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Dr. Gregory Pais, ND
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Home arrow Naturopathic News arrow Issue #70 - July 2008
Issue #70 - July 2008
  1. INTRODUCTION
  2. WEBSITE SERVICES
  3. BACKGROUND, TRAINING, EXPERIENCE
  4. FOOD WISDOM-- Cabbage
  5. SUPPLEMENT FACTS: NATURAL VERSUS SYNTHETIC-Vit. D, E
  6. VITAMIN B6 DEFICIENCY COMMON
  7. OSTEOPOROSIS DRUGS CAUSE FRACTURES
  8. EMERSON ECOLOGICS
Welcome to this issue of Naturopathic News, issue #70. It's my mission to help you find natural solutions to health problems. This newsletter is one way to do that. The more educated you are about your health options the better able you will be to take control of your health. If you would like to stop receiving my newsletter send me an email and let me know. If you have a friend or family member who you think would appreciate the information provided, send me their email address.


WEBSITE SERVICES
Here are some pages that are of particular interest:

Store: There are 220 products from Emerson listed on this page. If yours isn't one of them please let me know and I will add it so you can order online. This is particularly convenient after hours or on the weekend. Of course, you can always order by phone from Emerson at 800-654-4432.

Newsletter: Here you will find all 69 issues of my health newsletter, "Naturopathic News".

Optimal Health Points: This is my blog that I update every week. Check out the entry for July 9 entitled "Just SAy No to Cholesterol Drugs For 8 Year Olds."



BACKGROUND, TRAINING, EXPERIENCE
I have written extensively about my background and training in February 2005 and May 2006. For those of you who missed it the first time or have joined since, I thought it would be helpful to do so again.

The main impetus behind my decision to attend the National College of Naturopathic Medicine (NCNM) in Portland, Oregon was my focus on homeopathic training. At that point, 1988, I had worked with nutrition for 15 years, done bodywork for 14 years, and been an herbalist for 6 years. Like many practicing homeopaths, my desire to learn the art and science of homeopathy came about by being successfully treated homeopathically. Though I had worked with the major alternative healing modalities for years (including Traditional Chinese Medicine), once introduced to homeopathy I knew that it was the most powerful tool that I had experienced. The question was, where to get good training?

Unlike other practitioners content with correspondence courses I did not feel that a distance-learning situation was appropriate to fully study medicine. Plus, how could I truly learn the structure and function of the human organism by just reading a book? I felt that for me to offer powerful healing modalities like nutrition, homeopathic medicine, etc., I needed hands on medical training. Since the last medical school that taught homeopathy in the United States closed in the 1940s, I chose naturopathic medical school. The fundamental principles of naturopathy are similar in nature to the philosophy that underlies homeopathy. And it is much safer and much less obstructive to the healing process to give an herb or a supplement as opposed to falling back on conventional medicine.

The program at NCNM was 4 years of classroom and clinical training. In the 4200 hours that made up the requirement I took all of the homeopathic courses available (7 11-week quarters), and externship with practicing homeopaths (150 hours). I also worked in a homeopathic free clinic in downtown Portland for 3 semesters. I basically crammed in as much homeopathy as possible to go along with the anatomy, physiology, histology, gynecology, geriatrics, and all the other courses that make up modern day medical school.

NCNM has one of the best homeopathic libraries in the country with masterpieces both modern and historical. In four years I made it through most of the several hundred homeopathic texts that were available, the dozens of homeopathic medical journals from the US and other countries, and an extensive collection of taped homeopathic seminars with some of the world's best homeopathic teachers. I had chosen NCNM because it had the best homeopathic department and the most extensive homeopathic library. I was the proverbial kid in the candy shop.

The principles and philosophy of homeopathy are not dried dicta with no application in daily practice. Every semester from second year on, including the summers, we spent an increasing number of hours in clinic. First under the strict supervision of the physicians on staff, but more and more on our own with their guidance and support. Working with patients is where you put the principles and philosophy into practice. We saw everything-Breast cancer, HIV, suicidal depression, herniated discs, etc. It was a great way to learn homeopathy-in the trenches.

