Monthly Archives: July 2014

Sun Protection Updated

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Summer is officially here. That means that most of us are in the sun much more frequently. Most vacations and general summer fun occurs outdoors – either hiking, biking, swimming or playing tennis. Even just the walk around the neighborhood or gardening can give us hours of sun exposure.

There is much evidence that sun exposure, particularly sunburns, can lead to skin cancer, which accounts for 40% of all cancers. Melanoma, the most dangerous form, is one of the leading causes of cancer deaths.

Avoiding burns, and sun exposure in general, which can also cause wrinkles and sun damaged skin, is another conundrum.

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Unsafe Skin Protection
Oxybenzone, the leading active ingredient in most popular sunscreens, can be dangerous in and of itself. The non-profit Environmental Working Group offshoot site Cosmetics Database gives sunscreens with oxybenzone a very poor rating. The reason for this is that when exposed to sunlight, oxybenzone can break down into byproducts that are actually carcinogenic. There is evidence for possible reproductive danger as well. Researchers recommend that this be avoided in children. 3

Avobenzone, another popular active ingredient, breaks down in sunlight and causes allergic reactions as well as possible hormone disruption. Health researchers are calling for more research into the bioaccumulation affect of these products on humans as well as wildlife. 5
The Cosmetics Database guide to sunscreens (http://www.ewg.org/2014sunscreen/8-sun-safety-strategies/) also points out that rates of melanoma have tripled in the past 35 years, and there is no evidence that sunscreen has done anything to reverse that trend. While the sunscreen industry is booming, the evidence that their products will prevent cancer has been lacking. The FDA, National Cancer Institute and International Agency for Research on Cancer agree that the data do not support the assertion that sunscreens alone prevent skin cancer. (The proven major risk factors for melanoma are fair skin, indoor tanning, number of moles on the skin, freckles, family history, UV exposure and severe sunburns.) 2

Impactful tidbits from the Cosmetics Database article I found interesting:
• Sunscreen increased rates of melanoma (Gorham 2007)
• Outdoor workers have lower rates of melanoma than indoor workers
• Increased Vitamin D (which we get from the sun) may reduce skin cancer risk

One fear that many health providers share is that people using sunscreen believe that they are protecting themselves from cancer, and therefore may spend more time in the sun, soaking up those UV rays. One study showed that while the sunscreens studied did prevent burns and photoaging, they actually increased growth of melanoma. 6
Retinal Palmitate, now found in many popular sunscreens, has it’s own problematic effects. In some FDA sponsored studies it has been shown to increase skin cancer.
PABA, another common ingredient in sunscreen, may also cause damage to the skin. Researchers found that application of normal amounts of PABA can damage melanocytes in the skin, the cells that are responsible for tanning and our natural defense against sun damage. 4

So why would we lather our bodies with products that could cause cancer when exposed to sunlight? Well, the truth is that most people are not aware of much of what they rub into their skin. Or they think that we don’t absorb them into our bodies. This is just appalling to me, considering that many drugs are delivered through the skin – such as hormone patches or nicotine patches. Along with the problematic sun protection ingredient, many contain other chemicals such as phthalates (which can be hormone disruptors) and petrochemicals as part of the vehicle for the lotion. Two free apps that I use when shopping for sunscreens and any other body care products are Think Dirty and the Cosmetics Database. You can scan the barcode of the product and get an instant rating while you shop – without having to have a degree in chemistry!

FDA logjam of new sunscreen chemicals
Recently an article in the San Francisco Chronicle pointed out that our European and Canadian counterparts have many more choices in sunscreen products, yet the FDA has them in a log-jam here, with 8 new chemicals pending review for years or over a decade before a decision is made on their safety. One that has great promise for protecting both UVA and UVB rays, is ecamsule (also referred to as Mexoryl), thought by some health experts to be better than anything we have available so far in this country. 1

Myself along with many of my colleagues recommend physical blockers, such as zinc oxide or titanium dioxide, rather than the chemical ones. The downside is that they are not as sweat- or waterproof, and therefore need to be reapplied more frequently. Protecting your skin with hats and clothing is also effective and should particularly be used with children, who are much more at risk for developing cancer if they are burned in the sun.

Is protection possible from internal ingestion of a fern extract?
Native peoples of Honduras and Guatemala have been using the extract of the fern plant Polypodium leucotomos for centuries. Scientists have found that this extract protects skin from oxidative damage, sunburn, photoaging and prevents tumors from beginning to grow in relation to UV exposure. On research study in healthy human volunteers showed that it prevented UV damage, UV related reddening of the skin, and offered photoprotection of the Langerhans cells. 7

Research has shown that this extract apparently bolsters our skin’s natural defenses against more rapid aging caused by UV rays. It prevents the rays of the sun from breaking down photoprotective molecules. 8

According to Michael Downey in a recent issue of Life Extension magazine, the extract “not only prevents, but also repairs, the sun’s damaging effects on the skin. It prevents sunaged skin by directly inhibiting MMP (matrix metalloproteinase) expression, preventing the breakdown of collagen in the first place. It repairs sun-aged skin by stimulating new production of collagen and elastin – healing and regenerating photoaged skin after exposure to ultraviolet radiation.” 11 (Life Extension is one of the manufacturers of the product. That said, the research in the article is well documented.)

