Tuesday, December 28, 2010

Vitamin K Deficiency Appears to be a Major Risk Factor for Developing Arthritis

Boston University rheumatologist, Tuhina Neogi, reported at the World Congress on Osteoarthritis in Brussels that people who are deficient in vitamin K has twice the incidence of developing osteoarthritis of the knee. Those who eventually developed arthritis in both knees over a 30 month period were 3 times more likely to be vitamin K deficient. Vitamin K is also a factor in Rheumatoid arthritis and in Osteoporosis. Supplements containing both Vitamin D and Vitamin K are now available, and should be considered for a comprehensive preventive program.

See Family Practice News (click here), November 1, 2010, pp. 36-37.

Tuesday, December 21, 2010

Merry Christmas!

This will be the last blog posting until after Christmas.

One Cause of the Skyrocketing Costs of Medical Care

An exciting new drug, fondaparinux, significantly reduced the incidence of blood clots released from thrombophlebitis in the legs. The drug is given by self-injection for up to 45 days. The cost of the treatment for one patient is up to $7380. You have to treat 88 patients at a total cost of as much as $650,000 to prevent one clot. And no lives were saved. Because the study was published in the New England Journal of Medicine, the chances are that this drug will be very popular indeed. Dr. Lee Goldman of Columbia University and Dr. Jeffrey Ginsberg of McMaster University wrote a commentary in the same journal calling for cost to be a consideration in the FDA approval of drugs. I couldn’t agree more, but that would require sanity and common sense.

See New England Journal of Medicine (click here). 2010;363:1222-32, 1278-80.

Tuesday, December 14, 2010

Be Careful About Lasik Surgery

Many are reassured because Lasik surgery has a 95.4% success rate. Patients choose the procedure to eliminate the need for glasses and contacts. But Bert Bieler, MD, of Cherry Hill, N.J. wrote a letter-to-the-editor in American Family Physician pointing out that 14 million such procedures were performed in North America between 1997 and 2009. That means that more than 600,000 patients had an unsuccessful outcome or a “failed” procedure with either complications or worse vision afterwards. Dr. Bieler urged caution, as we should exercise for many surgical procedures, for example bypass surgery, when medicines might do just as well.

See American Family Physician (click here), Nov. 1, 2010, P. 1044.

Tuesday, December 7, 2010

Rapid Weight Loss is More Effective than Gradual Weight Loss

Contrary to what physicians have been taught for many years, rapid weight loss programs designed to lose up to 4 pounds a week have been shown to be more effective than the usual goal of a pound a week. Rapid weight loss can be achieved with a 500 calorie diet. We have seen good appetite suppression with HCG, although that approach has been criticized by the AMA. HCG is given by the patients themselves by shots, but homeopathics preparations have recently become available. Acupuncture can also help decrease the appetite while on very low calorie diets. Maintenance is still a crucial part of either program.

See Family Practice News (click here), Sept. 1, 2010, p. 42.

Friday, December 3, 2010

Huge Rise in Diabetes Predicted

Insulin-dependent Diabetes is doubling every 20 years because of genetics and people living longer. Non-insulin-dependent diabetes is rising at an even faster pace due to increased American obesity. This will present a major obstacle to primary care physcians, according to a recent conference reported in Family Practice News. Patients with diabetes frequently have multiple complications and require complex treatments to control their glucose, lipids and blood pressure. Special clinics are sometimes needed for difficult cases. We currently do not have the resources to properly treat all the expected new cases of this disease. Once again, we need to turn to healthy lifestyle changes to prevent diabetes, which can be done in a good number of cases.

See Family Practice News (click here), Sept. 1, 2010, P. 14.

Tuesday, November 30, 2010

Coming off Anti-Depressants Safely

First, anti-depressant medications can be extremely helpful for some patients. When they are helpful, they should be used at least for 9-12 months. Second, some herbals can be as effective as the drugs with fewer potential side effects. I like to use SAMe and PeanRich. Others like St. John’s Wort, but it too can have side effects. Patients want to come off the drugs because they no longer need them, the side effects are bothersome, the cost is high, or they were never were that effective. Third, if you come off anti-depressants, do so slowly and under a doctor’s supervision. We often use a supplement called Empower plus to to help the transition. We also find it extremely helpful to measure the urine neurotransmitters so we can boost up the ones that are low. This can be an effective way for patients to get the benefits without the drugs.

See Holistic Primary Care, Fall, 2010, p. 7.

Tuesday, November 23, 2010

Sinusitis Often Does not Respond Well to Antibiotics

Sinus cleansing might be a better approach than antibiotics for persistent sinusitis and even for upper respiratory infections, according to an article in Holistic Primary Care. Sinus irrigation with salt water, usually with one version or another of the Neti Pot, clears out mucous and makes it easier for the body to conquer the infection. Homeopathics can also help by stimulating the immune system. We have been using the cold laser with excellent results. Keep in mind that chronic sinus infections are mostly due to fungus and need to be treated with anti-fungals, probiotics and a low-carbohydrate diet.

See Holistic Primary Care, Fall 2010, P. 8.

Thursday, November 18, 2010

Medicine is Simple: Lifestyle Works far Better than Drugs or Surgery

Colin Kopes-Kerr, MD, wrote a powerful editorial in American Family Physician stating that it is clearly time for change. For centuries, medical practice has responded to disease with drugs, remedies, surgery and a pittance of lifestyle counseling. He lists 10 major studies that demonstrate the higher value of primary prevention, which consists of a healthy diet (5-7 servings of fresh fruits and veggies a day), no obesity, regular exercise (150 minutes a week), no smoking, and reduced stress (15-20 minutes of pure relaxation a day). The impact on disease prevention, longevity and quality of life is huge, twice as much as everything else that is taught in medical schools. It is not that hard to do, for most of us. Get busy, America, and stay well.

See www.aafp.org/afp(click here) American Family Physician, Vol 82, No. 6, Sept. 15, 2010:610-14.

Tuesday, November 16, 2010

The Right to Bear Arms is Uniquely American

Lawrence Gostin, JD, of Georgetown University Law Center wrote an editorial blasting the US judicial system for its interpretation of the second amendment. “Why is the right to bear arms fundamental, when it appears that firearms—designed to cause injury or death—are antithetical to social order and public safety?” In 2007, the US had 78,622 nonfatal injuries and 31,224 deaths due to firearms. The firearm death rate for our children less than 15 years old is 12 times higher than the combined rates in 25 comparable countries. A homeowners gun kills many times more friends and family members than intruders, and too frequently it does not remain in the home or in possession of the owner.

See JAMA, October 6, 2010—vol 304, No. 13: 1485-6.

Tuesday, November 9, 2010

Forget Mouth-to-Mouth CPR!

Physicians from around the country participated in a 5-year study to evaluate CPR taught to the general population and medical personnel. They concluded that patients had increased survival with compression-only CPR. Only 30% of patients needing CPR get it. Avoiding the mouth-to mouth guideline increased the percentage of patients receiving CPR. For those who did get either kind of CPR, survival of patients was in the 10-20% range, but it was better when compression was not mixed with breathing for the patient, if intubation was not available. The best action is to compress vigorously at 100 times per minute until the patient can be shocked by a portable defibrillator.

See JAMA, October 6, 2010—Vol 304, No. 13, 1447-1455.

