How to Cook Cabbage

The humble cabbage is an economically important plant with European origins. While eaten all over the world, it has a reputation of being boring because it’s often used as a simple side dish for gatherings such as backyard barbecues. However, ignore it and you’ll miss out on its culinary potential and health benefits.

Different Ways of Cooking Cabbage

Before learning how to cook cabbage, it’s important to first prepare cabbage properly, and that starts from choosing the best cabbage possible. The Spruce Eats recommends that you “look for heads with plenty of outer leaves, and check the bottom to make sure the leaves are not pulling away from the stem.”

Inspect the leaves to make sure they are fresh and have minimal wilting, and look for those that have tight groupings. Here’s another useful tip: If you’re at a farmers market, ask the producer when the cabbage was harvested — cabbages are sweeter after a frost.

The next step in cooking cabbage is to prepare it. Better Homes & Gardens has outlined easy-to-follow steps on how to ready the vegetable before cooking:

  • Remove the loose outer leaves and rinse the head with water.
  • Slice the head in half, then slice further into quarters.
  • Remove the core from the wedges.
  • If you want to coarsely chop a wedge, simply slice a wedge perpendicular to the knife and cut into one-fourth-inch pieces.

Now that you know how to prepare cabbage, it’s time for you to cook it. But the question is, what is the best way? The answer depends on what you want, as there are several ways to cook cabbage. These ideas adapted from EatingWell magazine provide several methods you can try at home:

How to Cook Cabbage on the Stove

Braised Cabbage

  • Heat coconut oil in a large pot on medium heat.
  • Add quartered cabbage (with the core taken out), stirring occasionally for five minutes until the leaves wilt.
  • Add organic chicken or vegetable broth into the pot, with a dash of salt, pepper and bay leaves. Bring to a simmer, cover the pot and lower heat until cabbage becomes tender.
  • Add a splash of apple cider vinegar and increase temperature to medium high. Continue to cook until most of the liquid evaporates.

Steamed Cabbage

  • Place a steamer inside a large pot, then add enough water to fill the bottom of the pan. The water level must not reach the steamer basket.
  • Let the water boil, then add cabbage slices to the steamer. Cover the pot until the cabbage is cooked thoroughly, around 10 to 12 minutes.

Sautéed Cabbage

  • In a pan, heat coconut oil over high heat.
  • Add chopped cabbage, stirring occasionally for seven to 10 minutes until the leaves wilt.
  • Season the cabbage with salt and pepper, then add fennel seeds (optional).

Boiled Cabbage

  • Fill a large pot with water until it reaches a height of half an inch. Slightly salt the water.
  • Bring the water to a boil and add cabbage slices. Cover and simmer for 15 to 20 minutes. Turn the slices once.
  • Remove the water and continue to boil until the remaining liquid evaporates. Add organic grass fed butter and toss the vegetables.

How to Cook Cabbage in the Oven

Roasted Cabbage

  • Heat the oven to 245 degrees Fahrenheit.
  • Cut the cabbage into wedges and toss in coconut oil. Place the wedges in a single layer on a baking sheet, then season with salt and pepper, plus caraway seeds (optional).
  • Roast the cabbage until tender, around 25 to 35 minutes. Flip once halfway through cooking.

Cooking Different Types of Cabbage

If you don’t cook with cabbage often, the green variety is probably the one you’re most familiar with. However, there are actually other varieties available, leading to different characteristics that you can take advantage of, depending on what you’re cooking. The Spruce Eats outlines the four most commonly used cabbages:

  • Green cabbage — The most common cabbage variety, it resembles iceberg lettuce. It has a peppery taste when eaten raw, but becomes sweeter when cooked.
  • Red or purple cabbage — This variety is practically the same as green cabbage, as it may be interchanged in recipes without changes in flavor. The only difference is that your food will take on a redder appearance. Furthermore, if you cook red cabbage with an alkaline substance (such as tap water), it will turn blue because of the anthocyanin in the leaves. It’s recommended you add acidic agents, such as lemon juice, if you want to maintain the red look.
  • Savoy cabbage — It looks similar to green cabbage, but has wrinkled leaves and is considered to be the most tender and sweetest cabbage variety.
  • Napa cabbage — It has a milder flavor, with sweetness and frilly leaves.

Now that you know the cabbage varieties, which one goes best with what dish? The Michelin Guide provides useful insight on the best dishes to cook for each cabbage:

  • Green cabbage — Best prepared shredded to make great coleslaw or sauerkraut. Also works well in soups.
  • Napa cabbage — Heavily used in East Asian cuisine, this cabbage is used to make kimchi.
  • Savoy cabbage — Works great as a wrap for ingredients such as meat, or braised for a different flavor.
  • Red cabbage — Best used on salads or coleslaw, as well as sauerkraut.

Ways to Cook Cabbage

The versatility of cabbage lies in the many ways you can cook it. You can enjoy it on its own or as part of a main dish. The only limit is your creativity. Here are some easy recipes to help you get started:

Boiled Cabbage: Simple Boiled Cabbage Recipe

Ingredients:

  • 1 medium head cabbage
  • 1/2 teaspoon Himalayan salt
  • 3 to 4 tablespoons melted organic grass fed butter
  • Black pepper to taste

Procedure:

  • Rinse the cabbage and cut into six wedges.
  • Pour filtered water onto a pot until it is one-half inch deep. Add the cabbage slices and salt, and simmer. Cover the pot for eight to 10 minutes.
  • Turn the cabbage and simmer for another eight minutes until tender. Discard the water, and simmer until the remaining liquid evaporates.
  • Sprinkle with salt and pepper and serve.

(Recipe adapted from The Spruce Eats )

Fried Cabbage: Lemon Garlic Sautéed Cabbage Recipe

Ingredients:

  • 10 cups shredded cabbage
  • 1 1/2 tablespoons coconut oil
  • 1 tablespoon garlic, minced
  • Red pepper flakes, crushed
  • 1/2 teaspoon Himalayan salt
  • Half of a lemon, cut into wedges

Procedure:

  • Heat the oil in a large skillet over medium-high heat.
  • Add all ingredients (except the lemon), stirring occasionally until the cabbage becomes tender, around 10 to 15 minutes.
  • Squeeze two lemon wedges over the cabbage. Adjust seasoning as needed and add more lemon to taste.
  • Serve and enjoy.

(Recipe adapted from Inspired Taste )

Steamed Cabbage: Simple Steamed Cabbage Recipe

Ingredients:

  • 1/4 small cabbage, cut into slices
  • 2 tablespoons raw, grass fed butter
  • Salt to taste

Procedure:

  • Fill a large pot with water and place a steam basket on top of it. The water must not touch the basket.
  • Boil the water and add the cabbage slices to the steam basket.
  • Cover the basket and cook until the vegetable becomes tender, around five to eight minutes.
  • Place cabbage in a container, add butter and salt, and serve.

(Recipe adapted from The Spruce Eats )

Roasted Cabbage: Easy Roasted Recipe

Ingredients:

  • 1 medium head cabbage, cut into 6 to 8 wedges
  • Coconut oil for drizzling
  • Salt and ground black pepper

Procedure:

  • Heat the oven to 500 degrees Fahrenheit.
  • Place the cabbage wedges on a baking sheet in a single layer. Drizzle with oil and seasoning on one side, then repeat the process on the other side.
  • Roast the cabbage until lightly browned, which is about 10 minutes. Flip wedges and continue cooking for another 10 minutes.

(Recipe adapted from Serious Eats )

Sautéed Cabbage: Quick Sautéed Cabbage Recipe

Ingredients:

  • 1 small head white cabbage
  • 2 tablespoons raw grass fed butter
  • 1 1/2 teaspoon Himalayan salt
  • 1/2 teaspoon freshly ground black pepper

Procedure:

  • Cut cabbage in half and slice as thinly as possible around the core. Discard the core.
  • In a large pan, melt the butter over medium-high heat. Add cabbage, salt and pepper and sauté for 10 to 15 minutes until the cabbage begins to brown.
  • Add more seasoning to your liking and serve.

(Recipe adapted from Food Network )

Grilled Cabbage: Grilled Cabbage Steaks

Ingredients:

  • 1 large cabbage head, cut into 1/2-inch thick rounds
  • Coconut oil, for brushing
  • Himalayan salt and freshly ground pepper
  • Crushed red pepper flakes
  • Chopped organic bacon (already cooked), for serving
  • Crumbled blue cheese made from grass fed milk
  • Chopped green onions
  • Homemade ranch dressing

Procedure:

  • Create a medium-high heat for the grill.
  • Brush the cabbage steaks on both sides with oil, then season with salt, pepper and the red pepper flakes. Grill for five minutes on each side.
  • Top with the bacon, cheese and green onions. Drizzle with the homemade ranch dressing.

(Recipe adapted form Delish )

Cabbage Stir-Fry: Quick Stir-Fry Cabbage Recipe

Ingredients:

  • 2 teaspoons coconut oil
  • 1 small onion, sliced
  • 1 clove garlic, minced
  • 1 teaspoon ginger, minced
  • 1 head napa cabbage, sliced
  • 2 tablespoons organic soy sauce
  • 1 tablespoon organic apple cider vinegar
  • 2 teaspoons organic sesame oil, for drizzling

Procedure:

  • Heat the oil in a large pan over medium-high temperature.
  • Add the onion, garlic, ginger and sauté for a minute.
  • Add cabbage and cook until leaves begin to wilt, about two minutes.
  • Add the soy sauce and vinegar, stirring for three minutes.
  • Remove from heat and drizzle sesame oil.

(Recipe adapted from Food Network )

Cabbage Recipes: Cabbage Soup

Making your own cabbage soup is one of the best ways to introduce yourself to this wonderful vegetable. Aside from being tasty in its own right, it’s the best meal to warm up a cold winter day. To make the most out of this dish, you will need a slow cooker.

Crock Pot Cabbage Soup

Cook Time: 4 hours Serving Size: 4 servings

Ingredients

  • 2 to 3 free-range organic chicken breasts
  •  2 tablespoons coconut oil
  • 2 celery stalks, chopped
  •  3/4 cup carrots, chopped
  •  1/2 cup zucchini, peeled, deseeded and chopped
  •  3 garlic cloves, minced
  •  1 small yellow onion, diced
  • 1 teaspoon dried basil
  •  1/2 teaspoon dried oregano
  •  4 cups chicken broth
  •  1/2 head of cabbage, chopped

Procedure

  • Coat slow cooker with coconut oil, then add chicken.
  1. Add chopped celery, carrots, zucchini, garlic and onion. Next, add basil, oregano, salt, pepper and broth.
  2. Cook soup on high for approximately two hours and then remove bones from chicken and add chicken back to the pot. Add the chopped cabbage.
  3. Cook soup on high for an additional two hours before removing from the slow cooker. Enjoy!

