|Issue #94 - July 2010|
Welcome to this issue of Naturopathic News, issue #94. It's my mission to help you find optimal 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 please 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.
The Minimum Dose
Recently the question has come up with different patients concerning dosing with their homeopathic medicine. If they’ve responded to their remedy they then want to take more. Isn’t more remedy better? If a little bit is good won’t a lot be better? Correspondingly, if you take less then there will be less of an effect. Right?
I think this perspective comes from the world of conventional medicine. If you take 2 aspirin there will be more of an effect than with 1 aspirin. Taking more of a drug means causing more chemical effects on the body’s physiology. When you need to cause less of a chemical effect on the body then you take less of the drug. Simple, easy to understand.
Homeopathic medicine isn’t drug medicine. Applying the same understanding from drugs to homeopathics just won’t work. If anything it will just confuse you. Remember, in any potency 12c or above (or any LM potency) there is no physical substance present. That’s right, nothing of the original substance remains in a homeopathic medicine that is a 12c potency or higher. So it’s not possible for ‘more’ molecules of a 12c potency to be more effective. Those molecules aren’t there to begin with.
That’s the fundamental problem. Homeopathy is dynamic medicine. Though based in preparation from animal, vegetable, or mineral substances, often the potencies used contain none of these. At the same time some patients notice that the amount of medicinal solution they consume makes a difference. Sometimes they’re better on a smaller amount; sometimes they’re better on a larger amount.
A very important consideration is that dosing is a very individual process. Depending on what symptoms are being addressed and what else is being done, a particular dose will (or won’t) be effective. We want to get the most improvement with each dose given and redose only when the effects of the previous dose are just beginning to taper off. Steroid drugs, antibiotics, antifungals, topical preparations, and other treatments can interfere with accurately assessing the normal healing process.
Here are some dosing concepts that will help you understand:
1. When in doubt, less is better.
2. When interfering therapies are being used at the same time as homeopathics symptoms may worsen long-term and be harder to manage effectively.
3. Just because one symptom is better or worse, you may not be better or worse.
4. Sometimes the best dose is to wait and not dose at all.
PARKINSON'S DISEASE AND VITAMIN D
Researchers at the National Institute for Health and Welfare in Finland found a correlation between lower blood levels of vitamin D and an increased risk of developing Parkinson's disease.
This study included 3,173 participants in the Mini-Finland Health Survey who were free of Parkinson's disease between 1978 and 1980. Frozen blood samples obtained during this period were analyzed for serum 25-hydroxyvitamin D. Over the 29 year follow-up period, 50 subjects were diagnosed with Parkinson's disease.
Average vitamin D levels among the participants were approximately half of current recommended levels, which is most likely attributable to Finland's higher latitude. Those whose serum vitamin D levels were among the top 25% of the subjects had one-third the adjusted risk of developing Parkinson's disease than that of subjects whose vitamin D levels were among the lowest fourth.
This investigation is the first study to demonstrate an association between insufficient vitamin D levels and the subsequent development of Parkinson's disease. In their commentary, the authors explain that the vitamin has shown neuroprotective effects via antioxidative mechanisms, immunomodulation, enhanced nerve conduction and other means. "The vitamin D receptors and an enzyme responsible for the formation of the active form 1,25-hydroxyvitamin D have been found in high levels in the region of the brain affected most by Parkinson disease," they note. In other words, if you’re low in Vitamin D you’re more likely to have abnormalities in the area of the brain affected by Parkinson’s disease. "In intervention trials focusing on effects of vitamin D supplements, the incidence of Parkinson disease merits follow up," they conclude.
Archives of Neurology July, 2010
DR. PAIS’S COMMENTS: Parkinson’s disease is a devastating brain disorder that gradually robs people of the ability to control their own movements. During Parkinson’s, cells in the parts of the brain that control movement and regulate mood are gradually destroyed. The primary defect in Parkinson’s is a loss of dopaminergic neurons (such as dopamine-producing neurons) in a part of the brain called the substantia nigra. Dopamine is a neurotransmitter that modulates movement. In Parkinson’s disease, the dopamine-producing nerve cells are destroyed by high levels of oxidative damage.