Thursday, November 4, 2010

Inadequate Dose of Glucosamine Does not Help Back Pain

A Norwegian study published in the AMA Journal supported the pharmaceutical industry by claiming that glucosamine does not work for arthritis in the low back. They were able to do so by using only half the effective dose of 3 Gm per day and omitting cofactors, especially MSM and certain herbals like boswellia. I find that the liquid glucosamine/MSM combo preparation works better than the pills for most patients. Glucosamine does not work for everyone, but neither does Motrin, Celebrex, or Alieve, which cause way more side effects in the stomach, kidneys, and heart.

See JAMA 2010;304(1):45-52.

Tuesday, November 2, 2010

You Don’t Have to Use CPAP for Sleep Apnea

Sleep apnea is frequently missed, partly because it is not thought of and also because patients cannot imagine sleeping with a machine. Some people do quite well with CPAP, but others do not. Several new oral appliances can be worn at night with an 80% success rate if the baseline apnea-hypoxia index is less than 30 events per hour. If the appliances do not work, surgery can be considered, including the newer procedures that alter the positioning of the jawbone. Finally and probably primarily is effective weight loss. The greater the weight loss, the better the result. We have some good techniques to insure weight loss nowadays. So that might be the best answer for you.

See Family Practice News (click here), July issue, p. 74.

Thursday, October 28, 2010

Drug Interactions are Common in the Elderly

Many elderly patients take 10-12 prescription drugs. Dangerous drug interactions are frequently unavoidable with this many meds. Most doctors do not thoroughly check for interactions. If you are taking a lot of medicines, including over-the-counter drugs and supplements, ask your pharmacist to check you for interactions. Then ask your doctor about any issues that come up. Some interactions create potential problems but are being tolerated fine in your situation. Others might put you at risk. About 100,000 deaths are caused each year by properly prescribed drugs in hospitals. Finally, work with your doctor to minimize the prescription drugs you need to take. Often, a nutrient plan can help you do without drugs. This approach is much safer, and can save you money as well.

See Family Practice News (click here), July, 2010, p. 68.

Tuesday, October 26, 2010

On Becoming Addicted to Acid-Blocking Drugs for Reflux

The use of PPI drugs such as Prilosec, Nexium and Protonics for gastro esophageal reflux disease (GERD) has increased dramatically in recent years. A Danish study showed that discontinuing long-term use of these drugs was very difficult in most patients, even though patients had no abnormal endoscopic findings. When the drug is stopped there is a rebound of symptoms, just like withdrawal symptoms when a patient is addicted to a controlled substance. Long-term use of PPI drugs can increase the risk of hip fractures. Once a patient gets through a gradual tapering of a PPI over 3-12 weeks, he or she might be able to get off the drug, but additional therapy (like Refluxin from Cardiovascular Research) might be needed for some time.

See Family Practice News (click here), July, 2010, p. 59.

Thursday, October 21, 2010

Sun Exposure and Melanoma Risk

Reports from Norway and Spain indicate that increased exposure to sun increases the risk of melanoma in exposed areas but decreases the risk of melanoma in areas not exposed, such as vulvar melanoma. Other studies have indicated that higher serum levels of vitamin D result in improved survival in melanoma patients. This is another indication that Vitamin D is the “wonder drug” of the 21st century.

See Family Practice News (click here)July 2010, p. 48.

Tuesday, October 19, 2010

Uncovering Suicide Risk in Patients that are Depressed

Dr. Guy Diamond has developed a web-based behavioral health screen to assess anxiety, depression, substance abuse and most importantly, suicide risk. This tool will become available in the fall of 2010 (about now). It takes about 10 minutes for a teenager or young adult to complete, and will be used primarily as a screening tool before the patient sees a doctor for a routine checkup. This area of health concern is often neglected. A pediatric task force is considering designating a Pediatric Mental Health Month, which I think is a good idea.

See the American Academy of Pediatrics Task Force on Mental Health Care.

Friday, October 15, 2010

Hair Mercury Testing in Pregnant Women

Dr. Gideon Koren of the Mother Risk Program, who is a regular columnist for Family Practice News, discussed recent FDA guidelines that pregnant women should avoid shark, mackerel, and swordfish altogether but are allowed only 12 ounces a week of fish and shellfish, due to their mercury content. Mercury is a potent neurotoxin that can cause birth defects. His organization gives these recommendations but also offers their women a hair mercury test, which he says is available at most university medical centers. This is quite a turn of events and an out-of-date statement at the same time. Twenty years ago, if an alternative doctor ordered a hair analysis, medical boards considered that grounds to threaten his or her license. Now few alternative doctors use hair analyses because they are only positive if the patient excretes the mercury instead of storing it. Much more accurate is a challenge test to see how much of the mercury in the body you can pull out (or chelate). Preferably, the test should be done before the pregnancy to develop the best treatment and prevention strategy if mercury or other toxic metals are present.
See Family Practice News(click here), July, 2010 issue, p. 37.

Tuesday, October 12, 2010

Onset of Menopause Correlates to Risk of Cardiovascular Disease

Dr. Melissa Wellons of the Multi-Ethnic Study of Atherosclerosis (MESA), funded by the NIH found that women who began menopause before the age of 46 y.o., had double the risk of cardiovascular disease in later life, regardless of other risk factors, race, ethnicity and whether the menopause was surgical or not. In another development, the Endocrine Society issued a formal statement that women age 50-59 y.o. have a 30-40% reduction in total mortality if they start hormone replacement therapy (HRT) and take it for 5 years compared to those who start the therapy in their 60’s or higher. The risk is almost all due to progestin therapy. Estrogen itself or mixed with bio-identical HRT (estrogen plus progesterone) does not appear to increase the risk of breast cancer. The usual cautions of individualizing the therapy and using the lowest dose for the shortest duration apply.

See Family Practice News(click here), July, 2010 issue, p. 36.

Thursday, October 7, 2010

The HPV Vaccine for Teenage Girls to Help Prevent Cervical Cancer Controversy

Merck Pharmaceuticals continues to urge that all teenage girls receive this vaccine to prevent them from getting infected by the HPV virus, which is transmitted by sexual intercourse unless condoms are used. Most doctors agree that females in this age group who are sexually active, particularly with multiple partners, should be vaccinated. Last year a prominent editorial and article in the AMA journal questioned whether enough was known about the risk/benefit ratio of this vaccine and criticized the aggressive marketing campaign by Merck. There is concern that lowering the HPV virus incidence might not prevent cancer. It is not known how long the vaccine effect lasts, and significant side effects are possible.

See JAMA(click here,subscription required) 2009;302:795-6, 781-6.

Wednesday, October 6, 2010

Seasonal Flu Shot Recommendations for Children

If you agree with the CDC’s recommendation that all children receive flu shots, you should note that the H1N1 virus, whose epidemic scare that never materialized last year, has been mixed in with regular flu shots this fall. If your child got two doses of the seasonal flu vaccine the first year plus one shot of the H1N1 vaccine last year, then he or she would only need one regular flu shot this year. If not, two shots will be required. We recommend one dissolvable tablet of muco coccinium every two weeks to help prevent or lesson the effects of all kinds of flu. Anecdotally, this homeopathic preparation has worked very well for our patients in the past. A recent JAMA study showed that the risk of serious complications was no more for H1N1 infections than for seasonal flu.

