|Issue #133 October 2013|
Welcome to this issue of Naturopathic News, issue #133. 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.
OSTEOPOROSIS & VITAMIN D
This story came out last week from the University of Auckland, New Zealand. Seemed like the headlines were everywhere exclaiming that Vitamin D supplementation did not affect bone mineral density.
These researchers searched extensive databases for research trials assessing the effects of vitamin D (D3 or D2, but not vitamin D metabolites) on bone mineral density. They included all randomized trials comparing interventions that differed only in vitamin D content, and which included adults (average age >20 years) without other metabolic bone diseases.
All the data was pooler together and they focused the percentage change in bone mineral density from baseline. Out of 3930 references they looked at 23 studies. There were 4082 participants, 92% women, average age 59 years. 19 studies had mainly white populations.
Mean baseline serum 25-hydroxyvitamin D concentration was less than 50 nmol/L (20 ng/dL) in eight studies (1791 people)—this is serious deficiency. In ten studies (2294 people), individuals were given vitamin D doses less than 800 IU per day. Bone mineral density was measured at various sites—lumbar spine, femoral neck, and total hip.
The researchers reported that there were six findings of significant benefit. However, their conclusion was that using Vit. D for osteoporosis prevention was ‘inappropriate’.
The Lancet, Early Online Publication, 11 October 2013 doi:10.1016/S0140-6736(13)61647-5
DR. PAIS’S COMMENTS: As these headlines are blasting all over the internet today I thought it would be a good idea to actually take a look at the details of this research that we can see so far. As this is a prepublication excerpt I’ll probably have more to say once it is fully available.
Their conclusion from the headlines is pretty simple to see—they’re proclaiming that Vit. D does not increase bone mineral density. How can they say that when six of the studies had statistically significant results? When Vit. D did increase bone density for those people. Good question. This seems to be yet another instance of bias in the reporting of a ‘natural’ treatment. In this case a vitamin. The headline could just as well as read “Vit. D helped ‘X’ number of people increase their bone density, just not everyone.”
Part of the problem with these studies overall is that in 10 of the studies (2294 people) a dose of 800 IU per day was given. At this point we don’t know whether the Vit. D that was given was D2-less active, or D3-most active (what I use). And we don’t know how much was given to the 1791 people with severe deficiency. I can tell you that it takes at least 1200 IU/day to raise levels from 20 ng/dL-30 ng/dL. And to raise from 20 ng/dL to 50 ng/dL it takes at least 4300 IU/day. What all of this means is that for at least some of the people with severe deficiency they weren’t getting enough Vit. D per day to raise their levels, much less increase bone density.
The other thing I can tell you is that for 2 of my patients with diagnosed osteoporosis, when they changed only the amount of Vit. D they were taking, their next DEXA scan showed increased bone density. Now that isn’t statistically significant overall, but they really appreciated it.
FOOD DYES CAUSING BEHAVIORAL PROBLEMS IN KIDS
Concerns about synthetic food dyes led
many manufacturers in
Doctors diagnosed Kendall King with
Attention Deficit Hyperactivity Disorder, or ADHD, last year and put her on
powerful drugs. But her mother, Kelly King, says, “It just didn’t feel right to
me.” The Kings heard about a possible connection between food dyes and
hyperactivity. Within weeks of taking
dyes out of her diet,
Food manufacturers in the
The FDA voted against putting warning labels on foods, but it believes more research is still needed. Still, some grocery chains, like Whole Foods, won’t sell synthetic dyes.
Warning labels are required in much of
Kelly King would like to see the synthetic
dyes eliminated in the
A statement from the FDA says it does not believe that artificial food dyes cause hyperactivity in children in the general population. However, the FDA says food dyes may exacerbate problems in susceptible children diagnosed with ADHD because they may have a unique intolerance to them. The FDA is now reassessing safety studies relating to food dyes. Here is the agency’s full, unedited statement: “Based on the data reviewed in the body of scientific literature, FDA last year concluded that a causal relationship between exposure to color additives and hyperactivity in children in the general population has not been established. However, for certain susceptible children with ADHD and other problem behaviors, the data suggest that their condition may be exacerbated by exposure to a number of substances in food, including, but not limited to, artificial food colors.”
