January 24, 2017

The Problem with Cancer Screening

by Dr. Scott Saunders, M.D.

Cancer testing is a large part of a doctor’s business.  We have been told that if we find cancer early, and cut it out, burn it with radiation, or poison it with chemotherapy, we can make a bigger difference.

While there is a lot of debate over this issue, we still continue to try to detect cancer early – or before it even starts.  I’m going to focus on the most common cancer screening tools, the ones you’ve all heard about, and that you were told you should do – or else!  These include:

  1. Mammograms
  2. Colonoscopy
  3. PSA testing
  4. PAP smears

I started studying cancer screening over ten years ago when I had a patient with an inexplicable case of cancer.  Because there were many cases in her family, Cecilia was always afraid of getting cancer and did all she could to prevent it by eating all organic and exercising regularly.  She even got all her cancer screening tests, PAP smears, annual mammograms and a colonoscopy at age 50.

One day, she came in to see me with a lump in her left breast.  It was large, a couple of centimeters, and not tender.  I looked at the mammogram report done only a few months before and it was negative for any signs of malignancy.  I reassured her that it was probably a cyst, but we would send her for an ultrasound to be sure.  A biopsy was done, it was cancer and, in spite of all the treatments, she died just over a year later.

Since I had known Cecilia for years and knew she was diligent in her health care, I was shaken by her death.  I wondered how we could have missed such a large tumor.  How could the mammogram have missed it only months before?  I asked the radiologist to review it, and he found no evidence of any mass in that exact location at that time.  So, I started doing some real research on the test itself, and was shocked by what I found!  Not only were mammograms questionable, but most of the cancer screening tests did more harm than good!

Mammography

A mammogram is an x-ray, and x-rays don’t distinguish the difference between normal tissue and cancer.  Instead, the radiologist looks for tiny calcium deposits that indicate there is some inflammation in the tissue.  The problem is that calcium deposits happen with any kind of inflammation, and are not specific to cancer.  Thus, many women who don’t have cancer are told they do, and the aggressive real cancers are missed; like in Cecilia, because they don’t form calcium deposits.[i]  The newer mammograms are better able to distinguish tissues with less radiation, however the problems with screening persist.

The primary problem with mammograms is that they don’t decrease mortality, at all.  In the long-term studies, including the Canadian study[ii] and the Oslo study (noted above) after 25 years and 14 years, respectively, the incidence of mortality from breast cancer remained the same – in spite of finding more cancer.

The Canadian Study showed that 22% of the women who were treated for cancer didn’t even have cancer! Or, they would not have died from it if they did.

Thus, the statistics of women having a mammogram and getting “cured” of cancer with chemotherapy and radiation may only represent those women who never had it in the first place! Click to Tweet.

The eight major long-term studies have been reviewed extensively.  The most detailed study of all of them, the 2011 Cochrane Review[iii], said:

“Screening is likely to reduce breast cancer mortality. As the effect was lowest in the adequately randomized trials, a reasonable estimate is a 15% reduction corresponding to an absolute risk reduction of 0.05%. Screening led to 30% over-diagnosis and overtreatment, or an absolute risk increase of 0.5%. It is thus not clear whether screening [mammography] does more good than harm.”

In short: The risk (0.5%) is greater than the benefit (0.05%) by TEN TIMES!  In other words, you are ten times more likely to end up with treatment for a cancer you didn’t have, than to prolong your life span by finding and treating a tumor earlier.

What do I do to screen for breast cancer?

Other screening tests for breast cancer have similar problems… and that is finding something that gets treatment, but would not have become life-threatening if left alone.  One of my patients wanted MRI screening tests because she was afraid of the radiation (there is about a 1/5000 risk) from a mammogram, and didn’t want her breasts pinched in the machine.  A mass was found, and biopsy showed it was an Interductal Carcinoma In-Situ, and she was told she needed surgical removal, radiation, and chemotherapy.  She opted-out of treatment, and she is still fine – with her mass that continues to grow – twelve years later.  She would have been considered a “cure” if she had been treated.

