|Issue #125 February 2013|
Welcome to this issue of Naturopathic News, issue #125. 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.
15 YEAR ANNIVERSARY
In 1998 we moved our 2 boys, 1 cat, 1 dog, 5 Angora goats, and 8 Angora rabbits to the 14 acre farm we found in Steam Valley. For the first couple of years many asked us why we would leave Colorado to move here. Three reasons—farm, family, and practice. Phylleri’s sister lived here with her family. Land was inexpensive enough that we could afford a place in the country to raise our kids and start a farm. And there was initially enough support for my naturopathic practice.
In April it will officially be 15 years of practice in Lycoming County. Many thanks to all of you who welcomed us and have helped support my practice since then. Though CAFOs, gas wells, and a poor economy have intervened, we’re still here. I’m still bringing the best that natural medicine has to offer to all of you.
Thanks to all of you.
2013 OPTIMAL HEALTH LECTURE SERIES
Going Gluten Free
Wednesday, March 20, 2013
6:00pm until 7:30pm
James V. Brown Library
19 East Fourth Street, Williamsport, PA 17701
Are You Thinking About Going Gluten Free?
What is gluten and why should you avoid it? D you have questions about the simplest way to do this?
Find out what you can do for yourself. Learn what conditions respond to removing gluten from your diet.
I will discuss simple steps to sport your health and prevent illness. Come to this free 1.5 hour lecture Wed., March 20, 2013, from 6:00-7:30 pm at the James V. Brown Library
19 East Fourth Street, Williamsport, PA 17701
James V. Brown Library has offered us the use of the Lowry Theater room to make this event happen. I’ll bring my 39 years of natural medicine experience to light in this informative free lecture. More than likely someone you know has stopped eating gluten. They’re telling you all sorts of stories about what gluten is and where it comes from. Come to this lecture and get information you can depend on to help get healthy.
I will discuss nutritional and lifestyle factors involved in going gluten free and what that change might do for your health. Learn the best that natural medicine has to offer.
Remember to mark your calendar for Wed., March 20, 2013, from 6:00-7:30 pm at
James V. Brown Library
19 East Fourth Street
Williamsport PA 17701
Just Scheduled: I will be appearing on Ken Sawyer’s radio show on WRAK, Friday, March 8, at 8am. I’ll be talking about going gluten free and how it can help you get well. Please call in, say hello, and ask a question.
WHAT REALLY CAUSES KIDNEY STONES
(And Why Vitamin C Does Not)
Orthomolecular Medicine News Service, February 11, 2013
OMNS free subscription link http://orthomolecular.org/subscribe.html
OMNS archive link http://orthomolecular.org/resources/omns/index.shtml
A recent widely-publicized study claimed that vitamin C supplements increased the risk of developing kidney stones by nearly a factor of two. The study stated that the stones were most likely formed from calcium oxalate, which can be formed in the presence of vitamin C (ascorbate), but it did not analyze the kidney stones of participants. Instead, it relied on a different study of kidney stones where ascorbate was not tested. This type of poorly organized study does not help the medical profession or the public, but instead causes confusion.
The study followed 23,355 Swedish men for a decade. They were divided into two groups, one that did not take any supplements (22,448), and another that took supplements of vitamin C (907). The average diet for each group was tabulated, but not in much detail. Then the participants who got kidney stones in each group were tabulated, and the group that took vitamin C appeared to have a greater risk of kidney stones. The extra risk of kidney stones from ascorbate presented in the study is very low, 147 per 100,000 person-years, or only 0.15% per year.
Key points the media missed:
The number of kidney stones in the study participants who took ascorbate was very low (31 stones in over a decade), so the odds for statistical error in the study are fairly high.
The study was observational. It simply tabulated the intake of vitamin C and the number of kidney stones to try to find an association between them.
This method does not imply a causative factor because it was not a randomized controlled study, that is, vitamin C was not given to a group selected at random.
This type of observational study is fraught with limitations that make its conclusion unreliable.
It contradicts previous studies that have clearly shown that high dose ascorbate does not cause kidney stones.[2-6]
The study authors' conclusion that ascorbate caused the low rate of stones is likely due to a correlation between the choice of taking a vitamin C supplement with some other aspect of the participants' diet.
