Help for Insomnia on the Internet

There is a fully automated, 9 week program available on the internet called SHUTi that appears to be very helpful for most participants. It uses a technique called cognitive-behavioral intervention, which is a well-established psychiatric technique. In the past, the biggest obstacle to this therapy is the lack of trained therapists to provide it, and next has been the cost. A study at the University Health System of 44 patients (average age 45 y.o.) found SHUTi to be effective in 73% of the cases six months after the training began. Learning the technique on the internet achieved comparable results to those who were treated face-to-face.

See Family Practice News(subscription required-click here), August, 2009, p. 32 . Or search for SHUTi on the internet.

Should Lipid Levels be Measured Non-fasting?

Recently, elevated non-fasting triglyceride levels have been shown to increase the risk of cardiovascular disease more than fasting levels. HDL and Total cholesterol levels have been thought to be about the same, whether fasting or not. That is why the latter can be measured in health screenings. A Hungarian study presented at the International Atherosclerosis Society meeting confirmed these suspicions. It looks like lipid levels of the future will like by collected non-fasting to assess the true risk.

See Family Practice News (subscription required), August, 2009, p. 15.

How Low for Blood Pressure and Cholesterol?

A Harvard study of patients with known coronary artery disease showed that there was less risk for future events if the LDL (bad cholesterol) is brought to 100 mg/Dl. It also showed that bringing BP below 110 over 60 was harmful. Ideal BP seemed to be about 130/70 in this study (known as the TNT study). Many cardiologists push the LDL and BP to lower levels with multiple drugs. This study did not justify such over-control, and in fact concluded that the risk might be higher for such patients. Those without coronary artery disease were not studied.

See Family Practice News (click here-subscription required), August, 2009, p. 9 .

What About the H1N1 (swine flu) Vaccine?

On 9/10/09 a research report indicated that the vaccine might be more effective than previously thought so that only one shot might be required (in addition to the regular flu vaccine, of course). Safety issues have not yet become apparent. The National Vaccine Advisory Committee is recommending the vaccine for virtually everyone, but they also caution that we need to monitor adverse effects very carefully and transparently, which has not always happened in the past. Potential side effects include paralysis and death. Thus far, the swine flu illness does not look to be very severe, except for high risk individuals, although that could change. The vaccine does contain mercury. My recommendation is to take 2000-5000 iu of vitamin D daily and 1000-3000 of vitamin C. You can take mucococcinium (a homeopathic available through our office) one pill every two weeks for prevention. If you get sick, monolaurin and “colds and flu” homeopathic are usually helpful, and I would generally avoid Tamiflu medication. The vaccine is your choice, but I doubt if I will take it.

See Family Practice News (click here) subscription required, August 2009 issue, p. 4.

Fat and Health Care Reform

A Toledo Blade editorial cited a recent study showing that obesity adds $147 billion to health care costs in the US everyyear. Every American deserves the opportunity to avoid catastrophic health care costs, and I sincerely hope that Congress and the Obama Administration find a way to solve the national disgrace of inadequate coverage for so many of us. But far more important than covering routine office visit care for acute illnesses is preventive medicine and incentives for healthy lifestyle choices. This is the only way we will achieve effective medical care and stop spiraling costs.Even Ben Franklin, who suffered terribly from Gout and Obesity, realized that an “ounce of prevention is worth a pound of cure”.

See The Blade (click here), Toledo, Ohio, August 9, 2009

Medications Linked to Sudden Death in ADHD Children

A recent study funded by the FDA and the NIH uncovered alink between the use of stimulant medications used to control hyperactive behavior in children to sudden, unexplained death in a few but significant number, ages 7-19. Stimulant meds contain a black box warning against sudden death for children but also for strokes, arrhythmias and heart attacks for adults. There are many alternative choices to such drugs in the integrative field, including herbals, homeopathics, adrenal support, essential fatty acids, and amino acids to balance neurotransmitters, all of which are much safer than pharmaceuticals and often work very well. Prescriptions for ADHD drugs increased fourfold from 1986 to 1996, and has remained steady since then. It is time to think out of the box, the black box that is.

See Mortar and Pestle, St. Rita’s Hospital (click here), Volume 9, Issue 7, July,2009.

The AMA

The American Medical Association claims to represent most physicians in the United States. Nothing could be further than the truth. Of 900,000 practicing physicians in the country, the AMA claims membership of only 157,000 (17%). They pad their numbers by offering students and residents greatly reduced or free memberships. Even that number is going down. About 50% of students were members in 2008, compared to 59% in 2004. The founder of Sermo suggests that the biggest risk to US physicians is the AMA. A recent survey of 4000 physicians indicated that 75% were not AMA members, and 89% said that the organization does not speak for them. According to its annual report 85% of its annual revenues come from non-dues sources, such as advertisements from drug companies and sales of coding books,which does not include appropriate codes of alternative medicine, by the way.

See Sermo.com (membership required) and AAPS News click here-(members only), August 2009

The Newest Recommendations on High Cholesterol and Statin Drugs

Stephen Sinatra is a prominent cardiologist who refuses to give knee-jerk support to the standard line on lipid problems, because the usual recommendations are not supported by good research. If your cholesterol is high, he recommends a VAP or LPP test to look much deeper into how much risk you actually have. If you are a male between ages 50 and 75 and you have high levels of small, dense LDL, use a statin drug (I would prefer red yeast, a natural statin). Over 75 y.o., forget the statins. If you are female, the statins are not particularly useful. You are better off using proteolytic enzymes and fish oils to reduce inflammation. If your Lp(a) is high, statins will not help. Niacin and nattokinase will do much better (in my experience, chelation helps even more). Lipitor-associate amnesia has been identified in 662 cases in a recent study by Graveline and Cohen.

See articles on these two subjects in the June, 2009 issue of the Townsend Letter (click here), p. 60-62 and p. 64-70. .

Routine Suppression of Stomach Acid Increases the Risk of Pneumonia

It has become commonplace for physicians to prescribe acid suppressors like omeprazole or Prilosec, Protonics, and Nexium to patients upon admission or discharge from the hospital. The reason is to prevent stress-induced ulcers. 40-70% of patients receive these drugs, even without symptoms. The problem is that the lack of stomach acid eliminates an important part of the immune system’s protection against infection. The incidence of pneumonia in such patients is 30%, according to an article in the AMA journal by Harvard researchers, and the risk begins within a few days of beginning the drugs. These medications can be useful to treat ulcers or GERD (reflux), but they should not be used preventively. Integrative Physicians commonly use natural products to achieve the same results, such as mastica or licorice.

See Herzig SJ, JAMA, May 27, 2009, p. 2120 (click here)