DR. PAIS’S COMMENTS: It’s no surprise that the FDA waffles on how significant the effect of food dyes on kids really is. Doctors who pay attention strongly make that connection. In fact, the Feingold Diet (popularized by Benjamin Feingold, MD) was successfully used to treat tens of thousands of children diagnosed with ADHD. The basis of his approach was removing all artificial colors, flavorings, and preservatives from the child’s diet to improve their health.
DO YOU HAVE GOOD BLOOD PRESSURE? By Paul J. Rosch, M.D.
The American Institute of Stress. Clinical Professor of Medicine and Psychiatry.
Up until a few weeks ago, if you asked anyone, including doctors what they considered a normal or desirable adult blood pressure to be, 120/80 would have been the most frequent response. Not any more. According to the new JNC-7 guidelines, 120/80 puts you in a new disease category called "prehypertension" and at increased risk for heart attack, stroke, or kidney disease. The recommendations for rectifying this potentially deadly disorder are the usual advice to lose weight, avoid salt and sodium rich foods, exercise regularly, stop smoking and reduce stress. However, we all know how difficult it is to achieve these goals, much less maintain them. And even if you do, the results are not that rewarding, even for patients with blood pressures of 160/100 and higher.
People with prehypertension are even less likely to find that lifestyle modification will normalize their blood pressure, which means that medication will be required. Chalk another one up for the drug companies. The first advice generally given to all patients with high blood pressure is to significantly restrict sodium intake. However, the vast majority fail to respond to this unless they have certain genetic traits. In some, calcium deficiency can be the culprit and they improve with calcium supplementation. These individuals may actually worsen on a low sodium regimen since this would sharply reduce the intake of dairy products that are the major source of dietary calcium. Others benefit from potassium and/or magnesium supplements. Jogging and running may help lower blood pressure for some people but more often has little effect and can even cause a rise.
Hypertension, like fever, is not a diagnosis like diabetes, but rather a description. It is simply an elevated blood pressure reading on some measuring device that can have many different causes. That helps to explain why we have some 100 drugs to treat high blood pressure. Unfortunately, there is no algorithm to guarantee which one will work best or be the safest for any specific patient. Similarly, a fever of 103° in a patient with lupus may require giving cortisone but if that identical 103° temperature reading were due to tuberculosis, cortisone could bring the fever down but might prove lethal. Conversely, appropriate antibiotics would be an effective treatment for tuberculosis but would provide little benefit in lupus.
Risk Factors And Other Fallacies
In order to successfully treat a disease it is necessary to remove or reduce its cause rather than its manifestations or markers. Treating a persistently elevated blood pressure or temperature is very different than treating an elevated blood sugar. While the goal in diabetes is to lower the blood sugar to normal, responses to medication and/or diet are much more predictable and sustained since the cause can almost always be identified.
An elevated temperature can be a purposeful physiologic response to stimulate immune system defenses. Hyperthermia due to artificially induced fever has been used to treat erysipelas, tuberculosis, neurosyphilis and certain malignancies. Giving non-specific drugs just to bring an elevated temperature down to normal could do more harm than good in certain situations. The same may apply to many older individuals with arteriosclerotic vessels, where a higher blood pressure is needed to maintain adequate blood flow to the kidneys and other vital organs.
Whatever happened to the good old days when a normal systolic pressure was 100 plus your age? Not everyone agrees with this and the upper limit is now usually considered to be 140/90, even for people over 70. Nevertheless, some senior citizens will consistently complain of weakness and dizziness if their blood pressures are lower than the 120/80 value that is now recommended. This is particularly true for women, who normally tend to have higher blood pressures than men in this age group.
Much of this "one-size-fits-all" approach comes from confusion over what a "risk factor" really represents. Most risk factors for heart disease are merely "risk markers" that simply have some statistical association with an increased incidence of coronary events. There are over 300 risk factors for heart attacks, including a deep earlobe crease, premature vertex baldness, high selenium toenail levels, having a pot belly, not having a nap or one or two glasses of wine a day. Attempting to treat or remove such markers will accomplish nothing since they do not cause coronary disease. The same can be true for lowering an elevated systolic or diastolic blood pressure unless the treatment is directed at what is causing the problem, which is usually not clear.
