Introduction to myasthenia gravis — A rare, neurological autoimmune disease

The immune system plays an important role in keeping your body healthy. It helps protect your organs and tissues from disease-causing foreign bodies such as bacteria and viruses. To do this, your immune system releases specific antibodies that work to prevent infections.1

In certain situations, however, your immune system turns against your own body, causing autoimmune diseases to develop. Examples of autoimmune diseases include rheumatoid arthritis, lupus and multiple sclerosis.2 There is no known cure for autoimmune diseases. Instead, treatment focuses on relieving the symptoms.3

One autoimmune disease you should pay attention to is myasthenia gravis, which causes weakness in your voluntary muscles throughout your body. The Myasthenia Gravis Foundation of America estimates that 14 to 20 per 100,000 people, or 36,000 to 60,000 people, currently have it. Elderly men and middle-aged women are commonly at risk of this disease.4

Myasthenia gravis can be confused with other diseases

In addition to the rarity of myasthenia gravis among the population, patients have difficulty getting the proper treatment because its symptoms can be similar to other diseases. According to a study published in Seminars in Neurology, myasthenia gravis may be mixed with “disorders that limit eye movements … brainstem, cranial nerves, neuromuscular junction, muscles or local orbit anatomy.” Systemic diseases such as sepsis are possibly mixed up with myasthenia gravis as well.5

Due to the various diseases that can be confused with myasthenia gravis, a person who has it can have a delayed diagnosis that can last for months, or even years, especially if the symptoms are only mild.6

Common misconceptions about myasthenia gravis

Not many are educated about how myasthenia gravis affects the human body and how it can be treated. John L. Keefe, an attorney specializing in disability law, outlines common misconceptions about myasthenia gravis:7

  • Laziness — You may think that a person with myasthenia gravis is just lazy, especially when asking for help with even the simplest of tasks. This is not true, because the disease can weaken your muscles to the point of inactivity.
  • It’s made up — Some days you have normal muscle control, but on other days, your muscles become very weak. This can lead people to think you’re faking a disease.
  • Exercising regularly could have helped — While regular exercise is beneficial for most people, a person with myasthenia gravis can easily become tired with the slightest movement. The cause of the fatigue is not the lack of exercise, but the faulty immune system.
  • It’s just all in the mind — Saying that a person with myasthenia gravis simply doesn’t want to get better is offensive. In truth, the disease can appear at any time, causing days where you feel very weak. Support is needed for those who have the disease.

Learn more about myasthenia gravis in this guide

Myasthenia gravis is a disease that should not be taken lightly. While it usually appears in the elderly, it can still happen to anyone — even newborn children.8 This guide will help you learn about this neurological condition, including its symptoms, diagnostic methods and how it can be treated.

Learn More About Myasthenia Gravis

Myasthenia Gravis: Introduction

What Is Myasthenia Gravis?

Myasthenia Gravis Symptoms

Myasthenia Gravis Causes

Myasthenia Gravis Types

Myasthenia Gravis Diagnosis

Myasthenia Gravis Treatment

Myasthenia Gravis Prevention

Myasthenia Gravis Diet

Myasthenia Gravis FAQ

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What Is Myasthenia Gravis?

Dr. Weil on the development of integrative medicine in modern practice

Dr. Andrew Weil, director of the University of Arizona Center for Integrative Medicine, is one of the true pioneers of this field, having advocated holistic approaches to health for about 50 years.

“I was always interested in science and biology,” Weil says, and “I have a lifelong interest in plants … that led me to be a botany major at Harvard as an undergraduate and started me on a career interest in medicinal plants.”

Fascinated by mind-body interactions, Weil began studying alternative medicine in college. After graduating medical school, he did a yearlong fellowship with the National Institutes of Health. He also did a fellowship with the Institute of Current World Affairs, which allowed him to travel around Latin America and Africa to collect information on medicinal plants and traditional healing.

“I chased around the world looking for healers and to see what I could learn because I felt that what I had learned in my conventional medical education wasn’t going to serve me. I saw the methods do too much harm, and I had learned nothing about keeping people healthy,” Weil says.

“The irony is that when I finished traveling and landed back in Tucson, it turned out the person who had most to teach me had been here all along. That was Dr. Robert Fulford. He was a doctor of osteopathic medicine (D.O.). He was then in his 80s and a master of cranial therapy.

He really made me aware of the healing power of nature. I am an enormous fan of osteopathic manipulation and cranial therapy. I recommend them a lot. I hope more D.O.s will go back to their roots and again practice manipulation …

After I finished my internship, I took a course at Columbia University on medical hypnosis — one of the most interesting courses I ever took. As a result of that, I also make frequent referrals to hypnotherapists. I have, again and again, seen how changes in the mental realm initiate healing and affect the physical body.

To me, that’s one of the great limitations of the dominant scientific and medical paradigm, which only looks at the physical as being real and believes that changes in the physical system must have physical causes to be physical. Nonphysical causation of physical events is not allowed for. Integrative medicine philosophy challenges that materialistic paradigm.”

The emergence of integrative medicine

It wasn’t until the 1990s that medical institutions began opening up to Weil’s methods. “I had a large following in the general public, but none of my medical colleagues paid any attention to me,” he says. In the ’90s, however, health care economics began faltering, forcing institutions to start listening to what patients really wanted.

At a fundamental level, integrative medicine is the solution to the desperate problems and complications of chronic degenerative disease experienced in the U.S. Conventional medicine is really ineffective when it comes to these issues. As for the best way to help conventional physicians embrace these strategies, Weil says:

“My focus has been on training physicians and allied health professionals through the University of Arizona Center for Integrative Medicine. We have a two-year intensive fellowship. We now have 1,800 graduates: highly physicians, nurse practitioners and physicians’ assistants in practice in all states and in a number of other countries.

Many of them are now training other people. We also have a curriculum in integrative medicine in residency training that’s now been adopted by 70-some residency programs around the country (as well as in Canada, Germany and Taiwan).”

While 1,800 doctors are a drop in the bucket — a fraction of a percent of the 1.1 million physicians in the U.S.1 — they are important change agents.

“I think for things to change, there has to be a grassroots sociopolitical movement in this country, in which enough people get angry enough about the way things are,” Weil says. He hopes the growing numbers of health professionals trained in integrative medicine will catalyze that movement.

We also need to elect representatives who are not beholden to the vested interests that want the system to go on as it is. Those interests are blocking the implementation of more effective and less expensive strategies.

“We may have to have a total crash of the health care system for things to change,” Weil says. “To every graduating class of our fellows, I say, ‘You are the ones who could start this movement in the country.’ Doctors are victimized by the current system. They should be marching in the streets, demanding change.

