It's, Like, A Third Of A Stealth Bomber

The rhetoric in the healthcare reform debate is rising. Much of the, in the trenches, battle is being waged in the blogosphere, but it is spilling out into the mainstream media, and they're behaving, pretty much, true to form. Newspapers are failing left and right. What sustains them is advertising. One business that does continue to spend money advertising is the drug industry. Not biting the hand that feeds you does not make you inherently evil, but it does bring your objectivity into question, and before you go calling for my public execution, yes, I realize that applies to me, as well.

The prize in this fight is over funding of the National Center for Complementary and Alternative Medicine, or NCCAM. NCCAM is a subset of the Nationl Institute of Health. NIH has a budget of about 29 billion, about 300 million of which goes to alternative medicine.(1) Drug companies routinely invest 100 million to get approval for one blockbuster drug that can return somewhere on the order of 13 billion per year in sales, as Lipitor does. Point being this seems to be much ado over a relatively paltry chunk of change. It's like, a third of a stealth bomber.

So, who's throwing the sand?

There are numerous websites that go by some pretty high sounding names, like sciencebasedmedicine.org, which publish posts by people who can put MD behind their names, and many, lesser lights, like Quackwatch.org and Naturowatch, which are the brainchild of one of the bigger quacks out there, one Stephen Barret.(2) Takes one to know one, I guess.

One of the stars of this group is a fellow by the name of Kimball Atwood IV MD. Dr. Atwood is a board certified Anesthesiologist and a Clinical Assistant Professor at Tufts University School of Medicine.

Now, I have no doubt that the good doctor is a bright boy, and genuinely sincere in his beliefs, but he is obsessive in his violent opposition to functional medicine. He's also wrong a lot.

Earlier today he reposted an article he wrote in 2001 on sciencebasedmedicine.org. entitled, Naturopathy and Liberal Politics: Strange Bedfellows. I'll post a link to the entire article at the bottom of this.(3) There are a few excerpts that are kind of intrigueing:

He recalls his undergraduate days in the early 70's as being a time of "intellectual laissez-faire".

He then goes on to state some of the most intellectually laissez-faire ideas imaginable:

1. "Streptococcal pharyngitis is dangerous, and so far we have only one sure way to reduce the danger."

True. The only way to REDUCE THE DANGER, is to have a healthy, functioning immune system. Treating it once we have it has little to do with reducing the danger.

2."Heavy metal toxicity is rare"

The increases in Autism, Alzheimers and Parkinson's alone suggest otherwise. Maybe in 1850, but not today.

3. ..." as are food allergies"...

Food allergies are quite common. Food sensitivities even more so.

4. ..."and chronic yeast infections"...

Also, quite common. The modern diet is grain based, which feeds yeast. Gonna happen.

5. "Sugar in the diet doesn't have anything to do with ear infections."

In small amounts, maybe, but the average diet has a huge excess of it which is inflammatory and does contribute to feeding the bacteria, so, yes, it does have something to do with it.

6. "Childhood immunizations really do, dramatically and safely, prevent terrible diseases."

Depends on your definition of safely. If 90% of kids vaccinated don't have a problem, that might be considered safe, unless your child was one of the ten. they're safe, as long as you test your child to determine if they're good detoxifiers. If they have low levels of glutathione, have had digestive problems, or a hair analysis shows that they aren't excreting mercury efficiently, they're very much not safe.

7. "An acute asthma attack needs to be treated with a bronchodilator."

True. But what does that have to do with interventions in the form of dietary, and environmental changes done before the acute attack that will lessen their frequency?

8. "Goldenseal doesn't act, in any significant, clinical way, as an antibiotic."

Maybe, maybe not, but there is some interesting evidence that it may inhibit tumor growth.(4) We certainly need to study this further.

And, finally, the piece de resistance; "So far, the only way humanity has found to understand the objective world is through scientific research, and the knowledge gained through science is cumulative, even if at some level it remains tentative."

Here, Dr Atwood is hoisted by his own petard. He claims scientific research is needed, yet he petitions to cut funding for that very research.

Our healthcare is at a crossroads. We have to understand these other modalities. Cutting funding for that science makes no sense. Better administration of it makes a lot of sense. Better study design makes even more.

I don't know what the underlying agendas are for people like Kimball Atwood or Stephen Barret. I do know their arguements don't hold up to scrutiny.


