|Issue #63 - December 2007|
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Accuracy in Reporting
If you've worked with me for any length of time we've probably had a discussion about how important reporting your symptoms is. More than likely I've grilled you about your altered feeling and function. Asked you "What does the pain feel like?", "How do you feel when you're in that situation?", "What is your experience of depression?". You may not always have an immediate sense of the value of this information. I want to share a recent patient experience with you that dramatically highlights its significance.
About 2 weeks ago a mom brought in one of her sons to see me. I hadn't seen B in several months as he had done very well and no longer needed ongoing care. However, he'd recently been exposed to poison ivy (in November!) and was in dire straights.
It had been a long time since I had seen anyone with symptoms as bad as B's. Years ago at the California School of Herbal Studies, Michael from Canada had gotten poison oak (West Coast strain) all over his body. His face was greatly distorted by the swelling. B was at least as bad or worse. He also had it in his chest, arms, back, and privates. But when asked by his mom what he wanted to do he said, "I don't want steroids". So here he was in my office for homeopathic care.
In the course of 45 minutes we went into as much depth as possible concerning every aspect of his symptoms. B was used to this as he had responded very well to homeopathic remedies. After all this time there wasn't a lot to go on. Unlike conventional medicine the label doesn't determine the treatment. There are over 50 homeopathic remedies that are noted for Rhus poisoning. Which is why it's so important to get information specific to the patient. Hence the length of time and the detail required individualizing the case.
Usually it's best to know what's strange, unusual, or peculiar in the case as that will tell you where to look for a remedy. It's also important to know how the person has changed since the illness began. What stood out at this visit, and what I latched onto, was the fact that B felt better with really hot water. In my experience it's unusual for people with itchy, burning, stinging skin (B's symptoms) to feel better with hot water-they are usually worse. So with this linchpin and a couple of other specific symptoms I confidently gave B the homeopathic remedy Rhus-tox in a 1M potency. Rhus-tox because it best fit the symptoms-especially better with hot water, and a 1M potency because of the nature and quality of the illness.
The report the next day was, "No improvement." I had a break in my schedule so I asked the mom to bring B back in. If anything his face was more swollen and his right eye was partially closed. After another 45 minutes we hadn't been any more successful in getting information. I went back to asking about the hot water issue only to learn that B is always better with hot water. In other words this was not a change in his state. Hence I wasn't looking at the right information.
I went back to asking the mom what was different and she said not really anything-as she had said several times already. However, this time she made an aside about how B wanted to be by himself-because of how he looked. Turns out this is very unusual for B. He really likes being around people and is quite social. When I asked him directly he said this was a big change. This led me down a completely different direction of questioning until I got one more big change-he didn't want to be consoled. Usually, when he's sick he's all over his mom-but not this time. Another big change. These were really the only symptoms I had. Everything else-itching, scratching, and the eruptions-were common manifestations of poison ivy.
Because of these 2 big changes from his Normal state, and a couple of other confirmatory symptoms, I gave him the homeopathic remedy Natrum muriaticum 200c. The difference in response from the first remedy was striking. Within an hour of taking the first dose of Natrum muriaticum he began to feel better, and the itching was gone. When asked about having a friend over he had an enthusiastic response. Over the next 24 hours the swelling decreased and he was outside playing and laughing. Within 48 hours the swelling was 80% gone and he was back to normal.
What's important to understand in this case? There was such a dramatic and rapid improvement in B's state of health when I chose a remedy that truly matched his altered state. And absolutely no change when his normal symptoms were used. A seemingly circumstantial change-"he doesn't want to be around anybody because of how he looks"-was a significant marker of the shift in his vitality. To quote my homeopathic mentor David Kramer we need to be "Sherlock Holmesopaths", questioning every statement and looking at the details others pass by. B's Vital Force was distuned by his exposure to poison ivy. To restore health we need to ascertain the details of this distunement and apply the homeopathic remedy that best matches the altered state. When that is done cure is rapid, gentle, and permanent.
