Category Archives: Possible cause of Autoimmune disease

Do you have a yeast problem ?

Once you have IBS & IBD, you’ll hear a lot about candida yeasts and a host of other bacteria with very long names.  Some of them are misunderstood and their role is much debated in the medical community.   Some yeasts like Candida do live harmoniously in the body and have a specific function, but once they are out of balance due to high carb foods, stress, lifestyle and certain drugs like birth control, they can become overgrown and wreck havoc on your colon.

Science has yet to identify each and all of the gut bacteria and their functions, so I believe Candida is also used as catch all for a lot of other unidentified yeasts or bacteria.  I have a very hard to cure strain of Candida, called Krusei, which is believed to be a by-product of chocolate production.  I also had a long list of other pathogens but they all contributed to the toxicity and I treated them all the same.   It’s very difficult to identify all of the pathogens in lab tests – hospitals and M.D’s use different testing protocols then Naturopaths, but elimination diets can help without spending a fortune getting tested.

There is a Candida diet out there, but it’s so limiting, you can’t have fermented vegetables, cheese and mushrooms.   A fellow Chapter Leader with Weston A. Price Foundation has a very good article on Candida.  Thank you Sara Pope from Healthy Home Economist.   Sara has some great recipes, I might add.

Don’t Waste Your Time: Why the Candida Diet Doesn’t Work

by Sarah, The Healthy Home Economist on November 15, 2012

 

Candida is a term that refers to a large family of yeasts (one celled fungi) that under normal circumstances, harmlessly inhabit the tissues of humans.   This is because a balanced intestinal tract from mouth to colon contains a preponderance of beneficial bacteria that keep Candida in check.

When not enough beneficial bacteria are present in a given body tissue to keep Candida under control, Candida transforms from a harmless state into an invasive species.  In this rapidly growing state, Candida puts out long stringy hyphae or “roots” which can penetrate through the tissues of the body.

Candida overgrowth can occur in many tissues of the body such as oral candidiasis known as thrush,  the scalp as dandruff, or vaginal yeast infections.

What Causes Candida Overgrowth?

Candida is an opportunistic pathogen that can rapidly take over when a person is under a course of antibiotics.  Antibiotics decimate beneficial gut flora but have little effect on Candida, giving this normally harmless yeast the chance to take over dominance of the gut environment very quickly.

Many women don’t realize it, but oral contraceptives imbalance the gut in the same way as antibiotics giving Candida an open door to take control.

A diet of processed foods high in sugars and simple carbohydrates also encourages Candida overgrowth as yeasts thrive on sugars.

Babies born via C-Section or to mothers who were treated with IV antibiotics during labor are especially vulnerable to the ravages of Candida overgrowth as they are not exposed to a healthy balance of gut flora from their travels down the birth canal prior to the moment of birth.

Symptoms of Candida Overgrowth

Symptoms of Candida overgrowth are many the most common being fogginess in the morning upon waking (brain fog), digestive complaints of all kinds and a myriad of skin issues.

Many women plagued by yeast infections don’t realize that the source of the problem is actually their diet and the pathogenic state of their gut environment.  Using drugs and creams to resolve the problem is only a temporary solution when the source of the problem – gut imbalance – is not addressed head on.

The Anti-Candida Diet

Some 20 years ago, my husband and I tried the Candida Diet to resolve gut imbalance that had been exacerbated by our stressful and overworked lifestyle at the time.

It failed miserably.

Why?

Because the Candida Diet goes only part of the way in attempting to resolve gut imbalance by removing all food sources for Candida.

For example, the Candida Diet removes sugar from the diet in all forms – even maple syrup and honey.  Fresh fruit, however, is allowed.

Candida overgrowth can frequently trigger an allergy to molds and other types of fungi, so fermented foods including cheese and dairy are also eliminated along with any breads and other foods containing yeast.

Other foods excluded from the Candida Diet include vinegar, mushrooms, tea, coffee, dried fruit and any form of fruit juices.

