Monday, November 23, 2009

New Mammography Guidelines

This is a special report in response to the U.S. Preventive Services Task Force regarding the Screening for Breast Cancer. You can read this report directly at: http://www.ahrq.gov/clinic/USpstf/uspsbrca.htm

U.S. Preventive Services Task Force Key Recommendations were:

- Recommend against routine screening mammography in women aged 40 to 49 years.

- Recommends screening mammography every 2 years for women between the ages of 50 and 74

- Concludes that the current evidence is insufficient to assess the benefits and harms of clinical breast examinations by physicians and other health providers

- Recommends against clinicians teaching women how to perform breast self-examination.





You may find yourself torn between confusion, anger and concern as you try to do what is best. I have heard most react negatively to these guidelines. My reaction to points 1 & 2 concerning mammogram guidelines has been strongly in favor of them. I am still undecided on points 3 and 4 regarding clinical breast exams and self exams.







Why I Support the USPSTF Mammogram Recommendations:





  1. Less x-ray exposure. These guidelines are an improvement because they result in ionizing radiation with more caution and result in less risk. The task force states that “Radiation exposure (from radiologic tests), although a minor concern, is also a consideration." I suspect they are understating how much radiation factored into their conclusions.



The U.S. has been the only country in the world to recommend premenopausal routine mammographic screening. The guidelines for screening mammograms starting at age 40 were based on optimistic assumptions on their safety. It turns out that the ionizing radiation used in mammography is 2-5 times as damaging to the tissue as x-rays used in chest x-rays. This increased biologic effect of mammographic x-rays had not been factored into safety estimates (see Radiation Research 162, 120–127 (2004) and International Journal Radiation Biology (2002, vol. 78, no. 12, 1065-1067).



This new understanding would make each mammogram more comparable to 14-35 chest x-rays. The International Journal of Radiation Biology article calculated the risk to benefit using this new understanding of the radiation used in mammography. This new calculation results in concluding that mammograms should be started later. They suggested starting screens at age 47 at the earliest and starting annual mammograms at around age 60 instead of 50. Note that these ages would be much higher if, instead of 2x, the upper end of the estimate is used (5x). Those who understand the radiation effects are more cautious in recommending mammography.





  1. More realistic estimates of benefit. These guidelines help to shatter the myth that mammography dramatically changes the course of breast cancer. The conclusions in which mammography is stated to make the most differences focus on the assumption that there is little downside to screening. The downsides include:
Unnecessary studies including surgery needed to prove that there is no cancer
- Unnecessary treatment. For example, excessive screening may result in treating DCIS which may have never caused disease. Ductal Carcinoma in Situ is commonly diagnosed via mammography but often does not actually develop into what most people would think of as cancer – it stays fairly dormant. No one actually knows when this should be treated. Overtreatment exposes women to harm and perhaps no benefit
-
The Psychological Stress of the ordeal can cause disease
-
Possibly spreading the cancer through unnecessary biopsies. This is a theoretical concern which is hard to quantify



You may be surprised that in some studies the benefits may not even exceed the risks. One well done Swedish trial concluded that “Screening for breast cancer with mammography is unjustified” Why there was more harm than benefit. To read the actual article published in The Lancet go to the following:


You can see the full text free as well; just sign up with a username and password

This is The Lancet, January 8, 2000 Volume 355, Issue 9198, Pages 129 – 134



The Cochrane Collaboration is an international, independent non-profit group which is often cited as one of the best medical reviewing organizations. They concluded that while mammography has benefit it also causes harm and stated: “It is thus not clear whether screening does more good than harm.”The 2001 Cochrane Review of Breast Mammography http://www.cochrane.org/reviews/en/ab001877.html

.
3. These guidelines will hopefully encourage women to focus on using natural ways to prevent cancer – an area which is ignored in October: Vitamin D, Iodine/Iodide, Progesterone, Cruciferous Vegetables and avoiding plastics, pesticides, hair dyes and underwire bras. I will cover more on these later

4. These guidelines may result in more widespread use and clinical studies involving breast thermography and breast ultrasound. These hold the promise of lower false positives and no radiation.



Recommendations:



These are my thoughts but obviously we are dealing with way too many unknowns to be dogmatic. We do not know the natural progression of DCIS, we do not know the exact risk of radiation nor do we have all the studies we would like to see on thermography, ultrasound and prevention strategies. We do have a lot of studies on these topics but I would like to see more. For more information on thermography see my January 09 post.



In order to settle this in your mind and make an informed decision, you will want to do your own research. Ask Questions. Factor in your risk factors for breast cancer – the above guidelines were for routine screening – not high risk individuals. Overall, Think Prevention and Safe Screening for early disease. More restraint with mammography and greater use of thermal imaging and ultrasound make more sense.



What I see points to much more success on the Prevention Side: Vitamin D (around 1000 iu for every 25 lbs is a general guideline but check your 25-Hydroxy-Vitamin D levels), Iodoral 1 a day helps insure adequate iodine intake (see www.PhysiciansPreference.com, Eat Your Veggies and if you are not getting at least 5 servings of fruit and vegetables daily I highly recommend increasing your intake – especially the cruciferous vegetables such as broccoli, cauliflower, Brussels sprouts, kale, cabbage, and bok choy. Fruit & Vegetable capsules are an excellent way you can conveniently supplement your intake by taking 2 fruit and 2 cruciferous vegetable containing vegetable capsules a day. You can order a well researched fruit & vegetable capsule through www.naturalwellnesschoices.com. Progesterone capsules and cream are available to our wellness center guests. Over the counter Progesterone cream is also available at www.physicianpreference.com and off course avoid heating food in plastic and avoid cosmetics that are petrochemical based (most are) and hair dyes.






