Sugar substitutes may interfere with liver’s ability to detoxify, researchers say

https://www.foxnews.com/health/sugar-substitutes-interfere-liver-ability-detoxify

‘With an estimated 40% of Americans regularly consuming non-nutritive sweeteners, it’s important to understand how they affect the body’

Two sugar substitutes, also known as non-nutritive sweeteners, may disrupt the function of a protein that plays an important role in detoxifying the liver and the metabolizing certain drugs, including blood pressure medications and antidepressants, a new study suggested. 

These sweeteners are commonly used in foods and even some medications to give a sweet taste while providing an alternative to table sugar with few or no calories, according to nutrition experts. 

“With an estimated 40% of Americans regularly consuming non-nutritive sweeteners, it’s important to understand how they affect the body,” Laura Danner, a doctoral student at the Medical College of Wisconsin said in the release.

Danner, who presented the new research at the American Society for Biochemistry and Molecular Biology annual meeting this week in Philadelphia, also said in the release, “In fact, many people don’t realize that these sweeteners are found in light or zero-sugar versions of yogurts and snack foods and even in non-food products like liquid medicines and certain cosmetics.” 

Non-nutritive sweeteners, acesulfame potassium and sucralose, were analyzed while using liver cells and cell-free assays, which allow the study of cellular processes such as transport, the authors explained in the release. 

The investigators found that acesulfame potassium and sucralose inhibited the activity of a protein in the body called P-glycoprotein (PGP). PGP pumps many foreign substances out of cells, according to health experts, and is part of a group of transporters that help cleanse the body of drugs, toxins, and drug metabolites. 

“We observed that sweeteners impacted PGP activity in liver cells at concentrations expected through consumption of common foods and beverages, far below the recommended FDA maximum limits,” Stephanie Olivier Van Stichelen, PhD, who lead the research team, said in the release. “To our knowledge, we are the first group to decipher the molecular mechanism by which non-nutritive sweeteners impact detoxification in the liver.” 

According to the team’s work, the study also showed that the sweeteners stimulate transport activity and likely bind to PGP. This causes a competition with and inhibits the transport of other substrates such as xenobiotics, drugs and their metabolites, short-chain lipids and bile acids, the release stated. According to a presentation by Danner, this potentially leaves other PGP substrates such as certain medications left trapped in cells, possibly leading to liver toxicity.

In a case where an individual takes blood pressure medications, antidepressants and antibiotics, which are medications that rely on PGP as a primary detoxification transporter, this could be problematic, the researchers said in the release. 

The researchers did recommend that the findings be further confirmed through preclinical and clinical studies, since their study is preliminary. 

“If future studies confirm that non-nutritive sweeteners impair the body’s detoxification process, it would be essential to study the potential interactions and determine safe levels of consumption for at-risk groups,” Danner said in the release and added, “It might also be important to include specific amounts non-nutritive sweeteners included on food labels so that people can better track their intake.” The researchers noted in the release that PGP also plays a role with maintaining the blood-brain barrier and therefore it is important to explore how inhibition of this protein may interfere with the function of cells in other organs besides the liver. 

The researchers plan on conducting further research on the two sweeteners using more complex models of drug transport and also plan on studying mixes of these sweeteners, since that is typically how they are found in food products.

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Dear Pain Warriors , our feature documentary film on the epidemic of Chronic Pain is going strong on Amazon Prime and Tubi, for FREE . We have 8 stars on IMDB , the international data base of movies.

Our goal is to get it seen by doctors ,nurses , healthcare providers and decision makers . Please SHARE and help us spread the word.

We were just awarded 3 prizes at film festivals around the world for our efforts. People are getting the message that Chronic Pain is a serious issue that MUST be recognized by society. Please help our stories be told. Thanks 

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Perhaps you can help with this relatively new practice of pharmacists in FL.  It just started occurring over the last month or so, where a patient who has been going to the same pharmacy for years, suddenly out of nowhere and without reason, the pharmacist is stating, “l am not comfortable filling this prescription”. Another arbitrary statement is ,”…it’s my clinical opinion you are on too much medication” ( or something to that effect).

