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Dr.

Frank Shallenberger’s

Vol. 7, No. 11 November 2008

The Hidden Cause of Fatigue,


Hypertension, High Cholesterol,
and Diabetes
Anita had a bad problem. She was tired At first her doctors thought it was just
every day; often to the point of complete because of her age. After all, she was 64
exhaustion. She had been this way for sever- years old. And all of her blood tests were nor-
al years, and now it seemed that there was mal. But the problem just kept getting
no relief in sight. worse.
After two years of this, Anita had
another complete physical examination,
In this Issue along with all the standard blood tests. Her
blood pressure was slightly elevated. So were
Q You don’t have to visit the doctor her blood sugar and cholesterol levels. But
to find out if you have sleep apnea. her doctor couldn’t find anything to account
This easy test can tell you in a for her fatigue. He was stumped. So he sent
matter of minutes........................ p. 2
her home with a prescription for a blood
Q What’s the best way to lose pressure pill, but admitted it wouldn’t help
weight? Low carb, high carb, low fat, her feel better.
or vegetarian? The answer might Then something happened that broke
surprise you ................................ p. 4
the case apart. She passed out. She was just
Q There’s a simple way to avoid standing in the kitchen when she suddenly
the most deadly forms of and without warning passed out. Her hus-
prostate cancer ............................ p. 6 band immediately called the paramedics.
Q Why women with breast cancer In the emergency room, a very astute
shouldn’t avoid soy — even though emergency room doctor told her that he
their doctor told them to ............ p. 8 knew what had been causing not only her
fatigue, but also her elevated blood pressure,
Coming Next Month cholesterol, and blood sugar. He thought she
• Your risk for this type of cancer has had sleep apnea.
skyrocketed in recent years — but it’s Now Anita was not typical of most peo-
easy to prevent. I’ll show you how.
ple with sleep apnea. She wasn’t overweight,
• The secret to great sleep you can get and she didn’t snore. But the emergency doc-
from your dentist. tor insisted that her symptoms indicated
sleep apnea.
The Most Common Kind kind. Statistics show that it accounts for
about 84% of all cases.
Because it is so common, you probably
In OSA, the reason that breathing
know a lot about sleep apnea already. More
stops is that the airflow through the upper
than four million Americans have it. People
airway becomes obstructed or blocked.
with sleep apnea literally stop breathing
during their sleep. This may happen as CSA is completely different than OSA.
many as hundreds of times during a single There is no obstruction. It’s simply a prob-
night. And each episode may be as long as a lem with how the brain controls breathing
minute or even longer. during sleep. The brain does not respond
normally to changes in your blood levels of
There are three different forms of sleep
oxygen and carbon dioxide. It is often the
apnea: obstructive sleep apnea (OSA), cen-
result of taking alcohol, sedatives, or sleep-
tral sleep apnea (CSA), and complex sleep
ing pills before bed. It can also be caused by
apnea. Complex is a combination of central
other medications, especially the combined
and obstructive. OSA is the most common
effect of several different medications. And

Do You Have Sleep Apnea?


The symptoms of sleep apnea are many. Situations
They include fatigue, forgetfulness, intellectu-
al impairment, depression, headaches, morn- • Sitting and reading
ing dry mouth or sore throat, drowsiness dur- • Watching TV
ing the day, falling asleep inappropriately,
impotence and decreased libido, gastro- • Sitting inactive in a public place
(e.g. a theater or a meeting)
esophageal reflux, carbohydrate craving, and
constant hunger. Sleep apnea can cause all of • As a passenger in a car for an hour
these conditions. without a break
Sleep apnea can also cause serious
health problems and disease. It can cause car- • Lying down to rest in the afternoon
when circumstances permit
diovascular disease, strokes, high blood pres-
sure, heart failure, diabetes, metabolic syn- • Sitting and talking to someone
drome, and weight gain. If you have any of
these symptoms or conditions, you may have • Sitting quietly after a lunch without
alcohol
sleep apnea. You can also use the Epworth
Sleepiness Scale to determine the likelihood • In a car, while stopped for a few
of having sleep apnea. minutes in traffic.

