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The Tail Wagging the Dog: Death Categorization Drives Healthcare Decisions

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By World Mercury Project Guest Contributor Joy M. Fritz, posted here with permission.

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I work with doctors, coroners and the local county registrars every day to create death records. It’s what I do for a living and I wanted to share my thoughts on the mortality rates being thrown around on mainstream and social media regarding the influenza epidemic. Please note: This information I am sharing is not limited to influenza reporting, but rather, serves as a case study of how the mortality rate recording system (mal)functions at large.

I am sorry to say that death rates are NOT as simple or as valid as every news broadcaster with perfectly-trained vocal delivery makes them sound, and they are absolutely not the infallible pillar of medical history that the CDC purports.

This failed mechanism in the mortality rate ‘generator’, if you will, is the same for the hotly debated adverse vaccine reactions. This is the reason you see horrible adverse vaccine reactions and deaths being claimed by parents on social media, but no line item for them in national statistics.

An Imperfect System

Our current system for capturing mortality rates can and does provide a mostly uninvestigated and inaccurate picture of what causes a death. The process for creating and registering causes of death for public records is a complicated, convoluted, and politicized one. It is completely open to both ignorance and the manipulations of personal, professional, and governmental interests.

I have come to realize how greatly this reality becomes a public health issue during this current flu season when every major media outlet is providing us with live updates on the accruing death toll. Seeing these reports caused me concern for my family. My husband and I discussed what preventive treatment we might consider. I started reading the FDA package inserts for different flu immunization options to get informed on which might be safest for our infant and six-year-old. What I ultimately wanted to investigate was the risk of death. My kids getting sick is just part of life; other people getting sick is just part of life; lowering the risk of death to my family and the people around me is what I cared about when it came specifically to the seasonal flu.

The process for creating and registering causes of death . . . is completely open to both ignorance and the manipulations of personal, professional, and governmental interests.

I started researching mortality rates to find the line item in the CDC reports for “deaths due to influenza” vs. “adverse reaction to influenza medications and immunizations”. I found influenza rates, no problem. Flu medications and shots? No deaths reported. Awesome. What a simple decision to make! But, being in the mortuary industry and curious about how they get these reports, I looked at the last full report for 2014, dug deeper, and eventually found that they simply code and reorganize the data that they receive from death records—the very death records that I am typing up and registering every day.

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So my head started to explode. And I felt, and still feel, sick. I realized that without being aware of it, I knew exactly how influenza deaths are recorded, and why there was no line item in the CDC’s mortality rates for adverse reactions to common medical treatments.

Before I continue, please know that I will not be explaining all the ins and outs of my job, nor the incredibly rare reality that medication complications and adverse reactions do get captured (usually in box 112 of the death record, not as the primary underlying cause). Those exceptions are made possible by exceptional, and likely, very principled people, choosing individually to go above and beyond the call of protocol, whether that be the family that is aware of the impact of the legal documentation that occurs after death and stays level-headed and involved mere hours after the death of their loved one, or an insanely humble and honest doctor, in conjunction with the coroner medical-legal officer who trusts and cooperates with the honest doctor and vigilant family to think outside the box of their standard procedures. Almost five years and nearly 5,000 death certificates later, I can say with confidence that that kind of post-death communication concoction is at a statistical percentage point that even the CDC would consider insignificant.

What most people don’t know is that doctors are not allowed to attest to anything that is not a strictly NATURAL cause of death.

Core Considerations

So, in the spirit of very uncomfortable truthfulness, I will share a snapshot of the core issues embedded in the daily procedures of creating the death statistics that we so desperately need to make prudent health decisions for ourselves and our families. I will also include some examples of how these core issues would manifest into faulty statistical analysis at the level of our public health and lead to the miscalculation of the benefits and risks surrounding our individual medical choices.

Core Issue A: Doctors who provide causes have not all been trained the same way, and therefore do not provide standardized responses. This may at first glance seem minor, as it always has to me, but this directly affects the cause that the doctor lists on the death certificate. Some doctors prefer listing the underlying cause of death as the recent complications that occurred in the last days or weeks before death, such as pneumonia or influenza, while leaving out the more chronic illnesses that had led to the decline in health. Other doctors decide they will provide the more long-standing health conditions as the cause of death (for instance, diabetes, asthma or congenital abnormality) while leaving out the more immediate illnesses. Some doctors include both the short-term and long-term diagnoses.

Many factors play a role in which approach doctors choose. These include in what capacity the doctor saw the patient (hospital vs. hospice care for example) or the immediate availability of the complete medical record within the time frame being impressed by the mortuary due to upcoming funeral or cremation services, or simply the way the doctor personally prioritizes information. Furthermore, doctors feel limited as to what they can provide for a cause by the professional context in which they saw the patient, as determined by their specialty. For example, a primary care physician might provide a cause of death as “coronary artery disease” since that was what he/she was prescribing medication to the patient for, whereas the patient could simultaneously be being treated for stage four chronic kidney disease and be on dialysis. In this case, rather than the objectively more serious health condition being listed on the death certificate, the health condition that the doctor is most comfortable attesting to is listed. Again, way too many factors to go into in this piece, but the basic issue of the lack of standardization in cause of death diagnosis and reporting remains.

In the case of a patient who dies after contracting influenza, this patient could have all of the above-mentioned conditions on his/her medical record simultaneously, from influenza to asthma, pneumonia, congenital abnormality, coronary artery disease and chronic kidney disease. Any ONE of those conditions listed is correct and valid, and could be entered as a stand-alone cause which would then be registered by me and the local and state registrar’s offices without a query. It’s the doctor’s preference and his medical opinion—yet the national attention given, medical research dollars, and yearly health choices we all make are swayed by whichever cause this particular doctor, with his/her own particular training and personality, decides to jot down on the worksheet and send back to me to enter into the official record.