Quinoa, pronounced keen-wah, though not a botanical cereal is treated as a grain in cooking. Unlike other grains it is a complete protein containing a balanced group of essential amino acids. It's a good source of protein as its protein content is quite high-12-18%. It's also a good source of dietary fiber and the mineral phosphorus. It is high in magnesium and iron. Quinoa is gluten free and hypoallergenic for most people. I recommend eating only the organic variety.
Because of the bitter saponin coating present on the grains it's important to rinse it thoroughly before cooking. You may need to experiment to find your desired texture but I find that a 2.5 to 1 water to grain ratio works best. Just bring to a boil and simmer for 15-20 minutes until it's fluffy.
Sodium Nitrite and Sodium Nitrate
These chemicals are found in processed meats like hot dogs, salami, pepperoni, bacon, bologna, ham, sausage, and SPAM. They are used to make these meats appear red. These substances react with stomach and other stomach chemicals to form nitrosamines. Nitrosamines have been shown to cause cancer in animals. Children and pregnant women should avoid these chemicals. And in fact, anyone wanting to decease their risk of cancer should stop eating foods these chemicals.
DIABETES AND VITAMIN D
This 17-year follow-up of roughly 4,000 men and women, found that individuals with higher blood levels of vitamin D had a 40 percent lower risk of developing type 2 diabetes than those with lower levels of this vitamin. This level of protection goes way beyond any current drug protection.
187 people developed type 2 diabetes during follow-up. After adjusting for gender, age, and month when blood samples were obtained, a statistically significant inverse association was observed between the blood vitamin D level and the development of type 2 diabetes. Those with the highest vitamin D levels had a 40% lower risk of developing type 2 diabetes as those with the lowest vitamin D levels.
Diabetes Care, October 2007
DR. PAIS'S COMMENTS: The benefits of optimum vitamin D levels seem to go on and on. Now we can add diabetes protection to the list. At the cost of only a few cents each day a disease that costs billions of dollars to treat each year could be prevented. When safe, low-cost preventive strategies like this are not suggested by your medical practitioner is it any wonder the cost of health care in this country is astronomical?
CHRONIC FATIGUE SYNDROME AND CHILDHOOD TRAUMA
A traumatic childhood may be linked to severe fatigue and chronic aches in adulthood.
Recently a study showed that people who experienced emotional pain and trauma early in their lives are at greater risk of suffering from chronic fatigue syndrome (CFS). CFS is a condition that affects approximately 400,000-900,000 adults in the United States.
CFS is defined as an unexplained continuous or recurring fatigue that may be accompanied by headaches, memory loss, and muscle pain. Researchers in Wichita, Kansas administered a questionnaire measuring childhood trauma disorders to CFS patients and individuals without it. People with CFS were more likely to show symptoms of depression and other psychiatric disorders. CFS-diagnosed adults reported greater trauma incidence than those without the syndrome. Victims of childhood sexual abuse and emotional neglect had a stronger link with CFS.
Archives of General Psychiatry, 2006;63:1258-1266:1267-1272
DR. PAIS'S COMMENTS: Not that it takes a research study to prove this kind of connection but it's a promising sign that conventional medicine is recognizing Mind-Body connections. Most often CFS is a condition that resists pharmaceutical care, causing many to turn to supplements and herbs. Many patients in my practice with this kind of history respond very well to the correct homeopathic medicine.
EAT BREAKFAST STAY HEALTHY
This study looked at data collected from 25,176 Dutch adolescents (ages 13-16 years). The factor most strongly associated with overweight and obesity was skipping breakfast. Subjects were in two grade brackets - grade 2, consisting of 13-14 years olds, and grade 4, consisting of 15-16 year olds. For the 3 factors analyzed - skipping breakfast, alcohol consumption, and physical inactivity - skipping breakfast was found to have the strongest association with overweight and obesity.
