My Roller Coaster Cancer Journey
– March 2022 Update –

Dr. Al Danenberg Nutritional Periodontist

March 13, 2022 [printfriendly]

Starting at the end of June 2021, life for me has been a roller coaster ride. My body has been challenged like at no other time – complications with my immunotherapy, fighting external viruses, dealing with body pain, and plummeting into depths of depression.

As a quick recap, I was diagnosed with Multiple Myeloma in September of 2018, following what I thought was an extremely healthy lifestyle the previous 6 years. My oncologist gave me 3-6 months to live if I did nothing. I rejected chemotherapy and used my medical background and research to develop what I now call my 10 Unconventional Cancer Protocols.

This approach was not without setbacks, as I found myself in Hospice for end-of-life care in 2019. However, as you know, that was NOT the end of my story. I adjusted my approach with my continued research, and I began thriving.

However, these last 9 months have been bordering on horrific. I always try to keep an upbeat tone when I share my findings with you, but I also believe it’s important to be transparent and real. I look forward to the day when I can say, “I’m thriving again!”.

Here’s what’s been going on behind the scenes:

 

My Strength

My first pillar of strength has been my astonishing wife. And once again, she has come through with flying colors. But I can tell you, “I don’t make it easy for her.” I’ve been known to be a pain in the ass.

In addition, my oncologist stands out as stellar in his own right.

He is the most empathetic and committed medical professional I know. He is a conventional, allopathic specialist who practices in a large oncology group where I live. I dare not tell you his name, because he must follow the standard of care for his cancer patients or else his practice and most likely the medical licensing board would end his career if he deviated. But he always is interested in my “out of the box” thinking and the research I have put into my 10 Unconventional Cancer Protocols.

After my diagnosis in 2018, I have been adhering to my protocols, which have served me well. But by the end of June 2021, my path became repeatedly choppy.

 

June – September 2021

A botched injection of my monthly immunotherapy on June 22, 2021, may have weakened my body’s defenses. I wrote all about it HERE.

At first, I thought I developed severe side effects from this monoclonal antibody called Darzalex. (Darzalex is a human-derived monoclonal antibody that attaches itself to a specific protein on the surface of malignant plasma cells. Then the body’s immune system can eat up these tagged malignant plasma cells.)

But what developed by the beginning of July was far worse and more complicated.

Early in July, I developed a sore throat and cough. I used my Bee Propolis Spray and Nebulized 0.1% Hydrogen Peroxide saline that took care of those symptoms. Then almost immediately after that I experienced extreme exhaustion, overall muscle and intense joint pain, and headaches which just got worse. And then there was diarrhea, which I don’t deal with very well.

I never had a fever, loss of taste, or loss of smell.

These “side effects” started deteriorating my body. My oncologist believed that the exaggerated symptoms were the compounding effects from the SARS-CoV-2 virus. It made sense that my body was weakened from the recent immunotherapy injection, and I was more susceptible to contracting the virus.

But it is difficult to determine what is going on for some patients with multiple myeloma. Since multiple myeloma produces dysfunctional antibodies, my immunoglobulins are not functioning as those would be for someone without cancer of the plasma cells in the bone marrow.

Shortly after developing all my symptoms, I had my monthly blood work drawn. My CBC showed lower than normal hemoglobin. I had a significant rise in my neutrophil count and a significant drop in my lymphocyte count. My blood chemistries showed increased serum calcium and elevated alkaline phosphatase. My immunofluorescent blood work showed a spike in my serum dysfunctional IgA antibodies. It was bizarre, but all these biomarkers were moving in the wrong direction after July 2021. This had not happened before.

 

October – November 2021

Again, I returned to my specialist’s office on 10/19/21 for a round of new blood work. At that time, he also scheduled me for a new PET Scan on 10/26/21.

The most compelling biomarker that suggested I had COVID was my NLR, which was skyrocketing when I had another CBC drawn on 11/2/21.

NLR is the Neutrophil/Lymphocyte Ratio. It is a reliable blood marker for systemic inflammation and a most robust marker for COVID. A severely high NLR has been reported in various recent medical papers to be a hallmark of severe COVID-19.

A normal NLR is between 1:1 and 3:1. In this published study, the average NLR for hospitalized COVID patients was 6.15. When that ratio rose above 8.17 in the study, the risk of death increased. Strikingly, my NLR on 11/2/21 was 42.0 – a seriously disturbing level!

But I never had to be hospitalized. My efforts to support my immune system have played an important part in my body’s ability to heal – albeit slowly.

Another tool in the toolbox is the PET Scan. When I had my PET Scan on 10/26/21, it showed that my multiple myeloma had become slightly-to-moderately activated again and centralized in my colon area, lower spine, and pelvis.

Did all this start with a botched immunotherapy injection at the end of June? Was COVID causing havoc with my physical body, my bloodwork, as well as my multiple myeloma? The answers seem to be, “YES!”

I became very depressed.

I remember in September 2018 I was at the oncologist’s office for the very first time. My wife and adult children were at this appointment. The oncologist told me of my diagnosis and prognosis. After we discussed the options of chemo and other treatment, he said that eventually all meds eventually would prove ineffective. Then, I would succumb to the manifestations of multiple myeloma.

Was this the end? Was I going downhill for the last time? Good thoughts were replaced by dark, destructive, negative energies.

 

December 2021 – January 2022

Once again, my wife pulled me out of the abyss of depression by my bootstraps and set me straight. She has been my guiding light and pillar of strength since we married in 1969. And certainly, since my cancer diagnosis in 2018, she has been my partner in my cancer journey.

I continued with all my 10 Unconventional Cancer Protocols, but I added two new elements that I believe can assist in healing my body – colostrum and hydrogen-rich water.

I also began another round of my monthly immunotherapy (i.e., Darzalex FasPro) on 1/4/22 since I thought I was recovering well from the COVID symptoms.

 

Colostrum

I wrote about my experiment with eating Colostrum-6 every day. There is an abundance of research touting the health benefits of colostrum, especially with healing the gut. And you know how much emphasis I place on a healthy gut for overall health and immune support.

 

Hydrogen-Rich Water

I also wrote about another new pet research project of mine, molecular hydrogen. There are over 15 years of published medical articles about its ability to bring the body back into a state of balance or homeostasis. At high levels of concentration, molecular hydrogen dissolved in water may produce significant clinical benefits. This study describes the benefits for adults over the age of 70.

Two of the most interesting aspects of high-dose molecular hydrogen dissolved in drinking water (16PPM) is that it is a discriminating free-radical scavenger and an anti-inflammatory agent.

The emphasis is on discriminating. That means it does not destroy the good free radicals that the body creates for many biologically necessary functions. It only neutralizes the excessive free radicals and the most dangerous of them.

 

February – March 2022

Assuming that the immunotherapy would be OK, I had another injection on 2/1/22.

I was wrong!

I once again developed serious side effects. My joints and muscles became extremely painful, and I had difficulty raising my arms and walking. My shoulder joints became frozen” (adhesive capsulitis).

I felt debilitated and incapacitated.

On 2/28/22, I had a new PET Scan. And on 3/1/22, I had new blood work and an appointment with my oncologist. He reviewed that day’s blood work and the results of the PET Scan from the previous day.

This was a crucial day in my Cancer Journey.

He told me that my Darzalex FasPro subcutaneous injections have exceeded the risk-benefit ratio. And my blood work and symptoms were reflecting this toxicity.

It now appeared that my symptoms beginning after my botched Darzalex injection on 6/22/21 and then reappearing after this last round of Darzalex on 2/1/22 were directly related to the severe and compounding side effects of Darzalex along with the underlying and lingering effects of COVID-19.

Both of which woke up my cancer, which was confirmed in my newest PET Scan taken on 2/28/22.

The Scan showed a continuation of the resurgence of multiple myeloma spreading to other areas. Through no fault of my own, but rather the fault of Darzalex’s side effects and the SARS-CoV-2 Virus, the bone marrow cancer was rearing up its ugly head.

I had to consider my next steps and options.

 

Next Steps & Options

  • I could not be in denial.
  • I could not get depressed.
  • I had to maintain the proactive attitude that brought me to where I was before June 22, 2021, when all these problems started.
  • I knew I would no longer put Darzalex into my body.

My oncologist suggested chemo, but I once again declined. Here’s why …

At my diagnosis in 2018, I rejected chemo because my quality of life could have been significantly decreased with the chemo. And quality of life meant more to me than longevity with increasingly debilitating symptoms.

Chemo cocktails are a potentially damaging combination of chemicals which can disturb all biological functions as well as everything I have been doing to support my immune system.

I am not in agreement with other conventional specialists who have said that chemo is the only answer. The side effects, which are numerous, are testaments to the fact that the recommended chemotherapy drugs have produced serious complications for some patients. The response to my concerns from many allopathic oncologists is that there are always other meds to offset the side effects from chemotherapy.

However, I can’t rationalize that statement. I can’t make any sense of it in my head because my goal is to allow my immune system to do what it can do to heal my body. The last thing I want to do is disturb and short circuit my body’s biochemical functions.

So, I know that following my 10 Unconventional Cancer Protocols will assist my body in healing as best as possible – just as it did in the past. I have no expectation that my Protocols will take me into remission or cure this bone marrow cancer.

A greater power than I am able to comprehend has created the human machine I call “me”. This omnipotent, omniscient, omnipresent, cosmic energy source made “me” perfectly balanced and functional. Why would I hamper “me” from doing what it was designed to do by God? I have a strong spiritual belief that I am here on this Earth in this body to learn important lessons, and my cancer journey is a significant part of those lessons.