CORE ISSUE B) What most people don’t know is that doctors are not allowed to attest to anything that is not a strictly NATURAL cause of death. Falls, medication complications or overdoses, causes with the word “injury” in it, anything that is considered an unnatural or external cause is outside the realm of their jurisdiction as far as the death record is concerned. The coroner would need to be contacted and agree to certify or co-certify a death record that has an unnatural or external cause listed. This is a whole other, very complicated reporting issue that I will not get into in this post. I will say, however, from the perspective of a mortuary representative, that everyone involved (doctor, coroner, registrar and myself) understands that the delay caused by any coroner involvement is highly dreaded and avoided if at all possible due to the amplified grief it can cause the family if they do not want an autopsy or investigation done or have to suffer a delay in services and/or an upset in their own personal closure process.

However, the majority of doctors are aware of their own limitation to certify only natural causes of death. And usually in the interest of serving the grieving family, they will provide the simplest natural cause that they know will quickly pass the approval of the local registrar’s office, fulfill their duty as a signing physician, and enable the grieving family to move forward with their scheduled burial or cremation services. It should be noted here that doctors are under an additional pressure since they have a limited time set out by their State Health and Safety Codes to provide causes of death to a funeral home. In California, it is within 15 hours of death, although that is rarely achieved. Delays of more than a few days after death would risk them getting their license reported to the state medical board for lack of compliance.

What Works About This System?

The system is created in such a way that naturally occurring infectious disease (such as influenza) can be and is being reported and recorded in national mortality rates. However, the lack of standardization in the way doctors report it creates an unreliable number to set as the threshold for what constitutes an epidemic.

What Does NOT Work About This system?

It does not report on the true consequential timeline of the patient’s medical treatment, including unnatural and external complications and errors in their medical care and is therefore woefully inadequate as the basis for ANY medical claims or recommendations.

The first example to illustrate the impact of this issue is as follows:

I read a post from a nurse the other day that shared her story of being hospitalized due to complications of the flu. Even though she had gotten the flu shot every year, she had only gotten influenza this year. Five days after experiencing flu symptoms, she went to her medical provider and was prescribed Tamiflu. She went through her course of medication. Her flu symptoms eased but she started getting a tightness in the chest, which further worsened until she needed to be hospitalized for pneumonia and a close call with sepsis. The conclusion of her post—and her medical opinion as a nurse—was that this year’s flu was very dangerous and anyone less healthy than she could have easily died with her symptoms, so she urged everyone to please get the flu shot to prevent the flu from spreading.

The saddest part about reading her story was discovering that she must not have read the Tamiflu manufacturer’s insert, which states that “No influenza vaccine interaction study has been conducted” and “Efficacy of TAMIFLU in patients who begin treatment after 40 hours of symptoms has not been established” and furthermore, “Events reported more frequently in subjects receiving TAMIFLU compared to subjects receiving placebo in prophylaxis studies, and more commonly than in treatment studies, were aches and pains, rhinorrhea, dyspepsia and upper respiratory tract infections.” (emphasis added)

This would lead to an alternate, very feasible medical conclusion that her hospitalization and pneumonia was the result of using a medication that has not been tested on a population of her vaccination status and symptoms duration, which also has the adverse reaction of a URTI.

…the likelihood of influenza causing the death is greater than the medication causing the death because of mortality rates—but they are the ones creating the mortality rates…

But what if someone less healthy than herself with her exact symptoms and medication course HAD died? Her medical opinion, and many other medical care providers’ opinions would have been that it was influenza that had caused the death, instead of the complications of the medication. In the medical provider’s mind, the likelihood of influenza causing the death is greater than the medication causing the death because of mortality rates—but they are the ones creating the mortality rates—so what is considered reasonable likelihood is being created in a closed loop, a regurgitating cycle.

So, whether the attending physician at the hospital was aware of this medical misstep by the other medical provider or not, in this case the hospital physician could simply put “Influenza” on the causes of death worksheet and send it back to me. Influenza would be entered in the death record and be reported in the state and then national database as such with no question from me or the government registrars.

A Public Health Reporting Conundrum

What this has created, then, is a serious public health reporting conundrum. Death due to complications of improperly prescribed medications are NOT being calculated into the national reporting agencies in a real-time setting. Neither would they be communicated in real-time to the public. Instead, people would simply hear of the rising influenza death toll and run for more medication (and likely not be reading the manufacturer’s insert either to verify if they truly are good candidates for that medication).

I have many friends and family in the medical industry and it is easily admitted that legal and personal liability is a factor in the considerations of proper reporting.

In this medication example, as you can imagine, even IF the recorders realize that the medication was prescribed erroneously, it would not be in the professional best interest of the medical provider or medical facility to report this prescription error and its possibly fatal complications to the family or public health officials. I have many friends and family in the medical industry and it is easily admitted that legal and personal liability is a factor in the considerations of proper reporting. However, if and when this possibly fatal prescription misstep was ever reported, it would be in some very passive EMR analysis many months or years later, with no urgency or real-time public health warning. The ability for government to cross-check and minutely examine nearly three million decedent medical records of varying electronic availability—annually—is just not there.