(Recipe adapted from Paleohacks )

Cabbage Health Information

Cabbage belongs to the cruciferous family of vegetables, which include broccoli, cauliflower, collard greens, kale and Brussels sprouts. Cruciferous vegetables are known for their bitter taste due to their sulfuric compounds, but this very feature makes them unique from a nutrition perspective. You may refer to the table below to give you an overview of the vegetable’s offerings:

Cabbage Nutrition Facts

Serving Size: 3.5 ounces (100 grams), green, raw

 

Amt. Per
Serving

% Daily
Value*

Calories

25

 

Calories from Fat

0.7

 

Total Fat

0 g

0%

Saturated Fat

0 g

0 g

Trans Fat

 

 

Cholesterol

0 mg

0%

Sodium

18 mg

1%

Total Carbohydrates

5.8 g

2%

Dietary Fiber

2.5 g

9%

Sugar

3.2 g

 

Protein

1.28 g

 

Vitamin A  98 IU

Vitamin C

36.6 mg

Calcium  40 mg

Iron

0.47 mg

*Percent Daily Values are based on a 2,000-calorie diet. Your daily values may be higher or lower depending on your calorie needs. Source: USDA

Health Benefits of Cabbage

Research has shown that cruciferous vegetables contain sulforaphane, a compound that has anti-inflammatory properties, chemoprotective compounds and osteoporosis-fighting abilities. A 100-gram serving of cabbage contains 2.5 grams of dietary fiber, which may benefit your health in profound ways, such as:

  • Reducing the risk of cardiovascular disease — Higher intake of dietary fiber may significantly reduce the risk of death from cardiovascular disease, according to a meta-analysis published in 2017.
  • Lowering the risk of colon cancer — A 2017 study published in Metabolism noted that dietary fiber may help lower your risk for colon cancer.
  • Managing Type 2 diabetes Those affected with Type 2 diabetes may fare better when dietary fiber intake is increased, as it may help decrease glucose absorption into the bloodstream.

To learn more about cabbage, I recommend reading the article “What Is Cabbage Good For?”

Go Crazy With Cabbage

At first, cabbage may seem like an ordinary, boring vegetable. But as it turns out, all you need is some creativity and it can easily become one of your favorite ingredients to cook with. The sulforaphane and dietary fiber are great bonuses to your health as well.

Frequently Asked Questions About Cabbage

Q: Is cabbage good for you?

A: Cabbage is a healthy vegetable that you should add to your diet. Research shows that cabbage contains sulforaphane, which is a compound found in cruciferous vegetables. This veggie family contains antioxidant properties that may benefit your health in several ways.

Q: Can you freeze cabbage?

A: Yes, you can freeze cabbage, but it needs to be sliced up, blanched and cooled in ice water first. From there, you can enjoy the vegetable all year long.

Q: Is cabbage keto?

A: According to Perfect Keto, cabbage is a low-carb veggie that may fit in a ketogenic diet plan without affecting ketosis.

Q: Is cabbage a low-carb veggie?

A: The United States Department of Agriculture (USDA) notes that a 100-gram serving of cabbage contains only 5.8 grams of carbs, making it a low-carb food.

Regenerative Medicine for Nerve and Neuropathic Pain

Dr. Matthew Cook is a former anesthesiologist who became a regenerative medicine specialist and founder of BioReset Medical1 in Campbell, California. In this interview, we discuss several novel therapies offered there, which can be next to impossible to find elsewhere.

“I went to medical school and did an anesthesiology residency at University of California San Francisco (UCSF) … I was doing regional anesthesia, so I was basically doing nerve blocks all day, every day …

After that … I figured out how to do almost every surgery, from total knee replacement to shoulder surgery, without having to do general anesthesia. I sort of evolved into finding out that I could fix a lot of those problems either by treating nerves or treating ligaments, tendons, fascia and joints. I started the regenerative medicine practice.

As part of my journey of doing that, I found that NAD [nicotinamide adenine dinucleotide] was one of the most powerful tools in terms of resetting human biological systems. I started incorporating, putting it into different protocols,” Cook says.

The Importance of NAD for Optimal Health

NAD+ is a vital coenzyme found in all living cells. It’s essential for over 700 enzymatic reactions in your body, including ones occurring in your mitochondria. Without sufficient NAD, you’re likely to age and die prematurely.

Nicotinamide adenine dinucleotide phosphate hydrogen (NADPH) is the reduced, phosphorylated form of NADP+. NADPH is a reducing agent necessary for anabolic reactions, including lipid and nucleic acid synthesis. 

For example, without sufficient amounts of NADPH, your body cannot recharge glutathione once it becomes oxidized. The reason I’m so intrigued with Cook’s work is because very few clinicians understand the importance of NAD, let alone apply it clinically. One exception is in the treatment of alcohol addiction. Cook explains:

“People have been using NAD or its precursors, for example niacin, in addiction since the ’60s … Early on in Alcoholics Anonymous, niacin was an important component of the protocol … Of the 700 enzymes that NAD catalyzes, one of them is alcohol dehydrogenase.

Every time an alcohol molecule is broken down, two NAD+ molecules are consumed … Daily continuous long-term exposure to [alcohol] ends up leading to a very extensive depletion in the NAD levels. Our NAD levels probably drop by 90% from age 1 to age 90.

We can do a lot to either prevent that or accelerate that in the case of addiction. I started my experience by treating people with addiction and had fairly profound results in terms of repleting people’s total body source, by giving people a 10-day intravenous (IV) experience.”

Aside from niacin, two other more commonly used precursors to NAD are nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN). While these will help, they’re not excellent.

Cook, on the other hand, uses the actual NAD+ molecule, administered either through IV, subcutaneously, transdermally or submucosally — either sublingually or transrectally. This, I believe, is the leading edge and a strategy that can go a long way to restoring health, and not just for those struggling with alcohol addiction.

Clinical Uses of NAD

As noted by Cook, NAD is involved in some 700 enzymatic reactions, so listing them all is not possible here. Importantly, though, it can activate enzyme systems, DNA repair, and sirtuins (so-called “longevity proteins”) that are crucial to multiple enzymatic pathways within the mitochondria, where your cellular energy is generated.

“As a simple example, there are mitochondria in nerves. One thing I found is that people who have nerve pain, people who have neuropathic pain, if I give them NAD — and I’ve used every single one of the routes just mentioned — nerve pain will go down,” Cook says.

“It turns out if I give NAD surrounding a stem cell therapy or any regenerative medicine therapy, the therapy seems to work better … NAD seems to help turn the immune system on and get it functioning [properly]. It helps people start to detox and get their detox pathways going …  

I’ve noticed it improves cognitive function. It helps people recover from traumatic brain injury, from concussions. I think it’s very, very profound in terms of what happens, in terms of the central and peripheral nervous system.

I’ve spent a lot of time treating patients with myriad conditions, from Parkinson’s and dementia to peripheral neuropathy. I’ve seen improvements in all of those areas.

My approach to almost all of those problems is very multifactorial and multimodal. NAD is one of the tools that I use. I find it to be very helpful … In biological systems, there are messengers that turn on other components of a system that modulate that system.

Our goal is to do something that modulates either up or modulates down, depending on the situation we’re facing. That modulation creates harmony and equilibrium, and then that resets us.”

A common side effect of rapid NAD IV infusion is a flush-like experience similar to that of niacin. This flushing effect is likely an effect of methyl depletion, and can be circumvented by taking a methyl donor such as glycine or trimethylglycine.

Strategies That Increase NAD

Aside from using a precursor such as niacin, NR or NMN, other ways to increase NAD include exercise and fasting or time restricted eating.

It bears mentioning, however, that unless you’re attending to the basics of health — optimizing your sleep, limiting EMF exposure, exercising, intermittently fasting and avoiding food for at least three hours before bed — then simply adding NAD or NAD precursors may be a waste of time. It’s not a magic molecule that’s going to cure all your ills if you are violating basic health tenets.

Benefits of Hyperbaric Oxygen Therapy

One crucial consumer of NAD is PARP, or poly-ADP ribose polymerase (its name was recently changes to ARDT). Whereas alcohol dehydrogenase takes out two NAD molecules, PARP takes about 150 each time it repairs a single- or double-stranded DNA break. Electromagnetic fields (EMFs) tend to overactivate PARP due to the DNA damage incurred.

Naturally there are many other sources of oxidative stress as well, and regardless of the cause, PARP will help repair it, but it needs NAD as a sirtuin protein.

Other nutrients you can use would be molecular hydrogen and hyperbaric oxygen. To me, hyperbaric oxygen and NAD are the two vital tools that can help optimize longevity, laid on the foundation of everything else we know about staying healthy.

Hyperbaric oxygen therapy or HBOT involves increasing the atmospheric pressure in the hyperbaric chamber while you’re breathing a high concentration of oxygen. This increases the oxygen partial pressure in your body, beginning in your lungs, followed by your blood vessels and eventually your brain. In other words, you’re increasing the amount of oxygen tension in your brain.

“One of the expressions a lot of hyperbaric people will say is, ‘Oxygen heals.’ I definitely think that’s true,” Cook says. “About once a week, I’ll do a subcutaneous NAD. This morning, I took some vitamins, a subcutaneous NAD, and then I got in the hyperbaric chamber for 20 minutes. I can’t imagine feeling better than I feel right now.”

In the interview, Cook also shares a story about how hyperbaric oxygen therapy and NAD administration the week before a major surgery radically cut the patient’s recovery time — and eliminated her need for pain medication altogether.

Hyperbaric oxygen therapy is approved for 17 clinical conditions (although insurance will only cover a few of them). Just imagine the benefits were more people given access to this before going under the knife for complicated surgeries. It could actually result in significant cost savings.

Hyperbaric oxygen also appears to have significant antiaging benefits, likely because it’s a potent anti-inflammatory that removes senescent cells and increases stem cell activation.

It can also help improve cognitive function, and improves oxygen and nutrient supplies in your body. Oxygen is used in mitochondria. If you don’t have enough oxygen, you can’t optimize your energy production, so that’s an important variable for health and longevity.

BioReset Training for Clinicians

While Cook’s treatments are hard to come by elsewhere, he is training other clinicians, trying to spread this information. For more information, see BioResetNetwork.com. There, you will find a full video NAD certification course.

“I go over the science and a lot of what we’re talking about [here],” Cook says. “I go over everything I found to make it work better with fewer side effects, which I think is important. I go over our protocols of how we give it in combination with other things. I often give [NAD] with ketamine.”

On Ketamine

Ketamine is a drug that turns off one of the depression pathways in the brain and makes you feel safe. For that reason, it is sometimes used in the treatment of post-traumatic stress disorder (PTSD). Cook explains:

“One of the many things that our protocol for PTSD [includes] is an infusion of intravenous ketamine, which we would give after an NAD infusion … It’s a mild psychedelic. It gives them an ability to see that they’re going to be OK.