The Epworth Sleepiness Scale To check your sleepiness score, total the
points.
Use this “chance of dozing” scoring sys- If you score less than 6, congratulations,
tem to see if you have sleep apnea. Simply you are getting enough sleep.
choose the most appropriate number for each
of the following situations: If your score is between 7-8, this is the
average response.
0 = no chance of dozing A score of 9-12 is borderline.
1 = slight chance of dozing However, if your score is greater than
2 = moderate chance of dozing 12, you have an 80% chance of having sleep
3 = high chance of dozing apnea, and you should ask your doctor for
further testing.

REF: Johns, Murray W. (1991). “A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale.” Sleep 1991 (14):
540-5.

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lastly, it can be a side effect of a serious ill- In this study, researchers evaluated 68
ness, such as encephalitis or a neurodegen- patients for sleep apnea. All of them had
erative illness like Parkinson's. symptoms of sleep apnea, as well as elevated
Epworth Sleepiness scores. All of their doc-
A Deadly Condition tors considered them to be “highly likely” to
Whether you have OSA or CSA (or have sleep apnea. And half of the partici-
both) the final result is the same – the brain pants had this confirmed using an overnight
is starved of oxygen during sleep. But most study in a sleep lab. The other half used
people don’t realize just how damaging that only overnight home oximetry. The
is. When the brain doesn’t get enough oxy- researchers found that overnight home
gen, it is not able to enter into the deeper, oximetry is just as accurate and easier to
restorative stages of sleep that are so impor- obtain than a formal sleep lab study.
tant for health. But the best part about overnight home
Additionally, many studies indicate that oximetry is that most oxygen supply compa-
each apneic event causes a “fight or flight” nies will provide it free of charge! And this
reaction in the body. This causes harmful means that doctors can easily screen for
hormonal imbalances, such as excessive cor- apnea in virtually everyone they suspect of
tisol production. Those changes, coupled having the problem. I have been able to
with the low oxygen saturation level of the diagnose all three kinds of sleep apnea many
blood, can cause significant damage – even times simply with a free overnight home
disease – to the body over time. oximetry. And I believe that CSA would not
be considered so rare if more doctors used
A Better Test – And It’s Free! this test.
Overnight home oximetry is so easy to
Most data you’ll read about CSA say it’s
do. All it involves is wearing a small clip
rare, less than one out of every 200 cases of
that fits over the end of one of your fingers.
sleep apnea. But I think that’s mostly because
You put it on before you go to sleep and take
it’s under-diagnosed. Under-diagnosed for
it off the next morning. A small wire con-
two reasons.
nects it to a measuring device known as an
First, because doctors and patients usu- oximeter. The system continually monitors
ally don’t think of it. Everyone knows about and records the level of oxygen in your tis-
the symptoms associated with OSA, such as sues during the night. The next morning, it
weight gain and snoring. But CSA can occur prints out the minute-by-minute results,
without these symptoms. graphed and analyzed. OSA causes intermit-
Second, many doctors think that the tent episodes of decreased oxygen levels on
only way to accurately diagnose sleep apnea the graph. CSA, on the other hand, shows a
is in an overnight sleep lab. Overnight sleep much more continuous pattern. Complex
labs are very expensive, often costing from sleep apnea shows a little of both.
$4,500-$6,000 per test. So many doctors
won’t recommend them. The Wrong Way to Treat
Sleep Apnea
There’s no doubt that overnight sleep
studies are the most comprehensive evalua- After the emergency room doctor sug-
tion for sleep disorders. But in most cases, gested sleep apnea, Anita went to an overnight
they are not needed. There’s an equally sleep lab. Fortunately for her, her insurance
effective way to diagnose both CSA and OSA company paid for it. And the test successful-
that does not require a night spent in a ly diagnosed CSA.
sleep lab – or the extreme expense. The test To treat her CSA, her doctor prescribed
is overnight home oximetry. Researchers C-PAP. C-PAP stands for “continuous posi-
recently documented the effectiveness of tive airway pressure.” C-PAP is the most
overnight home oximetry.

