Dimension Announces Positive Preclinical Results for an Adeno-Associated Virus Delivery of Factor VIII in Hemophilia Treatment

Dimension Therapeutics recently revealed positive preclinical results from a novel adeno-associated virus (AAV) that delivers Factor VIII as a therapeutic approach for hemophilia A patients. The results were presented in a poster, titled “Optimized AAV-Mediated Human Factor VIII Gene Therapy in Hemophilia A Mice and Cynomolgus Macaques” at the 19th American Society of Gene and Cell Therapy (ASGCT) Annual Meeting, held in Washington, DC, on May 4-7.

Image result for Dimension Announces Positive Preclinical Results for an Adeno-Associated Virus Delivery of Factor VIII in Hemophilia A Treatment

Hemophilia A, also known as factor VIII (FVIII) deficiency, is a genetic disease caused by missing or defective factor VIII, a protein that is involved in clotting processes, estimated to affect 20,000 people in the US alone.

Dimension is a biopharmaceutical company that has been focusing on developing AAV gene therapies for patients with rare diseases associated with the liver. One of their products, DTX201, is designed to deliver FVIII gene expression for long periods, potentially reducing the need for intravenous injections of concentrated recombinant FVIII into hemophilia A patients.

In collaboration with Bayer, Dimension is advancing investigational new drug (IND)-enabling studies for DTX201 in hemophilia A treatment since June 2014, to obtain permission to ship the product to clinical investigators and start Phase 1 clinical trials. Dimension will be responsible for Phase 1/2 clinical trials and developmental activities and, if the treatment proves safe and efficacious, Bayer will conduct a confirmatory Phase 3 trial.

Results from a collaboration with researchers at the University of Pennsylvania (“PENN”) have shown that specific product components, such as the virus capsid, or the enhancer and promoter regions of the FVIII gene, can be selected to further optimize DTX201 effects, including the long-term expression of FVIII. A 30-week study has revealed that FVIII expression levels upon DTX201 administration supported the advancement of the product into IND-enabling studies for treatment of hemophilia A patients. Preclinical studies completed thus far also suggest that DTX201 has the potential to be an effective and well-tolerated treatment for hemophilia A.

“As a leader in hemophilia and evolving new treatment approaches for patients, Bayer has been an ideal partner for us to pursue our program in hemophilia A,” said Dr. Annalisa Jenkins, MBBS, FRCP, Chief Executive Officer of Dimension in a press release. “We continue to benefit greatly from our research collaboration with PENN that has enabled the delivery of high quality in vivo studies to support our Hemophilia A program.”




Multiple myeloma is a treatable but incurable blood cancer that typically occurs in the bone marrow. It is a relatively uncommon cancer, affecting approximately 30,000 new people each year.1 Difficult to diagnose until it is in the advanced stages, it is mainly treated with chemotherapy and stem cell therapies. But the survival rate is increasing, especially as advances in treatment are being discovered. Here are the ten things you need to know about the disease.


Nothing can replace the care of your clinician or doctor. Please do not make changes to your treatment or schedules without first consulting your healthcare providers. This article is not intended to diagnose or treat illness.


Multiple myeloma is a type of cancer that typically occurs within a bone due to the presence of malignant plasma cells. Under normal circumstances, plasma cells develop from B cells—a type of cell that the immune system uses to fight disease or infection. When B cells react to an infection or disease, they change into plasma cells, which are responsible for creating antibodies to help fight germs. These plasma cells are found mainly in bone marrow.

Sometimes, after plasma cells develop, they can begin to grow out of control and create a tumor called a plasmacytoma. These tumors generally develop within a bone but can occasionally be found in other body tissues. When a person develops more than one of these tumors, they have multiple myeloma.


Unlike many other cancers, there are very few known risk factors associated with getting multiple myeloma. These factors are listed below.

  • Age: The majority of diagnoses are in people who are more than 45 years old (96 percent), and more than 63 percent of diagnoses are in people older than 65. Less than one percent of cases are in people younger than 35.2
  • Race: For reasons unknown, it is more than twice as common in African-Americans than in white Americans.
  • Gender: Men are at a slightly higher risk than women.
  • Family history: A person with a parent or sibling who has the disease is four times more likely to get the disease, too.
  • Obesity: Being overweight or obese increases the risk.
  • Having other plasma cell diseases: A person with solitary plasmacytoma (a single tumor), or someone diagnosed with monoclonal gammopathy of undetermined significance, which is a plasma cell disorder that does not normally cause problems, is more likely to later develop multiple myeloma.
  • Radiation: People exposed to are at a higher risk.
  • Workers exposed to ionizing radiation have been shown to have an increased risk of the disease as well, according to a study conducted at US Department of Energy facilities.
  • Workplace exposure: Some studies have shown that workers in occupations such as agriculture, leather, petroleum and cosmetology, and workers exposed to chemicals such as asbestos, benzene, and pesticides are at an increased risk.

Researchers do not have a clear understanding of what causes multiple myeloma, though they have made progress into better understanding how specific DNA changes can cause plasma cells to mutate. Studies show that abnormalities in genes called oncogenes, which promote cell division, develop early in the growth of plasma cell tumors. Studies also show that myeloma cells have abnormalities in their chromosomes; specifically, research has revealed that pieces of chromosome 13 are missing.