No randomized clinical trials have ever proven that lowering an elevated systolic blood pressure to 140 reduces the risk for death due to coronary disease. A good example of this was the multicenter Multiple Risk Factor Trial (MRFIT) designed to demonstrate that reducing hypertension, high cholesterol and smoking would lower coronary mortality. After screening some 350,000 middle-aged men, close to 13,000 believed to be at greater jeopardy because of a preponderance of these putative risk factors were selected. They were divided into a treatment group to lower these markers and a control group that received usual care. After 10 years and $115 million, although the treatment group substantially achieved their objectives, they fared no different than controls who received usual care. In point of fact, a subset of hypertensives treated with diuretics had the highest mortality rates, probably from ventricular fibrillation due to potassium depletion.
The MRFIT objective was to get blood pressures below 140/90. One can only wonder what the mortality rate would have been if under 120/80 had been the goal. Stress and Pseudohypertension My personal experience has been that a significant percentage of patients being treated for "essential hypertension" can stop their medication without any adverse effects. When such individuals are admitted to the hospital for surgery or some unrelated condition and these drugs are discontinued deliberately or inadvertently, it is not unusual for blood pressures to fall to normal levels and remain there, only to rise again after discharge.
Stress related or "white coat" hypertension is quite common. In one study published in the Journal of the American Medical Association, more than one in four patients with elevated blood pressures in the doctor's office were found to have normal values on ambulatory monitoring. All were taken off drugs with no adverse effects. Decades ago, when healthy young men being examined for insurance policies or entry into the armed services had high readings but no retinopathy, albuminuria or other indication of sustained hypertension, we used to reassure them and have them lie down and relax in a quiet room. After 15 or 20 minutes, repeated measurements were invariably much lower and usually normal. Busy doctors don't have time for that today. It's much easier and safer for them to prescribe a pill, since everyone knows that hypertension is the "silent killer". In addition, treating hypertension is easy, doesn't take much time or energy and is apt to be quite remunerative since periodic electrocardiograms and chest X-rays to monitor cardiac size and laboratory tests are readily justified. Only a few questions need to be asked, the patient often does not need to disrobe in an examining room and the entire encounter often takes less than ten minutes.
A not uncommon scenario is that when the patient returns after the initial diagnosis of hypertension has been made and a medication has been prescribed, he or she is even more nervous, blood pressure is still high or higher and the dose is increased. This may be repeated on subsequent visits and/or additional drugs are ordered. The result may be dizziness or other side effects that the patient now attributes to a worsening of hypertension, causing even more stress. It is also not generally appreciated that heart rate and blood pressure shoot up whenever we speak or try to communicate in some other way. The seminal investigations of this phenomenon have been done by Jim Lynch who showed that such elevation are greater if we are talking to someone of perceived higher social stature, more rapidly than usual, and if the content of the conversation deals with some important personal issue. Blood pressure rises in deaf mutes when they use sign language but not when they move their hands meaninglessly but with the same amount of energy. The only time this does not occur is in schizophrenic patients off of medication, possibly because they no longer communicate.
I have been involved in this research with Jim for over 25 years. Although these transient spikes in both systolic and diastolic pressure can be alarmingly high, patients are completely unaware of this and have no symptoms. By using an automated blood pressure device that displays systolic, diastolic and mean arterial pressure on a monitor, it is possible to teach patients how to lower their pressures. We have also found that these rises are not blunted by any antihypertensive drugs and are actually exaggerated by beta blockers. It is not uncommon for anxious patients to talk immediately prior to or even while the doctor is inflating the cuff, which can increase blood pressure up to 50 percent in some people. There is no good evidence that such hyperreactivity is associated with any increased incidence of sustained hypertension.
The same is true for elite weight lifters, who can have pressures of 400/250 or higher when they perform the supreme Valsalva maneuver. Another source of pseudohypertension is that the same size cuff is used for all adults, which can cause significantly false high readings in fat arms. The width of the cuff should be 40 percent of the circumference of the arm. This is important because of the large number of obese people and others who are engaged in body building activities. Time of day, room temperature, a full bladder, eating, drinking or smoking within the past hour, standing, sitting or supine can all influence measurements.
