1830 S. Alma School Rd
Bldg 7, Ste 135
Mesa, AZ 85210
(480) 839-2273
Click here for directions
Sign up for Dr. Bogash's Rantings and instantly receive a Free copy of his ebook "Fight The Obesity Crisis"
June 18, 2004
James Bogash,D.C.Mesa,AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com
Zinc for severe pneumonia in very young children: double-blind placebo-controlled trial.
To me, this is another no brainer. Zinc supplementation is very safe and very inexpensive. In this study it reduced the hospital stay by one day and the duration of pneumonia by one day. The cost of the zinc in this study was probably under $5 (exchange rate for hospital = $45) and saved many hundreds if not thousands of dollars in hospital charges. But once again, do not look for zinc supplementation in a hospital near you soon. The Journal : Back Issues - Click here for more information.
Gastrointestinal bleeding after the introduction of COX 2 inhibitors: ecological study.
This is a very interesting article. When the COX-2 selective inhibitors were first released, I was seeing many patients come in that were prescribed this class of drugs, most inappropriately (was only supposed to be used in patients at high risk of GI complications). However, the number has dropped off to almost zero. This once blockbuster class of drugs seems to be falling to research that is finally showing that it is not all that effective as a pain med, and it’s side effect profile is really nothing to brag about, either. And all this coupled with the fact that this is a very expensive class of drugs compared to other NSAIDs. This article notes that, with the 41% increase in NSAID use (due entirely to the increased use of COX-2 inhbitors), a 10% increase in hospitalization rates for upper GI bleeds was seen. Sell your Pharmacia stock. bmj.com Mamdani et al. 328 (7453): 1415 - Click here for more information.
Prevalence of Vitamin D Deficiency Among Healthy Adolescents.
The results of this study are a little surprising (24% of kids were deficient), but I can assume that our demonizing of sunlight is much to blame. There have been many studies lately pointing to deficiencies of Vit D in almost every age group. The thing to consider here is that every single cell of the body has a receptors for Vit D even though we may not yet know the full breadth of what this vitamin does. But I can guarantee, even with what little we know, that chronic, widespread deficiencies of Vit D will lead to increased rates of MS, osteoporosis and certain types of cancer. Arch Pediatric Adolesc Med — Abstracts: Gordon et al. 158 (6): 531 - Click here for more information.
A Randomized Controlled Trial to Change Antibiotic Prescribing Patterns in a Community.
Okay. Pediatric journals print studies that show that educating a provider to lower antibiotic use in ineffective. Does anyone else out there have any idea how to reign in the antibiotic overuse? This is not just a matter of creating antibiotic resistant bacteria. This deals with the larger problem of destroying off normal flora and thereby losing their protective and beneficial effects on our health. Arch Pediatric Adolesc Med — Abstracts: Doyne et al. 158 (6): 577 - Click here for more information.
Incidence of High-Strain Patterns in Human Coronary Arteries–Assessment With Three-Dimensional Intravascular Palpography and Correlation With Clinical Presentation.
I thought this was interesting. We are starting to get pretty ingenious with our cardiovascular imaging (and opening up cans of worms in regards to exactly how well we are really “treating” CVD). With this type of ultrasound imaging the physician can actually tell if the plaque is deformable or not. The deformable plaques are much more likely to rupture and lead to heart attacks. Interestingly, these plaques also correlated with CRP levels. Circulation — Abstracts: Schaar et al. 109 (22): 2716 - Click here for more information.
Proinflammatory effects of copper deficiency on neutrophils & lung endothelial cells.
I do not like to look at a “one deficiency-one outcome” situation because I think that almost every condition (with few exceptions) is multi factorial and a wholistic approach needs to come from multiple angles. However, sometimes research comes out that does remind us of the importance of individual nutrients. To me, this article would support the inclusion of both whole grains as well as a good quality multivitamin.
Proinflammatory effects of copper deficiency on neutrophils and lung endothelial cells – Immunol Cell Biol, Vol 82, Issue 3. Click here for more information.
Prevalence and Features of the Polycystic Ovary Syndrome.
This article suggests a prevalence as high as 8% of PCOS which puts it as the most common endocrine abnormality of reproductive aged women in the US. PCOS has been linked very strongly to insulin resistance. This link seems to come from elevated insulin affecting 15,20 lyase, the enzyme that converts testosterone to estrogen. So, elevated insulin slows conversion to estrogen, essentially rising levels of testesterone, which messes up the ovulation process. The problem is that PCOS has traditionally been treated with oral contraception, which is know to worsen insulin resistance. Another perfect example of how we can actually screw the body up worse if we try to override human physiology instead of balance it. JCEM — Abstracts: Azziz et al. 89 (6): 2745 - Click here for more information.
Fructose Reduces Circulating Insulin and Leptin, Attenuates Postprandial Suppression of Ghrelin, and Increases Triglycerides in Women.
This has been a tough one to explain. Research has shown that fructose (as in high fructose corn syrup) has little effect on insulin levels. This would, at first glance, make it seem a-ok from a dietary standpoint. But most functional medicine practioners have recommended avoiding it for a long time now. This article starts to shed some light on the harms of this dietary factor. Basically, fructose does not effect insulin, but it does affect leptin and ghrelin in a negative way. Lower leptin levels were seen (remember that leptin speeds up metabolism and suppresses hunger) and higher ghrelin levels (ghrelin will stimulate appretite) in the participants fed high fructose diets. This could definately lead to weight issues. JCEM — Abstracts: Teff et al. 89 (6): 2963 - Click here for more information.
Range of Neurologic Disorders in Patients With Celiac Disease.
Celiac disease (allergy the the gluten portion of certain grains such as wheat) is one of those conditions that exemplifies the problem with mainstream medicine. While specialities are common, this is not how the body works. Here we have a gastroenterological problem wreaking havoc on the neurological system. I still recall a patient I had several years back. He was diagnosed with dermatatitis herpatiformis 10 yrs prior to coming into my office. This condition is strongly associated with celiac disease. Did his doctor recommend a gluten free lifestyle? No. Gave him dapsone (used for leprosy) and told my patient that a gluten free diet was too difficult. My patient willingly went on a gluten free program with only the mere mention that this would be best for him. I think he always knew this was best but was never told this. How much damage was done to his neurological system in the 10 years before he went on a gluten free diet? Incidently, ADD/ADHD was one of the conditions noted in this article as being related to CD. Pediatrics — Abstracts: Zelnik et al. 113 (6): 1672 - Click here for more information.
Low Maternal Dietary Intakes of Iron, Magnesium, and Niacin Are Associated with Spina Bifida in the Offspring.
This is one of the reasons I tell patients that the pharmaceutical prenatals are general some of the poorest quality and most expensive vitamins I’ve ever seen. Some of them are so blatantly poor as to only contain folic acid, iron and calcium. Most are nothing more than a basic support. Few contain biotin, magnesium and niacin. I don’t think there are ANY that contain all three. They are based on a pharmaceutical model–not a model of healthy pregnancy. They should all be tossed in the garbage where they belong (care to know how I really feel?). Nutrition.org — Abstracts: Groenen et al. 134 (6): 1516 - Click here for more information.
Xylooligosaccharides and Fructooligosaccharides Affect the Intestinal Microbiota and Precancerous Colonic Lesion Development in Rats.
I can’t wait for my next game of Scrabble. Is the board even long enough for “xylooligosaccharides?” Anyway, fructooligosaccharides (FOS) are pretty well known for their ability to beneficially affect the intestinal flora and the health of the cells of the colon. This study in rats further supports this, but also finds that xylooligosaccharides were more effective than FOS. Both are naturally found in fruits and veggies. Nutrition.org — Abstracts: Hsu et al. 134 (6): 1523 - Click here for more information.