References:

1. http://www.washingtonpost.com/wp-dyn/content/article/2009/03/16/AR2009031602139.html

2. http://www.raysahelian.com/quackwatch.html

3. http://www.sciencebasedmedicine.org/?p=415

4. http://www.ncbi.nlm.nih.gov/pubmed/17661039?ordinalpos=10&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_res

Tending Your Intestinal Garden

A reader from upstate New York had taken a job at a local health food store and asked about probiotics, which she was getting many requests for from her customers.

Even most doctors know enough now to recommend some kind of probiotic, if only a yogurt a day, to their patients who've been prescribed an antibiotic. Which ones and how many are a bit more complicated.

In order to get some perspective on the role these things play in overall health, I'll refer to an earlier post here where I compared the intestines to a faulty car exhaust. By way of review, if a car exhaust leaks carbon monoxide back into the car, that's bad. Intestinal leakage back into the body, same thing.

Our digestive system, from beginning to end, comprises over half of our bodies surface area. At a glance, that may seem far fetched, but if you remember your high school biology, the intestines, both small and large, are not smooth stretches of pipe, but convoluted, pocketed organs. The villi and diverticuli are nooks and crannies, that if you stretched them out, would cover a lot of ground.

Hopefully, it isn't too big a leap to think that, if this is over half of our bodies surface area, a similar amount of our immune activity will take place there. This does appear to be the case. Good intestinal flora are critical for good immune function. If there's one key to a long and healthy life, it's a healthy, properly functioning immune system. Just type the words intestinal flora and immune health into pubmed.org and you'll find about 100 studies, and that's just the tip of the iceberg. It's important.

Visualize your intestines as a garden, with bad, disease causing bacteria as weeds that threaten to choke out good, flowering probiotic strains. Think of populating your intestines with probiotics as tending your intestinal garden.

There are many, many strains of probiotics, the most researched being lactobacillus acidophilus and bifidobacteria bifidum, aka acididopilus and bifidus. Saccharomyces boulardii, a probiotic yeast, is, also, of keen interest to researchers because of its, apparent, ability to resist antibiotics.

You want to get them past your stomach and into your intestines and have them colonize. This is easier said, than done, as the stomach tends to be acidic, the intestines alkaline, and their survival on a trip over terrain that varied is difficult. For this reason, good probiotic supplements will have cultures numbering in the billions. Not all the soldiers survive the trip.

Napolean had a line, "An army travels on its stomach." This probiotic army is no exception. The food it eats are complex sugars known as prebiotics, mainly inulin, found in jerusalem artichokes, chicory, garlic, and FOS(fructo-oligosaccharides). Prebiotics help probiotics adhere to the intestinal wall, and enhance the likelihood that the colony will survive. Many of the more advanced blends on the market contain both pre and pro biotics.

Probiotic blends that are live cultures must be refrigerated. Although there are many non-refrigerated, soil based bacteria forms on the shelves of health food stores, they really don't work very well.

Also, it's best to take them between meals. Probiotics have difficulty sticking to the intestinal walls if they are taken with food.

Finally, this is about far more than simple, good digestive health, or something to do to counter an antibiotic. Good intestinal flora is crucial in the management of virtually every auto-immune disorder, from rheumatoid arthritis, lupus, all the inflammatory bowel issues, asthma, allergies, psoriasis, eczema, cancer, autism, the list goes on. There are a handful of supplements that I tell clients are non-negotiable. A good probiotic is on that short list.

Symptoms vs. Systems

A reader asked if there was a link between LSD use by parents and autism in their children.

I typed LSD and autism into http://www.pubmed.org/ ,and got 8 hits, 2 of which had nothing directly related to the question, 4 that were published before 1975, and only 2 that were even remotely recent, and they didn't directly address the question, which lead me to conclude that we really don't know.

His question, however, opens up a, veritable, pandora's box of follow up questions, most obvious, to me, at least, is, Why don't we know?, followed by, What do we know?, followed by, What role does the media play in all this?

The first question is for another day. I'm going to try to narrow the focus on the other two by jumping to a highly volatile, emotionally charged, question about autism, namely what role, if any, vaccinations play in autism. I realize it's a jump from LSD and autism to vaccines and autism, but I do think it can better illustrate how things get convoluted.

In order to get your mitts around this, you need to go back to the late 90's, when an English doctor named Andrew Wakefield got his study linking the MMR Measles, Mumps and Rubella triple vaccine to autism published in the Lancet.

Long story short, his research was later found to be totally corrupt.(1)

Fast forward a few years and The New England Journal of Medicine publishes a study "proving" that mercury in vaccines plays no role in autism.

This study was also later found to be just as hopelessly corrupt. (2)

So, you now have dueling studies, each claiming the opposite, published in what are, argueably, the two most prestigious, peer reviewed medical journals in the western world, that are both bogus.