Research also shows that in approximately half of people diagnosed with multiple myeloma, a translocation has occurred. This is when “a part of one chromosome has switched with a part of another chromosome in the myeloma cell.”4 Scientists have also discovered that people with plasma cell tumors have abnormalities in other bone marrow cells, which might cause too much plasma cell growth.


The early stages of multiple myeloma may not have any symptoms, and even when symptoms are present, they may be similar to those that occur with other conditions. Below are some of the common symptoms of the disease:

  • Fatigue
  • Bone pain and/or bone fractures
  • Nausea/vomiting
  • Increased thirst
  • Increased/decreased urination
  • Increased risk of infections
  • Confusion
  • Loss of appetite/weight loss
  • Restlessness that is later followed by significant fatigue and weakness
  • Problems with kidney function


targeted treatment multiple myeloma

There are many drugs available to treat multiple myeloma, with chemotherapy and autologous stem cell transplants (when stem cells are collected from the patient) the most common, but several of the most recent and exciting treatments to become available are two medications called daratumumab and ixazomib, and a form of treatment known as immunotherapy.

Darzalex (Daratumumab): In November 2015, the FDA granted “accelerated approval” for daratumumab injections in the treatment of multiple myeloma. The drug may only be used by individuals who have already undergone at least three other types of therapy.

Darzalex is part of a category of drugs called monoclonal antibodies. It works by binding to a protein called CD38, which is typically found on the surface of myeloma cells. Once it is attached to the cell, the drug attacks the cell while simultaneously signaling to the immune system to fight against the cells.

Almost one-third of clinical trial participants (with a median of five previous therapies) responded positively to the drug. Daratumumab may be purchased from

Ixazomib: Recently approved by the FDA, this completely oral treatment is used in combination with standard myeloma drugs to treat people who have already undergone at least one previous therapy. Clinical study results showed that the drug taken in combination with lenalidomide and dexamethasone increased “progression-free survival (PFS) in patients with relapsed/refractory multiple myeloma.”5

Immunotherapy: Immunotherapy is when a person’s immune system is used to treat an infection or disease. In a recent study, scientists discovered that 70 percent of people with multiple myeloma who were treated with immunotherapy had a “significant clinical response” to the disease.6 In the study, 14 of the 20 participants with an advanced form of multiple myeloma had a “near-complete or complete response three months after treatment; median progression-free survival was 91.1 months, while the overall survival lasted 32.1 months.”7 Further, no significant side effects were reported. This is an important advance, given that current treatments such as chemotherapy and autologous stem cell transplants have low long-term responses and an average survival rate between three and five years.8


NBC News anchor Tom Brokaw was diagnosed with multiple myeloma in August 2013 following a bout of severe back pain. Though he originally wanted to keep the diagnosis private, he eventually announced his fight against the disease. His memoir, A Lucky Life Interrupted, was published last year and details his journey following his diagnosis. In it, Brokaw discusses the challenges he faced from the disease: weight loss, the inability to sometimes walk without help, the side effects from his medications, and the moment when he learned that the disease was affecting 60 percent of his blood. After 16 months of treatment, his cancer went into remission.


Several different diagnostic tests must be used to confirm a multiple myeloma diagnosis because it is challenging to diagnose based on a single laboratory result. A physical evaluation will be done alongside a review of the individual’s history, symptoms, blood and urine tests, and a bone marrow biopsy. Other tests might include an MRI, CT scan, PET scan and X-rays.

In order to definitively diagnose multiple myeloma, a person must meet at least one major and one minor or three minor criteria. Those criteria are:

Major criteria:

  • Plasmacytoma (based on a biopsy)
  • The existence of 30 percent plasma cells in a bone marrow sample
  • Increased levels of M protein in either blood or urine

Minor criteria:

  • 10 percent to 30 percent plasma cells in a bone marrow sample
  • Osteolytic lesions
  • A minor elevation in M protein levels in blood or urine
  • Low levels of antibodies (that are not produced by cancer cells) in the blood.


The criteria as discussed above helps doctors determine not only whether a person has the disease, but also under which classification the disease falls. Those classifications are:

  • Monoclonal gammopathy of undetermined significance (MGUS)
  • Asymptomatic myeloma, which is then divided into two subcategories:
  • Smoldering myeloma
  • Indolent myeloma
  • Symptomatic myeloma

Once the classification is known, a doctor will then determine which stage of the disease exists, which will help establish the prognosis and treatment options.

The most common way to diagnose the stage of the disease is through the International Staging System (ISS), which is based on two different blood test results: the beta 2-microglobulin (β2-M) and the albumin. There are three stages of classification under the ISS:

  • Stage I: β2-M less than 3.5 mg/L and albumin greater than or equal to 3.5 gm/dL
  • Stage II: Either β2-M greater than 3.5 mg/L but not greater than 5.5 mg/dL and/or albumin less than 3.5 g/dL
  • Stage III: β2-M greater than 5.5 mg/L

The Durie-Salmon Staging System is an older system of diagnosis. This uses four measurements to determine which stage of the disease exists: 1) the amount of hemoglobin in the blood; 2) the amount of calcium in the blood; 3) the production rate of M protein; and 4) the number of bone lesions. The disease’s stage is then further subdivided based on kidney function.

