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Impotence Predicts Heart Attacks, Diabetes

Men who are impotent are at increased risk for heart attacks and diabetes. (Atherosclerosis, February 2011). The two most common causes of impotence are blood vessel disease (arteriosclerosis) or lack of the male hormone, testosterone. When a man lacks testosterone, he usually has little or no sexual desire. On the other hand, if he still has desire, his testosterone is usually normal but his blood vessels are usually damaged and the same damage that occurs in the penis also occurs in the arteries leading to his heart.

Lack of male hormones is strongly associated with increased blood levels of triglycerides and the bad LDL cholesterol that increase risk for metabolic syndrome, obesity, diabetes, high blood pressure and atherosclerosis. Giving testosterone to men deficient in that hormone lowers levels of triglycerides and the bad LDL cholesterol, and helps to slow the progression of blood vessel damage.

All men who have difficulty achieving erections need to get blood tests for diabetes (HBA1C), testosterone, prolactin (a hormone that causes impotence and is produced by a brain tumor), cholesterol and triglycerides, and have their blood pressure checked. Most of these men will have serious blood vessel damage from arteriosclerosis and will need a program that includes *losing weight if overweight, *starting a supervised exercise program, *restricting refined carbohydrates (sugared drinks and foods made from flour), fried foods and red meat, *increasing intake of fruits and vegetables, and *checking their vitamin D3 (should be greater than 75 nmol/L).

Men who need testosterone replacement should not take testosterone pills because they go from the intestines to the liver to lower the good HDL cholesterol and increase risk for heart attacks. They should use a route that bypasses the liver such as testosterone injections or testosterone gel that is rubbed on the skin.


Dear Dr. Mirkin: What causes osteoarthritis of the knee?

We do not know, but a report from Japan shows that people who have osteoarthritis are far more likely to be overweight and have high blood pressure, high cholesterol and high blood sugar levels (The Journal of Rheumatology, published online February 15, 2011). Each risk factor for diabetes increases a person's chances further of having knee osteoarthritis.

When you have knee pain, your doctor orders many tests to see if you suffer from an overactive immunity such as rheumatoid arthritis, an infection such as a type of reactive arthritis, crystal disease such as gout, or trauma, such as an old football injury. If he finds none of these, he diagnoses osteoarthritis. Osteoarthritis may be caused by many things, but the most common causes are the degenerative diseases of western civilization associated with obesity, lack of exercise, eating too much food, and perhaps eating too much of the wrong foods such as refined carbohydrates and meat, and too little fruits and vegetables. It may be that when you are under-active and overeat, you fill up your fat cells. and the full fat cells turn on your immunity to destroy the cartilage in your knees and other joints.


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Dear Dr. Mirkin: Can having low levels of vitamin D cause diabetes?

Probably. Low blood levels of vitamin D are associated with diabetes and high blood pressure (Diabetes Care, January 31, 2011). Men and women with borderline high blood sugar (100-125) and high systolic blood pressure (120-129) are 2.4 times more likely to be deficient in vitamin D. They also have substantially larger waist circumferences and higher blood triglycerides, and lower good HDL cholesterol.

Before insulin can do its job of driving sugar into cells, it must first attach on special hooks, called insulin receptors on each cell. Lack of vitamin D prevents insulin from attaching to its receptors on cells. So insulin cannot do its job and blood sugar levels rise, which causes the pancreas to release huge amounts of insulin. Then the following events occur to comprise the metabolic syndrome that precedes diabetes:

• High Triglycerides - Insulin converts the elevated blood sugar to triglycerides.
• High Cholesterol - The liver takes triglyceride molecules and cholesterol molecules to form a lipoprotein that eventually is converted to the bad LDL cholesterol that damages arteries.
• Low Good HDL Cholesterol - as triglycerides flood the bloodstream, the good HDL cholesterol is used up carrying triglycerides from the bloodstream to the liver.
• Fat Belly - Insulin causes fat to be deposited in the belly and around organs.
• High Blood Pressure: Insulin constricts arteries to raise blood pressure.

In another study, diabetics were given 1)yogurt, 2)yogurt with vitamin D, or 3)yogurt with vitamin D and added calcium. Both groups given vitamin D had much lower blood sugar levels than those given just yogurt (American Journal of Clinical Nutrition, published online February 2, 2011).


Recipe of the Week:

Eggplant Sauce for Whole Grains or Pasta

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February 27th, 2011
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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