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Clinical
What’s the Best Way Researchers at Stanford University
to Lose Weight? Medical School assigned 311 overweight women
to follow one of four diets: The Atkins diet (very
Let’s say you’re one of the more than 50% low in carbohydrate), The Zone diet (moderately
of Americans who is overweight. And let’s say low in carbohydrate), The Ornish diet (high in
that you already know that being overweight is carbohydrate), and the LEARN diet (high in
a bad idea. It’s one of the best ways to make carbohydrate, low in fat, based on national
sure you die earlier, and suffer more doing it. guidelines). The women followed the various
So let’s say that you have finally decided to diets for one year.
lose that weight once and for all. After all, if you The winner? The Atkins diet. Women on
are like the majority of Americans who are over- the Atkins diet lost about twice as much weight
weight, you have already lost and regained the as those on the other diets.
same weight over and over again. But this time “Well what about their cholesterol levels?”
it’s going to be different. This time the National you might ask. “I bet they went sky high on
Institute of Health (NIH) has made it easy for that diet because it’s so high in fat and protein.”
you. They compared the four major weight loss Actually, the reverse happened. The lead author
programs to see which one worked the best. said that blood-fat levels were lower on the

commonly prescribed treatment for all your side. You have to sleep on your back.
forms of apnea. And that’s unfortunate. And sleeping on the back tends to worsen
While C-PAP is usually very effective at cor- most cases of sleep apnea.
recting apnea, many patients consider it
worse than the condition it’s treating. Here
• The continuous pressure of air in
the nose and pharynx tends to dry out the
are a few reasons why: upper airway. This results in a dry, stuffy,
• C-PAP is incredibly awkward. congested nose, which can then lead to
Imagine having to sleep with an appliance allergies and cause sinus infections.
strapped over your face that’s continuously
shooting pressurized air into your nose.
• It can also cause problems when you
travel or go anywhere that electricity is not
How well do you think you would sleep? available, like camping.
• The noise from the pump is enough Overall, even though C-PAP usually
to wake up even the heartiest sleeper, does successfully correct sleep apnea,
including anyone else trying to sleep in the patients still feel tired and rundown. So it’s
same room. not surprising that many patients stop
• It’s almost impossible to sleep on using the device and just accept their symp-
toms. That was certainly the case with Anita.
Real Cures (ISSN 1062-4163) is published monthly by
Soundview Publishing, LLC. Publisher: Wallis W. Wood; The Solution
Editor: Frank Shallenberger, MD. Subscriptions $49 per
year; foreign addresses add $13 U.S. per year. Send new When I first met her, Anita had
subscriptions or changes of address to our Business Office:
P.O. Box 8051, Norcross, GA 30091-8051, 800-728-2288 or stopped using her C-PAP for over six
770-399-5617. Real Cures is a newsletter containing gen- months. And she still complained of fatigue,
eral comments on health, nutrition, and medicine. Readers
are advised to consult with their own physician before sleepiness, and depression. I performed an
implementing any health idea they read about, whether overnight home oximetry, and it was the
here or in any other publication. Copyright © 2008 by
Soundview Publishing, LLC. All rights reserved.
worst tracing I had ever seen. It showed
Unauthorized reproduction of this newsletter or its con- that when she was awake, her oxygen levels
tents by xerography, facsimile, or any other means is illegal. were normal. But when she fell asleep, they