The three stages of the disease as determined by the Durie-Salmon Staging System are: Stages I, II and III. Each of these stages is then subdivided into either Stage A or Stage B based on whether kidney function is affected. (Stage B means there is significant kidney damage.)

  • Stage I: Though a person with Stage I often shows no symptoms of the disease because there are fewer cancer cells present in the body, other signs will be present, such as: amount of red blood cells within or a little below the normal range, a normal amount of calcium in the blood, low levels of M protein in the urine or blood.
  • Stage II: More cancer cells are present in the body than in Stage I. An individual who does not fit into either Stage I or Stage III is said to have Stage II.
  • Stage III: There are many cancer cells present. Other characteristics of this stage include; hypercalcemia, high levels of M protein, anemia, and significant bone damage.

Note: In any stage, if kidney function is affected, the prognosis will be worse.


multiple myeloma treatment

The most common multiple myeloma treatment has typically been chemotherapy followed by stem cell transplants. Because the disease is not curable, this method of treatment aimed to create longer and longer stretches of time during which it did not progress. Now, however, significant advances in research have dramatically changed not only the prognosis but the treatment that is offered. In fact, treatments have advanced so much that there is an increasing discussion among the scientific community as to whether a stem cell transplant should be done after diagnosis or if it is better to wait until a relapse.

Scientists are currently experimenting with different combinations of medications to increase the survival rate. For example, efforts are being made to combine certain drugs that not only have diminished side effects but that also “lengthen stretches of progression-free survival (PFS).9Other drugs are being studied to see how they can work with the body’s immune system to fight the disease.

“It’s a massive convergence of our understanding of biology, the technology becoming available to understand myeloma cells and how they respond, the genetic subtypes of myeloma, the ability to engage both the patient community and researcher, to transfer data and information,” says Walter Capone, president and CEO of the Multiple Myeloma Research Foundation, in an article with Cure.10


The International Myeloma Foundation—while not an official sponsor of the more than 150 multiple myeloma support groups around the world—conducts yearly conferences for support group leaders. Information on support groups according to an individual’s geographical location can be found on the IMF website.

multiple myeloma facts family


According to Cancer Research UK (which used data from 2010-2011), 78 percent of men diagnosed with the disease survive for at least one year and 50 percent survive for five years or longer. For women, that number is 75 percent for one year and 44 percent for at least five years or longer.11

In the United States, researchers reported that a “newly diagnosed myeloma patient 15 years ago, for example, was about one-third as likely as someone without myeloma to live another five years.”12 Those same researchers found that “By the end of the 2000s, in contrast, that same myeloma patient would be 45 percent as likely as someone without myeloma to live another five years.”13 According to the American Cancer Society, the median survival rate for Stage I is 62 months; Stage II: 44 months; and Stage III, 29 months.14

With advances in treatment, as well as ongoing clinical studies, those prognoses continue to increase. In fact, the prognosis today of someone diagnosed with the disease is nearly triple what it once was.



Let’s Not Confuse Misophonia and Sensory Processing Disorder – Part 1

Recently there have been some people who want to redefine misophonia as a form of sensory processing disorder (SPD) or sensory over-responsiveness. I think there are good reasons to not combine misophonia and SPD, and especially not to consider misophonia as a form of SPD. This is confusing to some individuals who have both SPD and misophonia. The disorders are not mutually exclusive. I think it is well-meaning individuals who have both disorders that are promoting they be combined. From their experience, the two disorders combine to create a horrible sensory problem, but the disorders should not be combined because they are distinctively different.

Image result for sensory processing disorder

Research on SPD has been underway for at least two decades. It has gained increased attention because children with autism often have sensory issues, and there are generally considered SPD. SPD was considered for inclusion in the Diagnostic and Statistical Manual of Mental Disorders (DSM), release 5, which occurred in 2013. But it was not included in the DSM-5, likely because there is still a strong debate over whether SPD is a real disorder. For instance, see the Scientific American article, Is Sensory Processing Disorder for Real?

SPD includes three broad categories. These are sensory modulation disorder, sensory-based motor disorders and sensory discrimination disorders. Sensory based motor disorders and sensory discrimination disorders do not have symptom similarities to misophonia, so I will not discuss them further.

Sensory modulation disorder appears as a problem with the intensity, duration, or frequency of the stimuli. It includes three categories:
– sensory under-responsivity – not at all like misophonia
– sensory craving/seeking – not like misophonia. People with misophonia avoid trigger stimuli.
– sensory over-responsivity – appears to have similarities with misophonia

Sensory over-responsivity (which I will call SPD from here on for simplicity) shows up as fearful, stubborn (or other negative behaviors), and self-absorbed behavior, in response to strong/loud stimuli. It may also include distress, anxiety, anger, and other strong emotions when exposed to stimuli, especially when the stimulus is prolonged. For example, an SPD child may have a fear response when hearing a toilet flush, but if he is forced to stay close, and there are repeated flushes, his emotions and behavior will escalate. Sometimes the emotions and extreme behavior happen instantly. It is common for children with SPD to have meltdowns. Emotional distress, meltdowns, and negative behaviors are common with misophonia, but with misophonia anger and disgust are the most common emotions. Misophonia occasionally includes a fear response, but never includes self-absorbed behavior. Misophonia also includes anxiety, and children (and even adults) with misophonia often have meltdowns.