September 24, 2003 Research Update
James Bogash, D.C. Mesa, AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com
Impaired Fracture Healing in the Absence of TNF-alpha Signaling: The Role of TNF-alpha in Endochondral Cartilage Resorption.
It is quite common for drugs to be developed and marketed that affect certain biochemical pathways before we fully understand these pathways. This is evidenced by the withdrawl of many medications after they are approved by the FDA. Of particular concern for me is the new drugs that block TNF-alpha being used for rheumatoid arthritis, Crohn’s and psoriasis. While I understand that many patients with these conditions are suffering with their symptoms, I know that many of these patients have not exhausted (or, in many cases, even attempted) natural approaches. TNF-alpha is now known to be an integral component of bone healing and formation, fighting off cancer and fighting off infections. Blocking this messenger may yield more long term problems than it solves.
Impaired Fracture Healing in the Absence of TNF- Signaling: The Role of TNF- in Endochondral Cartilage Resorption. Click here for more information.
Reduced Osteocyte Density with Osteoporotic Vertebral Fracture.
The idea that the denser the bones, the stronger the bones, is an idea that is far too simplistic. We now know that it is not just the density, but the quality of the bone that also plays a role in fracture risk. This study finds that there are less active bone cells (osteocytes) in patients who have suffered vertebral fractures. The authors suggests that less osteocytes would make the bone less response to microtrauma and changes in stress on the bone.
Reduced Iliac Cancellous Osteocyte Density in Patients With Osteoporotic Vertebral Fracture. Click here for more information.
Dietary glycine prevents chemical-induced experimental colitis.
Glycine is one of those amino acids that has been used for a long time for GI complaints. Here we see further support for this idea. Also included in a regimine including glycine would be soluble fiber and probiotics.
Gastroenterology Online. Click here for more information.
Ginkgo Biloba.
Once again, American Family Physician does a nice review of a natural agent. I have used ginko in my office with good results for dementia, hearing loss and impotence. However, I usually consider ginko in anyone younger than 50 years of age ineffective enough to not be worth the money..
Gingko Bilboa – September 1, 2003 – American Family Physician. Click here for more information.
Gene–Diet Interactions in Brain Aging and Neurodegenerative Disorders.
Once again, it is becoming more clear that another chronic degerative condition (in this case Alzheimer’s and Parkinson’s) are diseases of lifestyle. Elevated levels of homocysteine is being found to a major play in onset of these disorders. Of course this would mean that folic acid, B6 and B12 supplementation are essential for lowering your risk of these conditions.
Ann Intern Med — Abstracts: Mattson 139 (5): 441. Click here for more information.
The Relative Safety of Ephedra Compared with Other Herbal Products.
This is a letter to the Editor by Dr. Julian Whitaker on the safety of ephedra. This herb has gotten a bad rap lately, but most adverse effects we have seen have been from overuse. People drop dead daily from LABEL use of Tylenol and ibuprofen but there’s no big congressional push to outlaw those two. Remember that natural medicine is held to a much higher standard and, more often than not, can withstand the additional scrutiny.
Ann Intern Med — Whitaker 139 (5): 385 -a. Click here for more information.
Elevated Homocysteine with Higher Risk of Recurrent Coronary Events and Mortality in Acute Myocardial Infarction.
There’s that nasty homocysteine word again. Funny, for as often as it pops up in the medical literature, clinicians rarely pay heed to ordering homocysteine. This is especially disappointing because we know that supplementation with folic acid, B6 and B12 can lower levels of homocysteine.
Arch Intern Med — Abstracts: Matetzky et al. 163 (16): 1933. Click here for more information.
High Pressure Induces Superoxide Production in Isolated Arteries.
Wow! This article suggests that increased blood pressure alone is enough to start a cascade of damage in the cells lining the arteries. Increased superoxide without ample antioxidants to quench this free radical will result in further damage to the cell. This damage can begin the infiltration of white blood cells that begin plaque formation. This lends more support to the idea of antioxidant supplementation such as Vit C, E and CoQ10 to lower risk of CVD.
Circulation — Abstracts: Ungvari et al. 108 (10): 1253. Click here for more information.
Osteopathic Manipulation as Adjuvant Therapy in Children with Recurrent Acute Otitis Media.
While I love to see articles such as this (the findings not really a big surprise to any chiropractor), it is unfortunate that any press this article receives will not extend to chiropractic. Heck–why should it? Just because DCs perform 90% of manipulations and DOs have manipulation as an elective?? Oh well. Remember to add probiotic supplementation and avoidance of dairy to manipulation and just about every ear infection should become history.
Arch Pediatr Adolesc Med — Abstracts: Mills et al. 157 (9): 861. Click here for more information.
Lifestyle changes play a major role in reducing cardiovascular disease.
One of the researchers at this conference believes that, in the Nurse’s Health Study, 82% of CHD deaths could have been prevented with lifestyle changes. 82%. Think on that number. Essentially, here in the US CVD could drop off of the map of major causes of death. Knowing what we now know, there is absolutely NO excuse why CVD is still the major killer it is. None.
Vienna, Austria – Long-term studies on the effect of lifestyle changes on cardiovascular disease risk and mortality show that those who adopt a combination of several healthy habits achieve the greatest cardioprotective effect. Patients who stop smoking, follow a healthy diet, exercise daily, and drink a glass of wine or beer now and then are less likely to develop cardiovascular disease or die from it was the take-home message of a clinical seminar on the effect of lifestyle changes on cardiovascular health here at the European Society of Cardiology Congress 2003. Combination is the key “We cannot identify particular items that can be isolated, like a pill; rather, lifestyle changes have a synergetic effect,” said Dr Susana Sans Menendez (Barcelona, Spain), who was chairing the session. In this respect, the latest data from the Nurses’ Health Study, a long-term evaluation of over 120 000 nurses from 11 US states started in 1976, showed a combined impact of the following lifestyle components on primary prevention: moderate or vigorous exercise at least 30 minutes daily, a diet low in trans-fatty acids but high in omega-3 fatty acids and folate, regular intake of alcohol, a low BMI, and smoking cessation. “A total of 82% of CHD deaths in the general population would have been prevented with adherence to this healthy lifestyle,” said Dr Karin Michels (Harvard Medical School, Boston, MA), who presented the latest results of their study at the meeting.
January 10, 2002
James Bogash, D.C. Mesa, AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com
Physical and psychological correlates of headache in young adults.
Sometimes I am amazed at just how prevalent headaches are in today’s society, both in research studies and in my own practice. Not that it’s any great surprise, but this study finds that neck and back injuries before age 12 were linked to tension HA in young adults. I would like to change this to improperly treated neck and back injuries. HA originated from the neck muscles is an incredibly common cause of HA, and yet I cannot tell you how many patients come into my office that have had HA for literally decades, and NO ONE HAS EVER TOUCHED THEIR NECK!! It just makes me want to throttle someone that a significanct portion of this patient’s HA could have been eliminated decades earlier if someone had just addressed the cervical spine and musculature. JNNP — Abstracts: Waldie and Poulton 72 (1): 86. Click here for more information.
Dietary Antioxidants and Asthma in Adults.
I’m not going into a long tirade about fruits and veggies being an integral part of a healthy life and how very few people here in the US even come close to 5+ servings per day. Instead, I will use this article to press a very important issue. Rarely is asthma treated with anything other than pharmaceutical drugs that deplete bone and stunt growth, and yet there is compound research that shows that asthma indeed can be affected by lifestyle choices. We need to start making those recommendations. AJRCCM — Abstracts: SHAHEEN et al. 164 (10): 1823. Click here for more information.
Sex hormone binding globulin as prepubertal marker for hyperinsulinaemia.
