Category Archives: EZ 46 – Medicines & Sciences

Leaky Gut Syndrome

by Dr Mecherl Lim

MD (MA) Naturopath (ND),  Holistic Kinesiology



A possible cause of LEAKY GUT is increased Intestinal Permeability or Intestinal Hyperpemeability.

That could happen when tight junction in the gut, which control what passes through the lining of the small intestine, don’t work properly. That could let substance leak in the bloodstream.

People with Celiac Disease & Crohns disease experience this. Example,  Toxins in form of Medications, like Steriods, Antibiotics, Advil, Acid reducing drugs and environment toxins like Mecury, Pesticides & BPA from plastic. Stress and Age might also contributes to a Leaky Gut.

Digestive issues include Bloating, Gas, Diarrhea, Irritable Bowel Syndrome (IBS), Cramp, Food Sensitivities, Aches & Pains.

Leaky Gut Sydrome aren’t unique. They are shared by other problem too. Leaky Gut often overlooked as a condition when under disgestive stress, and almost completely ignored if you have been diagnosed with another disease.

However, it is often a root cause of many health concerns,when the gut cannot properly digest nutrients.


A number of symptoms can arise from Neurological, Endocrine and Metabolic eg: Mood Changes, Memory Lapses, Irritable Bowel, Cancer, Loss of Energy, reduced

in Immune Response, Arthritis, Malnutrition, Bloatedness,

Chronic Fatigue, general Seasonal Allergies, Food Allergies, Intolerences, Skin Rashes (related to inflammation), Nutritional deficiencies, (improper absorption),

weakend immune system (from overexertion), Candida Over Growth, Constipation, ongoing Diarrhea, Atopy, Chronic Uticaria, Ulcerative Colitis, Acute Gastroenterities, Cystic Fibrosis, Exocrine Pancreatic Defects, Poor Digestion, Iron Deficiency, Bowel Cancer, Rheumatoid Arthritis, Ankylosing Spondylitis and Maldigestion.

When your immune system attacks particles that escape into the blood stream, regardless of whether they are harmful or not, the killer cells inadvertenly attack healthy cells in the process creating more inflammation thoughtout the body.

Symptoms may spread body wide, but still be attributed to other lifestyle factors. Gaps from intestinal lining widen from inflammation.

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  • We could support Liver Function to improve Detoxification such as 1st Phase MHT 5 Days Detoxification programme and followed by 2nd Phase MHT Detoxification as we need to check yeast infections and parasites as the person may be suffering from Achlorhydria, Lactose Intolerance and Pancreatic Insufficiency (refer
  • Reinoculating the bowel with beneficial colonic bacteria, by supplementing with good bacteria count such as Proflora A.
  • Restabilising the gut epithelium to normal function.
  • Eliminate or reduce the insult to the gut barrier from xenobiotic or food allergies.
  • Follow an elimination diet or eliminate substances that produce toxic insult to the gut. 80% of individuals who have food allergens or intolerences have LEAKY GUT SYDROME.
  • Limit the uses of Alcohol, Antibiotics, Aspirin, and NSAIDS as they damage the gut barrier.
  • Reduce exposure to exogenous xenobiotics eg: pesticide, insecticides, and irritant chemicals, by eating more organically grown vegetables.
  • Increase the intake of high fibre foods, slippery elm, bananas and cabbage.
  • Increase intake of fish, cod, tuna, salmon or their oil.
  • Support the liver with supplements on phase II as above mentioned.
  • Glucosamine and Glutamine improve the bowel wall integrity and reduce bowel leakiness.
  • Improve digestion by supplementing with digestive enzymes

Plastic And Aesthetic Surgery In Today’s World

Dr. Lee Kim Siea

Consultant Plastic and Aesthetic Surgeon

Plastic Surgery is a sub-speciality of general surgery, it deals mainly with forms and functions of the whole body. The word plastic is derived from the Greek word ‘plastikos’ which means ‘fit for molding’, it has nothing to do with the plastic wares that we know about, plastic materials are certainly not used in the surgery.


There are two main division of plastic surgery, reconstructive surgery and aesthetic or cosmetic surgery.  Reconstructive surgery deals mainly with repair and restoration of the loss or damaged tissues. Tissues such as bone, flesh and skin can lost or damaged in trauma, burns or surgeries to remove cancers, the resultant defects can be repaired and restored using various type of tissues from nearby or other parts of the body with various surgical techniques. The restoration of the defects give back the form and functions to the patients, allowing them to live more normally. Imagine the loss of lower jaw from surgical removal of a cancer without reconstruction…. Hand and microsurgery is an integral part of plastic surgery.