As dysfunctional as our health care system is, it’s generating rivers of money. That money is flowing into very few pockets — the pockets of Big Pharma, the manufacturers of medical devices and the big insurers. Those vested interests have total control of our representatives …

I think doctors today are so unhappy. I hear many, many doctors say they wish they hadn’t gone into medicine. They’d never let a son or daughter of theirs go into medicine. I never heard anything like that when I was in college. Medicine looked like a very desirable profession. You could be your own boss. You were highly regarded in society.

All that has changed. Throughout history, much of the satisfaction of practicing medicine derived from the therapeutic connection with the patient, the getting to know someone. All that has evaporated in this era of for-profit, corporatized medicine. The time allowed for medical visits gets shorter and shorter.

The main obstacle is that our priorities of reimbursement are totally backward. We happily pay for drugs, for invasive procedures, for diagnostic testing. We don’t pay health professionals to sit with patients and talk to them about diet or teach them breathing exercises. That has to change.

Of course, we also need to have data to show to the people who pay for health care that integrative approaches using lifestyle modification and natural therapies save money and produce outcomes that are equal to or better than those of conventional medicine.”

Breathing basics

One of Weil’s health strategies is a simple breathing technique called “The 4-7-8 Breath.” “I teach that whenever I get the chance. I’ve done it with all my patients. I teach it to all our fellows. I do it with friends. I teach to all groups I speak to,” Weil says.

“It’s breathing in through your nose to a count of 4, holding your breath for a count of 7, blowing air out through your mouth to a count of 8, and doing this for four breath cycles at least twice day day. You have to practice it regularly. It is the master key to changing the activity of the involuntary nervous system,” he explains.

“Of all the remedies that I’ve given to patients over the years, the one that I’ve gotten the most positive feedback about is that simple technique. It costs nothing, uses no equipment, takes very little time. Medical doctors don’t take it seriously because they don’t believe that something so simple — something that does not involve a drug or device — can change anything in the body. For that reason, little research has been done on breath work.

I do the 4-7-8 breath at least twice a day — when I wake up and when I go to sleep — and any time during the day that I feel that I want to focus and relax. (I now do eight breath cycles at a time and don’t recommend any more than that.) One result that I’ve seen in myself: I have a very low heart rate. It’s usually in the low 40s, sometimes in the high-30s.

I exercise regularly, but I’m not fanatical. I swim and walk every day. But up until maybe 20 years ago, my heart rate was around 70. The only way I can explain the change is that it is a result of doing that breathing exercise regularly. It has increased my vagal tone, slowed my heart rate and kept my hands very warm most of the time. It’s the power of the relaxation response — one of the great rewards of doing this breathing practice.”

Aside from activating your parasympathetic nervous system, which increases your heart rate variability, proper breathing will help improve your digestion and blood circulation and lower high blood pressure.

Maintaining cognitive and physical health into your senior years

At 77, Weil is also a testament to the cognitive benefits of this and other holistic techniques. His mental acuity for someone in their late 70s is truly remarkable, and doesn’t seem to have changed since his youth. When asked what he attributes his general health to, he says:

“I get good rest and sleep. I use supplements wisely. I’m a great believer in the power of mushrooms. I take a number of mushroom products that I think are helpful both mentally and physically. I eat a lot of fermented foods. You know there’s increasing research on the connection between the microbiome and mental-emotional well-being.

I think that’s another strategy. And I drink matcha green tea every day. (I am so much a fan of it that I created a company — Matcha Kari — and got the URL matcha.com to bring high-quality matcha from Uji, Japan, to people in this country.

I spend time with people who are active and happy and positive and I think that’s a great strategy as well. I have two companion animals, two wonderful dogs that I spend a lot of time with. I attribute a lot of my well-being to living with them as well.”

Among Weil’s favorite medicinal mushrooms are turkey tail and lion’s mane. Turkey tail has a number of cancer-protective effects, both preventively and therapeutically, while lion’s mane contains a unique nerve-growth factor. “I recommend it to people with neuropathy,” Weil says. There’s also evidence suggesting lion’s mane can help improve cognitive function.

True food kitchen

Last year, I had the opportunity to try out the True Food Kitchen while at the Paleo f(x)™ conference in Austin, Texas — a restaurant chain Weil conceptualized. He explains:

“I’m a very good home cook. I’m not a chef. But over the years, many people have said, ‘You ought to open a restaurant.’ I was never tempted to do that because I know nothing about the restaurant business, and it looked like a very tough business.

But about 11 years ago, a mutual friend introduced me to a very successful restaurateur in Arizona, Sam Fox. I proposed the concept of a restaurant that would serve wonderful, delicious food that was also healthy. His immediate reaction was, “Health food doesn’t sell.”

I think he thought I meant tofu and sprouts. He regarded me as a hippie and didn’t see any possibilities for a collaboration. I invited him and his wife to my home. I cooked a meal for them. They liked the food. His wheels began to turn, and he said he would give it a try, but he was very skeptical that the concept would succeed.

We opened our first True Food Kitchen in Phoenix 11 years ago. It was a success right out of the gate. There are now 29 of them around the country. People love the food. We still don’t have any real competition. The menu is based on my anti-inflammatory diet, with something for everyone there.

You can go with a mixed group. There are meat entrees — although not many of them — wonderful produce and fish. Gluten-free people can get what they want, people who are vegans, paleo or keto can find what they want there. It’s been a great delight to see people liking the kinds of food I’ve enjoyed most of my life.”

We certainly need more restaurants like that, because eating too much processed food is one of the key challenges most people have. While you may not think of restaurant food as processed, a vast majority of it is.

Staying active is a key component of longevity and health

About 50% of 80-year-olds experience sarcopenia, loss of muscle mass. As noted by Weil, one of the key prevention strategies for sarcopenia is to stay active and use your muscles as much as possible. This is also why strength training is so highly recommended for seniors.

“I use my muscles a lot,” Weil says. “I am careful in what I do, but I go up and down stairs a lot when I get the chance. I lift things. I don’t feel that I’ve lost muscle strength. I certainly have more aches and pains than I did when I was younger, but I think my musculoskeletal system is in good shape …”

“It’s important to pay attention to how your body changes and how it reacts to different things … In my 20s, I ran for a time — until I got signals from my knees that they didn’t like that. I shifted to cycling and did that for a long time. And then I got into swimming, which agrees with me very much. I think it’s good to be flexible and open to change …”

Integrative medicine is the answer to many growing problems

Like me, Weil sees integrative medicine as the way of the future. “I’ve always said that one day we’ll be able to drop the word ‘integrative’ and it’ll be just ‘good medicine,'” he says. He believes this transition is inevitable, because the forces that are taking down our health care system continue to build.

This includes a growing population of seniors, uncontainable health care costs due to our dependence on expensive technologies and drugs, and growing epidemics of lifestyle-related disease that conventional medicine cannot successfully manage.

“This is happening all over the world, but it’s most advanced in the U.S.,” he says. “Our health care system is farther over the cliff. At the same time that we are paying more for health care than any other people in the world — now 18% of our GDP — we have worse health outcomes than any other developed nation. The World Health Organization ranks us 38th, on par with Serbia. Something is very wrong with that picture. It’s unsustainable.”