The text contained herein does not constitute medical advice. Natural Wellness Choices & Dr, Ellsworth advise you to consult your own physician before acting on any recommendations contained in this email or blog posting













Saturday, November 14, 2009

Hypothyroidism and the Limitations of Blood Tests

Hypothyroidism is an important condition to recognize and properly treat. Some diseases associated with hypothyroidism include:

· Coronary artery disease
· Congestive heart failure
· Chronic fatigue
· Depression
· Memory problems
· Fibromyalgia – painful muscles
· Attention deficit
· Chronic or recurrent infections
· Fertility problems
· Menstrual irregularities

Medical Dogma & The Tyranny of the TSH
Since hypothyroidism causes so much suffering, disease and death, we must do everything possible to properly identify those who need treatment. Sadly, it appears that the medical community has actually taken many steps backward in their approach to hypothyroidism.

If you saw a doctor in 1960 and you had hypothyroidism, you would have been diagnosed based on your symptoms and physical exam findings and treated with natural thyroid. You would have improved and enjoyed good health. Today you would typically not be so fortunate.

Since the 1970’s doctors have been actually trained to ignore symptoms and signs of hypothyroidism unless they see an elevated pituitary hormone called the Thyroid Stimulating Hormone (TSH). If the TSH is elevated doctors are taught to treat using L-Thyroxine (aka T4). The TSH was adopted as the standard for diagnosing hypothyroidism by a consensus opinion in 1973. This decision was made on the basis of “expert opinion” and consensus rather than actual studies which show that using the TSH is the best way to approach hypothyroidism. The advocates of the TSH standard felt that it provided a more objective means of determining thyroid status than clinical parameters and after more than 30 years the TSH Approach has become medical dogma. The assumption that it is the right thing to do appears to be validated by the fact that so many physicians are doing it. Could we be missing something?

Does the TSH Approach Work?

Yes and No. The TSH is an excellent indicator of severe underproduction of thyroid hormone. A high TSH is typically present when the production of thyroid hormone is dramatically lowered such as when the thyroid gland is removed. The regulation system detects a low level of thyroid hormone and attempts to get the levels back to normal by making an excessive amount of TSH in a vain attempt to get the thyroid gland to produce more.

While a high TSH does indicate the underproduction of thyroid, a TSH level within the reference range does not assure optimal thyroid status. Why? Hypothyroidism is low thyroid function within our cells. No blood test can directly measure the thyroid activity within the cells of our body.

Why would a cell have sluggish thyroid function?

A. Underproduction – the thyroid gland produces too little thyroid

B. Cellular Underutilization – thyroid hormone only does it job within the cells of our body. Numerous steps are involved in thyroid hormones effect to help the cells produce and use energy. The cell will function sluggishly if the thyroid hormone is not used efficiently

C. A Combination of A and B

One should realize that for the medical community to use the TSH as the sole basis for diagnosing hypothyroidism one must make several huge assumptions that are not typically discussed in textbooks or lectures. The majority of the medical community has adopted a model which knowingly or not has assumed the following to be true:

1) The central regulation mechanisms in the hypothalamus and pituitary gland are assumed to be working perfectly. The thermostat like set point for serum thyroid levels within our brain is assumed to function perfectly – unaffected by aging, stress, nutritional deficiencies, toxins or genetic factors.

2) Perfect utilization of thyroid at the cellular level is assumed. Once again this assumes that the delicate process of utilizing thyroid is unaffected by aging, stress, nutritional deficiencies, toxins or genetic factors.

3) “Anywhere in the range” is fine for an individual. The model that doctors typically use assumes that individuals are perfectly fine if they are anywhere within the reference range.

Is assumption #1 true? Do central regulatory mechanisms work perfectly?
No. Consider the following quote made in the respected Primary Care Clinics:

“With significant physiologic stress, illness, inflammation and aging, however, there is demonstrable suppression of thyrotropin, making the thyrotropin test unreliable”

Primary Care: Clinics in Office Practice Volume 35, Issue 4, (Dec 2008) 669–705

Is assumption #2 true? Is thyroid hormone perfectly used in our cells at all times?
No. Hormone resistance is common

Our new understanding of endocrine dysfunction suggests that hormone resistance is more common that previously recognized. Consider both leptin and insulin.

- Underproduction is uncommon: Underproduction of leptin is rare and underproduction of insulin constitutes less than ten percent of all diabetes

- Cellular underutilization of hormones is common: leptin is almost universal with obesity and most with type 2 Diabetes have high insulin levels associated with their insulin resistance

If leptin and insulin resistance is common, could thyroid resistance be common as well?

We now have strong evidence that the intracellular conversion of thyroxine (T4) to the active form triiodothyronine (T3) is inhibited by numerous common factors. Hypothyroidism related to intracellular factors will not be reflected in changes in either the TSH or free hormone levels. Drs. Boc and Starr have adopted a reference mechanism of Hypothyroidism Type I for underproduction and Hypothyroidism Type 2 for peripheral hypo-utilization (described in the book, Hypothyroidism Type 2, Mark Starr, M.D.).

