|Issue #29 - February 2005|
Welcome to this issue of Naturopathic News, issue #29. 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.
“A DAY IN THE LIFE” OF A HOMEOPATHIC CASE
Part 1: Background, training, experience
This is the first part in a new series on homeopathy that I am writing this year. I thought it might be very useful to have an overview about what goes on behind the scenes in the practice of homeopathic medicine. My goal is that you will have a much better sense of what it takes to work homeopathically and that this understanding will assist in your healing process. If there are particular aspects that you would like me to cover, please let me know.
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 like the proverbial kid in the candy shop.
The principles and philosophy of homeopathy are not dried dictums 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, no matter 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 of 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 had 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 when he had 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 know 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.
I hope this first part of the series 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.
VIT. D AND PROSTATE CANCER
Getting a little sunshine may be one way for men to cut their risk of prostate cancer. A large study presented at a cancer conference, 2/24/95, found that men with higher levels vitamin D in their blood were half as likely to develop aggressive forms of the disease than those with lower amounts.
"When you were little and your mother said, `Go outside and play,' it wasn't just to get you out of her hair," but may have been instinctive advice about something good for health, said Dr. Eric Klein, a prostate cancer specialist from the Cleveland Clinic.
He had no role in the research, which involved nearly 15,000 men in the Physicians' Health Study at Brigham and Women's Hospital and Harvard Medical School in Boston. Five years ago, this study found that men who consumed a lot of calcium had modestly higher rates of prostate cancer.
The new findings fit with that notion, because too much calcium lowers vitamin D, and are especially believable because researchers got them by measuring blood samples rather than relying on what men said they ate - an imprecision that has hurt past studies of food and cancer risk.
Blood samples were taken in 1982, when the study began. Eighteen years later, 1,082 of the men had developed prostate cancer. Their levels of two common forms of vitamin D in the stored blood samples were compared with those of 1,701 men in the study who did not get cancer.
Levels of one or the other vitamin D derivative did not make much difference in prostate cancer risk. However, men with higher levels of both had roughly half the risk of developing aggressive tumors - the kind most likely to kill - than men with lower levels, said Dr. Haojie Li, who led the study.
That is in keeping with what previous studies have shown about prostate cancer, Klein noted.
Men in northern latitudes have higher cancer death rates, and vitamin D levels are lower in older men, who are most prone to prostate cancer.
Melanin, which gives skin its color, blocks ultraviolet light that spurs vitamin D production. Blacks, who have a lot of melanin, also have the highest rates of prostate cancer.
Experiments also suggest vitamin D inhibits cell growth. "So there is some lab evidence that vitamin D may be anti-cancer," Klein said.
How much should people get? The recommended daily amount is 400 international units, but most scientists think that is probably low, Li said.
Most milk is fortified with the wrong form of vitamin D (body can’t use it), and drinking a lot of it might raise the risk of prostate cancer because of its calcium content. Getting enough vitamin D from food is difficult, but doctors do not recommend supplements because they can cause unsafe levels of calcium to build up.
"If you start overloading on vitamin D you're going to cause other problems," said Dr. Durado Brooks, chief of prostate cancer research at the American Cancer Society.
GP: This is not a prescription to just run out and start taking Vitamin D. You have to use the correct form and should only take it if you need it. And then only in the proper amount.
HUGE CONFLICT OF INTEREST
Ten of the 32 government drug advisers who last week endorsed continued marketing of the huge-selling pain pills Celebrex, Bextra and Vioxx have consulted in recent years for the drugs' makers, according to disclosures in medical journals and other public records.
If the 10 advisers had not cast their votes, the committee would have voted 12 to 8 that Bextra should be withdrawn and 14 to 8 that Vioxx should not return to the market. The 10 advisers with company ties voted 9 to 1 to keep Bextra on the market and 9 to 1 for Vioxx's return.
Eight of the 10 members said in interviews that their past relationships with the drug companies did not influence their votes. The two others did not respond to phone or e-mail messages.
Researchers with ties to industry commonly serve on Food and Drug Administration advisory panels, but their presence has long been a contentious issue. The agency has said that it tries to balance expertise - often found among those who have conducted clinical trials of the drugs in question or otherwise studied them - with potential conflicts of interest.
Several of the panel members flagged with conflicts said that most or all of the money went not to themselves but to their universities or institutions.