This is an interesting article that may give us some insight on preventing the startling rise in Syndrome X prevalence. Exactly what role SHBG plays is not yet known, but lower levels may increase free concentrations of hormones such as testosterone, and this hyperandrogenicity may be the real player. Either way, I feel that finding markers for those at risk so they can make lifestyle changes would be a moot point if everyone make healthier lifestyle choices… ADC — Abstracts: Galloway et al. 85 (6): 489. Click here for more information.
Hypothalamic involvement in chronic migraine.
This is a very interesting article that relates hormonal dysregulation between the hypothalamus and adrenal glands as a causative factor in chronic migraines. The article suggests that delayed melatonin release and hypercortisolemia may be factors causing the HA. It always bothers me when I have patients that come in with HA that have been put on pain meds or antidepressents. Headaches are a sign of unbalanced physiology, and these meds in no way address this. I remember one of my “longest enduring headaches” patient. She had HA for forty plus years. We addressed dysfunction in her neck, balanced insulin and cortisol levels, and fixed her constipation and she became HA free. She was happy her HAs were gone, I was happy we restored normal physiology and lowered her risk for any number of chronic diseases. JNNP — Abstracts: Peres et al. 71 (6): 747. Click here for more information.
Reproductive hormonal dynamics in the perimenopause.
This is an older article but one I had to throw in just to blow apart standard thinking. So many people (and physicians included0 believe that perimenopausal symptoms are a result of lack of estrogens. The treatment? More estrogen, of course (in the form of equine estrogens foreign to the human body). Unfortunately, the reality is that perimenopause is associated with elevated estrogens. The symptoms of perimenopause are from rapid changes in estrogen levels, not elevated estrogen. Blunt the peaks with progesterone cream (downregulates estrogen receptors and makes cells less sensitive to estrogen) and fill in the troughs with phytoestrogens and most of the symptoms and signs of perimenopause disappear… JCEM — Abstracts: Santoro et al. 81 (4): 1495. Click here for more information.
Mucosal Flora in Inflammatory Bowel Disease.
This article suggests that patients with IBD have a decreased ability to keep bacteria from growing along the mucosal layer of the gut. A few things to consider here. First, this article does not suggest it, but I would consider the makeup of that flora incredibly important as to the manifestations of the disease. Second, I have seen in several Crohn’s patients that yeast infiltration plays a major role in symptoms. Maybe it is possible that IBD patients have decreased ability to fight off bacteria at the mucosal layer. Maybe in these patients it is incredibly important to maintain high levels of non-pathenogenic bacteria (probiotics) and avoiding lifestyle behaviors that alter that balance negatively… Gastroenterology — Abstracts: SWIDSINSKI et al. 122 (1): 44. Click here for more information.
Hypochlorhydria, Inflammation, Parietal and G-Cell Populations.
This study has incredible implications. This is a mouse study, but if it holds true in humans (and if this concept ever makes it out of this journal…) it could blow a hole in one of the highest prescription classes in Western civilization. This article suggests that the normal stomach upregulates its ability to make MORE acid in response to inflammation caused by bacterial infection. On the other hand, stomachs with impaired gastric acid production (hypochlorhydria), are more suseptable to infection and further injury from bacteria. The hypochlorhydria can be genetic or from treatment with acid suppressive drugs. The bottom line–we need to seriously re-evaluate or use of acid suppressive therapy in patients with gastritis and ulcers and especially H. pylori infection. Gastroenterology — Abstracts: ZAVROS et al. 122 (1): 119. Click here for more information.
June 23, 2003 Research Update
James Bogash, D.C. Mesa, AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com
Supplementation with branched-chain amino acids in advanced cirrhosis.
It seems like I’ve been coming across more and more patients who have or know someone close to them that has a liver that is failing. Given the increased pharmaceutical drug and over the counter pain relievers (Tylenol is now one of the top or possibly even #1 cause of liver failure) this is not surprising. Here we see branched chain amino acids protecting the liver. Add to this regimen milk thistle and N-acetyle cysteine and you’ve got some powerful tools to help retain what functional liver these patients have left.
Gastroenterology Online - Click here for more information.
Glycyrrhizin, an active component of liquorice roots, and replication of SARS-associated coronavirus.
This study found that licorice was more effective than many other common prescription antivirals on the market. I’m trying to figure out why this wasn’t all over the news…
The Journal : Current Issue - Click here for more information.
SSRIs: suicide risk and withdrawal.
Wow. GlaxoSmithkline withheld info from the UK’s regulatory agency when it got approval for paroxetine (Paxil). The study basically showed no increased efficacy over placebo. My question is…this kind of behavior is rampant here in the US as well. How on Earth do these companies not get shut down by the regulatory agencies? Unfortunately, I think we can all guess at the answer.
The Journal : Current Issue - Click here for more information.
Induction of interleukin-12 production in mouse macrophages by berberine deviates CD4+ T cells from a Th2 to a Th1 response.
Berberine is a compound that was made famous by goldenseal. In this study berberine was able to shift the cytokine balance from a Th2 to a Th1 mediated profile. In essence, this would help shift an asthma or allergy sufferer towards a more normal response. Interestingly, berberine is also well known to be an effective broad spectrum antibiotic, antihelminth and antiviral compound. Click here for more information.
Epidural corticosteroid injections for sciatica.
The epidural for low back pain is always one that hits close to home. In my own practice, I rarely see long term benefit from steroid injections. Flexion/distraction therapy is an extremely effective and safe treatment for sciatic pain. Also, I see a high number of patients that have been told they have sciatica but, clinically have no evidence of it. This may be another example of clinicians using advanced imaging like MRIs instead of using their exam findings and intuition.
Ann Rheum Dis — Abstracts: Valat et al. 62 (7): 639 - Click here for more information.
Metabolic disturbances in obesity versus sleep apnoea: the importance of visceral obesity and insulin resistance
I must admit this is a very interesting concept. Basically, this article opens up the idea that sleep apnea may actually be a manifestation of underlying insulin resistance and obesity. We have always known that abdominal obesity was a risk factor for sleep apnea, but the association with insulin resistance would really change the approach to treatment. I am always in support of a CPAP machine because sleep apnea can have some pretty serious long term consequences, but now we should add aggresive lifestyle changes for insulin resistance as well. Click here for more information.
Effect of vitamins and aspirin on markers of platelet activation, oxidative stress and homocysteine in people at high risk of dementia.
It was nice to see therapeutic levels of the vitamins used in this study. Many times the researchers will use levels just barely above the RDA and when the findings do not show a benefit, the results are plastered all over the news. Here we see 1 mg of B12 (something like 15,000 times the RDA) and 2 mg of folic acid (5X). The antioxidant levels are not as high as I would like but they still showed lowering of markers of oxidative stress. Click here for more information.
Effects of low-dose warfarin and aspirin versus no treatment on stroke in a medium-risk patient population with atrial fibrillation.
This article touches on what I consider a controversial topic. The chronic use of warfarin in a patient with atrial fibrillation produces a “small beneficial effect” on stroke and major vascular events. The question is, does a “small beneficial effect” justify the continued use of warfarin that would prohibit intake of foods (green, leafy veggies, ginko, ginseng, high dose Vit E, fish oils) that have a huge beneficial effects across the spectrum of multiple chronic diseases? This is a question that only a patient and their prescribing physician can answer, evaluating the risk for other chronic diseases vs ischemic stroke. Click here for more information.
Adolescent diet and risk of breast cancer.
While it should come as no surprise that the diets we eat in our teenage years will affect our risk of cancer down the line, at some point our national organizations (AHA, American Cancer Society, American Dietetic Association) need to wake up and smell the coffee. As a nation, we do a sickeningly poor job at prevention given the sheer volume of preventative measures. Now, at a time when the bar is raised further (i.e. educating our teens…) our national organizations maintain the status quo. Click here for more information.