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Evidence for Pharmacogenetic Testing in Patients With Treatment-Resistant Depression

https://www.uspharmacist.com/article/evidence-for-pharmacogenetic-testing-in-patients-with-treatmentresistant-depression

Toronto—Pharmacogenetic testing is increasingly a game-changer when it comes to selecting medications for a range of conditions.

In fact, a new Canadian study suggests that it was associated with an 89% increase in remission rates compared with treatment-as-usual (TAU) in patients with treatment-resistant depression (TRD).

The 52-week double-blind study, comparing pharmacogenetic testing-guided treatment to TAU, from the Centre for Addiction and Mental Health (CAMH) in Toronto was published recently in the journal Translational Psychiatry. It is touted as the first-of-its-kind in Canada.

The participants were 276 patients who had been previously diagnosed with TRD; this meant they did not improve after trying at least two antidepressant medications.

“Remission, or full recovery from symptoms, is one of the most challenging endpoints to achieve when treating major depressive disorder,” stated senior author James Kennedy, MD, PhD, head of the Tanenbaum Centre for Pharmacogenetics at the Campbell Family Mental Health Research Institute at CAMH. “The findings from this study contribute the first randomized, controlled data in Canada to the growing body of evidence of the clinical value of combined multi-gene pharmacogenetic testing.”

Pharmacogenetics uses customized genetic testing, usually with a cheek swab, to help clinicians select appropriate drugs and dosages based on their unique genetic makeup.

Background information in the study pointed out that the pharmacological treatment of depression “consists of stages of trial and error, with less than 40% of patients achieving remission during first medication trial.”

The authors noted, however, that in a large, randomized-controlled trial (RCT) in the U.S. called Genomics Used to Improve Depression Decisions (GUIDED), significant improvements in response and remission rates were observed in patients who received treatment guided by combinatorial pharmacogenomic testing.

The Canadian “GAPP-MDD” RCT was a year-long, three-arm, multicenter, participant- and rater–blinded trial that evaluated clinical outcomes among patients with depression whose treatment was guided by combinatorial pharmacogenomic testing compared with TAU. Defined as the outcome was symptom improvement (change in 17-item Hamilton Depression Rating Scale [HAM-D17]) at Week 8. Secondary outcomes included response (>50% decrease in HAM-D17) and remission (HAM-D17 <7) during the same time period.

The researchers found that patients in the guided-care arm had greater symptom improvement (27.6% vs. 22.7%), response (30.3% vs. 22.7%), and remission rates (15.7% vs. 8.3%) compared with TAU, although the differences were not statistically significant. Still, the authors observed that relative improvements in response and remission rates were consistent between the GAPP-MDD (33.0% response, 89.0% remission) and GUIDED (31.0% response, 51.0% remission) trials.

“Together with GUIDED, the results from the GAPP-MDD trial indicate that combinatorial pharmacogenomic testing can be an effective tool to help guide depression treatment in the context of the Canadian healthcare setting,” they wrote.

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I got a message from two of my regular readers a few minutes ago with this messaage:

Hi Steve. Just wanted to let you know that 8 of your posts that I’ve shared, (previously removed by fb) have been returned w/an apology…?! Interesting….

I just made a new post with a hyperlink to my blog and it DID NOT GET REJECTED !!!

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FDA advisory panel votes against recommending COVID-19 booster shots for most Americans

https://nypost.com/2021/09/17/fda-advisory-panel-refuses-to-green-light-booster-shots-for-people-16-and-over/

A Food and Drug Administration advisory panel voted against green-lighting COVID-19 booster shots Friday for most people — throwing up a major hurdle for President Biden’s plan to dole out a third dose to most Americans.

But the independent panel, which reviewed a 23-page FDA briefing document highlighting recent studies,  recommended emergency use of a third dose for Americans over age 65 and those at high risk of severe infection.

The panel said more data is needed before it can okay boosters for people ages 16 and older, and that the two-dose Pfizer regimen is still highly protective against the spread of the super-contagious Delta variant for most people.

“In particular, there is a lack of data on effectiveness and duration,” Dr. Michael Carome, director of Public Citizen’s Health Research Group, said at the meeting Friday.