The study could not determine the nature of this type of correlation, because it lacked a detailed study of each patient's diet and a chemical analysis of each stone to provide a hint about the probable cause.
So we have a poorly designed study that did not determine what kind of stone was formed, or what caused the stones that were formed. These are serious flaws. Drawing conclusions from such a study can hardly be a good example of "evidence based medicine."
Different Types of Kidney Stones (Renal Calculi)
There is a considerable variety of kidney stones. Here are five well-known ones:
1. Calcium phosphate stones are common and easily dissolve in urine acidified by vitamin C.
2. Calcium oxalate stones are also common but they do not dissolve in acid urine. We will discuss this type further below.
3. Magnesium ammonium phosphate (struvite) stones are much less common, often appearing after an infection. They dissolve in urine acidified by vitamin C.
4. Uric acid stones result from a problem metabolizing purines (the chemical base of adenine, xanthine, theobromine [in chocolate] and uric acid). They may form in a condition such as gout.
5. Cysteine stones result from an hereditary inability to reabsorb cysteine. Most children's stones are this type, and these are rare.
The Oxalate Oxymoron
The oxalate/vitamin C issue appears contradictory. Oxalate is in oxalate stones and oxalate stones are common. Ascorbate (the active ion in vitamin C) may slightly increase the body's production of oxalate. Yet, in practice, vitamin C does not increase oxalate stone formation. Emanuel Cheraskin, MD, DMD, Professor of Oral Medicine at the University of Alabama, explains why: "Vitamin C in the urine tends to bind calcium and decrease its free form. This means less chance of calcium's separating out as calcium oxalate (stones)." Also, the diuretic effect of vitamin C reduces urine concentration of oxalate. Fast moving rivers deposit little silt. If on a consultation, a doctor advises that you are especially prone to forming oxalate stones, read the suggestions below before abandoning the benefits of vitamin C. Once again: vitamin C increases oxalate but inhibits the union of calcium and oxalate.
Oxalate is generated by many foods in the diet, including spinach (100-200 mg oxalate per ounce of spinach), rhubarb, and beets.[8-10] Tea and coffee are thought to be the largest source of oxalate in the diet of many people, up to 150-300 mg/day.[8,11] This is considerably more than would likely be generated by an ascorbate dose of 1000 mg/day.[5,12]
The study we are discussing didn't tabulate the participants' intake of oxalate, but on average they had relatively high intakes (several cups) of tea and coffee. It is possible that those who had kidney stones had them before the study started, or got them during the study, due to a particularly high intake of oxalate. For example, the participants that took vitamin C may have been trying to stay healthy, but the subset of those who got kidney stones might also have been trying to stay healthy by drinking a lot of tea or coffee, or eating green leafy vegetables such as spinach. Or they may have been older people who got dehydrated, which is also very common among men who are active outside during the summer. Among the most important factors in kidney stones is dehydration, especially among the elderly.
Ascorbate in low or high doses generally does not cause significant increase in urinary oxalate.[2-6]
Ascorbate tends to prevent formation of calcium oxalate kidney stones.[3,4]
Risk factors for kidney stones include a history of hypertension, obesity, chronic dehydration, poor diet, and a low dietary intake of magnesium.
Kidney stones and magnesium deficiency share the same list of causes, including a diet high in sugar, alcohol, oxalates, and coffee. Magnesium has an important role in the prevention of kidney stone formation. Magnesium stimulates production of calcitonin, which draws calcium out of the blood and soft tissues back into the bones, preventing some forms of arthritis and kidney stones. Magnesium suppresses parathyroid hormone, preventing it from breaking down bone. Magnesium converts vitamin D into its active form so that it can assist in calcium absorption. Magnesium is required to activate an enzyme that is necessary to form new bone. Magnesium regulates active calcium transport. All these factors help place calcium where it needs to be, and not in kidney stones.