If you can't trust the New England Journal of Medicine or the Lancet, who can you trust?

This still leaves the question unanswered. Is there a link between mercury laden vaccines and autism?

Autism is not a single cause disorder. It is systemic, and the factors present vary by individual. But there are some consistencies that do show up fairly often. People with autism tend to have low levels of glutathione, which is a key detoxifier in the body, particularly of metals. They also have a higher than normal incidence of inflamed bowels. Up to 95% of autistic kids have intestinal problems.(3) This is akin to having a car with a bad exhaust system that sends carbon monoxide back into the car. There's a condition called leaky gut, which is pretty much, as it sounds. Waste material leaks out of the digestive system back into the body.

Now, thimerosol laden vaccines can put 187.5 ug/kg of mercury into a childs body, when the EPA lists .5ug/kg as the safe limit.(4) You tell me. You overload an at risk person's body like that, what do you think the result will be?

Granted, not everyone's at risk. Check your child's glutathione levels. Hair analysis can give you an indication whether they are excreting mercury. Have a stool sample done to determine gut permeability, flora balance and for fungal infestation before you allow them to be vaccinated. And if your school district pressures you, get a lawyer.

References
1. http://www.briandeer.com/wakefield-deer.htm
2. Hyman, M. Altrn Ther Health Med 2008 14(6)12-15
3. Ibid p 14
4. Ibid p 15

A Pill for an Ill

Sustainability is a buzzword that is being bandied about quite a bit recently, especially in my world.

What got me thinking about this was a short film that a client sent me a link to called The Story of Stuff. http://www.thestoryofstuff.com/ . "You cannot operate a linear system on a finite planet." Good stuff.

There is no more unsustainable a system than the current healthcare mess. Of the mind boggling numbers that most people have heard so often that they're becoming numb to them, the one that tweaked my, admittedly, eclectic sense of humor, was that two of the top ten drugs in terms of sales in 2005 were Zyprexa and Resperdal, two drugs for schizophrenia. Almost 9 Billion dollars in scripts for schizophrenia in one year. Come on!!! You can't tell me that there's 9 Billion dollars worth of schizo's out there, not even in New York. (Oh, learn to laugh, already. Life's too short.)

All kidding aside, 13 billion for Lipitor, when any practitioner with half a brain knows that cholesterol is way down the list on risk factors for heart disease? Years ago, on his radio show, Ronald Hoffman reported that he had been called on the carpet by the AMA once for not prescribing a statin for a patient with high cholesterol, preferring to use more natural means, quite successfully, as I recall.

Strongarming doctors to overprescribe. Sounds more like an episode of the Sopranos.

The good news is that the tipping point should, finally, be near. There's 30 years of good science now that demonstrates to the insurance companies beyond any doubt that it is in their best interests to pay for prevention. Institutional change is slow, but steady.

But it still starts with each of you. You have to get involved. Right now, only 14 states license Naturopathic doctors. The bill in New York has been languishing in the legislature since 2005. I work with four Naturopaths. They did three years of pre-med and four years of medical school, all the residency and interning that any allopathic med student does, and the ones I know are better diagnosticians, and would be better primary care physicians than 90% of the allopaths I know. You should have the choice. The American Association of Naturopathic Physicians website is very easy to navigate. Even I could figure it out. Click on the legislation link and it will guide you. http://www.naturopathic.org/

Regulating the Regulators

Fish stink from the head.

Last week I spoke out against the nomination of a health czar whose only qualification was that of a career politician and lobbyist for the drug industry.

So, who should it be, he asked, rhetorically. Cards on the table, whoever it is had better be seriously battle tested, politically, and have some major league media savvy. But it also has to be someone with a deep understanding of how the body actually works, and how to integrate therapies to produce positive outcomes, not just how to sell drugs. The time has come.

This week, my nominations.

1. Jeffrey Bland PHD; Of my three choices, Bland will be the least known to the general public, yet, argueably, the best choice of the three. He's been teaching the tenents of functional medicine to healthcare practitioners like, well, Andy Weil and Mehmet Oz, for close to thirty years. He co-founded Bastyr University, which is the equivalent to Harvard Med for a Naturopathic Doctor. Last week at his seminar on the Future of the Clinic, in NYC, he mentioned that he, Weil and Oz would be testifying before Congress on what the shape of healthcare reform should look like. There's a link to his website on this blog. You can look up his credentials. Naturopaths and nutritionists who've attended any of his seminars over the last thirty years, pretty much, to a fault, genuflect at the mere mention of his name. He has a mind that boggles the mind, and he is tough. He would not buckle under the weight of Washington political pressure.