“Current evidence does not appear to show a need for boosting.”

The FDA is not bound to follow the advice of the independent advisory panel but has followed its guidance so far on COVID-19 vaccinations.

Overall, the panel voted 16-2 not to recommend a third dose for people 16 years and up while unanimously green-lighting it for people 65 years and older.

In coming to its decision, the advisory panel scrutinized several studies to determine whether a booster shot was effective and necessary at least six months after a second dose.

The panel noted research published in the New England Journal of Medicine in July showing that people who have received both doses of Pfizer’s COVID-19 vaccine are still 88 percent protected against getting sick from the Delta variant.

The much-anticipated vote comes after a key member of the panel, Dr. Paul A. Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, last week called third doses “premature.” 

“There is no compelling reason to get a third dose now,” he told the New York Times.

The independent group of experts on Friday also reviewed a Pfizer study of 306 people showing that virus-fighting antibodies jumped threefold after a booster shot was given around six to eight months after the second dose.

But Meg Seymour, of the National Center for Health Research, argued there wasn’t enough data for older adults.

“The total safety sample is very small,” she said. “Twelve people over 65 is much too small to draw conclusions about safety.”

Another study out of Israel, which was also highlighted by the vaccine maker, tracked about 1 million people age 60 and older and found that a third jab was “roughly 95 percent” effective at protecting against the Delta variant.

The efficacy is comparable to the protection seen shortly after the vaccine’s rollout earlier in the year.

Still, the panel was ultimately not convinced by those studies and others.

The FDA’s reviewers had suggested ahead of the vote that they preferred to focus on research involving Americans, insisting that domestic studies “most accurately represent vaccine effectiveness in the US population.”

Meanwhile, President Biden and the country’s top health advisers insisted last month that booster shots would be needed — and likely available the week of Sept. 20.

Dr. Anthony Fauci, the nation’s top infectious diseases expert, said he was “certain” that Americans would need a booster shot eight months after their second shot.

But not everyone in the scientific community agrees. The World Health Organization recently argued against boosters, saying that rich nations shouldn’t dole out a third dose when poor countries don’t have enough vaccines for their first.

“It is unfortunate the While House announced the need for booster shots prior to the FDA’s assessment of the data,” Seymour admitted at the panel meeting Friday.

Dr. Peter Marks, director of the Center for Biologics Evaluation and Research within the FDA, acknowledged the divisive viewpoints during opening remarks to the advisory panel.

“We know there may be differing opinions in interpreting the data,” he said. “We strongly encourage all the different viewpoints to be voiced and discussed regarding the data, which is complex and evolving.”

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This is a question & answer zoom call that I had with RSDSA – whose mission statement is: Reflex Sympathetic Dystrophy Syndrome Association (RSDSA) mission is to provide support, education, and hope to all affected by the pain and disability of CRPS/RSD, while we drive research to develop better treatments and a cure.

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Looks the FDA is finally starting to pay attention to the MME system…  I made this post on my blog a couple of weeks ago Was/is the CDC 2016 guidelines built on a “false foundation ” and created a covert genocide on a protect class of people ?     and shared a article that would STRONGLY SUGGEST that the MME system had no double blind clinical study nor science behind it.  I had to go down THREE LAYERS DEEP to find out who was participating in this PUBLIC WORKSHOP and in scanning over the participants … the workshop appeared to be “pretty heavy” on  bureaucrats, people from academia, and groups that mostly deal with ADDICTION.

In my professional opinion, it will be IMPOSSIBLE to create any MME system that was highly accurate and results can be replicated, but I am sure that the FDA workshop will try to cobble something together that they can claim is based on science and is supported by some hypothetical clinical study/data.