Treating Numbers Instead of a Person
Authoritative advice for treating blood
pressure has changed dramatically over the years. Forty years ago, the chapter
on hypertension in
Today, that would be grounds for malpractice. The chapter, which was written by John Merrill, a leading authority on hypertension from Harvard, goes on to emphasize that: "The physician must constantly weigh the value of making his patient 'blood pressure conscious' by a specific regimen and regular follow-up, against real need for any particular form of therapy. Above all, in treatment or prognostication, he must avoid engendering in the patient a fear of the disease which may be unwarranted in our present state of knowledge." Contrast this with the current cookie cutter approach of treating numbers that are often meaningless instead of people. There is absolutely nothing new about prehypertension, which was previously referred to as "high normal" at levels higher than 120/80. This would still be a preferable description since nobody knows whether these individuals will go on to develop sustained hypertension or are at any significantly increased risk for its complications.
All these new guidelines essentially accomplish are to convert 45 million healthy Americans into new patients by creating fear. This is precisely what the experts emphasized we should take pains never to do! How could so many doctors have been so wrong for so many years? Whatever happened to the Hippocratic dictum Primum non nocere (First of all, do no harm)? It used to be the primary concern of all doctors but seems to have now been sidelined or forgotten in the frenetic and impersonal pace of modern medical practice. What is wrong is that physicians are treating a reading on a blood pressure machine in a cookbook fashion rather than the patient or the cause of the problem.
What Causes Hypertension?
Blood pressure (BP) is essentially determined by cardiac output (CO) or the force with which blood is pumped out of the left ventricle and the degree of systemic vascular resistance (SVR) that is encountered. Hypertension can be caused by increased cardiac output, increased vascular resistance or both. Although the cause of essential or primary hypertension in a patient may not be known it is safe to say that it is mediated by one or both of these two mechanisms. Prior to these new guidelines, 120/80 was considered to be optimal and 120-129/80-84 was within the normal range. High normal was 130-139/85-89 and Stage 1 or mild hypertension was 140-159/90-99. Stage 2 (160-179/100-109), Stage 3 (179-209/100-110) and Stage 4 (>210/>120) reflected increasing degrees of severity.
What should you do if one number is high and the other is normal or low? Which is more important, the systolic (upper) or diastolic (lower) measurement? The previous emphasis on diastolic pressure was based on early studies on young people. Diastolic pressure, which is the pressure when your heart relaxes between beats, rises until around age 55 and then starts to decline. Systolic pressure is the pressure when your heart beats and it increases steadily with age. A systolic pressure above 140 with a diastolic pressure below 90 is referred to as isolated systolic hypertension. It is common in older individuals due to hardening of the arteries and slight elevations were not considered serious.
Studies now show that an elevated systolic pressure is an independent risk factor for complications that is far greater than the risk associated with a high diastolic pressure in older patients with hypertension. Most patients with hypertension have no symptoms and blood pressure elevations are often discovered during a routine physical examination or if measurements are obtained in connection with application for life insurance, employment or blood donation rather than any complaint due to its presence. It is important to reemphasize that blood pressures are very variable and that emotional stress and numerous other factors such as smoking, coffee, over the counter drugs containing caffeine or decongestants, a cold room, full bladder, improper cuff size, etc. can all give false high readings.
Measurements should be taken with the arm supported at the level of the heart and not until the patient has been sitting for at least five minutes. If an elevation is found, the blood pressure should be taken after five minutes in the supine position and then immediately on standing and two minutes later to rule out postural effects. At least two readings should be made at each visit separated by as much time as possible. Three sets of readings at least one week apart are advised before prescribing drugs that may have to be taken perpetually. Measurements should be made in both arms and the higher one selected to monitor.
Every effort should be made to rule out known causes of hypertension, such as coarctation of the aorta, sleep apnea, obesity, pregnancy, oral contraceptives and other medications. However, busy doctors don't have time to go through all the above. It's much easier to prescribe a drug and hope it works. If not, there are plenty of others to try.