One of magnesium's many jobs is to keep calcium in solution to prevent it from solidifying into crystals; even at times of dehydration, if there is sufficient magnesium, calcium will stay in solution. Magnesium is a pivotal treatment for kidney stones. If you don't have enough magnesium to help dissolve calcium, you will end up with various forms of calcification. This translates into stones, muscle spasms, fibrositis, fibromyalgia, and atherosclerosis (as in calcification of the arteries). Dr. George Bunce has clinically demonstrated the relationship between kidney stones and magnesium deficiency. As early as 1964, Bunce reported the benefits of administering a 420 mg dose of magnesium oxide per day to patients who had a history of frequent stone formation.[14,15] If poorly absorbed magnesium oxide works, other forms of better-absorbed magnesium will work better.
Calcium oxalate stones can effectively be prevented by getting an adequate amount of magnesium, either through foods high in magnesium (buckwheat, green vegetables, beans, nuts), or magnesium supplements. Take a magnesium supplement of at least the US RDA of 300-400 mg/day (more may be desirable in order to maintain an ideal 1:1 balance of magnesium to calcium). To prevent a laxative effect, take a supplement that is readily absorbable, such as magnesium citrate, chelate, malate, or chloride. Magnesium oxide, mentioned above, is cheap and widely available. However, magnesium oxide is only about 5% absorbed and thus acts mostly as a laxative.  Milk of magnesia (magnesium hydroxide) is even more of a laxative, and unsuitable for supplementation. Magnesium citrate is a good choice: easy to find, relatively inexpensive and well absorbed.
The Role of Vitamin C in Preventing and Dissolving Kidney Stones
The calcium phosphate kidney stone can only exist in a urinary tract that is not acidic. Ascorbic acid (vitamin C's most common form) acidifies the urine, thereby dissolving phosphate stones and preventing their formation.
Acidic urine will also dissolve magnesium ammonium phosphate stones, which would otherwise require surgical removal. These are the same struvite stones associated with urinary tract infections. Both the infection and the stone are easily cured with vitamin C in large doses. Both are virtually 100% preventable with daily consumption of much-greater-than-RDA amounts of ascorbic acid. A gorilla gets about 4,000 mg of vitamin C a day in its natural diet. The US RDA for humans is only 90 mg. The gorillas are unlikely to all be wrong.
The common calcium oxalate stone can form in an acidic urine whether one takes vitamin C or not. However, this type of stone can be prevented by adequate quantities of B-complex vitamins and magnesium. Any common B-complex supplement, twice daily, plus about 400 milligrams of magnesium, is usually adequate.
A Dozen Ways to Reduce Your Risk of Kidney Stones
1. Maximize fluid intake. Especially drink fruit and vegetable juices. Orange, grape and carrot juices are high in citrates which inhibit both a buildup of uric acid and also stop calcium salts from forming. 
2. Control urine pH. Slightly acidic urine helps prevent urinary tract infections, dissolves both phosphate and struvite stones, and will not cause oxalate stones. And of course one way to make urine slightly acidic is to take vitamin C.
3. Avoid excessive oxalates by not eating (much) rhubarb, spinach, chocolate, or dark tea or coffee.
4. Lose weight. Being overweight is associated with substantially increased risk of kidney stones.
5. Calcium is probably not the real culprit. Low calcium may itself cause calcium stones .
6. Most kidney stones are compounds of calcium and yet many Americans are calcium deficient. Instead of lowering calcium intake, reduce excess dietary phosphorous by avoiding carbonated soft drinks, especially colas. Cola soft drinks contain excessive quantities of phosphorous as phosphoric acid. This is the same acid that is used by dentists to dissolve tooth enamel before applying bonding resins.
7. Take a magnesium supplement of at least the US RDA of 300-400 mg/day. More may be desirable in order to maintain an ideal 1:1 balance of magnesium to calcium. Many people eating "modern" processed-food diets do not consume optimal quantities of magnesium.
8. Take a good B-complex vitamin supplement twice daily, which contains pyridoxine (vitamin B6). A deficiency of vitamin B6 produces kidney stones in experimental animals. Vitamin B6 deficiency is very common in humans. A vitamin B1 (thiamine) deficiency also is associated with stones. 
9. For uric acid/purine stones (gout), stop eating meat. Nutrition tables and textbooks indicate meats as the major dietary purine source. Natural treatment adds juice fasts and eating sour cherries. Increased vitamin C consumption helps by improving the urinary excretion of uric acid. . For these stones, use buffered ascorbate "C".