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l Pearls
Atkins diet than on any of the other diets. dizer” or “slow oxidizer” genetics.
So is the Atkins diet is the best way to lose I’ll explain all about how to determine the
weight? Well, yes, and no. right diet for permanent weight control, and
When you break down the data, you find how to find out whether you are a fast or slow
that results were different for different people. oxidizer in a future issue of Real Cures. Until
Although on average the Atkins diet was the then, here’s a clue. You know those skinny peo-
most effective, some people actually lost more ple who can eat all day and never gain a pound?
weight on the other diet programs. They’re the fast oxidizer type. Knowing where
The bottom line is this: For the average you are on the fast-slow oxidizer spectrum
person, the best way to lose weight, and to avoid makes it a lot easier to know how you should be
regaining it, is to cut back on carbohydrates. eating for the best possible weight control.
This may very well mean cutting way back — REF: Gardner CD, Kiazand A, Alhassan S, et al. “Comparison of
the Atkins, Zone, Ornish, and LEARN diets for change in weight
forever! But for other people with different and related risk factors among overweight premenopausal
genetic make ups, it may be better to use a more women” Journal of the American Medical Association, 7 March
moderate reduction in carbohydrates. It all has 2007, Volume 297, Pages 969-977.
to do with whether or not a person has “fast oxi-

were low 100% of the time! This is a clear ed her on weekly intravenous chelation
indication of CSA. therapy to pull these out of her body. Now
So how do you fix CSA? First, always all of this is very good, but the main thing
remember that God designed the body to the body needs to heal is oxygen.
heal itself. And most of the time it will do An Alternative to C-PAP
just that as long as it has all the tools it
needs to do the job, and as long as you Several years ago, I discovered that
remove any impediments to healing. there was a very effective, inexpensive, safe,
With CSA, what might the body need and easy way to treat all three kinds of sleep
that it isn’t getting? Here’s an interesting apnea. It’s called overnight oxygen per nasal
statistic that might offer a clue. cannula. A nasal cannula is one of those
Approximately one in five people who suffer under-the-nose oxygen tubes that you see all
from depression also suffer from sleep the time in the hospital. Unlike the C-PAP
apnea, and people with sleep apnea are five setup, it is lightweight, comfortable, and
times more likely to become depressed. So allows you to sleep on your side. It also does-
while it’s not clear whether the apnea caus- n’t use any pressure, so there are none of
es the depression or vice-versa, I decided to the other complications of C-PAP.
treat Anita’s depression using the amino A device that generates oxygen from
acid tyrosine. At the same time. I also start- room air, called an oxygen concentrator, sup-
ed her on a general program of healthy eat- plies the oxygen. Oxygen concentrators do
ing combined with a vitamin, mineral, and make some noise, but they are much less
hormonal supplements. noisy than C-PAPs. And unlike C-PAPs, you
I then looked for heavy metals because can position them across the room, reducing
I know that heavy metal toxicity is very the noise.
common. It also can poison the body’s sys- The rationale for using overnight oxy-
tem that maintains normal sleep breathing. gen per nasal cannula to treat apnea is obvi-
Her results came back confirming excessive ous. If your breathing is decreased to the
levels of both lead and cadmium. So I start- point that your oxygen levels fall, then

—5—
breathing a higher concentration of oxygen it turns out positive, forget C-PAP, and go
should raise the levels to normal. And here’s straight to using the overnight oxygen per
the best news — it works really well. nasal cannula system.
I gave Anita about three weeks to get No matter what kind of sleep apnea
used to sleeping with the oxygen cannula, you may have, it’s also important to abstain
and then rechecked her overnight home from alcohol and tranquilizers, get regular
oximetry. Her second tracing came back exercise, and lose any unnecessary weight.
completely normal! I knew that we were on Once this is done, if you primarily have
the right track. OSA, the chances are good that you will be
When I saw her six weeks later, she able to stop the oxygen eventually. But for
told me that her energy levels were also nor- some, especially those who have a high cen-
mal. She was driving, staying up late, and tral apnea component, it may be necessary
pretty much doing whatever she wanted to to use it indefinitely.
do. A repeat check of her lab tests showed But That’s Not All
that her blood sugar and her cholesterol were
now in the normal range. She was sleeping Although most cases of apnea will
well, and was no longer feeling depressed. respond completely to overnight oxygen
Several months later, I was able to per nasal cannula, more serious cases of
wean her off of her blood pressure medica- OSA may not. These cases often require the
tion, as it returned to normal. use of a plastic dental appliance that fits
in the mouth.
So don’t assume that you don’t have
sleep apnea just because you’re not over- In next month’s issue, I’ll tell you all
weight and don’t snore. If you’re seriously about the splint that I use. And I’ll tell you
fatigued, do the overnight home oximetry. how to find a doctor or dentist in your area
Most oxygen supply companies will supply that can make one for you. Q
one free of charge. If there’s any chance at REFS: Mulgrew AT, Fox N, Ayas NT, Ryan CF. Diagnosis and
initial management of obstructive sleep apnea without
all that you or someone you love might have polysomnography: a randomized validation study. Ann. Intern.
sleep apnea, ask your doctor to order one. If Med. 146 (3): 157-66.