 

Naysayers Have Nothing on my Support System

Although my wife is there to encourage me, I don’t always get love from everyone.

For example, when I publish my cancer journey updates on some social media sites, some individuals leave their comments in capital letters like they’re screaming at me.  Recent comments have been …

  • “GET THE HELL OFF THIS SITE”
  • “YOU’RE KILLING PEOPLE BY TELLING THEM TO EAT RED MEAT”
  • “YOU’RE A FAKE AND A SCAM ARTIST”

Generally, the most vitriolic comments are coming from those who shout,

  • “BECOME A VEGAN IF YOU WANT TO CURE YOUR CANCER”

 

Where Am I Going?

I don’t know.

I do know where I want to go. And I have the motivation and attitude to get there.

By stopping the offending Darzalex and continuing with all my 10 Unconventional Cancer Protocols, I expect to get back to “my normal”.

I realize that multiple myeloma is real and spreading in my body. But I also realize that my body has the potential to assist the fight without any outside chemical side effects.

One of the excellent investigative journalists I regularly follow on an uncensored social media site says, “The virus is gonna virus”. I’ll take his insight one step further and say, “The cancer is gonna cancer”.

I continue to forge ahead and always am looking to tweak my Protocols with methods to enhance my existing immune system to become the best it can be under my current circumstances. I still am dealing with lingering bone pain. But I’m working on that.

And I am moving forward with great expectations and abundance of proof that what I have done in the past has worked and will produce excellent benefits for me as time moves on.

Again, I must emphasize that I do not have a cure for cancer, and what I am doing for myself is my own personal journey. My goal is to be transparent and candid about my experiences – both good and bad.

Of course, my awesome wife is always by my side, and my empathetic oncologist is rooting me on.

 

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My Greatest Fear
– Humpty Dumpty Had a Great Fall –

Dr. Al Danenberg Nutritional Periodontist

December 19, 2021 [printfriendly]

My greatest fear is that I may “get broken” beyond repair. And then I would lose my quality of life. I also might not be able to continue sharing and teaching all I have learned along my amazing Cancer Journey.

Yes, old dogs can learn new tricks! And at the age of almost 75, I am an “old dog” with lots of “new” tricks. But a broken dog can’t jump up and down any longer. And I like to show off.

Everything I’ve learned I want to share. I have not found anybody who has connected the medical dots as I have. But as Humpty Dumpty fell and shattered into pieces, my fragile and porous skeleton could do the same.

I don’t have a fear of death. And certainly, I am not in denial of my situation. I am realistic.

My greatest fear is suffering severe pathological fractures in the future that could incapacitate me and end the quality of life which I enjoy today.

 

My Dilemma

My dilemma is that my mind is working overtime, but my physical body has been challenging me recently.

A recent study showed that fully vaccinated patients with multiple myeloma have an increased rate of COVID-19 infection and have an increased risk of dying compared to vaccinated individuals without cancer.[1] And I’m not vaccinated for reasons I’ve discussed in previous Blogs.

My cancer journey has taken me through a lot. Most recently, the 10 Unconventional Cancer Protocols I created have helped me through COVID and Long Haulers without meds and without hospitalization. I am impressed with the overall strength of my immune system because of these protocols. As I have repeated in the past, my oncologist is amazed!

Multiple myeloma is a bone marrow cancer. It weakens the immune system’s ability to create necessary antibodies, which are created by plasma cells in the bone marrow to fight invaders. Multiple myeloma also can create severe bone lesions throughout the skeleton making bones very fragile.

Initially, the symptoms in 2018 that brought me to my physician were pain in my right shoulder and sternum area. I had no idea that my problems were anything more than a torn ligament or a damaged muscle. At that time, I had no idea I had a crack in my pelvis, broken ribs, and a vertebral compression fracture causing bone and breathing pain.

Once the diagnosis of IgA Kappa Light Chain Multiple Myeloma was confirmed in September 2018 and I was given 3-6 months to live, the obvious became real to me. Most likely I would die from the complications of multiple myeloma. And I was prone to painful and life-threatening fractures even if I only twisted or bent my body in such a way that a weakened bone would snap.

My ultimate realization of my fragile body occurred in August 2019. That is when I was standing in my bathroom, twisted to the left to throw my used dental floss into the trashcan, and instantly my right femur snapped in half. I collapsed to the floor – breaking several ribs and splitting my right humerus in half. These severe fractures eventually put me in a Hospice Hospital to die.

Amazingly, I rebounded, revoked Hospice, and returned to my protocols. To the shock of most people around me, I was recovering. And when I saw my oncologist in October 2019, he was pleasantly surprised once again.

 

COVID

I continued with an excellent quality of life until 6/22/21, when I received a botched injection of my monthly immunotherapy (Darzalex[2]), which is not chemotherapy. Within a week after this injection, I began having various areas of bone and muscle pain. My oncologist and I thought these symptoms were a combination of side effects from the Darzalex injection. Yet, I never experienced bad side effects from this therapy in the past.

But then I experienced overall joint pain, total exhaustion, lack of energy, diarrhea, headaches, and a persistent cough. I finally recognized that the progressively worsening symptoms were the effects from the SARS-CoV-2 virus which took over my weakened body. The complications after the Darzalex injection in June 2021 set my body up to make me more susceptible to the virus.

 

COVID & NLR

My concerns were documented after my routine monthly CBC (Complete Blood Count) following the COVID infection and the peak of my symptoms.

The CBC looks at the components of the blood – red blood cells. white blood cells, platelets, hemoglobin, etc. A ratio of two specific white blood cells has recently been explored and documented in COVID patients. It is the ratio between the number of neutrophils and lymphocytes circulating in the blood. It is called the NLR (neutrophil lymphocyte ratio).

For a healthy individual, the NLR is usually between 1:1 to 3:1. However in severe COVID patients, the ratio is elevated along with the number of lymphocytes being significantly below normal. In a current study of hospitalized COVID patients, those with an NLR of 7.45 or higher were more likely to require a ventilator and had a higher risk of dying.

A significantly elevated NLR has become a “hallmark of severe COVID”. After my severe symptoms, my NLR was 42:1 – an extremely elevated ratio. This has never occurred before in my CBC results and concerned me.

My oncologist believes now that the increased activity of my malignant plasma cells as shown on my most recent PET Scan taken on 10/26/21 (after my severe symptoms were receding) is related to COVID’s effects on my bone marrow cells. Malignant plasma cells cannot produce healthy antibodies to the virus. So, millions of dysfunctional antibodies were produced in my bones that created more bone lesions as seen on this PET Scan.

And all those bone lesions make my skeleton more and more fragile. Like Humpty Dumpty, I’m prone to life-threatening pathological fractures.

And bone lesions cause bone pain.

 

Recovery

Bone pain is a symptom of progressing multiple myeloma. Fortunately, my bone pain in subsiding. And this bone pain just may be the final stage of “long-haulers COVID”. Whatever the cause of my bone pain, my ongoing efforts to improve my immune system should allow healing, and I’ll be fine in time. Just as I was before contracting COVID.

My most recent monthly blood work on 11/30/21 showed that my NLR dropped from 42:1 to 24:1. Still very high, but markedly better. I’m moving in the right direction!

Once again, I emphasize that the quality of life is most important to me – not longevity. But I want to live as long as possible if I can be productive for my family, friends, and myself.

Believe me, I am not a victim.

Don’t pity me.

I am a survivor.

But I am a realist.

Today, I am doing very well considering all that I have been through. I’m encouraged that I have returned to walking outside a little more than a mile most days of the week.

My attitude is positive as I deal with this challenge successfully. I’ve done it before, and I’ll do it again with my 10 Unconventional Cancer Protocols. My wife is my pillar of strength and has taught me this lesson very well.

 

Concluding Thoughts & Inspiration

There are many unknowns.

What I do know is I have found a way to do the impossible: I’ve taken an incurable diagnosis and reclaimed my quality of life even without chemotherapy. I’ve also recovered successfully from COVID. I’ve researched and experimented to beat the odds and created a system that allows me to achieve the best health and healing potential possible in my situation.

Imagine what could happen if you incorporate these methods into your life before you get sick like I did. And if you have a serious diagnosis, there is always a way to improve your situation by looking at it from a different perspective and being proactive as I have.

I’m reminded of a study that was published in 2019 that showed that 88% of the US adults are metabolically unhealthy. And this leads to serious chronic diseases including cancers. Today, I am in the minority with healthy metabolic flexibility.

My greatest joy in life is my family. My second greatest joy is helping others, just like you. If you haven’t taken the time to book a consult with me, please do. I would love nothing more than to leave a legacy of improved health and wellness.

I’ve incorporated all the lessons and facts I’ve learned into my 12-Week Balanced Metabolic Coaching ProgramIt’s customized to your specific health goals and needs. If this is your first time working with me, you can book a complimentary 30 minute consult to ensure we’re the right fit to work together.

If my journey has taught you anything, I hope it’s to take control and be proactive with your health. Heal your body before it’s too late. I can help.

 

 

[1] https://www.cancertherapyadvisor.com/home/cancer-topics/multiple-myeloma/covid19-multiple-myeloma-patients-increased-risk-treatment-risk/?mpweb=1323-166044-7637569

[2] https://imf-d8-prod.s3.us-west-1.wasabisys.com/2020-10/U-DarzaFaspro_EN_2020_h4_web.pdf

 

Schedule a ”30-Minute Free Consult” with me to answer some of your questions and determine if we are a good fit for a coaching program! CLICK HERE.