This idea of protecting out skin from the inside out is appealing to me as a naturopathic doctor. Whenever people come in for help with skin issues, applying some treatment to the outside is nothing more than a Band-Aid to me. Collagen damage can’t just occur on the surface. I love the idea of protecting our cells from the inside. The mechanism of this effect on many cells in the body has been, and continues to be, well researched. 9 Not only for the prevention and treatment of sun-induced skin damage, but also promising scientific evidence for treatment of melasma and vitiligo. 10

Final thoughts
My ongoing conversation with my very pale dermatologist includes the fact that my perspective on my body is that I have it while here to use and enjoy. This includes my heart, lungs, eyes and yes, my skin. I don’t want to give any organ unnecessary burden, but if I have to stay inside and avoid having any fun in the sun, then it is just not worth it to me. Just like I will not cut down on increasing my heart rate or allowing my liver some toxins to eliminate, I will not give up my tennis matches or hikes with good friends. I will however be as wise as possible, by using safe and effective skin protection strategies.

References:

1. Colliver, V. May 27, 2014. Fresh sunscreen ingredients stuck in FDA backlog. San Francisco Chronicle.
2. Skin cancer on the rise. Environmental Working Group EWG 2014 Guide to Sunscreens. http://www.ewg.org/2014sunscreen/8-sun-safety-strategies/
3. Gilaberte Y. Sun protection in children: realities and challenges. Actas Dermosifiliogr. 2014 Apr;105(3):253-62. doi: 10.1016/j.adengl.2013.05.006. Epub 2014 Mar 21.
4. Xu C et al. Photosensitzation of the sunscreen octyl p-dimethylaminobenzoate by UVA in human melanozytes but not in keratinocytes. Photochem Photobiol. 2001 Jun;73(6):600-4.
5. Schlumf M et al. In vitro and in vivo estrogenicity of UV screens. Environ Health Perspect. 2001 Mar;109(3):239-44.
6. Wolf P et al. Effect of sunscreens and UV radiation-induced enhancement of melanoma growth in mice. J Natl Cancer Inst. 1994 Jan 19;86(2):99-105.
7. Gonzalez S et al. Topical or oral administration with an extract of Polypodium leucotomos prevents acute sunburn and psoralen-induced phototoxic reactions as well as depletion of Langerhans cells in human skin. Photodermatol Photoimmunol Photomed. 1997 Feb-Apr;13(1-2):50-60.
8. Gonzalez S et al. Fernblock, a nutriceutical with photoprotective properties and potential preventive agent for skin photoaging and photoinduced skin cancers. Int J Mol Sci. 2011;12(12):8466-75. doi: 10.3390/ijms12128466. Epub 2011 Nov 29.
9. Rodriguez-Yanes E et al. Oral administration of polypodium leucotomos delays skin tumour development and increases epidermal p53 expression and the antioxidant status of UV-irradiated hairless mice. Exp Dermatol. 2014 May 24. doi: 10.1111/exd.12454. [Epub ahead of print]
10. Ahmed AM et al. A randomized, double-blinded, placebo-controlled trial of oral Polypodium leucotomos extract as an adjunct to sunscreen in the treatment of melasma. JAMA Dermatol. 2013 Aug;149(8):981-3. doi: 10.1001/jamadermatol.2013.4294.
11. Downey M. Protect Against Sun-Induced Skin Aging from the Inside Out. Life Extension. July 2014.

Are there Toxins in my tea?

Tea

Tea is the most widely consumed beverage worldwide, second to water. The incredible health benefits of green tea are not news to most people. Green tea benefits your health as an antioxidant, anti-inflammatory, antimicrobial, anticarcinogenic, antihypertensive, brain protector as well as lowers cholesterol.

Some of the downsides may be less well known. We will begin here with a review of some of the most well studied benefits of green tea.

 

EGCG (Epigallocatechin gallate) & Cancer

In the last decade, there has been a good deal of research showing the anti-cancer properties of green tea and it’s main constituent, epigallocatechin gallate (EGCG), showing positive results in epidemiological, cell culture, animal and human studies in various types of cancer.

 

Cell culture studies, including those on the polyphenols in green tea, show that tea polyphenols increase apoptosis (programmed cell death) and arrest cell proliferation in tumor cells but not in normal, healthy cells.1 Animal studies also show that treatment with green tea can decrease cancerous tumors in skin, colon, liver, mammary glands and stomach.