Aesthetic / cosmetic surgery concerns with improving the physical forms of the person. Patients are usually well physically, however, they are driven by dissatisfaction of the physical appearance of certain part(s) of their body.  In severe cases, they can be totally unhappy with their whole body. This dissatisfaction can result in minor or severe psychological disturbance affecting self-esteem to the extent of affecting their life. Improving the appearance thus restores their self- confidence resulting in improvement of their life. As society becomes more affluent, people are looking to more than just basic needs, money is spent to make themselves more beautiful; clothing, hairdo, accessories are made more and more expensive and attractive. Some will venture into changing or improving their appearance with aesthetic/cosmetic procedures.

Plastic surgery is not new, the history can be dated back to 15th century when there was an epidemic of syphilis resulting in many disfigured people. Plastic surgery was performed to restore the appearance of these people. The most notable procedure was the nose reconstruction which was recorded in many parts of the world including Europe and India. Procedures than were painful with many complications, even death, results were unsatisfactory by today’s standards, it has evolved through many advances in techniques, better understanding of the processes and importantly availability of more advanced materials and tools.

Aesthetic procedures can be surgical or nonsurgical. Surgeries are what plastic surgery is well known for, this involves operations to improve the appearance of the patients who are otherwise healthy; facelifts, nose operations, eyelids operations, body contouring operations, breast augmentations and fat grafting are some of the well- known examples.

Nonsurgical procedures are done without or with minimum incisions. Among the well- known ones are laser/light and energy based devices, injectables like BOTOX and fillers, thread lifts, medical skin cares and recently stem cell treatment. The aim is to beautify and rejuvenate without using the scapel.  This is the field that is growing rapidly; the affordability, the fear of surgery and minimum down time have made these procedures extremely popular. However, they are not without problems and complications, it is important to look for a qualified doctor like plastic surgeon to perform these procedures.

Beauty is a concept, it has no universal criteria. Beauty is in the eyes of the beholder. It is influenced by many factors including media. There are, however, a number of parameters that make a person’s appearance pleasing to the eyes- symmetry, proportions and harmony are important. Everyone has his/her own unique appearance and attractiveness, it is up to a plastic surgeon to enhance the attractive features and minimize the short comings in order to bring out the best in the person. The plastic surgeon must have an eye for beauty, ability to appreciate beauty and be able to visualize the results before even doing the procedure. It is both art and medicine. My philosophy is to enhance the natural beauty and not to change the person’s appearance. Although the concept of extreme makeover is being  promoted, I see it being too dramatic and too risky as the complication rate is too high; besides, it is too costly.

Plastic surgery/aesthetic procedures are not just for women. There is an increasing number of men looking for plastic/aesthetic procedures, a man with big eyebags, frown furrows, saggy face and a pot belly would not make as good an impression to clinch that crucial deal against a younger looking, more energetic appearing competitor.

Plastic surgery is simply not just for the rich and famous or the vain selected few. We seek improvement in all areas of our life, for example our physical health and mental well- being; many of us spend hours in the gym, even a manicure/pedicure takes hours; we spend lots of money on our dressing and accessories. Plastic surgery or aesthetic procedures are just an extension of this to improve our appearance, it gives a tremendous boost to our self- confidence. A lady beautifully dressed with expensive clothing and accessories would not have the same impact if her face looks old and haggard. Plastic surgery/aesthetic procedures in today’s modern world enhance our life style, it is more and more accepted as a way to enable us to look our best at whatever age.

Statin, to use or not to use, That’s the question!

Dr. Goh Eng Leong

Consultant Cardiologist & Physician

B.Sc. (Med.), M.D. (UKM), M. Med. (S’pore), MRCP (UK), FNHAM, AM

Since 1950s, high cholesterol (LDL – C : Low – Density Lipoprotein Cholesterol) has been identified as a major risk factor for the development of atherosclerotic diseases (ischemic heart disease, stroke and peripheral vessel disease).

Many epidemiological and interventional studies have provided robust evidence to the association between high cholesterol and atherosclerotic disease, which is the number one killer worldwide.