People Get Better on the Candida Diet But They Don’t Heal

The typical scenario for a person who goes on the Candida Diet goes something like this:

  • They feel better almost immediately – primarily because all the sugar has been removed from their diet.
  • They continue on the diet for some time perhaps many months or even a year or more and are pleased to see that their symptoms of Candida overgrowth diminish considerably during that time.
  • After a period of time, they try to reintroduce some of the foods that were removed only to discover that their symptoms come raging back with full force.
  • They realize that it is going to be next to impossible to continue the Candida Diet indefinitely as it is simply too hard to give up cheese and any and all sweets forever.
  • They get discouraged, give up and stop the Candida Diet.

Why Doesn’t the Candida Diet Work?

The paradox of the Candida Diet is that symptoms greatly diminish but the person doesn’t actually heal from the root cause of the problem which is a breech in the integrity of the gut lining.

Healing is prevented on the Candida Diet for the following key reasons:

Reason #1:  The Candida Diet allows foods like potato, yams and other starchy vegetables.

Reason #2:  More important than the allowance of starch in the Candida Diet, however, is the ultimate fatal flaw:  the inclusion of grain based foods.

Even if the Candida Diet is used in conjunction with a gluten free, casein free diet, it fails in the majority of instances.

The reason is that disaccharides, or double sugars, are present in many carbohydrates including ALL grains – not just gluten containing ones.  An inflamed, inbalanced gut overridden with Candida is unable to digest double sugar molecules completely because the lack of beneficial gut flora has compromised the function of the enterocytes.

According to Dr. Natasha Campbell-McBride MD, author of Gut and Psychology Syndrome and one of the key scientists at the forefront of gut restoration research today, the enterocytes are the cells that reside on the villi of the gut wall and produce the enzyme disaccharides which breaks down the disaccharide molecule into easily absorbed monosaccharide molecules.   When the enterocytes are not nourished and strengthened properly by adequate beneficial flora, they become weak and diseased and may even turn cancerous.   They do not perform their duties of digesting and absorbing food properly.

The critical importance of the enterocytes to health cannot be overstated! Weak and diseased enterocytes also have trouble digesting starch molecules which are very large with hundreds of monosugars connected in long branchlike strands.   People with weak digestion due to Candida overgrowth and messed up enterocytes have a terrible time digesting these complex molecules leaving large amounts of it undigested- the perfect food for pathogenic yeasts, bacteria, and fungi like Candida to thrive upon.

Even the starch that manages to get digested results in molecules of maltose, which is – you guessed it – a disaccharide!     This maltose also goes undigested due to a lack of the enzyme disaccharides and becomes additional food for Candida.

Therefore, when one follows the Candida Diet and yet still consumes grains and starches, food molecules that are not fully digested continue to putrefy, inflame, and provide food for Candida thereby preventing healing even if some improvement is noted from the removal of all sugars.

What is the Best Diet for Combatting Candida?

In conclusion, it is best not to waste your time with the Candida Diet.  It doesn’t work in the majority of cases and you will ultimately feel frustrated in your efforts to heal over the long term.

The best diets for healing and sealing the gut wall and permanently rebalancing the gut environment are

Sarah, The Healthy Home Economist

Source:  Gut and Psychology Syndrome, Dr. Natasha Campbell-McBride MD

 

 


 

The Vicious Cycle of IBD

Elsewhere on this website, I’ve written that I’ve had IBS all my life progressing into microscope colitis and eventually Crohn’s. Remicade was a godsend and within 28 hrs., I was no long bleeding. Within 6 months, I was the road to wellville. These drugs truly are a miracle – it allows my mind and body to heal. Except nobody told me to stop eating junk or sugar while on it. I truly believe my binging eating on sugar and junk food caused the drug to fail. In desperation I was forced to try a lot of eliminate diets. Some worked for a week or 2 and others different. I was virtually my own experiment and terrified that I would end up a bloody mess once again. I ended up narrowing down my list of the 2 biggest culprits in diet that exacerbated my IBD – sugar, sugar and gluten. It was pretty obvious after a year of experimenting.