On cannabis

One positive change is the growing acceptance of medicinal marijuana and hemp, the latter of which was legalized in the 2018 Farm Bill. While Weil no longer uses cannabis, he recounts his personal history with the plant during his 30s. He also conducted the first ever double-blind human experiments with cannabis, which were published in the journal Science in 1968.

“We’ve been very stupid in our relationship with that plant,” he says. “Cannabis sativa — the word ‘sativa’ means useful — is amazingly useful. It gives us a very high-quality oil and an edible seed, a medicine, an excellent fiber and an intoxicant. That’s a lot of ways for one plant to serve us.

We have let a multibillion-dollar industry in hemp textiles slip away to China, a multimillion-dollar industry in edible hemp products go to Canada. We have rejected cannabis as medicine for a long time. I’m very happy to see this change.

I regard cannabis as the plant world’s equivalent of the dog. Dogs long ago decided to co-evolve with us. Cannabis has done the same thing. We can’t unravel the ancient history of cannabis, because as far back as we can look, it’s always been associated with human settlements and human activity.

It wants to do nothing other than to serve us. It lets us manipulate its genome. It just wants to help us and we have turned it away. It’s nice to see that change.”

Psychedelics may have a place in medicine

Weil also believes there’s a place for psychedelics, such as magic mushrooms. “The great magic and potential of psychedelics is that they can show you possibilities that you otherwise would not have believed,” he says. However, once you’ve touched on these new possibilities, he says you need to find other, nondrug ways to re-experience or maintain them.

“If you try to use the drugs as the sole method of having them, they fail you,” he warns. “The example I have written and talked about [is] when I was about 28, I wanted to learn to practice hatha yoga. I worked with a number of postures.

The one I had the most difficulty with was the plow — where you lie on your back and try to touch your toes on the floor behind your head. I worked at this for a long time and I got my toes to within a foot of the floor but no further, because I would have excruciating pain in my neck. No matter how I persisted, I couldn’t make further progress.

One spring day, I took a dose of LSD with friends in a beautiful outdoor setting. I felt terrific. My body was completely elastic and flexible, and I thought I ought to try that yoga pose. I lay down, got my feet over my head and lowered them. I thought I had about a foot to go and they touched the ground. I couldn’t believe it. I raised and lowered them. It was a source of such delight.

The next day I tried to do it and I got my toes within a foot of the floor and had a horrible pain in my neck. But now there was a difference. I had seen that it was possible. I was motivated to keep at it and, in a few weeks, I was able to do it. If I had not had that experience, I don’t think I would have kept up the practice. To me, that’s a model of how these drugs work. They can show you possibilities.

I think they have tremendous potential in medicine. Everyone looks at their use in psychotherapy, and that’s fine, but I think they have a tremendous potential to change how people experience their bodies. For people who have chronic diseases, a structured psychedelic session can show them that it’s possible to be without pain or other symptoms. And that can motivate them to figure out how to maintain the improvement in other ways.”

More information

While Weil says he’s done writing books, he’s in the process of writing a collection of stories from his life. The University of Arizona Center for Integrative Medicine in Tucson, which he still heads up, is also entering a new phase of growth.

“The university has made a solid commitment to make integrative medicine a top priority,” he says. We will get a dedicated building on campus and will open the first integrative medicine primary care clinic in Tucson early next year.

You can find more information about this on the Andrew Weil Center for Integrative Medicine website. There, you can also sign up for online courses to explore topics such as nutrition, integrative pain management, cardiovascular health management and more. There’s also a research section you can peruse to learn more about the benefits of integrative medicine.

“We think we have a model that is replicable, sustainable, profitable that can be eventually replicated throughout the health care system here and elsewhere. We’re expanding our teaching programs. We have a very strong research initiative as well.

This is all very exciting — something I’ve waited for, for a long time … I think the future is going to be very bright for our field. Medicine doesn’t change as a result of intellectual argument. It changes as a result of economic necessity. And time is on our side.

Our health care system is in deep, deep trouble. The wisdom of what [Dr. Mercola] and I have been advocating for so long will become more and more apparent as the health care crisis deepens.”

How to Make Meatballs

Meatballs, in the most basic sense, are made from ground meat that has been formed into dense, round shapes. The type of meat used can vary, from lean ground beef to fatty ground pork or veal. You can even use fish! When making meatballs, the meat is enhanced with moist breadcrumbs, flavored with herbs, spices or cheese, and then an egg is added as a binder to help hold the meat’s round form.

Thanks to their popularity and flexibility, you’ll see meatballs in various dishes — served as appetizers, added to pastas, mixed into soups or even skewered and grilled during outdoor picnics. Different countries have their own version of this tasty little dish. Morocco has its lamb meatballs, while Swedish cuisine is known for its Kottbullar, made popular by IKEA, although there are claims that the recipe actually came from Turkey, and is known as köfte.    

It’s likely that you have your own time-tested method on how to make homemade meatballs, passed down to you through a family recipe. There are numerous ways to cook meatballs: baked, in a slow cooker or Crock-Pot, fried or even barbecued. If you don’t have your own method, here are a few ways of cooking meatballs you can explore. Try them all and see which one is your favorite!

A Few Meatball Cooking Tips Before You Get Started

Even if you have an easy meatball recipe on hand, there are instances when the dish doesn’t turn out as  expected. The most common mistakes can result in overcooked, flavorless and dry meatballs. To avoid this, here are a few tips from The Kitchn on how to cook well-seasoned and juicy meatballs:   

  • Select the right kind of meat — Fattier meats like pork, beef and lamb will result in more tender meatballs. If you opt to use poultry like chicken or turkey,  watch the meatballs carefully — otherwise they can end up tough or overcooked. Don’t use just one kind of meat — blend different kinds together for great flavor.  Whatever type of meat you choose, make sure it comes from sustainable sources, like grass fed beef or chicken.
  • Keep your meat and other ingredients cold — It’s best to prevent the fat from melting and breaking down before cooking. You can use a chilled bowl to mix the ingredients, or if adding ingredients that are precooked, like onions, allow them to cool down before mixing them with the meat.
  • Moisture is important — Remember that when you cook meat, the protein in it shrinks, causing the meat to toughen — this is why adding moisture is crucial. You can do this by adding moist breadcrumbs, eggs and milk to your mixture.
  • Taste test the meat mixture — The reason many meatball recipes turn out bland is because the cook doesn’t test the mixture before cooking the entire batch. To do this, simply take a small amount of the meat and fry it in a pan with a small amount of oil (coconut oil works best). You can then take a bite and determine which seasoning — salt, pepper or herbs and spices — needs to be added.
  • Form meatballs gently — Packing meatballs tightly is a common mistake and will result in a tough, rubbery and chewy mess. Avoid this by forming the meatballs quickly but gently. Use your hands with a little bit of oil on them (so the meat will not stick). Using an ice cream scooper is also a great idea.   