To combat this deadly disease, the quest for drugs that could reduce cholesterol has begun since 1960s. Of all the investigational drugs developed, Statin emerged to be the first established lipid lowering medication that is able to reduce cholesterol effectively.

In 1976, the Japanese biochemist Akira Endo isolated a factor from the fungus Penicillium citrinum which he developed into the first Statin. He named it Compactin or Mevastatin.

In 1978, Alfred Alberts at Merck Research Laboratories discovered a potent inhibitor of HMG – CoA reductase in a fermentation broth of Aspergillus terreus, which was named Lovastatin, Mevinolin or Monacolin K.

Since Lovastatin had been commercialized, six other statins – two semi – synthetic statins (simvastatin and pravastatin) and four synthetic statins (Fluvastatin, Rosuvastatin and Pitavastatin and Atorvastatin) – have been introduced to the market over the years.

As a practicing cardiologist, I think Statin is the most controversial medication in the history of medicine. While many mega – clinical trials have proven the benefits of Statins in term of reduction of cardiovascular mortality and morbidity, a lot of negative publicity on Statins have demonised these medications. Social medias are the major channel where the fallacies of Statins spread virally. The minor side effects of Statins are exaggerated and the therapeutic effect of Statins are covered. These type of negative and bias reports on Statins have caused confusion not only to general public but also to physicians.

I hope I can put the facts of Statins in its correct perspective by presenting the scientific evidence to dispel the confusion and misunderstanding. As Socrates’s famous saying : there is only one good – KNOWLEDGE ; and one evil – IGNORANCE.

LDL and Statin : The irrefutable truth – proven in many mega clinical trials

  • High LDL cholesterol causes cardiovascular disease. There is a strong and graded positive association between LDL cholesterol and the risk of cardiovascular disease. This association applies to men and women, and to those with or without established cardiovascular disease. A 1% increase in LDL cholesterol is associated with a > 2% increase in coronary artery disease over 6 years.
  • Reduction of LDL will reduce mortality and morbidity, the lower LDL better the clinical outcome. Meta – analysis of many Statin trials has showed a dose dependent relative reduction in cardiovascular disease with LDL reduction. Every 1 mol / L reduction in LDL cholesterol is translated into a 20 – 25% reduction in cardiovascular disease mortality.
  • Statin is the mainstay of treatment to reduce LDL and cardiovascular mortality and morbidity.
  • Statin causes atherosclerotic plaque regression.
  • Bad publicity on Statin has caused a reduction in the usage of Statin by patients and prescription of Statin by physicians. The decline in the use of Statin translated into increase in CV morbidity and even death. The benefit of cardiovascular protection of Statins really outweighs the small risk of side effects. Let us have a closer look on the side effects of Statins.

Side effects of Statin

  • Muscle pain :
    • Myalgia : 5%, reversible. The problem of muscle pain can be reduced by monitoring of certain risk factors (old age, kidney impairment and concomitant administration of some medications which may cause drug – drug interaction)
    • Rhabdomyolysis – severe form of muscle breakdown with acute kidney injury is very rare : 1 in 100,000
  • Hepatotoxicity : Side effects on liver
    • Asymptomatic raise in liver enzyme ALT occurs in 3% of patients.
    • Severe acute liver failure is also very rare – 1 in 100,000
  • Cancer : no increase in risk. In fact Statin may confer protection from cancer mortality
  • Dementia and cognition function loss : no increase in risk. In fact Statin may reduce dementia risk.
  • Hemorrhagic stroke : small risk. But Statin reduces overall stroke risk.
  • Diabetes :
    • 5 – 10% risk
    • But the cardiovascular protection is much more than this small diabetic risk.
    • Even if patients develop diabetes they still live longer and healthier compared with those who have high LDL not taking Statin and no Stain induced diabetes.
    • High risk factors of Statin induced diabetes are high baseline blood sugar and metabolic syndrome.
    • Patients who are talking Statins are encouraged to live a healthy lifestyle to reduce the risk of diabetes

Understand these facts of Statins will help us to dispel Statin – phobia. Statins should definitely not be prescribed for all. But the high risk patients should take Statin to reduce the cardiovascular risk. The benefit of Statins should not be denied in these group of high risk patients just because of fear of side effects.

I encourage readers to discuss any issues on Statin use with respective physicians if there is any further doubt.