One big difference with misophonia and SPD is the age of onset. SPD is generally present at very young ages. It shows as an infant who is upset by a loud toy, or a toddler who is afraid of a vacuum cleaner. One of my grandkids could not tolerate the sound of the toy grill on the playhouse, so I muffled the speaker. Misophonia can develop at any age. About half of those with misophonia had onset by age 10. But misophonia does begin in later years for some. A recent study I conducted shows about 5% of individuals had onset of misophonia as adults, and for some, it did not begin until they were in their 50s.

With both misophonia and SPD, a person has a strong emotional response to auditory, visual, or tactile stimuli, but SPD triggers and misophonic triggers are very, very different. I will discuss this in my next post.



The Brain Of An Introvert Compared To That Of An Extrovert: Are They Really Different?

The difference between extroverts and introverts

With all this talk about introversion and extroversion these days, you might already know which one you identify with. But the way our brains are wired — and our brain chemistry — can help us understand what’s really going on in the minds of introverts and extroverts that make them who they are.

The brains of introverts and extroverts aren’t really that different when it comes to the big picture. Introverts aren’t “smarter” than extroverts, and vice versa. But research completed over several decades has shown that the brains of introverts and extroverts are activated differently depending on their circumstances, and it has a lot to do with dopamine, a neurotransmitter that controls the brain’s reward and pleasure systems.


Common knowledge dictates that introverts are quieter and tend to feel more energized from spending time alone, while extroverts are louder and gain reinforcement and energy from being with others. Extroverts often exhibit qualities of charm, charisma, and persuasion, while introverts tend to be creative and prefer to work alone.

But it’s not always black and white: we all exist on a spectrum between introversion and extroversion, manifesting qualities of each depending on the circumstance. If you’ve partied your extroverted self out for the weekend, you might want to spend Monday night completely alone in your pajamas reading a book or watching Netflix. If you find that your co-workers are distracting even though you enjoy being social, you might find it nice to take up some introverted qualities like brainstorming alone. And being an introvert doesn’t mean being a hermit: introverts can often be charming social butterflies in their own quiet way.


In the 1960s, a psychologist named Hans Eysenck theorized that extroverts had a lower level of something called “arousal.” Eysenck believed that extroverts required more stimulation from the world in order to feel alert and awake, while introverts were easily over-stimulated. This helped to explain extroverts’ sense of risk-taking, challenges, and constant social company to keep them stimulated, while introverts often had to seek out alone time in order to lower their over-stimulation — thriving best at home, in library corners, or in peaceful parks.

This notion paved the way for scientists to delve a little deeper into our minds to help understand what defined these two different personalities. In 2005, researchers concluded in a study that it all might be linked to dopamine — the reward system in the brains of extroverts responded differently than those of introverts. In the study, researchers used a brain scanner to examine responses from participants who were doing a gambling task. They found that when gambling brought positive results, the extroverts exhibited a stronger response in two regions of the brain: the amygdala and the nucleus accumbens, showing that they processed surprise and reward differently than introverts. If extroverts responded more strongly to gambling paying off, they probably would respond more strongly to adventures, social challenges, or taking risks.

A 2012 study completed by Randy Buckner of Harvard University discovered that introverts tended to have larger, thicker gray matter in their prefrontal cortex — a region of the brain that is linked to abstract thought and decision-making — while extroverts had less gray matter. Buckner concluded that this might be accountable for introverts’ tendencies to sit in a corner and ponder things thoroughly before making a decision, and extroverts’ ability to live in the moment and take risks without fully thinking everything through (which has its cons and benefits, of course).

Your brain is the most complex part of your body — and far more research needs to be done to understand what causes, and defines, personality. But perhaps instead of trying to draw a line between the two, maybe it’s best to be somewhere in the middle, taking part in the best of both worlds. As Hungarian psychologist Mihaly Csikszentmihalyi explained, his most artistic patients often drifted between introversion and extroversion: “[They’re] usually one or the other,” he wrote, “either preferring to be in the thick of crowds or sitting on the sidelines and observing the passing show.”



How Many Carbs To Eat +Most Popular Low Carb Diets + Rapid Keto Meal Plan + What Does Keto Feel Like?


Starting Atkins means making choices beyond food. Most low carbers have questions. What’s going to happen and is this good for me? Howlow is low carb?

  • Most popular low carb diets
  • Deciding how many carbs to eat
  • What keto feels like and how to reach it

William Banting is considered the father of low carb diets. He was a severely overweight British undertaker who attempted the first low carb diet under the supervision of Dr. William Harvey.

Overhead view of a personal scale.

Banting created the very first low carb diet with food guidelines and suggestions. He ate four meals a day of proteins, greens, dry wine and limited amounts of fruit.

What happened? He lost 50 pounds.

Banting documented his success with low carb. He also documented past failed attempts of losing weight with other styles of eating.