 

Breast Cancer therapies utilizing the catechins of green tea have been studied extensively in the past two decades. The research has varied significantly, in terms of in vivo or in vitro, carcinogens looked at, green tea catechin dose used, and whether or not it was green tea extract or a synthetic version that is higher in EGCG. The effect is not always statistically significant, but what is consistently found is the protective effect of green tea in all of the breast cancer trials. This suggests that further trials of green tea extracts should be done, particularly in high-risk women. 7

 

Estrogen receptor alpha cells responded better to tamoxifen in the presence of EGCG. And growth of non-malignant breast epithelial cells is not affected by EGCG. 5

 

Researchers studying the nanoparticles of green tea found that while they did not have the EGCG (or caffeine or theobromine) that has been studied so heavily, they did have a benefit in cancer therapy. They form a complex with doxorubicin and improve the uptake of the drug into cancer cells. This led to increased cytotoxicity of lung cancer and breast cancer cells. They also were found to have increased uptake and cytotoxicity in multi-drug resistant breast cancer cells. 6

 

EGCG has been shown to have very potent free-radical quenching capabilities, which is especially important in detoxification and preventing oxidative damage.

 

More studies are needed to determine which populations and which organ systems are likely to benefit the most from green tea consumption. But there is sufficient evidence to know at this point that it does help keep cancer at bay, and without much downside, can be assumed to be a reasonable tonic to include in your daily diet.

 

 

 

Theanine & Anxiety

Recent years have seen large increases in data available on the central nervous system effects of theanine. Theanine is an amino acid component of both green and black teas, although is somewhat higher in green tea. L-theanine is the form in supplements for human use. It was previously thought it should be taken as a supplement to achieve the greatest calming effect, rather than to just have a cup of green tea. Recent research shows that it crosses the blood brain barrier, increasing alpha brain waves, even with just a simple cup of green tea. Alpha waves are seen on EEG and mostly found in wakeful relaxation with eyes closed. This seems to help people focus on mental tasks. The unique quality of theanine is that it helps produce alert focus while also producing a sense of calm. Many calming herbs and pharmaceuticals also create sleepiness. Not so with theanine. Although if your anxiety is keeping you awake, theanine may help induce sleep just by reducing anxiety levels. The calming effect of theanine is related to it’s upregulation of inhibitory neurotransmitters, while also regulating dopamine and serotonin levels in the brain. 2 Other areas where theanine shows some promise include stroke recovery and schizophrenia.

 

Polyphenon E and Cervical Cancer

Polyphenon E is a topical ointment with a standardized amount of epigallocatechin gallate (EGCG) from green tea. It has been used in several studies showing elimination of HPV related warts. 3 It has also been shown in cell cultures to reduce cervical cancer by inducing apoptosis and inhibition of telomerase activity. 4

 

Green Tea and Anti-Aging

Tea has been used since ancient times for it’s proposed health benefits. Now we are coming up with scientific research to help prove this and also to understand the mechanisms of action. Several new research studies have recently been published that show the benefits of green tea on effects of aging.

 

Polyphenolic compounds from green tea contain compounds that show strong affinity to reactive oxygen species. They show the ability to neutralize free radical damage and initiate other positive biological effects. 10

 

Emulsions of green tea and lotus applied to the skin are shown to reduce wrinkles, scaliness and skin roughness. Green tea and lotus were also each studied alone in this trial and were found to have synergistic effects when applied together. 8 Another meta-review of studies of botanicals for skin wrinkles showed no benefit with green tea, but also pointed out at that the study designs were not adequate. 9 More research is needed in this area.

 

Another review article pointed out that green tea has a beneficial effect in limiting skin cancer growth, along with reducing ultraviolet light induced photoimmunosuppresion. 12

 

 

Diabetes and Heart

Green tea has been shown to help with metabolic disorders including insulin resistance, type 2 diabetes, hypertension, and decrease cholesterol. 11

 

 

What about the bad stuff?

If you’ve been reading so far waiting for the other shoe to drop, fear not. It isn’t so bad. At least nothing that you can’t avoid with a little education.

 

Look out for toxic elements!

Canadian researchers recently studied 30 different types of black, green and oolong teas found on local store shelves. They looked at both regular and organic teas. They looked at toxic elements in the tea leaves themselves, tea brewed for 3 minutes and then tea brewed for 15-17 minutes. Here is the heartbreaking news: all teas contained lead. In the teas brewed for just 3 minutes, 73% contained lead, and in the tea brewed for 15-17 minutes 83% contained lead at levels that are considered unsafe for pregnancy and lactation. There was no difference in lead levels between organic and regular teas. 13

 

Interestingly, while many of the tea leaves contained mercury, no mercury was found in the brewed teas. There is some binding that occurs in the tea leaves that keeps it from leeching out in to the tea.

