policies. On Jan. 1, 2013, Hopkinsville became the 22nd municipality in Kentucky to implement a comprehensive smoke-free ordinance or regulation," bringing to 34 percent the share of Kentuckians who live in jurisdictions covered by comprehensive smoke-free ordinances or health-department regulations. For a list of the communities and percentages, and those with bans that are less than comprehensive, from the Kentucky Center for Smoke-Free Policy, click here.

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.
By Al Cross
Kentucky Health News

Kentuckians now favor a statewide smoking ban by a margin of 3 to 2, according to the latest Kentucky Health Issues Poll conducted last fall for the Foundation for a Healthy Kentucky. Interestingly, 38 percent of the Kentucky adults polled said they were smokers, much more than the 29 percent found by a year-long federal survey. Among those identified as smokers, 37 percent favored such a law, while it was favored by 68 percent of former smokers and 75 percent of those who said they had never smoked.

Overall, 59 percent of those polled said they supported a state law that would prohibit smoking in most public places, including workplaces, public buildings, offices, restaurants and bars, while 38 percent said they opposed it and 4 percent said they had no opinion. The figures showed a 5-point shift toward support since the last poll, in 2011. The gain was among smokers and former smokers.

Support for the law was higher among registered voters than non-voters, perhaps a consideration for legislators considering the proposal. Among voters, 62 percent favored it while 36 percent opposed it. Only 50 percent of nonvoters supported it. Support was slightly higher among Republicans (64 percent) than among Democrats (59 percent; only 44 percent of independents, who comprise about 7 percent of Kentucky voters, said they supported it. The poll also found that support for the law increases as age and income increase.

As for the apparent oversampling of smokers, pollster Eric Rademacher said self-reporting of such habits is known to vary according to time, and the differences in his poll and the federal survey "are likely due to the different time frames in which they were conducted and the different methodology employed by each study." He added, "For example, a person who regularly smokes might openly disclose that information at one point in the year. However, at another point in the year, that same person might be directly exposed to news or advertising that paints smoking in a negative light from a societal perspective. Hearing that information could make the person more reluctant to discuss their smoking behavior with researchers soon after they have seen or heard it.”

Rademacher is co-director of the Institute for Policy Research at the University of Cincinnati, which did the poll for the foundation and the Health Foundation of Greater Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by telephone from Sept. 20 to Oct. 14. This included 1,360 landline interviews and 320 interviews with cell phone users. In 19 of 20 cases, each statewide figure will be accurate to plus or minus 2.5 percentage points. Smaller samples, such as those of smokers and non-smokers, have larger margins of error. There are other sources of variation inherent in public opinion studies, such as non-response, question wording, or context effects that can introduce error or bias. For a copy of the poll's full questionnaire and guidance to interviewers, click here. For more information, go to www.healthy-ky.org
or www.healthfoundation.org/kentucky-health-issues-poll.

The Foundation for a Healthy Kentucky noted the health implications that a smoke-free law would address: "Secondhand smoke poses serious health risks. Smoke-free environments are the only way to fully protect nonsmokers from these hazards. To reduce these risks, many Kentucky communities have adopted smoke-free policies. On Jan. 1, 2013, Hopkinsville became the 22nd municipality in Kentucky to implement a comprehensive smoke-free ordinance or regulation," bringing to 34 percent the share of Kentuckians who live in jurisdictions covered by comprehensive smoke-free ordinances or health-department regulations. For a list of the communities and percentages, and those with bans that are less than comprehensive, from the Kentucky Center for Smoke-Free Policy, click here.

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.
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Legislature likely to tweak, clarify and limit last year's 'pill mill bill'

State lawmakers could narrow the focus of last year's "pill mill bill" during the legislative session that begins tomorrow, to concentrate on adults with long-term prescriptions for frequently abused painkillers, John Cheves of the Lexington Herald-Leader reported yesterday. Doctors, hospitals and patients have complained that HB 1 in its current from "restricts too many drugs in too many clinical settings, needlessly complicating medical care in an effort to shut down storefront pain clinics that recklessly hand out prescriptions," Cheves writes.

Under the law, people with long-term prescriptions for controlled substances must submit to urine drug testing to determine if they are actually taking the drug rather than selling it, and if other unprescribed drugs are in their systems. Some patients complained they were being charges hundreds of dollars for urine tests because their insurance companies denied coverage of such testing. One couple was charged more than $900 for tests to get prescriptions for insomnia and anti-anxiety medication.

The new rules, being drafted by the Kentucky Board of Medical Licensure, would reduce the mandate for drug screening to pain medicine prescriptions of 90 days or more. Other medications would not require testing unless the doctor thinks it's necessary. The new rules will say that other types of testing which would be cheaper, including hair, could be used. The board is also restricting its focus to powerful painkillers, including hydrocodone and oxycodone.

The new regulations are subject to approval by the legislature, which could write its own restrictions into law, but the consensus appears to be that the law needs tweaking, not major changes. for example, House Speaker Greg Stumbo said it should be changed to clarify that hospitals don't have to run a new background check on a patient every time they give another dose of a controlled substance during his stay. (Read more)
State lawmakers could narrow the focus of last year's "pill mill bill" during the legislative session that begins tomorrow, to concentrate on adults with long-term prescriptions for frequently abused painkillers, John Cheves of the Lexington Herald-Leader reported yesterday. Doctors, hospitals and patients have complained that HB 1 in its current from "restricts too many drugs in too many clinical settings, needlessly complicating medical care in an effort to shut down storefront pain clinics that recklessly hand out prescriptions," Cheves writes.

Under the law, people with long-term prescriptions for controlled substances must submit to urine drug testing to determine if they are actually taking the drug rather than selling it, and if other unprescribed drugs are in their systems. Some patients complained they were being charges hundreds of dollars for urine tests because their insurance companies denied coverage of such testing. One couple was charged more than $900 for tests to get prescriptions for insomnia and anti-anxiety medication.

The new rules, being drafted by the Kentucky Board of Medical Licensure, would reduce the mandate for drug screening to pain medicine prescriptions of 90 days or more. Other medications would not require testing unless the doctor thinks it's necessary. The new rules will say that other types of testing which would be cheaper, including hair, could be used. The board is also restricting its focus to powerful painkillers, including hydrocodone and oxycodone.

The new regulations are subject to approval by the legislature, which could write its own restrictions into law, but the consensus appears to be that the law needs tweaking, not major changes. for example, House Speaker Greg Stumbo said it should be changed to clarify that hospitals don't have to run a new background check on a patient every time they give another dose of a controlled substance during his stay. (Read more)
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