Effect of supplemental phytonutrients on impairment of the flow-mediated brachialartery vasoactivity after a single high-fat meal.
UGHHH!! That’s just what we need–a research article that finds that a fruit-and-veggies-in-a-pill can help balance out the effects of a high fat meal!!! As Americans we are always looking for the easy way out and this will just support that attitude. NOTHING will ever replace a diet low in saturated fats and high in fruits and veggies. NOTHING!!
Cardiosource - Click here for more information.
June 17, 2003 Research Update
James Bogash, D.C. Mesa, AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com
Estrogen Plus Progestin & Dementia & Mild Cognitive Impairment.
Despite an attempt to promote HRT as protecting against dementia and Alzheimer’s, this study shows increased risk. Heck…if this stuff didn’t have billions of dollars behind it pushing for its use, I’m darn sure these compounds would have a skull and crossbones on them and kept in a high cabinet where the kids couldn’t get to them.
JAMA — Abstracts: Shumaker et al. 289 (20): 2651
click here for more information
Effect of Estrogen Plus Progestin on Stroke in Postmenopausal Women
Ditto on the above with an increased risk of ischemic stroke. Hey, this isn’t me making this stuff up just to make it look bad!!
JAMA — Abstracts: Wassertheil-Smoller et al. 289 (20): 2673 - Click here for more information.
Incidence of Recurrent Venous Thromboembolism After Treatment w/ Vitamin K Antagonists in Relation to Time Since First Event.
This one is kind of an important one for me because I’ve had numerous patients in my office who have been on blood thinners for years for an isolated event many, many years ago. Basically, there doctors where afraid to take them off of the blood thinners for fear of recurrence. I remember a recent patient that had a clot in the femoral artery probably 10 years prior and had been on thinners since, with getting his blood checked every two weeks and the works. Fine and dandy, right? No future risk of stroke, right? This patient has Parkinson’s that was progressing. High dose vitamin E and ginko may protect against progression but these are no-nos with blood thinners (or so the “standard of care” would have us believe). This patient needed to have a serious heart-to-heart with his PCP and decide on his options. This study finds that after 9 months, risk from a one-time incident is negligent and blood thinners may no longer be needed.
Arch Intern Med — Abstracts: van Dongen et al. 163 (11): 1285 - Click here for more information.
Rapid MRI vs Radiographs for Patients With Low Back Pain.
This study found no additional benefit to ordering MRI over standard Xrays. Interestingly, this study found that patients who had MRIs were more likely to undergo surgery. Basically, this supports what I always tell patients–just because something shows up on an MRI (i.e. disc herniation) does not mean that it is causing your current symptoms. Nothing replaces a good exam. An MRI should NOT be used to make a diagnosis, but rather to confrim what you already know or clarify a diffiucult case presentation.
JAMA — Abstracts: Jarvik et al. 289 (21): 2810 - Click here for more information.
C-section increases risk of hospital care in childhood for asthma, gastroenteritis.
While these results may seem confusing at first, recall that a newborn’s first exposure to beneficial bacteria is through the vaginal vault during delivery (provided that the mother has not undergone antibiotic therapy anytime in the past that may have destroyed or upset local flora in the vaginal vault). This exposure sets in motion a series of processes that help the developing child’s immune system mature properly. Click here for more information.
Treatment of multiple sclerosis with the pregnancy hormone estriol.
I’ll take this opportunity to freshen up on female hormones. The human produces three estrogens; estradiol, estrione and estriol. Estriol is generally considered the friendly hormone, and many regimens of natural HRT rely heavily upon estriol. In this study we see estriol as possibly being protective against MS. This study tried to figure out why MS symptoms seem to be reduced or in remission while a woman is pregnant (a condition where estiol levels are high) and found that estriol may be a factor.
Entrez-PubMed - Click here for more information.
Probiotic strains in IL 10 knockout mice and link with cytokine balance.
Many theories have been proposed as to why probiotics favorably impact the immune system, and this mouse study shows that probiotics actually have the ability to favorably alter the cytokine balance away from a Th-1 dominated state, which would lower risk of autoimmune conditions such as MS, lupus and rheumatoid arthritis.
Gut — Abstracts: McCarthy et al. 52 (7): 975 - Click here for more information.
Live probiotics protect intestinal epithelial cells from the effects of infection with enteroinvasive Escherichia coli.
With all this good research backing up probiotic use, I think I’m going to run out and eat some dirt…or, maybe just make a fruit smoothie with probiotic cultures mixed in.
Gut — Abstracts: Resta-Lenert and Barrett 52 (7): 988 - Click here for more information.
H. pylori Eradication Can Result in Significant Weight Gain.
This presentation follows on the heels of a research study that shows increased ghrelin levels (a hormone that increases hunger) with H. pylori eradication, with the hypothesis that this may lead to increased weight gain. This article supports that hypothesis. And remember in ten years when the shift starts moving away from H. pylori eradication that you read it here first…
DDW 2003: Abstract W1064. Presented May 21, 2003.
May 27, 2003 (Orlando) — Eradication of Helicobacter pylori in patients with epigastric pain resulted in a significant increase in weight, and this was in a population that was somewhat overweight to begin with, British researchers reported here last week at Digestive Disease Week 2003. Lead investigator Athene Lane, MD, from Frenchay Hospital and the University of Bristol in the U.K., reported on findings of 10,537 individuals involved in the Bristol Helicobacter Project, a community-based, randomized, controlled study designed to evaluate the effects of H. pylori eradication. Of the total number of individuals involved, 1,634 subjects tested positive for H. pylori on 13C-urea breath testing. These individuals were then randomized to receive either ranitidine bismuth citrate 400 mg twice daily plus clarithromycin 500 mg twice daily for two weeks or placebo. Height and weight were measured at baseline and then at a six-month follow-up visit. All subjects also answered a questionnaire about dyspepsia symptoms before and after treatment. Average body mass was 77.2 kg at baseline and 75.9 kg at the six-month mark, with subjects on active treatment gaining an average of 0.6 kg more than subjects randomized to placebo, Dr. Lane reported. In total, 19% of patients receiving active treatment gained 3 kg or more compared with 13% of patients receiving placebo. Dr. Lane told Medscape that subjects who reported the greatest symptom relief after eradication therapy were those most likely to gain weight. “Weight gain was presumably the result of symptom relief,” she said.”General practitioners may want to warn their patients about what they eat [after treatment for H. pylori infection],” Dr. Lane continued. “They may want to caution them…because this was a significant amount of weight gain in many patients.”
Probiotics Significantly Reduce Symptoms of IBS, Ulcerative Colitis.
It’s nice to see that probiotics are finally making it into the limelight. Sadly, this is about a decade behind the research and probably another decade before it makes it into clinical practice. Currently, most docs that have some inkling that certain bacteria may benefit the GI tract tell their patients to eat yogurt–which is usually laden with sugar or aspartame and has relative minute levels of probiotics compared to supplemental usage.
DDW 2003: Abstract M1582, presented May 19, 20003; Abstract W1523, presented May 21, 2003.