While I’ve enjoyed remission for 7 yrs. and prefer to stick with a diet free of gluten and sugar – just because I feel so terrific and it keeps my weight in check. I also don’t ever have to worry about slipping back into a flare. When I think I might (loose stools, gas) I just jump back on the diet.

I’ve talked about diet and science supporting the cause of our IBD. Here’s an excerpt from the book. I would encourage everyone to read the full science article found in the book. It was written by a biochemist to cure her own child, which she did 40 yrs. ago. The science is there. Her daughter remains in remission and an active member of her Mother’s foundation.

I DO NOT recommend to anyone throwing away their drugs. If you are on them, use them to be stable and maybe your doctor would eventually taper down to a point that was mutually agreeable.

SCIENCE BEHIND THE DIET

In order to understand how the diet works, it is important to understand the disease process occurring in the gut or, WHY the diet works.

“We must never forget that what the patient takes beyond his ability to digest does harm.”
Dr. Samuel Gee.

The Specific Carbohydrate Diet™ is predicated on the understanding that Ulcerative Colitis, Crohn’s Disease, Irritable Bowel Syndrome, and gluten therapy resistant Celiac are the consequence of an overgrowth and imbalance of intestinal microbial flora. By altering the nutrition we take in, we can effect the constitution of our intestinal flora, and bring it back into balance, healing our digestive tracts and restoring proper absorption.

The intestinal tract forms a rich ecosystem, comprised of over 400 bacterial species. Some are harmless, and others not. In the gut of a healthy person, these various communities of microbes compete with each other for scarce nutritional resources. Consequently, they exist in a state of balance, and the stomach and small intestine harbour only a sparse population of microbial flora. In the large intestine, each type inhibits an overabundance of the others, and this prevents the waste products and toxins of a particular type of microbe from overwhelming the body. The stomach and upper intestine are also protected by high acidity, and the action of peristalsis.

The Vicious Cycle

When the balance in the gut is disturbed, an overgrowth of intestinal flora can result. Microbes migrate to the small intestine and stomach, inhibiting digestion and competing for nutrients. The gut then becomes overloaded with the byproducts of their digestion. This bacterial overgrowth can be triggered by overuse of antacids, reduced stomach acidity due to aging, weakening of the immune system through malnutrition or poor diet, and alteration of the microbial environment through antibiotic therapy.

The components of our diet, particularly carbohydrates, play an enormous role in influencing the type and number of our intestinal flora. When carbohydrates are not fully digested and absorbed, they remain in our gut, and become nutrition for the microbes we host. The microbes themselves must digest these unused carbohydrates, and they do this through the process of fermentation. The waste products of fermentation are gases, such as methane, carbon dioxide & hydrogen, and both lactic & acetic acids, as well as toxins. All serve to irritate and damage the gut. There is evidence that increased acidity in the gut due to malabsorption and fermentation of carbohydrates, may lead common harmless intestinal bacteria to mutate into more harmful ones. Further, lactic acid produced during the fermentation process has been implicated in the abnormal brain function and behaviour sometimes associated with intestinal disorders. The overgrowth of bacteria into the small intestine triggers a worsening cycle of gas and acid production, which further inhibits absorption and leads to yet more harmful byproducts of fermentation. The enzymes on the surface of the small intestines are destroyed by the now present bacteria, and this further disrupts the digestion and absorption of carbohydrates, leading to further bacterial overgrowth. As both the microbial flora and their byproducts damage the mucosal layer of the small intestine, it is provoked to produce excessive protective mucus, which further inhibits digestion and absorption.