Cellular resistance can be compared to a factory with enough workers showing up but they are unable to do their job efficiently. The workers are our hormones but the factory is the cell.

We can see how many workers are showing up for work by measuring the hormone level but we cannot see how well they are working inside the factory. To gain a window into the status of our cellular factories we must step back and look at the person who is made up of all those cells. If every cell in our body is sluggish, we will see it reflected in having some of the symptoms of sluggish cell function – tired, cold, dry skin, depressed mood, memory and focus issues, constipation, aches and pains, hair loss. The body temperature may be low.

It is a cellular world

The study of what happens in our cellular factories is more challenging and has only recently been worked out in detail. We now know that cells regulate thyroid function independent of the brain/pituitary regulation system. It is well known that many chronic illnesses produce the so called sick-euthyroid syndrome characterized by normal thyroid labs but decreased thyroid function. This is often seen in many hospitalized patients with serious illnesses. We now know that under stress our cells can slow metabolism of some tissues by increasing the intracellular conversion of T4 to Reverse T3 instead of the active form of thyroid T3.

The cellular regulation of thyroid is not reflected by changes in the serum thyroid levels or the TSH. In fact these changes may only occur in certain organs and not others. During starvation the brain thyroid function continues but less critical function in the muscles and GI tract will be slowed. The TSH remains unchanged while our tissues are adjusting thyroid function to cope with our stressors. Interestingly, those of Irish decent tend to have a higher rate of thyroid underutilization problems (Hypothyroidism Type 2) due to the fact that their ancestors were the ones who survived the great potato famine of 1845 and 1852. Those who more readily slowed their metabolism presumably by producing more reverse T3 would have had a survival advantage. Therefore, descendents of these survivors may be more prone to produce reverse T3 when they encounter stress from any source; however, their TSH levels are unchanged.

Is assumption #3 true? Is the entire reference range of the TSH or thyroid hormone level necessarily that which will be optimal for an individual?
No. The reference range simply describes where most of the population is. This is made up of people of all backgrounds, young and old, healthy and ill. In order for you to have the best possible thyroid status you need to be at your optimal level. For example, when one buys shoes, one is interested in getting a little more specific than getting a “normal” shoe. I have never heard anyone say “just give me any size normal shoe in that style.” In fact most normal shoes are not right for your foot. Similarly, a person with the signs and symptoms of low thyroid and a test result that is at the 50th percentile may feel great at the 60% percentile. Another person may be in the 10th percentile and be perfectly healthy because that is their optimum.


An optimal thyroid status is much more than feeling good. In 2008 the HUNT study showed that women with a higher TSH had a 69% higher rate of heart disease (odd ratio 1.69). This dramatically increased rate of heart disease was found with TSH levels within the reference range. (see Thyrotropin Levels and Risk of Fatal Coronary Heart Disease The HUNT Study Arch Intern Med. 2008;168(8):855-860 http://archinte.ama-assn.org/cgi/content/full/168/8/855)


Conclusion: When the TSH is used alone to diagnose hypothyroidism, most who suffer from hypothyroidism will be missed. A high TSH typically indicates underproduction of thyroid. A normal TSH can be present in those with severe cellular underutilization of thyroid. This appears to be common and must be addressed. The TSH Standard for hypothyroidism diagnosis and management needs to be revised to reflect our current understanding.


Next issue: What Causes Hypothyroidism and What You can Do About it

Saturday, October 3, 2009

Strontium – For Strong Bones and More


In August I sent a newsletter about strong bones and made several suggestions. I have an important addition to make to my previous recommendations: Strontium

Strontium is a key component of our bone and connective tissues. If you look at the periodic table of elements you will notice that strontium is in the same row as calcium. What makes strontium unique is that it has the ability to actually increase the density of bone and connective tissue and help make it both stronger and healthier.

Strontium reversing Osteoporosis

1959 the Mayo Clinic gave 1.7 grams of strontium per day as strontium lactate to 32 with osteoporosis. The results showed 84% had less bone pain. There were no significant side effects bone mass appeared to increase (measuring tools were less precise then).

1985 McGill University in Montreal conducted a very small study with just 3 people. I mention this study because it was unique in that bone biopsies were actually done to directly measure the bone density both before and after 6 months of treatment with strontium. After 600 to 700 mg/day of strontium given as strontium carbonate there was a 172% increase in bone formation and less pain.

In 2002, the results of a large multi-center trial known as the STRATOS Trial (this stood for the “Strontium Ranelate for Treatment of Osteoporosis trial) showed that strontium given to 353 osteoporotic women with at least one previous vertebral fracture increased bone density. Strontium was given as strontium ranelate in the dose of 500 mg, 1000 mg or 2000 mg per day for 2 yr which provided 170, 340 or 680 mg of elemental strontium respectively per day. The lumbar bone density increased in a dose-dependent manner. Those who took the 680 mg/day of elemental strontium (2000 mg of strontium ranelate) appeared to have the best combination of efficacy and safety.