See the CDC Advisory Committee on Immunization Practices (click here), June 24, 2010 Guidelines and JAMA 2010 June 8 issue;304:1091-8 (subscription required).

Thursday, September 30, 2010

Weight Gain in People Over 50 y.o. Increases the Risk of Diabetes

It is well documented that excessive weight gain in younger people increases the risk of diabetes, but recent work indicates that there is a 3-5-fold increase in diabetes for those who gain at least 9 kg (about 20#) after the age of 50 y.o. Of course, that also increases the risk of heart attacks, strokes, blindness, and kidney disease. The weight gain at that age consists mainly of an increase in fat. Thus it is important to lose excess fat and maintain it at a normal level. I have heard reports of a new type of chocolate that dramatically shuts down the appetite, resulting in significant fat and weight loss. It should be available through physicians in the next few months.

See JAMA (click here) 2010;303:2504-12.

Tuesday, September 21, 2010

Studies Dispute Benefit Claims of Statin Drugs

The July, 2010 issue of Family Practice News contains several articles that I will comment on over the next month. It is packed full of useful information. Leading off is a dynamite article that discusses two major critiques of the JUPITER Trial that trumpeted statin drugs as primary prevention of cardiovascular events. Dr. Michel de Lorgeril in France came just short of accusing the authors of total fraud, while earning billions of dollars for drug companies they had connections to. He documented how the study was improperly terminated early, allowing for inflated estimates of benefits and underestimated harms. The causes of death listed in the study in both the placebo and treated groups were way out of balance for what was expected. The case-fatality rate was actually 3 times higher in the rosuvastatin group than it was in the placebo group. Dr. Kausik Ray at the University of Cambridge in England did a massive meta-analysis of pharmacological lipid lowering that showed that the all-cause mortality of statin drug treatment for prevention was no better than placebo. This contrasts greatly with the 20% reduction claimed by the JUPITER study that has been the basis for most of the surge in statin treatment in recent years.

See Arch. Intern. Med. 2010;170:1032-6 and in the same issue pp. 1024-31.

Thursday, September 16, 2010

Some Good Measures in Health Care Reform

Many people are concerned about recent health care legislation. I share some of those concerns, but a lot depends on the way it is implemented. We must by vigilant in identifying any new rules that interfere with patient choice. However, there are some good things about the legalization that almost everyone can embrace. Coverage of pre-existing conditions is at the top of my list. Decisions by health insurance plans to deny coverage can now be appealed to outside authorities, and in urgent cases, expedited review within 24 hours is required. Insurance companies will now have to justify rate increases. The new Patient Bill of Rights will soon be released. Medical homes, in which family physicians and other primary care docs will coordinate care, are included in the Affordable Care Act, and they have recently been shown to cut costs, booster quality, and improve satisfaction for both patients and physicians. Our practice at the Celebration of Health Association is one of the early applicants to become certified as a medical home. We anticipate that certification will enhance acceptance of some of the alternative practices that we provide.

Tuesday, September 14, 2010

Brown Rice Proves to be Much Healthier than White Rice

Two large Harvard studies documented what we have known for a long time about whole grains. Regular consumption of brown rice resulted in a much lower incidence of diabetes than white rice. This has a greater significance in the orient, where rice can consist of 75% of the diet. But it is also relevant in the US, especially since a growing number of people have celiac disease or an intolerance to many grains. Rice is usually tolerated for such people, and brown rice is definitely the way to go.

See Arch. Intern. Med. 2010;170:961-9.

Thursday, September 9, 2010

Defensive Medicine Drive Up Medical Costs

Medical Economics references an eBook by Jackson Healthcare whose surveys revealed that defensive medicine is responsible for 35% of diagnostic tests, 29% of lab tests, 19% of hospitalizations, 14% of prescriptions, and 87% of surgeries. This obviously is a big factor in escalating health care costs. There is some evidence that defensive medicine actually increases the risk of medical malpractice lawsuits, rather than being protective.

Defensive medicine continues to be taught to younger doctors in training. It would be much better to establish trust in the doctor/patient relationship. Potential adversaries do not work well together to achieve optimal health.

See ModernMedicine.com (click here) or August 20, 2010 issue of Medical Economics.

Tuesday, September 7, 2010

Annual High-Dose Vitamin D Actually Increases the Risk of Falls and Fractures

Australian researchers at University of Melbourne have detected an increase fracture and fall rate for those patients treated with a rather bizarre short cut. Patients were give 500,000 units of vitamin D once a year for 3-5 years. Many studies have shown the importance for raising the vitamin D level, but it is now clear that reasonable doses of vitamin D (about 5000 iu) should be on a daily basis. Careful monitoring with blood tests to make sure that the treatment is effective are probably needed.

See Family Practice News (click here), June 1, 2010, p. 20.

Thursday, September 2, 2010

Seasonal Flu Vaccine Raises the Risk for H1N1 Infection

Four studies by Canadian investigators in Vancouver found that those who were vaccinated with the usual flu vaccine had a lesser incidence of the flu, but had a 68% higher risk of getting H1N1 infection. For those less than 50 years of age, the increased risk jumped to 123%. The widespread use of flu and H1N1 vaccines, especially in children, is premature, in my opinion, especially since most of them contain Mercury. Mucococinium is a homeopathic that works quite well, in my experience, both as a preventative and a treatment for various forms of the flu. Further studies are really needed. Our current national approach appears to be ineffective and perhaps dangerous.

See Family Practice News (click here), April, 15, 2010, p. 23.

Wednesday, September 1, 2010

Bran Reduces Inflammation in Female Diabetics

The Nurses’ Health Study out of Harvard has produced yet another interesting finding. Female diabetics in the study had a 28% lower risk of all-cause mortality and a 35% lower risk of cardiovascular disease if they ate generous amounts of whole grains, particularly bran. Like many chronic degenerative diseases, diabetes is associated with moderately increased levels of markers for inflammation and endothelial dysfunction. Whole grains reduce these markers, and this is the mechanism suggested for the protective effect.

See Family Practice News (click here), June 1, 2010, p. 18.

Thursday, August 26, 2010

Pneumococcal Vaccine Might Increase the Risk for Heart Attacks and Strokes

A small protective effect of flu vaccine on the incidence of heart attacks and strokes has been reported, and a similar preventive action has been suggested for the most common pneumonia vaccine. However, Dr. Hung Fu Tseng of the Kaiser Permanente Southern California managed care group looked at 84,000 men who had been vaccinated and reported no protective effect. Their conclusion that there was no protection, however, appeared to be politically motivated. Their findings actually showed a 3-4 times higher incidence of strokes and heart attacks in patients that received this common vaccine. That risk should have hit the headlines, and instead was swept under the rug. Pneumococcal vaccine is still recommended for everyone over the age of 65, children and people who have come down with at least one episode of pneumonia. We need to take a long, hard look at what is going on, after this important study.

See Family Practice News (click here), June 1, 2010, p. 17.

Tuesday, August 24, 2010

High-Dose Flu Shot on its Way

Last December, the FDA approved a new high-dose flu shot that is four times as strong as previous seasonal flu shots. This new shot is designed to increase the antibody response for older adults, who are more susceptible to the respiratory flu. Research has shown higher antibody titres, but there is no evidence that this shot will translate into fewer patients getting the flu. Complication rates and mercury levels used as preservatives in the shots are not clear at this time. Caution is suggested for now.