No matter how good my training was, no matter how much homeopathy I had studied, despite the extensive background I already had, starting private practice was the true test. I graduated in 1992, passed my naturopathic medical board exams, and received my Oregon state naturopathic license. I ended up in Ft. Collins, CO where I practiced from 1993-1997. This is where I successfully treated my first case of multiple sclerosis, helped my first child patient diagnosed with Asperger's syndrome, weaned my first patient off Zoloft, and saw women comfortably deal with menopause without the need of prescription hormones.

In some ways I had it easy (and still do). I have the power of naturopathic medicine 'watching my back'. 6-month-old baby with a fever-no problem-wet socks to the rescue. When one of my patients asked me to treat her 8-year-old son with pneumonia, homeopathy and hydrotherapy saw him through. Herbs, supplements, hydrotherapy, nutrition, I used it all where and when appropriate. And my patients got well-hundreds of them.

Professionally the time I spent in Ft. Collins was quite productive. In 1994, I decided to dedicate an entire year to using LM potencies. These potencies, though a part of homeopathy for 150 years, were not well known or taught at that time. Many of my most difficult cases of serious pathology-ulcerative colitis, multiple sclerosis, etc., benefited by the expertise I gained in this area. By 1997 I felt ready to take my training to the next step. After studying the requisite materials I took the HANP board certification exam. DHANP stands for Diplomate of the Homeopathic Academy of Naturopathic Physicians. This is the national board certification in homeopathy for licensed naturopathic physicians. This certification represents a commitment to ongoing continuing education and a particular level of competency in homeopathic practice.

Our move to Pennsylvania in 1988 saw our family's dream of country living fully realized. Steam Valley Fiber Farm, north of Williamsport, is home not only to us but also angora goats, sheep, border collies, Maremma guardian dogs, ducks, chickens, and a large organic garden and fruit orchard. This way of life sustains me and has helped me provide the best in naturopathic and homeopathic care to my patients.

I hope this has given you a sense of the context that I work within. Where I've come from, the training I've been through, and what I bring to the table when you walk in the door.


FOOD WISDOM
Cabbage
Cabbage is in the family of vegetables known as cruciferous, a name derived from their cross shaped flowers. All cabbages are cruciferous including broccoli, Brussels sprouts, cauliflower, kale, and collards.
 
Cabbage contains iron, calcium, potassium, and vitamin C. Cabbage is also high in vitamins B1, B2, and B3. Lengthy cooking tends to lower the nutritional value considerably. Red cabbage is higher in fiber than green, with 4 ounces of it boiled and drained offering 2.7 grams. It's higher in vitamin C, offering 25.8 grams for 4 ounces cooked. Red cabbage is also higher in calcium, iron, and potassium than its green cousin.
Savoy and Napa cabbage contain 20% of the RDA for vitamin A, while red and green cabbages contain considerably less. Bok choy contains the most vitamin A, supplying 60% of the RDA, although it is equal to red and green cabbage in other nutrients.

Foods in the cabbage family inhibit the growth of breast, stomach, and colon cancer due to phytochemicals. Some of the phytochemicals seem to produce anticancer enzymes. Sulforaphane is a chemical that increases your body's production of enzymes that disrupt cell-damaging free radicals and reduce your risk of cancer. Stanford University scientists have determined that sulforaphane boosts your levels of these cancer-fighting enzymes higher than any other plant chemical. A University of Utah School of Medicine study on 600 men revealed that those who ate the most cruciferous vegetables had a much lower risk of colon cancer.

A well-known remedy for healing peptic ulcers is drinking cabbage juice. A medical study at Stanford University's School of Medicine gave thirteen ulcer patients five doses a day of cabbage juice. All were healed within seven to ten days.

Excessive consumption of cabbage may contribute to thyroid problems, including goiter.


SUPPLEMENT FACTS: NATURAL VERSUS SYNTHETIC
VITAMIN D
If source listed is        Fish Oils                                   It's Natural
If source listed is        Irradiated Ergosteral (Yeast)    It's Synthetic
If source listed is        Calciferol                                 It's Synthetic

VITAMIN E
If source listed is         Vegetable Oil             It's Natural
If source listed is         Wheat Germ Oil         It's Natural
If source listed is         Mixed Tocopherols     It's Natural
If source listed is         d-alpha tocopherol     It's Natural
If source listed is         dl-alpha tocopherol    It's Synthetic



VITAMIN B6 DEFICIENCY COMMON
Tufts University researchers have discovered that vitamin B6 deficiency is much more common in the United States than previously thought. The US government has consistently held the belief that vitamin B6 deficiency is rare in this country. Leading to the1998 the Recommended Daily Allowance (RDA) to be set in a range, depending on age and sex from 1.3 mg to 2 mg daily. This is the first study of its kind to assess, on a large scale, the B6 status of Americans. The Tufts study has shown that this RDA may be too low for at least four specific, large population groups.