DR. PAIS’S COMMENTS: I think Dr. Rosch really says it all here. This is a very interesting article written by an MD who has treated a lot of patients. Interesting especially in light of the next article.
BLOOD PRESSURE DRUGS INCREASE RISK FOR BREAST CANCER
Previous studies have indicated that blood pressure lowering drugs may increase the risk for certain cancers. To evaluate associations between use of various classes of blood pressure medications and risks of invasive ductal and invasive lobular breast cancers among postmenopausal women, a study was conducted in the Seattle-Puget Sound metropolitan area. Participants were women aged 55 to 74 years, 880 of them with invasive ductal breast cancer, 1027 with invasive lobular breast cancer, and 856 with no cancer serving as controls.
Results demonstrated that use of calcium-channel blockers for 10 or more years was associated with significantly higher risks of both ductal breast cancer and lobular breast cancer. The relative risk for developing breast cancer was 2.5 times (250%) greater among users of calcium channel blocking drugs.
Use of Antihypertensive Medications and Breast Cancer Risk Among Women Aged 55
to 74 Years. JAMA Intern Med. 2013 Aug 5. doi: 10.1001/jamainternmed. 2013.9071.
DR. PAIS’S COMMENTS: Drugs to lower blood
pressure are among the most commonly prescribed medicines in the
According to the National Cancer Institute
more than 232,000 women will be diagnosed with breast cancer in the
Each year about 100 million prescriptions are filled for calcium-channel blockers.
Calcium channel blockers have been shown to produce an increased risk for heart attacks. Other side effects include constipation, allergic reactions, fluid retention, dizziness, headache, fatigue, and impotence (about 20% of users). More serious side effects include disturbances of heart rate or function, heart failure, and angina.
Examples of calcium-channel blockers include:
HOMEOPATHY WORKS BETTER FOR EAR INFECTIONS
A randomized controlled pilot compared homeopathy and conventional therapy in acute otitis media (acute ear infection). 81 children were randomly assigned to a homeopathically or conventionally treated group. The trial was also “blinded” — neither the parents nor the researchers knew who belonged to which group. Conventional treatment involved use of anti-inflammatories, analgesic, and fever-reducing medicines for three days, followed by antibiotics if the child hadn’t improved by at least 50%. Homeopathic treatment used LM potencies.
“All children had their eardrums examined by an ear, nose, and throat (ENT) specialist—at entry to the study, and at days 3, 7, 10, and 21—and rated on the Tympanic Membrane Examination scale. Parent assessments of their children’s symptoms were also taken at these times. The use of an ENT specialist assessing on the basis of visual observation of the eardrum, unaware of which treatment a patient was receiving, is a rigorous, objective outcome measure, placing the quality of this study at the highest levels of clinical research. At entry to the study, both groups had nearly identical ratings on each of the twelve parameters assessed, meaning they were perfectly matched for comparison.
“Cure” was defined as a score of zero on all assessment scales. The results were:
• Four in the homeopathic group were cured by day 3, versus one in the conventional group.
• By day 3, total symptom score dropped from 14.2 to 8.2 (6 points) in the homeopathic group and from 14.5 to 12.5 (2 points) in the conventional group.
• 39 of 40 children in the conventional group required antibiotics.
• 0 of 38 children in the homeopathic group required antibiotics.
Researchers concluded that “By day 3, the difference between the two groups in favor of the homeopathic group was hugely significant statistically, with the odds being less than 1 in 1000 that the findings occurred by chance.”
Homeopathy 2012 Jan;101(1):5–12).
DR. PAIS’S COMMENTS: The numbers speak for themselves. Which treatment would you choose?
I’ll never forget my son’s only ear infection. He woke up in the middle of the night crying from the pain. As sleepy as I was I gathered together three good symptoms to prescribe on, gave him the homeopathic medicine that matched his state, and he was back to sleep in 5 minutes. Then I was.
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Here are some pages that are of particular interest:
Store: There are 399 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 132 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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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!
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
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
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. At the same time, I receive a percentage of each supplement sale. 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.
Pais, ND, DHANP