The Kitchn recommends baking your meatballs instead of frying them. By doing so, you can avoid the oil spatters while getting the same brownness as you would if you fry the meatballs.

How Long Should You Bake Meatballs?

Knowing how to make meatballs in the oven requires a few considerations, including the size of your meatballs, the cooking temperature and the type of meat you used. According to Reference.com, the ideal cooking time for meatballs is 20 to 25 minutes at 400 degrees Fahrenheit. If your meatballs are larger than 1 1/2 inches, a longer cooking time may be needed. However, if they’re very small, your meatballs may be ready in as little as 10 minutes.

What’s important when baking meatballs is that the center should have a temperature of 165 degrees Fahrenheit. You can check the temperature using a meat thermometer. You can also take out a meatball and cut it in half to check the center. If it’s no longer pink, it’s  ready to go. Here’s an easy baked meatball recipe from The Spruce Eats you can try.

Easy Homemade Meatballs Recipe

Total Time: 45 minutes
Prep Time: 15 minutes
Cook Time: 30 minutes
Yield: 4 servings

Ingredients:
1 pound lean ground beef
1 egg
2 tablespoons water
1/2 cup bread crumbs
1/4 cup onion, minced
1/2 teaspoon salt
1/8 teaspoon pepper  

Procedure:

  • Heat the oven to 350 degrees F.
  • Combine the egg, breadcrumbs, water, onion, salt and pepper in a large bowl and mix well. Add the ground beef, breaking it in chunks, and mix gently but thoroughly. You can use your hands to make sure all ingredients are well-integrated.
  • Form the meat mixture into balls that are about 1 inch in diameter. Put on a broiler pan or a pan with sides topped with a wire rack.
  • Bake the meatballs at 350 degrees F for 25 to 30 minutes, or until meatballs register 165 degrees F on a meat thermometer.

 

Check Out These Delicious Meatball Recipes

Once you’ve got the basics on how to make baked meatballs, you can start experimenting with different recipes and ingredients. The first two recipes below are ideal if you’re following a ketogenic diet:

 

The Best Turkey Meatballs Recipe

Ingredients:
10 slices bacon
2 pounds ground turkey
3 small red chilies
1/2 medium green pepper
1 small onion
1/2 teaspoon salt
1/2 teaspoon pepper
2 large handfuls spinach
3 sprigs thyme
2 large eggs
1 ounce pork rinds

Procedure:

  • Heat your oven to 400 degrees F and place the bacon strips onto a baking sheet. Cook for 30 minutes.
  • While waiting for the bacon to cook, make the meatballs. Dice the red chilies, onion and green pepper.
  • Using a food processor, grind the pork rinds into a powder and then set aside.
  • Grind a handful of spinach and thyme.
  • In a large mixing bowl, add the vegetables, pork rinds and turkey. Combine well and evenly. Add the eggs to the turkey mixture and combine again.
  • Remove bacon from the oven and allow to cool. Drain the excess grease from the baking sheet and set aside.
  • Make 20 meatballs from the turkey mixture and put them on the baking sheet. Cook for 15 to 20 minutes or until juices run clear.
  • Make a spinach “butter” by placing the remaining spinach, the rendered bacon fat and the seasonings of your choice (you can use basil, garlic or cayenne pepper) in the food processor. Process well until smooth.
  • To serve, skewer the meatballs with a toothpick and add a dab of spinach “butter” .

This recipe makes 20 meatballs.

(Recipe from Ruled.Me )

 

 

Keto Swedish Meatballs Recipe

Prep Time: 10 minutes
Cook Time: 20 minutes
Total Time: 30 minutes

Ingredients:

Meatballs:
1 pound ground beef
1 pound ground pork
2 eggs
2 tablespoons dried parsley
2 tablespoons dried minced onion
1 teaspoon salt
1 teaspoon garlic powder
1/2 cup ground pork rinds
1/2 cup parmesan cheese, freshly grated

Gravy:
2 cups beef broth
1/2 cup sour cream
1 teaspoon salt
1/2 teaspoon ground black pepper
2 ounces salted butter
1/2 cup red onions, minced
1/4 teaspoon Worcestershire sauce
1 pinch instant coffee powder (optional)

Procedure:

  • Heat the oven to 375 degrees F.
  • Mix all the meatball ingredients in a large mixing bowl, until thoroughly combined. Form into 1 1/2-inch balls.
  • Place meatballs on a baking sheet in a single layer, at least 3 to 5 centimeters (1 to 2 inches) apart. Bake for 15 to 20 minutes until meatballs are browned and cooked thoroughly.
  • To make the gravy, brown the onion in butter in a large skillet. Add salt, pepper, broth, Worcestershire sauce and coffee powder and let simmer for 15 to 20 minutes.
  • Reduce heat to low and then add the sour cream, stirring well.
  • Add the cooked meatballs to the gravy and let simmer on low for an additional 5 to 10 minutes. Serve hot.

(Recipe from Diet Doctor )

 

There are also meatball recipes that cater to people who have specific dietary needs or eating preferences. Check out these two examples:

 

Gluten-Free Meatballs

Prep Time: 15 minutes
Cook Time: 25 minutes
Total Time: 40 minutes

Ingredients:
1 pound ground chicken or turkey
1 egg
2 tablespoons coconut oil
1 tablespoon Worcestershire sauce
1/4 cup almond flour
1/2 cup parmesan cheese
3 cloves garlic, minced
2 teaspoons dried Italian seasoning
1 teaspoon dried parsley
1/2 teaspoon onion powder
1/4 teaspoon dried fennel
1/4 teaspoon red pepper flakes
1/4 teaspoon kosher salt
1/4 teaspoon ground black pepper

Procedure:

  • Heat the oven to 425 degrees F. Line a baking sheet with parchment paper.
  • Whisk the egg, coconut oil and Worcestershire sauce together.
  • Add in the parmesan cheese, almond flour and spices.
  • Mix in the ground chicken using your hands, until well-combined.
  • With a small cookie scoop, scoop out a tablespoon-sized ball of the mixture and place on the baking pan. Repeat until all of the mixture gone.
  • Bake at 425 degrees F for 20 to 25 minutes or until the meatballs are  golden brown with a 165 degrees F internal temperature.