May 21, 2003 (Orlando) — Probiotic therapy, primarily in the form of Lactobacillus acidophilus and Bifidobacteria infantis, significantly improves symptoms and quality of life in patients with irritable bowel syndrome (IBS) and other bowel disorders, researchers reported in a number of presentations here at Digestive Disease Week 2003.In a study designed to assess the efficacy of probiotics alone or in combination with antibiotics in patients with IBS, Stephen M. Faber, MD, from Albemarle Gastroenterology Associates, PC, in Elizabeth City, North Carolina, evaluated treatment in 44 patients with IBS. Twenty patients received probiotics alone and 24 received ciprofloxacin 500 mg twice daily for one week and two probiotic formulations, Lactobacillus (NCFM) 10 billion/g and Bifidobacteia infantis (Bifdo), 10 billion/g for four weeks. Patients completed the IBS-Quality of Life (IBS-QOL) questionnaire and the Symptom Frequency Index (SFI) before and after treatment. For the study group as a whole, IBS-QOL scores averaged 66.2 before treatment and 84.6 after treatment. SFI scores before treatment averaged 38, decreasing to 18 after treatment. In patients who received both probiotics and antibiotics, IBS-QOL scores averaged 67.6 before and 87.8 after treatment. SFI scores averaged 35 at baseline, decreasing to 18 after treatment.In the probiotic-only group, baseline IBS-QOL scores were 69.3, increasing to 86.4 after treatment. SFI scores were 39 at baseline and 17 after treatment.Differences in IBS-QOL and SFI scores between probiotic plus antibiotic treatment and probiotic-only treatment were statistically insignificant, Dr. Faber reported.A retrospective look at IBS patients treated with probiotics indicates that there is a deficiency of Lactobacillus in the gut flora in patients with IBS, Dr. Faber noted, “but we’re not ready to call IBS an infectious disease.”Probiotic therapy also improved symptoms of ulcerative colitis (UC) in a separate study presented by Richard N. Fedorak, MD, professor of medicine and director of the division of gastroenterology at the University of Alberta in Edmonton, Canada. In a safety and efficacy study of the probiotic formulation VSL3 (VSL Pharmaceuticals, Inc., Ft. Lauderdale, FL), which contains eight lactic acid bacterial species, Dr. Fedorak and colleagues evaluated 30 patients with active mild-to-moderate UC with recent flares. Patients continued with previous treatment that included mesalamine, corticosteroids, and/or azathiaprine, as long as the treatment regimen was stable prior to the study. Patients took two VSL3 sachets twice a day for six weeks. Ulcerative Colitis Clinical Scores were measured and sigmoidoscopy performed at baseline and after the six-week treatment period. Dr. Fedorak reported that remission occurred in 63% (19 patients) and there was a clinical response in an additional 23% (seven patients). There was no response in 13% (four patients). Worsening of symptoms occurred in one patient.Dr. Fedorak said that probiotic therapy was not associated with any adverse clinical or biochemical events. “I haven’t heard of getting into trouble with probiotics,” Dr. Faber told Medscape. “These are organisms that are supposed to be in the gut. The body knows how to control them, so it doesn’t seem that you can overtreat.”While probiotics have been recognized as beneficial components of food, Dr. Fedorak pointed out that “we don’t use it as a food product anymore but as a treatment.”Infantile diarrhea can be shortened by about a day from the usual three- to four-day course. That is very important in infants. Probiotics are effective with rotavirus symptoms, with antibiotic-induced diarrhea, in pseudomembranous colitis, and perhaps in radiation-induced diarrhea,” he said.But Dr. Fedorak cautioned that “we don’t know how they work. They appear to strengthen the mucosal barrier of the bowel and improve immune function. And we don’t know which probiotics to use or in what combination.”
May 29, 2003 Research Update
James Bogash, D.C. Mesa, AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com
Spinal manipulative therapy is an independent risk factor for vertebral artery dissection.
Had to comment on this one. With the risks that some researchers have stated, patients would be dropping dead left and right in my office alone. Other, more favorable researchers doing very large studies (this one had 171) have estimated that 1 chiro in 40 will experience a cerebral-vascular incident in THEIR LIFETIME OF PRACTICE. When we talk deaths, there are literally less than 100 on record over the past 50 years or so. Compare this to NSAIDs, a common therapy for neck pain. Conservatively, 16,000 deaths PER YEAR. And a quick search on PubMed did not produce ANY articles showing benefit of NSAIDs in neck pain. And yet these researchers have started a cascade of controversy that states that risks of spinal manipulation outweighs benefits. Talk about double standards!! Neurology — Abstracts: Smith et al. 60 (9): 1424 - Click here for more information.
Peppermint oil reduces gastric spasm during upper endoscopy.
Peppermint has been used for centuries to calm GI spasms. For patients with irritable bowel syndrome, many have found relief with peppermint oil. Here we see it replacing a commonly used antispasmodic during endoscopy. Gastrointestinal Endoscopy Online - Click here for more information.
Risk of CVD–Related, All-Cause Death & Serum Enterolactone.
There is much evidence suggesting a protective effect of plant lignans (found in whole grains, flaxseed, soy…) on many diseases including CVD and breast and endometrial cancer. However, many of these studies are not raising a fundamental question. Lignans are converted by intestinal bacterial to enterolactone. What impact does the widespread destruction of normal flora with antibiotics have on this conversion rate? Arch Intern Med — Abstracts: Vanharanta et al. 163 (9): 1099 - Click here for more information.
Intermittent fasting effects on glucose metabolism, neuronal resistance to injury from calorie intake.
One of the only well founded true “anti-aging” approaches out there is calorie restriction w/o nutrient restriction. Well, unfortunately, this approach is just not fun. Well, we may have an easier alternative. Alternate day fasting in mice appears to produce the same favorable changes in insulin sensitivity, serum glucose and ability to protect neurons from injury. PNAS — Abstracts: Anson et al. 100 (10): 6216 - Click here for more information.
Seasonal Prevalence of Intestinal Parasites in US During 2000.
Most people are blissfully unaware of the high prevalence of parasites here in the US and believe infection with parasites is limited to those outside of the US. Welcome to reality. A study of 5,792 samples showed a prevalence as high as 43% in the summer of several types of parasites. Think that course of diarrhea last week was the flu???… Thanks to DSD newsletter for bringing this to my attention. American Journal of Tropical Medicine and Hygiene, June 2002 Abstracts - Click here for more information.
Inertia on folic acid has caused unnecessary deaths.
I commend this author on her heroism in stating that some 350,000 deaths due to cardiovascular disease could have been prevented in the past decade if physicians would’ve started recommending and industry fortifying with folic acid. Of course, this number would need to be extraplated back an additional 3 decades because first hints that folic acid could prevent neural tube defects begin in the late 50′s. The morale?? While waiting on the sidelines to recommend a potentially beneficial vitamin like folic acid, which, incidently, has never been linked to one single death at 400 mcg, millions were dying. How many nutrients are in the same situation now that folic acid was in 40+ yrs ago? bmj.com Ellis 326 (7398): 1054-c - Click here for more information.
Mitochondrial dysfunction in elderly: possible role in insulin resistance.
This is an interesting concept and would lead to some additional intervention for lower insulin resistance in an elderly population. Mitochondrial support with supplements such as coenzyme Q10, carnitine and malic acid may be warranted in this situation. This would, of course, be on top of lifestyle changes, resistance training, chromium and essential fatty acids to affect the insulin resistance. Entrez-PubMed - Click here for more information.
Adverse renal effects of anti-inflammatory agents: evaluation of selective and nonselective cyclooxygenase inhibitors.
With the sharp increase in COX-2 use such as Celebrex and Vioxx (most of this use being inappropriate for its indications), we really need to evaluate the selective COX-2 inhibitors against other known damages from NSAIDs. Here we see that the COX-2 inhibitors are just as dangerous to the kidneys as traditional NSAIDs. And much more expensive. Hey–just use the cheaper NSAIDs and save the extra money for that kidney transplant!! Click here for more information.
Evaluation of cyclooxygenase 2 inhibitor use in patients admitted to a large teaching hospital.
For those of you that thought I was just babbling about the overuse of COX-2 inhibitors…Click here for more information
Up regulation of TNF-alpha, interferon gamma in ankylosing spondylitis during treatment with etanercept.