In the Tufts study, published in the May 2008 issue of the American Journal of Clinical Nutrition, researchers evaluated plasma levels of the most active form of B6, known as pyridoxal 5' phosphate (P5P) in 7822 males and females, age one and older. P5P is the most biologically active form of Vitamin B6 in humans. P5P functions in over 100 enzymatic reactions, especially the metabolism proteins.

According to Martha Savaria Morris, PhD epidemiologist at the Jean Mayer USDA Human Research Center on Aging at Tufts University, "Across the study population, we noticed participants with inadequate vitamin B6 status even though they reported consuming more than the Recommended Daily Allowance of B6, which is less than 2 milligrams per day". Researchers defined Vitamin B6 deficiency as plasma P5P concentration less than 20 nmol/L.

Four groups were found to have the highest prevalence of B6 deficiency including "women of reproductive age, especially current and former users of oral contraceptives, non-Hispanic African American men, men and women over age 65, and male smokers". Alcoholics are also at higher risk for vitamin B6 deficiency.

Researchers found that about 75% of women using oral contraceptives who did not take nutritional supplements were found to be deficient in P5P and that females age 13-54 had a much higher incidence of deficiency than males of the same age. Of the entire study population, 25% of those that did not take nutritional supplements, and 11% of those who took supplements were found to have P5P deficiency.
Plasma pyridoxal 5'-phosphate in the U.S. population: the National Health and Nutrition Examination Survey, 2003-2004. From the Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and the National Institutes of Health Office of Dietary Supplements, Am J Clin Nutr 2008 87: 1446-1454.

DR. PAIS'S COMMENTS: These findings illustrate that generalized nutrient recommendations, made by inadequately trained individuals, are ridiculously inadequate for tens of millions of people.

Repercussions of Vitamin B6 Deficiency
Dementia, depression, and other neurological abnormalities
Required in the synthesis of the    neurotransmitters serotonin, norepinephrine, and histamine from tryptophan, tyrosine, and histamine.  P5P can be highly concentrated in the brain even when low levels exist in the blood.

Anemia
It is a precursor for hemoglobin

Impaired nutrient metabolism
It is necessary for niacin (Vit. B3) metabolism

It is involved in the synthesis of intrinsic factor-necessary for Vit. B12 absorption

It is involved in essential fatty acid metabolism

It is vital for the formation of sphygolipids involved in the development of the myelin sheath surrounding nerve cells.

Immune Response
Vitamin B6 deficiency decreases the production of lymphocytes, white blood cells responsible for antibody production. Decreased lymphocytes inhibits our ability to mount an immune response.

Heart Disease
Along with B3 and B12 it works to regulate the metabolism of homocysteine. Elevated homocysteine levels are a known risk factor for heart disease.

Vitamin B6 antagonists

Probably the biggest cause of deficiency is the addition of Vit. B6 antagonists to the environment.  This has occurred in the last 50 yrs. They are:
1) Birth Control Pills (BCP).
2) Tartrazine (yellow dye #5)- From 1949-1970 nearly 1 million pounds/year were used in foods and medications.
3) Maleica Hydrazide is used in agriculture as a plant growth regulator and herbicide (potato chips have significant amounts as well as peroxides and free radicals).
4) PCB's-polychlorinated biphenols-they have been banned but there are incredible amounts in the environment. They have been found in 99% of all Americans tested and 100% of all Canadians. Fish is the primary source of PCB's from contaminated water. In 1975- 69% of all breast milk         tested positive and in Michigan, of more than 1000 women tested, 100% were positive.
5) Hydrazine compounds used in medicine INH (isonicotinic acid hydrazine) and hydralazine.
6) Antioxidants in the petroleum industry and plating materials and antitarnish agents used in metal manufacturing.
   
Signs of Vitamin B6 deficiency
Depression, nausea, vomiting, fatigue, seborrheic dermatitis, mucous membrane lesions, swollen tongue, and peripheral neuritis. Also altered mobility, hyperirritability, and abnormal head movements and convulsions.