Damage to the mucosal layer involves injury to the microvilli of our absorptive cells. These microvilli act as the last barrier between the nutrition we take in and our bloodstream. As our absorption is inhibited, folic acid and vitamin B12 deficiency can lead to impaired development of microvilli, while an abnormally thick layer of mucus prevents contact between microvilli enzymes and the carbohydrates we ingest. The small intestine responds to this spiraling irritation by producing more goblet (mucus-making) cells, creating yet more mucus. Finally, as the goblet cells become exhausted, the intestinal surface is laid bare, and is further damaged, and possibly ulcerated. As more carbohydrates are left in the gut, they cause water and nutrients to be pulled from the body into the colon, resulting in chronic diarrhea. Absorption is further hindered as diarrhea increases the rate with which food travels through the gut.

The Diet

“The Specific Carbohydrate Diet™ is based on the principle that specifically selected carbohydrates, requiring minimal digestive processes, are well absorbed and leave virtually none to be used for furthering microbial overgrowth in the intestine. As the microbial population decreases due to lack of food, its harmful byproducts also decrease, freeing the intestinal surface of injurious substances. No longer needing protection, the mucus-producing cells stop producing excessive mucus, and carbohydrate digestion is improved. Malabsorption is replaced by absorption. As the individual absorbs energy and nutrients, all the cells in the body are properly nourished, including the cells of the immune system, which then can assist in overcoming the microbial invasion.” The simpler the structure of the carbohydrate, the more easily the body digests and absorbs it. Monosaccharides (single molecules of glucose, fructose, or galactose) require no splitting by digestive enzymes in order to be absorbed by the body. These are the sugars we rely on in the diet. They include those found in fruits, honey, some vegetables, and in yoghurt.

Double sugar molecules (disaccharides: lactose, sucrose, maltose and isomaltose) and starches (polysaccharides) are primarily avoided on the diet. Some starches have been shown to be tolerated, particularly those in the legume family (dried beans, lentils and split peas only). However, they must be soaked for 10-12 hours prior to cooking, and the water discarded since it will contain other sugars which are indigestible, but which are removed in the soaking process. Small amounts of legumes may only be added to the diet after about three months. The starches in all grains, corn, and potatoes must be strictly avoided. Corn syrup is also excluded since it contains a mixture of ‘short-chain’ starches.

Yoghurt

Finally, the SCD™diet relies on properly fermented yoghurt, and in some cases, acidophilus supplements, to help repopulate the gut with healthy intestinal flora. By increasing the population of ‘good’ bacteria in the gut, the overgrowth of harmful bacteria is put in check. As the competition for nutrition between the various strains of bacteria resumes, the variety of intestinal flora is brought back into balance. Yoghurt must be properly prepared by fermenting it for 24 hours. This allows enough time for the bacteria in the yoghurt culture to break down the lactose (disaccharides) in milk, into galactose (a monosaccharide). All SCD™diet yoghurt is homemade, as commercially available yoghurts are not properly fermented.

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Information published on this Web site is intended to support the book Breaking The Vicious Cycle by Elaine Gottschall and is for information purposes only. It is not the intention of this site to diagnose, prescribe, or replace medical care. Your doctor or nutrition expert should be consulted before undertaking a change of diet.

Thyroid Disease is an epidemic

For the last couple of years, I’ve heard a lot about thyroid disease from family and friends. A friends who can’t loose 20 lbs. despite dieting on an accredited program; husband was recently treated; a teenager with thyroid cancer and many more…… it makes me wonder. I am posting 2 articles on this page, so please read both. The first article is from a medical Doctor who is a board certified Internist who also integrates holistic medicine into this practice. He believes the thyroid also controls our autoimmunity to a degree and could be the root cause of a number of diseases. While he doesn’t mention IBD, it’s worth reading.

It’s important to watch the video as it explains how blood tests are often inconclusive. You need to dig deeper. The second article talks about the implications of soy in our diet and it’s effect on the thyroid. Soy is a problem for most IBDers. We cannot digest it.