2004 - New England Journal of Medicine: 1649 postmenopausal women with osteoporosis and at least one vertebral fracture to receive 2 g of oral strontium ranelate per day (total of 680 mg of elemental Strontium) or placebo for three years. Strontium increased bone mineral density at by 14.4 percent at the lumbar spine and 8.3 percent at the femoral neck. Fracture risk was reduced a whopping 41%. The authors concluded that: “Treatment of postmenopausal osteoporosis with strontium ranelate leads to early and sustained reductions in the risk of vertebral fractures.”

2005 Another large multi-center trial result was released in The Journal of Clinical Endocrinology & Metabolism Vol. 90, No. 5 2816-2822 This study was a double blind study looking at 5091 postmenopausal women with osteoporosis for 5 years. Fracture rate again decreased 39-45%. Conclusion: “This study shows that strontium ranelate significantly reduces the risk of all nonvertebral and in a high-risk subgroup, hip fractures over a 3-yr period, and is well tolerated. It confirms that strontium ranelate reduces vertebral fractures. Strontium ranelate offers a safe and effective means of reducing the risk of fracture associated with osteoporosis.

Strontium and Cavities

Epidemiologic studies have shown that strontium concentrations of 6 to 10 mg/liter in the water supply are associated with a reduced incidence of cavities. Animal studies show that adding these levels of strontium reduced cavities.

Strontium and Arthritis

A study of the cartilage-forming cells known as found that strontium strongly promoted cartilage growth in-vitro (test tube like conditions). Hopefully we will see larger studies done one the benefits of strontium in osteoarthritis.

Bottom line

Strontium dosed at 680 mg of elemental strontium a day is a safe and effective way to prevent and reverse osteoporosis. While the largest and most recent studies used strontium ranelate, we have earlier studies which show that other strontium salts are effective including strontium carbonate, strontium lactate, and strontium gluconate. In other words, the key ingredient is strontium.

Strontium has also resulted in less bone pain in those with vertebral fractures and may be useful in reversing the pain and joint damage in osteoarthritis. Studies also suggest strontium helps prevent cavities.

Strontium is best absorbed on an empty stomach and when taken alone without other minerals. Calcium can block strontium absorption. Calcium may be taken at another time of day .

My updated recommendations for strong bones are to:

Avoid

· Soda/soft drinks (the acid in them weakens bone)

· Smoking

· Excessive caffeine

· Excessive grain intake

· Milk? There is actually an inverse relationship between how much a society drinks milk and bone density

Do

· Optimize Vitamin D

· Daily eat 5-9 Servings of Fruit and Vegetables, drink Vegetable Juice, take Fruit/Vegetable capsules (www.NaturalWellnessChoices.com to order)

· Eat green leafy vegetables like spinach and collard greens

· Optimize Hormones: DHEA, Progesterone, Estrogen and Testosterone

· Exercise – weight bearing exercise

· Get natural sunlight

· Supplemental calcium, magnesium

· Vitamin K2 (about 100 mcg a day)

· Strontium 680 mg a day

One product with strontium is the NSI Strontium at Vitacost.com http://www.vitacost.com/NSI-Strontium. At our wellness center, Physicians Preference is currently formulating a bone formula which will contain strontium.

References

Reginster JY, Deroisy R, Dougados M, et al. Prevention of early postmenopausal bone loss by strontium ranelate: the randomized, two-year, double-masked, dose ranging, placebo-controlled PREVOS trial. Osteoporosis Int 2002; 13:925-31

Pierre J. Meunier, et. Al. The Effects of Strontium Ranelate on the Risk of Vertebral Fracture in Women with Postmenopausal Osteoporosis. New England Journal of Medicine Volume 350:459-468 January 29, 2004 Number 5 http://content.nejm.org/cgi/content/abstract/350/5/459

Meunier, P.J., Slosman, D.O., Delmas, P.D., Sebert, J.L., Brandi, M.L., Albanese, C., Lorenc, R., Pors-Nielsen, S., De Vernejoul, M.C., Roces, A., Reginster J.Y. Strontium ranelate: dose-dependent effects in established postmenopausal vertebral osteoporosis&emdash;a 2-year randomized placebo controlled trial. J Clin Endocrinol Metab, May 2002; 87(5):2060-6.

Meunier, P.J., Roux, C., Seeman, E., Ortolani, S., Badurski, J.E., Spector, T.D., Cannata, J., Balogh, A., Lemmel, E.M., Pors-Nielsen, S., Rizzoli R., Genant, H.K., Reginster J.Y. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis, N Engl J Med, 2004, Jan 29;350(5):459-68.

Strontium: Breakthrough Against Osteoporosis by Ward Dean, MD

Monday, August 24, 2009

Osteoporosis Drugs – Fact versus Fiction

You see the ads. You hear the hype.

Your doctor recommends them…What do you do?

Bisphosphonates
The drugs for osteoporosis known as bisphosphonates decrease bone resorption by inhibiting the cells that break down bone (osteoclasts). They actually bind to and become part of the bone and eventually stop bone formation.