CANCER DRUG KILLS MORE THAN IT HELPS
Pfizer is pulling Mylotarg, a leukemia medicine, off the U.S. market after a study found a higher death rate and no benefit for patients.
Mylotarg is a drug that got approval under the fast-track process. As such it had to pass follow-up tests to prove it worked. The FDA has asked Pfizer to withdraw the drug after a recent clinical trial raised issues about its safety and clinical benefit.
DR. PAIS’S COMMENTS: In the first couple months of treatment the fatality rate for Mylotarg was 5.7% compared to 1.4% without the drug. In other words you were 4 times as likely to be killed if you took Mylotarg than if you didn’t take it.
NO STATINS IF YOU’RE HEALTHY
The reanalysis of the massive JUPITER trial involving almost 18,000 people with low or normal cholesterol but elevated levels of the inflammatory C-reactive protein (CRP) -- turned up no evidence of the "striking decrease in coronary heart disease complications" reported by the trial investigators. Instead, the reanalysis has called into question the involvement of drug companies in such clinical trials, according to an article in the June 28 2010 issue of the Archives of Internal Medicine.
Michel de Lorgeril, MD, of Joseph Fourier University and the National Center of Scientific Research in Grenoble, France, and co-authors argue that a major discrepancy exists between the JUPITER trial's report of significant reductions in nonfatal stroke and myocardial infarction (MI) but a lack of effects on fatal stroke or MI. Moreover, cardiovascular mortality and the case-fatality rate for MI fell far below predicted rates.
"The JUPITER data set appears biased," de Lorgeril and co-authors concluded. They say that the links between the study sponsor and study investigators are too strong to ignore.
"Three other trials involving rosuvastatin (Crestor) therapy in high-risk patients did not show any protection. The authors of the JUPITER study fail to comment on these negative trials but go on to report secondary endpoint and subgroup analyses that appear to support the efficacy and safety of rosuvastatin therapy," de Lorgeril and colleagues wrote.
Moreover, de Lorgeril and co-authors point out that nine of 14 authors of the JUPITER article have financial relationships with AstraZeneca, which sponsored the trial. "The sponsor's pervasive role is clearly described in the second paragraph of the 'Methods' section of the report: 'the sponsor collected the trial data and monitored the study sites,'" the authors wrote. De Lorgeril and co-authors concluded that "the results of the JUPITER trial are clinically inconsistent and therefore should not change medical practice or clinical guidelines. The results of the JUPITER trial support concerns that commercially sponsored clinical trials are at risk of poor quality and bias."
Adding to the controversy, authors of another article in the same issue of Archives reported that a meta-analysis of 11 large primary-prevention trials showed no effect of statin therapy on all-cause mortality in high-risk patients.
The JUPITER trial (Justification for the Use of Statins in Primary Prevention) has stood alone in its finding of a significant benefit in patients with no evidence of coronary heart disease.
On the basis of their review, de Lorgeril and co-authors concluded that "the time has come for a critical reappraisal of cholesterol-lowering and statin treatments for the prevention of CHD (coronary heart disease) complications. The emphasis on pharmaceuticals for the prevention of CHD diverts individual and public health attention away from the proven efficacy of adopting a healthy lifestyle, including regular physical activity, not smoking, and a Mediterranean-style diet."
The meta-analysis reported in the same issue of the journal encompassed 11 randomized clinical trials involving 65,229 patients and 244,000 person-years of follow-up. The primary objective was to determine whether statin therapy reduces all-cause mortality among intermediate and high-risk people with no history of cardiovascular disease.
Collectively, the trials documented a total of 2,793 cardiovascular deaths. Analysis of all-cause mortality showed a nonsignificant reduction in relative risk in patients treated with statins.
The findings call into question current clinical guidelines regarding use of statins' cardiovascular prevention. In an editorial Lee A. Green, MD, of the University of Michigan in Ann Arbor, said the studies add fuel to a high-stakes debate. "Most patients who have major coronary events do not have previously known disease, so primary prevention could deliver large outcome benefits," wrote Green.