This failed mechanism in the mortality rate “generator”, if you will, is the same for the hotly debated adverse vaccine reactions. This is the reason you see horrible adverse vaccine reactions and deaths being claimed by parents on social media, but no line item for them in national statistics. It is not because they don’t exist or don’t happen. The real-time data reporting system of death recording is not set up to calculate these deaths. The families that become aware of the adverse reactions in time to request investigation (<24 hours after death), and are able to request any relevant pathological specimens to be procured before the burial or cremation of their loved one, would then need to have the time and resources to go through the lengthy reporting and court procedures through the Vaccine Adverse Event Reporting System (VAERS) and the National Vacine Injury Compensation Program (NVICP). A very few families do, and if they can establish enough scientific evidence (like pathology reports) and find and produce enough experts and professional support, they MIGHT eventually get the causes of death amended and compensation for their loss paid out by the allotted government fund. And after five, 10, 15 or 20 years, this passive data capture system might accrue enough statistical information to be reported back to the medical community so that they adjust their recommendations. However, with the HHS claim that only around 1% of vaccine injuries are reported to VAERS, even this may not be realistic.

So, just like in the medication example, any death due to an adverse reaction to the flu shot or for ANY regularly scheduled wellness immunization, would similarly not be captured in the standard process of death recording. As before, the doctor can still provide either influenza or any other natural-occurring immune response as the only cause of death. He would send it to me and I would enter it in, get the state to approve it, and “Voila!”—a thoroughly inaccurate mortality rate reporting. 

Impacting Informed Consent

One of the most difficult realities for me to recognize in examining the mortality rate reporting system that I am a part of, is that the medical community itself is suffering from the ignorance that this kind of circular mortality rate generating system creates. Doctors and coroners are limited by the already existing mortality rates to gauge the likelihood of what caused death. That kind of system can only regurgitate the same causes of death over and over again by forcing its reporters to use the same types of “acceptable” death diagnoses that already exist.

And these are the statistics the medical community uses to educate themselves and provide informed consent to the patient on what the most prudent option is for medical care to safeguard health and prevent death.

And, yes, I will take the opportunity here to say that we can logically apply this critical analysis of the lack of proper data capture to those reluctant to vaccinate or use medications. There is no current national data capture system that records the morbidity or mortality rates of those who choose less medical intervention or choose to not vaccinate themselves or their kids. We don’t know what their life expectancy, quality of life or mortality rate is in our modern day, with the advancements in hygiene, technology and post-disease-diagnosis medical care availability being considered. It could absolutely be worse, statistically, but we wouldn’t know.

For nationally reported statistics, we are left then with bad data on one side, and no control group data on the other. Hardly the recipe for safe or settled scientifically guided medical care.

Now where does that leave you and me? Our highly subjective—yet somehow infallible—weaponry of mortality rates, whether from national statistics or the social media horror stories, has us and all our friends and family swinging the manic flag of “People are dying!”

This flu season, for example, some of our friends are saying, “People are dying from flu! Get vaccinated! Take medication!” while other friends are saying, “People are dying from adverse reactions to medications and shots! Don’t get vaccinated! Drink elderberry!” And we are all running for the nearest remedies that we are sure will help us because of statistics—OR because we don’t see statistics reflecting our lived reality, so we do the best we can to discern our health without statistics.

But I’m the one creating these statistics and I offer you this: If you take one thing away from this, take away a healthier skepticism about even the most accepted mainstream, nationally reported, CDC or other “scientific” statistics. Humans who had no concept of their widespread impact made them. The numbers are not hard—they are very, very fluid. And conversely, have a healthier skepticism about all the alternative remedies we welcome as hopeful scientific-ish options. There is no unbiased, century-long, data capture system set up for these choices either.

As a parent, the most painful part of taking a step back and looking at all this, is having to humbly admit—I don’t know what the right thing to do is.

I don’t have the unbiased data I need to make the safest decision for my children.

I don’t know what the right thing to do is for myself, or for my husband.

I don’t know what side of the fence to stand on in the vaccination and mainstream medicine battlefield, and I don’t want to stand on a side: I just want the unbiased, uncorrupted and standardized data needed to accurately assess the benefits vs. the ultimate risks for my family’s health.

For nationally reported statistics, we are left then with bad data on one side, and no control group data on the other. Hardly the recipe for safe or settled scientifically guided medical care.

A Self-Reporting System

In the face of this fallible data capture system, my own resolution that I am willing to publicly recommend—no matter what medical choices you decide are best—would be:

  • Become self-reporters. Keep a health journal for each family member complete with dates and times and severity of symptoms of illness, and track dates and dosages of any medical treatment administered. Track degree of fevers, severity of migraines, frequency of ear infections, changes of behavior, hospitalizations, medication dosages and immunization combinations, etc.
  • Think critically and ask questions when you see inconsistencies in any health recommendations offered to you or your family. Request and encourage a satisfactory discussion of benefits and risks with your medical provider.
  • Download and thoroughly read the manufacturer’s insert provided on the FDA’s website for any medication or immunization you are considering, and verify that you are a good candidate for that medication. If you decide to use that medical treatment, record any minor reactions in the health journal, immediately report any somewhat severe reactions to your medical provider, and ask for that information to be added to your electronic medical record so that it might inform any future medical provider on your individual contraindications you may have in other medication courses. Remember that each of us is liable for our own health choices; you cannot expect a medical provider to be a perfect assessor of what’s best for you.
  • Follow up and make sure proper reporting was done on the medical provider’s part to the appropriate national databases, or report it yourself:  MedWatch reports for medications and VAERS reports for vaccines. This recommendation is less for you and more for others and for the sake of having the appropriate authorities informed so they can eventually take medical treatments off the market and create the demand for safer ones. Those kind of databases can only function well for the populations they serve if they are being used by everyone.

Yes, people are dying. Each and every day. I do their death records every flu season or surfing season. And try as hard as we do—and no matter how absolutely shredded inside I am, especially when I do an infant or child’s death certificate—we will never eradicate death. We CAN work to slowly eradicate and reform bad systems and misinformation. And even though there is no immediate gratification in it, we will probably save more lives when we work intelligently, truthfully and ethically towards a better future. That usually starts with a lot of humility and admitting that change is needed.