These drugs include:

Alendronate sodium - Generic and Fosamax
Ibandronate sodium - Boniva
Isedronate sodium - Actonel
Etidronate disodium – Didronel
Pamidronate disodium - Aredia
Tiludronate disodium - Skelid
Zoledronic acid - Aclasta; Reclast

All of these drugs are related and have similar side effects. They differ mainly by how often they are taken and whether they are a pill or IV. In this article I will refer to them collectively as Bisphosphonates

Why are these drugs so popular?
· Massive marketing campaigns
· They do increase bone density readings which leads many to mistakenly believe this means better bone
· They can produce a short term decrease in the risk of fractures in a few – a point that is greatly exaggerated by proponents of these drugs
· Doctors feel the need to do something and they are largely ignoring the best solutions

Reasons not to take Osteoporosis Drugs
· If you have osteopenia they have been shown to increase the fracture risk
· If you have osteoporosis, the chances of short term benefit is remote (1/81 chance)
· Long term these drugs essentially poison & kill bones and produce many side effects – some of them very serious
· The result in weaker, more brittle bone – especially after 5 years
· There are safer, natural approaches

Most Taking These Drugs Have No Personal Benefit
The studies showing benefit for these drugs are in the first 5 years of treating osteoporosis. The reason people take these drugs is to prevent fractures; however, a 2008 review of more than 12,000 women using alendronate showed only a 1-2% absolute risk reduction in women who have already developed osteoporosis.

The majority of the prescriptions written for these drugs are for individuals who have only some bone loss called osteopenia. The Hype in the media is the message that “these medications will protect your bones.” The reality is that they actually increase fracture risk. The FIT study – the Fracture Intervention Trial showed that when these drugs are used as for osteopenia, there is an increased risk of fractures. You can read this study in the reference section at the end.

Side Effects
Bone is alive and is in a constant state of remodeling by dissolving small bits of old bone (a process known as resorption) and building new bone. This remodeling allows bone to repair itself from fractures both large and microscopic.

When the levels of our bone building hormones begin to fall in midlife, bone resorption outpaces the bone building. This results in a net loss of bone which can be milder (osteopenia) or more severe (osteoporosis). The bone builders in women include Progesterone, DHEA and Estrogen. In men Testosterone and DHEA are important bone builders.

Instead of replacing declining hormones, many physicians are recommending bisphosphonates. Is this wise? Bisphosphonates do not just slow bone resorpting osteoclast activity, they poison them and eventually stop bone production by the osteoblasts.

These compounds strongly bind to the bone and become part of it. This is very unnatural.
As the graphs below show, these drugs eventually stop the bone building process.


These drugs transform living bone into inactive – essentially dead, chemically altered skeletons. Do they work to reduce fractures? In those with osteopenia they increase the fracture risk. In those with osteoporosis they temporarily decrease the fracture risk – for about 4-5 years. However, the chance of personally benefiting during this 5 year period is very low – about 1 in 86 chance.

After 5 years on these drugs, the cumulative effect of

1)preventing the repair of micro-fractures
2) blocking bone formation and
3)adding a foreign chemical to the matrix of the bone

results in bone that looks good on the bone density machine but is actually weak, brittle and essentially dead.

The increased fractures associated with these drugs may occur suddenly – even without trauma.

In addition to sudden fractures one can develop bone death in the jaw bone – especially after dental procedures and joint and muscle pain. In 2008 an FDA alert was issued warning of sudden bone and muscle pain with these drugs that can persist after the drugs are stopped.

To Summarize - Side Effects of Bisphosphonates include:
· Increased risk of fractures with osteopenia
· Increased fracture risk with osteoporosis after 5 years
· Irritation and ulcers of the esophagus
· Fractures of the femur (often without any trauma – they just snap)
· Low calcium in the blood
· Jaw bone decay (osteonecrosis) – especially after having a tooth removed
· Atrial fibrillation (increases risk 1.86 times) – this can lead to stroke/death
· Joint, bone, and muscle pain (potentially irreversibly) may occur within days, months, or years after starting a bisphosphonate

Bottom line: These drugs have serious side effects and poor effectiveness – Avoid Them

These drugs are most often used for osteopenia where they can actually increase fracture risk. Their long term effects in all who use the drugs is to possibly permanently impair the ability of the bone to grow as well as to remodel and repair small micro-fractures. The net result produces brittle, near dead bone. The bones appear to be able to recover partially when these drugs are stopped but some effects are permanent.

Safer, natural approaches
Why would you want to take a drug that actually blocks bone formation when there are actually natural ways of increasing bone production?

Avoid
· Soda/soft drinks (the acid in them weakens bone)
· Smoking
· Excessive caffeine
· Excessive grain intake
· Milk? There is actually an inverse relationship between how much a society drinks milk and bone density


Do

· Optimize Vitamin D
· Daily eat 5-9 Servings of Fruit and Vegetables, drink Vegetable Juice, take Fruit/Vegetable capsules (http://www.naturalwellnesschoices.com/ to order)
· Eat green leafy vegetables like spinach and collard greens
· Optimize Hormones: DHEA, Progesterone, Estrogen and Testosterone
· Exercise – weight bearing exercise
· Get natural sunlight
· Supplemental calcium, magnesium
· Vitamin K2 (about 100 mcg a day)
-Strontium - 680 mg a day can significantly build bone


In many cases doctors may not be aware of the negative effects of these medications. I trust this information will help you make better decisions about your health care. Some references you may find useful are below.

Selected References
Effect of Alendronate on Risk of Fracture in Women With Low Bone Density but Without Vertebral Fractures Results From the Fracture Intervention Trial
http://jama.ama-assn.org/cgi/content/full/280/24/2077

Dr. Susan M. Ott at the University of Washington, Seattle wrote an article entitled Long-Term Safety of Bisphosphonates which was published in The Journal of Clinical Endocrinology & Metabolism (Vol. 90, No. 3 1897-1899). You can read the text at http://jcem.endojournals.org/cgi/content/full/90/3/1897.

Alendronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst. Rev., 23 http://www.ncbi.nlm.nih.gov/pubmed/18253985

An emerging pattern of subtrochanteric stress fractures: A long-term complication of alendronate therapy? Injury, 39 (2), 224–231. http://www.ncbi.nlm.nih.gov/pubmed/18222447

Drugs to build bones may weaken them. New York Times, July 15, 2008
http://www.nytimes.com/2008/07/15/health/15well.html?partner=rssnyt&emc=rss

Alonso–Coello, P., et al. 2008. Analysis. Drugs for pre-osteoporosis: Prevention or disease mongering? BMJ, 336 (7636), 126–129. http://www.bmj.com/cgi/content/full/336/7636/126
Carmona, R. 2004. Bone health and osteoporosis. A report of the Surgeon General. http://www.surgeongeneral.gov/library/bonehealth/content.html

Brown, S. 2008. Vitamin D and fracture reduction: An evaluation of the existing research. Alt. Med. Rev., 13 (1), 21–33. http://www.thorne.com/altmedrev/.fulltext/13/1/21.pdf

Saturday, July 18, 2009

Nasal Washing (AKA Sinus Irrigation/Rinse)

Nasal Washing (AKA Sinus Irrigation/Rinse)


Why should you do a nasal wash?

I have become a big fan of nasal washing. This simple and easy to use tool can be very powerful when used regularly. For many years, I only emphasized nasal washing when an upper respiratory illness began. While nasal washing is quite useful in relieving the symptoms of infections, it is even more useful when used regularly. I now recommend anyone with any respiratory issues perform nasal washing 1-2x/day and increase to 3-4x/day if allergies worsen or at the onset of a respiratory infection. Regular nasal washing cleans mucus, decreases swelling and flushes out allergen which can make a dramatic difference in your health. You can expect to see:

· Less sniffing
· Less nasal voice
· Less clearing of your throat (post nasal drip)
· Decreased snoring and potentially better sleep for all J
· Relieve pregnancy rhinitis – the congestion during pregnancy
· Clears passages for CPAP users
· Children who wash have less missed school days and less doctor visits
· Improved ability to taste and smell
· Less infections
· Less asthma symptoms
· Less use of antihistamines, antibiotics and asthma medications
· More energy
· Better concentration
· Less use of antihistamines, antibiotics and asthma medications


What Rinsing Device Should I Use?


The 2 most popular units are the NeilMed Device and the Neti Pot. The Neti Pot is like an Aladdin’s Lamp that uses gravity. The NeilMed and another Product called Nasopure involve gently squeezing the bottle and uses positive pressure to provide more thorough rinsing. You can the NeilMed and Neti Pot devices in most drug stores. You can order the Nasopure device at www.nasopure.com and it is also in some stores.

A Picture is worth a Thousand Words
In order to really understand what rinsing involves you really need to watch a video. You can click on the links below (or cut and paste). They are worth your time.

Nasal Rinsing 101 (using the NeilMed): http://www.youtube.com/watch?v=qen6kJdn-y8
Neti pot demonstration: http://www.youtube.com/watch?v=j8sDIbRAXlg
Nasopure Demonstration: http://www.youtube.com/watch?v=yOBQcLBxTe4



What is the correct nasal washing technique?

• Wash your hands
• Make the nasal wash solution using boiled or distilled water
• Make the saltwater, or saline, solution fresh for every nasal wash
• To make an Isotonic saltwater solution, mix ½ teaspoon of uniodized salt in an 8-ounce glass of warm water. Uniodized salt is used because iodized salt may be irritating when used over a long period of time. Add a pinch of baking soda. A pinch is a small amount you can pick up between two fingers
• To make Hypertonic Saltwater Solution (more effective) use 1 tsp. of salt with ½ tsp. of baking soda per 8 oz.
• Use the entire 8 ounces of saltwater during the nasal wash
• Discard any unused saltwater and prepare a new saltwater solution before the next nasal wash

Isotonic Solution
An isotonic solution has the same concentration of salt as fluids in the body. While isotonic solutions do not have as many benefits as hypertonic solutions, many people like to begin nasal washing with these because they are milder.

Hypertonic Solution Studies show hypertonic solutions have benefits over isotonic:
Thins thick secretions most effectively
Removes 80% of allergens and can actually kill bacteria, fungi and viruses
Shrinks swollen membranes better


Precautions
Do not use regular tap water without boiling first or use distilled water
Do not wash if nasal passage is completely blocked
Use only lukewarm water. Do not use cold or hot water
Avoid rinsing later than one hour before bedtime, in order to avoid any residual solution dripping in the throat
No Plain Water! Plain water without salt and baking soda will result in severe burning sensation
Can they brush their teeth? A person who does a nasal wash should be able to brush their own teeth. This ensures safe use of the product

Not in my nose!
I know many think “there is no way I am putting anything up my nose!” Nasal Washing really is quite easy and can even be pleasant. I encourage you to give it a try. Once you see the benefits, you will want to continue this simple wellness tool.