(Recipe adapted from Wheat by the Wayside )

 

Easy Tempeh Vegan Meatballs
Prep Time: 10 minutes
Cook Time: 20 minutes
Total Time: 30 minutes

Ingredients:
1 225-gram pack of organic tempeh
3 green onions, greens and whites sliced
1 clove garlic, roughly chopped
2 tablespoons nutritional yeast flakes
1 tablespoon organic soy sauce or tamari
1 to 2 tablespoon/s water
1/4 cup almonds
1 teaspoon fresh herbs of your choice
1/8 teaspoon sea salt
1/8 teaspoon black pepper, ground
1/2 tablespoon coconut oil (optional)

Procedure:

  • Heat oven to 350 degrees Fahrenheit. Place all the ingredients except the coconut oil in a food processor and process until smooth.
  • Get a small amount of the mixture and roll it in your palms. You should create about eight golf ball-sized tempeh balls.
  • Place baking paper on a baking tray. Alternately, you can spread a half-tablespoon of coconut oil on the baking tray. Space out the meatballs evenly on the tray.
  • Let cook for 20 minutes, rolling them once halfway through so they brown evenly. Serve with a salad or with a delicious tomato sauce and pasta.

(Recipe from The Conscious Dietitian )

 

Frequently Asked Questions (FAQs) on Cooking Meatballs

Q. Are meatballs healthy?

A. The nutritional value of meatballs depends on the ingredients you use. Opt for grass fed meats or pastured chicken and eggs. Adding in herbs and spices to your meatballs can boost their nutritional content. The cooking method also matters. If you opt to fry instead of bake your meatballs, make sure to use coconut oil and not vegetable oils.

Q. Can you prep meatballs ahead of time?

A. You can shape meatballs and keep them in the fridge a day ahead. Make sure to cover them well and that they don’t end up being squished together. You can also freeze them if you plan to store them for a longer time. Just make sure to thaw before cooking.

Q. How do you keep meatballs moist?

A. The Kitchn recommends using eggs, moist breadcrumbs and milk in your meatball mixture.

Q. How do you keep meatballs from falling apart?

A. You will need to use an ingredient that will “bind” the meat together, such as an egg or breadcrumbs.

Q. How long can I keep uncooked meatballs in the fridge?

A. Ready-to-cook meatballs can be kept overnight in the fridge. If you want to freeze them, you will need to cook them first. Frozen cooked meatballs may last for three months.

Q. Do meatballs need breadcrumbs?

A. Moist breadcrumbs are necessary to bind the meatballs. But if you don’t have any, use a slice of torn-up bread, crumbled saltine crackers or even panko as a substitute.

Q. What can I use instead of eggs in meatballs?

A. Just like breadcrumbs, an egg serves as a binder for meatballs. A one-fourth cup of whole milk ricotta or feta cheese may work as a replacement. If using in spaghetti or tomato-based dishes, you can use tomato paste (2 tablespoons per egg). Mashed potatoes (half a cup for two eggs) may be a good egg replacement as well.

About Small Contributions


By Anna Von Reitz

Some friends are only able to send $5 or $10 toward the expenses we face here and they feel bad that it couldn’t be more.  But if you think about it, it’s the staying power that counts and the commitment to give what we can. 

If you think about the immensity of the problem, all contributions are small. 

Only God knows whose $5 or $10 kept us in the black all these months of struggle, but there have been many times when it came down to that.  So let’s hear it for those small donations that add up and keep the wheels rolling.  

When I was young I ran with a pack of very athletic Californians.  These people were all Norwegian scions and were tall and blond and built for all sorts of sports and outdoor activities.  They kept on and on about wanting to climb this particular (rather low, but still a “mountain”) in the local area where we lived and I, the short and slightly flabby and only German member, kept saying— “No, I have no interest in climbing any kind of mountain.” 

Germans, being Germans, are pragmatic by nature.  It’s built into the warp and weft.  We don’t, if we run true to form, climb mountains for no reason.  We might walk for pleasure, we might even hike, but it is a rather rare German bird that sets off to climb a mountain just because it’s there.  

Notice— I didn’t say I couldn’t climb that mountain, just that I wasn’t interested in doing so. 

Nonetheless, they kept at it, week after week and month after month.  Finally, in exasperation, I agreed to climb the mountain with them.  So, one Saturday morning, we set off.  

Of course, they immediately out distanced my stubby legs and were soon lost in the rain forest mist.  I was left chugging along far behind, so far behind that I could no longer hear their cheerful voices up ahead. 

But by then, I was disgusted to be climbing a mountain for no reason.  And I grimly plodded along, ever upward. 

A couple hours later I met the first one of them coming back down the trail. His  hiking boots had chafed his feet and he was limping home with blisters.  

My sympathies.  Despite my smallish physique, I had actually used my hiking boots enough to break them in and I was doing fine in that respect.  So I wished him well and kept climbing. 

One after another, for all their various reasons, I met them all on their way back down the mountain. 

I was all alone and the only one who made it to the top of the mountain late in the afternoon.  I had brought along a plastic garbage bag to pick up the beer cans and empty film cartridges and other detritus that climbers always leave behind at the summit.  Don’t ask me why.  I am not of the mentality that climbs mountains for no reason.  

So I picked up the trash and took in the view and took photographs and headed for home, hauling the trash bag out and walking and climbing more swiftly going downhill in hopes of getting to the trail head before dark—- which I did. Just barely.  

My point is that the tortoise who endures and knows what it takes to climb a mountain is a better bet than the rabbit who doesn’t, and the size of a contribution is not necessarily the measure of it, any more than the size of a climber determines their success.  

It’s the will behind it all that matters.  It’s the grit.  It’s the decision we make to take action and keep climbing.  

Like the Widow’s Mite, a small gift from small resources is the moral equivalent of a large gift from large resources. And it all counts.  Ten bucks a month over the course of a year is $120.  Not such a small donation, is it?  Not when you think and feel and see the bigger picture spread out before you. 

There are three elements to a lawful claim upon property — status, standing, and jurisdiction. The only people who have established their correct political status on the public record, the only ones having the standing to bring a claim in behalf of our States of the Union, and the only ones left guarding the land jurisdiction of this country, are all those who have listened and taken action to reclaim their Good Names and correct the falsified political status records.  

We, ourselves, our band of brothers and sisters from all across this country, are the only ones determined enough and in position to rebut the claims of all the foreign Secondary Creditors of “the” United States.  We didn’t want to climb this mountain, either, but here we are. 

Despite everything that the perpetrators allege and throw against us, we keep coming.  Despite the lies and the disruptions and the widespread ignorance and every other obstacle, we are building our Assemblies, too.  As each State Coordinator steps forward and serves notice that their State of the Union is populated, another miracle happens— America is reborn.  

Soon, the immensity of all our “little” contributions will become more obvious, the impact of simple truth-telling and logic will emerge out of the confusion and the pile of purposeful lies and omissions that we have had to sort through.  That’s another mountain we were not eager to climb.  

But we did so.  Today, I ask you to remember a great man you never knew. His name?  Bill Benson.  Bill climbed his mountain, too.  

As a retired forensic auditor for the State of Illinois, he began to suspect that something was wrong with the records and the claim that the Sixteenth Amendment (the Federal Income Tax) was ever ratified by the States.  