 

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My Cancer Journey
– Another Bump in the Road –

Dr. Al Danenberg Nutritional Periodontist

November 14, 2021 [printfriendly]

Let me bring you up to speed with my Cancer Journey …

  1. My first goal in my cancer journey was to maintain a quality of life, which I have.
  2. My second goal was to avoid synthetic chemicals that could destroy my immune system, which is critical for healing the body. This I have done.
  3. My next goal was to create a set of Protocols which is designed to support a robust immune system. This is also what I have provided for myself.
  4. And my success from my diagnosis of incurable bone marrow cancer in September 2018 up until June 22, 2021, has been remarkable.

I never claimed to have a cure for cancer or for any other chronic diseases. And I don’t have a cure today. But by improving my immune system through various pathways and becoming metabolically flexible, I have helped my body heal and have lowered the risk of future diseases.

Now, I am facing another challenge in my cancer journey – a bump in the road. I plan to fight it intelligently and overcome the odds again.

But let me tell you, “This bump scared me!”

My symptoms came on abruptly.

It all started with a botched injection of my monthly immunotherapy on June 22, 2021. I wrote all about it HERE. I even wrote about a prescient meditation that may have been a warning for me of things to come HERE.

 

A Bump in the Road

I saw my oncologist on 10/12/21 because of a progressing pain which I believed was a series of serious treatment side effects that started on 6/22/21 with my monthly injection of Darzalex. The most pain was in my right shoulder and back. Then it isolated to an area of a possible cracked rib at the base of my right rib cage on the front of my body. I also was starting to have pain in my left and right femurs where I suffered fractures about 2 years ago.

In addition to those symptoms, I had diarrhea, headaches, extreme exhaustion, generalized muscle and joint pain, and an irritating cough.

Dr. George, my oncologist, ordered more blood tests.

My CBC showed lower than normal hemoglobin. I had a significant rise in my neutrophil count and a significant drop in my lymphocyte count. My blood chemistries showed increased serum calcium and elevated alkaline phosphatase. My immunofluorescent blood work showed a significant spike in my serum dysfunctional IgA antibodies. (My current diagnosis is IgA Kappa Light Chain Multiple Myeloma with innumerable skeletal lytic lesions.)

My oncologist’s first thought was that my cancer was regrouping and becoming more aggressive.

He put me on dexamethasone 12mg for 4 days on and 4 days off, which I started immediately. The dexamethasone was intended to kill malignant plasma cells.

I returned to his office on 10/19/21 for new blood work. The steroid improved all the biomarkers. He also scheduled me for a new PET Scan on 10/26/21.

 

Another Possible Cause

Originally, my oncologist believed (and I concurred) that the Darzalex had stopped being beneficial and was the sole culprit. Dr. George recommended that I discontinue my Darzalex therapy, which I did. His concern was that my body was weakening, and I was succumbing to the cancer.

He now believes that my side effects from the botched Darzalex injection on 6/22/21 could have weakened my system and allowed me to contract COVID. All the symptoms were consistent with those of the Delta Variant. However, I never had a loss of smell, loss of taste, or a fever. And the extreme high neutrophil and low lymphocyte ratio is now considered a sign of severe COVID infection. (The spike in my neutrophil-to-lymphocyte ratio was 42.0; normal should be between 1.0 – 2.0.)

If this was COVID, and my immune system is effectively fighting this virus, then I should recover and return to the way I was before June 22, 2021.

 

PET Scan Results

My oncologist and I went over the results of the PET Scan in his office on 11/2/21. This was an enlightening discussion.

My PET Scan was disappointing.

It revealed a slight-to-moderate uptick in the multiple myeloma activity. This could be the result of the SARS-CoV-2 virus, which stimulated an overgroth of bone marrow cancer cells. These dysfunctional antibodies could not fight the SARS-CoV-2 virus. However, they crowded out the healthier marrow cells, which were trying to function normally. Then, the overabundance of malignant plasma cells created additional bone lesions, increasing the serum calcium and alkaline phosphatase levels as well as deep bone pain.

The Scan also showed inflammation in the colon which is where the COVID virus most likely settled in my body since I had days of diarrhea.

My experience may be happening to many others who have bone marrow cancer. The real science only now is being reported. This may be a “heads-up” for many.

 

Deeper Dive into Real Science

I believe I am successfully healing from COVID and its complications. I can’t prove this, but I now think my severe side effects from my June injection of Darzalex allowed the COVID virus to invade. But other aspects of my robust immune system are fighting off the virus.

Recently published medical papers are now uncovering the real science.

For example, healthy T cells of the immune system are more resistant than antibodies to threats posed by emerging variants of the SARS-CoV-2 virus. Studies have shown that people who have been infected with SARS-CoV-2 virus typically generate T cells that target at least 15–20 different fragments of coronavirus proteins. The COVID vaccines only create antibodies to one specific coronavirus protein. However, contracting the actual virus will generate a large variety of T cells that could snare a virus. T cell immunity is different and possibly more effective than antibody immunity, This T cell activity makes it very hard for the virus to mutate and escape cell recognition, which is what is currently happening for antibodies generated by the current vaccines.

You may have read that Collin Powell was fully vaccinated but died from COVID complications recently. He had multiple myeloma as well as Parkinson’s Disease. Most likely he had metabolic and mitochondria dysfunction. His multiple myeloma (malignant bone marrow plasma cells) might not have allowed the vaccine to produce the proper antibodies to the spike protein in the vaccine. And his weakened immune system might not have allowed him to generate enough effective T Cell activity against the virus.

In January 2021 (Blood Cancer Discovery) and in April 2021 (HemOnc), it was reported that bone marrow cancer patients had a compromised immunity from the vaccines because of the inability to produce the functional and critical antibodies to fight the virus. And typical bone marrow cancer patients have a severely depressed immune system in general. In an article published on 10/28/21 in JAMA Oncology, investigators discussed COVID-19 Mortality and Adverse Outcomes in US Patients With or Without Cancer.

This newly discovered science has definite consequences and ramifications for me. While bone marrow cancers greatly compromise the all-important immune system, my efforts to recreate the strength of my immune system using my Unconventional Cancer Protocols potentially have given me a positive edge.

As the real science unfolds, more and more will be learned about the innate and adaptive immune system, natural immunity, and vaccines.

 

My Next Steps

As I have said, my enhanced immune system from my Unconventional Cancer Protocols may have been able to deal successfully with the viral infection at home – no hospitalization and no other meds. The goal of my Protocols has always been to recreate a robust immune system.

After the initial COVID symptoms resolved somewhat, I had symptoms of Long-Haulers COVID for a few weeks with generalized but consistent body aches and an annoying dry cough. I know that my immune system is dealing with these symptoms slowly but effectively.

I am relieved with this interpretation because it makes sense to me. And I anticipate recovering well. Today, I’m still a little tired. But the cough from the Long-Haulers is completely gone.

However, I am not in denial of the cancer in my body and what it might do to me in the future. I also know that I most likely will never go into remission. My primary goals are to continue to lead a productive life and to live a quality of life! (I’m going to keep writing and publishing until I can’t. Be Warned!!)

In my case, I have used a shotgun approach to build up my immune system. I am not able to force my plasma cells to become healthy and create all the necessary antibodies it was designed to create. I don’t have, and never have claimed to have, a cure for cancer. But the human body is an amazing machine. There are many additional pathways and methods by which the immune system can attempt to heal.

My course of treatment is to return to my immunotherapy with monthly Darzalex injections. And of course, I’m continuing to be aggressive with my Unconventional Cancer Protocols. They include 10 integrated Protocols I have researched and follow. I tweak them on a regular basis as is necessary. Some may be more important than others, but the sum of them together are more powerful than each on its own.

I’m also adding another whole-food product in significant quantity that has had very interesting research in assisting gut healing, reduction of inflammation, proper bone metabolism, and possibly the reduction of various cancers. It is Bovine Colostrum. I will write a dedicated Blog about this and post it next week. After my research, my “go-to” bovine colostrum is Colostrum-6. I eat it every day.

In the future, I look forward to a negative PET Scan as I had in May 2020. A negative PET Scan of multiple myeloma does not mean remission. But it is a good sign of moving in a positive direction.

And of course, I will continue to be transparent. It is important to me to share my ups and downs will all others who have fears and concerns as I have had.

 

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I’ve Gotta Get Used to WHAT?
– 7 Critical Steps to Get Healthy –
 

Dr. Al Danenberg Nutritional Periodontist

July 20, 2020 [printfriendly]

 

 

 

 

I was listening to the news the other day. Many of my friends suggested that tuning into the TV news channels was the first thing I did wrong. And I get them. So much stress and hatred and divisiveness out there in our precious “Land of the Free and Home of the Brave”!

 

So, I was told from my television set that I’ve “gotta” get used to living with COVID-19. That includes all of us in the US. What the hell?

 

I’m not stupid. I’m a realist. But to get used to this pandemic as if it will be our buddy? Well, it may be our buddy if you think of it as a wakeup call to get our internal health into better shape.

 

First of all, one of the problems with our civilized society is that “we are told to get used to something that is not pleasant and not wanted”.