This article really raises some concern with me (beyond my previous level of concern over this class of drugs). Recall that TNF-alpha is a cytokine that controls many other aspects of the immune system and is generally thought of as an up-regulator of the immune system. However, we do know that this class of molecule is also important in fighting cancer cells. Elevated TNF-alpha levels are associated with autoimmune diseases such as rheumatoid arthritis, ankylosing spondylitis and Crohns and a new class of drugs “binds up” these TNF-alpha molecules floating around in an attempt to lower clinical aspects of these conditions. However, in this article we see that etanercept (a TNF-alpha blocker) surely does binds up TNF-alpha, but the T-cells of the body respond by producing even more. While this may be okay while on the therapy, what happens with the patient terminates medication usage? Will this “super” elevated TNF-alpha level result in even worse degree of disease than prior to medication usage? We just don’t know yet. Ann Rheum Dis — Abstracts: Zou et al. 62 (6): 561 - Click here for more information.
October 3, 2002
James Bogash,D.C.Mesa,AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com
Acidic Drinking Water and Risk of Childhood-Onset Type 1 Diabetes.
This article is very intriguing to me and raises several issues. The findings of this study show that acidic municipal water led to a fourfold increase in risk of developing Type 1 DM. Zinc was also evaluated, and higher levels were protective. The authors suggest that the acidity may work indirectly by fostering the growth of certain types of bacteria that influence risk. A few comments here. First, this just strengthens the case for filtered/bottled water. Second, zinc is known to help modulate the Th1/Th2 cytokine expression–might this help guide the immune system into proper development and avoid autoimmune disorders? Or might the zinc support healthy immune function and override any infections that may lead to Type 1 DM? Stay tuned…Dia Care — Abstracts: Stene et al. 25 (9): 1534 - Click here for more information.
Increased insulin resistance in women with recurrent pregnancy loss.
The treatment of infertility in today’s medical environment rarely addresses lifestyle factors that contribute to problems achieving and completing a full term pregnancy. In any couples having difficulty, insulin resistance should always be addressed as a primary intervention. Insulin resistance has been strongly linked with polycystic ovary disease, which is notorious for creating problems with ovulation and therefore conception. Entrez-PubMed - Click here for more information.
Troglitazone Antagonizes Metabolic Effects of Glucocorticoids.
Ahh…the slippery slope of multiple medications; each drug designed to counteract the effects of the one before it. How about doing everything possible to reduce the steroid use in the first place, and if still absolutely necessary, using weight training and diet to manage the insulin resistance? What a novel concept!!! Diabetes — Abstracts: Willi et al. 51 (10): 2895 - Click here for more information.
FDA fails to reduce accessibility of paracetamol despite 450 deaths/ year.
It’s just Tylenol, right? Give it to your child to lower a fever, right? (Despite the fact that antipyretic therapy–lowering fever-has NEVER been studied as either safe OR effective!) Try to figure this one out– L-tryptophan, a very effective treatment for depression that was heavily used until 1989 when 37 deaths occurred due to contaminated shipments (95% of which came from one single out of the US company…), was banned by the FDA and still is not available. If my math is correct, since that time, 5,850 deaths have occurred due to UNCONTAMINATED paracetamol. Can you say “bias?” bmj.com Moynihan 325 (7366): 678 - Click here for more information.
Rates of Spontaneous Reporting of Adverse Drug Reactions in France.
Lets follow the path here. The FDA can be paid to push a drug through before it has been properly studied. Within 7 years, about 20% of these drugs are then given black box warnings or removed from the market AFTER their release. And these warnings rely on input from the clinicians in the field using the drugs. Sound a little hairy so far? Well, it only gets better…this study finds that, despite greater than 100,000 (in France alone) adverse drug responses, less than 5% were actually reported. And chiropractic’s detractors try to say chiropractic is dangerous?????
Rates of Spontaneous Reporting of Adverse Drug Reactions in France - Click here for more information.
Why should gastroenterologists be interested in nutrition and obesity?
Umm…because it is the keystone upon which health and disease pivots? Because it holds the potential to stave off most diseases known to man? Because it can modify the progression and severity of many (if not all…) chronic diseases, many of them GI disorders? Because the GI tract is the first and largest area food we eat is exposed to? Why is this even a question?? This is a sad state of how behind medicine is when it comes to health. Gastroenterology Online - Click here for more information.
Cyclo-Oxygenase 2 Function Is Essential for Bone Fracture Healing.
This is a clinical decision nightmare. The newest arsenal in the fight against arthritis pain is the highly overused class of drugs called COX-2 selective inhibitors (Celebrex, Vioxx). These are supposed to be safer on the GI tract. Recent concerns have arisen over potential damage to the heart with their use, and now we see that the COX-2 enzyme is needed for proper bone healing. How many patients out there are improperly given the selective COX-2 inhibitors for pain relief following joint replacement surgery or fracture? Have to admit that those pharmaceutical reps are doing a good job pushing off-label uses for their drugs!
Cyclo-Oxygenase 2 Function Is Essential for Bone Fracture Healing - Click here for more information.
October 24, 2002
James Bogash,D.C.Mesa,AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com
Coenzyme Q10 could slow functional decline in Parkinson’s disease.
A few interesting comments on this article. First, the highest therapeutic dose used in this study was 1200 mg…which is a pretty high dose as far as what I use in my office. Unfortunately, CoQ10 is not cheap and this would be prohibitive for many patients unless insurance covered some portion of it (dream on…). Interestingly, despite the fact that this study showed a clear benefit (44% reduction in worsening of symptoms) the authors still suggest “it would be premature for a PD patient to take these high doses until a phase III clinical trial is done.” Do you think a Parkinson’s patient who knows that progressive is inevitable would like to wait?
Effects of Coenzyme Q10 in Early Parkinson Disease: Evidence of Slowing of the Functional Decline. Click here for more information.
Work stress and risk of cardiovascular mortality.
It is well known that chronic states of stress lead to increased cortisol levels, and this increase in cortisol wreaks havoc on most body systems. One way it does this is by increasing insulin levels, producing abdominal obesity and increasing risk of heart disease. Insomnia, difficulty focusing and hormone disruptions can also be added to the list of detrimental effects of hypercortisolemia. Anyone care to take up a collection for billboards advertsing “stress kills?” bmj.com Abstracts: Kivimäki et al. 325 (7369): 857 - Click here for more information.
Homocysteine and Risk of Ischemic Heart Disease and Stroke.
This meta analysis finds an 11% increase in ischemic heart disease and 19% increase in stroke. While the authors were not jumping up and down about these results, I strongly disagree. First, one single solitary factor raised risk more than 10%. A single, solitary, VERY modifiable risk factor. (As far as cost, my office offers a 2,000 mcg B12 and 800 mg folic acid for about $8/month…that would equal to about $3,840 for forty years’ worth…hardly the cost of diagnosing CVD). Remember, Western medicine rarely gets beyond the idea of “one cause, one cure.” Natural approaches to CVD would attack multiple angles, with efficacy rising with a more broad scope approach. Lastly, this review accepts what is currently accepted as “normal” for homocysteine levels. It is highly possible (and we see it in many other lab values) that “normal” values are actually too broad. That would result in patients with “high normal” homocysteine that contributes to their CVD but would actually have counted against association.
Homocysteine and Risk of Ischemic Heart Disease and Stroke: A Meta-analysis. Click here for more information.
MTHFR 677CtoT Polymorphism and Risk of Coronary Heart Disease.
Chalk up another 16% risk for another modifyable risk factor (actually not modifyable, but rather compensatable). Here we see that genetic variants with a sluggish enzyme that converts oral folic acid to its active form increases risk of CHD. So up your level of folic acid (at no additional cost because you’re already taking it to affect homocysteine levels…) to at least 400 mg (preferably 800 mg).
MTHFR 677CrarrT Polymorphism and Risk of Coronary Heart Disease: A Meta-analysis. Click here for more information.
