FDA Issues Warning on Use of Common Drugs for Osteoporosis

The FDA has issued a label change for biphosphonate drugs (Fosamax, Actonel, Boniva, and Reclast). Because of upper leg fractures, jaw necrosis, and esophageal cancers that have been associated with these drugs, it is no longer appropriate to use them for more than 3-5 years for osteoporosis. However, there is no conclusive evidence that using them for such a short time is effective in the long run. Further, the warning did not address using the drugs for the lesser condition of osteopenia. My advice usually is to avoid the drugs and balance moderate doses of calcium and magnesium with high doses of vitamin D3. Transdermal natural progesterone might be added if needed. See the FDA warning label for bisphosphonate drugs (click here).

Shop to Save Lots of Money in Health Care Expenditures

The Toledo Blade did a survey to compare prescription prices among area pharmacies. For one month of Lipitor, there was a $32 variance. Lisinopril varied from $25 to $4. Metformin was free at some pharmacies and $35 at another. Prices varied all over the map. Not one pharmacy was consistently cheaper than others. We did a similar survey about lab charges and found variances of hundreds of dollars. In general, hospital labs tended to be more expensive and tests drawn in doctor’s offices were less so. A few minutes on the telephone might save you lots of money if you comparison shop. See The Blade, November 6, 2011, page one.

The “Million Hearts” Initiative to Reduce Cardiovascular Disease

The Department of Health and Human Services has launched an ambitious campaign to save lives from heart attacks. The strategy is to control hypertension, to reduce high cholesterol, stop smoking and lower consumption of sodium and trans fat. I am happy to join the Initiative, but I expect to get much better effects by encouraging exercise and offering the widespread use of EDTA chelation therapy with appropriate nutrient supplementation. Curbing unnecessary catheterization testing and surgery are also near the top of my list. See the Dept.of Health and Human Services.

Why We Tend to Regain the Weight We Lose When We go on a Diet

An article in the New England Journal of Medicine by Priya Sumithran and associates showed that levels of various circulating hormones, including insulin, remained low 1 year after significant very low-calorie weight loss. Such low-levels of hormones correlated with increased hunger. Thus participants tended to regain the weight they lost. This might be the mechanism by which HCG added to a 500 calorie diet for 3-6 weeks not only produces effective weight loss, but also reduces hunger so that weight loss is more likely to remain intact long-term. This should be studied further. See New England Journal of Medicine (click here-subscription needed), October 27, 2011, pp. 1597-1604.

Zeroing in on the Causes of Autism

Dr. Richard Soloman, Medical Director of Autism Services at Mercy Hospital in Toledo had an interesting article in the Blade in October, 2011. He pointed to recent research in twin studies that confirmed multiple genetic defects that cause dysfunctional webs of neurons. The expression of these genes, however, might depend on environmental insults, such as the mother taking antidepressant drugs during the year before delivery or her prenatal exposure to organophosphate pesticides. He believes that immunizations have been ruled out as a cause. While most of the studies that have been done have come to that conclusion, too many parents have reported that association for me to agree. It is also rewarding to see great improvements in autistic children who are treated with high-dose nutritional therapies. See the California Twin Study (click here) and the study by Stephanie Engel with the Mount Sinai Children’s Environmental Center (click here)

Recent Concern About Taking Vitamins and Minerals is Very Misleading

Several articles have appeared in the scientific and popular press lately implying or stating that it may be harmful to take high dose or multivitamins. The studies cited are greatly misleading because they rely on faulty premises. They study the wrong type of nutrients, an inadequate dose, or they try to isolate a single nutrient, when it takes a combination of nutrients to work together to enhance the complex biochemical reactions in the body. Pharmaceutical companies love to promote false information about vitamins and minerals that might serve as competitors for their profitable drugs. While it may be true that the wrong type of vitamin E, folic acid or vitamin D or inappropriate iron or copper supplements might not be good for you, many nutrient therapies have excellent therapeutic effects. A knowledgeable physician or nutritionist can give you good guidance. See International College of Integrative Medicine(click here) or American College for Advancement in Medicine (click here) to find an integrative doctor.

Younger Doctors More Likely to be Concerned About Vaccines

At the annual meeting of the Infectious Diseases Society of America a study showed that recent medical school graduates were 15% less likely to say that vaccines were safe and effective. Younger docs were also more likely to say that children get more vaccines than are good for them. The authors concluded that these physicians had no experience with the devastating disease that the vaccines have helped to prevent. Another study showed that 21% of pediatricians refused to see families who declined vaccines on schedule. Perhaps an alternative conclusion is that younger docs are more likely themselves to have children who might be put at risk by getting too many vaccines close together. See Family Practice News (click here, subscription needed), 11/1/11 p.1-2

Cranberry Extract Preferred Over Antibiotics to Prevent Recurrent Urinary Tract Infections

Short-term, antibiotics were more effective, but 90% of women who took antibiotics developed drug-resistant bacteria. Cranberry was less effective initially but resistance occurred in only 28% of the cases. Thus the use of cranberry or no prophylaxis at all were preferred by many women and their physicians. We like to use uva ursi in addition to cranberry to get higher effectiveness and much less resistance. See Archives Int. Med(click here). 2011;171:1270-1278.

Positive Lifestyle is Extremely Effective in Preventing Sudden Cardiac Death in Women

Harvard’s Nurses’ Health Study has come to the conclusion that women who do not smoke, maintain a healthy weight, exercise regularly, and follow a healthy diet have a 92% reduction in risk of a sudden heart attack compared to those who have none of the lifestyle factors. This translates to attribute 79% of sudden cardiac deaths in women stemming from unhealthy lifestyles. Similar findings have been found in men but not to this degree. See Stephanie Chiuve, JAMA (click here), 2011,;306:62-69/

New Developments in Alzheimer ’s disease

A panel of blood tests that measure the amyloid burden has been developed in Australia. It shows promise as a predictor of Alzheimer’s dementia but it is not available yet. Right now, the best screening test might be a chelation challenge test for heavy metal accumulations. Most common culprits are high levels of aluminum, mercury and lead. Treatment of metal toxicity can show improvement. Antidepressants have also been tried, but they have not shown benefit. On the other hand, patients who have regular exercise and other positive lifestyle changes have been shown to have a lower incidence of Alzheimer’s and those afflicted have a much higher cognitive function. See Family Practice News (click here), August, 2011, pp. 2, 19, 52.

Osteoporosis Drugs Put Patients at Risk

225 million prescriptions have been filled for the bisphosphonate drugs since 1995 when Fosamax was introduced to treat osteopenia and osteoporosis. Now the FDA is wondering whether the drugs do more harm than good. Serious complications such as jaw necrosis, increased thigh bone fractures and cancer of the esophagus keep coming up. Lawyers have been aggressively advertising for clients who have been injured by these drugs. A safer approach would include minerals in proper balance, high dose vitamin D, exercise and perhaps strontium. An integrative physician would be the best guide. See the International College of Integrative Medicine (click here) or American College for Advancement in Medicine (click here) to find a knowledgeable doctor.