See Family Practice News (click here), June 1, 2010, p. 15 and the FDA report on Fluzone High Dose (click here).

Thursday, August 19, 2010

Blood Clots are a Common Reason Why Hospitals Can be Dangerous

About 900,000 venous thromobembolisms (VTE—blood clots) occur in the US annually, mostly after a hospitalization and sometimes with a fatal outcome. There are published guidelines on how to prevent VTEs, but physicians and hospital personnel tend to underestimate the risk and to often do not carry out effective preventive measures. If you or a loved one requires hospitalization, ask about early ambulation, anti-coagulant medication, compression stockings and various devices such as intermittent pneumatic pressure. When traveling, get up and change positions every hour, and do not sit for long periods with your legs crossed. These measures really work and can be life-saving.

See Family Practice News (click here), June 1, 2010, p. 13, the American Society of Hematology, and the Center for Disease Control.

Tuesday, August 17, 2010

Excess Overtime Work is a Good Way to Die Early of a Heart Attack

European researchers looked at men and women who regularly worked more than 11 hours a day. They found a 1.6 increase risk of heart attacks, angina, and premature death. Lack of exercise, poor diet, alcohol intake and hypertension did not seem to be factors, but a Type A personality and sleep deprivation were possible causes. Apparently, one can live a full life in about 2/3 the time just be working oneself to death. Rest and relaxation are important parts of a healthy lifestyle.

See Family Practice News (click here), June 1, 2010, p. 12.

Wednesday, August 11, 2010

The Risk of Endometriosis is Reduced with Fish Oils

Harvard’s women’s health initiative showed that the incidence of endometriosis is reduced up to 48% with a higher intake of omega 3 fatty acids. The incidence was much higher with a diet high in trans fatty acids. The same findings have been found for cardiovascular and auto-immune diseases. Common sources of trans fatty acids are French fries, margarine, and crackers. The risk was slightly higher for those who ate diets very high in animal fats. The total amount of fat was not a factor.

See Family Practice news (click here), May 15, 2010, p. 44.

Tuesday, July 20, 2010

Middle-Aged Marathoners Might Have Increased Risk of Heart Attacks

Dr. Jonathan Swartz reported at a recent American College of Cardiology meeting that middle-aged marathoners had lower cholesterol levels, slower heart rates and lower body mass indices, but had increased calcium in their coronary arteries, higher blood pressure, and more aortic stiffness than controls who were not runners. This indicates that high intensity, long-term running might be hazardous. A more moderate schedule is certainly beneficial. This is study had similar findings to a 2008 clinical trial in Germany that was published in the European Heart Journal.

See Family Practice News(click here), May 15, 2010, p. 10.

Thursday, July 15, 2010

HRT is Still Indicated but could be a Lot Safer

The 2010 position statement by the North American Menopause Society continues to recommend hormone replacement therapy around the time of menopause but discourages long-term use. Clear indications include severe hot flashes, vaginal atrophy, pain on intercourse, high risk of osteoporosis, and possibly diminished mental capacity. HRT is not indicated in patients with uterine cancer, but studies with breast and ovarian cancer are inconclusive. HRT does not reduce the risk of cardiovascular disease. Progesterone should be used along with estrogen unless there has been a hysterectomy. Most unfortunately, the statement does not distinguish natural progesterone from synthetic. The latter is dangerous, while the natural form has considerable positive benefits. In my opinion, bio-identical hormones are safer and more effective than Premarin and other pharmaceutical products.

See Suzanne Somers (click here) books and Family Practice News (click here), April 15, 2010, p. 33.

Tuesday, July 13, 2010

Topical Treatments for Osteoarthritis are Safer than Oral Treatments

Long term treatments with nonsteroidal anti-inflammatory drugs (NSAID) for wear and tear arthritis has been discouraged in recent years. Ibuprofen, Motrin, Advil, Celebrex, Tylenol and similar drugs have been linked to gastric ulcers, kidney damage, hypertension, and possibly cardiovascular disease. In Europe, topical treatments are much more common than in the U.S. Drugs such as Diclofenac and Pennsaid have recently been approved for topical use. Natural prescriptions using DMSO, curcurmin and other substances also appear to be effective as well. Oral natural products such as glucosamine, MSM, bromelain and boswelia can also be very effective without the risk.

See Family Practice News (click here), April 15, 2010, p. 32.

Tuesday, July 6, 2010

Chamomile Shown to be Effective for Depression and Anxiety

In a study funded by the National Institute of Mental Health, Dr. Mathew A. Shore reported that chamomile extract in doses of 220mg 1-5 times a day was effective in relieving general anxiety disorder and depression. The study was randomized, double-blind and placebo-controlled. Side effects were much more common in the placebo group. A soothing cup of chamomile tea appears to be a very safe, effective way to lessen the effects of stress.

See Family Practice News (click here), April 15, 2010, p. 21.

Tuesday, June 29, 2010

Next blog posting will be July 6th due to the Holiday. Happy 4th!

The Wrong Treatment is Common in Children with Abdominal Pain

Dr. Ghasson Wahbeh, a gastroenterologist at the Seattle Children’s Hospital, made a strong point at a recent pediatric meeting about children with abdominal pain. Many are being treated with PPI drugs, like Prilosec, Nexium and Protonics. The children usually have functional bowel problems triggered by bacterial imbalance, allergies, reactions to medications, constipation, or other insults. PPI drugs are specific for GERD (gastro esophageal reflux). They are expensive and can cause side effects over time. Once you stop PPI drugs, acid secretion rebounds, giving the impression that the patient continues to need the drug. Nutritional treatments are effective in treating abdominal pain, but treatment over months might be required. Even if GERD is present, recent reports indicate that melatonin might be just as effective and much safer than PPI drugs.

See Family Practice News (click here), May 1, p. 41.

Thursday, June 24, 2010

Frequent Skin Exams Might Eliminate Fatalities from Malignant Melanoma

Dermatologist, Dr. Ronald N. Shore, reported his remarkable experience over a 17 year period in private practice. He visually examined the skin of all of his patients every six months, and biopsied the lesions that he felt were suspicious. He found several melanomas but all were of such recent onset that they were curable. Looking through the scientific literature, Dr. Shore found two other papers in prominent journals with the same findings. This is remarkable because malignant melanoma can be a deadly cancer, especially in its nodular form. Its incidence is rising, presumably related to sun exposure in the past. Your family doctor could very likely get the same results with frequent examinations. Just ask.

See Family Practice News(click here), May 1, p. 26.

Wednesday, June 23, 2010

Most Patients Who Get Heart Attacks are Considered Low Risk

A 2003 article in the British Medical Journal clearly showed that 60% of patients who had heart attacks were considered low risk by the famous Framingham criteria. In fact almost 2/3 of cardiac events occurred in patients with low to intermediate risk. About 10% of those who are considered low risk have abnormal ankle/brachial blood pressure ratios. This is an easy and cheap test for peripheral artery disease that should be offered in most family practice offices, according to a JAMA article in 2008. Those who have abnormal peripheral circulation should now be considered at higher risk for heart attacks. Ask your doctor for A/B ratio for circulation problems.