 

And while choosing tea that is organic isn’t necessarily going to protect you from the elevated lead levels, purchasing tea from different countries certainly could. The study showed that all green tea from China, organic and regular, had elevated lead levels. While tea from Sri Lanka did not. Organic green tea from Japan showed moderate levels of lead, arsenic and cadmium.

 

Take it easy on cream and sugar!

Tea flavonoids protect cells from free radical damage. This is because tea contains high levels of antioxidants, the polyphenols we’ve talked about already. But many people are doctoring up their tea with things that completely eliminate the activity of these antioxidants. As it happens, more people do this to black tea than to green. Researchers showed that the addition of milk, sugar and honey decrease the antioxidant levels in tea in a dose-dependent manner. Addition of the natural sweetener stevia had no negative effect on the antioxidant levels, so it should be the sweetener of choice in any tea. 14

 

 

Where do we go from here?

It is clear that green tea has many beneficial qualities. Having several cups each day can provide myriad health benefits. My favorite way to have my green tea is to brew kombucha – that way I get the catechins and some probiotics all in one place. But we need to be smart to avoid any negative attributes. Educate yourself about where your tea comes from. Most of us tend to drink the same brand over and over again. Find out where it’s grown and if they do any testing to make sure it does not have toxic contaminants. If you are taking a concentrated green tea capsule for medicinal purposes, I would do the same research. Make sure that you aren’t also getting concentrated lead. Many of the best supplement companies do regular testing to make sure there are no toxins in their products. If they aren’t, I wouldn’t take it.

 

And for sure stay away from milk and sugar in your tea.

 

 

 

 

 

  1. Chen, D et al, Green tea and tea polyphenols in cancer prevention. Front Biosci. 2004 Sep 1;9:2618-31. PMID:15358585
  2. Yokoyama, M. The tea polyphenol, (-)-epigallocatechin gallate effects on growth, apoptosis, and telomerase activity in cervical cell lines. Gynecol Oncol. 2004 Jan;92(1):197-204.
  3. Garcia, FA. Et al. Results of a phase II randomized, double-blind, placebo-controlled trial of Polyphenon E in women with persistent high-risk HPV infection and low-grade cervical intraepithelial neoplasia. Gynecol Oncol. 2014 Feb;132(2):377-82. doi: 10.1016/j.ygyno.2013.12.034. Epub 2014 Jan 2.
  4. Zeng L, et al. Effects of physiological levels of green tea extract epigallocatechin-3-gallate on breast cancer cells. Front Endocrinol (Lausanne). 2014 May 7;5:61. doi: 10.3389/fendo.2014.00061. eCollection 2014.
  5. Yi S, et al. Tea nanoparticles for immunostimulation and chemo-drug delivery in cancer treatment. J Biomed Nanotechnol. 2014 Jun;10(6):1016-29.
  6. Yiannakopoulou ECh Effect of green tea catechins on breast carcinogenesis: a systematic review of in-vitro and in-vivo experimental studies.Eur J Cancer Prev. 2014 Mar;23(2):84-9. doi: 10.1097/CEJ.0b013e328364f23e.
  7. Mahmood, T. Combined topical application of lotus and green tea improves facial skin parameters. Rejuvenation Res. 2013 Apr;16(2):91-7. doi: 10.1089/rej.2012.1380.
  8. Hunt, KJ, Botanical extracts as anti-aging preparations for the skin: a systematic review. Drugs Aging. 2010 Dec 1;27(12):973-85. doi: 10.2165/11584420-000000000-00000.
  9. Hsu S. Green Tea and the skin. J Am Acad Dermatol. 2005 Jun;52(6):1049-59.
  10. PloS One. 2014 Jan 3;9(1):e84468. doi: 10.1371/journal.pone.0084468. eCollection 2014.
  11. Barbosa, NS. CAM use in dermatology. Is there a potential role for honey, green tea, and vitamin C? Complement Ther Clin Pract. 2014 Feb;20(1):11-5. doi: 10.1016/j.ctcp.2013.11.003. Epub 2013 Nov 20.
  12. Schwalfenberg G, et al. The benefits and risks of consuming brewed tea: Beware of toxic element contamination. J Toxicol 2013. 370480.
  13. Korir, MW. The fortification of tea with sweeteners and milk and its effect on in vitro antioxidant potential of tea product and glutathione levels in an animal model. Food Chem. 2014 Feb 15;145:145-53. doi: 10.1016/j.foodchem.2013.08.016. Epub 2013 Aug 11.

2.     Lardner, AL. Neurobiological effects of the green tea constituent theanine and its potential role in the treatment of psychiatric and neurodegenerative disorders. Nutr Neurosci. 2014 May 28;17(4):145-55. doi: 10.1179/1476830513Y.0000000079. Epub 2013 Nov 26.