Banting simply urged people to eradicate their uses of dairy, beer and starchy foods.

The Atkins Diet

In 1972, Dr. Robert Atkins released his book Dr. Atkins Diet Revolution.

At the time, conventional wisdom suggested the way to lose weight was through a low-fat, calorie reduced diet.

Atkins went against convention, reporting that in his practice he’d seen patients experience tremendous success eating luxurious foods, such as cheese, butter, bacon, lobster, steak and heavy cream.

The First Atkins Diet

The Atkins diet plan was met with skepticism by the medical community.

However, dieters embraced the idea of eating foods usually forbidden or restricted on traditional weight loss diets.

Many experienced success, and starting a low carb diet became a popular way of losing weight.


The New Atkins

In 1992, Dr. Atkins released Dr. Atkins New Diet Revolution, which followed similar principles as his earlier book.


Other Low Carb Diets

Due to the tremendous success, other low carb diets soon followed: SugarBusters, Diabetic, South Beach, The Zone, Primal, Paleo, Low Sugar, etc.

These diet plans usually limited or eliminated grains, sugar and starchy vegetables. Instead, dieters ate leafy greens and other low carbohydrate/high fiber vegetables, meat, fish, poultry, full-fat dairy, fats and oils.

Different diets make different recommendations, but the guidelines are similar when it comes to eating carbs: less is better.


How Low IS Low Carb?

A number of scientists, nutritionists and other experts involved with low carb dieting got together in 2008, and for the first time, defined what makes up a low carb diet.

Here’s what they came up with:

Low Carb Keto Diet: Less than 50 carbs and 10% calories daily

This is usually the level where carb reduction introduces statisticallysignificant advantages of being in ketosis, and a greater rate of fat loss when compared to other diet plans.

Low Carb Diet: 50-130 carbs daily and between 10-26% of calories

Moderate Carb Diet: 130-225 carbs daily and between 26-45% of calories


How Many Carbs Do I Need?

The scientific and practical amount of carbohydrate needed in the diet is ZERO – NONE.

Dietary carbohydrates are not a requirement in any body function.

In fact, it seems that the lower the carbohydrate level in the diet the better the long-term health.

Studies now link age-related degenerative diseases to high levels of carbs in the diet.

Very low or zero carb diets are common in many primitive cultures.


How Do I Get Into Ketosis?

People who normally eat high carb meals have fueled their bodies with glucose and fructose obtained from carbs.

The body experiences a new condition of ketosis when a person converts to the low carb diet.

In this metabolic state, the body burns mainly fat and spares the lean muscle tissue.

There are specific diet and exercise techniques, such as intermittent fasting sessions and high intensity interval training workouts to help you get into ketosis faster, and maximize weight loss.

Why Lower Carbs Lead to Fat Loss

In his book, Good Calories, Bad Calories, author Gary Taubes explains how low carb diets bring about weight loss.

Carbs contain sugars. According to Taubes, when you eat carbs, the sugars in them cause your blood sugar to rise.

In response, your pancreas releases insulin into your bloodstream.


The Carb-Insulin Connection

One of insulin’s functions is moving fuel (food) to fat cells to keep energy stores in case of famine.

When insulin is present, it also keeps the fat locked inside of fat cells, and your body will not burn the fat as a source of fuel.

When you eat a low carb diet, you reduce spikes in blood sugar, and your pancreas releases very little insulin.

Once your body has depleted its carbohydrate stores, then it begins to rely on stored fat as its primary source of fuel, leading to rapid loss of excess stored fat.

When these changes occur, you have reached the metabolic state of ketosis.



Keto: What’s Happening

When you start a low carb diet, the more commonly used glucose fuel is suddenly no longer available.

The body reacts by dropping the pancreas’ production of insulin and increasing the hormone glucagon.

This hormone  stored fat reserves (in the form of triglycerides) for cells to use as their new energy source.

However, the cells are slow to react to this new fuel source, and the person feels weak or lacking energy.

The resistance to burning fatty acids for energy can vary greatly among dieters.


What Does Keto Feel Like?

Some people feel this weakness, but others pick right up and take off with the feeling of greater energy than before!

The liver breaks down the extra fatty acids when they are not being used by the cells. This causes a discharge of the ketone molecules into the blood.

A temporary, strange taste in the mouth and mild breath odor signals these ketones are present.


Your New Brain and Metabolism

Your new metabolism uses ketones for energy – which your brain loves.

The brain uses ketones very efficiently, contrary to the myth that the brain is powered by glucose only.

Some areas of the brain will still need glucose, which the body now easily makes from excess protein, amino acids or fats.

Carbohydrates are not required to support a normal blood glucose level and not required in the low carb diet as brain fuel.

The body can make all the glucose required from protein and fats in the diet, and it makes glucose at a healthy level in this way.


It May Surprise You

  • Ketones are also the preferred energy source for the muscles of the heart.
  • Ketosis encourages better sleep patterns and boosts energy levels.
  • While you are in ketosis, the weight lost during a low carb diet is fat loss.
  • Weight loss happens quickly and easily.


There are plenty of surprising, healthy reasons to start a low carb dietother than losing weight.