So he and a few others began the long, long trek, all across this country, digging into records in State Archives that nobody had looked at in a hundred years, getting Certified Copies, and painstakingly piecing together the proof that the Sixteenth Amendment was never ratified by the States of the Union. 

That proof, a two volume set of over-sized books published as “The Law That Never Was” absolutely documents the deceit and the fraud against the American People.   

As a thank you, the Powers That Be arrested Bill Benson on false federal charges and denied him the medication he needed to live.  

I suffered for him then and I suffer for him now.  

This afternoon I am told that the large platform scanner your contributions made possible completed the job of scanning every page of  “The Law That Never Was” into the digital form for The Library of the Continental Congress.  

The rats who are so famous for burning books will never be able to destroy the record he gave up his easy retirement and ultimately, his life, to create.  

Bill was hopeful that all his work and effort would bear fruit, that people in this country would look at the records and come to their own conclusions.  

There are no small contributions.  Write a letter, tell your kids, pass it on, elbow your best friend and fill them in.  Cash in your pocket change.  Take on a piece of the puzzle. Rebuke Satan. Collar a Congressman. Report their abuses and hypocrisy to the United Nations.  Do whatever you can.  And keep doing it.  

We’re not only going to climb this mountain.  We are going to move it.  If we have to do it $5 at a time, that’s how we will do it.  Raindrops make an ocean and single footsteps gain the summit — never forget that.  

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See this article and over 1800 others on Anna’s website here: www.annavonreitz.com


To support this work look for the PayPal button on this website.

12-Year-Old ‘Drag Kid’ Performed at Gay Bar for Tips

The mother of ‘Desmond is Amazing’ – a 12-year-old ‘drag queen kid,’ has defended her decision to allow her son to perform on stage at a gay club in New York while patrons tossed money at the boy.

After revealing that 7 different agencies had conducted investigations into whether Desmond was being abused, his mother Wendy told hosts of an Australian TV show that there was nothing wrong with the show.

“Do you think that’s the right environment for a 12-year-old?” asked the host, noting that some of the gay men in attendance felt “very uncomfortable” about the performance.

“No – it was an all ages show, it was in a queer safe space, obviously there are not a lot of heterosexual safe spaces right now that he can perform in,” said Wendy, before she changed the subject by complaining about people “bringing guns to drag queen story hour”.

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WhatDoesitMean.com 6-15-19… “Top US Official Makes Treason Charge Against Hillary Clinton As America Descends Into “Legal Lunacy””

This WDiM points out some of the “insanity of desperation” the deep state players are currently demonstrating. The Ellen Weintraub statement was also highlighted in today’s x22Report video, and it shows (to me, at least) that the Alliance’s plan for entrapment and allowing the deep state players to “take themselves out” is going full blast.

This whole business also relates to the last Kp message, and one part of that said, “there is clearly… so much going on all over the place, on this level, that level, and so on, that it just does sometimes feel like “too much”… [but]… the ultimate guide… is my Higher Inner Self.” So in the end, I feel it’s important to “stay above the fray” which we are now viewing.

It needs to happen, it is happening, and as Q has often stated, we should just “Enjoy the show“.

“…the state of “Legal Lunacy” the Americans have descended into now includes the powerful Chair of the US Federal Election Commission Ellen Weintraub having just declared in an official statement: “Let me make something 100% clear to the American public and anyone running for public office: It is illegal for any person to solicit, accept, or receive anything of value from a foreign national in connection with a U.S. election.”—an official declaration on treason that strikes at the very heart of Hillary Clinton because of the infamous Trump-Russia Dossier

“…the latest episode in the now over two-year running made-for-television series future historians will name “American Goes Insane”, began airing this week when President Donald Trump gave an interview wherein he said he’d consider taking intelligence dirt about a rival from a friendly ally—a familiar plot script as this is EXACTLY what the Obama Regime did, in 2016…

“Most important note about this latest “America Goes Insane” episode, though, this report says, is that its plot twist contains what is most famously known as a “Trump Trap”—best described as an intentionally provocative statement made by President Trump in order to expose leftist hypocrisy and reveal a deeper hidden truth—and in this case saw both being delivered by Ellen Weintraub…

“As is to be expected, this report continues, the leftist-controlled American mainstream propaganda media are failing to inform their citizens that FEC Chair Ellen Weintraub’sdeclaration is a direct treasonous indictment of what both Hillary Clinton and President Obama had done against Trump—and is a failing that these media lapdogs to their socialist Democrat Party masters are performing at the same time they’re accusing Trump of “obstruction”…

“In new signs that President Trump is starting to turn the tide against these leftist US Federal Courts and re-take control of the US military, this report details, this past week alone has seen a Trump controlled US Federal Appeals Court throwing out the unjust Obama Regime rape conviction of a West Point cadet

“As President Trump continues his relentless march for truth and freedom fighting and defeating everything his leftist enemies throw at him, this report concludes, even top Democrat Party pollster Chris Kofinis has just warned “anyone who believes that the Democratic candidate is headed for a landslide victory right now is doomed to repeat the tragic history of 2016”—a warning based on historical facts these deluded socialist Democrats and their leftist media lapdogs continue to ignore…

“…Democrat Party front runner Joe Biden this week campaigning in Iowa in front of about 100 people described as “a small crowd almost all over 55, some significantly older”… at the same time, Trump is preparing to travel to Orlando-Florida next week where a staggering over 100,000 people have requested tickets to see him announce that he is running for re-election in 2020.”

————————————————————-

Top US Official Makes Treason Charge Against Hillary Clinton As America Descends Into “Legal Lunacy”

A fascinating new Ministry of Foreign Affairs (MoFA) report circulating in the Kremlin today noting that negotiations on the transfer from a United States prison to Russia may soon begin for student Maria Butina, who was unjustly convicted for “Russia Hysteria” crimes, says that the state of “Legal Lunacy” the Americans have descended into now includes the powerful Chair of the US Federal Election Commission Ellen Weintraub having just declared in an official statement: “Let me make something 100% clear to the American public and anyone running for public office: It is illegal for any person to solicit, accept, or receive anything of value from a foreign national in connection with a U.S. election.”—an official declaration on treason that strikes at the very heart of Hillary Clinton because of the infamous Trump-Russia Dossier that gathered information using Kremlin sources and was authored by former British MI-6 agent Christopher Steele—was paid for by the Clinton Campaign and Democratic National Committee—and that Hillary Clinton herself later defended on the Daily Show by saying that “it’s part of what happens on a campaign”.  [Note: Some words and/or phrases appearing in quotes in this report are English language approximations of Russian words/phrases having no exact counterpart.]