Specifically, among the 13-14 year olds, the adjusted odds for being overweight was 2.17 for skipping breakfast, 1.86 for alcohol consumption, and 1.73 for physical inactivity. Statistically significant associations were also found for adolescents aged 15-16 years. Dose-response relations were found for all 3 risk factors and overweight. Analysis models considering all 3 risk factors found skipping breakfast to have the strongest relation with overweight (OR=1.68 for ages 13-14 and 1.32 f or ages 15-16) and obesity. This would suggest that eating breakfast regularly may help to prevent overweight and obesity in adolescents.
"Skipping breakfast, alcohol consumption and physical inactivity as risk factors for overweight and obesity in adolescents: results of the E-MOVO project," Croezen S, Visscher TL, et al, Eur J Clin Nutr, 2007 Nov 28.
DR. PAIS'S COMMENTS: No, your local fast food restaurant does not count as breakfast. Whole foods with a focus on protein, fruit, and unprocessed grains are good choices. Quinoa makes a good breakfast, try it.
PARKINSON'S DISEASE AND FOLATE, B12
This study involved 111 Parkinson's disease (PD) patients. Results indicated that low folate levels may be associated with depression, and low vitamin B12 levels may be associated with cognitive impairment.
Serum folate and vitamin B12 levels were measured in the patients. The patients showed significantly lower serum folate and vitamin B12 concentrations than non-PD individuals. Depressed PD patients had significantly lower serum folate levels compared to non-depressed patients, while cognitively impaired patients had significantly lower vitamin B12 levels compared to cognitively non-impaired patients.
The authors of this study conclude, "...lower folate levels were associated with depression, while lower vitamin B12 levels were associated with cognitive impairment."
"Folate and vitamin B12 levels in levodopa-treated Parkinson's disease patients: Their relationship to clinical manifestations, mood and cognition," Triantafyllou NI, Nikolaou C, et al, Parkinsonism Relat Disord, 2007 Dec 3
DR. PAIS'S COMMENTS: With a progressive disease like Parkinson's any non-toxic therapeutics should be utilized where helpful. Folate and B12 have an interdependent relationship that goes beyond their status as B vitamins. Because of the poor digestion, limited nutrition, and lack of access to healthy foods of elderly individuals, nutritional considerations make a lot of sense. The best-case scenario would be to treat holistically so that these nutrients could be obtained from foods. When that is not possible, the low-cost nature of supplementation for these 2 vitamins should make it an easy choice.
FOOD AND SCHOOL PERFORMANCE
2,222 elementary school children were involved in this study. Poor overall school performance was associated with an unhealthy dietary pattern. This was defined as high intakes of low-quality foods, such as sweets and fried foods, and low intakes of highly nutrient-dense foods, such as fruits, vegetables, meat, fish, and eggs.
Thus, the authors conclude, "The study shows that children with unfavorable overall school performance were more likely to eat sweets and fried foods, and were less likely to eat foods rich in protein, vitamins, and minerals."
"Association between unhealthful eating patterns and unfavorable overall school performance in children," Fu ML, Pan WH, et al, J Am Diet Assoc, 2007; 107(11): 1935-43.
DR. PAIS'S COMMENTS: You wouldn't think it would take a research study to make this point. Feed kids crap and they won't do well in school. Load them up on sugar and caffeine from soft drinks and fast food and watch them self-destruct. Is it any wonder there are so many behavioral problems in schools when the food choices are so bad. Instead of giving our children drugs to control their behavior why not disconnect the soda and candy machines and prevent any fast food restaurants within a 10-mile radius. "No Fast Food" zones to go along with the "Drug Free Zones". What a concept.
CANCER RECURRENCE AND BETA CAROTENE
This was a prospective study involving 540 patients with head and neck cancer being treated with radiation therapy. A higher than usual intake of beta carotene was found to be associated with a reduction in the occurrence of severe adverse effects of radiation therapy as well as a reduction in the occurrence of cancer recurrence.