5 ways to prevent breast cancerWhether you use MRI, ultrasound, mammogram, or thermogram, you must consider what you will do once you find a bump!  Do you wait?  Do you treat aggressively?  Unfortunately, we have more questions than answers.  Judging by the numbers in the Cochrane study above, I might opt out of screening for this one.  Instead, I would do my best to prevent breast cancer from forming in the first place: [am4show guest_error=’noaccess’]

  1. Breast feed the baby
  2. Vitamin D3 – 50,000 IU per week
  3. Iodine – 6.25mg per week
  4. Selenium – 200mcg per week
  5. Low-inflammation diet (no sugar) high in nutrients

Colonoscopy

You enter the GI doctors’ office, having been up all night with diarrhea to clean out your bowels.  They give you sedation to ease the pain.  You climb into the upside-down chair and hear gloves snap as the doctor inserts a long scope into…

OK.  Is this good?  It’s not comfortable, but is it worth the pain?  Let’s look at the risks and benefits.

The biggest risk of colonoscopy are related to perforation – or puncturing a hole – in the colon.  Other risks are bleeding, Dysbiosis (bad bacteria growing back), and inflammation.  A hole in the wall of the colon allows stool to get into the abdomen, causing infection, and sometimes death.  These happen most often in the elderly, and those who are disabled.  It happens between 2 in a thousand and 5 in a hundred, depending on the study and the one who performs the procedure.[iv]

The risk of death from colonoscopy is not small: 1/3,000 to 1/30,000 depending on the study and circumstances.[v] risk of death from colon cancer in the United States is around 1/10,000.[vi]  Thus, the risk of complications from colonoscopy is on the same level as the risk of death from the cancer.

It’s very hard to interpret the studies on colonoscopy because they are done for so many different reasons.  The statistics seem to indicate that there are as many as 50% fewer advanced cancers diagnosed if you get a screening test; however, the death rate doesn’t change very much.[vii]

5 ways to prevent colon cancerSo, this test has a different problem than the mammogram, it is risky; you can have significant harm or death – this risk must be weighed against the benefits.  The benefits of finding cancers is useful if they can be removed and by so doing prevent problems.  But, don’t think it will prevent you from dying of this dreaded disease.

I would weigh the risks and benefits.  I would not personally do a screening test unless there was some reason to do so, such as blood in the stool, or a family history, or inflammatory bowel disease.  I would work on colon cancer prevention instead:

  1. Eat vegetables every day
  2. Avoid corn, soy, and canola oil
  3. Avoid sugar
  4. Vitamin D3 – 50,000 IU per week
  5. Selenium – eat a few brazil nuts every week

PSA testing

Last week, my brother went through his second biopsy of the prostate gland.  He didn’t want to do it, but the doctor said he must to determine if there is any cancer in there.  You see, he had a PSA test, which was elevated, so he was sent to a urologist for further evaluation.  The urologist had nothing else to do, so he did a biopsy, which was negative.  Now, this requires follow-up, just because someone thought of it.  So, my brother repeats the PSA, and it’s still high so he suffers 12 more needles in his prostate (the Spanish Inquisition should have thought of this!).

Medicare quit paying for the PSA screening test because it causes a lot of procedures for no benefit.  What was found in multiple studies was essentially the same problem as the mammogram, but on STEROIDS!

PSA screening helps to find TEN TIMES more prostate cancer, but death from prostate cancer doesn’t change.  Click to Tweet.

So, we’re finding it, radiating it, surgically removing prostates and giving all sorts of poisons, but the overall rate of death remains the same.[viii]

In this case, we even have several studies to indicate that treatment may do more harm than good, as noted in the NIH Consensus Paper on the subject:

“More than half of cancers detected with PSA screening are localized (confined to the prostate), not aggressive at diagnosis, and unlikely to become life-threatening. However, 90 percent of patients receive immediate treatment for prostate cancer, such as surgery or radiation therapy. In many patients, these treatments have substantial short- and long-term side effects without any clinical benefit. Appropriate management of screen-detected, early-stage, low-risk prostate cancer is an important public health issue given the number of men affected and the risk for adverse outcomes, such as diminished sexual function and loss of urinary control.”[ix]

5 ways to prevent prostate cancerThough the doctors recommend expensive and painful tests and treatments, they offer no benefit to the patients. In fact, they often do more harm than good.[x]

The PSA test is not a bad test as an indicator of prostate inflammation, generally.  The problem is that it has become associated with cancer, so if it is high everyone gets overly concerned about that and miss the real problem.  If we could instead look at the PSA as an indicator of prostate inflammation only, it might become a useful test.