 

Second, we need to understand that we can start proactive and personal efforts to strengthen our body to fight this “killer”. No one will do this for us. Not the government. Not the health insurance industry. And not manmade chemicals.

 

For the most part, all of these attempts might be applied with the greatest and most admirable intentions. However, real health can occur only by strengthening our immune system naturally.

 

Fortunately, we are Free to make decisions for ourselves. And we are Brave to make these decisions based on our DNA blueprint, our food supply, and our lifestyles.

 

 

DNA Blueprint

All humans share approximately 99.9% of the same genetic code or blueprint.[1] The other 0.1% make you “who you are” and me “who I am”. What’s fascinating is that our genetic blueprint knows exactly what it requires to keep us alive and thriving. Our DNA blueprint also knows what it can’t tolerate.

 

At one extreme, our DNA requires us to drink, to breathe, and to consume certain nutrients to carry out our daily biological functions.

 

At the other extreme of the pendulum, our DNA knows what it cannot endure without killing us. For example, our DNA code cannot handle poisons or constant irritants to our body that cause continuous inflammation. In between these extremes, our DNA can deal with almost everything.

 

Obviously, we wouldn’t prevent our body from getting water to drink, air to breathe, or food to eat. Yet we keep insulting our body at the other extreme with chemicals and irritants that damage our body, which our DNA blueprint has no means to remove or neutralize.

 

More specifically, most of us continue to eat certain foods that tear into our gut like a splinter that keeps stabbing our finger in the same puncture wound. Our DNA blueprint cannot save us from these constant insults time after time. Are we either too ignorant to stop these insults or too stupid to ignore the consequences until it is too late?

 

You can’t fool mother nature. Just give your body what it needs and avoid what it never evolved to tolerate. To me, this is so simple. Why doesn’t our society get it? Doing this will improve the most important power we have to fight external invaders to our body – our immune system.

 

 

Immune System

I’ve spoken about our immune system and living in a petri dish in past Blog articles.  I want to review the immune system in simple terms and to reemphasize the steps to take to get our body into the marvelous healing machine that it was designed to be. An all-encompassing intelligent power has created our body to be self-sufficient, protective, and reparative.

 

We deal with infections and remain healthy based on the strength of our immune system. It is a complex biological process that identifies any invader to the body, mounts an appropriate defense, rids the body of that pathogen, and remembers that individual attacker if it attempts to invade us in the future.

 

The immune system is our “biological armed forces”. The method of action to mobilize these “armed forces” is fascinating, complex, yet not completely understood. What we know is this: the mucous membranes; a healthy, intact gut; and a nutrient-dense, anti-inflammatory diet are the principal actors as this drama plays out.

 

 

Communication

The immune system takes its cues from the gut microbiome, which lies on the mucous layer of its mucous membrane.

 

The “mucous membrane” lines the body cavities and tubular organs including the gut and respiratory passages. It’s an epithelial barrier that secretes a protective mucous layer. The mucous membrane makes up about 4,300 square feet in the human body. That’s like the square footage of a large home.

 

Approximately 38 trillion microbes cover the mucous membranes. The far majority of these living organisms are in the gut. In the gut, the microbiome is several layers thick. And this ocean of microbes talks between themselves and among all the other microbes located on all other mucous membranes in the body. It’s like a huge communication network that alerts the entire population of microbes to what’s happening on their turf simultaneously.

 

Practically all pathogens and irritants that enter the body must pass through the mucous membranes. The microbiome sitting on the mucous membranes becomes aware that there may be strangers in its midst. The friendly microbes have a unique and critically important role to play. They are the neighborhood watch group. They signal the immune cells in the epithelial barrier that there is something foreign that has just invaded and needs to be eliminated.

 

The gut microbiome and its mucous membrane are the central command center for the entire body. About 70-80% of the body’s immune system is located in the epithelium of the mucous membrane of the gut. When there is an invader anywhere in the body, the microbiome associated with its local mucous membrane relays messages to the gut microbiome. Then, the gut microbiome alerts the gut immune system that there is a pathogen or toxic element that needs to be removed. Effects from the gut immune system travel to all corners of the rest of the body directing all areas to react to the invasion.

 

The beneficial microbiome also communicates with the immune cells located in the lymph tissues throughout the body. All immune cells become involved with the fight to remove the invaders. This communication system rivals the most complex systems created by man. The human body is an amazing machine operating beyond comprehension.

 

There also are complex feedback loops to temper the immune system’s fight and eventually bring it back to a non-inflammatory state.

 

 

7 Critical Steps to Get Healthy

Be respective of your DNA blueprint. Give your body what it needs and avoid whatever it doesn’t want. This way, you will strengthen your immune system.

 

As I explained, our immune system is critical for fighting infections and maintaining overall wellness. This includes oral health. Boosting your immune system is the best and least expensive medical insurance you could “buy”. If you reinvigorated your immune system, think how much less you would have to spend on medical as well as dental care. To do this, you need to be proactive and start ASAP:

 

1. Consume nutrient-dense, anti-inflammatory foods. Various ways of healthy eating provide necessary nutrients while avoiding over-processed carbohydrates, added sugars, unhealthy fats, chemical ingredients, and other irritants to the gut. I have created Al’s Better Belly Blueprint to be a source of healthy eating.

 

Subscribe HERE for my new weekly newsletter called, “Belly Bites with Dr. Al”.  This newsletter will have a link to my new Blog post, discuss stuff I’m doing and recommending, and relate how I am progressing with my Unique Cancer Journey. As an extra added bonus, I’ll send you the PDF of the new launce of my Dr. Al’s Better Belly Blueprint.

 

2. Maintain a healthy gut. Consume specific probiotics, prebiotics, amino acids, and immunoglobulins to (1) improve the population and quality of the gut bacteria, (2) restore a healthy mucosal layer, and (3) repair damage to the epithelial gut barrier.[2],[3] Dr. Al’s Better Belly Blueprint includes a specific spore-based probiotic to help this happen.

 

3. Sleep restoratively. Sleep about 7-8 hours a night starting between the hours of 9 PM to 11 PM. Make the room dark, cool, and quiet.

 

4. Exercise efficiently. This includes a combination of (1) some aerobic exercise a few days a week, (2) brief, high-intensity interval training 1 day a week, (3) strength training 1-2 days a week, and (4) non-exercise movements during the course of every day.

 

5. Reduce stress. Meditate; practice yoga; try diaphragmatic breathing; and experiment with progressive, total body muscle relaxation. Emotional stress will damage the gut microbiome and cause “leaky gut”, which will lead to significant and ongoing chronic systemic inflammation. This will tax the immune system to the extent that the immune system will be compromised and unable to mount an aggressive attack when needed to destroy serious invading pathogens.

 

6. Get out in the sun. Sun exposure creates Vitamin D in your body. This vitamin regulates the body’s absorption of calcium and phosphorus and facilitates normal immune system function. It also improves your resistance against certain diseases. For a short period of time daily, try to expose as much of your skin to the sun based on your skin type, the time of day, the season, and your geographical location. Your blood level goal for “25 Hydroxy Vitamin D test” is about 40-60 ng/ml. Toxicity usually does not occur until the blood level is above 150-200 ng/ml. If you can’t get adequate Vitamin D from sun exposure and food, then consider taking supplements of Vitamin D3 along with Vitamin K2. Other minerals and vitamins are required for proper biological functions of Vitamin D. These are available from a nutrient-dense, anti-inflammatory diet.

 

7. Practice effective oral hygiene. Your gut bacteria and your mouth bacteria “talk” back and forth. Make sure you brush your teeth at the gum margins, floss and clean the surfaces between each of your teeth, and scrape the topside of your tongue to remove odor forming bacteria and microscopic food remnants. Have your biological dentist examine your mouth for any hidden areas of infection in the gums or the bone. Any infection in your mouth will continuously weaken your immune system.

 

If COVID-19 does anything for us, it should be to kick our butts into the recognition of how unhealthy we are. I am here if you need me. You could schedule a 50-minute Virtual consult with me to go into a more in-depth and specific discussion. Here is a link to my website to book it:

 

[1] https://www.genome.gov/about-genomics/fact-sheets/Genetics-vs-Genomics

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561432/

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6733369/

COVID-19
– A Lesson Learned –

Dr. Al Danenberg Nutritional Periodontist

June 8, 2020 [printfriendly]

 

 

 

COVID-19: A Lesson Learned

 

There is nothing good that I can say about the COVID-19 virus, its resulting pandemic, or the severe toll it has taken on lives and the economy. But there is an important lesson that may come out of this horrific time in our lives.

 

The lesson is revealing and basic. It is the condition in which we find ourselves. It is the reality that we are not a healthy society. The fact is that our immune system has been deficient to fight this virus and take it down.

 

What’s going on?

 

 

The Reality

Three examples of our underlying health concerns come from The Centers for Disease Control and Prevention (CDC). Statistics gathered show 60% of US adults have a chronic disease[1]; 70% of American deaths is caused by a chronic disease[2]; and 72% of our population is overweight.[3] The events of COVID-19 painfully and abruptly have shown medical professionals and the general public that we must take proactive measures to assure a healthier body going forward. A physiologically unhealthy body cannot fight infections. An unhealthy body will continue to succumb to viruses and other pathogens.

 

We have become aware that underlying health conditions are mostly a result of poor lifestyle choices and indulgent dietary habits. If we want to honor longevity and secure a future without chronic disease, then we must make changes. We must become educated about what to do. We must become proactive in our own health. We must be taught about healthier lifestyle choices and foods to eat as well as not to eat. The government won’t do it; pills won’t do it; improved insurance coverage won’t do it.