Interesting reading….from 2 PhD’s and 1 board certified Internist.

http://w3.newsmax.com/newsletters/brownstein/thyroid_video/video3.cfm?s=al&promo_code=136DC-1

This second article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Spring 2012. Thyroid NewsWritten by Kaayla Daniel, PhD, CCN & Sylvia Onusic, PhD

Cristina Fernandez, the President of Argentina, had her thyroid removed in January of this year only to find out the gland wasn’t cancerous after all. Although her supporters whooped with joy at this news, doctors can’t put her thyroid back, and Fernandez will be on thyroid meds for life.1 Were her doctors incompetent or did they act appropriately? As that debate continues to rage over the internet, the Fernandez case has also led to widespread discussion of why thyroid cancer incidence, especially among women, has dramatically increased over the last thirty years.

AN EPIDEMIC OF THYROID CANCER

According to the National Cancer Institute, the incidence of thyroid cancer has nearly doubled since the early 1970s. Thyroid cancer now affects about eleven people per hundred thousand in the United States. In January 2008, there were 458,403 Americans alive with a history of thyroid cancer of which 100,952 were men and 357,451 women. In 2011, 56,460 new cases of thyroid cancer were diagnosed and 1,740 people died of the disease.2,3

Doctors do not know why the numbers of thyroid cancer cases are increasing though some blame increased overweight and obesity, radiation exposure, and diets low in fruits and vegetables.

RADIATION

Certainly exposure to radiation is a known risk factor for thyroid cancer.4 In 2009 epidemiologist Joseph Mangano, PhD, took data on thyroid cancer incidence from the Centers for Disease Control for the years 2001 to 2005, compared it with the proximity of nuclear power stations, and found that the counties with the highest thyroid cancer incidence were located close together in eastern Pennsylvania, New Jersey, and southern New York. He concluded, “Exposure to radioactive iodine emissions from sixteen nuclear power reactors within a ninety-mile radius in this area…[is] likely a cause of rising incidence rates.”5 Pennsylvania has the highest rate of thyroid cancer in the U.S.

In 2010 the Associated Press revealed that 75 percent of U.S. nuclear power plants leak radioactive materials into our air and water.6 And many of the one hundred four commercial nuclear power plants and thirty-four nuclear research stations now operating in the U.S. sit in seismically active locations, including at least four near the “high risk” San Francisco Bay area and three within the San Francisco Bay area itself.7 As might be expected, there is a high incidence of thyroid cancer in the San Francisco Bay area.

FRACKING

Radiation in ground water linked to hydraulic fracturing—or fracking—the process used to extract oil or natural gas deep in the earth—has also been linked to increasing rates of thyroid cancer. Fracking has also led to a 2,400 percent increase in earthquakes compared to the number of quakes that occurred in the years before fracking started in the U.S. 9,10 Geologist Tracy Bank, speaking at the American Geological Society meeting in Denver last November, reported that fracking releases rock-bound uranium, posing a further radiation risk to our groundwater.11

HORMONE HAVOC

Hormonal factors may also play a significant role, according to the National Cancer Institute. Although NCI arrived at this conclusion due to the preponderance of thyroid cancer cases in women under age forty-five, human estrogens should be regarded as just one piece of the hormonal picture. Xenoestrogens—estrogenic substances found in the diet and the environment— also play a role. Commonly found in plastics, pesticides, cosmetics, personal care products, our water supply, factory-farmed meats and soy foods, Xenoestrogens can be significant “endocrine disruptors” and interfere with the functioning of many systems in the body.12

While it’s human nature to try to single out one factor to blame, the causes of thyroid cancer most likely are many and synergistic. Exposure to radiation, mercury, fluoride, 13,14 plastics, pesticides, dioxins, solvents, low iodine intake,15 and estrogens and estrogen mimickers found in commercial meats and produce, plastic and hormone replacement therapies have all been implicated. And so has soy.