It’s one of the most profound things that I do … The woman I saw this morning was a victim of terrible sexual abuse. For the last 40 years, she hasn’t been able to lie down in bed on her back because she thinks, at all times, that someone’s going to attack her.

She told me that for the last two months, she lies on her back and she feels totally safe and she hasn’t thought about [the abuse]. She told me to mention it to you.

That’s sort of emblematic of the type of things that we’re seeing. That, along with … NAD is part of a reset that’s temporary. We’re resetting the biological system, and then supporting the natural function afterward.”

Hydrodissection for Pain Relief

Another interesting treatment Cook offers is hydrodissection, a technical skill that his training as an anesthesiologist allows him to do well. During his residency as UCSF, he started using ultrasound to locate nerves, allowing for more precise delivery compared to simply looking at anatomy — an idea raised by his colleague, Dr. Andrew Gray.

Eventually, Cook realized he could inject other things besides a local anesthetic, such as 5% dextrose, placental matrix, stem cells, platelet-rich plasma and fat.

“Once I found that out, within about three months, I had a full-time practice and wasn’t doing anesthesia anymore … It seems to fix peripheral nerve pain. Sometimes it fixes nerve pain from an inflammatory perspective. Sometimes it fixes nerve pain that’s just from impingement.

For example, with carpal tunnel, we stick a needle in and we put fluid around the medial nerve. That’s probably going to, depending on what you put around that nerve, be scientifically proven to be much more effective than carpal tunnel surgery.

We treat every nerve from head to toe, in multiple different locations with multiple different solutions, to turn inflammation off, to relieve entrapment and to reset that biological system.”

Alternative Back Pain Treatments

One of the most common problems that people see their physician for is low back pain. In these cases, Cook will often do a caudal epidural, injecting a chosen substance into the epidural space to surround all the nerves. He explains:

“The spinal cord comes down and spreads into a whole bunch of nerves in the lumbar area. The anatomical name for it is cauda equina, because all of those nerves look like a horse’s tail.

We’re actually doing a hydrodissection in the epidural space. That seems to have a fairly profound effect of resetting the actual nerves coming off the end of a spinal cord. We also do hydrodissection of fascial planes in the back that can be quite profoundly helpful at resetting back pain …

I figure out which nerves are entrapped, which nerves are in pain, and then which muscle groups are involved. Then I either do hydrodissection or I use ultrasound- or fluoroscopy-guided approaches to put something regenerative there.”

Addressing Herniations and Compressed Discs

In cases where a disc is herniated or the compressed disc is putting physical pressure on a nerve, Cook recommends first addressing the posterior ligamentous complex, which includes the iliolumbar ligaments, sacroiliac ligaments, SI joints and facets. About half the time, this will allow a frontal disc herniation to slide back into place.

“A lot of some of the top people who were doing intradiscal therapies will now do posterior approaches first, because it’s very low-risk and very much easier to do,” he says. “A lot of times, I’ll do that to get started. However, if there is a disc herniation, we will use fluoroscopy, which is X-ray, and stick a needle into the disc.

I’ll either put exosomes, PRP or bone marrow into the disc to try to stabilize it. In some cases, we’ll actually put those products in the disc above and below, depending on what’s happening. Often, I’ll also try to treat the nerves around there.

There are nerves in front of the discs, actually, that control your fight or flight nervous system, called the sympathetic chain … We’ll look at see if there are muscle groups that are not working well and start to turn them on by turning on the nerves that go to them.

And then, [we put] something good both around the facet joints and in the deep spinal muscles called the multifidus, which are responsible for most of your proprioception — which is where you are in space. Parallel to that, I’m trying to get a sense of, ‘What else is going on? Can I give hyperbaric oxygen to make the treatment work better? Can I give NAD?’ A lot of times that will help …

A lot of times, if people would have had bad chronic pain, we’ll give ketamine. Ketamine will sort of reset pain and that will start to change the experience. A lot of times they’re on high-dose pain meds, so we’ll use NAD to get them off the pain meds …

I can’t tell you how many people I have who were told they absolutely had to have a [spinal] fusion, and they’re walking around with no pain … Now, this is experimental. It’s new …

Probably the best teacher of this on the planet is my mentor for ultrasound, Dr. Tom Clark. He teaches physicians at a site called MSKUS.com. We teach there and we also teach in my office these approaches on how to do it, and then how to put it all together …

I like to say I spent the first half of my life putting people to sleep and having them undergo surgery. Now I’m spending the rest of my life waking them up and preventing surgery.”

Sample Case History

Cook shares a particularly fascinating success story of a man who’d heard him speak about nerve hydrodissection on Ben Greenfield’s podcast. He was a quadriplegic from a rollover motor vehicular accident. “He was in total spasticity all the time,” Cook says.

Cook performed a hydrodissection, placing exosomes around all major nerves in the man’s arms, legs and epidural space. Afterward, he was able to begin moving his legs — something he’d not been able to do since his accident, three years earlier.

“He started to get this control. Then he went from being able to stand in a locked-out position with the help of two strong people, to being able to do 20 or 30 squats. That was a pretty interesting experience. All of his neuropathic pain went away,” Cook says.

“My next treatment that I’m going to do for him will be with placental matrix because the placental matrix actually is a scaffold that stays around the nerve within the sheath.”

While results have been encouraging, Cook stresses they were not permanent, which indicates the need for further treatments.  

More Information

These really are exciting times. Case stories like that testify to the fact that your body has incredible ability to self-repair and regenerate, given the proper aid. Fortunately, we’re now seeing more doctors like Cook who are operating well outside the conventional box and making new discoveries.

“[Health is about] getting your lifestyle right and then finding appropriate biological tweaks that allow you to heal the DNA breaks, activate the right enzymatic sequences and cascades, so that that system just functions naturally,” Cook says, essentially summarizing what he does at BioReset Medical.

Again, if you’re a clinician and would like to incorporate some of these techniques in your practice, sign up for Cook’s educational courses on BioReset Network. “Soon, there’s going to be an army of people out there, all over the world, doing this type of stuff. It’s going to be a relatively normal standard of care type of approach,” Cook says.

In the meantime, prospective patients can contact Cook via BioResetMedical.com. Simply scroll down the page and fill out the contact form to speak to a team specialist about your case, or call the phone number listed at the top.

If you’re not on the West Coast and can’t travel, contact Cook’s office for a referral to a certified clinician in your local area. The website will eventually include a listing of trained physicians.

Flint’s Deadly Water

The water crisis in Flint, Michigan — one of the poorest cities in the U.S. — began in April 2014, when the state took over city management and decided to switch the city’s water supply from treated Detroit Water and Sewerage Department water to water from the Flint River, a notoriously polluted waterway.

The state’s takeover of Flint’s city management was due to the city being near bankruptcy. For this reason, the influence of city council officials over decisions relating to Flint’s water sourcing was limited.

As longtime Flint resident Rhonda Kelso told CNN in 2016,1 “We thought it was a joke. People my age and older thought ‘They’re not going to do that.'” Indeed, supplying the city with water from a known polluted source seems neither rational nor reasonable nor even ethical. But it wasn’t a joke.

This cost-cutting strategy was implemented to save $5 million — a temporary measure while a new pipeline was being built for the newly created Karegnondi Water Authority, which would supply fresh water from Lake Huron to the mid-Michigan area, including Flint.

Flint’s Unprecedented Health Crisis

Problems became apparent almost immediately following the switch. Residents noticed their tap water had turned a dirty brown, and had an odd smell and taste.

In a March 2016 article,2 CNN interviewed Flint resident LeeAnne Walters, whose twin boys developed strange rashes after the switch. One of them was also diagnosed with lead poisoning. Other people also suffered mysterious illnesses, including hair loss, nervous system disorders and cancer.

The featured PBS Frontline documentary, “Flint’s Deadly Water,” which initially aired September 10, 2019, reveals how this entirely preventable tragedy was allowed to occur, and how after five years, the public health ramifications are still ongoing, with no justice in sight.

In my view, Frontline has exceeded 60 Minutes in digging deep into serious issues. This is an absolutely brilliant piece of original investigative journalism that PBS committed significant resources to produce.

As highlighted in the documentary, aside from poisoning thousands of people with toxic lead, Flint’s contaminated water supply also spawned one of the nation’s largest outbreaks of Legionnaires’ disease3 — a severe and potentially lethal form of pneumonia contracted from contaminated water — with cases being reported to this day.4

Frontline’s investigation shows that, just as with the lead issue, state officials not only failed to take the appropriate action to prevent and stop the deadly outbreak, they interfered with and prevented a thorough investigation that could have saved lives.

As noted by Flint city councilman Eric Mays, who is interviewed in the film, Legionnaires’ disease has been the real killer in this case, yet the death toll from Legionnaires’ disease has gone largely unnoticed outside of Flint.

“That was the one [thing] I think they tried to hide the most,” Mays says. “That’s the one I still think they don’t want people outside of Flint to know [about]”

Officially, 12 died and more than 90 were sickened by Legionella during the height of the outbreak in 2014 and 2015.5 The true death toll, however, is likely well over 100, as the Frontline documentary shows clear evidence of state manipulation of the statistics.

A review of death records shows 115 residents died from pneumonia during the peak of the outbreak, and Frontline hired two epidemiologists from Emory University who concluded there was a statistically significant issue in Flint. According to PBS:6

“Epidemiologists and infectious disease specialists told us that some of those people could have been Legionnaires’ disease cases that were left undiagnosed, untreated and, ultimately, uncounted.”

Legionnaires’ Disease Cover-Up in Flint

As reported by Frontline, the outbreak of Legionnaires’ disease began in June 2014, shortly after the city’s switch to water from the Flint River. The Legionella bacterium is unique in that it lives and thrives in water. The disease is contracted not via human to human contact, but rather by the inhalation of contaminated water droplets or spray.

As noted by Janet Stout, Ph.D., a Legionnaires’ disease specialist with Special Pathogens Laboratory in Pittsburg, if you control the bacteria in the water, you control the spread of the disease. In Flint’s case, proactive remediation was never undertaken, thus allowing the outbreak to grow.

By mid-summer 2014, there were more than a dozen confirmed cases of Legionnaire’s at Flint hospitals, yet residents of Flint remained unaware of the growing health crisis as no public announcement was made.

As noted in the film, it wasn’t just one failure that led to the lead and Legionella problems in Flint. Basically, all safeguards that are typically in place failed, and officials at all levels of government failed to take appropriate action.

An old decommissioned water treatment plant was reopened to treat the Flint River water, but it was ill equipped to handle such highly polluted water. Hours before the switch took place, the plant foreman, Matt McFarland, urged his sister to warn everyone she knew and tell them not to drink the water, saying the plant wasn’t ready and the water wasn’t safe.