Other Diseases Increase the Risk of Cardiovascular Disease and Memory Loss

Separate recent articles have pointed out that several diseases increase the risk of cardiovascular disease, including heart attacks. Included are diabetes, rheumatoid arthritis, psoriasis, hypothyroidism, and gout. Furthermore, depression, diabetes and kidney disease can increase the risk of dementia. This is not a complete list. But if you or your relatives have any of these problems, be sure that you are also being checked for underlying heart problems and decreased circulation to the brain. Preventive measures such as lifestyle changes and perhaps chelation therapy might be lifesaving as well as improving the quality of the rest of your life. See Family Practice News (click here subscribtion required), June and July issues, 2011.

Avoid Energy Drinks, Especially in Children

The American Academy of Pediatrics has stated that energy drinks have no place in a young person’s diet. The amount of caffeine in one drink might exceed 500mg, which is equivalent to 14 cans of common caffeinated soft drinks. The amount of sugar in one serving of these drinks can be as high as 270 calories. The pH is highly acidic, which can lead to dental cavities (and might increase the risk of allergies and even malignancies—my note). Unaware of the dangers, some schools offer energy drinks in vending machines. Water should be used to hydrate children, especially while participating in athletics. See Pediatrics 2022(click here);127:1182-9.

Most Parents Worry About Vaccines

The CDC conducted a study showing that only 23% of parents had no concerns about childhood vaccinations. The authors of the study concluded that the parents did not have experience with the diseases that were being prevented and also had misconceptions about the potential side effects of vaccines. They noted that there has been a rise in the incidence of whooping cough (pertussis) and measles with increasing numbers of parents who are refusing vaccines. I believe that the CDC is underestimating the depth of concern that patients feel. Even though autism/vaccine studies have been negative, in individual cases with susceptible children, I continue to be concerned that autism might be stimulated by a vaccine or by multiple vaccines administered together. Too many parents link the onset of autism to receiving a vaccine. Using a homeopathic to prevent vaccine injury might be useful for families that proceed with vaccines. Another reasonable request is to spread the vaccines out instead of taking many at one visit. See the CDC 2010 HealthStyles Survey (click here)

Statin Drugs and Muscle Aching

Despite that cardiologists often underplay the incidence and risk of muscle aching in patients taking statin drugs, the FDA recently reduced the allowable dose of simvastatin. Higher doses of the drugs have been associated with myalgias, especially in the first 12 months of therapy, in elderly female patients and in those who are also taking a calcium channel blocking drug (especially diltiazem). In severe cases, rhabdomyolysis can occur, which can be fatal. The risk of Diabetes also rises with increased doses of statins. Red yeast is a much safer, natural alternative. A novel approach of taking the drugs only on every other day has also been suggested. See Family Practice News, July 2011, p. 30.

Concussions in Athletes Can Lead to Psychiatric Problems

Dr. Claudia Reardon of the University of Wisconsin published a review article in Sports Medicine summarizing the mental problems that can occur many years after the traumatic brain injury of a concussion. Symptoms include depression, insomnia, ADHD, irritability, apathy, eating disorders and personality changes. The National Football League is studying the effects of concussions. One emerging recommendation is that younger athletes require more time to recover from concussions before returning to play. If you have ever had a concussion, be sure your family knows, so they can be on the alert for future problems. See Sports Med. 2010;40:961-80.

Strontium Moves to First Line Treatment of Bone Density

Two grams a day of strontium was shown to reduce the fracture rate in patients with osteoporosis in a 10 year Belgium study. Combine this therapy with exercise, vitamin D, moderate dose calcium with magnesium, and perhaps natural progesterone; and you will likely get better results than using the biphosphonate drugs such as Fosamax. The latter drugs reduce bone resorption. Strontium not only reduces bone resorption but also increases bone formation by 20-25%. See Family Practice News, July 2011, p. 42, the TROPOS study in J. Clin. Endocrinol. Met. 2005 and the SOTI trial in N. Eng. J. Med. In 2004.

Don’t Do List for Family Physicians

The National Physicians Alliance has examined the evidence and published a short list of what is often ordered without justification by family physicians: X-rays for low back pain without unusual red flags within the first 6 weeks of pain, antibiotics for sinusitis in the first 7 days unless symptoms worsen after initial improvement, annual screening EKGs for asymptomatic patients, pap tests in patients less than 21 years old or in those who have had hysterectomies for benign disease, and DEXA scans for women under 65 or men under 70 with no risk factors. I agree. However, low back pain and sinusitis can be aggressively treated with natural remedies that do not carry the risk of standard meds, and ultrasound heel scanning can detect and monitor osteopenia quite well without the risk of radiation. See Arch. Intern. Med. 2011, p. 231, reported in Family Practice News (click here), June 1, 2011, p. 44.

Cardiac Surgeons Criticize the Decline in Bypass Rates

According to the SYNTAX trial reported in the New England Journal, there was a 15% reduction in the number of bypass procedures performed from 2001 to 2008. There was a lesser decrease in the number of stents placed. Their conclusion was that bypass was being underutilized, for some unknown reason. How about the possibility that far too many of these procedures have been done in this country for many years? The evidence shows that lifestyle changes as a primary treatment is often a better choice than surgery. We do many more cardiac surgeries for heart disease than any other country in the world. Further, there is an increased use of alternative medicine. The results of the TACT trial on chelation therapy is due out in early 2012. Hopefully, that will stimulate an even great drop in the use of cardiac surgery. See New England Journal of Medicine (click here, subscription needed). 2009;360:961-72.

Any Use of NSAID Drugs After a Heart Attack Increases the Risk

A large Danish Study contradicted the American Heart Association recommendation that NSAIDs such as Motrin, ibuprofen, and Celebrex are safe to use in patients who have had heart attacks. Even a short-term use of these drugs was associated with a 45% increase risk of death and 30 days of treatment increased the risk by 65%. This class of drugs is associated with kidney disease and ulcers as well. Generally speaking they should be avoided if possible. Alternatives include glucosamine, MSM, boswellia, curcumin, and many other natural products. See Family Practice News (click here), June 1, 2011, p. 16.

Women with Heart Disease are Often Missed

The American Heart Association points out that in 2007 one in thirty deaths in women were from breast cancer and one in three were from heart disease. Two thirds of women who die suddenly of heart disease have no previous symptoms. Those who do have symptoms are more likely to have shortness of breath or pain in the back or jaw than the typical sub sternal chest pain that men have. Obesity, even borderline hypertension or diabetes, and pregnancy complications can increase the risk. We suggest several tests that can detect vascular problems: Cardio Risk to detect early plaque in the carotid arteries, an ultrafast CT scan for calcium scores, and a heart rate variability test to look for micro vascular disease. If in doubt, chelation therapy might be a life-saving treatment. See the Associated Press article in the Toledo Blade(click here), July 6, 2011, Section A, p.3.