 

And so, this opens up an opportunity for the biological dentist. He or she is the perfect medical professional to start the ball rolling. Why?

 

 

Role of Biological Dentists

I’ve talked about biological dentistry in the past (HERE. HERE.) Dentists obviously focus on the mouth. Biological dentists comprehend the importance of a strong immune system for oral health and overall wellbeing. Well-educated dentists understand that nutrition is critical for cells to function properly. They know that every cell in the body can communicate with every other cell in the body. Biologically-trained dentists realize that the mouth is a mirror of systemic health as well as systemic disease. Since dentists see many of their patients a couple of times a year, they have the continuous opportunity to monitor a patient’s overall health and influence their patients’ self-care.

 

 

Immune System

About 70-80% of our immune system resides in our gut. The cells of the immune system and the gut bacteria regulate and support one another. If the garden of healthy gut bacteria becomes overgrown with harmful bacteria, then the interplay between the gut bacteria and the immune system can become severely compromised. In addition, if the gut barrier membrane becomes damaged, unhealthy toxic substances will leak out from the gut lumen into the blood system (i.e. leaky gut). The toxic reaction in the bloodstream is called metabolic endotoxemia, which then leads to chronic system inflammation. This spread of inflammation throughout the body via the circulatory system could lead to the manifestation of various chronic and autoimmune diseases. An unhealthy gut, a compromised immune system, and systemic inflammation will cause disease and other changes in the mouth.

 

The mouth is the entrance for nutrients to get into our body. And proper nutrition and lifestyle changes can repair an unhealthy gut and improve the functions of the immune system. Biological dentists may be the first healthcare professionals to visualize and diagnose problems in the mouth and enter into a discussion about the methods to improve a patient’s immune system. Uniquely, biological dentists are in a position to repair the damage to the mouth. Also, they can refer patients to other medical professionals when necessary to treat various remote health problems manifesting in the mouth.

 

To start off, biological dentists can evaluate a person’s diet by interpreting his or her 3-Day Food Journal. They can learn about a patient’s current lifestyle choices by taking a complete medical and dental history. The dentist is ideally situated to gather all these facts and begin to suggest lifestyle changes and dietary changes to enhance the immune system.

 

The IABDM (International Academy of Biological Dentistry and Medicine) offers an online program for dentists to become a Certified Biological Nutritional Dental Professional. The program details the natural methods to improve an ailing and dysfunctional immune system.

 

 

Economic Changes

Interestingly, COVID-19 also has created positive changes in the economic and investment world. Investors are switching their attention from what was previously considered important to what is truly important – human health. An article in MarketWatch on June 1, 2020 stated that there will be a distinct emphasis on preventive medicine and specifically the methods to strengthen the performance of the human immune system.

 

Longevity and quality of life are becoming the focus in the biotech space. And individuals cannot live long if not properly protected from pandemic threats. A strengthened immune system may be able to fight and neutralize diseases early. An immune system functioning at peak performance can increase the quality of life and prevent debilitating chronic diseases. There is even a specialty investment fund focused on the longevity industry.

 

So, it is compelling that the investment world is emphasizing a means to boost the immune system moving forward.

 

 

Summary

As patients become educated about health, longevity, and a robust immune system, they will demand healthcare professionals to guide them in their decisions. A properly trained biological dentist is the ideal health professional to have an in-depth conversation with the patient to help achieve these goals. The biological dentist understands the interrelationships between the mouth and the rest of the body. Biological dentists can assist patients with developing a healthy diet, a healthy gut, a healthy lifestyle, and a healthy immune system. All will lead to a healthy mouth, which is the purview of the biological dentist.

 

 

[1] https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm

[2] https://cmcd.sph.umich.edu/about/about-chronic-disease/

[3] https://www.cdc.gov/nchs/fastats/obesity-overweight.htm

 

 

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COVID-19, Gum Disease, & Diet

Dr. Al Danenberg Nutritional Periodontist

May 18, 2020 [printfriendly]

 

 

You might be scratching your head and asking yourself, “What is he talking about? Is he just trying to catch my attention? Maybe even confuse me?”

 

Well, I’m talking about the correlation between COVID-19, Gum Disease, and Diet. That connection is our immune system. And yes, I want your attention so I can share my thoughts about this association, your overall health, and your well-being. I certainly don’t want to confuse you.

 

 

COVID-19

New research is suggesting that the COVID-19 virus could be life-threatening by initially damaging red blood cells[1] and causing hypoxia[2]. The theory goes like this:

 

  • The virus attacks red blood cells by attaching to the iron portion of its hemoglobin.
  • The virus oxidizes the iron and releases it into the bloodstream.
  • Then, the COVID-19 virus replaces the iron with itself in the red blood cell.
  • The virus controls the red blood cell, which now is unable to carry necessary oxygen to other cells and organ systems. This results in hypoxia.
  • The oxidized iron pours into the bloodstream causing severe oxidative stress, which causes systemic inflammation initiated by the immune system.
  • Zinc in the body mobilizes itself to offset the damage from the free-floating oxidized iron thereby depleting the body of its necessary levels of zinc. This can cause a loss of smell and taste among other effects.
  • The oxidative stress from excessive iron, severe systemic inflammation as a result of the immune system’s overproduction of inflammatory chemicals (cytokines), and hypoxia can cause the lungs and other organs to fail, possibly leading to death from COVID-19.

 

 

This is just a theory. So much is being learned about the virus day by day. But this theory makes sense. It could result in the clinical signs and symptoms of this pandemic that are being observed and documented throughout the world.[3]

 

 

Gum Disease

The gum tissues in your mouth are susceptible to chronic systemic inflammation. The oxidative stress occurring from an excess of unhealthy oxidized iron causes the immune system to create acute and chronic systemic inflammation. These physiological changes cause dysfunction in the immune system – especially if the immune system was already weakened or dysfunctional from emotional stress, environmental toxic substances, an unhealthy gut, or poor diet choices.

 

Active gum disease will increase as the immune system fails to control the overgrowth of harmful bacteria in the mouth. Periodontal infection will release virulent bacteria and inflammatory elements into the bloodstream complicating the already spreading systemic inflammation. Inflamed and bleeding gums will increase the potential for increasingly destructive forces occurring from the COVID virus.

 

 

Diet

A diet including inflammatory foods and lacking nutrient-dense foods will damage the gut’s garden of bacteria, its mucous layer, and its epithelial barrier. The result will be the leakage of toxic substances into the bloodstream from the lumen of the gut. The immune system attempts to gobble up these toxic substances by releasing various chemicals and cells to fight the invasion. These immune system actions create inflammation that spreads throughout the circulatory system to all organ systems. However, if you have periodontal disease and if the COVID-19 virus is present, then your immune system already could be overwhelmed.

 

 

Vicious Cycle

A weakened immune system, active periodontal disease, and unhealthy food choices continue to promote chronic systemic inflammation. If COVID-19 invades the body, the existing chronic systemic inflammation will exacerbate the potential virulence of the virus.

 

So, there could be a vicious cycle escalating exponentially.

 

Fortunately, the far majority of infected people will not succumb to death. Their body’s immune system will overcome the virus at a point where the virus is inactivated by the antibodies that are naturally produced by the adaptive immune system. Other negative feedback pathways will go into effect and reduce the immune system’s production of inflammatory chemicals. But there are proactive precautions that uninfected individuals could take to enhance their immune system.

 

I’ve talked about how to improve the immune system in previous blogs – especially HERE. But in summary, a nutrient-dense, anti-inflammatory diet along with lifestyle changes will enhance the health of the gut and provide the immune system with many of the necessary ingredients to defend your body.

 

Supplements of vitamin C, vitamin D, glutathione, and zinc have been suggested to help prevent or possibly treat COVID-19 infection. However, along with lifestyle changes, the nutrient-dense, anti-inflammatory diets I have recommended will provide most of these nutrients in their natural states as they exist in real, unprocessed foods.

 

Medical research will come up with an adequate treatment protocol to deal with the acute and life-threatening manifestations of the COVID-19 virus. Scientists also may develop an effective vaccine or an array of vaccines to protect people prior to the invasion of the COVID-19 virus. But your proactive efforts to support your immune system will also help with fighting the virus, preventing periodontal disease, and avoiding other chronic diseases. A healthy immune system will go a long way in maintaining your well-being.

 

 

[1] https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173

[2] https://www.hemob.org/covid19-news/2020/4/8/coronavirus-pneumonia-and-hydroxychloroquine

[3] https://www.jillcarnahan.com/2020/04/16/emerging-theories-that-may-help-us-solve-the-covid-19-puzzle/

 

 

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The Stress of COVID-19
and its consequences

Dr. Al Danenberg Nutritional Periodontist

April 13, 2020 [printfriendly]

 

Stress of COVID-19Stress!

 

You can’t see it or touch it or smell it. But it’s all around us.

 

Everyone talks about it and experiences it.

 

Life in our modern world seems to create it. Or maybe we are creating it for ourselves.

 

But then came COVID-19, and it blew all of us away!!

 

 

COVID-19’s Effects

I don’t have to tell you about the stress we have endured during this pandemic. COVID-19 has changed all of our lives abruptly and severely. Sadly, a number of us have gotten sick; many of us have lost jobs or businesses; a few have died. The emotional trauma of these bombshells is taking its toll. I’m not sure if life will ever be the same as it was before the virus raised its ugly head and spread like a raging hurricane.