2. Andrew Weil MD;

3. Mehmet Oz MD;

If you're reading this and don't know who the other two are, I can't help you.

Any one of these guys would be just great. They should all hold up to the vetting process. None are in bed with big pharma, yet they all know their medicine. None of them are naive when it comes the realities of what the job entails. They're virtually unassailable. Weil and Oz are Mt. Rushmore-like in their level of belovedness. So is Bland among healthcare practitioners.

The nomination of someone like these three would truly signal the dawn of a new day in healthcare, and not more politics as usual.

Actually, I might rather have Andy Weil as the drug czar. You'll have to read his book, The Natural Mind, to understand the cryptic nature of that remark. He wrote it almost forty years ago, and it's still the best, most insightful book on drug policy I've ever read.

"The Graveyards are Full of Indispensible People"

That quote was by Col. Lawrence Wilkerson, Colin Powell's former Chief of Staff, last week on MSNBC. He was referring to an Obama nominee to the defense dept., I forget who, but he could just as easily have been talking about Tom Daschle.

The nominee that Wilkerson was referring to had ties to defense contractors, gee what a surprise, but the White House claimed he was "indispensible". Wilkerson said that there were plenty of other, just as qualified, candidates out there who didn't come with that kind of baggage.

I was preparing to really blast the Daschle nomination for Health Czar, until I got home last night and found out I was beaten to the punch, and he'd already withdrawn. Obama, himself, was on TV, defending him as the best qualified candidate to lead healthcare reform, and most of the mainstream press and their pundits seemed to be agreeing with him.

What allegedly sank Daschle was his failure to report taxes on some gifts. This isn't even the symptom of the symptom. Daschle, himself is the symptom. Start with this link, http://www.salon.com/opinion/walsh/?last_story=/opinion/walsh/politics/2009/02/03/daschle/ , then click on Glen Greenwalds link in the article, then click on Matt Tiabbi's link in that one, and Stephanie Mencimer's 2002 article on his wife. If you don't feel the need for a shower after that description of Daschle's level of stink, I can't help you. Tiabbi's quote was the best; "In Washington, there are whores and there are whores, and then there is Tom Daschle. Tom Daschle would suck off a corpse for a cheeseburger." I love this kid.

Healthcare reform is a HUGE topic. You have to start by cleaning out the sludge at the bottom of the barrel, and guys like Daschle clearly demonstrate that sludge to be bipartisan.

But it starts with each of us, and how we perceive the problem. A colleague, Dr. Chris Saltpaw, said, "In Chinese Medicine, you have to divorce yourself from every Western pardigm you've been conditioned with. In order to truly understand it, you have to understand the nature of nature."

Think about this. Our species, and every other species here, as well, evolved on the surface of a planet with very distinct rhythmns. A 24-25 hour light/dark cycle, a 365ish day cycle with very distinct seasonal rhythmns. We have hormonal cycles that rise and fall in harmony with those cycles. You want to stay healthy, stay in touch with those cycles. Lose touch with them, you will fall out of health, and then, fall prey to every snake oil drug dealer out there, and their agents, people like Tom Daschle.

God, how I hate politics.

Resveratrol

I've been asked a lot of questions this week about resveratrol in the wake of a 60 Minutes story on it, so I thought this would be a good time to discuss it.

Interest in this goes back 15-20 years, when a phrase "The French Paradox" was coined, which referred to the observation that the French ate like pigs, drank like fish, smoked like chimneys, yet didn't drop like flies as much as we did. Ironically, 60 Minutes, of all people, did a story on it in the early 90's.

What they seemed to drink the most of was red wine, the grapes of which resveratrol is a major constituent. It's also found in pine trees, peanuts and other plants, one of which, polygonnum cuspidatum, turns up in Chinese Medicine used for liver and heart conditions.

The ensuing body of science on resveratrol is far too vast to be covered in one blog entry, so I won't try.

What I will do is to try to provide some overview.

In order to get a sense not only of what resveratrol does, but why it might do this, one has to step back and view plants as existing in the same, toxic environment that we do. They have a need to develop protection from said toxins, too. They evolve to produce these protector compounds, called flavanoids and polyphenols. Turns out, the animals who eat(or drink) these plants seem to have some of this protection conferred upon themselves, too. At least, that's the theory, and the evidence is piling up in favor of it. http://www.lef.org/resveratrol/

The above link talks about the main areas of research. I'm going to focus on the aging question and the best source.