What to Do When Your Doctor is Stumped

The AARP magazine addressed this issue recently. They list common illnesses that are missed, partly because lab tests for them are often not definitive: Lupus, Parkinson’s, Celiac disease (gluten intolerance), chronic fatigue, fibromyalgia, M.S., and Lyme disease. Another problem is that standard treatments for these problems are often ineffective or have toxic side effects. Alternative medicine can be very effective and safe in treating these diseases. I suggest that the alternative approach should be tried first. The same issue lists four surgeries that should be avoided if possible, and I agree. They include: Stents in patients with stable angina, complex spinal fusion, hysterectomy, and knee arthroscopy without a distinct tear in the cartilage. See AARP, the Magazine, July/August, 2011 issue.

Double CT Scans Increase Your Risk

Medicare has determined that far too many CT scans are repeated right away to get more information, especially at community hospitals. The problem is more than the considerable cost. Each CT scan has the radiation exposure of 350 chest x-rays. Excess radiation increases the risk of cancer and other chronic degenerative diseases. If you are offered a second CT scan, it is probably better to just say no, unless of course it is a matter of life or death. Other major tests are expensive and potentially dangerous. For example, coronary catheterizations are often suggested just to see how a patient is doing. In fact, other means of testing can give similar info. What the caths do best is increase the pressure to do unnecessary cardiac surgery. See the Toledo Blade’s(click here) printing of a New York Times article, June 20, 2011, Section A, Page 6.

Taking Health Care Research Seriously

An editorial in the AMA journal described the explosion in research findings and how difficult it is to put the results into everyday practice. They recommend that social scientists become more involved in spreading the word about new developments. Also recommended is more emphasis on multiple interventions in research protocols to get greater effects. This would be a better approach to examine natural remedies, which are often synergistic with each other. Not mentioned in the article is that large, expensive studies are required to find statistically significant outcomes. What follows is the larger the study, the less likely the intervention will help the patient. For example large studies have shown that statin drugs might reduce heart attacks, but you have to treat 100 patients to prevent one heart attack.

See Pronovost PJ. Time to Take Health Delivery Research Seriously. JAMA, (click here subcription needed) July 20, 2011, 310.

Find Out Your Risk From Radiation Exposure

The American Imaging Management (AIM) has developed a Patient Safety Program. AIM is a separate company that provides utilization review for Anthem Blue Cross. If you go to their website, the program will help you calculate whether you are at high risk from cumulative X-ray exposure. The radiation from one abdominal CT scan is equivalent to that of 400 Chest X-rays, or 2.2 years of natural background radiation. Your risk is determined by your lifetime exposure.

Go to www.americanimaging.net/safety (click here)

Mammograms Shown to be Ineffective in Europe

A study from 6 European countries published in the British Medical Journal indicated that screening mammograms had no effect on mortality from breast cancer. The study compared similar countries that were much more aggressive in performing the screening procedure to those who were not. In all three cases, there was no improvement in outcomes attributable to increased surveillance. Since mammograms carry extra risk from radiation with compression and they detect only cancers that are already present, breast thermograms might be a preferable screening tool. There is no risk from the latter, and they detect the tendency toward cancer before the disease actually develops.

From news release in the Toledo Blade, August 8, 2011.

U.S. Health Statistics Lag Behind

Life expectancy in the U.S. is 78.1 years, in Switzerland 81.9 years. MRI exams per 1000 people in the U.S. is 91.2, in Canada 31.2. Our coronary bypass rate is 521 per 100,000 people, in Ireland it is 128. Our death rate from heart attacks is 145 per 100,000, in France it is 54. Health expenditures here are 16% of GDP, in France 11% and in Ireland 7.6%. The message is that we could drastically reduce health care spending and greatly improve results by emphasizing prevention and the use of natural healing. A good place to start is with Chelation therapy.

See Brook RH, Facts, Facts, Facts: What is a Physician to do? JAMA, July 27, 2011, 432-433.

Americans Give the Health Care System Very Low Grades

Recent surveys by the Commonwealth Fund and the Robert Wood Johnson Foundation suggest a major dissatisfaction with U.S. health care. 2/3 of respondents gave it a barely passing or failing grade overall. 71% said they had trouble getting access to care when needed. Nearly half said their care was poorly coordinated and wasteful. About half also gave hospital care a grade of C, D, or F. Our practice has recently been recognized by the National Center of Quality Assurance as a Physician Practice Connections®--Patient Centered Medical Home™(PPC-PCMH), which directs that the patient’s family doctor coordinates the care and makes it more accessible. Hopefully, this will improve our national health care, make it more affordable and accessible.

See Family Practice News(click here), May 1, 2011, p. 60.

The Risk of Sudden Death from Taking ADHD Stimulants

The risk is not high but it is does happen. Patients should be questioned for a history of fainting with exercise, known cardiac abnormalities, and a family history of sudden cardiac death at a young age. If there is a yes answer to any of these inquiries or if the physician hears a click or murmur with a stethoscope, an EKG should be obtained and/or the patient referred to a specialist before stimulants like Ritalin are prescribed. It is safer to take natural supplements and look for food allergies to treat ADHD. It is not a standard guideline, but the same questions might be asked during a pre-participation PE for sports, with a similar workup if any of the answers are positive.

See the from the American Academy of Child and Adolescent Psychiatry, Dr. James J McGough of UCLA presenting.

Avoid Withdrawal Symptoms from Anti-Depressants

Anti-depressants can be helpful for some people, but others do not get the expected improvement or might get significant side effects. Still others take them for a period of time and just want to get off them. What you do not want to do is stop them suddenly. Dr. Kurt Kroenke of Indiana University warms against the Antidepressant Discontinuation Syndrome, which can make patients miserable and possibly suicidal for several weeks. I prefer to taper such meds over two weeks and replace them with a nutrient program like Empower plus. Another option would be to measure the neurotransmitters and boost up the ones that are low with specific amino acids. If the intention is to switch to another medication, tapering is not usually needed.

See Family Practice News,(click here) May 1, 2011, p. 32.

Triglycerides Noted as a Significant Risk Factor

The American Heart Association has dramatically reduced the allowable level of triglycerides to 100 mg/dl. Previous limits have been 150-200. The good news is that drug therapy is not recommended unless the level exceeds 500, which is more closely associated with pancreatitis than heart disease. Of note is that the good cholesterol (HDL) is inversely proportional to triglycerides. One can dramatically reduce triglycerides by going on a low carb diet, especially avoiding table sugar and fructose. Then the HDL will usually rise to cardioprotective levels. Weight loss, exercise and fish oils are also helpful.

See American Heart Association, Circulation (click here-subscription needed), 2011.

Natural Therapies for Diabetic Nerve Pain

Guidelines for treating diabetic nerve pain were published this spring by two Physical Medicine groups. Unfortunately, the only remedy that had good evidence was pregabalin, which is expensive and has side effects. Many of the existing therapies, such as gabapentin, anti-depressants and narcotics, which are commonly prescribed had only limited evidence for effectiveness. Natural approaches, such as capsaicin, alpha lipoic acid, electrical nerve stimulation, Reiki and cold laser treatments, had mixed results, just like the drugs. The study only looked a pain relief and did not look at side effects and quality of life. The guideline did stress that significant relief might be obtained in specific patients with any of these therapies. I suggest using a combination of natural remedies to attempt to find the best result with the least side effects.