 

The psychological ramifications are yet to be realized. So many of us have feelings of desperation and are demoralized. Those that are demoralized feel that no matter what they do and how hard they work will make no difference. They are falling into the abyss of depression and feelings of worthlessness.

 

 

Stress and the Gut

You may not realize it, but stress affects your gut, your immune system, and your brain. Especially if the stress is continuous and seems to have no end. The consequences could be subtle or might create significant and immediate effects. Or, it may affect our body months or years later manifesting as one of many types of chronic diseases. The pathway to tragic illnesses is pretty amazing and probably will surprise you.

 

Emotional stress can lead to changes in the intestinal wall by opening up spaces between the cells of the epithelial barrier. This is a natural process that allows additional water, sodium, and glucose to get into the blood system. Your body needs these to assist in the chemical changes induced by stress. When short bouts of stress are resolved, then the holes in this gut barrier return to normal. However, significantly increased stress from financial and social disruptions caused by COVID-19 can last a long time. No one knows how long these stresses will endure. What is certain is that chronic, overwhelming stress will induce serious problems. The resulting damage to the gut epithelial barrier will allow the continuous leakage into the blood system of harmful substances from the gut lumen – especially lipopolysaccharides (LPS).

 

 

Endotoxemia Causes Chronic Disease

LPS (which is an endotoxin) is the outer cell wall of dead gram-negative gut bacteria that is highly toxic. Endotoxemia is a disease where large amounts of lipopolysaccharides leak into the bloodstream continuously and course throughout the body. The immune system initially overreacts to excessive and continuous LPS causing a cascade of highly inflammatory chemicals. The immune system may settle down but will still produce inflammatory chemicals as long as the source of emotional stress is still present. The overall result is chronic inflammation circulating to all cells and organ systems. Ultimately, debilitating chronic diseases could manifest.

 

Some of the chronic diseases include depression, chronic fatigue syndrome, chronic heart failure, type 2 diabetes, autism, non-alcoholic fatty liver disease (NAFLD), inflammatory bowel disease (IBD), asthma, and dental diseases including periodontal disease and tooth decay. The immune system also may begin destroying normal human cells causing autoimmune diseases like type 1 diabetes, rheumatoid arthritis, and multiple sclerosis.

 

The Centers for Disease Control (CDC) has reported that chronic diseases are responsible for 70% of all deaths in the US.[1] For the most part, these chronic diseases originate from low-grade, systemic, chronic inflammation originating in the gut.

 

In addition to the “leaky” gut as a result of continuous stress, poor diet and unhealthy lifestyle choices can create a “leaky” gut.

 

Poor food and lifestyle choices will cause chemical changes in that gut that promote the overgrowth of pathogenic bacteria. The unhealthy change in the bacteria of the gut is called dysbiosis. Pathogenic species cause a breakdown in the protective mucosal layer as well as the epithelial barrier of the gut. Dysbiosis causes the immune system to produce inflammatory chemicals. Once toxic substances from the gut leak into the circulatory system, the immune system goes into high gear. It creates a cascade of inflammatory chemicals, which flood all the pathways leading from the gut to the rest of the body.

 

So, the emotional stress produced by COVID-19 along with dysbiosis in the gut are powerful ingredients directing the body to go into a prolonged tailspin leading to disastrous outcomes.

 

Resolving Stress

I have written several articles about dealing with stress and have published these Blogs on my website. Here are three that you might find interesting and helpful: HERE, HERE, HERE.

 

 

Resolving Endotoxemia

A double-blind randomized controlled trial was published in 2017[2]. The investigators showed how a supplement containing spore-based probiotics could heal a damaged gut lining and resolve endotoxemia.

 

Brian McFarlin and his researchers selected 28 participants whose blood tests demonstrated significant endotoxemia after consuming a high-fat, high-carbohydrate meal. This select group of individuals were divided into two groups. Both groups took two capsules of a daily supplement for four weeks. One group took placebo capsules, and the other took capsules containing five different spore-based bacillus probiotics. At the end of the trial, participants ate another high-fat, high-carbohydrate meal. Their blood was tested before the meal and then retested after the meal. Five hours after the meal, the results showed an average decrease of endotoxemia of 42% in the group taking the probiotic capsules. However, the group taking the placebo actually had a 36% increase in endotoxemia. The authors suggested that the positive results might be improved significantly if the probiotics were taken for several more months. Also, the overall results probably would be significantly more effective if the participants were eating nutrient-dense, anti-inflammatory foods rather than high carbohydrate, processed foods.

 

 

My Personal Experience

I am only one of billions of people dealing with the stress caused by COVID-19. I also am one of those in the high-risk group because of my age (73 years old) and my underlying health condition (incurable bone marrow cancer which I am successfully treating unconventionally). The stress from lifestyle changes caused by COVID-19 is as real for me as for everyone. Knowing about stress and dealing with stress are two different things.

 

I try to destress using some of the methods I described in my article I referred to earlier. And I also help heal my body from endotoxemia by following my daily Protocol to Restore Normal Gut Bacteria. Part of my Protocol consists of the spore-based bacilli probiotics that were investigated in Brian McFarlin’s peer-review study which I referenced above[3].

 

I am trying to do my part to do what I can do for myself and to share what I know with all my readers.

 

[1] https://www.apha.org/~/media/files/pdf/factsheets/chronicdiseasefact_final.ashx

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561432/

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561432/

 

 

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The Cure for COVID-19
Hear Me Out

Dr. Al Danenberg Nutritional Periodontist

April 6, 2020 [printfriendly]

 

Cure for COVID-19

 

The entire world, and specifically our government, is moving in a direction that will never address the real problem of COVID-19! Hear me out. I know it sounds like I am “off my rocker”. However, I’m talking about what our body really needs. This is a wakeup call!

 

  • Yes, I agree that it is critical to treat the acute infection.
  • And yes, I agree that this will save lives that would be lost.
  • And surely, pharmaceuticals may be the only means to accomplish this.

 

But what happens when the next pandemic or whatever horrendous invisible microbe strikes again in the future? A real cure must be all-encompassing and basic.

 

 

Mother Nature

Do you remember the slogan, “It’s not nice to fool Mother Nature”? I’m dating myself, but this was a popular commercial ad on TV in the 1970s for a popular brand of margarine. The idea was that this butter substitute would fool your taste buds into believing it was real butter. It even would fool Mother Nature. Actually, margarine is a product that will cause serious health complications.

 

Along this line, I believe today we think we’re fooling Mother Nature by pretending we’re eating healthy foods and living healthy lifestyles. But we’re not fooling anyone. As a society, we don’t understand that among our most basic needs, we need to consume essential nutrients and avoid toxic substances. The result of our deception has been to gradually weaken our body’s ability to fight infections.

 

Medical science is digging into physiology and pharmaceuticals to create the cure for COVID-19. Money is being poured into the coffers of research to invent and manufacture something to destroy this virus quickly and effectively. Although this treatment may be critical right now, it will not support our most important defense system that fights the fight for our body – our immune system.

 

 

Immune System

Our body is bombarded by millions of invaders 24 hours a day, 7 days a week. Yet, the human body was designed to identify an invader and mount its “armed forces” to kill it. When the immune system is at peak performance, its attack is quick, efficient, and effective. Following the natural attack, these biological warriors leave behind a specific soldier. If the same invader were to get into our body again, this deputized soldier would take over immediately to kill it.

 

To accomplish all this, our complex immune system is divided into two separate forces – the innate immune system and the adaptive immune system.

 

 

Innate Immune System

The innate system is activated quickly whenever a foreign substance is detected in our body.  The defense mechanisms include physical barriers such as skin, chemicals in the blood, and immune system cells that individually attack foreign elements entering the body. The innate immune response is immediately activated by specific chemical properties of the invader, called an antigen.

 

Adaptive Immune System

The adaptive system is an antigen-specific defense mechanism. Once an antigen is detected, processed, and recognized, the adaptive immune system creates an army of immune cells specifically designed to attack that antigen. In addition, a unique and highly effective response by the adaptive immune system is to store “memory” cells for that specific antigen. Memory cells create “immunity” for future attacks from that exact antigen. If our body is attacked again by that invader, memory cells will create an onslaught of antibodies that will go to work against that antigen.

 

 

Immune Compromised

Sadly, the far majority of us are immune compromised! That means that we can’t mount a strong and efficient immune response to destroy the invaders. How do I know?

 

  • Well, just look at the obesity rate in the US. It’s 42.2% based on CDC statistics.[1] This is a sign of a compromised immune system.
  • Then look at the prevalence of chronic diseases in the US. The CDC has determined that 45% of US adults have at least one chronic disease, and 70% of all deaths are the result of a chronic disease.[2] These are additional signs of a compromised immune system.
  • And then look at how many people take at least one prescription drug or depend on over-the-counter medicines. The CDC states that 48.4% of US adults take at least one prescription drug.[3] Once again, this is a sign of a compromised immune system.

 

 

I submit a major cause of a weakened immune system is our choice of food. Take a look at the typical breakfast: donut, coffee sweetened with sugar, and a glass of orange juice. Then look at the typical lunch: burger on a bun with gooey sauce, salty fries, and a Coke. Or maybe it’s a vegan meal which is devoid of animal products but includes all the other junk. And don’t forget the in-between snacks made up of over-processed carbs, sugar, unhealthy fats, and bunches of chemicals. This eating style has been termed the Standard American Diet (appropriately known as SAD). It is one of the ways we have destroyed our immune system. And so, we continue decimating our immune system slowly – meal after snack after meal.