See Family Practice News(click here), May 1, p. 15.

Thursday, June 17, 2010

Inflammation Anywhere Might Increase the Risk of Cardiovascular Disease

A 10-year Danish study reported that the more severe the inflammation from psoriasis, the higher the risk of cardiovascular disease. Similar studies have linked Rheumatoid arthritis with heart disease. I wonder if we should have Inflammation Clinics, that treat inflammation regardless of the cause. Especially if we can quiet inflammation with natural treatments that do not have side effects, we will likely improve circulation and immunity, which are crucial factors in most chronic degenerative diseases. This sounds like getting more toward controlling the basic mechanisms of disease rather than treating just the symptoms, along with the side effects that the drugs often contribute.

See Family Practice News, (click here)May 1, 2010, p. 14 referencing a poster presentation at the American College of Cardiology spring meeting, 2010.

Wednesday, June 16, 2010

Excess Salt Consumption is a Major Public Health Problem

Jane E. Henney, chair of an Institute of Medicine issued a strong report in April, 2010 identifying excessive salt consumption as a major cause of hypertension, strokes, and heart attacks. Whereas the maximum amount recommended per day is 1500 mg for most people, men consume about 3X that amount and women and children consume about twice that much. School lunches, restaurant food, especially fast food, snacks, and processed food (even frozen vegetables) are major culprits. The FDA, the NIH, HHS, and the Centers for Disease Control all plan to take action on the IOM report, which was commissioned by Congress. Aggressive action might save 100,000 lives and billions of health care dollars each year. Start now to reduce your salt intake. It really makes a difference.

See the Institute of Medicine Report, April, 2010.(click here)

Thursday, June 10, 2010

Blood Pressure Variability is a Dangerous Risk Factor

A massive study in London (ASCOT) was reported at the spring meeting of the American College of Cardiology, indicating that blood pressure that varied a lot from visit to visit was more dangerous than consistently high BP. Patients were not previously thought to be at as high risk if their BP was down to normal levels at least a good portion of the time. Not so. The risk for labile BP that goes up and down is 4X as high for strokes and 3X as high for heart attacks. Calcium channel blocking agents had the most consistently good results. Although not tested, extra magnesium might be effective as well, because of a similar mechanism of action.

See Family Practice News (click here) May 1, 2010, p. 1.

Tuesday, June 8, 2010

Family Docs Not Skilled in Weight Loss Techniques

Patients want information on weight loss, but physicians say they don’t have enough training, according to a Family Practice News article in April. This was based on a survey by Harris Interactive. Many patients can lose weight by increasing exercise and reducing calories. A lower carb diet has been shown to be successful for more people than other diets. Some people do not lose a significant amount of weight, when they cut back on food and increase exercise. Some of these have food allergies that hold weight on their bodies. Others slow their metabolism when they cut back on food. Not infrequently, the latter group has a metabolic problem such as not enough thyroid or an imbalance of neurotransmitters or hormones. HCG injections are not approved for weight loss, but many who are having difficulty find them very helpful. Appetite suppressants are not very helpful because they are temporary, and the pounds are usually regained fairly soon.

See Family Practice News(click here), April 1, 2010, p. 5.

Thursday, June 3, 2010

Family Practice on the Upswing

Family Practice News reported that there was a 9% increase in Family Practice residency matches this spring. 91% of residencies were filled, 45% by US graduates. The health care reform law provides incentives for family practice, including fee increases. There also will be a need for significantly more family physicians because of more people having insurance. I attended a seminar in Los Angles in April by the NCQA about becoming a Medical Home. The Medical Home puts family docs at the head of health care teams that all work together for the benefit of the patient. Conventional evidenced-based care is offered, but patients have the right to choose the type of care they want, including alternative medicine. Medical home certification is accepted by medical boards as the highest quality of family practice. We will apply for certification this summer.

See Family Practice News (click here), April 1, 2010, p. 2.

Wednesday, June 2, 2010

Chelation Therapy and Cardiovascular Disease

The Townsend Letter’s May, 2010 special issue is devoted to cardiovascular disease. John Parks Trowbridge, Garry Gordon, Majid Ali, Robert Rowen, and myself all had articles about the benefits of chelation therapy. Jonathan Wright discussed the great benefits of using salt with potassium, magnesium and lysine added in Finland. Stephen Sinatra highlighted the awesome foursome of CoQ10, l-carnitine, magnesium, and d-ribose to enhance ATP production in heart muscle. I am pleased to be in such esteemed company for a very worthwhile project.

You can order the issue for $7.50 at the Townsend Letter (click here) or call 360-385-6021.

Thursday, May 27, 2010

Lifestyle Factors Accelerate Aging, Risk Factors Not Controlled

Two articles hit the news on April 27. A British study reported that bad habits can age the body up to 12 years. The habits are smoking, more than 2-3 drinks a day, less than 2 hours of exercise a week, and fewer than 3 servings of fruit and veggies daily. The CDC stated in an on-line report that nearly half of the adults nationwide are at high risk of heart disease and 15% of those are not aware that they have a problem. Major risk factors include high cholesterol, hypertension and diabetes. These risk factors are basic, but there are more. The effects of stress and pollution (especially from lead and mercury) are equally dangerous. All of the factors are treatable, with minimal reliance on medications, which have their own set of side effects. Prevention and safe, effective treatments are the answer to our health care crisis.

See. The Toledo Blade (click here), April 27, 2010, p. 1&4.

Tuesday, May 25, 2010

Distracted Driving is a Huge Risk Factor

Researchers from the University of Michigan and Georgetown found that 16% of driving fatalities were caused by distracted driving. In 2009, 515,000 people were injured while not paying attention to the road. When texting, drivers are not seeing the road 4.6 out of 6 seconds. Texting drivers had accident rates 23 times as high as nontexting. Truck driver texting was twice as dangerous. Cell phones also increased the risk, and there was no difference with hands-free phones. Please pull over. You might be putting us all at risk.

See JAMA (click here), 4/14/10, p. 1419-1420.

Thursday, May 20, 2010

Calcium Reduces Risk of Cancer

A Puerto Rican study funded by the National Cancer Institute found a 40% reduction in the incidence of breast cancer in women who take calcium supplements. Previous studies have indicated that calcium helps prevent colon cancer as well. Calcium helps with DNA repair. To get the maximum benefit, I suggest that you take at least 500 mg of calcium daily that is balanced with magnesium, add a multivitamin, and top it off with about 5000iu of Vitamin D. A family history of breast cancer, long term use of a synthetic progestin, and no history of breast feeding are other important risk factors.

See Bloomberg News, 4/20/2010.

Wednesday, May 19, 2010

HbA1C Has Now Become the Standard for Diagnosing Diabetes

No longer is a fasting blood sugar considered a valid test to see if you have diabetes or a tendency for it. The HbA1C measures the average blood sugar over a 3-month period, and is a more accurate indicator. Levels at 6.5% or higher diagnose diabetes. Levels between 5.5-6.4% raise the yellow flag that you have prediabetes, and need to improve your diet and exercise immediately. If you already have diabetes, levels at or below 7% indicate good control. Pushing to the low 6’s is not necessarily better, probably due to the added drugs required, some of which result in weight gain.

From Family Practice News (click here), 3/15/10, p. 16.