Within weeks, residents began complaining of foul-smelling and discolored water coming out of their tap. Some reported rashes. Yet the response they got was there wasn’t anything to worry about and the water was safe for consumption.

Not only was the improperly treated water speeding up corrosion and causing lead to leach out of Flint’s aging water pipes, it also quickly became a breeding ground for Legionella. As noted by Stout, when Legionnaires’ disease outbreaks occur, standard procedure involves testing water supplies for Legionella, and then disinfecting the source of the bacteria.

Yet for some reason, this was not done in Flint, even though the fact that they had a large and growing outbreak on their hands was readily apparent, and the Flint River water was the prime suspect.

CDC Prevented From Doing Its Job

When Stout was contacted by county officials about the growing Legionnaires’ problem, she told them to contact the Centers for Disease Control and Prevention. That’s standard procedure. The CDC will perform the necessary testing so the outbreak can be properly remediated and contained. The problem, however, was that CDC protocols require an invitation from state officials.

County officials requested help from the CDC to rein in the outbreak, but the state refused to issue the prerequisite invitation. Instead, Frontline shows an email response that reads, “if there are areas where we would like to request CDC’s assistance, we’ll get in touch.”

Even when the CDC persisted in recommending a full investigation, as Flint was now ground zero for one of the largest outbreaks of Legionnaires’ in years, state officials refused to take them up on the offer. Making matters worse, the county health department also failed to notify the medical community about the outbreak.

It wasn’t until the end of 2015, when the high lead levels became front-page news, that state officials had to face the fact that the water switch was having serious consequences.

Still, the cover-up continued. As the lead crisis grew, then-governor Rick Snyder ordered a switch back to Detroit water, but it took several more months before the Legionnaires’ outbreak was publicly admitted. Even then, Snyder didn’t admit the link between the outbreak and Flint River water.

Legionella Contamination Finally Admitted

January 13, 2016, Snyder and two top state health officials held a televised press conference in which Snyder announced there had been a spike in Legionnaires’ disease during 2014 and 2015. For many, including Ron Fonger, a reporter with The Flint Journal who had been writing about Flint water for a year, the news came as a complete surprise.

Snyder did not, however, admit that the outbreak had anything to do with the switch to Flint River water. Michigan health and human services director Nick Lyon said: “The DHHS cannot conclude that this increase is related to the water switch due to lack of clinical isolates during the time period.”

As noted by Stout, to make that determination, you actually have to test the water — and they didn’t. Lyon also said, “This is part of our effort to be transparent and share information as quickly as we can.”

Meanwhile, the Legionnaires’ disease had been ongoing — unaddressed and unannounced — for two years. So much for transparency and timely notice. Also not mentioned was the fact that the CDC had pushed for a full investigation eight months earlier, and had been rebuffed.

Soon after that press conference, state Attorney General Bill Schuette launched a criminal investigation to determine whether laws had been broken.7 Todd Flood was appointed special counsel for the investigation.

In the summer of 2016, infectious disease experts Shawn McElmurry, Ph.D., from Wayne State University, and Dr. Marcus Zervos from Henry Ford Hospital, met with Lyon and other top health officials, calling for stepped up surveillance for Legionella.

Lyon was told that if he did not take appropriate measures, people could die. According to McElmurry and Zervos, Lyon’s chilling response was, “Well, they have to die of something.”8 For the record, even though the allegations were published by numerous news outlets including The Washington Post,9 Lyon declined to personally comment on the men’s claims, and his attorney denied that he’d said it.

The Criminal Investigation

By the end of July 2016, the state’s attorney investigation had led to claims being filed against nine state and local officials on a variety of charges, including conspiracy, misconduct, neglect of duty and tampering with evidence relating to the lead and Legionnaires’ outbreak.

In June 2017, Lyon and Dr. Eden Wells, Michigan’s chief medical executive, were charged with involuntary manslaughter for their roles in the Flint water crisis.10 In particular, their failure to alert the public to the danger posed by the Legionella contamination, and their participation in the cover-up of the outbreak.

The state’s defense hinged on an unsubstantiated allegation that the outbreak originated not in the Flint River water, but in McLaren Flint Hospital, where about 60% of the cases had been reported.

This did not hold water, as at least 30% of the victims had no link to McLaren or any other hospital. What’s more, were it true that the state knew about an outbreak in a hospital, they would have been required to address it, and they didn’t.

The initial trial found all the defendants guilty and required them to go to trial. Sadly, that trial never occurred as a new governor came in, who assigned an attorney general early in 2019, who promptly dismissed the case against all the guilty government cronies.

Justice Delayed Is Justice Forgotten

McElmurry’s team eventually published the findings of their investigation in PNAS in February 2018, concluding that, indeed, the Legionella outbreak was caused by the change in the water supply, combined with failures at the water treatment plant.11

The state health department rejected the paper, going so far as to question the expertise of the team. The state published its own paper, laying the blame on McLaren Hospital.

Dana Nessel was sworn in as the new attorney general for Michigan in January 2019.12 She quickly ousted Flood and his investigative team and appointed new prosecutors for the case who subsequently dropped all charges against Lyon, Wells and several other officials.13 Flint residents were outraged.

Despite the fact that two judges had decided there was enough evidence to have the health officials stand trial, the new prosecutors claimed Flood’s investigation was “fundamentally flawed” and had to be redone from scratch, as it had “failed to collect all available evidence.”

In an interview with Frontline, solicitor general Fadwa Hammoud points out that the charges were dismissed without prejudice, “which means these charges could be brought up again.” Still, that’s small consolation for the residents of Flint, many of whom are starting to give up on justice ever being served.

As noted by one of the investigators on Flood’s team, “justice delayed will be justice forgotten.” And while justice rests, clusters of Legionnaires’ continue to pop up in Flint.14 Between January 1, 2019, and August 30, 2019, there were 16 confirmed cases.15

Kudos to Frontline for exposing a massive injustice in Flint that killed and harmed people and let responsible state officials off the hook. There is clear damage here that is going unpunished.

Tea With or Without Plastic?

Tea is important to people of many cultures around the world and it has been recognized for centuries as having dramatic and positive impacts on health. It is one of the most popular beverages worldwide, second only to water. There are several easy-to-grow herbs and plants that may be used to make tea at home, but most consumers choose a tea bag to brew their morning or afternoon beverage.

Chances are you’ve never given the tea bag a second thought. But some bags are made with a variety of plastics; researchers have found these leach out of the bag while it’s being brewed. Whether the bag is infused or sealed with plastic, exposure to heat may release microparticles into your tea.

As you become more aware of how plastic is finding its way into the water and food supply, it may spark questions about just how much you’re consuming. Plastics may be found in micro and nano sizes, some too small to be seen by the naked eye.

One key to understanding the size of plastic particles is their dynamic nature since the size and shape may change over time, or under environmental stress. Microplastics fall into a large range, defined as those from 5 mm to 0.1 micrometers (µm) in size, while nanoparticles are as small as 0.001 µm.1

To grasp the size of these plastic particles, note that 5 mm is roughly the size of five grains of salt.2 A hair shaft is approximately 100 µm, and the smallest microplastic is 1/10 the size of a single bacteria.3

How Much Plastic Would You Like With Your Tea?

A soothing cup of hot tea may be just what your body needs to boost phytochemicals and other nutrients. But did you know you may also be drinking 11.6 billion microplastic pieces and 3.1 billion nanoplastics with every cup of tea? Researchers from McGill University recently published the results of a study4 in which they analyzed plastic pollution released from tea bags.

They questioned whether plastic tea bags were releasing microplastics or nanoplastics after being submerged in hot water during the brewing process.5 They used four commercial products packaged in plastic tea bags. The tea leaves were removed to ensure any plastic particles in the tea did not contaminate the analysis of the tea bags.

The empty bags were then placed in hot water to simulate the brewing process. The water was evaluated using an electron microscope, in which the team found a single bag released billions of particles. The researchers report this contamination is at a level thousands of times greater than has been reported with other foods and beverages.

In addition to analyzing the amount of plastic released, the team also sought to determine the effect the particles may have on small aquatic organisms. Using water fleas, which are commonly used to model organisms in environmental studies, the researchers found that when treated with the microparticles and nanoparticles from the tea bags, the organisms survived but demonstrated anatomical and behavioral abnormalities.

Paper or Plastic?

The researchers acknowledged the effects on humans from drinking billions of particles of plastic remain unknown and they call for further study in this area.6 But, using paper tea bags is just as dangerous. Most tea bags and even coffee filters are treated with epichlorohydrin to reduce the chances of the product tearing during use.7

Epichlorohydrin is an industrial solvent and a known carcinogen; this chemical gets sprayed on some tea bags.8 In addition to the toxicity associated with the original chemical added to tea bags to reduce tearing, the California Environmental Protection Agency9 notes it degrades in water and may contain a certain impurity also known to cause cancer.

If you’ve been brewing your tea or coffee with bottled water in the hopes of avoiding contaminants commonly found in tap water, it is important to note most bottled water contains microplastics, which actually adds to the toxic burden from your tea bags.

Bottled water is often obtained from municipal water supplies, well water or spring water which is not regulated for polyfluorinated substances (PFAS) by the EPA. The FDA places responsibility for testing on the manufacturer without any oversight from a federal agency.

You May Be Eating One Credit Card in Plastic Every Week

In an analysis by the World Wildlife Fund10 (WWF) undertaken by the University of Newcastle in Australia, scientists found that on average, people are consuming approximately 5 grams of plastic every week in their food and water supply.

The researchers analyzed 52 studies, which highlighted a list of common foods and drinks. They found the average person may ingest as many as 1,769 particles of plastic every week in their water intake. The WWF reports that one-third of plastic waste ends up in the environment, with most of it being the result of mismanaged waste.

While plastic was initially advertised as reusable, half of all new plastic produced over the last 76 years has been manufactured in the most recent 16 years. As noted in the report, the largest source of ingested plastic microparticles is drinking water. Other foods and beverages with high levels include shellfish, salt and beer.11

When you add microparticles ingested from your tea bags, the weight multiplies quickly. The average person is consuming enough plastic every week — just from water — to make one credit card. When the amount of plastic in tea bags is factored into the equation, the charge against your health may come due soon.

Recycling Takes on a Whole New Meaning

A study evaluating plastic particles in human stool from the Medical University of Vienna was presented at the Annual United European Gastroenterology conference in October 2018. As reported in Salon Magazine:12

“Eight people from Finland, Italy, Japan, the Netherlands, Poland, Russia, the United Kingdom and Austria participated in the study. Each person kept a food diary the week before the stool sampling occurred which showed researchers that all participants were exposed to foods that were either wrapped in plastic, or they drank from plastic bottles. Six of the eight ate sea fish, too; none of them were vegetarians.”