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Long-Term Consequences of Mumps Vaccination: Many Unanswered Questions

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This is Part II of a two-part series on mumps. Part I discussed how mumps vaccination and the flawed mumps component of Merck’s MMR vaccine are fostering dangerous mumps outbreaks in adolescents and young adults.

It has been about five decades since the U.S. Food and Drug Administration (FDA) approved Merck’s first mumps vaccine. The company began launching combination MMR (measles, mumps and rubella) vaccines in the 1970s. Coincidentally—or not—an infertility crisis has been brewing over roughly the same time period, with dramatic declines in sperm counts and record-lowfertility levels. However, few investigators seem interested in assessing whether mumps outbreaks in highly vaccinated populations of teens and young adults could be having long-termeffects on fertility or other health indicators.

As described in Part I, childhood MMR vaccination has been an unmitigated disaster where mumps is concerned, deferring mumps infection to older ages and leaving adolescents and young adults vulnerable to serious reproductive complications. Public health reports show that the vast majority of mumps cases and outbreaks occur in youth who have been fully vaccinatedwith the prescribed two-dose MMR series, supporting a hypothesis of “waning immunity after the second dose.” FDA and Centers for Disease Control and Prevention (CDC) officials even admitthat mumps outbreaks in the post-vaccination era “typically involve young adults,” and that vaccination is failing to protect those who are college-age and above.

Myopically, many vaccine experts have called for a third MMR dose—or even “booster dosing throughout adulthood”—even though the FDA’s and CDC’s own research shows that MMR boosters in college-age youth barely last one year. As alleged in whistleblower lawsuits wending their way through the courts over the past eight years, Merck presented the FDA with a “falsely inflated efficacy rate” for the MMR’s mumps component, using animal antibodies and other fraudulent tactics to fool FDA—and the public—into believing that the vaccine was effective.

When infection arises after puberty, however, mumps is no laughing matter, presenting an increased risk of complications such as hearing loss, encephalitis and inflammation of the reproductive organs.

Mumps after puberty is no laughing matter

Around the time that the first mumps vaccine came on the market, the 1967 children’s classic The Great Brain humorously depicted mumps infection in childhood as a mere nuisance. The book’s young protagonist goes out of his way to intentionally infect himself with mumps so that he can beat his two brothers to the recovery finish line—and he experiences no adverse consequences other than his siblings’ annoyance.

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When infection arises after puberty, however, mumps is no laughing matter, presenting an increased risk of complications such as hearing loss, encephalitis and inflammation of the reproductive organs. About one in three postpubertal men with mumps develops orchitis(inflammation of the testes), which can damage sperm, affect testosterone production and contribute to subfertility and infertility. During a mumps outbreak in England in the mid-2000s, mumps orchitis accounted for 42% of all hospitalized mumps cases; the researchers attributed this outcome—which was the most common reason for hospitalization—to “the high attack rates in adolescents and young adults” that occurred “despite high coverage with two-dose MMR.” An analysis of a 2006 mumps outbreak in the U.S. reported that male patients were over three times more likely than female patients to experience complications, “due primarily to orchitis.”

An estimated 5% to 10% of postpubertal women will develop oophoritis (swelling of the ovaries) following mumps infection. Oophoritis is associated with premature menopause and infertility, but mumps-related oophoritis has garnered little notice.

Mumps infections are often asymptomatic or produce nonspecific symptoms such as fever, while cases of orchitis may present with no other mumps symptoms. Nonetheless, public health officials advise clinicians that orchitis is an instant cue to test for mumps virus, and testing often reveals elevated mumps antibodies. In a case report of MMR failure, British clinicians isolated a novel genetic strain of mumps virus from the patient’s semen two weeks after the onset of orchitis and found mumps RNA in the semen 40 days later; they also noted “the appearance of anti-sperm antibodies,” with “potential long-term adverse effects on the patient’s fertility.”

In 2017, researchers who reviewed 185 studies conducted in Western nations found that sperm counts had plummeted by 50% to 60% between 1973 and 2011—an average decrease of 1.4% annually. Commenting on this work, one analyst estimated that 20% to 30% of young men in Europe and North America have sperm concentrations associated with a reduced ability to father a child. Given estimates that as much as 40% of reproductive problems have to do with the male partner, there is agreement on the importance of “finding and eliminating [the] hidden culprits in the environment” that most researchers believe are to blame.

An estimated 5% to 10% of postpubertal women will develop oophoritis (swelling of the ovaries) following mumps infection. Oophoritis is associated with premature menopause and infertility, but mumps-related oophoritis has garnered little notice.

MMR’s and MMRV’s potential to impair fertility never studied

Merck has not evaluated either of its two MMR vaccines—the MMR-II and the MMR-plus-varicella (MMRV) vaccine—for their potential to impair fertility. Whether such testing would unearth direct effects on fertility (as appears to be possible with HPV vaccination in women) is thus unknown. However, mumps vaccination undeniably increases reproductive-age individuals’ risk of mumps infection and, in the process, increases the risk of fertility-altering complications. These facts alone should be attracting far more attention.

Unfortunately, because clinicians already tend to underdiagnose mumps infection and underestimate mumps complications, it is likely that they are failing to recognize possible vaccine-induced reproductive health consequences of mumps infection in their adolescent and young adult patients. In one university outbreak, “most physicians…did not suspect mumps,” and even when they became aware of the outbreak, “diagnosing mumps was not always straightforward.” Moreover, although differentiating between vaccine strains of mumps virus and wild types could provide valuable information, few clinicians have the capacity or inclination to perform testing of this type. A Japanese study of cerebrospinal fluid and saliva from patients with mumps complications found vaccine strain in nearly all of the samples and noted the information’s importance in helping determine whether the complications were vaccine-related.