Thursday, May 13, 2010

Sweetened Beverages Increase Heart Attacks and Diabetes

The computer-generated Coronary Heart Disease Policy Model, supported by an AMA grant concluded that there were 14,000 new cases of coronary heart disease and 130,000 new cases of diabetes caused by an increased consumption of sweetened beverages between 1990 and 2000, which includes soda, sports drinks and fruit drinks. The risk was additive to that caused by an increase in obesity during the same period. One solution proposed is ludicrous, adding a 1-cent tax on all such drinks. Anyone who has shopped for a drink at a gas station lately has noted a much greater increase in price than that in the last few years with no obvious decrease in volume sold. What we need is much better nutrition education in our schools and in our media. It can mean life or death or long-term disability.

Google Dr. Litsa K. Lambrakos of the University of California, San Francisco, reported in Family Practice News (click here), 3/15/10, p. 10.

Tuesday, May 11, 2010

Landmark Article on MMR Risk for Developing Autism Retracted by Lancet

In an editorial for Family Practice News, Dr. Stephen Pelton expressed relief that prominent English medical journal, Lancet, had retracted its 1998 article by Andrew J. Wakefield and associates that postulated that their might be a link between giving the MMR vaccine and developing autism and that it would be safer to separate the shots into individual units. In Japan this recommendation was followed, and the incidence of autism continued to increase. Pelton referred to other studies that have failed to show such a link. The extraordinary step of article retraction was obviously politically motivated. Pelton serves on the Advisory Boards of 3 drug companies. FP News is published by the same company as Lancet. There was no reason to void Wakefield’s article from the urgent debate. There is no one cause for autism. Genetically susceptible kids are stimulated to having their genes expressed by some combination of toxic chemical exposure. The incidence of autism is skyrocketing. We need a massive effort to make our kids safer from this devastating disease. Parents repeatedly link the beginnings of autism to vaccine administration. There is a lot we can do to make vaccine administration safer. Why don’t we focus on that, at least to start with?

See Family Practice News (click here), 3/15/10, p. 9.

Thursday, May 6, 2010

Glaxo-Smith Kline and Senate Debate the Risk of Taking Diabetic Drug

One of the biggest drug companies, GSK, has been chastised by a Senate Committee for hiding information from the public about Avandia causing an increased risk of cardiovascular disease. The report claims that GSK also tried to intimidate a scientist from submitting an article to that effect that was eventually published in the New England Journal of Medicine. At least 7 major drug companies have paid a total of $7 billion in fines since 2004 for such “unseemly activity”. Despite this cost of doing business, these companies continue to make huge profits in a troubled economy.

See Family Practice News (click here), 3/15/10, p. 5.

Wednesday, May 5, 2010

Osteoporosis Might Become Worse with Drug Treatment

Two fairly small studies reported in Family Practice News indicated that drugs like Fosamox and Boneva increased the quantity of bone growth, but decreased the quality so that there was an increased risk of fractures of the Femur after long-term use. Even though the studies were small, one of the studies was supported by biopsy findings and the other compared the results with calcium and low-dose vitamin D supplementation. Those patients taking supplements had better long-term results. Those taking at least 5000 iu of vitamin D might have even better results.

See Family Practice News (click here), 3/15/2010, p. 1-2.

Thursday, April 29, 2010

High Levels of Zinc Can Cause Neuropathy.

Researchers at University of Texas Southwestern Medical Center reported that 4 patients developed numbness, weakness and difficultly walking after ingesting high levels for zinc. An article in the February 10 issue of the Lima (OH) News reported on a 26 y.o. woman who became wheel chair-bound due to the zinc in her denture cream. The message is to avoid high doses of zinc over a long time. IF you need to take maintenance zinc, you probably should take copper as well to avoid a deficiency of the latter.

Google zinc and neuropathy and/or Dr. Sharon Nations at UT Southwestern Medical Center.

Tuesday, April 27, 2010

How much should we do to prevent relapse?

An article in the Findlay Courier quoted Cardiac surgeon, Gary Parenteau, about Bill Clintons recent balloon and stent procedure only 6 years after he underwent bypass surgery. Dr. Parenteau said, “Bypass is not a 100 percent cure-all forever (even with improved lifestyle and cholesterol control).” I believe a comprehensive program to prevent relapse should include chelation therapy, which reduces the clotting tendency, removes toxic metals and appears to stabilize the plaque to avoid heart attacks and strokes.

See The Courier (click here), Feb. 23, 2010, p. A6.

Tuesday, April 20, 2010

New Recommendations for Plavix Trade One Problem for Another

Plavix is used to prevent clotting that leads to future heart attacks after angioplasty with stents. Recent studies indicate that a much higher dose during the first week after these procedures might prevent 6 more heart attacks for every 1000 patients treated. However, this treatment will also cause 3 more severe bleeding episodes. Which would you like least, a brain hemorrhage or a repeat heart attack? Personally, I would much prefer chelation therapy and/or a combination of fish oils and nattokinase.

See Prescriber’s Letter, (ckick here-subscription required) October, 2009, vol. 16, no. 10, p. 57.

Tuesday, April 13, 2010

Are Anti-Depressants Safe During Pregnancy?

Depression during pregnancy is a risk factor in itself. According to Prescriber’s Letter, Paxil use by the mother can cause birth defects and should be avoided during pregnancy. In fact, for mild depression, counseling is now preferred over drug therapy. For severe depression, other drug therapy is still recommended. I would be cautious about herbal therapies, many of which act like drugs. But nutrient therapies, if carefully monitored might be a safer choice than drugs for treating most depression. We like to use various amino acids, such as 5 HTP, while measuring neurotransmittors to be sure that levels are therapeutic, not excessive.

See Prescriber’s Letter (click here,supscription required) October, 2009, vol. 16, no. 10, p. 56.

Thursday, April 8, 2010

H1N1 Flu is Spreading Widely but Effects are Usually Mild

Prescriber’s Letter published CDC guidelines on the H1N1 (swine flu), pointing out that about 97% of circulating influenza flu viruses this winter are H1N1. Of course, immunizations are widely recommended (even though they contain mercury). Seniors are lowest priority because of previous lifetime exposure. Treatment with Tamiflu or Relenza is recommended only for severe cases because resistance is emerging. H1N1 does not appear to be any more severe than other flu viruses for the general population. A new study in Canada contends that those who received a regular flu shot have a higher risk of coming down with H1N1. Our recommendation is to use a homeopathic (Mucococcinium) once every two weeks as a prophylactic and to be sure you are taking enough vitamin D (usually 1000-2000 iu for children and 5000 iu for adults.

See Prescriber’s Letter (click here, subscription required), October, 2009, vol. 16, no. 10, p. 55.

Wednesday, April 7, 2010

Clinical Trials of Limited Value When Studying Supplements

Epidemiologic or observational studies often indicate the positive effects of nutrient and biological substances such as vitamins C, D and E and Selenium and Magnesium, but large, double-blind trials do not confirm the benefit. The reason for this discrepancy was discussed in an article in Family Practice News. Dr. Paul Coates, director of the NIH Office of Dietary Supplements acknowledged that researchers might be designing the trials wrong, expecting nutrients to act like drugs (that block actions of the body rather than enhance normal function). At a meeting sponsored by the Scripps Center for Integrative Medicine, Dr. Jeffrey Bland pointed out that nutrients exert subtle, nonspecific effects on multiple pathways, creating many variables that are impossible to study with controlled clinical trials, whose purpose is to limit variables. Certainly, integrative physicians see the positive benefits of nutrient therapy every day, and there is no doubt that nutrients are much safer and cheaper than prescription drugs.