Each participant’s stool was tested for 10 different types of plastics, nine of which were found. The impact plastic has on your gut has still not been established. Lead researcher Dr. Philipp Schwabl from the Medical University of Vienna found the results astounding and believes the initial indications are13 “that microplastics can damage the gastrointestinal tract by promoting inflammatory reactions or absorbing harmful substances.”

As human waste is flushed down the toilet and processed at wastewater treatment plants, the process may be ineffective according to results from one study. Researchers14 in the United Kingdom evaluated water supply from six rivers in the northern part of England. Their data showed a higher number of microplastics in receiving waters that were downstream of the wastewater treatment plants.

Researchers believe this confirms that treated sewage is a key source of microplastics. Following those microplastics even farther downstream, it is likely they end up in the environment and may someday become part of the municipal water supply.

Enjoy the Benefits of Loose Leaf Tea

There are a significant number of health benefits to drinking tea, so it would be wise to continue the habit, while substituting loose leaf tea for tea bags. As I shared in a previous article, drinking tea may help you develop better brain connections, improve your cardiovascular health, reduce beta-amyloid plaques found in the development of Alzheimer’s disease and reduce the development of atherosclerosis plaques.

While brewing loose leaf tea may require an additional step or two, the process is a simple art form. Here are a few simple guidelines for making the “perfect” cup of tea:

Directions

1. Bring water to a boil in a tea kettle (avoid using a nonstick pot, as they too can release harmful chemicals when heated).

2. Preheat your teapot to prevent the water from cooling quickly. Add a small amount of boiling water to the pot or tea cup that you’re going to steep the tea in. Ceramic and porcelain retain heat well. Cover the pot or cup with a lid. Add a tea cozy if you have one, or drape with a towel. Let stand until warm, then pour out the water.

3. Put the tea into an infuser or strainer or put loose leaf tea into the teapot. Steeping without an infuser or strainer will produce a more flavorful tea. Start with 1 heaping teaspoon per cup of tea and 1 for the pot. The robustness of the flavor can be tweaked by using more or less tea.

4. Add boiling water. Use the correct amount for the amount of tea you added (i.e., for 4 teaspoons of tea, add 4 cups of water). The ideal water temperature varies based on the type of tea being steeped:

White and green teas (full leaf) — Well below boiling (170 to 185 degrees F or 76 to 85 degrees C). Once the water has been brought to a boil, remove from heat and let the water cool for about 30 seconds for white tea and 60 seconds for green tea before pouring it over the leaves.

Oolongs (full leaf) — 185 to 210 degrees F or 85 to 98 degrees C

Black teas (full leaf) — Full rolling boil (212 degrees F or 100 degrees C)

5. Cover the pot with a cozy or towel and let it steep, following the instructions on the package. If there are none, here are some general guidelines. Taste frequently as you want it to be flavorful but not bitter:

Oolong teas — Four to seven minutes

Black teas — Three to five minutes

Green teas — Two to three minutes

6. Once the desired flavor has been achieved, remove the strainer or infuser. If using loose leaves, pour the tea through a strainer into your cup and any leftover into another vessel (cover with a cozy to retain heat).

Lack of Sleep and Chronic Disease Are a Risky Combo

While sleep is still a largely neglected area of health, research shows that without proper sleep — both in terms of time and quality — every aspect of your health will be adversely impacted. Many important things happen during sleep, and only during sleep.

For example, sleep is required for the maintenance of metabolic homeostasis in and the removal of toxic waste from your brain, as well as the maintenance of biological homeostasis in your body. Without proper sleep, you leave yourself wide-open to chronic illness of all kinds, including diabetes,1 heart disease,2 neurodegeneration3 and cancer.4

According to recent research, lack of sleep when you’re already struggling with a chronic health issue could be a downright deadly prescription. As reported by CNN Health:5

“If you’re a middle-aged adult with high blood pressure, Type 2 diabetes or existing heart disease and you typically sleep less than six hours each night, you could be setting yourself up for cancer or an early death from heart disease.”

Lack of Sleep Makes Chronic Health Problems Extra Risky

The study5,7,8 CNN is referring to was published in the October 2019 issue of the Journal of the American Heart Association (JAHA). In it, researchers sought to determine whether short sleep duration would increase the risk of death associated with cardiometabolic risk factors and cardiovascular and cerebrovascular diseases.

Data from 1,654 adults from the Penn State Adult Cohort were evaluated. Using Cox proportional hazard models, the adjusted hazard ratio for all-cause mortality among those who slept less than six hours and had cardiometabolic risk factors (high blood pressure, elevated glucose or Type 2 diabetes) was 2.14 times higher than those who regularly slept six hours or more.

They also had a 1.83 times higher risk of dying from cardiovascular or cerebrovascular diseases. Among those with a diagnosis of heart disease or stroke, sleeping less than six hours a night increased their all-cause mortality risk by 3.17 times. Interestingly, it also increased their risk of dying from cancer, specifically, by 2.92 times.

All of these associations were found to be independent of age, sex, ethnicity, obesity, smoking and other health conditions that might influence the results. Conversely, sleeping less than six hours did not increase the risk of death in those that did not have cardiometabolic risk factors or a cardiovascular or cerebrovascular disease diagnosis.

Likewise, those with cardiometabolic risk factors or a cardiovascular or cerebrovascular disease diagnosis who slept six hours or more were not at increased risk for death either. It was specifically the combination of chronic health problems and short sleep duration that increased the risk of death, including cancer mortality.

Sleep Duration Plays a Role in Mortality Prognosis

As noted by the authors:9

“Our novel findings show that objective short sleep duration increases the mortality risk of middle?aged adults with CMRs [cardiometabolic risk factors] and those who have already developed CBVD [cardiovascular and cerebrovascular diseases].

Middle?aged adults with CMR who slept <6 hours were at a high risk of dying from CBVD, whereas middle?aged adults with CBVD who slept <6 hours were at a high risk of dying from cancer …

If these findings are replicated in other large cohorts with objective sleep measures, short sleep duration should be included in the prediction of the mortality prognosis of middle?aged adults with CMR or CBVD.

The primary finding of the current study indicated that there was an ?2?fold risk for all?cause, CBVD, and non?CBVD mortality in participants who had CMRs at baseline and demonstrated short sleep duration in the sleep laboratory.

Individuals who had CMRs and normal sleep duration at baseline, on the other hand, did not show a significantly increased risk on any of the mortality outcomes. This finding suggests that obtaining an adequate amount of sleep may minimize the adverse effect of CMRs on multiple mortality outcomes.

For instance, participants with both CMRs and short sleep at baseline showed an 83% higher risk of dying from CBVD, whereas their CMR counterparts with normal sleep duration had a modest 35% nonsignificant higher risk of CBVD mortality …

In conclusion, objective short sleep duration is an effect modifier of the mortality risk associated with CMR or CBVD. More important, our data suggest that short sleep may operate through different mechanisms on CBVD versus cancer mortality.”

Lack of Sleep Raises Your Risk for Heart Disease

That short sleep duration and/or poor sleep quality raises your risk of heart disease and cancer has been repeatedly demonstrated. For example, a study10 published in the October 2018 issue of Sleep Health found poor sleep excessively ages your heart, which in turn raises your risk of developing heart disease.

As explained by lead author Quanhe Yang, senior scientist in the Division for Heart Disease and Stroke Prevention of the U.S. Centers for Disease Control and Prevention:11

“The difference between a person’s estimated heart age and his or her chronological age is ‘excess heart age’ …

For example, if a 40-year-old man has a heart age of 44 years based on his cardiovascular risk profile — the personal risk of having a heart disease — then his excess heart age is 4 years. In effect, his heart is four years older than it should be, for a typical man his age. The concept of heart age helps to simplify risk communication.”

In this study, people who regularly slept five hours or less had hearts that were biologically 5.1 years older than their chronological age, while those who got seven hours of sleep each night had hearts showing signs of being biologically 3.7 years older than their chronological age.

Interestingly, the association between sleep and excess heart age was not linear. Those getting seven hours of sleep fared the best. At eight and nine hours, excess heart age started rising again, hitting 4.5 at eight hours and 4.1 at nine hours.

Sleep Quality Also Plays a Role in Heart Disease Risk

Another 2018 study12 found that even if you sleep a healthy number of hours, the quality of that sleep can have a significant impact on your risk for high blood pressure and vascular inflammation associated with heart disease.

Women who had mild sleep disturbance such as taking longer to fall asleep or waking up one or more times during the night were far more likely to have high blood pressure than those who fell asleep quickly and slept soundly throughout the night. According to the researchers:13

“Systolic blood pressure was associated directly with poor sleep quality, and diastolic blood pressure … Poor sleep quality was associated with endothelial nuclear factor kappa B activation. Insomnia and longer sleep onset latency were also associated with endothelial nuclear factor kappa B activation …

These findings provide direct evidence that common but frequently neglected sleep disturbances such as poor sleep quality and insomnia are associated with increased blood pressure and vascular inflammation even in the absence of inadequate sleep duration in women.”

Sleep Influences Your Cancer Risk

The influence of sleep is also seen in cancer. As noted in a 2009 study14 in Sleep Medicine Reviews:

“The pineal hormone melatonin is involved in the circadian regulation and facilitation of sleep, the inhibition of cancer development and growth, and the enhancement of immune function.

Individuals, such as night shift workers, who are exposed to light at night on a regular basis experience biological rhythm (i.e., circadian) disruption including circadian phase shifts, nocturnal melatonin suppression, and sleep disturbances.

Additionally, these individuals are not only immune suppressed, but they are also at an increased risk of developing a number of different types of cancer.”

As explained in this paper, while melatonin plays an important role, there’s a reciprocal interaction between sleep and your immune system that is independent of melatonin as well. When your sleep cycle is disrupted, your immune function can be suppressed, allowing cancer-stimulating cytokines to proliferate and dominate. According to the authors:

“The mutual reinforcement of interacting circadian rhythms of melatonin production, the sleep/wake cycle and immune function may indicate a new role for undisturbed, high quality sleep, and perhaps even more importantly, uninterrupted darkness, as a previously unappreciated endogenous mechanism of cancer prevention.”

Similarly, research15 published in 2012 found sleep-disordered breathing or sleep apnea increases your risk of dying from cancer. Those with moderate sleep apnea were twice as likely to die from cancer, compared to those able to breathe normally during sleep. Those with severe sleep apnea had a 4.8 times higher cancer mortality.

Melatonin Is a Powerful Cancer Preventive

While it may not be the sole mechanism, decreased levels of melatonin due to lack of sleep certainly appears to play a key role in cancer formation. In one study, 16 postmenopausal women who regularly slept nine hours or more had a 33% lower risk of breast cancer than those who slept six hours or less.

This inverse association was strongest in lean women. The researchers confirmed that melatonin levels rose in tandem with reported hours of sleep. On average, melatonin levels in those who slept at least nine hours were 42% higher than in those who got six hours or less.