SOY

Soy is widely marketed as a “health food” although soybeans naturally contain the phytoestrogens (plant estrogens) known as isoflavones. While not true hormones, isoflavones closely resemble estradiol (E2),16 the most potent of the three forms of estrogen found in the human body17 and the form of estrogen that has been implicated in thyroid cancer.18-20 Soy isoflavones cause significant endocrine disruption both directly by binding with estrogen receptors, and indirectly by interfering with the body’s production of estrogen, testosterone and other hormones. The effects are felt throughout the body, especially the thyroid and reproductive system, and are well documented in chapters twenty-six and thirty of The Whole Soy Story: The Dark Side of America’s Favorite Health Food.21

The key isoflavones found in soy, genistein and daidzein, are potent inhibitors of thyroid peroxidase (TPO), an enzyme involved in the synthesis of the thyroid hormones T3 and T4. In vitro experiments carried out at the National Center for Toxicological Research in Jefferson, Arkansas, Rao L. Divi, PhD, and Daniel R. Doerge, PhD, showed soy isoflavones will inhibit TPO and interfere with a critical stage in thyroid hormone production—the iodinization of the amino acid tyrosine. Although many people assume sufficient iodine will solve this problem, this interference occurs whether or not sufficient or extra iodine is present. As a result, the body produces useless mono-, di- and tri-iodoisoflavones and not mono, di and tri and quarto forms of thyroid hormone. In the human body, this interference can cause a drop in thyroid hormone levels, an increase in thyroid stimulating hormone and stress on the thyroid gland. To put it bluntly, this is a prescription for thyroid trouble.22, 23

Drs. Divi and Doerge, top scientists with the National Center for Toxicological Research, pulled no punches in their conclusion: “The possible association between long-term inhibition of thyroid hormone synthesis (goiter) and induction of thyroid follicular cell hyperplasia and neoplasia underscores the significance of these findings.” 24,25 Follicular cell hyperplasia is a precursor to thyroid tumors and neoplasia is an abnormal proliferation of cells and characteristic of cancer.

We also know soy products pose a special risk to hypothyroid patients treated with Synthroid and other thyroid drugs. According to Mike Fitzpatrick, PhD, boosting the thyroid with drugs like Synthroid, then depressing it with thyroid inhibitors like soy foods or isoflavones supplements, can put extreme stress on the thyroid. In fact, this is the classic way that researchers induce thyroid tumor in laboratory animals. The fact that soy is “natural” does not make it safe or weak. The phytoestrogens in a serving of soy food can provide up to three times the goitrogenic potency of the pharmaceutical thyroid-inhibiting drugs methimazole and 6-propylthiouracil. 26

Over the past seventy years, numerous studies have linked soy to thyroid disorders, especially hypothyroidism and the autoimmune thyroid disease Hashimoto’s thyroiditis. These studies are cited and discussed in detail in chapter twenty-seven of The Whole Soy Story. 27 Less evidence links soy to thyroid cancer, though so many studies proving stress on the thyroid would suggest clear and present danger. Soy proponents and industry spokespersons, however, prefer to assert that soy is protective, and the study cited most frequently is the Bay Area Thyroid Cancer Study.28

THE BAY AREA THYROID CANCER STUDY

This study is described in three articles published by Pamela Horn-Ross, PhD, and colleagues, in the journal, Cancer Epidemiology, Biomarkers and Prevention (CEBP), in 2001 and 2002.29-31

In the 2002 CEBP study, Horn-Ross, Hoggatt and Lee attempted to determine how soy phytoestrogen intake relates to thyroid cancer once other factors such as age, race and other known risk factors were taken into account. In the results section they reported, “In general, a reduction in thyroid cancer risk of 35 percent to 55 percent was associated with increased consumption of non-fermented traditional and nontraditional soy-based foods and sprouts.”32

An astonishing 35 to 55 percent reduction in risk with clear cause and effect certainly seems to support the idea of consuming soy—including modern industrial soy products—for thyroid cancer prevention. But what seems to be too good to be true is often just that. A long, hard look at the study—and not just at the headlines publicized by the soy industry—reveals serious flaws in design, methods, and analysis, including:

• This paper describes an observational, case control, matched study. As J.M. Utts and R. Heckard write in their textbook, Mind on Statistics, “The most common mistake made in reporting research studies is to imply that a cause and effect relationship can be concluded from an observational study. With an observational study, it is difficult, perhaps impossible, to separate the effects of confounding variables from the effects of the main explanatory variables of interest.”33

• The study was not a randomized, controlled trial, which is the gold standard for testing an intervention. Cases were not randomized to treatment groups but drawn from a cancer registry, which was a sample of convenience. As Utts and Heckard put it, “If the sample does not represent a larger population for the question of interest, and randomization to treatments was not used, no inferences can be drawn.”34

• The data were analyzed using unconditional logistic regression. When the sample comes from matched pairs—as was the case in this study—conditional logistic regression is the appropriate test, not unconditional logistic regression. As summed up in the Oxford Journal, “A simple rule of thumb is to use conditional logistic regression if matching has been done, and unconditional if no matching has been done. A second rule of thumb is, when in doubt always use conditional because it always gives unbiased results.”35

• Because the study used unconditional logistic regression, the researchers did not include the matching information in the analysis.36 This is most interesting in the light of research from the University Graduate School of Public Health in Kyoto, Japan, which examined 507 studies from 1991-2000 that used case control matched data sets.37 Of these studies, conditional logistic regression was used in 90.5 percent, and unconditional logistic regression in only 9.5 percent of them. Yet Horn-Ross and colleagues chose to use the unconditional method.

• Unconditional logistic regression analysis seriously overestimates the odds ratio when there are matching data—as was the case with Horn-Ross and colleagues—and great caution should be taken in interpreting the results.38 In Statistical Methods in Cancer Research, a classic text in disease epidemiology, Breslow and Day state: “The unconditional analysis of matched pair data results in an estimate of the odds ratio which is the square of the correct, conditional one: a relative risk of 2 will tend to be estimated as 4 by this approach…” (italic emphasis from Breslow and Day).39

• The spotlighted phytoestrogens yet included a large number of potentially interrelated variables that could interact with one another. In a high quality study, the researchers should have addressed the possibility of collinearity and taken care to rule it out. Collinearity is a bias in statistical procedure due to the correlation of multiple independent variables that influence a single dependent variable. Collinearity can lead to unstable and untrustworthy results.40

• All the subjects came from the San Francisco Bay Area and many were of Asian ethnicity. Environmental, climatic and ethnic aspects were not taken into account in the analysis. External validity is always a key question. Can these results be applied or generalized to other people? Given that people from other areas of the United States live under varying conditions and are of many different ethnicities, the results of the study—if valid—would apply only to the group from which they originated.

• Reliance on a Food Frequency Questionnaire (FFQ) to determine dietary intake during the year before the diagnosis of thyroid cancer, or for the year prior to the interview for the controls, is suspect. FFQs require people to remember what they ate, when they ate it, and how much.41 Over-estimation is common, particularly for foods eaten less often or for foods perceived as “healthy,” such as fruit, vegetables—and soy. In her article, Dr. Horn-Ross does not disclose how her FFQ was tested or evaluated prior to use in the San Francisco Bay Area Thyroid Study. She also admits “phytoestrogen consumption was not a hypothesis of this study when this FFQ was developed.”42

• In Table 1 of Horn-Ross’ article, “Selected characteristics of women participating in the multiethnic San Francisco Bay Area Thyroid Study,” we see how the cases and controls are similar on many variables such as age and number of pregnancies, but we do not know how many subjects were actually included or whether the Table represents all subjects or just a cherry-picked sample.

• In Table 2, “Consumption of selected phytoestrogen-rich foods and thyroid cancer risk among women participating in the Bay Area Thyroid Cancer Study,” the researchers make the dramatic pronouncement of reduced risk of 35 to 55 percent. However, this Table reports odds ratios but no actual risk data. Relative Risk, the basis for determinations such as “reduced risk,” cannot be calculated in a case-control study. Odds ratios can be used to represent relative risk if the disease is relatively rare, as is the case with thyroid cancer, but they are usually “bigger in each case” and “around ten percent larger than Relative Risk.” 43,44

• In Table 3, “Phytoestrogen consumption and thyroid cancer risk among women participating in the Bay Area Thyroid Cancer Study,” the researchers report an “increased consumption of four of the seven specific phytoestrogenic compounds as well as three summary measures were associated with a reduced risk of thyroid cancer . . .” Just how much reduced risk is never established or explained.