S-Adenosyl-L-methionine: its role in the treatment of liver disorders.
When a nutrient seems to affect multiple conditions, we can assume two case scenarios. A. The nutrient is offerred by a multi level marketing company and is reported to fix everything from diabetes to cancer to my bald spot. B. The nutrient affects a basic metabolic defect/deficiency that leads to many downstream conditions. SAM-e falls into the second category. SAM-e is a strong methyl donor, and methylation is an incredibly important process that is essential for many biological processes such as homocysteine conversion, protecting DNA from damage and, in this study, protecting the liver by assisting in the production of glutathione (the liver’s heavy hitter when it comes to detoxification). This would put SAM-e on the list along with milk thistle for any patients with liver problems. AJCN — Abstracts: Lieber 76 (5): 1183S - Click here for more information.
Fructose, weight gain, and the insulin resistance syndrome.
There are beliefs out there that fructose does not contribute to weight gain and alterations in insulin resistance. “Health” drinks contain glucose-fructose syrup and high fructose corn syrup is virtually ubiquitous in junk and processed food. Well, this study debunks these beliefs and supports the idea that fructose does get readily converted to fat in the liver, induces insulin resistance and increases blood pressure. AJCN — Abstracts: Elliott et al. 76 (5): 911 -Click here for more information.
Need for Mass Hepatitis A Vaccination of Indian Children.
Hmmm….a worldwide organization suggesting that Hep A vaccine is unnecessary because most children have antibodies to the virus by age 10. And yet, here in the US, we are pushing hard to vaccinate everyone against Hep A (and B for that matter…just to ensure that those tiny little IV drug users don’t get exposed via their sexual promiscuity…). Does this seem contradictory? We need to realize that our children are being USED in an attempt to prevent Hep A in adults. The vaccination has nothing to do with preventing the disease in children. In children the disease is hardly noticeable and self limiting. The truth would be nice for our parents–then let them decide if they still want their kids vaccinated. Click here for more information.
Bulletin of the World Health Organization 2002;80:728-731.
There may not be a need for universal vaccination of Indian children against hepatitis A, as a vast majority develop protective antibodies by 10 years of age, researchers from India report in the September Bulletin of the World Health Organization. Improvement in standards of living has led to a decreased prevalence of protective antibodies among children in various parts of the world. The result is an increased predisposition to severe forms of hepatitis A, but this mainly occurs in adults, Dr. Yogesh Batra and colleagues from the All India Institute of Medical Sciences in Delhi note. The paucity of specific data on hepatitis A seroprevalence in Indian children prompted the investigators to undertake a study of 500 school children between the ages of 10 and 17 years. The researchers tested for anti-hepatitis A antibodies using enzyme-linked immuno-sorbent assay (ELISA). A detailed clinical and biochemical evaluation was also conducted. Antibodies to hepatitis A were detected in 486 children (97.2%), indicating exposure to the virus, the researchers report. Anti-hepatitis A seroprevalence was 98.6% in children aged 10-12 years, 94.8% in children aged 13-14 years and 98.3% in children aged 15-17 years. There was no difference in anti-hepatitis A seroprevalence between boys and girls, Dr. Batra and colleagues report. A decline in the anti-hepatitis A seroprevalence among children is likely to result in an increase in incidence of hepatitis A infection among adults, Dr. Batra and colleagues warn. However, the incidence of hepatitis A in their hospital has more or less remained static between 1992 and 2000, so it is likely that anti-hepatitis A seroprevalence has changed little over the same period, the investigators believe. Similar results have been noted in other developing countries, where improvements in living conditions have not translated into a decline in the anti-hepatitis A seroprevalence, Dr. Batra comments. Thus, in endemic countries like India, where “exposure to hepatitis A virus is virtually universal” among children and the incidence of hepatitis A infection among adults has remained static, “mass vaccination against hepatitis A virus may not be cost-effective” or necessary, the Delhi team asserts.
January 18, 2003 Research Update
James Bogash, D.C. Mesa, AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com
Echinacea.
This is a pretty comprehensive review of this popular herb. Personally, I don’t ever remember recommending echinacea in my office. Most often, if some is getting sick or is sick, it’s more important to pay attention to what we shouldn’t put into our bodies, rather than what we should be putting in. In other words, refined carbs and trans and saturated fats can suppress the immune system so avoiding this garbage should be a primary approach to staving off illness. I do often recommend high dosages (1 gram every hour until bowel tolerance is reached–stools become loose or increased gas) of vitamin C if someone is not feeling well.
Echinacea – January 1, 2003 – American Family Physician - Click here for more information.
SSRI and Risk of Upper Gastrointestinal Tract Bleeding.
I must admit that this is the first time I have heard of this association, but the numbers are a tiny bit concerning….3.6 times the risk alone and a whopping 12.2 times the risk with cconcomitant NSAID use. Considering that counseling has gone the way of the sabre tooth tiger (remember when you used to associate psychiatrists with lying on the couch??) the use of meds has skyrocketed and this is a very, very real concern. Click here for more information.
Psychotropic Practice Patterns for Youth–A 10-Year Perspective.
Even before considering the previous article, the idea that utilization of psychotropic meds for youth is closing in on adult levels that drops my draw. Are our children that disturbed? And, even if they were (which I strongly doubt…) would anyone out there like to bet their right arm against the fact that these drugs in no way interfere with proper neurological development? Remember that the brain is plastic–it is constantly regenerating itself. The old adage that killing off brain cells in college never to be replaced is not true. Those new cells being produced are being bathed in meds that we have no true long term studies (unless you consider 3 years long in the life of a child) showing their safety.
Psychotropic Practice Patterns for Youth: A 10-Year Perspective - Click here for more information.
CRP as Predictor for Incident Diabetes Mellitus Among Middle-aged Men.
It’s very nice to finally see the mainstream medical journals viewing inflammation as a factor in many (actually all…) chronic diseases. Much press was given to CRP as an independent risk factor for heart disease and now we see the same association with diabetes. What I do find amusing is the “chicken with their head cut off” mentality looking for drugs to lower CRP. A huge trial is underway to see if statin drugs can lower CRP. Hey…save the money and have patient avoid refined carbs and exercise. That should do it most of the time!! Click here for more information.
Role of environmental estrogens in deterioration of male fertility.
Fertility is actually becoming quite big business in Western medicine and more and more of an issue with patients. If a woman is not fertile, their is something with their physiology that is imbalanced–estrogen dominance, polycystic ovaries, anovulation–that needs to be addressed. The medical approach of forcing ovulation on a system that is NOT ovulating because it is not ready for it just stumps me. Fix the menstrual cycle and fertility should return. I had a friend with poor lifestyle habits, including smoking. She had seen fertility doctors and was contemplating treatment. She finally quit smoking and was pregnant in weeks. With male fertility, external influences seem to be a major player–here we seen xenoestrogens affecting fertility. Want scary? Studies in mice has shown reduction in male fertility 3 generations later when zinc was deficient.
ScienceDirect – Fertility and Sterility: Role of environmental estrogens in the deterioration of male factor fertility - Click here for more information.
Acne Vulgaris — A Disease of Western Civilization.
Seriously? I thought it was a condition of antibiotic deficiency and was treated with dosing antibiotics for years on end. Wow, you really do learn something new every day. On a more serious note, if you consider the skin as an organ of detoxification, where toxins are pushed out (i.e. sweating) this is no big shocker. So the key to acne is cleaning out your system. Probiotics to restore the additional barrier in our gut between us and the environment, topical application of tea tree oil, avoidance of food allergies such as wheat and avoidance of the many chemicals we take in on a daily basis in processed foods and commerically grown fruits and veggies.
Acne Vulgaris: A Disease of Western Civilization - Click here for more information
Tea tree oil reduces histamine-induced skin inflammation.