See Family Practice News (click here), February 1, 2010, p. 55.

Thursday, April 1, 2010

White Coat Hypertension is not Benign!

An Italian Study showed that blood pressure elevations that appear to occur just in the doctor’s office are just as dangerous as sustained hypertension. Both the blood pressure and the weight increased substantially more in the group with White Coat hypertension than in the consistent hypertension group. Both groups developed an equal amount of left ventricular hypertrophy. Medications are often needed to control hypertension. However, we also like to use nutrients, herbs and lifestyle changes in place of or in addition to drugs. The Kaufman technique by neutralizing trigger points with gentle hand pressure can give long-lasting results as well.

See the HARVEST study (click here, subscription required) Dr. Lucio Mos, chief investigator, reported at the annual session of the American Heart Association.

Tuesday, March 30, 2010

Are Anti-depressant Drugs Effective?

Yes and no. A meta-analysis (study of studies) published in JAMA by Dr. Jay Fournier of the University of Pennsylvania found that anti-depressants were no better than placebo, except in severe cases of depression. When we measure neurotransmitter levels such as serotonin and dopamine in patients with being treated with these drugs for depression, we often find that levels are not raised as one would expect. You can raise these levels much more effectively by giving amino acids like 5 hydroxytryptophan. If depression is not severe, other methods, including herbs and nutrients, might be preferable to the drugs. In some cases, both can be used. An individualized approach is definitely called for.

See Family Practice News (click here), February 1, 2010, p. 5.

Wednesday, March 24, 2010

Study Shows the Value of Music Therapy in Brain Function

Dr. Gottfried Schlaug of Harvard reported to the annual meeting of the American Association for the Advancement of Science that patients with severe stroke on the left side of the brain who can no longer speak can sometimes be taught to communicate with singing. Similar results have been documented in autistic children who have regressed in their language development. Music therapy is a developing science that has great potential for difficult medical problems.

See Associated Press article in The Blade (click here), February 21, 2010, p. 11.

Tuesday, March 16, 2010

Getting the Best Value in Heart Surgeries

The Blade in Toledo congratulated the Cleveland Clinic in its editorial pages for signing an agreement with Lowe’s to do all of their employees’ heart surgeries with transportation costs thrown in and deductibles waived. The Clinic performed a record 4,128 such surgeries last year, and their complication rate is lower than the national average. This is probably better than sending patients to India for their cardiac surgery, but how about the idea of reducing the need for surgeries? With lifestyle changes and EDTA chelation therapy, we showed that the need for surgical intervention, and the incidence of heart attacks and premature deaths was much lower in patients treated with this non-surgical approach, and the much larger TACT trial is ongoing to confirm these findings.

See The Blade, February 19, 2010, p. 6 and Chappell LT, Shukla R, Yang J, Blaha R, et al. Subsequent cardiac and stroke events in patients with known vascular disease treated with EDTA chelation therapy: a retrospective study(click here). Evid Based Integrative Med 2005;2:27-35.

Tuesday, March 9, 2010

Evidence Supports Cold Remedies

The Prescriber’s Letter requires significant evidence to recommend therapies. It listed the following products that have some benefits to treat colds and flu: Nasal saline irrigation, zinc lozenges, vitamin D, echinacea, elderberry, probiotics, and possibly vitamin C. Most doctors ignore this evidence. Many recommend decongestants and other products that have no effect on the severity or length of viral infections, although they might help a patient feel better (at the risk of side effects). We are now offering 100,000 units of vitamin D or more by injection for acute viral infections.

See Prescriber’s Letter (click here), November, 2009, p. 65.

Thursday, March 4, 2010

Infants Need a Wider Variety of Foods

Frank Greer of the AAP’s Committee on Nutrition reports that rice cereal is a poor choice for introducing foods after breast feeding for the first 6 months of life. High protein and fiber foods should be included. Vegetables and fruits are also important to include not only directly to infants, but also indirectly by mother’s intake and then through breast milk. Babies exposed to a wide variety of foods either way are more likely to develop healthy eating patterns as they grow older.

See Family Practice News (click here), January, 2010, p. 70-1.

Tuesday, March 2, 2010

Alcohol and Breast Cancer

Marilyn Kwan of Kaiser Permanente in Oakland, CA found that women who were moderate to heavy drinkers had a higher incidence of breast cancer. Patients who already had breast cancer and continued to drink 3-4 times a week had a 1.3 times higher recurrence rate. Drinking a half a glass of wine or one beer daily appears to be the upper safe limit for cancer and also has some protective effect for coronary artery disease. It is a fine line between protection and increased risk.

See Family Practice News (click here), January, 2010, p. 46.

Thursday, February 25, 2010

Drug Treatment Replaces Surgery for Asymptomatic Carotid Blockage

Aggressive drug treatment with statins, ace-inhibitors and Plavix have improved the outcomes in patients with carotid stenosis enough that surgery is rarely indicated anymore. I find that similar results on platelet aggregation can be obtained with red yeast, niacin, fish oils and nattokinase. Even better if you add EDTA chelation therapy. We measure the aggregation to be sure that it is effective enough to inhibit the microemboli that cause complications from this disease. Interestingly, the lead author for this study out of London, Ontario, David Spence, was a vocal opponent of Chelation therapy years ago. I hope he is watching the results of the TACT study.

See Family Practice News (click here), January 2010, p. 20.

Tuesday, February 23, 2010

High HDL Cholesterol Can Lower the Incidence of Cancer

Haseeb Jafri of Tufts University Medical School did a meta-analysis (study of studies) and found that those with higher HDL’s not only had fewer heart attacks, but also a 24% relative reduction in the incidence of cancer. If your HDL is low, you can raise it with exercise or by taking Niasafe. Whether changing your HDL levels will reduce the cancer incidence is yet to be determined.

See Family Practice News (click here), January, 2010, p. 19.

Thursday, February 18, 2010

Ultra-fast CT scans for Calcium Score Proves Worthwhile

Mathew Budoff presented dramatic findings at the American Heart Association meeting. Patients who had calcium scores measured by CT scans had a 52% reduction in all-cause mortality compared to controls. This is a good screening test for coronary artery disease. Just knowing you have a problem apparently makes a big difference. Just think how much greater the impact would be if you then took Chelation to reduce your risk. The test can cost anywhere from $100-300, and insurance is starting to pay. I recommend it for most of my patients.

See Family Practice News (click here), January, 2010, p. 1,14.

Tuesday, February 16, 2010

Taking a Second Look at Fosamax

Fosamax and other bisphosphonate drugs have been used for a long time to treat osteoporosis. In the past I have not been excited about their use because they improve test results better than they reduce fractures. They also cause GI and musculoskeletal side effects. Recent reports indicate that they might inhibit the calcification of arteries, and the Women’s Health Initiative in Harvard reports that after several years of use, women had a 32% less incidence of breast cancer. That sounds awfully good to me. Side benefits like that are hard to find.