Saturday, June 20, 2009

Stimulants lead to Increased Risk for Sudden Death in Children 7 Fold

Stimulants lead to Increased Risk for Sudden Death in Children 7 Fold
American Journal of Psychiatry June 15 2009

Previous studies have shown that stimulants like Ritalin have an increased risk of high blood pressure and medical visits. A new well done study just released June 15th looked at 7-19 year olds who died of sudden death and compared them to those the same age and sex who died in motor vehicle accidents. There was a seven fold increase in the use of stimulants used in treating Attention Deficit Hyperactivity Disorder (ADHD) in those who died suddenly versus those who died in traffic accidents. This study gives strong evidence that stimulant use dramatically increases the risk of sudden death by 7 fold or over 700% increase!

FDA Response: If this had been a report on a supplement you would have heard about it on all the news channels and the producers of the supplement would be shut down immediately. Instead, the FDA urged caution in interpreting the results and suggested the report should not serve as the basis for parents to stop a child’s stimulant medication. No bottles of medications are being seized. No factories shut down.

While the FDA points out correctly that since the risk of sudden death in children is rare, the absolute number of sudden deaths is going to be low. We must remember are talking about medications that are often used for questionable reasons in children which have lethal side effects. No country in the world comes close to drugging their children like the USA.

Natural Approaches to ADHD
We must find a better way to help children with attention problems. What are some natural ways to improve ADHD? By far and away, proper nutrition is the most important issue.

Eat Nutritious Food
Avoiding sugar, high fructose corn syrup & food additives
Identify food allergies (wheat and dairy are the two most common)
Omega 3 supplements (fish oil)

Dr. Stitt and her husband developed a school healthy eating program. In 1997 they were invited to Wisconsin’s Appleton Central Alternative High School to implement their program. This school was basically the last stop before prison. The students were disobedient, dropping out and crime was so rampant that full time policeman patrolled the halls to control the violence.
One Monday, students returned to see soda machines and sugar laden cafeteria food had been removed. No more including artificial colors and corn syrup. Instead they had water coolers with water and a cafeteria filled with wholesome fruits, vegetables, whole grains, and proteins. Within three months the police officer had little to do and grades were way up. Crime was gone and the drop out rate went to zero. WATCH this remarkable story:

IMPACT OF HEALTH FOOD PART 1

IMPACT OF HEALTH FOOD PART 2

The above information is not new. We have known the importance of nutrition for decades. Why do schools still allow soda machines? Why do we serve junk food in cafeterias?
While we wait for schools to clean up the junk, we can all take action at home now. Please do not bring home junk food. Good nutrition promotes a happy home as well as good students. Will some children still have attention and learning issues when you clean up the diet? Yes, but virtually all improve with good new nutrition. Additional non-drug alternatives can be used to help students who have persistent ADHD symptoms.

Additional tools to help address ADHD:

Neurofeedback (see addadhdadvances.com/neurofeedback.html)
Treating hypothyroidism when indicated
Detoxification programs
Targeted supplements based on Testing

Additional Resources:

www.feingold.org
www.endadhd.com
www.blockcenter.com

Saturday, June 13, 2009

What Do You Do When Eating Well Is Not Enough?

What Do You Do When Eating Well Is Not Enough?

I hear this question almost every day. People are avoiding sugar, flour and processed foods. They are eating meat, fruit and vegetables and exercising regularly but …their weight is not where it needs to be. The blood pressure or blood sugar level is too high. They lack energy.
What can you do to go to the next level? Enjoy a plant based diet

Eating Plant Based Foods have been shown to have the following benefits:

1. Less obesity
2. Less heart disease
3. Lower blood pressure
4. Live longer
5. Less arthritis
6. Less bone loss
7. Lower cholesterol
8. Less food allergies
9. Less exposure to environmental toxins (which accumulate in animal fat)
10. Lower rates of cancer
11. Less diabetes (a low fat vegan diet can even reverse it)
12. Less kidney stones
13. Less gallstones
14. Less asthma
15. Less PMS and menstrual problems
16. Improved athletic performance and stamina

Daniel and Plant Based Eating
In the Old Testament Daniel had the opportunity to live like a king but Daniel asked asks to eat just vegetables for 10 days to see if he and is friends looked better or not. Results of this study: at the end of the ten days they looked healthier and better nourished! (from Daniel 1)

Veggies worked for Olympian Carl Lewis as well
Olympian Carl Lewis achieved his peak athletic performance after eliminating all animal products from his diet http://www.youtube.com/watch?v=bOTETXwfIaY

Plant Based Eating Plan - One step beyond my usual recommendations
I have typically recommended eating meat, fruit and vegetables with limited grains as a healthy diet. Compared to the typical American diet, this is a dramatic improvement. I regularly see weight drop, blood pressure and blood sugar decline. Just eliminating sugar, high fructose corn syrup, processed foods and most flour goes a long way toward improving health. If you are in great health doing this, you may not need to do anything else.

However, if you find yourself struggling with any chronic disease, desire to lose weight, lower blood pressure or blood sugar, you may want to do what Daniel did & Carl Lewis did: try a Plant Based Eating Plan.

Advantages of a Plant Based Diet
For some reason, when people start talking about plant based diets they start calling people names. Those who eat eggs and dairy are called ovo-lacto-vegetarians. Those who eat no animal products are called vegans. It may be just me, but I think that referring to yourself by how you eat is a bit strange. To say you are omnivore, vegetarian or vegan sounds like a religious or political affiliation. I do not think these labels are helpful. I prefer to describe it as following a plant based diet.