 

 

The Cure

An all-encompassing and basic cure is not a pill, not a vaccine, or not an expensive therapy created by the medical industry. The ultimate cure is relatively inexpensive but time consuming. It requires us to rebuild and invigorate our immune system so that it will function optimally. My cure is not a quick fix. It requires much more. To get there, an individual must reevaluate his or her diet, lifestyle, sleep, exercise, and stress. And then, changes must occur over time to get the immune system up to speed as it was designed to operate. (I elaborate on these lifestyle changes in my book that was released in 2017 titled Crazy-Good Living.)

 

By the way, boosting our immune system is the best and least expensive medical insurance we could “buy”. If we reinvigorated our immune system, think how much less we as a society would have to spend on medical care. To do this, we need to be proactive and start ASAP:

 

  • Consume nutrient-dense, anti-inflammatory foods. Various ways of healthy eating provide necessary nutrients while avoiding over-processed carbohydrates, added sugars, unhealthy fats, and chemical ingredients. I was eating a Paleo-type Diet for about 6 years before transitioning to the Carnivore Diet on 1/1/20. (I offer my PDFs for transitioning to a Paleo-type Diet as well as transitioning to a Carnivore Diet. Email me at: Dr.Danenberg@iCloud.com.)

 

  • Maintain a healthy gut. A healthy diet and methods to restore the gut’s balance of beneficial bacteria are essential. The gut houses 70% of the cells that make up the immune system. (I’ll send you my Protocol to Restore Normal Gut Bacteria if you email me at: Dr.Danenberg@iCloud.com.)

 

  • Sleep restoratively. Sleep about 7-8 hours a night starting between the hours of 9 PM to 11 PM. Make the room dark, cool, and quiet.

 

  • Exercise efficiently. This includes a combination of (1) some aerobic exercise, (2) brief, high-intensity interval training 1 day a week, (3) strength training 1-2 days a week, and (4) non-exercise movements during the course of every day.

 

  • Reduce stress. Meditate; practice yoga; try diaphragmatic breathing; and experiment with progressive, total body muscle relaxation.

 

  • Get out in the sun. Sun exposure creates Vitamin D in your body. This vitamin regulates the body’s absorption of calcium and phosphorus and facilitates normal immune system function. It also improves your resistance against certain diseases. Try to expose as much of your skin as you can to the sun based on your skin type, the time of day, the season, and your geographical location. Also, specific foods like salmon, sardines, shrimp, and egg yolks provide Vitamin D. If you can’t get adequate sun exposure or can’t eat enough foods that supply vitamin D, then consider taking supplements of Vitamin D3 along with Vitamin K2.

 

  • Practice effective oral hygiene. Your gut bacteria and your mouth bacteria “talk” back and forth. Make sure you brush your teeth at the gum margins, floss and clean the surfaces between each of your teeth, and scrape the topside of your tongue to remove odor forming bacteria and microscopic food remnants. (I’ll send you my protocol for How to Clean Your Mouth if you email me at: Dr.Danenberg@iCloud.com.)

 

My cure is inclusive. It gets us back to basics. Rather than just a Band-Aid or an aspirin tablet, my cure assists the body with overall healing and overall wellness.

 

[1] https://www.cdc.gov/obesity/data/adult.html

[2] https://www.fightchronicdisease.org/sites/default/files/docs/GrowingCrisisofChronicDiseaseintheUSfactsheet_81009.pdf

[3] https://www.cdc.gov/nchs/fastats/drug-use-therapeutic.htm

 

 

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MOVING FORWARD
Life As I Knew It

Dr. Al Danenberg Nutritional Periodontist

March 30, 2020 [printfriendly]

 

Life As I Knew It

 

My Unconventional Cancer Journey is now confronted by the world’s economic, medical, and emotional uncertainty. Life as I knew it is in flux and disarray. And it’s not just me. The pandemic is having worldwide consequences. Apparently, an enormous amount of people feel that things are falling apart all around them. Many are losing or already have lost their jobs. Numerous employers and entrepreneurs are finding their businesses are going under. An abundance of people has stopped spending and may never go back to their extravagant lifestyles. Untold totals of people have serious diseases, which now are complicated by COVID-19. No one knows exactly what is going to happen! Some say they know, but no one knows. Experts are making predictions on a daily basis but continue to change their opinions minute by minute.

 

 

Take a Deep Breath

Let’s take a deep breath.

 

I’ve been there two years ago. But not in the same way.

 

Beginning in 2018 when I learned that I would be dead in just a few months, I knew in an instant that my life had drastically changed. Nothing could be the same. Yes, my world had changed. Yes, I was T-boned by my diagnosis and prognosis. But I didn’t die! I survived and thrived.

 

And now the COVID-19 pandemic is everywhere.

 

 

My Mortality

Since September 19, 2018, I have been living with the reality of my mortality from my incurable bone marrow cancer. I have not been alone. Others have had to deal with their declining health-related issues. My journey may be unique only because I was given 3-6 months to live. I had rejected conventional chemotherapy and embraced an unconventional and more natural method of healing my body. My goal has been to maintain a quality of life – not to live for many years with a progressively degenerating disease.

 

Today, my life is further compromised. I am in the high-risk category for this pandemic virus because of my compromised immune system resulting from multiple myeloma. In addition, I feel the devastation experienced by the world’s population. Once again, I feel like I have been T-boned.

 

 

My Strength

With all the obvious unease and fear, there is an unwavering strength that has worked for me most of the time – attitude. It never was easy. As a matter of fact, it has been downright difficult. I have had rare but severe bouts of depression when my attitude was overcome by irrational fears. Yet I have been able to climb out of this emotional abyss quickly with the help of my pillar-of-strength.

 

Sadly, I entered a state of depression just yesterday. As in the past, my pillar-of-strength came to my rescue. I owe it all to my devoted and rational wife who has been my stabilizing force. When all else has failed for me, she has always been there to help me get my head back into gear.

 

We have been married for almost 51 years. She knows me inside and out. I hope I am there for her as she is there for me when I get into a funk. However, she rarely seems to fall into the hole I have been able to dig for myself. When I play the role of the victim, I can succumb.

 

 

Depression

Yesterday, I was getting overwhelmed. Friends had sent me videos of doomsday predictions by “apparently educated” experts. The TV is ablaze with sensationalism and deadlier and deadlier accounts of our worlds’ invisible disease. I started to feel locked inside my home because of my high-risk category. All of these things took their toll on me yesterday. Then my “victim” personality began to shine. The hole I was digging was growing deeper and darker.

 

But my astute wife got the message immediately. I initially reacted in a very unproductive and negative tone when she started asking me, “What’s wrong?”. I lashed out at her telling her that she did not understand me. Of course, she did understand me better than I understood myself. Fortunately, it didn’t take long for me to get it.

 

We talked about how I turned my life around even after my devastating cancer prognosis. She pointed out all that I have accomplished since 2018. My wife was specific about how I improved my life and the lives of many others who have looked to me for support and inspiration. I told you; she is my pillar-of-strength.

 

 

Productive Home-Time

My wife works full-time for a home medical equipment company specializing in respiratory care. Now, she is working at home. The powers-that-be moved her two computers, corporate telephone, printer, and all the spaghetti of wires from the corporate office to our home and assembled them on top of our kitchen table. Overwhelming! But she and I now are together 24 hours a day, 7 days a week.

 

So, we have begun to share “sheltering-in-place” together. When she takes breaks from her daily job responsibilities, we talk, play a little, watch some TV, try some puzzles, and talk about whatever comes up. Of course, I am constantly writing, giving interviews for podcasts, and providing Skype consultations all around the world. Most people at this point are interested in my unconventional cancer journey and how I am improving my diet and immune system.

 

Physically, I am able to improve my movement, flexibility, and strength. I have been able to do body weight exercises and stretches at home. Also, I have been walking almost a mile outside many days of the week. And my culinary skills have not taken a back seat to this pandemic. Cooking at home for my wife and me has always been fun. She is following a more Paleo-type Diet, and I am strictly on the Carnivore Diet.

 

Our time in the house also has helped my wife and me to be in contact with our adult kids and grandkids via telephone or text messaging. I’m learning more about my grandkids from texting than I have learned from them when things were normal.

 

And so, this pandemic, which seems to be overtaking all of our lives, very well might teach us lessons to survive and thrive. One of the most vital lessons possibly to come out of this disaster is for us to learn that supporting the health of our immune system is paramount. That means providing a nutrient-dense, anti-inflammatory diet; proper hydration; a balanced and supportive gut microbiome; restorative sleep; efficient exercise, and stress reduction.

 

 

From Me to You

I have discussed these pillars of health in my 2017 book, Crazy-Good Living. I also have updated much of the current medical research in my paper I titled, Your Gut is Killing You. As I have told readers in the past, my goal in life now is to give back and pay it forward. I will send you my PDF of Your Gut is Killing You if you send me an email request (Dr.Danenberg@iCloud.com). It’s rather lengthy – over 12,200 words with 261 cited references.

 

 

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Latest COVID-19 Facts

Dr. Al Danenberg Nutritional Periodontist

March 27, 2020 [printfriendly]

 

 

Statistics from around the world have helped to formulate some new and impressive facts about COVID-19. Above all, stay away from people; wash your hands; and don’t touch your mouth, nose, or eyes with your hands. But the newest facts will give you a heads-up going forward.