The Center for Science in the Public Interest, an advocacy group in Washington that maintains a large database of scientists' industry ties culled from disclosures in medical journals and other public documents, analyzed the panel members' affiliations at the request of The New York Times. The center has been a frequent critic of the F.D.A. and of the pharmaceutical industry. The center's analysis may understate the industry ties of the panel participants because some ties may not have been previously disclosed publicly.
Dr. Sheldon Krimsky, a science policy expert at Tufts University, said such conflicts were common on F.D.A. advisory panels. The F.D.A. often conceals these conflicts, and studies have shown that, taken as a whole, money does influence scientific judgments, Dr. Krimsky said.
He added, "F.D.A. has to work harder to fill panels with people without conflicts, and if they feel they have the best committee, they at least ought to make it transparent."
But Dan Troy, a Washington lawyer who was until last year the agency's general counsel, said that finding knowledgeable experts without financial conflicts was difficult. Suggesting that such conflicts skew a panel's decisions "buys into an overly conspiratorial view of the world," Mr. Troy said.
A spokeswoman for the F.D.A. said no one at the agency would comment on specific panel members' industry ties.
Before each of three meetings of the advisory board last week, an agency secretary read a statement absolving panel members of conflicts of interest because the committee's agenda involved "issues of broad applicability and there are no products being approved."
The secretary also said, "The Food and Drug Administration acknowledges that there may be potential conflicts of interest, but because of the general nature of the discussions before the committee, these potential conflicts are mitigated."
But the committee took nine votes - three for each drug - on whether Celebrex, Bextra or Vioxx hurt the heart, should continue to be marketed and, if so, under what restrictions. These votes were deeply important to the three companies - Merck, Pfizer, and Novartis - that came before the committee. Indeed, shares of Merck and Pfizer soared last Friday after the panel's votes.
Ten members of the panel have worked in some capacity in recent years for Merck, the maker of Vioxx; Pfizer, the maker of Celebrex and Bextra; or Novartis, which is applying to sell Prexige, a very similar pill discussed by the panel, according to the public disclosures.
Of the 30 votes cast by the 10 panel members on whether Celebrex, Bextra, and Vioxx should continue to be marketed, 28 favored the drugs. Among the 66 votes cast by the remaining 22 members of the panel, just 37 favored the drugs. The members with financial ties to the companies were 10 times more likely to favor the drugs as those without such ties.
Dr. Curt Furberg, a panel member and an epidemiologist at Wake Forest University who had no ties to any of the drug companies, said he was "uncomfortable with the Pfizer-friendly undertone" at the meeting. And he worried that Pfizer's financial relationships with some panel members might have played a role in setting that tone.
Andy McCormick, a spokesman for Pfizer, said the company had no plans to withdraw Bextra from the market. He also said that Pfizer played no role in helping to choose the panel.
Critics of the drug industry said they were not surprised that the panel's decisions would have been different if scientists with financial ties to the companies had recused themselves from the votes.
"My employees usually vote for me as well," said W. Mark Lanier, a lawyer in Houston who represents people who have sued Merck after taking Vioxx and suffering heart attacks or strokes.
Christopher A. Seeger, a lawyer in New York with many Vioxx clients, said the fact that scientists had not recused themselves simply highlighted the close ties between the drug industry and academic researchers. He said researchers were afraid to say anything negative about new drugs because doing so might jeopardize their chances of participating in clinical trials and publishing papers.
Celebrex, Bextra, and Vioxx have never been proven in clinical trials to cure pain any better than ibuprofen or more than a dozen other, older pain pills.
"Fifty patients a day probably die from those drugs, and who is speaking for them?" Dr. Furberg said.
GP: The ongoing revelations of the marketing of these drugs and their supposed ‘impartial review’ continue to demonstrate that the big drug companies dominate the manipulation of information. Because they wield the economic power they do, people die. Years ago comfrey was permanently taken off the market because of the deaths of 2 children who were given too much of something that was thought to be comfrey. If the makers of comfrey extracts had a multi-billion dollar drug income from its sales, comfrey would still be available over the counter today.
NSAIDS DO LITTLE TO RELIEVE KNEE OSTEOARTHRITIS PAIN
Nonsteroidal anti-inflammatory drugs (NSAIDs), including cyclo-oxygenase-2 inhibitors (Cox-2 inhibitors such as Celebrex, Vioxx, Bextra), reduce short-term pain associated with knee osteoarthritis only slightly better than placebo, and long-term use of these agents should be avoided, researchers from Norway report in the British Medical Journal Online First edition for November 24th, 2004.