Those who have sought to understand mumps vaccines’ poor performance point to a mixture of explanatory factors. These include waning immunity, the high population density and close quarters encountered in settings such as college campuses, incomplete vaccine-induced immunity to wild virus as well as viral evolution such that “the vaccine triggers a less potent reaction against today’s mumps viruses than those of 50 years ago.” However, some also quietly admit that individuals with “mild vaccine-modified disease” could be perpetuating the chain of transmission. This latter point ought to be raising questions about the logic and wisdom of administering further rounds of MMR boosters during outbreaks while ignoring the problems created by the doses already given.

… some individuals respond poorly to mumps vaccination and vaccine-induced antibody levels correlate poorly with protection from mumps infection, irrespective of the number of additional doses of mumps-containing vaccine they receive.

Most scientists appear to be either resigned to ongoing mumps outbreaks in vaccinated populations or actually accept periodic outbreaks as the cost of doing business. Publications by FDA and CDC researchers reveal these agencies’ awareness that some individuals respond poorly to mumps vaccination and that vaccine-induced antibody levels correlate poorly with protection from mumps infection, “irrespective of the number of additional doses of mumps-containing vaccine they receive.” Considering the effects on fertility, the generally abysmal track record of mumps vaccination and Merck’s fraudulent claims about efficacy, it is hard to fathom medical and public health experts’ complacency about current mumps vaccines and vaccine policies.


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Alternative News

Legal Challenge Against Forced Vaccination Filed in New York City

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On April 15, 2019, a legal challenge was filed in the New York State Trial Court by Robert Krakow, Robert F. Kennedy, Jr. and Patricia Finn against the New York City Department of Health and Human Hygiene for their forced Measles-Mumps-Rubella vaccination. The legal team asked for a temporary restraining order against the mandate that the Judge will likely review and provide an ex parte decision. Children’s Health Defense is supporting these efforts.

Last week, Children’s Health Defense reported that the NYC Commissioner of Health declared a public health emergency, ordering all people who live, work or reside in four Brooklyn zip codes to be vaccinated with the Measles-Mumps-Rubella vaccine. Non-compliance with the order is a misdemeanor subject to criminal and civil fines, including imprisonment. Only those with documented immunity, medical contraindications or infants under six months are exempt from the vaccine mandate.

READ THE PETITION
READ THE MEMORANDUM OF LAW
READ THE AFFIRMATION

Sign up for free news and updates from Robert F. Kennedy, Jr. and the Children’s Health Defense. CHD is planning many strategies, including legal, in an effort to defend the health of our children and obtain justice for those already injured. Your support is essential to CHD’s successful mission.

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Awareness

Magnesium Puts Psychiatric Drugs to Shame for Depression

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In Brief

  • The Facts:

    This article was written by Sayer Ji, Founder of Greenmedinfo.com where this article first appeared. Posted here with permission.

  • Reflect On:

    Is the priority of our federal health regulatory agencies and pharmaceutical companies human health, or profit? If there are more effective ways to treat several illnesses, why do they never mention them?

Depression is one of the most widely diagnosed conditions of our time, with over 3 million cases in the U.S. every year, and 350 million believed affected worldwide.1 Conventional medicine considers antidepressant drugs first-line treatments, including the newly approved injected postpartum drug costing $34,000 a treatment, to the tune of a 16 billion dollars in global sales by 2023. Despite their widespread use, these drugs are fraught with a battery of serious side effects, including suicidal ideation and completion — the last two things you would hope to see in a condition that already has suicidality as a co-morbidity. For this reason alone, natural, safe, and effective alternatives are needed more than ever before.

While research into natural alternatives for depression is growing daily — GreenMedInfo.com’s Depression database contains 647 studies on over 100 natural substances that have been studied to prevent or treat depression — it is rare to find quality human clinical research on the topic published in well-respected journals. That’s why a powerful study published in PLOS One titled, “Role of magnesium supplementation in the treatment of depression: A randomized clinical trial,” is so promising. Not only is magnesium safe, affordable, and easily accessible, but according to this recent study, effective in treating mild-to moderate symptoms of depression.

While previous studies have looked at the association between magnesium and depression,2-7 this is the first placebo-controlled clinical study to evaluate whether the use of over-the-counter magnesium chloride (248 mg elemental magnesium a day for 6 weeks) improves symptoms of depression.

The study design was a follows:

“ An open-label, blocked, randomized, cross-over trial was carried out in outpatient primary care clinics on 126 adults (mean age 52; 38% male) diagnosed with and currently experiencing mild-to-moderate symptoms with Patient Health Questionnaire-9 (PHQ-9) scores of 5–19. The intervention was 6 weeks of active treatment (248 mg of elemental magnesium per day) compared to 6 weeks of control (no treatment). Assessments of depression symptoms were completed at bi-weekly phone calls. The primary outcome was the net difference in the change in depression symptoms from baseline to the end of each treatment period. Secondary outcomes included changes in anxiety symptoms as well as adherence to the supplement regimen, appearance of adverse effects, and intention to use magnesium supplements in the future. Between June 2015 and May 2016, 112 participants provided analyzable data.”