Primary prevention of prostate cancer includes:

  1. Low-inflammation diet
  2. Zinc supplementation
  3. Lycopene (the red in tomatoes)
  4. Avoid corn and soy oils
  5. Eat fish, or fish oil weekly

PAP smears

The Papanicolau (PAP) Smear has much less controversy than the other screening tests.  All of the problems surrounding this test revolve around fine-tuning who should have it, when, and how often.  There is also an issue of adding on the HPV test for the virus that causes cervical cancer.

Though there has never been a randomized trial to evaluate this test, it has been shown in multiple populations to decrease the incidence of cervical cancer, as well as lowering the death rate.[xi]

Moreover, there is no risk to doing this test, besides the possibility of having an unnecessary procedure if it is wrong.  However, unlike the potentially deadly results of the other tests, colposcopy, biopsy, or even a surgical procedure carries little risk to the patient.

The only group that has greater risk from screening is those women under 24 years of age.  This is because the incidence of cervical cancer is so low, and because most who get HPV infection will clear it without developing cancer.  Thus, PAP smears are not recommended for women under 24.

The interval of screening could be anywhere from annually, for those who have high risk, to every 5 years for those who are at low risk.  Generally, women who have had three normal PAP tests and have a monogamous, or no, relationship I recommend every 5 year screening.  Those who have had a previous abnormal test and have a high-risk HPV test should be screened every year or two.  If there is a question, I recommend getting the HPV test along with it.  This virus is necessary, though not sufficient, to cause cervical cancer. The best way to prevent cervical cancer is to have a monogamous relationship with a single individual for life. Click to Tweet.

Conclusion

In short, I don’t recommend cancer screening tests, except the PAP smear.  I think primary prevention is the ideal, meaning preventing the cancer before it starts, and secondary prevention, meaning finding a cancer in an early stage to facilitate treatment, is not beneficial in the large majority of cases.

 

Dr. Scott SaundersDr. Scott D. Saunders, M.D. (Ask-an-MD) is a practicing physician, specializing in preventative health care, who utilizes eclectic health care for the whole family, including conventional, orthomolecular and natural medicine. He is also the medical director of The Integrative Medical Center of Santa Barbara in Lompoc, CA. He went to UCLA medical school and is board certified in family medicine. View natural remedies with Dr. Saunders at: http://drsaundersmd.com

 

 


[i] http://tidsskriftet.no/article/2220635/en_GB
[ii] http://www.bmj.com/content/348/bmj.g366
[iii] Gotzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2011;1:CD001877
[iv] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811793/
[v] Common Questions about Colonoscopy. American Society for Gastrointestinal Endoscopy. Nov. 2005. 13 Oct. 2006 [http://www.askasge.org/pages/procedures/colonoscopy/questions.cfm].
[vi] http://seer.cancer.gov/csr/1975_2009_pops09/
[vii] http://www.nejm.org/doi/full/10.1056/NEJMoa1301969
[viii] http://www.cdc.gov/cancer/prostate/statistics/index.htm
[ix] http://consensus.nih.gov/2011/prostate.htm
[x] http://jama.jamanetwork.com/article.aspx?articleid=1700496
[xi] http://www.cancer.gov/cancertopics/pdq/screening/cervical/HealthProfessional/page2

 

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Longevity Miracle: Studies Prove Exercisers Live Longer

Cyclists for Longevity by Flickr dirkjankraan.com

A large study at the National Health Research Institutes in Zhunan, Taiwan, published in The Lancet, found that as little as 15 minutes of physical activity a day can reduce the risk of dying by 14% and increase lifespan by three years.

More exercise leads to greater life gains.

Every additional 15 minutes of daily exercise further reduced all-cause death rates by 4%. This trend continued until a person was exercising for 100 minutes a day.

High intensity exercise though, is the gold standard for fitness… and longevity. It was recently endorsed by the European Society of Cardiology. A study conducted among cyclists in Copenhagen, Denmark showed it’s the relative intensity, and not the duration of cycling, which is most important in relation to all-cause mortality. It’s even more pronounced for coronary heart disease mortality. The study concluded that men with fast intensity cycling survived 5.3 years longer, and men with average intensity 2.9 years longer than men with slow cycling intensity. For women, the figures were 3.9 and 2.2 years longer, respectively.