Current recommendations call for the use of oral NSAIDs in the treatment of painful knee osteoarthritis and the majority of patients with osteoarthritic pain use these agents, the team notes in their report.
To estimate the analgesic effects of NSAIDs, including Cox-2 drugs, in patients with knee osteoarthritis, they analyzed the results of 23 placebo-controlled trials involving 10,845 patients, 7767 of whom received NSAID therapy and 3078 placebo therapy.
The results of the meta-analysis indicated that the change in overall intensity of pain with NSAIDs and Cox-2 inhibitors was not statistically significantly different from that of placebo. "The advantage of oral NSAIDs over placebo for short-term pain relief is small and probably clinically insignificant," Dr. Jan M. Bjordal from the University of Bergen and colleagues report.
Evidence for long-term efficacy of these agents is also lacking, the researchers emphasize, noting that only one randomized placebo-controlled study lasted longer than 13 weeks and no effect of NSAIDs was found.
"We know that many osteoarthritis patients use NSAIDs regularly on a long-term basis but there are currently no data to support such use," Dr. Bjordal said. "We are bit surprised that the poor overall effect of NSAIDs for osteoarthritis has not been discovered before, given the common nature of osteoarthritis and the escalating prescription of NSAIDs for osteoarthritic pain."
"It seems," Dr. Bjordal surmises, "that the adverse effect debate has overshadowed the other important factor, efficacy, which is needed to balance benefit and harms. If we really want to have an evidence-based clinical practice of medicine, common diagnoses like knee osteoarthritis are good places to start," the researcher concluded.
GP: So, not only do these drugs increase your risk for heart disease and stroke, not only have they been over-prescribed, not only have they killed an estimated 30,000 people, not only were they a more expensive version that didn’t reduce stomach bleeding, they don’t work any better than placebo (fake drug). Why do people take these drugs again? Who’s practicing unscientific medicine? Can you tell the quacks without a scorecard—yes you can. They’re giving away free samples of drugs that can kill you.
ANTIBIOTICS USELESS FOR UTI
Studies have shown women tend to get urinary tract infections (UTIs) more frequently than men. This is because the distance between the bowels to the urethra in women is shorter.
Consequently, UTIs are the most common infectious disease in women. One-third of women in the United States are diagnosed with at least one UTI that requires medical treatment before the age of 24.
However, many women are finding it difficult to manage this disease, as an increasing amount of UTIs are resistant to sulpha drugs -- medications used commonly to treat the infections. According to studies, these multi-drug-resistant UTIs may be linked to an unlikely source: Eating meat from cattle infected with a multi-drug resistant strain of E. coli bacteria. (E. coli is a source of well-recognized food-borne bacteria infections.)
In the late 1990s a team of researchers tallied UTIs treated at the Berkley campus student-health center and discovered nearly one quarter of the infections were resistant to sulfa drugs. Though this finding was not surprising, another was: About half of the infections were caused by an identical strain of E. coli.
After analyzing UTI infections at eight other clinics across the United States, researchers discovered more groups of people infected with the same UTI-causing bacteria that had been presented at Berkley. It was at this point when researchers realized the drug-resistant infection clusters were suspiciously similar to that of food-borne diseases, leading studies to focus on farm animals as the source of infection. And, after searching for an E. coli strain similar to the one linked to the cluster of UTIs, researchers uncovered that a single E. coli strain taken from a cow 17 years ago was nearly identical to the UTI strain they'd been studying all along.
While the findings don't offer definite proof that UTIs stem from food-borne bacterium, it is highly suspected that antibiotic resistance is transferred between animals and humans. It is also recommended that, in order to steer clear of UTIs, people should practice "commonsense hygiene" such as: Wiping from front to back after bowel movements (especially when loose or with the presence of diarrhea) and drinking plenty of water to flush any bacteria present from the urethra
Clinical Infectious Diseases January 15, 2005;40(2): 251-7
GP: You can be environmentally sound and reduce your risk of UTIs. Only use white unscented toilet paper. Many women react to the chemicals and dyes used in colored or scented toilet paper. Even better, use unbleached toilet paper which reduces your exposure to chlorine and means less dioxin for the environment. Most know about cranberry juice for UTIs. Cranberries (as well as blueberries) contain substances that prevent bacteria from attaching to the bladder wall. Problem is that many drink cranberry juice, which is full of sugar and makes the UTI worse. If your cranberry juice is sour, that’s the right one.
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