Importantly, melatonin both inhibits the proliferation of cancer cells and triggers cancer cell apoptosis17 (self-destruction). It also interferes with the new blood supply tumors required for their rapid growth (angiogenesis).18

A paper19 in the International Journal of Experimental Pathology also points out that melatonin modulates not only the production of blood cells and platelets in your bone marrow (haemopoiesis) but also the production of immune cells. It also plays a role in the function of those immune cells. As explained in the introduction of this paper:

“Physiologically, melatonin is associated with T?helper 1 (Th1) cytokines, and its administration favors Th1 priming. In both normal and leukemic mice, melatonin administration results in quantitative and functional enhancement of natural killer (NK) cells, whose role is to mediate defenses against virus?infected and cancer cells.

Melatonin appears to regulate cell dynamics, including the proliferative and maturational stages of virtually all hematopoietic and immune cells lineages involved in host defense — not only NK cells but also T and B lymphocytes, granulocytes and monocytes — in both bone marrow and tissues.

In particular, melatonin is a powerful antiapoptotic signal promoting the survival of normal granulocytes and B lymphocytes. In mice bearing mid?stage leukemia, daily administration of melatonin results in a survival index of 30–40% vs. 0% in untreated mice.

Thus, melatonin seems to have a fundamental role as a system regulator in hematopoiesis and immuno?enhancement, appears to be closely involved in several fundamental aspects of host defense and has the potential to be useful as an adjuvant tumor immunotherapeutic agent.”

General Sleep Guidelines

Considering the importance of sleep for preventing the two top killers in the U.S. (heart disease and cancer), just how much sleep do you need to reap protective benefits?

According to a scientific review of more than 300 studies published between 2004 and 2014, a panel of experts came up with the following recommendations. Keep in mind that if you’re sick, injured or pregnant, you may need a bit more than normal.

Age Group Hours of sleep needed for health

Newborns (0 to 3 months)

14 to 17 hours

Infants (4 to 11 months)

12 to 15 hours

Toddlers (1 to 2 years)

11 to 14 hours

Preschoolers (3 to 5)

10 to 13 hours

School-age children (6 to 13)

9 to 11 hours

Teenagers (14 to 17)

8 to 10 hours

Adults (18 to 64)

7 to 9 hours

Seniors (65 and older)

7 to 8 hours

Set a Nightly Alarm to Help You Get Enough Sleep

There’s simply no doubt that sleep needs to be a priority in your life if you intend to live a long and healthy life. For many, this means forgoing night-owl tendencies and getting to bed at a reasonable time.

If you need to be up at 6 a.m., you need a lights-out deadline of 9:30 or 10 p.m., depending on how quickly you tend to fall asleep. If you find it difficult to get to bed on time, consider setting a bedtime alarm to remind you that it’s time to shut everything down and get ready for sleep.

As for how to improve your sleep if you’re having trouble falling or staying asleep, see my “Top 33 Tips to Optimize Your Sleep Routine.”

Health Benefits of Living Near the Ocean

Many people dream of living near the ocean, and perhaps there’s an intrinsic reason why. Coastal living may be good for mental health, according to a study by researchers from the University of Exeter, England.1 The research builds on prior studies linking natural environments to mental health and well-being, and suggests that you may be able to boost your mood and more by choosing to live near the sea.

In the U.S., counties directly on a shoreline make up less than 10% of total land area (with the exception of Alaska), yet 39% of the population resides in them.2 Further, more people continue to seek out coastal living.

According to the National Ocean Service (NOS), the population of U.S. counties directly on the shoreline increased by nearly 40% from 1970 to 2010, and it’s estimated to increase by another 8% (or 10 million people) by 2020.3

“Coastal areas are substantially more crowded than the U.S. as a whole, and population density in coastal areas will continue to increase in the future. In fact, the population density of coastal shoreline counties is over six times greater than the corresponding inland counties,” NOS noted,4 and perhaps the boost to mental health is one reason why.

Living Near the Coast Is Good for Mental Health

Previously, it was revealed that general health in England is higher among those living closer to the coast. Further, the association was strongest among lower income groups.

For the featured study, researchers used data from the Health Survey for England, which surveyed 25,963 adults from 2008 to 2012. They compared respondents’ health to their proximity to the sea in order to determine if similar findings held true for mental health.

The results showed that urban adults living 1 kilometer (0.6 miles) or less from the coast had better mental health than those living more than 50 kilometers (31 miles) away.5 When the data were analyzed as a whole, there was a 20% reduction in poor mental health for those living near the coast compared to those who were farther away.

However, when household income was factored in, the study showed that for the lowest income respondents, there was a 40% lower risk of poor mental health for those living within a kilometer of the coast compared to those living 50 km away.

Even among those living between 1 km and 5 km (3.1 miles) from the coast, there was a 25% lower risk of poor mental health compared to those living farther away.6 The researchers explained:7

“Stratifying by household income revealed that the relationship between coastal proximity and mental health outcomes was present only for those with the lowest household incomes and extended to <5?km.

Specifically, the results imply that people living in urban areas in the lowest household income quintile are less likely to suffer from a common mental disorder (CMD) such as anxiety or depression if they live within 5 km of the coast, compared to those living in urban areas further inland (>50 km).

In particular, living within 1 km of the coast is associated with the strongest reductions in CMD likelihood for people from the most economically deprived households.”

Jo Garrett, who led the study, said in a news release, “Our research suggests, for the first time, that people in poorer households living close to the coast experience fewer symptoms of mental health disorders. When it comes to mental health, this ‘protective’ zone could play a useful role in helping to level the playing field between those on high and low income.”8

‘Blue Spaces’ Support Good Health

There’s been a lot of press about the positive role green spaces have on human health, and now researchers are turning their attention to “blue spaces,” i.e., bodies of water, and their effects on health. In Europe, the BlueHealth project is looking into how inland waterways and coasts affect health promotion and disease. Among their previous findings:

  • Living nearer to the coast was associated with better general and mental health, in part because it encourages participation in land-based outdoor activities, especially walking.9
  • When an urban riverside area in Barcelona, Spain, was renovated, there was a 25% increase in users of the space, which could promote physical activity and social interactions, leading to improvements in health and well-being.10
  • The urban riverside park regeneration was estimated to boost physical activity among adult users, leading to an annual reduction of 7.3 deaths and 6.2 cases of diseases. “This corresponds to 11.9 DALYs [disability-adjusted life years] and an annual health-economic impact of 23.4 million euros [$25.6 million].”11

Canadian research also revealed that living near water reduced the risk of premature death by 12% to 17% among urban residents, particularly for deaths related to stroke or respiratory-related causes.12

The researchers suggested more research is needed to determine why blue spaces boost health, but other experts have suggested it could be “due to opportunities for stress reduction and increased physical activity,” especially in socioeconomically deprived communities.13

There’s also evidence that sea spray from the ocean may have a cleansing effect on air pollution, perhaps leading to cleaner air.14 Likewise, in Wellington, New Zealand, increased blue space visibility was linked with lower psychological stress,15 and a study in older adults found those with the greatest sea view had lower levels of depression.16 Among older adults in Hong Kong, researchers noted:17

“Those with a view of blue space from the home were more likely to report good general health, while intentional exposure was linked to greater odds of high well-being. Visiting blue space regularly was more likely for those within a 10-15?min walk, and who believed visit locations had good facilities and wildlife present.

Longer blue space visits, and those involving higher intensity activities, were associated with higher recalled well-being. Our evidence suggests that, at least for older citizens, Hong Kong’s blue spaces could be an important public health resource.”

University students also benefit from blue space, which is “psychologically restorative” in the urban environment.18 Notably, the benefits of blue spaces extend beyond oceans to include freshwater blue spaces, like the North American Great Lakes. In fact, both distance to the Great Lakes and percentage of inland lakes had a protective effect on mental health.19

Stressed individuals also reported a “pronounced decrease in negative feelings” when they spent time in an urban wetland environment,20 which suggests many different types of blue spaces may be beneficial.

The Great Outdoors Is Good for You

Whether you live by the coast or inland, spending time in nature’s many different environments is protective to health.

A massive study involving data from 143 studies and more than 290 million people revealed that exposure to greenspace, defined as open, undeveloped land with natural vegetation, led to significant reductions in diastolic blood pressure (the bottom number), salivary cortisol (a physiological marker of stress) and heart rate, along with significant decreases in Type 2 diabetes and mortality from all causes and those specifically related to the heart.21

Further, increased greenspace exposure led to reduced incidence of stroke, high blood pressure, dyslipidemia, asthma and coronary heart disease. In those who are institutionalized, separate research has shown gardening, which necessitates spending time outdoors, promotes an “internal locus of control and well-being.”

A decrease in sadness and anxiety was noted among institutionalized older adults who gardened, while in general gardening by older adults is linked to:22

  • Feelings of accomplishment
  • Well-being and peace
  • A decrease in depressive symptoms
  • A protective effect on cognitive functions
  • The development of social links

Nature Therapy and Park Prescriptions

With the increasing research showing green and blue spaces have much to offer for human health and well-being, it’s not surprising that nature-based therapies are emerging as tools to improve public health.

In one systematic review of both controlled and observational studies, nature-assisted therapy led to significant improvements in a variety of health conditions ranging from obesity to schizophrenia.23 Benefits have also been documented for cancer survivors, including:24

  • Dragon boat racing, conducted on natural bodies of water, may enhance quality of life in breast cancer survivors
  • Natural environment may counteract attentional fatigue in newly diagnosed breast cancer survivors
  • Outdoor adventure programs foster a sense of belonging and self-esteem for children and adolescent cancer survivors
  • Therapeutic landscapes may decrease anxiety, improving health

A ParkRx, or Park Prescriptions, movement, created via a collaboration between the Institute at the Golden Gate, the National Recreation and Parks Association and the National Park Service, also exists. It involves a health or social services provider giving a patient or client a “prescription” to spend more time in nature in order to improve their physical health and well-being.25

How Much Time Is Ideal to Get the Benefits Nature Offers?

At least one study suggested that spending 120 minutes or more in nature during the previous week was associated with a greater likelihood of good health or high well-being.26

However, there were decreasing returns with nature exposure beyond 120 minutes, and the association flattened out and even dropped between 200 and 300 minutes per week, suggesting 120 minutes may be a sort of Goldilocks zone for reaping all the benefit that nature has to offer, without overdoing it — if there is such a thing.

Not all exposure to green or blue spaces can be measured in minutes, though. It may be that living near nature, whether it be natural land or water, yields the most benefits of all, by giving you easy access to its soothing effects and, perhaps, encouraging more walks and other physical activity along its trails and shores.