Generally speaking, as animal products decrease the health benefits increase. Similarly, as sugar, fat/oil decreases we see additional benefits. This is particularly important in reversing heart disease, diabetes and obesity.

A plant based diet which avoids adding vegetable oil and chooses from lower glycemic index unprocessed vegetables, fruits and grains is the healthiest of all.

Metabolic Advantages of a Plant Based Diet
In the February 12, 2004 issue of the New England Journal of Medicine, Yale researchers found that insulin resistance was associated with tiny amounts of fat that interfered with insulin’s ability to work. The fat called intramyocellular lipid “gums up” the delicate process in which insulin allows our cells to use glucose. When our body tries to compensate by making more insulin our appetite increases, fat is deposited around our waistline, blood pressure goes up and we accelerate aging.

In his book “Dr. Neal Barnard’s Program for Reversing Diabetes,” Dr. Barnard shows how avoiding animal products, vegetable oil and sugar dramatically lowers your intracellular fats or lipids.

The low fat, low sugar plant based approach turns on the genes for burning fat, increases our mitochondria and improves insulin sensitivity – all of which paves the way to slow aging, obtain an ideal body weight and lower the risk of virtually all chronic diseases we see in the USA.

Health Concerns about Plant Based Nutrition
Protein: Most people think you have to eat meat to get protein. This is not correct. A balanced diet with vegetarian foods provides plenty of protein. Anyone using a normal range of vegetables and grains will get plenty of protein. In fact, excessive protein is linked to health problems such as bone loss and kidney stones. A short video on the topic may help: Click HERE
http://www.youtube.com/watch?v=NtK16SfGlJI

Calcium & Iron: We do not need milk and meat to get these. The dark green leafy vegetables and beans are rich in calcium. Iron is found in whole grains, beans, and fruits.
B12: Vitamin B12 is a genuine issue for vegans. This is one vitamin that we do need to supplement.

Is it safe during Pregnancy? Infants, and Children
The American Dietetic Association has found vegan diets adequate for fulfilling nutritional needs during pregnancy, but pregnant women and nursing mothers should supplement their diets with vitamins B12 and D. Most doctors recommend adding iron and folic acid as well.
In fact a plant based diet reduces the risk of pre-eclampsia during pregnancy. Pre-eclampsia is a serious condition during pregnancy in which blood pressure rises and the blood vessels become leaky. Pre-eclampsia threatens the safety of both mother and child. Plant based eating also results in purer breast milk with much less environmental toxins.

Children also have high nutritional needs, but these are met within a vegetarian diet.

But what is wrong with eating some animal products?
There is nothing wrong with eating animal products in itself. However, most of us it eat far more than is optimal for our health. Additionally, our animals are raised in very unhealthy conditions; I recommend you watch The Meatrix http://www.themeatrix.com/ http://www.themeatrix1.com/

Dare to Daniel
You can read differences of opinion on optimal eating ad infinitum; however, you not know if plant based nutrition is for you unless you actually try it. Let me suggest you do what I just did, try a “Daniel Diet” - a low sugar, low fat plant based eating plan for at least 10 days.
Avoid all animal products – meats, dairy and eggs

Use minimal vegetable oils and nuts and of course avoid margarine

Choose from lower glycemic index foods -whole grain pasta, brown rice, sprouted grain breads, fruits, vegetables.

Give yourself 10 days and see how you feel. I just did and I am definitely seeing more energy and I have lost about 6 lbs. … eating all I want. Most say you will see even more improvement over 3 months.

You can always enjoy some animal products once you are enjoying ideal health but you might find it easier to completely avoid them. Moderation in an extreme society like ours is challenging.

Do not fear Complex Starches
Not all carbohydrate foods are created equal, in fact they behave quite differently in our bodies. Many people mistakenly believe all starches are“bad.”

What is the Glycemic Index?
Choosing low GI foods that have less insulin elevating effects is important to long-term health.
White flour has a glycemic index of 70 – this is high
Pasta is actually a low GI food coming in at 43-48 (do not overcook– this raises the GI)
Rice is 50 (brown is best)
Beans and lentils are low GI
Most fruit is fairly low (exceptions are watermelon and pineapple)
Yams and sweet potatoes are low while baking potato is high GI
Oatmeal and bran are lower GI breakfast foods – avoid most cold cereals

For more information see http://www.glycemicindex.com/


Resources for a low fat plant based diet

Books

The Engine 2 Diet: The Texas Firefighter's 28-Day Save-Your-Life Plan that lowers Cholesterol and Burns Away the Pounds (MY TOP RECOMMENDATION)

Prevent and Reverse Heart Disease by Caldwell Esselstyn


The McDougall Plan, by John McDougall, M.D.

Dr. Neal Barnard’s Program for Reversing Diabetes by Neal Barnard, M.D.

The China Study by T. Colin Campbell

Dr. Dean Ornish’s Program for Reversing Heart Disease, by Dean Ornish, M.D.

Websites:
http://www.drmcdougall.com/: the cookbooks are very useful. DVD’s help as well
http://www.plantbasednutrition.org/
http://www.pcrm.org/health