Extending the discussion of large risks and benefits, Green added that "three quarters of the patients who take statins are taking them for primary prevention, so enormous expenditures (from payors' perspectives) or revenues (from industry's perspective) are at stake." "In the long term, although sincere advocates on both sides will try to convince us otherwise, we really must admit that we do not know. We need good research to find out, and, as de Lorgeril and colleagues point out, that search must be free of incentives to find any particular desired answer."
DR. PAIS’S COMMENTS: It seems crystal clear. The only study that showed a statin drug was helpful in healthy people was sponsored by the drug company making the statin used. How is this not a conflict of interest? Drug companies make billions of dollars off statins. Sponsoring favorable results in drug studies seems to be one way they insure they’ll keep making this money.
ADHD AND PESTICIDES
Children with greater exposure to organophosphate pesticides appear to have an increased risk of developing attention-deficit/hyperactivity disorder (ADHD).
A 10-fold increase in the concentration of the most common dialkyl phosphate metabolites -- a measure of organophosphate exposure -- was associated with a 1.55-fold increase in the odds of having ADHD according to Maryse Bouchard, PhD, of the University of Montreal, and colleagues.
The relationship was not explained by gender, age, race/ethnicity, poverty to income ratio, fasting duration, or urinary creatinine concentration, the researchers reported in the June 2010 issue of Pediatrics. "These findings support the hypothesis that organophosphate exposure, at levels common among U.S. children, may contribute to ADHD prevalence," they wrote.
John Spangler, MD, of Wake Forest University Baptist Medical Center in Winston-Salem, N.C., said certain elements of the current study point toward a causal relationship.
Organophosphates interfere with the metabolism of acetylcholine, a key brain chemical in cognition, he said. "If its metabolism is altered over a long period of time, brain development will change,". "Nerve pathways will develop where they should not develop or fail to develop where they should." The strength of the association, as well as animal studies linking exposure to organophosphates and hyperactivity, also suggest causality, Spangler added. He noted that the potential dangers from organophosphate exposure can be alleviated through population interventions. "Just as public smoke-free laws reduce heart attacks and lung cancer, cracking down on the allowable level of residue on produce can have huge population pay-offs."
In this analysis, 1,139 children ages 8 to 15 who were representative of the general population were included. Overall, 119 met criteria for an ADHD diagnosis. Another 29 did not meet diagnostic criteria, but were taking ADHD medications regularly in the previous year.
Pesticide exposure was assessed with a single spot urine test for six dialkyl phosphate metabolites of the chemicals, and 93.8% of children had at least one detectable metabolite.
A 10-fold increase in the dimethyl alkyl phosphates was associated with greater odds of meeting diagnostic criteria for ADHD. The relationship was strengthened when the children who were taking ADHD medications but did not meet diagnostic criteria were included in the analysis. Children with higher had nearly twice the odds of having ADHD compared with children with undetectable levels.
Attention-deficit/hyperactivity disorder and urinary metabolites of organophosphate pesticides. Pediatrics 2010; 10.1542/peds.2009-3058.
DR. PAIS’S COMMENTS: The major source of pesticide exposure for children and infants is through the diet, as fruits and vegetables have been shown to have pesticide residue. The harm from pesticide exposure is greater in children because their developing brain is more vulnerable, and they eat more fruits and vegetables by weight then adults do.
The best way to address this is to prevent it. Have your kids eat organic fruits and vegetables. Environmental Working Group (EWG) has a great shopper’s guide that tells you which are the worst (and the best) fruits and vegetables. Sign up for it at
Please support the great work that EWG does.
Here are some pages that are of particular interest:
Store: There are 287 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 92 issues of my health newsletter, "Naturopathic News”.
Optimal Health Points: This is my blog that I update periodically. Check out my latest post, “No Deaths From Vitamins, Minerals, Amino Acids Or Herbs”.
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LET ME HELP YOU MAKE WISE SUPPLEMENT CHOICES
As is often the case, a recent new patient asked if I would review their choice and use of supplements and herbs. Why does this happen so often? For many, taking a vitamin or herb is their introduction to natural medicine. Their desire to be healthier drives them to take supplements and herbs. The death, pain, discomfort, and side effects experienced with over the counter and prescription drugs compels people to look elsewhere. It’s very different with supplements and herbs which, when used correctly, have an incredibly low risk of harm.