Eliminate Your Risk of the Most


Deadly Forms of Prostate Cancer
You probably already know that testos- and the treatment of this common cancer.
terone causes prostate cancer to grow faster. In the study, researchers at Weill
In fact, the first treatment doctors use to Cornell Medical College used a new technol-
fight prostate cancer involves reducing the ogy to examine prostate cancer tissue. They
body’s testosterone production. And yet studied the prostate cancer tissue from 455
prostate cancer usually progresses despite different cases. They discovered that half of
testosterone reduction. This points to the the prostates had special estradiol receptors
fact that other factors are at work. on the surface of their cells. The receptors
One of these factors is surprising. It’s made these cancers especially sensitive to
the female hormone estradiol. And a new estradiol. But there’s more!
study now shows that estradiol fuels up to They also found that the cases of
one half of all prostate cancers. That’s more prostate cancer that had these receptors
than testosterone fuels. This information is were the most deadly forms. This helps to
vitally important for both the prevention explain why prostate cancer is so mild in

—6—
some cases, while being so aggressive in passion flower plant called Chrysin. This
others. It also sheds some light on how to extract contains the bioflavonoid 5,7 dihy-
best prevent and treat this most deadly droxyflavone. You can find Chrysin at most
form of prostate cancer. health food stores. The usual dose is 500-
1,000 mg per day.
What Every Man Needs to Know
Another natural preparation is a pro-
Estradiol is the primary sex hormone prietary Chinese herbal combination that
for women. But men also make it. Their comes from Chi's Enterprises called
bodies use an enzyme called aromatase to Myomin. The dose is from one to two cap-
convert testosterone into estradiol. And as sules, taken two to three times a day. You
men get older, the action of this enzyme gets can reach Chi's at 714-777-1542.
stronger, causing them to have higher levels Another way to reduce elevated estra-
of estradiol. And although estradiol is great diol levels is with a medication called anas-
for women, it is no friend to men. trozole. It also goes by the trademark name
In fact, an increase in estradiol can of Arimidex. The tablets come in 1 mg
cause gynecomastia. With this condition, strength. The usual dose to reduce estradiol
older men actually start to develop breast levels is one half a tablet (½ mg), taken twice
tissue. It’s also a common cause of many a week. Taken at this dose, this medication is
other problems. These can include the almost always without any side effects.
weight gain, decreased sex drive, impotence, The result is a reduction in estradiol,
depression, and muscle weakness that hap- along with an increase in testosterone.
pens to men as they get older.
Next, older men should avoid excessive
No one knows for sure why the estradi-
alcohol consumption and weight gain. These
ol increases as men age. But we do know
are the two most common lifestyle causes of
that drinking alcohol and gaining weight
high estradiol to testosterone ratios.
can contribute.
No matter what the cause, here’s the Man’s Best Friend Is Not a Dog
point. As estradiol levels get higher, the risk — It’s Phytoestrogens
for estrogen-stimulated prostate cancer
becomes stronger. This fact leads to three Third, as men get older, they should
important considerations that every man eat progressively more flaxseeds, soy foods,
should know about. hummus (chick peas), and garlic. Why?
First, when it comes to fighting the Because these foods have the highest levels
threat of prostate cancer, it’s not enough of phytoestrogens. Phytoestrogens are a spe-
just to check PSA levels. In addition to cial class of molecules in plants. They react
checking PSA, all men over the age of 50 with the estradiol receptors on cells. This
should also have their estradiol levels and includes the receptors on prostate cells that
their testosterone levels checked. They cause cancer.
should do this at least every two years. That means phytoestrogens can signifi-
The most accurate way to do this is cantly reduce the effects of estradiol on the
with a saliva specimen. But your doctor can prostate. In essence, that’s how you stop
also use blood levels. A healthy level of prostate cancer. Simply eat more foods that
estradiol is less than 1/50th of the testos- are high in phytoestrogens. These include
terone level. The lower, the better. If the flaxseed (and other seeds), soy, garlic, and
ratio is higher than 1/50, there are specific olive oil. Doing so can prevent up to half of
herbs, as well as medications that will all prostate cancers. Q
diminish the effect of aromatase. REFS:
http://www.medaus.com/p/337,7996.html
One herbal preparation that has
http://ki.se/ki/jsp/polopoly.jsp?d=5607&l=en
worked for my patients is an extract of the