The study results were as follows:

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“Consumption of magnesium chloride for 6 weeks resulted in a clinically significant net improvement in PHQ-9 scores of -6.0 points (CI -7.9, -4.2; P<0.001) and net improvement in Generalized Anxiety Disorders-7 scores of -4.5 points (CI -6.6, -2.4; P<0.001). Average adherence was 83% by pill count. The supplements were well tolerated and 61% of participants reported they would use magnesium in the future. Similar effects were observed regardless of age, gender, baseline severity of depression, baseline magnesium level, or use of antidepressant treatments. Effects were observed within two weeks. Magnesium is effective for mild-to-moderate depression in adults. It works quickly and is well tolerated without the need for close monitoring for toxicity.”

 For perspective, conventional antidepressant drugs are considering to generate an “adequate or complete treatment response” with a PHQ-9 score “decrease of 5 points or more from baseline.” At this level of efficacy, their recommended action is: “Do not change treatment; conduct periodic follow-up.” The magnesium’s score of -6.0 therefore represents the height of success within conventional expectations for a complete response, which is sometimes termed “remission.” In contradistinction, conventional antidepressant drugs result in nearly half of patients discontinuing treatment during the first month, usually due to their powerful and sometimes debilitating side effects.8

To summarize the main study outcomes:

  • There was a clinically significant improvement in both Depression and Anxiety scores.
  • 61% of patients reported they would use magnesium in the future.
  • Similar effects occurred across age, gender, severity of depression, baseline magnesium levels, or use of antidepressant treatments.
  • Effects were observed within two weeks.

 The study authors concluded:

“Magnesium is effective for mild-to-moderate depression in adults. It works quickly and is well tolerated without the need for close monitoring for toxicity.”

Beyond Depression: Magnesium’s Many Health Benefits & Where To Source It

Magnesium is a central player in your body’s energy production, as its found within 300 enzymes in the human body, including within the biologically active form of ATP known as MG-ATP. In fact, there have been over 3,751 magnesium binding sites identified within human proteins, indicating that it’s central nutritional importance has been greatly underappreciated.

Research relevant to magnesium has been accumulating for the past 40 years at a steady rate of approximately 2,000 new studies a year. Our database project has indexed well over 100 health benefits of magnesium thus far.  For the sake of brevity, we will address seven key therapeutic applications for magnesium as follows:

  • Fibromyalgia: Not only is magnesium deficiency common in those diagnosed with fibromyalgia, 9,10 but relatively low doses of magnesium (50 mg), combined with malic acid in the form of magnesium malate, has been clinically demonstrated to improve pain and tenderness in those to which it was administered.11
  • Atrial Fibrillation: A number of studies now exist showing that magnesium supplementation reduce atrial fibrillation, either by itself, or in combination with conventional drug agents.12
  • Diabetes, Type 2: Magnesium deficiency is common in type 2 diabetics, at an incidence of 13.5 to 47.7% according to a 2007 study. 13 Research has also shown that type 2 diabetics with peripheral neuropathy and coronary artery disease have lower intracellular magnesium levels. 14 Oral magnesium supplementation has been shown to reduce plasma fasting glucose and raising HDL cholesterol in patients with type 2 diabetes.15 It has also been shown to improve insulin sensitivity and metabolic control in type 2 diabetic subjects.16
  • Premenstrual Syndrome: Magnesium deficiency has been observed in women affected by premenstrual syndrome.17 It is no surprise therefore  that it has been found to alleviate premenstrual symptoms of fluid retention, 18 as well as broadly reducing associated symptoms by approximately 34% in women, aged 18-45, given 250 mg tablets for a 3-month observational period.20 When combined with B6, magnesium supplementation has been found to improve anxiety-related premenstrual symptoms.19
  • Cardiovascular Disease and Mortality: Low serum magnesium concentrations predict cardiovascular and all-cause mortality.21 There are a wide range of ways that magnesium may confer its protective effects. It may act like a calcium channel blocker,22it is hypotensive,23 it is antispasmodic (which may protect against coronary artery spasm),24 and anti-thrombotic.25 Also, the heart muscle cells are exceedingly dense in mitochondria (as high as 100 times more per cell than skeletal muscle), the “powerhouses” of the cell,” which require adequate magnesium to produce ATP via the citric acid cycle.
  • Migraine Disorders: Blood magnesium levels have been found to be significantly lower in those who suffer from migraine attacks.26,27 A recent Journal of Neural Transmission article titled, “Why all migraine patients should be treated with magnesium,” pointed out that routine blood tests do not accurately convey the true body magnesium stores since less than 2% is in the measurable, extracellular space, “67% is in the bone and 31% is located intracellularly.”28The authors argued that since “routine blood tests are not indicative of magnesium status, empiric treatment with at least oral magnesium is warranted in all migraine sufferers.” Indeed, oral magnesium supplementation has been found to reduce the number of headache days in children experiencing frequent migranous headaches,29and when combined with l-carnitine, is effective at reducing migraine frequency in adults, as well.30
  • Aging: While natural aging is a healthy process, accelerated aging has been noted to be a feature of magnesium deficiency,31especially evident in the context of long space-flight missions where low magnesium levels are associated with cardiovascular aging over 10 times faster than occurs on earth.32 Magnesium supplementation has been shown to reverse age-related neuroendocrine and sleep EEG changes in humans.33 One of the possible mechanisms behind magnesium deficiency associated aging is that magnesium is needed to stabilize DNA and promotes DNA replication. It is also involved in healing up of the ends of the chromosomes after they are divided in mitosis.34

 It is quite amazing to consider the afformentioned side benefits of magnesium consumption or supplementation within the context of the well-known side effects of pharmaceutical approaches to symptom

management of disease. On average, conventional drugs have 75 side effects associated with their use, including lethal ones (albeit sometimes rare). When considering magnesium’s many side benefits

and extremely low toxicity, clearly this fundamental mineral intervention (and dietary requirement) puts pharmaceutical approaches to depression to shame.