Some people take this to an extreme and take every supplement or herb that someone tells them is ‘good for them’. It might be a clerk, an internet ‘expert’ source, or a friend who is marketing the latest or greatest fad. Most of these individuals or companies have no professional training or experience in the medical use of the supplements or herbs that they’re selling. The people they’re selling to come into my office with 5,10, 15, or more supplements that they’re taking. Sometimes it’s been so long since they started taking them that they don’t remember why they’re doing it. When I ask, they can’t tell me what, if anything, a particular product is doing for them. Yet, they can be quite fearful of stopping any of these items, as if their health would careen off a precipice without them.
Why do I think my approach is any different? Partly, it’s because of my background. I’ve literally been working with nutritional supplements since 1974. That’s 35 years assessing the quality and effectiveness of supplements. Starting in 1980 I started working with Western and Chinese herbs. The quality of herbs used and how they’re combined together has the greatest effect on the efficacy of the final product. Because I’ve grown, identified, harvested, and produced medicinal herbal products I recognize a good formula when I see one.
Licensed naturopaths like me receive the most extensive academic and clinical training in the use of nutritional supplements and herbal medicines of any professional in the United States. Nothing can substitute for such hands on experience, especially when you see, and are responsible for, the results of your treatments. Very different from the clerk in the store, or coworker who’s part of a MLM scheme.
What I’m offering to is easy access to this experience and training. Both for you and your family. If you have questions about the supplements or herbs you are taking, or are thinking about taking, now is the time to ask. Send me an email with the brand and name of the product you’re taking. Let me know that you want to bring the bottles in at your next visit, so I can see what you’re taking. Start a discussion on my Facebook fan page. Either way I’ll give you honest feedback about what I think is good, or what isn’t. We’ll fine tune what you’re taking to maximize effect and eliminate waste.
Let me hear from you and we’ll get started.
GET YOUR VITAMIN D TEST WITH ZRT LABORATORY
It just happened again the other day. A patient sent me a copy of the Vitamin D test she just had done. With frustrating results. The wrong test was done. After all these years, and all the information available, MDs and laboratories still order the wrong test. What a waste of money and time.
For a long time I looked for a home Vitamin D test. One that would be simple, easy, and accurate to do on your own. I finally found one. ZRT Laboratory in Beaverton OR. ZRT emphasizes research and technological innovation.
Until now, venipuncture blood serum has been the standard medium for testing Vitamin D. ZRT has developed and refined Vitamin D testing in blood spots. A few drops of blood from a quick and nearly painless nick of the finger, placed on a filter paper to dry are all that is needed. The total 25 (OH) Vitamin D is then determined by liquid chromatography/tandem mass spectrometry (LC-MS/MS). This method has been shown to be as accurate as the assay standard.
Ordering A Vitamin D Test
ZRT allows anyone to order a Vitamin D test kit for $95 plus shipping and have it sent to their home. ZRT will let me prepay for kits and send them to my office for $55 each. I am charging $65 per kit for patients to cover my overhead and analysis of results.
If you are interested in getting a Vitamin D test done through my office please prepay so I can order you a kit. Then you can either pick it up at my office or have it shipped to your home. Once you’ve taken the sample and sent it back to ZRT it’s only a matter of time before your results are sent back to me. I can even look at them online before the mail arrives.
If your doctor has refused to order a Vitamin D test or worse, ordered the wrong one, this is the fastest, least expensive, most accurate way to do it ourselves. Once we know what your Vitamin D levels are, the next step is making sure that you achieve optimum levels for prevention of disease and maintenance of health.
ITHACA OPTIMAL HEALTH
I’m excited to announce that I have opened a new office in Ithaca, New York. Why Ithaca? We feel very drawn to the area—socially, culturally, and politically. Now with the help of some friends we’re practicing there. Joy Weber, a massage therapist, has graciously opened her massage space to me, every 2nd Saturday of the month. I’ll be seeing patients there starting August 8. If you have any friends or family in the area let them know.
My Ithaca office address is 329 South Geneva St., Ithaca NY 14850.
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
580 E. 3rd. St.
Williamsport PA 17701