Just remember patience as your body (and scale) adjusts to all the changes.


Rapid Keto Meal Plan

The Keto Beginning is a highly recommended program – especially if you’re not ready for Atkins Maintenance phases or an increase in carbs every day.

Bust through plateaus, eat more carbs and uncover a life you love. Restore your weight, balance hormones and lift mood naturally.

This carb cycling keto meal plan slides you into fat-burning mode, without needing to go strict low carb.



What Are the Goals of Therapy for Agoraphobia?

The goals of therapy for phobia are to reduce or eliminate the symptoms so you can perform daily activities, including making and managing money, taking care of your household, and maintaining healthy interpersonal relationships.

About 10 to 12 percent of Americans suffer from a diagnosable phobia.

The type of treatment you receive depends on the type of phobia you have and the severity of your symptoms.

Woman sitting on sofa, looking pensive, listening to man in foreground
There are three types of phobia:

social phobia (social anxiety disorder)
specific phobia
A good mental health professional will customize a treatment plan for you, which may include both talk therapy and medication. A physician is more likely to add medication to an agoraphobia or social phobia treatment plan than for specific phobia.

The therapeutic goals of phobia treatment with psychoanalysis
Psychoanalysis is the one-on-one talk therapy you see in movies and on television. The therapist believes your phobia has roots in a repressed traumatic childhood experience and the goal is to work with you to uncover it. In order for psychoanalysis to successfully resolve your phobia, you must make a commitment to the process, which may take years.

A mental health professional is more likely to employ psychoanalysis for agoraphobia or social phobia than for specific phobia, because you don’t need to know the root cause of your fear for successful treatment.

Goals of exposure therapy as treatment for specific phobia
Your treatment goals for phobia are likely to be met through the CBT method Exposure Therapy. During this desensitization process, the therapist will gradually expose you to stimuli related to your fear in a safe and controlled environment. You’ve reached your goals when your distorted thinking diminishes to a functional level or disappears.
Therapeutic goals of psychoeducation treatment for specific phobia
The goal of psychoeducation is to restructure your thought patterns in order to overcome your irrational or overestimated fear and usually the first like of treatment for specific phobia. The therapist will help you learn to let your thoughts be helpful instead of debilitating. The response rate to therapeutic desensitization techniques is 80 to 90 percent.

Goals of Agoraphobia Treatment
Agoraphobia is the fear of being in situations where you can’t escape, such as a crowded stadium or on a bridge. The goals of agoraphobia treatment is to learn:

your fears are not likely to come true
your anxiety will gradually decrease in public and that you’re capable of managing your symptoms until they do
the factors that trigger your panic attacks, or panic-like symptoms, or make them worse
techniques to deal with your symptoms
how to change the unwanted and unhealthy behaviors through self-guided desensitization techniques
Goals of Social Phobia Treatment
Your treatment plan for social phobia is likely to include a combination of talk therapy, medication, and role-playing.
The goals of treatment for social phobia, or social anxiety disorder, include helping you to

change the negative thoughts you have about yourself
develop confidence in social situations, especially the ones you fear most
improve your coping skills
Medication commonly prescribed to help you reach your therapeutic objectives, include:

anti-anxiety medication
Example: The treatment plan for Jack’s spider phobia included one primary and three secondary goals of therapy.


TUCSON, AZ - APRIL 06:  Loaves of bread sit on racks at Small Planet Bakery April 6, 2008 in Tucson, Arizona.  The cost of staple foods has jumped in the past few years with the price of bread increasing by nearly 30 percent per pound since 2006, according to the Consumer Price Index. A slowing economy combined with continued pricing increases has prompted Americans to be cautious in their consumer spending practices.  (Photo by Chris Hondros/Getty Images)

celiac disease is not caused by early weaning according to recent study

Researchers in Sweden have released the results of an extensive study debunking the long held belief that early weaning is the cause of celiac disease. Instead of ending breastfeeding early, what did the study indicate was the actual trigger for celiac disease?

For years, there was a belief that weening a child from breastmilk early was the cause of celiac disease. Turns out, this is not the case. A recent Swedish study has revealed that the amount of gluten consumed is more apt to cause celiac disease than weening early or giving children gluten at an early age.

Image result for celiac disease is not caused by early weaning according to recent study

Dietician and doctoral student Andrén Aronson of Lund University in Sweden released a statement based on her thesis that it was the amount of gluten given to a child that triggers the disease.

“The timing of the introduction of gluten, on the other hand, does not seem to be of great significance.”The Local Sweden, reported that the study, entitled the Teddy project, followed 8,700 children in Sweden, Finland, Germany and the United States. In the United States, about one percent of all people have celiac disease, with an estimated two to three million people that have gone undiagnosed. In Sweden, that number jumps to between two and three percent of the entire population that has celiac disease. It is not surprising that there is such an interest in the Nordic country in uncovering the cause of celiac disease

What is celiac disease? According to the Celiac Disease Foundation, celiac is an autoimmune disorder that affects about 1 in 100 people worldwide.

“Celiac disease is a serious genetic autoimmune disorder where the ingestion of gluten leads to damage in the small intestine.”

Those who have celiac disease cannot tolerate the protein gluten. What happens when a person with the disease eats gluten, and where is the protein found?