Even if you can’t see the coast from your home, living near water affords you the luxury, or maybe the necessity, of visiting it often. No matter where you live, be sure to make spending time in nature a priority, and take advantage of its many health-boosting forms, from forests and mountains to rivers, wetlands and oceans.

Is a Colonoscopy Worth the Risk?

Knowing your potential risk for developing cancer can help you weigh the risks against the benefits of different tests for your situation. According to the American Cancer Society,1 more than 15.5 million people in the U.S. have a history of cancer. At least 1.7 million new cases will be diagnosed in 2019, which does not include a diagnosis of carcinoma in situ (noninvasive cancer).

The society estimates 606,880 people will die in 2019, which is 1,660 deaths every day. The four most common types include lung, breast, prostate and colorectal cancer. One of the screening tests commonly prescribed to rule out colorectal cancer is a colonoscopy.

Colorectal cancer can start in the colon or in the rectum but the two types are grouped together since they have many of the same characteristics.2 The society estimates there are 101,420 new cases of colon cancer diagnosed each year and 44,180 new cases of rectal cancer. Although it remains the third leading cause of cancer-related deaths in men and women, the rate has been dropping for several decades.3

According to the Colorectal Cancer Alliance,4 the five-year survival rate has been rising. They report there are more than 1 million colorectal cancer survivors alive in the U.S. Knowing your risk factors and making lifestyle changes to prevent the development of colorectal cancer are the basis of the most recently published Rapid Recommendation of The BMJ initiative.5

In Many Cases Routine Colonoscopies Are Unnecessary

The new practice guidelines published in The BMJ6 recommend physicians use a tool to estimate an individual’s potential risk for developing colorectal cancer in the next 15 years. The team recommends that only those who have a risk of 3% or greater should undergo screening tests.

Current guidelines recommend screening for everyone over the age of 50, without regard to their individual risk. At the age of 50, this is typically less than 3%.7 The international panel reviewed scientific evidence and research data to evaluate the risks versus the benefits of colonoscopies.

They found their recommendations could accurately be applied to healthy people from 50 to 79 years who expected to live another 15 years. The Centers for Disease Control and Prevention recommends colorectal cancer screening for those over 50.8

Using data from across the U.S., they found the number who were up to date with their screening went up 1.4% from 2016 to 2018, representing an additional 3.5 million people.

In addition to asking if screening made a difference in health outcomes, The BMJ initiative team also attempted to differentiate the type of testing best used to screen for colorectal cancer.9 They recommended that those with a 3% risk or greater over the following 15 years could choose from one of four screening options.

The first was a fecal immunochemical test (FIT) done every year, or every two years depending upon their risk factors. Patients may also choose a single sigmoidoscopy or, the weakest recommendation from the team, a single colonoscopy.

Possibility of Cancer Compared to Screening Hazards

From their examination of the evidence, the team believed a yearly FIT, sigmoidoscopy or colonoscopy could reduce the incidence of cancer while a FIT every two years may not have an effect on incidence over 15 years. They wrote:

“Based on benefits, harms, and burdens of screening, the panel inferred that most informed individuals with a 15-year risk of colorectal cancer of 3% or higher are likely to choose screening, and most individuals with a risk of below 3% are likely to decline screening. Given varying values and preferences, optimal care will require shared decision making.”

The team determined that the risks associated with colorectal cancer screening outweighed the benefits in many cases. For instance, the risk of death from a colonoscopy from one source was 1 in 16,318 procedures evaluated.10 In the same analysis, the researchers also found 82 suffered serious complications.

Colonoscopies Are Not Risk Free

Although a colonoscopy is supposed to help find early tumor growth, one study reported a 17% rate of missed diagnosis.11 Other risks associated with a colonoscopy include worsening stool patterns and contributing to the growth of colorectal polyps or tumors.

Perforation of the colon during the exam has an incidence of 0.2% to 5% and is widely recognized as a serious complication associated with a high morbidity and mortality rate.12 The risk of perforation rises with the age of the patient and the presence of two or more other health conditions. One study showed 51.9 people per 1,000 whose colons were perforated died within the first 14 days.13

Dysbiosis may occur after using harsh laxatives to prepare for a colonoscopy. A study published in Cell14 suggested even a short-term course of laxative use could trigger an immune response. Research on an animal model15 found treatment eliminated one family of beneficial gut bacteria and allowed another to flourish. Even two weeks after completing the laxatives the bacteria showed reduced diversity.

Many experts agree you should opt for the lightest level of sedation possible, or none at all, as full anesthesia increases risks. Those who have sleep apnea, are obese, have high blood pressure or diabetes are at increased risk from the anesthesia.16 Across the U.S. 34.4% of those undergoing a colonoscopy used anesthesia.17

The use of anesthesia was associated with a 13% increased risk of experiencing complications within 30 days of the procedure and specifically associated with an increased risk of perforations of the colon and/or a stroke. The risk of complications varied by area, with those in the Northeast reporting an increase of any complication of 12%, but among those performed in the West this increased to 60%.

Researchers who conducted one study found an increased risk of aspiration pneumonia.18 Another19 sought to determine if the procedure could be successfully completed without any sedation. Patients were given the option of undergoing a colonoscopy without premedication and then evaluated immediately following the procedure, two and five days later.

The researchers asked about the severity of pain and willingness to consider the procedure again without sedation. When questioned, only 5% experienced no pain; 41% had mild pain; 34% reported moderate pain and 20% said they experienced severe pain. However, despite the level of pain experienced, 73% were willing to repeat it without sedation and only 18% said they would request sedation the next time.

Equipment Contamination Another Risk of Colonoscopies

A real risk of undergoing an endoscopy of any nature is chance of improper sterilization of the flexible scope. David Lewis, Ph.D., and I discuss this in the short video above. One issue is the inability to thoroughly clean the inside of the scope.

Lewis describes a problem that he states is commonly experienced by physicians. During the examination the physician may be unable to see through the scope and is unsuccessful in the attempt to flush it using the air/water channel as it is clogged with human tissue from a past exam.20 The scope must be retracted and another one used.

Since endoscopes have sensitive equipment attached, they cannot be heat sterilized. Unfortunately, manufacturers have not been made to produce a scope with the ability to be heat sterilized. As Lewis points out:21 “We can put a Rover on Mars, surely we can build a flexible endoscope that we can put in an autoclave.”

These expensive tools are not disposable but require sterilization between each patient. Lewis reports that up to 80% of hospitals are sterilizing the flexible endoscopes with glutaraldehyde (Cidex). On testing, he finds this has complicated the process as it does not dissolve tissue in the endoscope but rather preserves it.

When sharp biopsy tools are run through the tube, patient material from past testing is scraped off and potentially carried into your body. This is why it’s important to find a clinic or hospital that uses peracetic acid to thoroughly sterilize the equipment by dissolving proteins found in the flexible endoscopes. Before scheduling any endoscopic examination call to ask how the equipment is sterilized between patients.

Tailor Lifestyle Choices to Reduce the Risk of Colon Cancer

Like many other types of cancer, colorectal cancer is often preventable. Research suggests only 5% to 10% of all cancer cases are due to genetic defects, while the rest are linked to environmental and lifestyle factors.22 The American Institute for Cancer Research writes that one-third of the most diagnosed cancers in the U.S. could be prevented through diet, exercise and maintaining a lean body weight.23

The extent that diet contributes to cancer death varies by the type of cancer, which researchers find is associated by as much as 70% in the case of colorectal cancer.24 For example, long-term exposure to chlorinated drinking water can increase the risk of leukemia, colorectal cancer and bladder cancer.

There are several strategies you can use to lower your risk of developing this potentially deadly disease as it is impacted by your diet, vitamin D levels, exercise and alcohol intake. I discuss several strategies you can integrate into your daily routine in my past article, “How To Help Protect Against Colon Cancer.”

Vitamin C Lowers Mortality in Severe Sepsis

One of the leading causes of death in American hospitals is something many are still unfamiliar with: septicemia (sepsis or septic shock). Also known as blood poisoning among lay people, sepsis1 is a last-ditch effort by your immune system to fight an infection in your body, which can lead to multiple organ failure and death unless promptly treated. As explained by the National Institute of General Medical Sciences:2

“The body releases immune chemicals into the blood to combat the infection. Those chemicals trigger widespread inflammation, which leads to blood clots and leaky blood vessels. As a result, blood flow is impaired, and that deprives organs of nutrients and oxygen and leads to organ damage.

In severe cases, one or more organs fail. In the worst cases, blood pressure drops, the heart weakens, and the patient spirals toward septic shock. Once this happens, multiple organs — lungs, kidneys, liver — may quickly fail, and the patient can die.”

While viruses, fungi and parasites all have the ability to trigger sepsis, bacterial infections are currently the most common cause. The most common types of infection triggering sepsis are respiratory and urinary tract infections.3 That said, research4 has demonstrated the number of fungal-induced sepsis infections is on the rise.

The problem is that sepsis is often overlooked as many are unfamiliar with its signs and symptoms. It’s also notoriously difficult to treat. A successful outcome relies on early detection and rapid treatment.

Sepsis Is the Costliest Condition Treated in the US

Each year, an estimated 1 million Americans get sepsis5,6 and up to half of them die as a result.7,8,9 According to data10 from two hospital cohorts, 34.7% to 55.9% of American patients who died in hospitals between 2010 and 2012 had sepsis at the time of their death (depending on which inpatient population they were in).

Experts are now calling for recognition11 of sepsis as a distinct cause of death, hoping this will result in better clinical practice guidelines. They also stress the importance of awareness in the community and the emergency room. To this end, September 13 has been designated “World Sepsis Day” to raise awareness.12

Conventional treatment, which is typically focused on high doses of antibiotics that further contribute to antibiotic resistant bacteria, is also a tremendous financial burden. A U.S. government report13,14 published in 2016 found sepsis was the most expensive condition treated in the U.S., racking up $23.7 billion in health care costs each year.

The good news is there’s an inexpensive treatment that has been shown to be very effective against sepsis. The bad news is the number of hospitals that have adopted it as standard of care is still limited.

Vitamin C Concoction — An Inexpensive Cure for Sepsis


In 2017, news emerged about a critical care physician who claimed to have discovered a simple and inexpensive way to treat sepsis using an intravenous (IV) cocktail of vitamin C and thiamine (vitamin B1) in combination with the steroid hydrocortisone.15,16

The precise protocol used was 200 mg of thiamine every 12 hours, 1,500 mg of ascorbic acid every six hours, and 50 mg of hydrocortisone every six hours.17

The doctor in question, Dr. Paul Marik, chief of pulmonary and critical care medicine at Sentara Norfolk General Hospital in East Virginia, published a small retrospective before-after clinical study18,19,20 showing that giving septic patients this simple IV cocktail for two days reduced mortality from 40% percent to 8.5%.