See the April 2011 editions of Muscle and Nerve(click here)

THE BLOG WILL BE ON VACATION AND RETURN AUGUST 9TH.

A Whole Lot More Adverse Reactions to Drugs in Hospitals

In the 5-year period beginning in 2003, there was a whopping 52% increase in adverse reactions to drugs. Most common was corticosteroids. Narcotics, anti-coagulants, anti-cancer drugs and immunosuppressants were also common reactants. 83% were in patients older than 45 years. Average costs per hospital stay were 50% higher for those who suffered adverse effects. Most of the drugs were not new. It appears to me that doctors are getting more aggressive in prescribing existing powerful drugs. Mixing in nutrients and herbs whenever possible would seem to greatly reduce these complications, as well as the cost of medical care.

See Agency for Healthcare Research and Quality. 2008 Nationwide Inpatient Sample.

Even Small Changes in Blood Pressure Can Result in Brain Damage

Dr. William B. White reported at the annual meeting of the American College of Cardiology that patients 75 years old and older who began with blood pressures averaging 126/66 lost measurable brain function and walking time for every 1 mm Hg increase in BP over the next two years. Previous concerns for rising BP were heart attacks and kidney problems, but it looks like the brain is affected as well. Rather than adding more drugs, lifestyle factors and natural therapies like garlic might be effective, in my opinion, and certainly safer as well.

See Family Practice News(click here), May 15, 2011, p. 16.

Those Who Have a Favorite Brand are More Likely to be Alcoholics

Dr. Susanne Tanski of Dartmouth Medical School reported to the Annual Meeting of the Pediatric Academic Societies that the amount of money that a company spends on TV advertising is very effective in convincing under age drinkers to use their product as a “favorite brand”. Those who develop a favorite brand are then more likely to become binge drinkers and alcoholics. Many such ads appear on ESPN and similar sports channels. Budweiser was the most common brand cited.

See Family Practice News,(click here) May 15, 2011, p. 33.

New Developments in Chronic Fatigue Syndrome and Fibromyalgia

Dr. Jacob Teitelbaum is a pioneer in the world of CFS and Fibromyalgia. He reports that moderately high doses of statin drugs have an anti-viral effect that can really help some patients with these problems. This finding is really strange, because statin drugs, which are used to lower cholesterol not infrequently cause severe muscle aching themselves. Sometimes this side effect can be reversed by adding high doses of CoEnzyme Q10 and the adrenal hormone, pregnenolone. If the patient does not have the side effect, he or she might benefit from taking a statin drug, like Lipitor. Much less likely to cause side effects, however, is red yeast, which might have the same benefit without the risk. The latter is my comment.

See newsletter@endfatigue.com (click here) , May 24, 2011.

Is the American Diabetic Association Killing Diabetic Patients?

The Alliance for Natural Health reported that the CDC estimates that there will be 140 million diabetics in this country in 40 years, and according to Life Extension estimates, more than 75% of adults over the age of 40 have pre-diabetes, and many have no idea. The problem is that the ADA recommends conventional screening tests that are not very sensitive in detecting the disorder, and prescribes dietary recommendations that do not sufficiently limit high glycemic foods, which results in poor control and more complications (kidney, blindness, heart attacks, strokes, etc.). Gluten sensitivity, allergies, pollutants, and vitamin D deficiency are also major factors that are usually not addressed. Patients should be tested with a HBA1C (normal <5.6) and a blood sugar fasting and 1 hour after a meal (normal < 85 and < 125 respectively). If these tests are abnormal, they indicate insulin resistance. A low carb diet is essential for good control, and an alternative doc can prescribe supplements if needed.

See ANH-USA, June 7, 2011.

Autism is Complicated

Finally, we know why research has been a total bust to find a cause and standard treatment for Autism. The Los Angles Times reported that two recent studies showed that Autism is apparently related to as many as 300 spontaneous genetic mutations. They do not yet know what is causing the mutations but it makes sense that multiple environmental and chemical exposures stimulate these abnormalities in susceptible children. That is why some parents adamantly link their child’s illness to various immunizations, while research has not proven the association in large studies. It also explains why certain children respond to some treatments, while others do not. Multiple therapies need to be tried in order to find a few that are effective. A more natural approach, in my opinion, would be more likely to reverse genetic expression than drugs.

See LA Times article reprinted in The (Toledo)Blade, June 10, 2011, p. 4.

Should Breast–fed Infants Receive Iron Supplements

There is a great controversy on this recommendation in the world of pediatrics. The American Academy of Pediatrics section on breastfeeding has suggested that the current guideline that all breastfed babies get iron supplements beginning at 4 months of age be eliminated. Dr. Richard Schanler of Albert Einstein College of Medicine states, “No one has shown any benefit for doing that.” He suggests that another way to increase iron stores in newborns is delayed cutting of the cord. Even without this simple measure, there is enough iron in infants to last at least 4 months. Iron containing solid foods can be added at 6 months. Some pediatricians adamantly advocate iron for breastfed infants and others for all infants. They site slightly lower hemoglobin levels in children where this is not done. Testing for iron deficiency can get expensive. The best approach is probably individualized from the overall risk status of the infant and the desires of the parents.

See Family Practice News (click here), December, 2010, p. 12-13.

Conventional Medicine Moving Toward Holistic Ideas

A survey of randomly selected conventional primary care doctors conducted by Holistic Primary Care showed that 80% are incorporating some modalities from holistic medicine. Nutrition and stress relief head the list. But there is a greater interest in supplements as well. One-fifth use some form of manual medicine. As often the case, a large number of practitioners use supplements, exercise regularly, and buy organic food for their own use, more so than those who recommend such measures for their patients.

See www.holisticprimarycare.net(click here)

Do Biphosphonate Drugs Cause Fractures Rather than Prevent Them?

Drugs such as Fosamox and Boneva are commonly prescribed to prevent fractures in patients with osteopenia and osteoporosis. Randomized trials have shown that long-term use (> 5 years) of these drugs can reduce the usual fractures that occur in old age. However, a large study reported in JAMA also showed that unusual fractures below the hip are increased somewhat with minimal trauma in patients who have used these drugs long-term. The authors suggest that long-term use of these drugs should be re-evaluated. In my experience, the more vigorous use of vitamin D, magnesium along with lower doses of calcium, natural progesterone, exercise, and sometimes strontium is often a better approach than reaching for the prescription pad for such patients.

See Park-Wyllie, et.al., JAMA, Feb. 23, 2011, p. 783-789.

Correcting Low Vitamin D Reduces Breast Cancer

The ridiculous recommendation by the Institute of Medicine that only 600iu of vitamin D is indicated for prevention of disease has been rebuked by another study. Katherine Crew was the lead investigator at Columbia University for a study that showed that females with vitamin D levels less than 20 mg/ml had a 40% higher risk of developing breast cancer than those with levels greater than 50. Oral doses up to 10,000 iu a day were proven safe to use in patients with low levels. Vitamin D testing should be routine. I like to see optimal levels at 60 iu or higher.

See www.holisticprimarycare.net (click here), editor Erik Goldman’s blog.