“When people with celiac disease eat gluten (a protein found in wheat, rye and barley), their body mounts an immune response that attacks the small intestine.”

This incurable disease requires patients to eat gluten-free for the rest of their lives. Found in items from bread to toothpaste, if anyone with celiac consumes gluten, this could become the cause for additional illness, including intestinal lymphoma. Thus, the need for those with celiac disease to adhere to a strict gluten free diet is mandatory.

This is not to be mistaken for the gluten-free bandwagon that has a lot of people – from celebrities to diet books authors – claiming that bread and pasta will make them healthier. For those with celiac disease, consuming even a small bit of gluten is very serious. For anyone else, consuming any amount of gluten does not have the same consequences.

Equipped with this new information, Aronson intends on furthering her study to include other countries. She is focused on trying to uncover why people in Sweden have celiac disease at a much higher rate than in other countries. She is also going to explore how beneficial bacteria, found in such food as Greek yogurt, may play a part in preventing celiac disease.



A Surprising New Finding About Trichotillomania

We tend to think of compulsive behaviors — such as hair-pulling, nail-biting, and skin-picking — as coping mechanisms used to deal with stressful situations. But, new research suggests there could be more behind these habits than we think.

The study, published in this month’s issue of the Journal of Behavior Therapy and Experimental Psychiatry, looked at a group of 24 people dealing with these body-focused repetitive behaviors (BFRBs). Compared to 23 control participants, those in the BFRB group reported a much greater urge to engage in nail-biting, hair-pulling, and skin-picking in a variety of scenarios — including those situations designed to create feelings of frustration, boredom, and impatience. Interestingly, these feelings aren’t traditionally thought of as triggering compulsive behaviors.

Trichotillomania 5 by Nevaya

From here, the researchers conclude that these compulsive behaviors have a common root: perfectionism, which makes it difficult for people dealing with them to relax and do things at a “normal” pace. These people may be extra prone to boredom and frustration in addition to stress.

The most recent version of the Diagnostic and Statistical Manual categorizes nail-biting, hair-pulling (trichotillomania), and skin-picking (excoriation or dermotillomania) as being related to obsessive-compulsive disorder. This is distinct from impulse-control disorders, which are often characterized by urges to harm oneself.

It’s estimated that about 1-3% of the U.S. population struggles with hair-pulling and up to about 5% deals with skin-picking, while nail-biting is thought to be more common. The classification of nail-biting in particular has been somewhat controversial, with many people seeing it as simply a bad habit. Although this is likely true for some, for others, it may be one version of a disorder with serious consequences.



Spiritual warfare as an explanation for narcissistic patterns and families


Narcissistic abusers are common in society even though not everyone uses the term “narcissist.” Many classic movies feature a war of good against evil with an antagonist who shows clear narcissistic or sociopathic traits. For example, Gollum in Lord of the Rings, or Palpatine in Star Wars. These characters are manipulative, sneaky, two-faced, and evil. They behave just like the narcissists who frustrate us in “real life.” We aren’t the first to encounter these types of people. They are all through movies, literature, stories and religion. From a scholarly point of view, we can look at the characteristics and see behavior that fits mental health diagnoses, but in popular culture, the same behaviors are explained in different ways.
***Warning, this post is going to turn religious. I come from a generic Protestant Christian background, and I’m not a typical Bible-thumper, but I do believe. The book and ideas I’m going to refer to are unusual in some churches, but gave me something to think about

Online, I have read various pages and articles about narcissists as people with a “Jezebel” spirit. I will admit, the idea of demons and spiritual warfare is a bit out there for me, but I can relate because I think they are describing the same types of people and the same types of struggle in a different way. Here is one brief webpage that compares what we call narcissism with what others call the Jezebel spirit:

In my opinion, what we might call evil is the same attitude that runs in certain personality disorders. What we might call a demon is one and the same. These are all the same cruel, disordered behaviors no matter what we call them. I have posted before that I have struggled with my Christian faith because of the horrible things that have happened to me. My narcissistic mother is religious in public, but cruel and manipulative at home. She will trash people in private but flatter them to their faces. She will lie, lie, lie to get what she wants, and people are fooled every time. I just watch with my eyes widened wondering how someone can get away with being such a manipulative two-face! And I see similar in my ex narcopath. He doesn’t play sweet and vulnerable like my mother does because he is so aggressive and dominant, but still, he can fool people into believing his lies even when there is clear evidence that he is lying. How DO they do that!?!?!? Arggh! Sometimes I literally ask myself, am I really dealing with spiritual warfare? How is it I can scream the truth, but no one hears me? How do the bullies in my life keep trampling on me? Do they have some kind of supernatural help? But then I think, “no, that is crazy talk. This can all be explained by science and psychology.” Maybe there’s really a mix here. Yes, we know how narcissism works, but maybe some of what the Bible would call evil is the same thing?