IMAGE

According to this report, the latest episode in the now over two-year running made-for-television series future historians will name “American Goes Insane”, began airing this week when President Donald Trump gave an interview wherein he said he’d consider taking intelligence dirt about a rival from a friendly ally—a familiar plot script as this is EXACTLY what the Obama Regime did, in 2016, when it accepted unsolicited information from Alexander Downer, an Australian diplomat who just happened to have helped arrange a $25 million government donation to the Clinton Foundation—and that saw Downer providing “intelligence dirt” with his claiming that he had witnessed a Trumpcampaign aide, George Papadopoulos, bragging about some dirt that the Russians supposedly had on Democratic candidate Hillary Clinton.

As in all such plot script reruns American television producers are famous for concocting, this report notes, in order to make the new “version” more acceptable to the viewing audience, the old one can’t even be mentioned at all—and is why the leftist cable news channels MSNBC and CNN spent 72% of their prime time hours “freaking out” about what President Trump said—while at the same time, they had to ironically ignore the fact that what they were really doing was accusing Obama of treason—as Trump has never accepted foreign “intelligence dirt” on anyone, but both Clinton and Obama had.

IMAGE

Most important note about this latest “America Goes Insane” episode, though, this report says, is that its plot twist contains what is most famously known as a “Trump Trap”—best described as an intentionally provocative statement made by President Trump in order to expose leftist hypocrisy and reveal a deeper hidden truth—and in this case saw both being delivered by Ellen Weintraub who, along with her being the powerful head of the US Federal Election Commission, is a Reform Jew whose husband is the Jewish-American industrialist Peter Weintraub.

The critical importance of FEC Chair Ellen Weintraub being a member of the Reform Judaism movement, this report explains, begins by understanding the historic event occurring during the 2016 US Presidential Election when Trump ally Israeli Prime Minister Benjamin Netanyahu granted Reform Jews the right to pray at Israel’s holiest sites—an issue critical to both Ellen Weintraub and her husband Peterboth of whom were visiting Israel when the second intifada broke out and were left trapped in their hotel—and because of sees today Peter Weintraub being the US national chairman of the  Friends of the Israel Defense Forces, whose “A Night of Heroes” celebration this past October-2018 in New York City was packed with Trump defense officials—with it further to be noted that Ellen Weintraub was Of Counsel to the Political Law Group of Perkins Coie—the law group that Hillary Clinton corrupted by funneling thorough it her illegal payments to get foreign “intelligence dirt” on Trump—and against both of whom Ellen Weintraub erupted against yesterday by declaring:

Let me make something 100% clear to the American public and anyone running for public office: It is illegal for any person to solicit, accept, or receive anything of value from a foreign national in connection with a U.S. election.

This is not a novel concept.

Electoral intervention from foreign governments has been considered unacceptable since the beginnings of our nation.

Our Founding Fathers sounded the alarm about “foreign Interference, Intrigue, and Influence.”

They knew that when foreign governments seek to influence American politics, it is always to advance their own interests, not America’s.

Anyone who solicits or accepts foreign assistance risks being on the wrong end of a federal investigation.

IMAGE

As is to be expected, this report continues, the leftist-controlled American mainstream propaganda media are failing to inform their citizens that FEC Chair Ellen Weintraub’sdeclaration is a direct treasonous indictment of what both Hillary Clinton and President Obama had done against Trump—and is a failing that these media lapdogs to their socialist Democrat Party masters are performing at the same time they’re accusing Trump of “obstruction”—an “obstruction”, mind you, that sees them accusing Trump of “thinking” about firing Special Counsel Robert Mueller and/or pardoning individuals Mueller may have been investigating—neither of which Trump actually did, as he had no reason to because there was no crime to obstruct in the first place.

In point of fact, this report notes, even if President Trump had fired Special Counsel Mueller, and/or pardoned everyone being investigated, it was perfectly legal under the US Constitution for him to have done so—best evidenced by President Richard Nixon firing the US Department of Justice prosecutors investigating his crimes, known as the “Saturday Night Massacre”, but whose impeachment indictment didn’t include these firings—and President George H. W. Bush issuing pardons to everyone being investigated in the Iran Contra Probe that shut the entire investigation down—that Independent Counsel Lawrence Walsh railed against by stating “the Iran-Contra cover-up, which has continued for more than six years, has now been completed”—and that no one in either the US Congress or mainstream media dared called “obstruction”, as they knew a President can legally fire and/or pardon anyone they choose to.

IMAGE

IMAGE [American people still not being told the truth that a President firing and/or pardoning anyone they so choose is NOT obstruction.]

While this latest “American Goes Insane” episode continues playing out with its “Trump Trap” plot twist, however, this report continues, the real “Legal Lunacy” battle President Trump is engaged in involves him attempting to re-take control of the US military away from leftist elements in the US Federal Court—a battle which sees Trump trying to discover why a Chinese communist company has been making parts for America’s most advanced and secretive multi-billion-dollar F-35 stealth fighter—which may explain why this F-35 has now been beyond shockingly discovered to be losing its stealth coating at supersonic speeds.

In new signs that President Trump is starting to turn the tide against these leftist US Federal Courts and re-take control of the US military, this report details, this past week alone has seen a Trump controlled US Federal Appeals Court throwing out the unjust Obama Regime rape conviction of a West Point cadet because it “was impossible to believe” and ordering him immediately released from prison and reinstated at West Point—another US Federal Appeals Court telling a leftist US Federal Judge in the Ninth Circuit that he “can’t substitute his own evaluation of evidence for a reasonable evaluation by the military in light of President Trump’s Executive Branch privilege”—and its telling another leftist US Federal Judge that he “made a grave error” when he blocked a Department of Defense policy that prevents foreign nationals from starting basic training until after their lengthy background checks are completed—all of which confirm the historical truth that generals, not judges, are best left to fight wars and defend nations—at least those hoping to survive and win like Trump wants to.

IMAGE [Commander-In-Chief President Donald Trump battles against leftist US Federal Judges to re-take control of US military.]

While battling against these leftist US Federal Judges to re-take control of the military forces he alone is supposed to command, this report further details, President Trump is furthering his war against the coup plotters trying to bring him down—that during this past week has seen his US Department of Justice providing “new details” to the US Congress about how extensive their “spying probe” against the Trump Campaign by Clinton and Obama actually is—that includes the DOJ now targeting CIA officers to see what exactly they did—and whose DOJ bloodhounds” are said to “be on the scent” of former CIA Director John Brennan for the crimes he committed.

At the same time President Trump’s investigators are zeroing in on former CIA Director Brennan, this report continues, Republican Party leaders in the US Congress are, also, now sounding the alarm about current FBI Director Christopher Wray “burying documents—and that followed the stunning revelation just made in a US Federal Court that the FBI doesn’t even posses the unredacted reports on the so-called “hack” of the Democrat Party servers said to have started this entire Trump-Russia fiasco in the first place—thus explaining why Trump’s former National Security Adviser General Michael Flynn fired his attorneys and hired as his new one the greatly feared attorney Sidney Powell—and whom, though initially claiming Flynn will still cooperate with prosecutors, everyone knows will have Flynn withdraw his guilty plea so she can face “Mueller’s Monsters” head on in a battle she’s won before when facing them.