See Family Practice News (click here), January, 2010, p. 1,5.

Thursday, February 11, 2010

CAT Scans are Dangerous

Yes, it is true that CAT scans expose patients to far more radiation that previously thought, and this could be very dangerous to your health. The Archives of Internal Medicine estimates that the overuse of CAT scans might contribute to 29,000 new cancers and 14,500 deaths each year. Because CAT scans are now available at many community hospitals now, and they do give good information to follow patients, their use has exploded. However, there are other tests, such as ultrasounds and MRIs that are much safer because they do not use Xrays, which cause cancer. Always ask if there is an alternative test to use or if the CAT scan is really necessary at this point. It is your total lifetime exposure that is the major factor. Save it until you really need it.

See Archives of Internal Medicine (click here) and USA Today (click here), December 15, 2009,

Tuesday, February 9, 2010

New Acne Guidelines

The Global Alliance to Improve Acne Outcomes has updated its treatment guidelines. No longer are oral antibiotics recommended for long-term use. The reason is that antibiotic resistance is emerging. A far more important reason, in my opinion, is that yeast overgrowth commonly occurs and wrecks havoc on the immune system. Topical retinoids like Retin-A, topical antibiotics, and Benzoyl peroxide at prescription strength are now recommended with the use of laser therapy if needed. Severe cases should be treated by a dermatologist. Diet supposedly plays no role, but in my experience, food allergies sometimes play a role.

See Family Practice News(click here), July 1, 2009, P.32.

Tuesday, February 2, 2010

New Drug to Treat Fibromyalgia

Forest Pharmaceuticals introduced Savella this fall to treat fibromyalgia, and it might be helpful for a few patients with this debilitating problem. Listed side effects include life-threatening serotonin syndrome or neuroleptic malignant syndrome, severe hypertension, tachycardia, mania, seizures, tripling of liver enzymes, increased risk of bleeding, headaches, constipation, insomnia, urinary retention, and others. Why not try thyroid and adrenal support, yeast treatment, and the many natural methods to control pain and inflammation? They are many times safer and usually quite effective, albeit different combinations are needed for each patient, which eliminates success in double-blind clinical trials.

See side effects for Salvella (click here) go to bottom of page and pull up the medical information.

Friday, January 29, 2010

Do Contaminated Dietary Supplements Pose a Threat?

The New England Journal of Medicine posted an alert on October 7, 2009 that 140 products on the market have been identified as having contamination with potentially toxic substances. Many are from outside the United States. NEJM calls for more regulation. Yes and no. Even with such contamination, vitamins and minerals are far safer than drugs. Hardly anyone dies of supplement ingestion and thousands die of drugs each year. If supplements were required to undergo the same testing as drugs, they would rapidly disappear, because their cost would be prohibitive. And they are far too valuable and much safer for that consequence. This was affirmed by the DSHEA act of Congress several years ago. However, the NEJM has a point. Some testing for toxicity should be required, and the best companies already do this on their own. It would be a disaster for Big Pharma and the AMA to successfully outlaw supplements so that all we would have to use are drugs. For now, the answer should be to get your supplements from a holistic physician or from a source recommended by one—they will know which ones are reliable and which ones are not.

See healthcarereform.nejm.org

Tuesday, January 26, 2010

Vitamin D Protects Against H1N1 Flu

A report from Dr. Norris Glick at the Central Wisconsin Center in Madison, WI concludes that vitamin D protects against the swine flu. CWC is a long term facility for people with developmental disabilities. For several years, the 25-hydroxy vitamin D blood levels have been monitored and patients have been treated if they are low. However, staff have not been so treated. In June, 2009, there was an outbreak of H1N1 flu. Only 2 out of 275 patients in the facility came down with H1N1, while 103 out of 800 staff members got the disease. Unfortunately, the CDC and state health authorities have ignored these findings. I recommend vitamin D supplements for most of my patients. I also want to protect them against heart disease, strokes, cancer and autoimmune problems.

Contact vitamindcouncil@vitamindcouncil.org

Thursday, January 21, 2010

Growth Hormone Would be Very Useful if not Suppressed by the American Medical Association

A Harvard study showed that overweight patients have 75% less Growth Hormone than normal, and that this risk translates into a higher incidence of atherosclerosis. One might think that cardiologists would rush to treat their obese patients with HGH to prevent heart attacks and strokes. However, the AMA and thus state Medical Boards repeatedly harass physicians for using this natural hormone for treating practically any adult patient. In my opinion, it should be malpractice not to treat such patients, not the other way around. This amounts to just another catastrophe in the politics of medicine.

See Family Practice News, September 1, 2009, p. 16.

Tuesday, January 19, 2010

Tight Blood Pressure Control has Mixed Results

We know that controlling BP to 130 mm Hg instead of 140 in diabetic patients significantly reduces the risk for heart attacks. A group in Italy studied non-diabetic patients with hypertension to see if they could get similar results. They did reduce the incidence of Left ventricular enlargement by about half (from 9% to 5%). Because they needed to use more drugs to accomplish this improvement, the incidence of heart attack, heart failure, stroke and death were the same in both groups. Since the study was funded by a major drug company, they did not state the obvious conclusion, that yes we should lower the blood pressure more than we do now, but we need to use non-drug methods to do so. When will we ever learn?

See Family Practice News (click here), September 1, 2009, p. 15.

Thursday, January 14, 2010

Addiction Medicine Becomes Recognized

A newly formed Board of Addiction Medicine now certifies physicians who treat patients hooked on legal and illegal drugs, including nicotine and alcohol. Previously, such treatment was done in inpatient centers by psychiatrists. Primary care physicians are beginning to diagnose and treat patients with these difficult problems. Some claim that a family doc will see at least 1-2 patients every day with addictions, but often these are not recognized. The Board emphasizes added drugs to quiet the addiction, but there are many more natural therapies that can be effective. We use acupuncture and the use of specific amino acids to rebalance neurotransmitters. These can be very effective for someone who seeks help.

See Family Practice News,(click here) Sept. 1, 2009, p. 1.

Thursday, January 7, 2010

False Security for Heart Attack Risk.

According to a report at the American Heart Association meeting, a majority of Americans are at a low 10-year risk for cardiovascular disease but at high lifetime risk. In the age group of 40-59 years, 80% have a 10-year risk score but ¾ have a high lifetime risk (>39%). Thus a 40 year old could be told he is OK even thought he is at risk of having a heart attack at age 52!

Not only do we need to keep up with a healthy diet, lab monitoring, and regular exercise, but most of us would benefit from chelation therapy as a preventive measure, even as early as 40 year old.

See Family Practice News, (click here) December, 2009. Page 1.

Tuesday, January 5, 2010

Breast and Pap Smear Screening

New recommendations for cancer screening have been lambasted in the press and by quotations from local specialists. Buried in the hoopla is the real reason for reommended changes. An article in Journal of American Medical Association in their October, 21, 2009 issue contends that the problem is that we are detecting early cancers that would be successfully treated even if their diagnosis had been delayed, and this is increasing the cost of medical care. My contention is that we should be using thermography for breast screening and developing new protocols for prostrate screening so that we actually prevent the development of cancer, rather than detect cancers already present that have to be treated after the fact.

See October 21 issue of JAMA (click here), P. 1685-1691. For information on thermography click here.