—7—
LETTERS TO THE EDITOR
Q. I’m a breast cancer survivor (estro- The other thing to remember is what I
described in this month’s article on prostate
gen receptor positive). My doctor told
me not to eat anything with soy in it. cancer in men. There are two kinds of estro-
What do you think of soy? — Betty S., gen receptors, the alpha and the beta. The
via e-mail alpha receptor stimulates the effects of
estrogen on a cell, while the beta receptor
Dear Betty, decreases its effect. Phytoestrogens selec-
I’ve heard this advice many times tively interact with the beta receptors. This
before, and it is just plain misdirected. I’ve is a second reason they will decrease, not
never seen any evidence that eating soy increase the effect of estrogen on breast
contributes to breast cancer in any way. If cancer cells.
your doctor can send me a study that shows Also, don’t forget that soy isn’t the only
that in women who have a history of breast food that has phytoestrogens. So do almost
cancer those who eat soy have a greater inci- all other beans and vegetables. So there’s no
dence of recurrence, please ask him/her to reason to avoid soy for this reason. In fact,
do so. I don’t think that study exists. In fact, more is usually better. Please see page 7
there are several population studies that say for more information on foods that contain
just the opposite — that eating soy is protec- phytoestrogens.
tive against breast cancer. Your GABA question is a big one!
I think this false alarm comes from GABA is the brain chemical that acts to
the fact that soy contains phytoestrogens. calm us down. Chronic worry and anxiety
Phytoestrogens are molecules that are simi- tends to deplete GABA. To make matters
lar enough to estrogen to bind to the estro- worse, because God made us all so different,
gen receptor sites on a cancer cell. And many people have naturally low levels of
there’s evidence that when they bind to a GABA in the first place. These would be the
cancer cell, they can cause a weak estrogen people that tend to feel tense and anxious
effect. So many doctors assume this means even when there doesn’t seem to be a signif-
that soy can promote the growth of cancer icant cause. GABA supplements can help to
cells with estrogen receptor sites. But this increase GABA levels, and in this way
is not what happens. decrease feelings of anxiety and tension.
When phytoestrogens bind to estrogen Betty, this is a great question, and I will give
receptor sites, they take up the whole site, you a much more complete answer in an
and real estrogen is not able to work. That’s upcoming issue. It will include how to diag-
a good thing. Here’s why: nose, who will benefit from GABA supple-
Postmenopausal women still do make ments, what kinds of supplements work,
estrogen. Even though their ovaries aren’t and what the correct doses are.
making estrogen, she is still getting it from
fat cells and from the adrenal glands. So it’s
still there. And it’s all too happy to bind to Got a Question?
breast cancer cells.
Do you have a question for Dr.
But when phytoestrogens use up the Shallenberger? If so, please send it (typed
estrogen receptor sites, they block real only) to him c/o Soundview Publications,
estrogen from binding to them. And even P.O. Box 8051, Norcross, GA 30091-8051 or
though they have a weak estrogen effect, feedback@RealCuresLetter.com. While he
they are blocking the much stronger effect won’t be able to respond personally, he’ll try
of real estrogen. This is why phytoestrogens to answer as many questions as he can in
not only don’t stimulate estrogen positive these pages.
breast cancer growth, they actually block it.

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