Prevention of Fractures Depends on Bone Flexibility as Well as Density

Just like heart attack prevention depends on a lot more than lowering cholesterol, effective fracture prevention is not simply increasing calcium density. A piece of chalk packed full of calcium breaks easily when dropped. Collagen supports the bone matrix flexibility and gives bone the ability to absorb stress and bend with trauma. Two simple ways to improve bone collagen are glucosamine/chondroitin and vitamin K. The former is frequently given as a supplement for osteoarthritis. The best source of vitamin K is green, leafy vegetables, but it also can be taken as a supplement in the form of 45 mg a day of K2, sometimes combined with vitamin D3. Those who are taking warfarin should not take vitamin K.

See John Neustadt, To Prevent Fractures, Consider Bone Density, Not Just Mineral Density, in Holistic Primary Care, Spring, 2011, p. 1-2.

Dogs Make You Healthy

Dr. Mathew Reeves of Michigan State University was the lead author of a study that showed that dog-owners get significantly more exercise and are thus healthier than those who do not own a dog. It is widely recognized that good health requires 150 minutes of exercise a week. Only one-third of those in the study who did not own a dog reached that level. Those with dogs not only exercised more frequently at that level but also were more likely to participate in leisure time sports. Another study at University of Missouri indicated that dogs were more effective companions than other humans to stimulate regular exercise.

See Marilou Johanek’s article in the Toledo Blade, March 17, 2011, section A, P. 9 or contact her at mjohanek@theblade.com.

“Bath Salts” to Get High

A new and dangerous craze is smoking, snorting, injecting or swallowing a product labeled as “bath salts” or “plant food”, which has been available at some convenience stores. On the street, it goes by such names as Cloud 9, Blizzard, Ivory Snow, Vanilla Sky, and Red Dove. Poison control centers are getting 10 X more calls for this substance than last year. The drug can cause paranoia, suicidal thoughts, violence, and death. Some states, but not all, have made the product illegal.

See Prescriber’s Letter, March, 2011, p. 18

Chronic Disease, Obesity and Poor Nutrition

Harvard pediatrician, David Ludwig, wrote a short but powerful article in a recent journal of the AMA calling for a reduction in processed foods, a restructuring of agricultural subsidies to promote high-quality foods, upgraded school lunch programs, restricted fast food advertising targeting children, and a general transition to whole-food, lower glycemic index consumption. Such measures would greatly reduce our obesity epidemic and reverse our dramatic increase in chronic degenerative diseases. We need to do our part on a personal level, and also to influence Congress to reset our country’s priorities.

See Technology, Diet, and the Burden of Chronic Disease. JAMA, April 6, 2011, vol. 305, 1352-1353. (see comment for the article).

New Concerns for Cell Phones

Cordless phones, WiFi, and cell phones produce electromagnetic fields (EMFs). Earlier concern that they might increase the risk for brain cancers and cognitive function has not been consistently shown in scientific studies. However, an international team led by Magda Havas at Trent University in Canada showed that healthy volunteers had a 40% increase in cardiac arrhythmias and disturbances in heart rate variability when exposed to the same EMFs. The concern is not so much that everyone is at risk from these changes, but who is at risk. If you are prone to heart rhythm problems, it would seem prudent to minimize your exposure.

See Dr. Havas’ ebook (with Camilla Rees), Public Health SOS: The Shadow of the Wireless Revolution, 2008. Order from www.electromagnetichealth.org (click here)

Sugar, Sleep and Survival

I met T.S. Wiley at a recent convention. She has written a fascinating book on how to get 9 hours of sleep a night, lose weight, eliminate depression, and avoid heart disease, diabetes, and cancer. She starts you out with restricting carbs and eating fresh meat and lots of veggies. In summer, added fresh fruits are allowed. Especially avoid all processed foods, pasta and bread. Don’t eat any fat that did not start out alive, directly from animal or plant. Drink water, get mild exercise for 15 minutes before each meal, do yoga. Lights out at 9 PM after reading from a book, no bedtime TV. Rise at dawn. Take a good probiotic and l-glutamine to settle your gut. If you need something more to make you sleepy, try kava or tyrosine first, then natural progesterone for women and testosterone for men.

See T.S. Wiley, Lights Out, Pocket Books 2000.

Why Animals Don’t Get Heart Attacks—But People Do

Mathias Rath, M.D. has written a thought-provoking book by this title. He uses comprehensive nutrition based on the work of Linus Pauling to suggest treatment and prevention of heart disease. According to the World Health Association, 12 million people die of heart disease and strokes each year. Animals almost never die of heart attacks. What is the major difference between the biochemistry of animals and humans? Animals manufacture the equivalent of 1000 to 20,000 mg a day of vitamin C. Humans do not produce it at all. Think about this while you take your daily dose of vitamin C.

See www.dr-rath-health-foundation.org (click here)

Cardiac Surgery Centers Expand at an Alarming Rate

According to Consumer Reports there were 163,149 cardiac bypass procedures performed at 955 centers in the USA in 2009. Ten years previously, there were 146,384 procedures done in 365 sites. Many more hospitals have added this service, largely for financial gain. The problem is that the low-volume centers have a 50% higher mortality rate. Overall, 29% of the centers did not follow published guidelines on coronary interventions, and thus were given only a one-star rating. The problem is even more significant because reporting was voluntary, and most of the centers that did not report were likely those who were not performing well. The take-home message is be careful where you go for your bypass. It might mean life or death.

See Family Practice News(click here), February 15, 2011, p. 17.

New Dietary Guidelines are Making More Sense

The government departments of Agriculture and Health and Human Services have jointly issued new dietary guidelines for those of us 2 years and older. Sodium should be restricted to 1500 mg in blacks, those greater than 51 y.o., and those with hypertension, diabetes, etc. and 2300 mg for the rest. Nutrient dense foods are recommended, such as whole grains, seafood (but not shark, swordfish and king mackerel due to high mercury content), eggs, beans, nuts and soy. The latter is controversial. Fewer solid fats make sense but I disagree with their recommendation of using low fat and fat-free foods because these are often highly processed. Foods with iron and folic acid for women, vitamin C, and vitamin B12 for those over 50 are recommended.

See www.dietaryguidelines.gov (click here)

Hypertension and High Cholesterol are Uncontrolled in the USA

The Center for Disease Control reports that 37 million American adults out of 68 million who have hypertension are not adequately controlled by medication. Likewise 48 million out of 71 million with high cholesterol are uncontrolled. 20 million with high blood pressure and 37 million with hyperlipidemia are not being treated at all. These numbers do not include those who live in nursing homes. The implication is that patients and their physicians are neglecting the former’s health care by not taking enough drugs, and some of that is true. However, lifestyle factors such as diet, exercise, obesity and smoking are at least twice as powerful treatments as drugs. Natural supplements such as red yeast for cholesterol and magnesium for hypertension are much safer and cheaper than many drugs that are available. Side effects and high costs discourage patients from taking prescription drugs. A more natural approach would produce better statistics and fewer heart attacks and strokes.