The other day, I found a book that I would not normally read. I grew up in a very average, normal Christian school that didn’t really teach the “weird” stuff. There was very little talk of demons, spirits or anything like that. No speaking in tongues, no miracles. Just day-to-day living and trying to be good. But, I picked up this book because I had read the theory of the Jezebel spirit online, and wanted to see more of what others had to say. It is called Jezebel by Bob Larson. Jezebel The writer is literally a self-described exorcist, so I read the book with a grain of salt. (No offense meant to other beliefs, but this is not normally what I would believe.) But, despite my reluctance to look for demons and exorcisms, I found that much of what the author described in spiritual terms were things I could relate to in academic terms.

For example, he describes Jezebel in terms that remind me greatly of my mother: seductive, willing to commit adultery, religious to serve her own needs, two-faced, hypocritical, looking to destroy reputations, lying, self-centered, and more. He also describes inter-generational abuse. He describes mothers who abused their children because their parents abused them. That is the cycle I am breaking in my family! To me, it is a learned bad behavior, but to Larson, it is a demon attached to the family members and “invited” in by sin. I underlined many sentences in the book–including one section about how girls whose fathers abandon them grow up not knowing how a good man should behave. (Been there, done that!) The author described so many of the struggles I have endured–abusive mother, generationally abusive family, missing deadbeat father, abusive husband….

While I’m not going to go look for an exorcist for my mother, and I don’t literally believe everything in this book, I found that it makes a lot of sense figuratively. If we think of abuse and narcissism as a “demon” to overcome, it makes much more sense. Even though I cannot relate to every word, I did get a lot out of this book, and I think it can be beneficial to read it as a parable or an example of the “evils” we deal with while trying to escape abuse. If nothing else, Christians need to be strong and bold in their faith to overcome the cycles of abuse.



Real causes of fatigue in thalassemia

So, we may safely assume that thalassemia sufferers are fatigued due to thalassemia.
But what would be the cause of that fatigue?

By finding what the causes are, we could convince doctors, researchers and other people
once and for all that this fatigue is real.

Of course in case of thalassemia major and intermedia the situation is a bit different – there is
additonal iron overload, ROS production etc. These mechanisms do not apply to thalassemia

Image result for Real causes of fatigue in thalassemia

As far as I can figure out:
1. Vitamin depletion.
Because of continuous production of erythrocytes different vitamins get used up faster than in “normal” people. Consecutive deficiency causes fatigue as different parts of body do not work
as they should and get fatiqued.
Vitamin deficiency can be easily alleviated by taking supplements (especially vitamins B complex)

2. Underoxygenation of tissues.
With unsufficient oxygen supply tissues do not have energy and experience different other problems, for example acidification.
But in case of sufficient hemoglobin (mine is 15,3 g/dl) underoxygenation should not be a problem, or is it?

Obvious solution to this problem is bringing hemoglobin to normal level (which may not be easy), taking antioxidants (they stop erythrocyte breakdown so they help increase hemoglobin) and taking vitamin E which makes blood thinner and erytrhocytes more flexible allowing better penetration of tissues.
Acidification may be fought by eating fruit or taking baking soda/sodium citrate.

3. Provoking inflammation/releasing different substances signalling brain that fatigue should be felt.
It is feasible that after erythrocytes break down there are certain substances released that cause inflammation (cytokines). Also the intracellular machinery may be somehow detected and this signals the brain to stop activity by inducing fatigue (strain -> broken cells -> necessity to stop the strain).
For example muscle cells release additionally endorphines, which cause this pleasant feeling of relaxation but also make you tired and a little dizzy.

Anyone has any idea of specific substance that can be released by erythrocytes breaking down?

4. Other disorders caused by thalassemia minor like allergies.
Well, as a matter of fact I think thalassemia’s involvement in causing other disorders is highly overrated but I mention it for the sake of the accuracy (I read such a statement in one of the threads). However my personal opinion is that simply all people get sicker due to pollution etc.

5. Bone pain.
Bone pain caused by bone marrow overproduction.

6. Heme/hemoglobin conundrum…
The first four items are kind of well recognized, this one is purely speculative.

This is the kind of question that can be answered probably only by a doctor/geneticist. If you are one or have a contact with one, you might want to pursue this question.

So I was wondering…

In case of beta-thalassemia (or alpha-thalassemia) one of hemoglobin chains is damaged.
Is it possible that this hemoglobin chain is used in different locations within the body?
Damaged hemoglobin in different locations would lead to impaired function and that would lead to fatigue (and other problems).

Possible different locations of hemoglobin:
– myoglobin in muscles
– complex III in electron transport chain
– complex IV (cytochrome c oxidase) in electron transport chain
– cytochrome c in electron transport chain

The question is if any parts of these compounds are expressed by the same genes as a particular hemoglobin? If so, we may have the answer.

This all gets even more complicated because of heme which is encoded by a different gene.
If it is the heme that is a common part of the above compounds, one would rather have porphyria and not thalassemia.

All in all this is all quite complicated (and I am not describing this correctly, I know) and a person is needed that knows exactly which part of the given compound is coded by a particular gene.

Why this kind of idea?
I have beta-thalassemia minor but I also have (metabolic) myopathy.
This means erythrocytes break down but also muscle cells break down. This is weird – it is much more likely that these two are interconnected somehow than they are not. So it is likely that the cause is the same for both of these disorders. So I am looking for this connection but I can’t find any.

This kind of connection in general might cause fatigue.