IMAGE [The “Deep State’s” most feared and relentless enemy Sidney Powell becomes new attorney for General Michael Flynn.]

As President Trump continues his relentless march for truth and freedom fighting and defeating everything his leftist enemies throw at him, this report concludes, even top Democrat Party pollster Chris Kofinis has just warned “anyone who believes that the Democratic candidate is headed for a landslide victory right now is doomed to repeat the tragic history of 2016”—a warning based on historical facts these deluded socialist Democrats and their leftist media lapdogs continue to ignore—best exampled, in 1984, when former Democratic Vice President Walter Mondale seemed to be facing nothing but calm seas and fair winds and proclaimed his campaign as being “the sweetest primary in history”, and whom the New York Times reported about by declaring “Walter F. Mondale now holds the most commanding lead ever recorded this early in a presidential nomination campaign by a nonincumbent”—a declaration made on the morning of the New Hampshire primary that by the end of the day saw Mondale being crushed by US Senator Gary Hart—a “crushing” victory anyone could see coming judging by the massive crowds Hart was seeing in New Hampshire rooting for him—with the counterpart today being Democrat Party front runner Joe Biden this week campaigning in Iowa in front of about 100 people described as “a small crowd almost all over 55, some significantly older—while at the same time, Trump is preparing to travel to Orlando-Florida next week where a staggering over 100,000 people have requested tickets to see him announce that he is running for re-election in 2020.

IMAGE [Orlando-Florida announces all day road closures around Amway Center arena (above) for 25 June as over 100,000 Trump supporters prepare to fill stadium, parking lots and streets to see and hear President Donald Trump announce his 2020 re-election bid.]

June 15, 2019 © EU and US all rights reserved. Permission to use this report in its entirety is granted under the condition it is linked back to its original source at WhatDoesItMean.Com. Freebase content licensed under CC-BY and GFDL.

Cost Of Prescription Drugs Increases 9.5% Annually, Coordinated By Industry

Scripps Research analyzed pharmacy insurance claims from over 35 million Americans, finding ‘continual, marked, annual increases’ of popular brand-name drugs, with price jumps often timed with competitors.

After reviewing tens of millions of insurance claims for the country’s 49 most popular brand-name prescription drugs, a team from Scripps Research Translational Institute found that net prices rose by a median of 76 percent from January 2012 through December 2017—with most products going up once or twice per year.

The substantial price increases were not limited to drugs that recently entered the marketplace, as one might expect, or to those lacking generic equivalents. In addition, the increases often were “highly correlated” with price bumps by competitors.

The researchers concluded that the current rebate system, which incentivizes high list prices for drugs and relies heavily on privately-negotiated rebates to pharmacies, plays a central role driving up costs for consumers. The byzantine and secretive rebate system, they noted, prevents consumers from making informed decisions about purchasing medications.

The study appears in the latest issue of JAMA Network Open.

It’s no secret that health care prices are growing exponentially in the United States, but what has been less clear is the extent to which certain prescription drugs are contributing to that trend—especially when prices are clouded by a complicated rebate system,” says lead author Nathan Wineinger, PhD, director of biostatistics at Scripps Research Translational Institute and assistant professor in Scripps Research’s Department of Integrative Structural and Computational Biology. “By looking at price data for the most popular brand-name drugs, we found striking and consistent price increases occurring at regular intervals, regardless of competition in the marketplace.”

The Scripps Research team obtained the prescription data from a proprietary Blue Cross and Blue Shield data set known as BCBS Axis, which includes commercial insurance claims from more than 35 million Americans covered by independent Blue Cross and Blue Shield companies in the United States.

With a focus on the 49 most popular brand-name drugs with pharmacy claim data available for the entirety of their five-year research window, Wineinger and his team, led by Eric Topol, MD, conducted a high-dimensional data analysis to examine each claim’s total price. This was represented by the total out-of-pocket costs paid by the insured consumer and the amount paid by the insurer.

Researchers determined that prices of top-selling branded prescription drugs increased by a median of 9.5 percent annually, which equates to a doubling in price every seven to eight years. And they found that pairs of brand-name drug competitors that treat similar conditions—such as Humira and Enbrel, both for rheumatoid arthritis—demonstrated highly correlated price increases.

“It’s bad enough to see the relentless increase in drug prices, but this work underscores it is occurring without transparency or accountability,” says Topol, founder and director of Scripps Research Translational Institute and executive vice president of Scripps Research. “It is especially concerning to see drugs in the same class having increases that appear to be coordinated.”

Wineinger explains that a prescription drug’s list price is typically set by the pharmaceutical company that makes the drug, reflecting the payment shared by the insurer and the patient who buys the product at a pharmacy. However, drug companies increasingly offer rebates to organizations called pharmacy benefit managers, or PBMs, which negotiate with pharmacies and insurance companies to determine which drugs are offered as preferred “formulary” options to insurance plan members.

Those rebates are returned to the pharmacy at a later date, paid out by drug companies based on the total sales volume of their products, and cannot be linked directly to any individual purchase. This makes prices especially difficult to track.

Some drug companies have defended list price increases by reasoning that rebates have increased at a similar clip. However, the researchers found that is not the case, and concluded that increases in list prices and a greater reliance on rebates are making drugs more expensive overall.

“Accountability and transparency are essential to developing a better understanding of rising pharmacy costs,” said Maureen Sullivan, chief strategy and innovation officer for the Blue Cross Blue Shield Association (BCBSA). “The Blue Cross Blue Shield Association developed the Alliance for Health Research to engage researchers in collaborative efforts to explore critical health care issues and enable valuable insights that can benefit consumers and the medical community.”

Article by Scripps Research. Authors of the study, “Trends in Prices of Popular Brand Name Drugs in the United States, 2012-2017,” are Nathan Wineinger, PhD; Eric Topol, MD; and Yunyue Zhang, all of Scripps Research.

 

Lord Greville Janner ‘Violated, Raped and Tortured’ Children in the Houses of Parliament

Simon Danczuk, the Labour MP for Rochdale, said the Labour peer was a 'serial child abuser' and criticised the Crown Prosecution Service for not allowing the allegations to be aired in court

Labour peer Lord Janner of Braunstone is a “serial child abuser” who “violated, raped and tortured” children in the Houses of Parliament, an MP has said.

Simon Danczuk, the Labour MP for Rochdale, said he was appalled that the Crown Prosecution Service had not allowed the allegations against Lord Janner to be heard in court.

Speaking in the House of Commons, Mr Danczuk said: “The shocking thing is that the CPS admits that the witnesses are not unreliable, it admits that Janner should face prosecution but refuses to bring a case.

“I know the police are furious about this and rightly so. Anyone who has heard the accusations will be similarly outraged."

It has been ruled that Lord Janner is too ill to stand trial

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