The patients' dietary intakes were assessed using food frequency questionnaires, and plasma levels of beta carotene were measured from blood samples. There was a significant inverse association found for beta-carotene. The odds for severe acute adverse effects of radiation therapy was less for patients with the highest dietary intake of beta carotene and less for subjects with high plasma levels of beta carotene. The rate of cancer recurrence was also significantly lower among subjects with higher plasma beta carotene levels
These results suggest that increasing one's intake of beta-carotene may help to reduce the risk of severe adverse effects of radiation therapy and may reduce the rate of cancer recurrence in patients with head and neck cancer.
"Acute adverse effects of radiation therapy and local recurrence in relation to dietary and plasma beta carotene and alpha tocopherol in head and neck cancer patients," Meyer F, Bairati I, et al, Nutr Cancer, 2007; 59(1): 29-35.
DR. PAIS'S COMMENTS: Beta carotene is one of those nutrients that seems to alternate between positive and negative studies. Some of this is due; I'm convinced, by the lack of biochemical and nutritional knowledge of most researchers. There is a significant difference between the action of synthetic and natural beta carotene. All the negative studies about beta carotene either did not state the type used, or they used synthetic forms. I never supplement with the synthetic form beta of carotene, only the natural form. The best source of which comes from the algae Dunaliella salina.
DIARRHEA FROM ANTIBIOTICS AND PROBIOTICS
This was a randomized, double-blind, placebo-controlled study involving 89 hospitalized patients. The results indicate that consumption of a lactobacilli-fermented milk may exert a protective effect against antibiotic-associated diarrhea.
The patients were randomized to receive either a lactobacilli-fermented milk (Lactobacillus acidophilus CI1285 + Lactobacillus casei) (44 patients) or placebo (45 patients) daily. Antibiotic-associated diarrhea occurred in 15.9% of patients in the lactobacilli group, compared to 35.6% of patients in the placebo group. Additionally, the average hospitalization stay was 8 days in the lactobacilli group, compared to 10 days in the placebo group. Consumption of the lactobacilli-fermented milk was well tolerated.
The authors of this study conclude, "The daily administration of a lactobacilli-fermented milk was safe and effective in the prevention of antibiotic-associated diarrhea in hospitalized patients."
"Effect of a fermented milk combining lactobacillus acidophilus Cl1285 and lactobacillus casei in the prevention of antibiotic-associated diarrhea: A randomized, double-blind, placebo-controlled trial," Beausoleil M, Weiss K, et al, Can J Gastroenterol, 2007; 21(11): 732-6.
DR. PAIS'S COMMENTS: The prevalence of diarrhea and gastric distress caused by antibiotics is high. Again, why isn't such a simple, inexpensive approach used? My 90-year old father-in-law is in a hospital in Texas because of the vomiting and diarrhea caused by the antibiotic he took. I hope his doctors are current with the research and are giving him a probiotic.
I am often asked what supplements I recommend. Many of you have been surprised to discover that I favor food over pills; lifestyle changes over fads. I have been working with nutrition for over 30 years, herbs for over 20 years. Where and when appropriate I recommend them to my patients. I strive to act from knowledge, experience, and research.
Emerson Ecologics (800-654-4432) carries almost all of the nutritional supplements and botanical extracts that I think are useful. Their customer service is excellent and their delivery is reliable (often only 2-3 days to this region). It's a great way to get physician quality products at reasonable prices.
To offset the cost of shipping, reference my name when you establish your account and receive a 10% discount on every order. If you have any questions about these items feel free to email me.
That's it for this issue of Naturopathic News. If you've thought a bit extra or learned something new, then I achieved my goal. As usual, if you have questions or concerns brought up by these subjects, let me know.
Gregory Pais, ND, DHANP