Speaking of tee tree oil… this substance has been used for hundreds of years as an antimicrobial to be used topically. Here we see a study that also confirms its anti-inflammatory abilities. This would mean that everyone should keep a bottle in their medicine cabinet for mosquito bites, bee stings, hives…
Entrez-PubMed - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12452873&dopt=Abstract.
Role of microecology in chronic inflammatory bowel diseases.
I had a patient come in yesterday that had spent 10 days in bed from a serious case of diarrhea. She went to a GI “specialist” who gave her a drug for colitis that made the diarrhea worse. After she contacted him, he suggested she try it AGAIN!!! Much the same result. Just amazes me sometimes–I really get the feeling that some (if not closer to “many”) specialist do not understand the physiology of the organ system they devote so much time to. This patient went back to her PCP because she was sure the specialist was going to kill her. She was put on a course of antibiotics and improved. When she saw me I gave her some probiotics to restore her GI environment to a more healthy state. I’m sure these same probiotics would have been just as effective (if not more) than the antibiotics.
Role of microecology in chronic inflammatory bowel diseases - Click here for more information.
Folate and vitamin B-12 and risk of fatal cardiovascular disease.
Here is a study that finds and recommends no benefit from supplementation on CVD. At first I was a little surprised, until I looked further into the study. The study did not look at supplementation and yet, in the summary, recommended that routine recommendation not be used until more studies are done. This study checked blood levels of folate and B12. However, we know that one of the main factors about whether supplementation will help is status of the MHTFR enzyme. In about 25% of the population, this enzyme has a difficult time converting folate into its active form 5-methyltetrahydofolate. If you want to find out if this is related, you need to check 5-MHTF levels in the blood and risk of CVD.
bmj.com Hung et al. 326 (7381): 131 - Click here for more information.
January 9, 2003 Research Update
James Bogash, D.C. Mesa, AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com
Long-term improvement in functional dyspepsia using hypnotherapy
While much of mainstream medicine has forgotten the contribution that stress makes to GI complaints, this article strongly reminds us of the power of the mind. In this study, after one year, 90% of patients treated w/ meds and 84% of patients treated w/ supportive care resumed medication usage. This is in stark contrast to the big fat goosegg percentage for the hypnotherapy group. Chalk another up for the power of the mind.
Gastroenterology Online - Click here for more information.
Low intracellular zinc induces oxidative DNA damage.
Do I really need to say anymore? Other than the fact that fruits and veggies and whole grains contain lots of zinc. One caution with long term zinc supplementation. Zinc and copper are antagonistic, so make sure you supplement with copper alongside zinc.
PNAS — Abstracts: Ho and Ames 99 (26): 16770 - Click here for more information.
Meals rich in carbs or proteins on plasma tryptophan and tyrosine ratios.
This is an important consideration. Tryptophan crosses the blood brain barrier to get converted to serotonin. Serotonin helps modulate sleep and mood and satiety (drugs like Prosac work to increase levels of serotonin by increasing the time it is able to affect nervous transmission). However, tryptophan has a harder time crossing the BBB with competition from other amino acids. So, paradoxically, foods with lots of protein will contain higher levels of trypthophan, but less of this actually makes it to the brain because of the competition from the other amino acids. Foods such as soybeans, bananas and beans have relatively high tryptophan levels can help to increase brain tryptophan. In addition, supplemental 5-HTP has been shown to increase brain serotonin levels as well.
AJCN — Abstracts: Wurtman et al. 77 (1): 128 - Click here for more information.
Trial of Antioxidant Supplementation in Critically ill Surgical Patients.
Shhhhh!!! We wouldn’t want word of this getting out!! The use of Vit E and C helped improve outcome and shorten hospital stay in critically ill surgical patients. Lets see…(the dosages were not noted here) the best quality supplements (which are usually NOT used in clinically studies) would probably cost at the absolute max $50 per month. Most likely this intervention would cost about $20 total for high quality, $10 for all others. And the safety of an intervention like this is unquestionable. So do we think there’ll be a rash of antioxidant supplementation use in the surgical arena? Click here for more information.
Rapid Respiratory Viral Testing & Antibiotic Use in Children’s Hospital.
The overuse of antibiotics in the pediatric setting is still excessive, despite researchers practically screaming in the medical journals to curb use. It always concerns me that these articles appear in pediatric journals and yet the pediatricians never seem to get the message. What exactly are they reading if they’re NOT reading their own speciality’s journals?? Scares me just a little… Anyway, anything that can be used to lower antibiotic use is a good thing. Most researchers worry about antibiotic resistance. I am much more concerned about the long term damage that destruction of the normal flora causes.
The Effect of Rapid Respiratory Viral Diagnostic Testing on Antibiotic Use in a Children’s Hospital. Click here for more information.
Effects of yoghurt on immune, clinical markers of rhinopathic patients.
Tying in with the previous article, here we see a small study that shows that yogurt, which is known to contain probiotic bacteria capable of favorably modulating the immune response, can lower allergic responses. Kill off that bacteria in newborns and infants and you have a strong case for development of allergies and asthma.
Effects of dietary yoghurt on immunological and clinical parameters of rhinopathic patients. Click here for more information.
Insights into milk protein allergy: Microenvironment matters.
This is an interesting article that delves a little deeper into the immunology between cow’s milk allergy. Essentially, in milk allergic subjects, their T cells (a portion of the immune system known as cell-mediated immune) produce cytokines (chemical messengers that tell other cells what to do) consistent with a Th2 profile. In English, exposure to milk in suseptable individuals causes cells of their immune system to produce more cells that create allergic symptoms. Even with all this knowledge, food allergy still remains a very uncommon approach to addressing allergic and asthmatic patients. Avoidance of common allergens (cow’s milk, corn, wheat, soy) should be the first approach to any patient with allergies or asthma.
Gastroenterology Online - Click here for more information.
ß-Carotene or Mixed Carotenoids Protects from UV-Induced Erythema
Remember all the hoopla about the increase in melanoma in children and adolescents? We heard alot about it here in AZ. All the experts were saying that we need to limit sun exposure and use more sunscreen. Not only person in the news approached this news with any grain of common sense. Does anyone out there actually think kids are getting more sun exposure now than we did 30 years ago??? Kids are plopped in front of computers and video games. Kids are coated with sunscreens (did they even MAKE sunscreen 30 years ago?) and told to stay out of the sun. So, while the logical person would say that sun exposure is actually less, those same people would ask why the increase in skin cancers? This article is a portion of the answer. Protection from the sun comes from inside. Substances like Vit C, bioflavonoids and carotenoids protect us from the sun and our kids are getting less and less of these in their diets.
nutrition.org — Abstracts: Heinrich et al. 133 (1): 98 - Click here for more information.
Zinc Deficiency Suppresses Development of Oral Tolerance in Rats.
Oral tolerance is the process by which the immune system surrounding the GI tract (close to 2/3 of the immune system is centered around the GI tract) samples an antigen (such as a protein from foods) and decides that this substance is okay and sends that same signal out to the rest of the body. Without this process, our body would be under the impression that we are under perpetual attack from proteins in our food.
nutrition.org — Abstracts: Finamore et al. 133 (1): 191 - Click here for more information.
Categories
- Anti aging truths
- Avoid heart disease and stroke
- Cancer tips
- Diabetes and obesity tips
- Diet choices for your best health
- Gut health 101
- Headache, migraine and seizure cures
- Healthy living in a toxic world
- Healthy pregnancy and women's health
- hormone
- Insomnia
- Members
- Men's health
- Miscellaneous
- Natural pain relief
- Osteoporosis cures
- Protecting and healing your brain
- Raising healthy children
- Strengthen your immune system
- Uncategorized
- Vitamins and supplements 101