10. Persons with cysteine stones (only 1% of all kidney stones) should follow a low methionine diet and use buffered vitamin C.
11. Kidney stones are associated with high sugar intake, so eat less (or no) added sugar. 
12. Infections can cause conditions that favor stone formation, such as overly concentrated urine (from fever sweating, vomiting or diarrhea). Practice good preventive health care, and it will pay you back with interest.
DR. PAIS’S COMMENTS: Kudos to the folks at the Orthomolecular Medicine News Service—another great article.
There are 20 References for this article. If you want to see them I’ll email them to you.
LOW VITAMIN D LEVELS LINKED TO BREAST CANCER
A prospective study led by researchers from the UC San Diego School of Medicine has found that low serum vitamin D levels in the months preceding diagnosis may predict a high risk of pre-menopausal breast cancer.
The study of blood levels of 1,200 healthy women found that women whose serum vitamin D level was low during the three-month period just before diagnosis had approximately three times the risk of breast cancer as women in the highest vitamin D group.
The study is currently published online in advance of the print edition of the journal Cancer Causes and Control.
Several previous studies have shown that low serum levels of vitamin D are associated with a higher risk of premenopausal breast cancer. “While the mechanisms by which vitamin D could prevent breast cancer are not fully understood, this study suggests that the association with low vitamin D in the blood is strongest late in the development of the cancer," said principal investigator Cedric Garland, professor in the Department of Family and Preventive Medicine at UC San Diego.
Analyses of vitamin D levels measured more than 90 days before diagnosis have not conclusively established a relationship between serum levels and risk of premenopausal breast cancer in the present cohort. However, this new study points to the possibility of a relevant window of time for cancer prevention in the last three months preceding tumor diagnosis—a time physiologically critical to the growth of the tumor.
According to Garland, this is likely to be the point at which the tumor may be most actively recruiting blood vessels required for tumor growth. “Based on these data, further investigation of the role of vitamin D in reducing incidence of premenopausal breast cancer, particularly during the late phases of its development, is warranted,” he said.
The new study drew upon 9 million blood serum specimens frozen by the Department of Defense Serum Repository for routine disease surveillance. The researchers thawed and analyzed pre-diagnostic samples of serum from 1,200 women whose blood was drawn in the same time frame—samples from 600 women who later developed breast cancer, and from 600 women who remained healthy.
A 2011 meta-analysis by Garland and colleagues estimated that a serum level of 50 ng/ml is associated with 50 percent lower risk of breast cancer. While there are some variations in absorption, those who consume 4000 IU per day of vitamin D from food or a supplement normally would reach a serum level of 50 ng/ml.
Garland added that a consensus of all available data has shown no known risk associated with this concentration of vitamin D, which is measured as serum 25-hydroxyvitamin D. But he urges patients to ask their health care provider to measure their serum 25(OH)D before substantially increasing vitamin D intake.
“Serum 25-hydroxyvitamin D and breast cancer in the military: a case–control study utilizing pre-diagnostic serum”, Cancer Causes & Control, 2013.
DR. PAIS’S COMMENTS: If you’ve worked with me for any length of time you know that Garland is reiterating what I say about testing your Vitamin D to know your levels. Then dosing based on those results. This is such a safe and easy way to lower your risk of breast cancer (and other cancers).
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 compel 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 36 years assessing the quality and effectiveness of supplements. Beginning 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.
Here are some pages that are of particular interest:
Store: There are 375 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 123 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”.
Come join my fan page at www.facebook.com/NaturalDoc
Help me bring information, news, and stories about natural medicine to the Facebook community.
For those of you who don’t know, Facebook is a social networking website. Users can add friends and send them messages, and update their personal profiles to notify friends about themselves. Additionally, users can join networks organized by city, workplace, and school or college.
Facebook pages help you discover new artists, businesses, and communities as well as those you already love. On my fan page www.facebook.com/NaturalDoc I post discussions that you can join in with and relay breaking health news related to disease prevention, clinical nutrition, and ways to make you healthier.
I’m looking forward to exploring this community with you. See you there!
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, plus $8 shipping. I am charging $65 per kit for patients to cover the total.
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.
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