Best Sources of Magnesium In The Diet

The best source of magnesium is from food, and one way to identify magnesium-containing foods are those which are green, i.e. chlorophyll rich. Chlorophyll, which enable plants to capture solar energy and convert it into metabolic energy, has a magnesium atom at its center. Without magnesium, in fact, plants could not utilize the sun’s light energy.

Magnesium, however, in its elemental form is colorless, and many foods that are not green contain it as well. The point is that when found complexed with food cofactors, it is absorbed and utilized more efficiently than in its elemental form, say, extracted from limestone in the form of magnesium oxide.

 The following foods contain exceptionally high amounts of magnesium. The portions described are 100 grams, or a little over three ounces.

  • Rice bran, crude (781 mg)
  • Seaweed, agar, dried (770 mg)
  • Chives, freeze-dried (640 mg)
  • Spice, coriander leaf, dried (694 mg)
  • Seeds, pumpkin, dried (535 mg)
  • Cocoa, dry powder, unsweetened (499 mg)
  • Spices, basil, dried (422 mg)
  • Seeds, flaxseed (392 mg)
  • Spices, cumin seed (366 mg)
  • Nuts, brazilnuts, dried (376 mg)
  • Parsley, freeze-dried (372 mg)
  • Seeds, sesame meal (346 mg)
  • Nut, almond butter (303 mg)
  • Nuts, cashew nuts, roasted (273 mg)
  • Soy flour, defatted (290 mg)
  • Whey, sweet, dried (176 mg)
  • Bananas, dehydrated (108 mg)
  • Millet, puffed (106 mg)
  • Shallots, freeze-dried (104 mg)
  • Leeks, freeze-dried (156 mg)
  • Fish, salmon, raw (95 mg)
  • Onions, dehydrated flakes (92 mg)
  • Kale, scotch, raw (88 mg)

 Fortunately, for those who need higher doses, or are not inclined to consume magnesium rich foods, there are supplemental forms commonly available on the market. Keep in mind, for those who wish to take advantage of the side benefit of magnesium therapy, namely, its stool softening and laxative properties, magnesium citrate or oxide will provide this additional feature.

For those looking to maximize absorption and bioavailability magnesium glycinate is ideal, as glycine is the smallest amino acid commonly found chelated to magnesium, and therefore highly absorbable.

For more information on natural solutions to resolving depression, download our free e-book on the topic “21st Century Solutions to Depression.” 

References:

1) World Health Organization. Depression fact sheet no. 369 2012 [cited 2016 December 20]. Available from: http://www.who.int/mediacentre/factsheets/fs369/en/.

2) Jacka FN, Overland S, Stewart R, Tell GS, Bjelland I, Mykletun A. Association between magnesium intake and depression and anxiety in community-dwelling adults: the Hordaland Health Study. Aust N Z J Psychiatry. 2009;43(1):45–52. Pmid:19085527.

3) Huang JH, Lu YF, Cheng FC, Lee JN, Tsai LC. Correlation of magnesium intake with metabolic parameters, depression and physical activity in elderly type 2 diabetes patients: a cross-sectional study. Nutrition J. 2012;11(1):41. pmid:22695027; PubMed Central PMCID: PMC3439347.

4) Tarleton EK, Littenberg B. Magnesium intake and depression in adults. J Am Board Fam Med. 2015;28(2):249–56. Pmid:25748766

5) Yary T, Lehto SM, Tolmunen T, Tuomainen T-P, Kauhanen J, Voutilainen S, et al. Dietary magnesium intake and the incidence of depression: a 20-year follow-up study. J Affect Disord. 2016;193:94–8. Pmid:26771950

6) Eby GA, Eby KL. Rapid recovery from major depression using magnesium treatment. Med Hypotheses. 2006;67(2):362–70. pmid:16542786

7) N Engl J Med. 2000 Dec 28;343(26):1942-50. Managing depression in medical outpatients.

8)  Damiano Piovesan, Giuseppe Profiti, Pier Luigi Martelli, Rita Casadio. 3,751 magnesium binding sites have been detected on human proteins. BMC Bioinformatics. 2012 ;13 Suppl 14:S10. Epub 2012 Sep 7. PMID: 23095498

9) G Moorkens, B Manuel y Keenoy, J Vertommen, S Meludu, M Noe, I De Leeuw. Magnesium deficit in a sample of the Belgian population presenting with chronic fatigue. Magnes Res. 1997 Dec;10(4):329-37. PMID: 9513929

10)  J Eisinger, A Plantamura, P A Marie, T Ayavou. Selenium and magnesium status in fibromyalgia. Magnes Res. 1994 Dec;7(3-4):285-8. PMID: 7786692

11)  I J Russell, J E Michalek, J D Flechas, G E Abraham. Treatment of fibromyalgia syndrome with Super Malic: a randomized, double blind, placebo controlled, crossover pilot study. J Rheumatol. 1995 May;22(5):953-8. PMID: 8587088

12) GreenMedInfo.com, Atrial Fibrillation and Magnesium (5 studies)

13)  Phuong-Chi T Pham, Phuong-Mai T Pham, Son V Pham, Jeffrey M Miller, Phuong-Thu T Pham . Hypomagnesemia in patients with type 2 diabetes. Clin J Am Soc Nephrol. 2007 Mar;2(2):366-73. Epub 2007 Jan 3. PMID: 17699436

14)  M de Lordes Lima, T Cruz, J C Pousada, L E Rodrigues, K Barbosa, V Canguçu. The effect of magnesium supplementation in increasing doses on the control of type 2 diabetes. Diabetes Care. 1998 May;21(5):682-6. PMID: 9589224