Best Food Sources of Vitamin B-6
(Cooking, freezing and processing alters the vitamin content of raw foods)
Bananas, acorn squash, watermelon, avocados, potatoes, and prune juice are all good plant sources of vitamin B6. Chicken breast and turkey are good animal sources. Animal sources of B6 are higher in P5P. Plant sources are higher in pyridoxine, which requires conversion to P5P for biological activity.

Vitamin B6 supplements
Many nutritional supplements include vitamin B6 in the form of pyridoxine hydrochloric acid. Pyridoxine requires adequate riboflavin (B2) for enzymatic conversion in the liver to the biologically active P5P form of B6.

When I am asking someone to increase their vitamin B6 status I first have them concentrate on the foods listed above. Then I'll recommend a supplement that contains vitamin B6 as pyridoxal 5' phosphate (P5P), and/or pyridoxine. Most of the time I recommend the B vitamins as a complex or in combination. Amounts more than 100 mg/day should not be taken without the supervision of a nutrition professional.



OSTEOPOROSIS DRUGS CAUSE FRACTURES
Evidence has been mounting for some time that suggests long-term alendronate use may use may overly suppress bone metabolism, limiting repair of microdamage and creating risk for insufficiency fractures. The concern rises mainly from a series of case reports showing a rare type of leg fracture that shears straight across the upper thighbone after little or no trauma. Fractures in this sturdy part of the bone typically result from car accidents, or in the elderly and frail. But the case reports show the unusual fracture pattern in people who have used bone-building drugs called bisphosphonates (e.g. Fosamax) for five years or more. Some patients have reported that after weeks or months of unexplained aching, their thighbones simply snapped while they were walking or standing.

The purpose of this study was to demonstrate an association between bisphosphonate use and a specific pattern of low-energy femoral (thigh) shaft fracture. Medical records were reviewed, and the incidence and duration of alendronate use was recorded. The incidence of a specific femoral shaft fracture in those patients taking alendronate compared with those not being treated was determined.

There were 59 females and 11 males. The average age was 74.7 years. Twenty-five (36%) were being treated with alendronate. None of the patients had used or were using other bisphosphonates. Nineteen (76%) of these 25 patients demonstrated a simple, transverse fracture. This fracture pattern was seen in only 1 patient (2%) not being treated with alendronate. This pattern was 98% specific to alendronate users. The average duration of alendronate use in those with the pattern was significantly longer than those who did not exhibit the pattern but were taking alendronate, 6.9 years versus 2.5 years of use, respectively. Only 1 patient with the fracture pattern had been taking alendronate for less than 4 years.

Bones are in a constant state of metabolic turnover - dissolving microscopic bits of old bone, a process called resorption, and rebuilding new bone. Experts are concerned that microscopic bone cracks that result from normal wear and tear are not repaired when bisphosphonate drugs suppress the bone remodeling process.
Neviaser AS, Lane JM, Lenart BA, et al. Low-energy femoral shaft fractures associated with alendronate use. J Orthop Trauma 2008 May-Jun;22(5):346-350.

DR. PAIS'S COMMENTS: This is not new information regarding these drugs. The Journal of Orthopaedic Trauma reported last month that, of 20 patients with this unusual type of fracture, 19 had been using the drug Fosamax for an average of 6.9 years.
In September 2007 the medical journal Bone reported on a study of 66 women, showing an association between Fosamax use and an accumulation of microdamage in bones.
Also in 2007, The Journal of Bone and Joint Surgery published a Singapore report of 13 women with low-trauma fractures, including 9 who had been on long-term Fosamax therapy.

For years we've known that the type of bone formation that results from using these drugs may not be as strong as normal bone. These bone fractures are proving the truthfulness of this information.

From the bisphonate drug studies we know that there is little benefit in taking these drugs more than five years. Patients should be informed of the potential risks and allowed to stop or take a break from these drugs. When fractures do occur, surgeons need to be alerted about long-term drug use, because the fracture may require more aggressive treatment and be slower to heal.
Given some of the other major side effects-ulceration of the digestive tract, bone death of the jaw-more focus should be given to weight bearing exercise, good nutrition, and appropriate supplementation like Vit. D.



EMERSON ECOLOGICS
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