See the NHANES study at www.cdc.gov/vitalsigns (click here)

50 Ways to Improve Your Life

A special issue of US News and World Report in December, 2010 listed 50 ways to improve your life. At the top of the list were some health tips. Only a few were given, but I particularly liked President Obama’s presidential fitness award, catching up on sleep on the weekends if needed, taking water before meals to help with weight loss, and the multiple benefits of taking up Tai Chi.

See US News and World Report, December, 2010.

Once Again, Atkins was Right

A study published in the September issue of the Annals of Internal Medicine confirmed many other studies that a low carbohydrate diet not only is superior to other diets for weight loss but also may reduce the death rates from all medical causes. In the December issue of US News & World Report, many diet gurus who previously opposed the Atkins diet acknowledged that Atkins might have had something with his emphasis on the toxic effects of carbs. David Jenkins from the University of Toronto has proposed the Eco-Atkins diet, which substitutes healthier protein sources, such as beans, for the animal fats suggested by Atkins. Not a bad idea, if you can do it. The problem is that vegetable sources of protein don’t give you a lasting source of energy, and sometimes make you crave carbs. Some people thrive on a vegetarian diet, but others need to mix in some animal protein, without too much fat mixed in.

See US News and World Report, December, 2010, p. 16-19.

Cardiac CT Scanning is Becoming More Popular

A report issued by 8 organizations, including the American College of Cardiology, states that CT scanning should be more widely used. Calcium scanning without the use of dye is now considered appropriate in patients who are at intermediate risk or low risk with a positive family history of heart disease. If the test is negative, the incidence of coronary artery disease is unlikely. CT angiography with dye is a much more expensive test that can replace catheterizations and angiograms in patients that are not at high risk. Both of these tests are safe to perform, but they do involve the radiation exposure equivalent to hundreds of chest x-rays.

See Family Practice News (click here), November 15, 2010, p. 34.

Decreased Use of Hormone Therapy Linked to Rise in Hip Fractures

Harvard’s Women’s Health Initiative reported in 2002 that hormone replacement therapy increased the risk of coronary artery disease and cancer. In the ensuing six years, the use of synthetic hormones in middle-aged and older women decreased from 85% to 18%, and the incidence of hip fractures increased sharply by 55%, as reported from a study of 80,995 women in the Kaiser Permanente group in California. In my reading of the data, the culprits for increased coronary and cancer risks were primarily progestins and secondarily Premarin, both synthetic drugs. Natural progesterone and estrogen from soy and yams were not implicated in the WHI study. It is important to check with your doctor on such matters, but we often use bio-identical hormones to relieve menopausal symptoms and prevent osteoporosis for limited periods of time when indicated.

See Family Practice News(click here), November 15, 2010, p. 42.

Family History Re-emerges as a Key Risk Factor

Having a least one parent who has had a heart attack doubles the person’s own risk for having one too. This risk is in addition to other factors such as hypertension and high cholesterol, according to INTERHEART, an international study. Family history was cited as a risk factor in the 1950’s, but Harvard’s classic Framingham study beginning in the 1970’s omitted family history from its risk score. This is a good example of how prescription drugs have dominated medical therapies in recent years. Getting answers from research depends on the questions one asks. Drug companies sponsor the majority of our research. That research serves their own interest. Common sense can be left behind.

See American Journal of Cardiology (click here). 2011;57:619-27.

Adult Women with Acne

Dr. Hilary Baldwin from the State University of New York, Brooklyn presented a paper at a seminar in San Francisco on Women’s dermatology that showed an increasing incidence in resistant acne in adult women. Topical treatments do not work very well in adults, and oral antibiotics are notorious for causing vaginal yeast infections. Spironolactone is an off-label treatment that is pretty effective but carries a black box warning because of developing tumors in mice. I find that the Smoothbeam laser is very effective for this problem, and also can reduce previous acne scarring as well as unsightly wrinkles in the face. Pantothenic acid at 500 mg twice a day can be very helpful.

See Family Practice News (click here), November 15, 2010, p. 52-3.

Vitamin K and Osteoarthritis

A study reported at the World Congress on Osteoarthritis looked at 1200 patients without arthritis at baseline followed for 30 months. Those who developed osteoarthritis in both knees had a twofold incidence of vitamin K deficiency. Those who developed osteoarthritis in only one knee had a threefold incidence in vitamin K deficiency. There is no study yet that determines that taking vitamin K prevents osteoarthritis, but it might be a prudent thing to do, especially if you are at risk. Vitamin K can be measured with a simple blood test. Deficiency in vitamin K has also been linked to osteoporosis.

See Family Practice News (click here), November 15, 2010, p. 65. Dr. Tuhina Neogi(click here) from Boston University and the MOST study (click here).

Diet Sodas Appear to increase the Risk of Strokes and Heart Disease

The Northern Manhattan study followed 2500 adults over a ten-year period, ending in 2010. Those who drank diet soda or even a mixture of diet and regular soft drinks had a significantly higher risk of developing heart disease and strokes than those who did not drink sodas at all. Those who just drank regular soda were not mentioned in the article, but their risk would definitely be significant at least in a subgroup with diabetes. Ingestion of diet sodas appeared to be an independent risk factor for vascular disease, taking its place alongside inactivity, obesity, excessive alcohol, hypertension and smoking. What should you drink instead? Lots of water. Maybe some fruit juices now and then, but it is better to eat an apple than to drink a glass of apple juice.

See the Northern Manhattan study, reported by the Associated Press, February 10, 2011.

Better Sleep is Added to the National Goals for 2020

Every decade our government lists our health goals for the next 10 years called the Healthy People report. This year better sleep was added to the list. 25% of US Adults say that they have insufficient sleep or rest at least 5 days out of a month. A major cause is sleep apnea, but others simply do not sleep well. Poor sleep contributes to car and motorcycle crashes. Only 31% of high school students get the recommended 8 hours of sleep a night. Careful attention to good sleep habits can bring great dividends to your health.

See Healthy People 2020 from the Department of Health and Human Services.

One Out of Five Americans Are at Risk of Gout

Gout is a painful form of arthritis that is related to an unhealthy accumulation of uric acid, which is a waste product in the body. High levels of uric acid (>7.0 in men and 5.7 in women) put patients at risk for developing gout and to some degree for heart disease as well. During a 15-year period ending in 2004, the risk of gout in males increased from 3.8% to 5.9%. There was a lesser but still significant increase in women. Only 5% of those who have gout are treated for it. It is not clear why the increase, but we can speculate that the cause is either more obesity or higher levels of toxic chemicals in the environment. Ask your doctor for a blood uric acid test to find out if you have it. If you do, lots of cherry juice is often an effective treatment.

See the National Health and Nutrition Survey (click here) (NHANES 2008).

Advances in Acne Treatment

Acne is a great frustration to many teenagers, and sometimes it continues for decades. In middle-age Rosacea causes a bright red pimply rash that is equally difficult. A study funded by the manufacturer but reported at the Annual Congress of the European Academy of Dermatology and Venereology showed a 70% reduction in acne lesions with the topical combination of adapalene 0.1% and the old standby benzoyl peroxide 2.5% combined in a gel with oral doxycycline. This treatment applies to all but the more severe cases with nodules and pustules. What they did not mention was that it is crucial to take probiotics at a different time of day from the doxycline, or you can develop severe problems with yeast overgrowth in the intestine and elsewhere. For the more severe cases of acne, Accutane is still recommended but the potential side effects are horrible. We have had excellent results with 4-6 treatments of the Smoothbeam laser as a simple office treatment. It is used in some university settings but has not been embraced yet by conventional medicine.