In the short paragraph about the public workshop below, the word “discuss” is mentioned THREE TIMES. Probably just more SMOKE & MIRRORS

Timeline of Selected FDA Activities and Significant Events Addressing Opioid Misuse and Abuse

https://www.fda.gov/drugs/information-drug-class/timeline-selected-fda-activities-and-significant-events-addressing-opioid-misuse-and-abuse

https://www.fda.gov/drugs/news-events-human-drugs/morphine-milligram-equivalents-current-applications-and-knowledge-gaps-research-opportunities-and

ABOUT THE PUBLIC WORKSHOP

The Food and Drug Administration (FDA or Agency) is announcing the following public workshop entitled ‘‘Morphine Milligram Equivalents: Current Applications and Knowledge Gaps, Research Opportunities, and Future Directions.’’ The purpose of the workshop is to bring stakeholders together to discuss the scientific basis of morphine milligram equivalents (MMEs) with the goals of providing an understanding of the science and data underlying existing MME calculations for opioid analgesics, discussing the gaps in these data, and discussing future directions to refine and improve the scientific basis of MME applications.

https://www.fda.gov/media/149829/download

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WHAT A CAN OF WORMS !

When did CORPORATIONS have “personal beliefs” ? The LGBTQ+ community not withstanding,  So the SC state legislature exempts all parts of the SC medical system is going to be exempted from civil rights discrimination of disabled under the Americans with disability act and civil rights act  ?  This appears to be in the same category as a few states passing laws that is supposedly going to protect prescribers from the DEA coming into the state and enforcing the Controlled Substance Act from prosecuting a prescriber that they believe has violated the law.

Can you imagine that a insurance/pbm company refusing to pay for opiate pain management because they fear that a pt could become addicted and they neither wish to cause a person to become a addict, nor be responsible for the cost of treating a pt for addiction.  Basically, their beliefs that prescribing opiates could affect their BOTTOM LINE.  Since a insurance/pbm company does not have a DEA license – unless they have a mail order pharmacy… they have neither the legal authority to prescribe nor dispense controlled substances, so any denial of paying for opiate/controlled meds would have to be for a concern of their bottom line.

Of course, this article indicates that this bill has just passed the SC House and has yet to be taken up by the SC Senate and even if passed by both Houses, it could be vetoed by SC governor, but both SC Houses have at or near a super majority of <R> so it could be possible for the SC legislature to over ride the Governor’s veto.

South Carolina House passes bill for doctors to deny care that violates ‘conscience’

The bill would excuse medical practitioners, health care institutions and health care payers from providing care that is inconsistent with their personal beliefs.

https://thehill.com/changing-america/respect/equality/3256708-south-carolina-house-passes-bill-for-doctors-to-deny-care-that-violates-conscience/

South Carolina lawmakers on Friday passed a bill allowing medical professionals and insurance companies to deny care based on personal belief. Some say the legislation, which now heads to the state Senate for consideration, would disproportionately impact LGBTQ+ people, women, and people of color.

Under the bill, titled the “Medical Ethics and Diversity Act,” South Carolina law would be altered to excuse medical practitioners, health care institutions and health care payers from providing care that violates their “conscience.” It would also shield those who decline to provide medical services to patients from civil, criminal or administrative liability.

Dozens of state residents in February testified against the bill, calling it vague and overbroad. They also shared concerns that the legislation would disproportionately impact marginalized communities.

In a statement on Friday, Human Rights Campaign Legal Director Sarah Warbelow said she finds it “disturbing” that politicians in South Carolina are prioritizing individual providers’ beliefs over the wellbeing of patients.

“This legislation is dangerously silent in regards to the needs of patients and fails to consider the impact that expanding refusals can have on their health,” she said. “Religious freedom is a fundamental American value that is entirely compatible with providing quality, non-discriminatory healthcare. It is not a license to deprive others of their rights simply because of personal beliefs.”

Warbelow said the bill sends a message to patients with non-medical views inconsistent with that of their doctors that they are “not equal members of society entitled to dignity and respect.”

“Let’s call this what it is – a vicious, discriminatory attack on vulnerable patients, including those who care for LGBTQ+ people,” Warbelow said.

According to the HRC, the bill could enable administrative staff to decline to submit insurance claims or health care providers to override patients’ end of life directives. Receptionists may also be entitled to turn away patients and medical researchers could refuse to publish the results of a state-funded study because the scientific evidence is inconsistent with their personal beliefs.

The South Carolina bill is just one of more than 320 pieces of legislation under consideration in state legislatures which discriminate against LGBTQ+ people, according to the HRC, which tracks such legislation.

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