Newsletter

Dr. M’s SPA Newsletter Volume 15 Issue 11

Heat Exhaustion Prevention and Awareness

It is that time of year in many parts of the country. Planning ahead of an event or extended time out in the heat is very important especially as we age or while pregnant.

Summer break does not end the competitive athletics. Kids of all ages are playing sports during the heat of the day all over the country this summer. This time of year poses a major risk of overheating for children and adolescents engaged in aggressive aerobic outdoor exercise. It is prudent to try to have vigorous workouts during the early morning hours preferably or later in the evening for the older kids who get to bed later by nature.

In our clinic, we have had admissions to the hospital for heat exhaustion and muscle breakdown known as rhabdomyolyisis. For example, a young man was practicing on the football field and overheated due to a combination of under hydration and excessive ambient temperature. Symptoms included excessive sweating, rapid pulse, muscle pain, nausea, vomiting and dizziness… and a literature review.

Enjoy, Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 9

Today, I’m diving into a fascinating article by Scott Zimmerman and Russel J. Reiter, titled Melatonin and the Optics of the Human Body, published in Melatonin Research (2019). This piece flips the script on what we thought we knew about melatonin, light, and how our bodies interact with the sun’s rays. It’s a game-changer, especially for how we think about kids’ health in our modern, screen-filled indoor living world.

First, what is melatonin? Melatonin is a hormone made from the essential amino acid, tryptophan. It was first isolated from a cow’s pineal gland. It is an old molecule as primitive bacteria made melatonin probably 2.5 billion years ago. Its synthesis in bacteria and eukaryotes is a common linkage. Most of us know that melatonin is the “sleep hormone,” produced by the pineal gland in the brain when it gets dark at night, signaling to our bodies that it’s time to wind down and prepare to sleep. It’s the chemical expression of darkness, driving our circadian rhythms and helping us catch those precious brain cleansing moments. Zimmerman and Reiter argue that this is only half the story or maybe even less than half. For decades, research has hyper-focused on pineal melatonin that is regulated by visible light hitting our retinas. Blue visible spectrum light in the early morning suppresses pineal melatonin, which is why we should dim those screens before bed. But here’s where it gets interesting, the pineal gland isn’t the only place melatonin is made, and darkness isn’t its only trigger. Our bodies are producing melatonin in ways we’re just starting to understand, and it’s tied to light in a way that was unexpected and evolutionarily fascinating. As with all things in science and evolution, we learn what we did not know and it all makes sense once the aha moment occurs…. and a literature review. Oh and a recipe.

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 8

Itaconate, what is it and why does it matter?

Science Heavy – skip to the bold for take home if you want to avoid the science.

The biggest takeaway from this complex science is this: High fat, high sugar diets (Ultra Processed Foods) are associated with decreased itaconate activity and increased inflammation. The science further answers the question of whether we should allow ultra processed food in schools.

Ultra Processed Foods likely reduce itaconate production driving inflammation, metabolic dysregulation, and gut dysbiosis, which could worsen active disease. Lower itaconate levels likely impair your body’s ability to resolve inflammation, potentially leading to prolonged issues with healing and repair. To support itaconate’s anti inflammatory activity, shift away from UPFs toward an anti-inflammatory diet (e.g., Mediterranean, rich in vegetables, omega-3s, and fiber) to reduce inflammation, support gut health, and enhance itaconate’s immune-regulating effects.

Science:…..

Enjoy,

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 7

Let’s dive into articles that have been critical to understanding type 2 diabetes and Insulin Resistance: the Ominous Octet and now the Egregious Eleven from the BMC Medicine paper and the 2009 Diabetes paper by Dr. Ralph DeFronzo. Peter Attia recently interviewed Dr. Defronzo and I am on listen #3 because it is so good and yet incredibly complicated. This piece is a compilation of that interview and reviewing Dr. DeFronzo’s papers.

“…all too often, the risk factors for these disorders are not addressed promptly in clinical practice, leading to irreversible pathologic progression… Traditional approaches to treatment involving sequential therapy, in which agents are added only after one has failed, contribute to clinical inertia and often prevent goal attainment, leading to adverse outcomes…. in turn contributing to increased morbidity and mortality. In contrast, early diagnosis and prompt, intensive intervention, often with initial combination therapy, leads to faster goal attainment and improved outcomes for at-risk patients.” (Handelsman et al. 2023)(Schwartz et. al. 2024)

…literature review.

Enjoy,

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 6

This is such an important topic to cover, even for a pediatrician. Dementia!

This problem is slated to exponentially worsen in the coming decades. And it starts at birth!

​In the intricate landscape of Alzheimer’s disease (AD), emerging research underscores a pivotal yet under explored facet for the why?, the brain’s energy immunometabolism. A recent study by Patel et al., titled “Global Energy Metabolism Deficit in Alzheimer Disease Brain,” delves into this domain, revealing significant metabolic disruptions that may illuminate novel upstream causes and possible therapies.

​ For the better part of the last few decades, all AD research centered on the amyloid and tau plaques as the causative problem. However, billions of dollars and many drugs later, this hypothesis has crashed and burned. Failed therapies coupled to the skyrocketing volume of AD patients in the US over the next few decades will burden the US healthcare system and families alike. Folks, we need better answers and therapies rapidly. Thus, I have been following this information on and off over the years looking for answers. Last month, Dr. David Perlmutter gave an excellent lecture on microglial cells in the brain and their impact on AD and neurocognition in general. One paper that he cited was the Patel paper. Let’s look at it.

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 5

Picture this, a tiny, 30 nm, relentless RNA virus named norovirus slips into your life, uninvited, and turns your gut into a battlefield. It’s not the flu. Forget that “stomach flu” misnomer. It’s a Caliciviridae family member, a nonenveloped, single-stranded RNA ninja that thrives in making chaos. As a pediatrician, I’ve seen it wreak havoc in kids and parents alike, and it’s a master of surprise.

It just played Risk in my GI tract last week. Not Fun!

Let’s unpack how it infects, spreads, and toys with us humans, straight from the AAP’s Red Book (2024) and other research. Norovirus causes an estimated 1 in 15 US residents to become ill each year as well as 71,000 hospitalizations and 800 deaths annually, predominantly among young children and the elderly.

Norovirus doesn’t knock, more so it sneaks in, needing under 100 viral particles to ignite trouble. You’re sipping contaminated water, munching an oyster from a shady bay, or your toddler’s unwashed hands after a playdate deliver the payload. It’s mostly fecal-oral, stool to mouth via food, water, or surfaces. But don’t sleep on aerosolized vomit. One hurl in a crowded daycare, and airborne particles linger, landing on toys, doorknobs, you name it for days. Did I say lingering! Smart viral spread!

Gorilla warfare is on!

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 4

What is measles – a refresher?

Measles is a serious, highly contagious and potentially deadly viral infection. It is caused by an RNA paramyxovirus. It is spread by contact with droplets from an infected person’s nose, mouth or throat. Sneezing and coughing can aerosolize the droplets and increase the range of infectious spread. Symptoms usually develop 8 to 10 days following exposure to an infected individual. A sick individual is contagious for 4 days before and 4 days after symptom onset. The reproductive rate is very high at 12+ meaning that 1 person will infect 12 and those 12 will get 12 more sick (144) and then 144 X 12 = 1728 X 12 = 20,736 and you are off to the exponential races….Plus, The Shock of a New Diagnosis: A Stoic Path Through the Storm.

Enjoy,

Dr. M

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