See Family Practice News (click here), January, 2011, p. 34.

Why Teenage Minds Occasionally Malfunction

Dr. Sherri Tenpenny published a fascinating article on brain toxicity in young people. Studies have shown an average of 207 toxic chemicals in the cord blood of infants. Immediately after birth, doctors add antibiotics, the hepatitis vaccine and preservatives. Then in the first 5 years of life we inject 35 vaccines of live or dead organisms, containing 59 different chemicals, too many of which are given at the same time. Coupled with further environmental exposures during the period of rapid growth, it is no wonder that some children develop ADHD, Autism, Depression, Oppositional Defiant Disorder, and increased violence and risk taking. Obviously, there are other factors as well, and some of these exposures have benefits as well as risks. But we are exposing our young people to many factors that can particularly influence their brains without full knowledge of the consequences.

See NaturalNews.com (click here), February 3, 2011, Sick Brains in Teens—Is There a Root Cause?

Walking Toward Mental Health

In an editorial, Dr. Gurprit Lamba summarized the mental health benefits of walking and similar aerobic exercise. Recent research has shown that neurocognitive performance is enhanced in college students that use a treadmill or stationary bike regularly. Biochemicals that counteract anxiety and depression in the body are increased with exercise. Even patients with schizophrenia did better with exercise. Patients being treated with medications for major depression often do better with regular exercise, but they do have to be careful. If they forget even one or two doses, they are more likely to get immediate symptoms because their drugs are metabolized quicker.

See Family Practice News,(click here) January 2010, p. 9

Gait Speed Might Be Considered a new Vital Sign

A report from Dr. Stephanie Studenski of the University of Pittsburg showed that gait speed correlated quite well with expected years of life in patients 65 years of age and older. Gait speed is measured by patients walking at their usual rate from a standing start for 6-8 feet indoors. All that is needed is a walkway of 4 meters and a stopwatch. The rate that corresponds to a median life expectancy is 0.8 meters per second. The measured range was from 0.4 to 1.4 meters per second. Those whose gait speed was 1.2 meters per second or higher had “exceptional” life expectancy. Those whose gait speed is reduced are then targeted with more concentrated preventive measures. This vital sign appears to be as predictive as body mass index, blood pressure, and family history. Welcome to the medicine of the future.

See JAMA 2010(click here);305:50-8.

What to do if You Have a Strong Family History of Breast Cancer

First, you should see your doctor and be tested for a BRCA DNA mutation. If you are positive, some have advocated prophylactic surgery to actually remove the breasts. A Danish study has found that such a radical procedure is probably unnecessary. Instead of annual screening with mammograms, MRIs are performed. This recommendation now applies to all women with a 20-25% risk, even if the BRCA tests are negative. I would add breast thermograms to the annual testing, and I would definitely give some chelation treatments to reduce toxic metals, one of which is gadolinium, which is contained in the dye used in MRIs. An accumulation of toxic metals increases the risk of cancers and heart attacks.

See Family Practice News (click here), January, 2011, p. 4.

Even One Cigarette is Harmful

The Surgeon General, Dr. Regina Benjamin, issued a report on December 9, 2010 that stated emphatically that even one cigarette can lead to damaged DNA, a heart attack or stroke, sudden infant death syndrome or other health problems. The 700-page report describes how tobacco causes damage, even when inhaled as second-hand smoke. Tobacco smoke contains 7000 chemicals, hundreds of which are know to be toxic and 70 of which are carcinogenic. Every day 4000 Americans under the age of 18 try their first cigarette, and 1000 of them become addicted. 1200 Americans die every day of smoking related diseases. Many states use the money they received from the tobacco companies for general expenditures instead of preventing smoking related deaths as it was intended for. We have a smoking epidemic that we need to address in a big way.

See www.surgeongeneral.gov(click here) to see the highlights of the report.

Daily Low-dose Aspirin Reduces the Cancer Death Rate 30-40%

Adult low-dose aspirin (81 mg) has been used to reduce the incidence of heart attacks and strokes, but caution has been advised because of an increased risk of bleeding episodes. Dr. Peter Rothwell headed a group in England that found that in those who took aspirin for 5 years or longer, the death rate for the following cancers was reduced substantially: esophagus, pancreas, brain, stomach, colorectal, prostate and lung. The pendulum is swinging back in favor of taking low-dose aspirin, especially if you have a family history of cancer and cardiovascular disease. However, if you bleed easily or have a history of a peptic ulcer, aspirin is not for you.

See Lancet(click here) 2010;376:1741-50.

Self-Treatment for Cardiac Emergencies

Dr. Sherry Rogers has a great newsletter called Total Wellness. In it she advocates the use of d-Ribose, a simple sugar available at any health foods store. It is used to increase energy, especially in patients with chronic fatigue, fibromyalgia or heart problems. Two scoops or packets also can prevent a threatened heart attack if given immediately. Conventional medicine advocates taking an aspirin at the first signs of a heart attack or stroke to minimize the damage. More effective than aspirin are magnesium and heparin, each of which is given by injection and each is 30-55% effective in preventing heart damage when there is significant chest pain. If you are at risk, talk to your doctor about putting your own emergency kit together. It could save your life.

The 12-minute Fitness Revolution
The Progressively Accelerating Cardiopulmonary Exertion (PACE) system was discovered by Dr. Sears. It focuses on maximal fitness, strengthening bone, improving the immune system and preventing heart attacks and strokes with a commitment of 12 minutes a day. You can use any physical activity that makes you breath harder. The basic workout consists of a warm-up for 2 minutes, exercise for 4 minutes, then 3 minutes, then 2, then 1, with a recovery time between. Surely you can find 12 minutes in a busy day to help you live longer and feel better.

Dr. Sears PACE program (click here)

Comparative-Effectiveness Research and Integrative Medicine

Recent legislation mandates comparative-effectiveness research (CER), which seeks to find which treatments work best in the “real world” of medicine. It recognizes that randomized clinical trials reduce the variables to a minimum and provide conclusions only for the average patient. Individuals and subgroups of patients are often ignored by our dependence on double-blind studies. CER will work through generating questions by “data mining” of large group practices and electronic medical records (EMRs). It is estimated that 50-78% of research conclusions are changed by further research and that at least 48,000 key clinical questions remain to be answered in family practice alone.

Obviously, integrative medicine approaches diagnosis and treatment radically different than conventional medicine. Patients who do not respond to standard treatment often thrive under the guidance of an alternative practitioner. However, integrative patients and practitioners are reluctant to utilize EMRs because of privacy issues. The most important source of new knowledge in medicine awaits discovery in the records of integrative patients. A way must be found to make the knowledge known while unquestionably preserving the privacy of the patients who have benefited.