Sentara Norfolk General Hospital, where Marik works, has since made the protocol its standard of care for sepsis, and others are starting to join in. Unfortunately, many hospitals are still dragging their heels, waiting for more clinical trials to be completed.

This despite the fact that the treatment is harmless in and of itself, meaning it won’t make the patient any worse than he or she already is. A 2018 review21 of the available research presents a hypothetical model for why and how the Marik protocol actually works, discussing how each of the three components are known to impact the biological processes involved in sepsis.

As noted in that review,22 reception of the treatment has been mixed, with some critical care leaders embracing it while others aren’t using it at all. What this means is that your ability to receive this potentially life-saving treatment is dependent on the hospital where you end up. 

On the upside, “Enthusiasm for this drug combination in sepsis has grown rapidly” since the release of Marik’s initial study results, and much larger studies are now underway.

One of them is the VICTAS study23 (Vitamin C, Thiamine and Steroids in Sepsis), sponsored by Emory University, which expects to have about 2,000 participants. The projected completion date for this study is October 2021, although preliminary results may become available as early as December 2019.

What to Do if Your Doctor Refuses to Administer This

If your doctor refuses to consider Marik’s protocol offhand, convince him or her to review the recent studies cited here that show this works.24,25,26,27,28,29,30,31,32,33 Simply look up the references in the endnotes to the previous sentence (references 24 through 33) and make copies to take to your doctor.

Alternatively, you can go to PubMed34 directly and type in “vitamin C” and “sepsis” in the search engine and you will get a list of the available research.

These articles are completely free to download. I hope you never need to access them, but if you do, you can print them and use the information to convince your medical team to use these simple life-saving strategies. If they refuse, I would strongly suggest you take control of the situation and find another doctor and/or hospital that will.

Vitamin C Alone May Lower Mortality Risk

Most recently, a study35,36,37,38 led by Dr. Alpha “Berry” Fowler was published in the October 2019 issue of JAMA. The study is not reflective of the Marik protocol per se, as it only used IV vitamin C, but its results are still tantalizing.

Fowler and his team sought to investigate the effectiveness of vitamin C infusion on organ failure scores and biomarkers of inflammation and vascular injury in patients with severe sepsis and acute respiratory failure.

Curiously, while the vitamin C infusion had no detectable influence on these end points, those who received the treatment did have a higher chance of survival, and spent less time in the hospital. As reported by NPR:39

“If you read the study summary, vitamin C didn’t help the patients. But if you dig deep into the paper, you will find that the people who got the treatment were much more likely to survive … The rub comes from the way the study … was designed.”

While vitamin C alone had no impact on organ failure scores and biomarkers of inflammation, when the researchers looked at 46 secondary endpoints, they discovered the mortality rate for the treatment group actually dropped from 46% to 30%. As noted by NPR:40

If death had been the primary endpoint of the study, this result would have been highly significant. The conclusion would strongly support the hypothesis that vitamin C is an effective treatment of sepsis.

But there’s a catch. Since Fowler and his colleagues looked at 46 secondary endpoints, it’s likely that something would randomly pop up as statistically significant. It’s as though they had 46 bites at the apple to find something meaningful …

What patients really care about, of course, is … whether they live or die. Fowler tells NPR that he now rues his decision to select an endpoint that seemed more likely to show a benefit …

Though he’s now bound by the rules of experimental design to downplay the mortality results, he personally feels a sense of success. ‘We’re all whooping and hollering because of what we found,’ he says.”

Fowler’s team also found that, on average, those who received vitamin C had by day 28 spent three fewer days in the intensive care unit than the placebo group (seven days compared to 10). By day 60, the treatment group had also spent seven fewer days in the hospital overall —15 days compared to 22.41

Vitamin C, Thiamine and Steroids Have Synergistic Effects

When asked for comment on Fowler’s study, Marik pointed out vitamin C and corticosteroids have a synergistic effect. In other words, Fowler’s study cannot really be used to judge the effectiveness of vitamin C, thiamine and steroids in combination, as it only used one of the three ingredients.

Vitamin C is well-known for its ability to prevent and treat infectious diseases on its own. Influenza,42 encephalitis and measles43 have all been successfully treated with high-dose vitamin C, and previous research has shown it effectively lowers proinflammatory cytokines and C-reactive protein.44,45,46

To investigate the mechanism of action for vitamin C in sepsis with and without steroids, Marik, in collaboration with John Catravas, Ph.D., a pharmacology researcher at Old Dominion University, and others performed a study47 in which endothelial cells from lung tissue were exposed to lipopolysaccharide — a type of endotoxin found in patients with sepsis — in the absence or presence of ascorbic acid and hydrocortisone.

Interestingly, when either vitamin C or the steroid were administered in isolation, very little improvement in endothelial barrier function occurred. When administered together, however, the infection was successfully eradicated and the cells were restored to normal.

The addition of thiamine is also important. Not only is thiamine required for metabolism of some of the metabolites of vitamin C, thiamine deficiency syndrome (beriberi) has many similarities to sepsis, and thiamine deficiency is relatively common in critically ill patients.48

Studies have also shown thiamine can be helpful for a long list of diseases and disorders, including mitochondrial disorders,49 heart failure,50 delirium,51 thyroid fatigue and Hashimoto’s (a thyroid autoimmune disorder).52 These and other health effects may help explain why thiamine works so well in conjunction with vitamin C and hydrocortisone for sepsis.

Marik told NPR that Fowler’s study does highlight two important things, though. First, that there are no side effects of vitamin C infusion in critically ill patients and, second, a lowered mortality risk. “You can argue about all the statistical nuances, but that’s what the study showed,” Marik told NPR.53

Potential Contraindication

While vitamin C and thiamine administration is incredibly safe, it may be contraindicated if you happen to be glucose-6-phosphate dehydrogenase (G6PD) deficient, which is a genetic disorder.54 G6PD is an enzyme your red blood cells need to maintain membrane integrity.

High-dose IV vitamin C is a strong prooxidant, and giving a prooxidant to a G6PD-deficient individual can cause their red blood cells to rupture, which could have disastrous consequences.

Fortunately, G6PC deficiency is relatively uncommon, and can be tested for. People of Mediterranean and African descent are at greater risk of being G6PC deficient. Worldwide, G6PD deficiency is thought to affect 400 million individuals, and in the U.S. an estimated 1 in 10 African-American males have it.55

Know the Signs and Symptoms of Sepsis

One of the most important steps you can take to protect your health is to recognize the symptoms of sepsis and seek immediate medical attention if you suspect it.

It is important not to make a diagnosis at home. Instead communicate your concerns with a medical professional so that proper testing and treatment can be implemented. Common signs and symptoms of sepsis include the following.56,57,58 Many of these symptoms may be confused with a bad cold or the flu. However, they tend to develop much more rapidly than you would normally expect.

A high fever with chills and shivering

Rapid heartbeat (tachycardia)

Rapid breathing (tachypnea)

Unusual level of sweating (diaphoresis)

Dizziness

Confusion or disorientation

Slurred speech

Diarrhea

Difficulty breathing, shortness of breath

Severe muscle pain

Low urine output

Cold and clammy skin

Skin rash

Nausea and/or vomiting

The Sepsis Alliance recommends using the acronym TIME to remember some of the more common symptoms:59

  • T — Temperature higher or lower than normal?
  • I — Have you now or recently had any signs of an infection?
  • M — Are there any changes in mental status, such as confusion or excessive sleepiness?
  • E — Are you experiencing any extreme pain or illness; do you have a “feeling you may die?”

Post-Sepsis Syndrome

While some will recover fully from sepsis, for many the problems do not end at discharge from the hospital. Survivors may suffer physical, psychological and/or neurological consequences for the rest of their lives. For some survivors, their immune function can remain depressed for as long as a year after their recovery, resulting in frequently recurring infections.

The combination of symptoms is called post-sepsis syndrome and usually last between six and 18 months. Symptoms of post sepsis syndrome may include:60,61

Lethargy (excessive tiredness)

Changes in peripheral sensation

Repeated infections at the original site or a new infection

Poor mobility

Muscle weakness

Shortness of breath

Chest pains

Swollen limbs

Joint and muscle pains

Depression, mood swings, anxiety or sadness

Hair loss

Dry flaking skin and nails

Taste changes

Poor appetite

Changes in vision

Difficulty swallowing

Reduced kidney function

Feeling cold

Excessive sweating

Post-traumatic stress disorder

Flashbacks and nightmares

Poor concentration and clouded thinking

Insomnia

Short-term memory loss

There is no specific treatment for post-sepsis syndrome, but most get better over time. The U.K. Sepsis Trust62 recommends managing individual symptoms and supporting optimal health as you’re recovering.

Not all medical professionals are aware of post-sepsis syndrome, so it may be helpful to talk about your symptoms and ask for a referral to someone who may help manage your mental, physical and emotional challenges.

How to Reduce Your Risk of Sepsis

Again, part of what makes sepsis so deadly is people typically do not suspect it, and the longer you wait to treat it, the deadlier it gets.63 If you develop an infection, stay alert to symptoms of sepsis and seek immediate medical attention if they appear. Even health care workers can miss the signs and delay treatment.

While health care workers have a responsibility to prevent infections that could potentially turn septic and to educate patients about warning signs of sepsis, you can lower your own risk by:

Promptly treating urinary tract infections (UTIs) — UTIs are the second most common type of infection,64 and one-quarter of sepsis cases are related to UTIs.65

Conventional treatment typically involves antibiotics, but research66,67 shows that UTIs caused by E. coli — which comprise68 90% of all UTIs — can be successfully treated with D-Mannose, a naturally occurring sugar that’s closely related to glucose. To learn more, see “D-Mannose for UTI prevention validated in a clinical trial.”

Properly cleaning skin wounds — About 1 in 10 sepsis cases are due to skin infections, so always take the time to properly clean and care for wounds and scrapes. Wash the wound with mild soap and water to clean out dirt and debris, then cover with a sterile bandage. Diabetics should follow good foot care to avoid dangerous foot infections.

Caring for any chronic illness affecting your risk of sepsis — Research has found illnesses that increase your risk may include chronic lung disease, chronic kidney disease, diabetes, stroke and cardiovascular disease.69

Avoiding nail biting — One study found 46.9% of the participants were nail biters.70 Exposure of the delicate skin underneath the nail, transferred from your mouth or acquired from the environment, increases your risk of infection.

Avoiding infections in hospitals — When visiting a health care facility, be sure to wash your own hands, and remind doctors and nurses to wash theirs (and/or change gloves) before touching you or any equipment being used on you.

If you have to undergo a colonoscopy or other testing using a flexible medical scope, remember to call and ask how they clean their scopes and what kind of cleaning solution they use.

If the answer is glutaraldehyde (brand name Cidex), find another hospital or clinic — one that uses peracetic acid. This preliminary legwork will significantly decrease your risk of contracting an infection from a contaminated scope.