15) Y Song, K He, E B Levitan, J E Manson, S Liu. Effects of oral magnesium supplementation on glycaemic control in Type 2 diabetes: a meta-analysis of randomized double-blind controlled trials. Cardiovasc Toxicol. 2008;8(3):115-25. Epub 2008 Jul 8. PMID: 16978367

16)  Martha Rodríguez-Morán, Fernando Guerrero-Romero. Oral magnesium supplementation improves insulin sensitivity and metabolic control in type 2 diabetic subjects: a randomized double-blind controlled trial. Diabetes Care. 2003 Apr;26(4):1147-52. PMID: 12663588

17)  F Facchinetti, P Borella, G Sances, L Fioroni, R E Nappi, A R Genazzani. Oral magnesium successfully relieves premenstrual mood changes. Obstet Gynecol. 1991 Aug;78(2):177-81. PMID: 2067759

18)  A F Walker, M C De Souza, M F Vickers, S Abeyasekera, M L Collins, L A Trinca. Magnesium supplementation alleviates premenstrual symptoms of fluid retention. J Womens Health. 1998 Nov;7(9):1157-65. PMID: 9861593

19)  S Quaranta, M A Buscaglia, M G Meroni, E Colombo, S Cella. Pilot study of the efficacy and safety of a modified-release magnesium 250 mg tablet (Sincromag) for the treatment of premenstrual syndrome. Am J Gastroenterol. 2008 Dec;103(12):2972-6. PMID: 17177579

20) M C De Souza, A F Walker, P A Robinson, K Bolland. A synergistic effect of a daily supplement for 1 month of 200 mg magnesium plus 50 mg vitamin B6 for the relief of anxiety-related premenstrual symptoms: a randomized, double-blind, crossover study. J Womens Health Gend Based Med. 2000 Mar;9(2):131-9. PMID: 10746516

21) Thorsten Reffelmann, Till Ittermann, Marcus Dörr, Henry Völzke, Markus Reinthaler, Astrid Petersmann, Stephan B Felix. Low serum magnesium concentrations predict cardiovascular and all-cause mortality. Atherosclerosis. 2011 Jun 12. Epub 2011 Jun 12. PMID: 21703623

22) Andrea Rosanoff, Mildred S Seelig. Comparison of mechanism and functional effects of magnesium and statin pharmaceuticals. J Am Coll Nutr. 2004 Oct;23(5):501S-505S. PMID: 15466951

23)  GreenMedInfo.com, Magnesium’s Hypotensive Properties.

24) GreenMedInfo.com, Magnesium’s Antispasmodic Properties.

25) Joen R Sheu, George Hsiao, Ming Y Shen, Yen M Lee, Mao H Yen . Antithrombotic effects of magnesium sulfate in in vivo experiments. Int J Hematol. 2003 May;77(4):414-9. PMID: 12774935

26) Afshin Samaie, Nabiollah Asghari, Raheb Ghorbani, Jafar Arda. Blood Magnesium levels in migraineurs within and between the headache attacks: a case control study. Pan Afr Med J. 2012 ;11:46. Epub 2012 Mar 15. PMID: 22593782

27) Mahnaz Talebi, Dariush Savadi-Oskouei, Mehdi Farhoudi, Solmaz Mohammadzade, Seyyedjamal Ghaemmaghamihezaveh, Akbar Hasani, Amir Hamdi. Relation between serum magnesium level and migraine attacks. Neurosciences (Riyadh). 2011 Oct ;16(4):320-3. PMID: 21983373

28) Alexander Mauskop, Jasmine Varughese. Why all migraine patients should be treated with magnesium. J Neural Transm. 2012 May ;119(5):575-9. Epub 2012 Mar 18. PMID: 22426836

29)  Fong Wang, Stephen K Van Den Eeden, Lynn M Ackerson, Susan E Salk, Robyn H Reince, Ronald J Elin. Oral magnesium oxide prophylaxis of frequent migrainous headache in children: a randomized, double-blind, placebo-controlled trial. Eur J Endocrinol. 2009 Apr;160(4):611-7. Epub 2009 Jan 29. PMID: 12786918

30) Ali Tarighat Esfanjani, Reza Mahdavi, Mehrangiz Ebrahimi Mameghani, Mahnaz Talebi, Zeinab Nikniaz, Abdolrasool Safaiyan. The effects of magnesium, L-carnitine, and concurrent magnesium-L-carnitine supplementation in migraine prophylaxis. Biol Trace Elem Res. 2012 Dec ;150(1-3):42-8. Epub 2012 Aug 17. PMID: 22895810

31) David W Killilea, Jeanette A M Maier. A connection between magnesium deficiency and aging: new insights from cellular studies. Magnes Res. 2008 Jun;21(2):77-82. PMID: 18705534

32) GreenMedInfo.com, What We Learned From The Accelerated Aging of Astronauts

33) Katja Held, I A Antonijevic, H Künzel, M Uhr, T C Wetter, I C Golly, A Steiger, H Murck. Oral Mg(2+) supplementation reverses age-related neuroendocrine and sleep EEG changes in humans. Pharmacopsychiatry. 2002 Jul;35(4):135-43. PMID: 12163983

34) William J Rowe. Correcting magnesium deficiencies may prolong life. Clin Interv Aging. 2012 ;7:51-4. Epub 2012 Feb 16. PMID: 22379366


Sayer Ji is founder of Greenmedinfo.com, a reviewer at the International Journal of Human Nutrition and Functional Medicine, Co-founder and CEO of Systome Biomed, Vice Chairman of the Board of the National Health Federation, Steering Committee Member of the Global Non-GMO Foundation.


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