See Djulbegovic, Mia and Benjamin, Implications of the Principle of Question Propagation for Comparative-Effectiveness and “Data-Mining” Research.
JAMA,(click here) January 19, 2011, P. 298-299.

H1N1 Flu Shots Were Poorly Accepted in 2009

According to data from the National Vaccine Advisory Committee at the CDC, only 38% of physicians and other health care workers were vaccinated for H1N1 last year. This is about the same rate as for the general population. Only 25% of adults who were immunecompromised received the vaccine. The biggest reason given was fear of side effects, especially the paralysis called Guillan-Barre syndrome. Of those who did receive the H1N1 vaccine, there was a slight increase in the syndrome, but not to high levels. Another reason given was late delivery of the vaccine to physicians, while pharmacies seemed to get their supply sooner. The pandemic predicted for last year did not materialize, nor has there been one this year. But some people who have contracted the disease have become pretty sick. The H1N1 vaccine is included in the regular flu shot this year. If you choose not to take it, I would suggest a homeopathic as a preventative (e.g. mucococcinium).

New Concepts in Health Care Delivery

The Affordable Care Act recently signed by Obama might significantly change the way medical care is delivered, at least by primary care physicians. Patient-centered medical homes (PCMH) will give qualified primary care doctors the responsibility to coordinate the patient’s care. It emphasizes a team approach and a shift from routine specialty care to family docs and pediatricians. Pilot projects have shown great savings by better preventive care, fewer hospitalizations and less testing. Our practice is in the process of becoming certified as a PCMH. PCMH patients will still have the choice between conventional and alternative medicine. Accountable Care Organizations (ACO) is another approach being encouraged by the government. ACOs pay the same total amount per patient to hospitals, specialists and primary care docs, which is then split among the participants. This smacks of socialized medicine, while pitting hospitals and docs against each other in competition for payment.

ACOs sound like a recipe for disaster. Finally, some groups of docs on their own have set up Direct Primary Care Models, which have some similarities to the PCMH but they eliminate insurance companies as middle men, except for high-deductible catastrophic care. Patients pay a flat fee directly (typically around $100 a month) to get unlimited access to their family doctors. A lot more prevention is done with longer office visits. ER visits and hospitalizations have been reduced significantly with Direct Primary Care. This might be something we could consider for the future.

Several Studies Point to the Importance of Sleep in Young People

Family Practice News reported on three studies showing how lack of sleep can adversely affect young people. Recommended levels of sleep is 8-9 hours per night. For each one hour of sleep deprivation, there is a 14% greater incidence of psychological disturbance, including major depression. After a traumatic event
sleep disruption often occurs and is a precursor for post-traumatic stress disorder (PTSD). Overweight children with sleep apnea, whether mild or more severe, had lower grades in school than those who did not. We certainly need to pay more attention to sleep problems for both children and adults.

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

Increased Risk of Autism if the Mother Lives Close to a Major Freeway

Heather Volk of the Sabin Research Institute of Children’s Hospital in Los Angles was the chief investigator for a recent study that showed twice as many autistic children in families that live close to a major freeway, some of which carry 300,000 vehicles a day. This confirms that exposure to toxic chemicals is a major factor in the 57% increase in the incidence of autism reported by the CDC from 2002 to 2006. This might be one reason why injections of methyl B12 is often helpful in autistic children, because it can improve detoxification in the liver.

See Dr. Volk’s article in Environmental Health Perspectives (click here)

D-ribose Boosts Energy in Patients with Fibromyalgia

Jacob Teitelbaum has been a pioneer treating Fibromyalgia and Chronic Fatigue, mostly with natural means and far more effectively than the conventional protocol of anti-depressants and pain pills. He recently did a quality of life and pain reduction study of 36 patients with fibromyalgia, giving them 5 grams of the
simple sugar, d-ribose three times a day. 69% of the patients showed significant improvement after only two weeks of therapy. This is a great benefit with no side effects for a very difficult problem.

Other studies have shown that d-ribose works by increasing ATP
production inside the cells. This can be further enhanced with soft
laser treatment.

See www.endfatigue.com(click here)

Erroneous Report from the Institute of Medicine on Vitamin D

Last month the IOM issued a report stating that
Americans should take no more than 600iu of vitamin D a day and that
most were not deficient in the vitamin. This conclusion is so
contrary to a massive amount of scientific evidence that the report
is both laughable and tragic. The Vitamin D Council offers many
articles that show that we need at least 1000-5000iu daily for
optimal health and that some need 10,000 iu or more. Furthermore,
vitamin D is very safe to take at these doses. The IOM is going to
be responsible for many of us to get infectious disease, heart
attacks, cancer, osteoporosis, and other diseases. Shame on them!

See vitamindcouncil.org (click here)

A Glimmer of Hope for Personalized Medicine

An editorial in the New England Journal of Medicine discussed the advent of genetic testing for susceptibility to disease, variability of patient response to multiple therapies, and assessment of molecular mechanisms. They called for the need to provide the right dose of the right medicine to the right patient at the right time. This is a welcome change from the cookbook medicine and rigid guidelines of the medical care system now put into place by government programs and insurance companies. Integrative medicine and nutritional therapies have a lot to offer when genetic expression needs to be altered. Hopefully, these will be leaders into the cost-effective medicine of the future.

See NEJM.org (click here), June 15, 2020.

Teenage Hearing Loss Increases

Harvard researchers found that adolescents had one-third more hearing loss in 2005-6 than in 1988-1994. The finding was unexpected. It was postulated that the introduction of vaccines against pneumococcus and haemophilus and the greater awareness of music-induced hearing loss would reduce the incidence of hearing loss. The reason for the increase is not proven, but the increased use of headphones and listening devices is the likely culprit. Be careful with the latest technology!

See JAMA(click here-subscription required), August 18, 2010, pp. 772-777.

Recent Studies Show Benefits of Fish Oils

Nordic Naturals manufactures a very pure form of fishoils, so they are prejudiced, but the investigators in Nordic’s recent collection are from reputable medical schools across the country. Recent published studies have shown benefit for behavior,depression, brain health, diabetes, heart health, kidney health, lung health and pain management. That’s a mouthful. Check out theirClinical Research Trials on their web site. I was impressed, because such documentation is often not done by supplement companies. You might be too.

Nordic Naturals(click here)

The BLOG will return Tues Jan 11th.

Popular and Scientific Media Like the AMA Journal Share the Blame!

Innumerable advertisements and articles for decades advocated tragically inaccurate medical advice such as: Cigarettes for your health (actually cause cancer and emphysema), baby formula to replace breast-feeding for optimal nutrition (actually result in obesity and decreased immunity), statin drugs for primary prevention of heart disease (instead cause muscle diseases, neuropathy, and fatigue), NSAID drugs for osteoarthritis (increase the incidence of kidney disease, gastric ulcers and heart attacks), and constant sunblock to prevent skin cancers (vitamin D deficiency increases solid cancers, heart attacks, strokes, autoimmune disease, and osteoporosis). So-called medical experts can be wrong, dead wrong.

Adapted from www.endfatigue.com/health.