 

 

Who is at Risk?

Everyone is susceptible to becoming infected – even children and young adults. The population most at risk are the elderly and anyone who has compromised lung function and/or a depressed immune system.

 

Surface Killing of COVID-19

The New England Journal of Medicine has tested how long the virus can remain stable on different kinds of surfaces within a controlled laboratory setting.[1] They found that it was still detectable on copper for up to four hours, on cardboard for up to 24 hours, and on plastic and steel for up to 72 hours.

 

Fortunately, coronaviruses are considered “enveloped viruses”. That means they have minimal self-protection and are one of the easiest types to kill. Therefore, washing your hands after exposure to the virus with soap and water for as little as 20 seconds will kill it. If you can’t wash with soap and water, apply 70% isopropyl alcohol on your hands and rub it in. In addition, spraying surfaces with this alcohol or other disinfecting sprays and letting the surface dry by itself will take care of coronavirus. Again, this virus is easy to kill before it gets into your body.

 

 

Innate Immune System

Your innate immune system is probably the most important mechanism to help your body fight any infection. A healthy person’s immune system will use many different “weapons” to effectively fight any invading pathogens, including invading viruses. Also, specific antibodies (Immunoglobulin G and Immunoglobulin M) will be produced and rushed through the systemic circulation in the battle. Since COVID-19 is a virus, anything that could destroy this virus or prevent a virus from duplicating would help prevent and possibly cure a viral infection.

 

 

LC-Plasma

A specific probiotic is known as Lactococcus lactis subsp. lactis JCM 5805 (i.e. LC-Plasma)[2]. LC-Plasma is a strain of lactic acid bacteria that activates human plasmacytoid dendritic cells (pDCs)[3], which play an important role to fight viral infections. Plasmacytoid dendritic cells produce large amounts of interferons (IFNs) which inhibit viral replication.[4] Also, pDCs activate downstream immune cells (i.e. B Cells, NK Cells, Helper T Cells, Killer T Cells, etc).

 

Studies have shown that a daily 50mg oral dose of heat-killed LC-Plasma cells will have prophylactic effects against viral infections in humans[5],[6],[7],[8],[9],[10] and is safe long-term.[11] These studies show that LC-Plasma metabolites provide benefits against several viruses including rotavirus, dengue, influenza, and the common cold. The metabolites of LC-Plasma are what activates pDCs. It is important to note that NO studies have proven LC-Plasma to be effective against COVID-19. However, LC-Plasma’s mechanism of action to stimulate the innate immune system to kill other viruses is impressive. (Enviromedica just released a spore-based probiotic called TerraFlora Deep Immune. It contains several spore-based probiotics along with 50mg of heat-killed LC-Plasma per daily dose.)

 

 

Diet & Healthy Gut

Another study just published in March 2020 reviewed various investigator’s results concerning the importance of the gut’s microbiome and its epithelial barrier on the immune system’s ability to fight viral infections.[12] As I have described in many of my previous Blogs, a nutrient-dense diet as well as supplements to support a healthy gut are vital to support a healthy and functioning immune system. These critical elements are part of my Unconventional Cancer Protocols, which I’ll send to anyone who wants a copy. (Email me at Dr.Danenberg@iCloud.com if you would like it.)

 

 

Possible Therapies

1 – Didier Raoult, MD, Ph.D, specializes in infectious diseases in France. He and other authors published a study on March 17, 2020.[13] In this study, 36 patients in the hospital with COVID-19 were divided into three groups. There was a control group of 16 patients who did not receive any experimental medications at their request. Another group of 14 patients received hydroxychloroquine (Plaquenil) 250 mg three-times-a-day for 10 days. The other group of 6 patients received Plaquenil 250 mg three-time-a-day for 10 days in addition to azithromycin (Z-Pak) 500 mg on Day 1 and 250 mg for Days 2-5. The results were impressive. At the end of Day 6, only 15% of the control group got better. At the end of Day 6, only 55% of the group receiving Plaquenil got better. But at the end of Day 5, 100% of the group taking both medications got better. I believe this protocol of Plaquenil along with Z-Pak is being investigated currently in New York.

 

2 – There are other drugs and vaccines in the pipeline, but they will take time to go through the necessary trials before being approved as treatment options. One important fact is this: Most recent medical research suggests that COVID-19 is hardly mutating. That is good on two fronts. On one front, if you contracted coronavirus, you most likely will have immunity for an extended period of time – maybe lifetime immunity. On the other front, if a vaccine is developed and released in a year or so for the general population, it most likely will be effective since it would have been created to treat the current strain.

 

3 – An additional treatment option that is being investigated has to do with patients who have had COVID-19 and recovered successfully. The treatment is called “convalescent plasma”.[14] The plasma from patients who have recovered could be infused into patients with active disease. There has been good success with this treatment for other types of viral infections, and the future looks bright for this intervention.

 

4 – Here is a controversial therapy that is undergoing deep study in China – high-dose intravenous (IV) vitamin C infusions.[15] ZhiYong Peng, MD of the Department of Critical Care Medicine at Zhongnan Hospital of Wuhan University recently registered a phase 2 clinical trial to test the efficacy of vitamin C infusions for the treatment of severe acute respiratory infection (SARI) associated with COVID-19. In the study, participants in the experimental group will receive 24 grams of IV vitamin C per day for 7 days. That’s more than 260 times the Daily Value (DV) for vitamin C for adults and children age 4 years old and up, which is 90 mg per day. Richard Cheng MD, PhD, Chinese Edition Editor of the Orthomolecular Medicine News Service, states there are at least three clinical trials in China studying the effects of high-dose IV vitamin C for the treatment of COVID-19. However, you should know that this is a controversial therapy. In this article published in Nutrition in 2019, the authors conclude that there is promise but the science hasn’t proven the benefits of high-dose vitamin C infusions for the critically ill.[16]

 

5 – New evidence is showing that the virus can attach to a specific site on the surface of a cell called angiotensin converting enzyme 2 (ACE2) receptors.[17] ACE2 receptors are present throughout the body.[18] However, they are abundantly present in the cells of the lung, blood vessels, and small intestine. ACE2 receptors are the designated “landing-sites” for ACE hormones, which play a role in constricting blood vessels that in turn raises blood pressure.

 

Once the virus attaches to the ACE2 receptor, it “hijacks” the cell and makes copies of itself. When the virus is done, it kills the cell and spreads. Some people have reported digestive problems as their only symptom before testing positive for COVID-19. The reason is that the virus attached to the ACE2 receptors in the gut.[19] Research is investigating a way to interfere with the virus’s attachment to the ACE2 receptor.

 

 

My Thoughts

We are all in the same storm but in different boats – financially, medically, and emotionally. This coronavirus has disrupted all of our lives. But don’t go to the place where blame is being placed on individuals, individual countries, or political parties. Moving forward, I believe our country and the world are experiencing a wakeup call that eventually will be positive for our future health. All of us must share in the lack of preparedness. Especially, it seems to me that almost no one in the conventional medical community is emphasizing a nutrient-dense anti-inflammatory diet or lifestyle changes to begin to improve our body’s innate immune system. Our innate immune system is critical for preventing this viral disease and improving overall health and wellbeing.

 

As I stated in the beginning of this article, those with a compromised immune system are at a higher risk of contracting COVID-19. Some individuals in this high-risk category are taking prescription medications to reduce ACE hormone. These medications are collectively called ACE inhibitors, which are used to reduce inflammation and blood pressure. It is suggested that ACE inhibitors may increase the availability of ACE2 receptors as landing-targets for the COVID-19 virus.[20] I already described how the coronavirus attaches to the ACE2 receptor to get into the cell. So, if there were more ACE2 receptors available, then there could be an increased risk for this viral infection to manifest.

 

[1] https://www.nejm.org/doi/full/10.1056/NEJMc2004973?query=featured_home

[2] https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1016%2Fj.exger.2018.06.028

[3] https://www.frontiersin.org/articles/10.3389/fimmu.2013.00372/full

[4] https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1016%2Fj.clim.2013.10.007

[5] https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1016%2Fj.clim.2013.10.007

[6] https://www.sciencedirect.com/science/article/abs/pii/S175646461630072X?via%3Dihub

[7] https://www.sciencedirect.com/science/article/abs/pii/S1756464617303274?via%3Dihub

[8] https://www.scirp.org/journal/paperinformation.aspx?paperid=75999

[9] https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1017%2FS0007114515002408

[10] https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1016%2Fj.antiviral.2018.10.020

[11] https://www.scirp.org/journal/paperinformation.aspx?paperid=84287

[12] https://www.ncbi.nlm.nih.gov/pubmed/32164844

[13] https://www.mediterranee-infection.com/wp-content/uploads/2020/03/Hydroxychloroquine_final_DOI_IJAA.pdf

[14] https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30141-9/fulltext

[15] https://www.medicinenet.com/script/main/art.asp?articlekey=228745

[16] https://www.sciencedirect.com/science/article/abs/pii/S0899900718306622?via%3Dihub

[17] https://academic.oup.com/jtm/advance-article/doi/10.1093/jtm/taaa041/5809509

[18] https://www.ncbi.nlm.nih.gov/pubmed/15141377

[19] https://www.gastrojournal.org/article/S0016-5085(20)30281-X/pdf

[20] https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/fulltext

 

 

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