Exercise reduces disease and death dramatically for all major progressive diseases.

According to a research study involving over 13,000 participants cited by Ray Kurzweil in The Future of Aging, the overall death rate for moderate exercisers was 60% less than the sedentary group–and the high fitness group scored much better with longevity. Yet some 70% of Americans do not participate in any type of physical activity.

As Dona Folk, my close friend and breast cancer survivor will tell you, exercise can also treat serious diseases such as cancer. A new report issued by Macmillan Cancer Support argues that exercise should be part of standard cancer care. It recommends all patients getting cancer treatment should engage in moderate-intensity exercise for two and a half hours every week.

A previous Harvard Medical School study found that breast cancer patients who exercise moderately for three to five hours a week cut their odds of dying from cancer by about half. In fact, any amount of weekly exercise increased a patient’s odds of surviving breast cancer. This health benefit also remained constant regardless of whether women were diagnosed early on or after their cancer had spread. Finally, research has found that exercise reduces the risk of breast cancer recurrence by about 40 percent.

Research has also shown that exercise can reduce your risk of dying from prostate cancer by up to 30 percent.

If you have cancer or any other chronic disease, tailor your exercise routine to your individual scenario, taking into account your stamina and current health and physical activity level. Always listen to your body, and if you feel you need a break, take time to rest. But even exercising for just a few minutes a day for longevity is better than not exercising at all.

Exercise is critical to help dodge or reduce diabetes as well as most other diseases. According to the American Diabetes Association, exercising moderately for only thirty minutes a day coupled with a 5-10% reduction in body weight resulted in an astonishing 58% reduction in diabetes. They also report that 90% of all people with diabetes are overweight.

Any exercise that gets the heart pumping may even reduce the risk of dementia and slow the condition’s progression once it starts, reported a Mayo Clinic study published in the September 2011 issue of Mayo Clinic Proceedings.

Improve your odds against prostate cancer by exercising. How can Home Cures That Work help you exercise more?

 

David Kekich is President/CEO of Maximum Life Foundation that focuses on aging research, a 501(c)(3) corporation dedicated to curing aging-related diseases. For more information, visit: www.MaxLife.org. David contributes to our column Living Healthy to 120: Anti-Aging Breakthroughs. MaxLife is helping to make the anti-aging dream a reality with cutting edge Bio-Engineering research and products.

At Last – Natural Menopause Relief

Victoria came in yesterday wondering if she should take hormones for menopause.  At age 54, she hadn’t had a menstrual period in over six months, but wasn’t having any of the usual symptoms of menopause either and was wondering what to expect.  She’d had a couple of hot flashes (“I think”), but they weren’t distressing.  However, even though her symptoms were minimal, she was told she needed the hormones to prevent osteoporosis and heart disease.

At age 45, Julia had already had over a year of hot flashes and they were keeping her up at night. After sweating so much at night, she couldn’t get right back to sleep; and it happened several times every night.  During the day, she was tired all the time and irritable both at work and at home.  She even started getting anxiety.  “Miserable…” was how she described herself.

As you can see, there are many faces of menopause.  Some women are really miserable with the hormonal changes and mood swings, while others seem to sail through without a blip on the hormone radar screen.  Because of this, the big question is, “Does every woman require hormone treatment?”

Options For Managing Menopause

Doctors have turned this very normal process of life into a disease.  It’s not a disease.  There is nothing about menopause that creates poor health, except for the symptoms.  The truth is women can live long and healthy lives without the hormones that produce ovulation and menses.  Because of this, menopause is one of the few conditions that should be treated symptomatically.

Treatment for menopause is really about controlling symptoms; if a woman has no symptoms and just stops her menstrual periods, she doesn’t need to do anything.  But, if her life is miserable with sleep deprivation, panic attacks, foggy brain, hot flashes, vaginal dryness and loss of libido, it may be prudent to find natural menopause relief from those symptoms.

The treatment options a woman has are very broad due to the wide variety of symptoms.  There are many herbal remedies, vitamin treatments, natural combinations, homeopathic remedies, creams, suppositories, patches, hormone replacements and prescriptions available to those navigating through menopause.  “How to choose?” is the biggest question.  Read on to find some helpful tools that might fit you.