• The odds ratios in Table 2 and Table 3 show that many are near or around 1.00 which means that there are no (null) effects. Many rows—subgroups—have too few cases and controls to show statistical value. For the other rows with subgroups, we have no indication of significance (p value). P value is given only for “trend across quintiles.”

In conclusion, this paper should not be accepted as a serious study of thyroid cancer risk related to phytoestrogen intake. The researchers failed to provide details concerning the number of models, the parameters included in each of the models, construction of composite variables (Table 3), and trend tests used to produce the statistical results (p values) in Tables 2 and 3. We don’t even know the statistical software used to fit the models. The article’s clearest and most powerful statement—a reduction in thyroid cancer risk of 35 percent to 55 percent was associated with increased consumption of non-fermented traditional and nontraditional soy-based foods and sprouts—comes without explanation out of the blue.

REFERENCES

1. CBS News. http://www.cbsnews.com/8301-501715_162-57354512/docs-argentine-leaders-thyroidwasnt- cancerous/

2. American Cancer Society: http://www.cancer.org/acs/groups/cid/documents/webcontent/003144-pdf.pdf

3. National Cancer Institute, SEER-Surveillance Epidemiology and End Results. Stat Facts Sheet. http://seer.cancer.gov/statfacts/html/thyro.html

4. USA Today. http://yourlife.usatoday.com/health/story/2012-01-15/Doctors-try-to-explain-increase-inthyroid-cancers/52584788/1

5. http://www.radiation.org/reading/pubs/091116Thyroidcancer.pdf. Accessed 1-11, 2012

6. http://today.msnbc.msn.com/id/43475479/ns/todaytoday_news/t/radioactive-tritium-leaks-found-us-nukesites/#.TyQKuVw5Knm

7. Nuclear Reactors in Earthquake Zones in the US. http://www.treehugger.com/corporate-responsibility/nuclear-reactors-in-earthquake-zones-in-the-us-map.html. 1-24- 12.

8. Horn-Ross, P et al. Why Are Thyroid Cancer Rates So High in Southeast Asian Women Living in the United States? The Bay Area Thyroid Cancer Study. Cancer Epidem Biomar. 2003, 12, 144-150.

9. http://www.activistpost.com/2012/01/thyroid-cancer-fracking-and-nuclear.html. Accessed 1-23, 2012.

10. Ananda, Rady. Food Freedom, Thyroid Cancer, Fracking and Nuclear Reactors. http://foodfreedom.wordpress.com/2012/01/18/thyroidcancer-fracking-nuclear-power. Accessed 1-19, 2012.

11. http://www.buffalo.edu/news/11885. Accessed January 24, 2012.

12. Golden RJ, Noller KL, Titus-Ernstoff L, et al. Environmental endocrine modulators and human health: an assessment of the biological evidence. Crit. Rev. Toxicol, 1998,28, 2, 109–227. doi:10.1080/10408449891344191. PMID 9557209.

13. Connett, Paul. Beck, James. Micklemp, HS. The Case Against Fluoride. (White River Junction, VT, Chelsea Green Publishing Company, 2010) 183-185.

14. NRC, Fluoride in Drinking Water: A Scientific Review of EPA’s Standards (National Academies Press, 2006) 266, ch.8, www.actionpa.org/fluoride/nrc/NRC-2006.pdf

15. Iodine Deficiency. http://emedicine.medscape.com/article/122714-overview. 1-23, 2012.

16. US Soyfoods Directory. http://www.soyfoods.com/nutrition/AbsorptionMetabolism.html. Accessed January 23, 2012.

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