My theory on its anti aging qualities is pretty simple. The studies highlighted in the link clearly demonstrate that resveratrol has an inhibitory effect on many cancers and a protective effect against heart disease. These are the two biggest health threats we have. If you delay or prevent these two things from happening, common sense dictates that, statistically, the population, at large, will live longer.

What science is learning is that food is more than mere calories. Food is also information. Information that may be signaling disease causing genes and turning them off. Red grapes are only the first to be studied extensively and for a fairly long time. There will be more. Keep your eye on hops. That could be tomorrow's resveratrol. Beer and wine. Who knew?

Which brings me to the best source. All jokes aside, excessive alcohol consumption is extremely dangerous. It's a known carcinogen and a lot of other things, few of which are good.

The best way to get this in efficacious amounts is through supplementation of a standardized extract. Most red wine contains very little resveratrol, and you'd have to drink a case of wine a day to get a protective amount of it.

Caveat Emptor; not all supplements are created equal. Cheap supplements usually means poor quality. Metagenics, Thorne, Standard Process, Pure Encapsulation are the best supplement manufacturers on the planet. None of them pay me. The company that does pay me makes very high quality products, as well.

Assume Your Audience is Intelligent

This is the time of year for Diet/Fitness books. After the holidays, it's natural for people to make committments to healthier living. The apocolyptic bottom came, for me, the other day, when I walked past Barnes and Noble on 6th Ave., and saw a new fitness book in the window by, none other than TO, aka Terrell Owens.

The topics that the existence of this book, and others like it, underscores, for me, and no, I didn't read it, nor do I intend to, are, fad diets and flawed partnerships.

Jeffrey Bland PHD http://www.jeffreybland.com/ , once said that if you walked into any bookstore and purchased any fad diet book on the shelf, took it home and executed what it proposed, you would experience positive results. He then said that the only thing that proved was that if you, "Stopped consuming grease filled bags, shoved through anomymous glass windows into high speed automobiles", you will become healthier.

Point being that there is always some truism in just about every diet/health book out there, and any change from blatently toxic behaviors will probably be good. But deeper, fundamental truths are a bit more elusive.

The second thought here concerns celebrity endorsements.

If we keep buying it, they'll keep selling it. Publishers are in a, for profit, business. It's not their fault if we buy an air brushed picture of someone who's only claim to fame was that they were on a sitcom 20 years ago. Nobody's holding a gun to our heads. Dumbing down only works if we allow it to. When ideas become more attractive to us than aging celebrities, our collective conciousness will move forward.

Partnerships with superficiality waste resources. The ideas are the true celebrities, because that's the substance. The interminable phalanx of self help glop purveyed by these people are like so many fast food meals, lots of calories, but very little nutrition.

I grew up, unapologetically, "Grateful Dead". Their publicist and biographer, Dennis McNally, once said that, in their entire 30 year performing life, they adhered to one, underlying principle; "Assume your audience is intelligent.". Now, when the Dead stopped playing in '95, I read in some industry publication that they were the highest grossing live musical act in the country. They accomplished that with very little traditional industry support. This suggests, to me, that the idea has some pretty strong merit, and you can be successful, not by pandering to the lowest common denominator, but by challenging people to rise to their greatest self.

I'm no economist, nor foreign policy wonk, but common sense tells me that this idea could be applied to our larger ship of state, too. Hopefully, it will.

Symptoms vs. Causes

If the roof collapses on a house, is it because the roof is faulty, or is it because the underlying foundation has rotted?

I got a call from a client yesterday that underscored this idea. Her six year old son was experiencing a package of symptoms that had been diagnosed as asthma by one doctor, and an unnamed autoimmune disorder by another.

I asked if tests had been done to determine intestinal permeability, yeast overgrowth, bacterial imbalance, and fungus. They had not. I explained that, even though these symptoms appear in his breathing apparatus, they often begin in the gut and intestines. No doctor had ever discussed this with her, so she, understandably, had some difficulty accepting this notion.

If the digestive tract is damaged, toxins will leak into the surrounding tissue and trigger the release of all sorts of inflammatory agents to try to suppress the uprising. They will also migrate to weakened areas in the body. In her son's case that was his sinuses and bronchi. For someone with a twisted knee, it would stiffen the knee.

This speaks to a larger issue of how we are taught to view our health. We have to learn to look for the underlying cause of any problem. Where does it start, not just where does it show up? Even down to what we're ingesting that creates an environment for the problem. We are discovering that food is more than just calories. Food is also information that signals genes. Some foods can turn on disease causing genes, some turn them off. Some foods produce inflamation, others reduce it.

If the roof collapses, look at the foundation first.