Remember: You are the only one who knows how you feel, so a doctor cannot tell you what will work for you.  Consider the advice you are given, try the ones that seem promising and then evaluate them for yourself.  This is definitely not a one-size-fits-all condition.  It just has to work for you!

Best Of Herbal Remedies

There are so many herbal preparations that it is impossible to list them all.  Let me say that many of my patients find one herbal remedy or another that works well for them. Streamlined doctors are told that herbal preparations don’t work, so they pass unbelief on to their patients.  This is unfortunate because, while they don’t work for all women, countless find great natural menopause relief and avoid having to take potentially harmful prescriptions.

Some of the preparations that I have seen women use successfully include:

  • Black Cohosh
  • Red Clover
  • Russian Rhubarb
  • Ashwaganda
  • Chayawanprash

I highly recommend Black Cohosh because it is the most visibly affective.  There are many preparations and combinations to try – just find the one that works the best for you. Recently, while shopping, I came across

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It’s Time to Learn the Difference

IT’S 2002 ALL OVER AGAIN, and women are being warned against taking hormone replacement therapy (HRT) because of its link to breast cancer. Why is history repeating itself? Because we haven’t learned an important lesson. Synthetic progestins are not the same as progesterone, and reporting on them as if they confer the same risks and benefits is absurd.

A study in the New England Journal of Medicine dated February 5, 2009, concluded that hormone therapy doubles the risk of breast cancer. Specifically, women past menopause who take both estrogen and progestin (such as in the form of Prempro) for five years or more have twice the risk of developing breast cancer. When these same women stopped their combination hormone formula, the number of breast cancer incidents dropped by about 28 percent within the first year.

This study is a follow-up to the landmark Women’s Health Initiative that studied more than 15,000 women between the ages of 50 and 79 who were taking HRT. In 2002, the study was stopped when researchers concluded that Prempro caused higher incidents of heart problems and breast cancer. Interestingly, the number of breast cancer cases dropped significantly since 2003. Dr. Rowan Chlebowski, a medical oncologist at Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, wanted to know why. So he assembled a team of researchers to determine if it was due to women halting their HRT or to more vigilant mammography practices.

It’s related to HRT use; getting regular mammograms didn’t affect the numbers at all. But it’s not related to all hormone therapy! The women who took only estrogen (usually in the form of Premarin) without the progestin were no more likely to develop breast cancer than women who took no hormones at all. (Progesterone lowers the risk of uterine cancer. Women without a uterus aren’t typically given a progestin.) This means the synthetic progestin is the likely culprit.

Flashback to 2002. Women around the world stopped HRT cold turkey, causing many to feel unhealthy. Why? Because many healthcare providers and researchers didn’t know or appreciate the difference between a synthetic progestin and progesterone, which is a bioidentical hormone. (For more information on bioidentical hormones, read “The ABCs of HRT” in the Women’s Wisdom Circle.) Progesterone matches a woman’s body exactly and has been shown to ease mood, sleep, and cycle-related issues. Progesterone supplementation has another unique advantage—it can be converted to other hormones, such as testosterone and DHEA, if needed. Synthetic progestin is an altogether different substance known to actually exacerbate perimenopausal and post-menopausal symptoms—in addition to increasing your risk of breast cancer, heart disease, and stroke.

It’s hard to believe that seven years have passed and yet the difference between synthetic progestins and progesterone is not widely understood. Dr. Northrup has been doing her best to educate women across the U.S. and the world and has recently appeared on TV, radio, and webcasts to share her knowledge. (To learn more click here.) She encourages all women to learn about all the options for hormone therapy available today, particularly those involving bioidentical hormones. Dr. Northrup also hopes that all women will look with a critical eye at mainstream news about HRT, especially the news that’s sensationalized. As is the case with the study described above, there’s more to the story than meets the eye.

 

Christiane Northrup, M.D. is a visionary pioneer and beloved authority in the field of women’s health and wellness. A board-certified OB/GYN physician, Dr. Northrup was also an assistant clinical professor for 20 years. Recognizing the unity of body, mind, and spirit, Dr. Northrup helps empower women to tune in to their innate inner wisdom to transform their health and truly flourish. Dr. Northrup is the author of Women’s Bodies, Women’s Wisdom, The Wisdom of Menopause and The Secret Pleasures of Menopause. She has also hosted six highly successfully public television specials. Her work has been featured on the Oprah Winfrey Show, the Today Show, NBC Nightly News, The View, the Rachael Ray Show, Good Morning America, and ABC’s 20/20.  Visit http://www.drnorthrup.com/ for more details.

 

 

To Soy or Not To Soy!

Soy products are big business in the health food industry. Promoted for its appeal as a natural, low fat, no cholesterol food, it’s easy to see why so many of us would buy into the claim that soy is a health food. Besides, if much of Asia enjoys dietary forms of soy on a daily basis then it must be good, right? Not necessarily. There are seemingly advantages and disadvantages associated with soy that may make you think twice about whether or not it’s truly beneficial to your body.

Nutritional Facts and Figures

Soybeans are nutritious. For vegans and vegetarians, soy is an important source of protein, rich in iron, zinc and calcium. Dr. Mercola, a natural health advocate, is largely against adding soy to the diet unless it’s the fermented variety such as Tempeh, Miso and Natto. Fermented soy may offer many health benefits to the body. Unfermented soy contains large amounts of natural toxins, including enzyme inhibitors that block the action of trypsin and other enzymes needed for protein digestion.

“They can produce serious gastric distress, reduced protein digestion and chronic deficiencies in amino acid uptake. In test animals, diets high in trypsin inhibitors cause enlargement and pathological conditions of the pancreas, including cancer,” says Mercola.com

Negative or Positive Results

Research shows that Asian people, who eat large quantities of soy, have lower rates of heart disease, breast cancer and prostate cancer, fewer hip fractures and fewer hot flashes. However, there is little research to prove that soy is the reason why. Where heart disease is concerned, the AHA does at least support soy foods for good heart health if only because they usually replace less healthful choices, like red meat, and because they deliver plenty of polyunsaturated fat, fiber, vitamins, and minerals and are low in saturated fat.

Questionably, the biggest pro to adding soy to the diet is its effect on cholesterol levels. In 1999, the FDA endorsed soy as a means to lower cholesterol. However, according to the American Heart Association’s, eating 50 grams of soy each day lowers LDL only about 3 percent. When you consider that 50 grams of soy protein is more than half the average person’s daily protein requirement, that’s a lot of soy for a relatively insignificant decrease. You would need to drink eight 8-ounce glasses of soy milk a day!

Soy provides isoflavones and essential fatty acids. According to the Health Services Agency of Stanislaus County, CA, these isoflavones are phytoestrogens, weak estrogen-like substances made by plants. “They are similar enough to estrogen that they are able to bind to estrogen receptors, possibly explaining how soy might protect against breast cancer.”

Unfortunately, these same phytoestrogens, in large quantities, may also have a negative impact. The Harvard School of Public Health brings attention to a handful of unsettling reports that suggest that concentrated supplements of soy proteins may actually stimulate the growth of breast cancer cells. “On August 12, 2000, two senior US government scientists, Drs. Daniel Doerge and Daniel Sheehan, announced their belief that soy products could cause breast cancer in women, brain cancer in both genders, and infant birth defects. Their internal protest letter within the FDA cited 28 studies showing the dangers of soy products containing isoflavones.

Possible Risks

When we think of soy, many of us first think of tofu – and the Asians. Also known as textured vegetable protein, tofu is high on Mercola’s list of soy foods to be avoided. Why? It’s commercially made in large metal containers and thus contains high levels of aluminum. It’s also flavored with MSG…yuk! But above all, soy infant formula remains top of the worst soy foods list for Dr. Mercola. “Infants fed soy formula have up to 20,000 times the amount of estrogen circulating in their blood stream than infants who are not fed soy formula!”

So…Soy?

To conclude, there is no evidence to show that soy-based foods eaten in moderation as part of a varied diet, are harmful. If you do want to add soy to your diet, to take advantage of the possible cholesterol and cardiovascular benefits, you would be wise to consume soy in moderation and at best only eat fermented forms.

Roger Asmus entered a fitness competition and won the Mr. Teenage Colorado in 1991. He was later named Mr. Mile High in 1996 and achieved his dream when he was proudly awarded the title of Mr. Natural Colorado in 1998. Roger has been highly sought after as a model and authority in the fitness world, appearing in national news and magazines sources. Roger is currently one of the top personal trainers in the country and is president of Core Health Innovations™.

 

 

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