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Dr. Gregory Pais, ND
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Home arrow Naturopathic News arrow Issue #39 - December 2005
Issue #39 - December 2005

Welcome to this issue of Naturopathic News, issue #39. It’s my mission to help you find natural solutions to health problems. This newsletter is one way to do that. The more educated you are about your health options the better able you will be to take control of your health. If you would like to stop receiving my newsletter send me an email and let me know. If you have a friend or family member who you think would appreciate the information provided, send me their email address.

 

2006 CHANGES

Starting with the New Year I will be making some changes with this email newsletter. Up to this point I have been sending it out as a Plain Text email without much formatting. The benefits of this approach are simplicity, small size, and ease of use. The downside is that the text is harder to read, graphics are not useable, and it’s difficult to differentiate one article from the next.

OPTIONS

Adobe Acrobat format (pdf files)
This is a common article format that incorporates graphics and text. Most people already have a copy of Adobe Acrobat Reader on their computer. If they don’t it’s available for free from the Adobe website. As pdf files aren’t platform specific they can be read on a Mac, Windows, or other computer.


Microsoft Word format
Again, almost everyone has a copy of Word or uses a word processing program that can read Word files. Formatting and graphics are easy to use. However, there are various computing security issues involved with using Word that I would prefer to stay away from.


Website
I will be rolling out my website(s) in 2006. All past issues of my newsletter will be indexed and available for download. Need to find that article on Vioxx from last year? No problem! You’ll be able to easily search for what you want. These newsletters will most likely be in the pdf format as well.

If you work as a professional web designer or know someone who does please help put him or her in touch with me.

 

HOMEOPATHIC POSOLOGY    

Posology is the science of dosing. For our purposes, all the ways that a homeopathic dose can be varied. As usual, some background will be helpful in understanding this topic.

In Hahnemann’s time, the first half of the 19th century, medicines of the day were crude extracts used in large doses. For instance, extracts of Mercury, which is an incredibly toxic metal, were used to treat syphilis. They were continuously given to salivate the patient. To the point where the oral mucosa was ulcerated and the underlying bone destroyed.

Hahnemann’s goal was to achieve the maximum healing effect with the minimum dose required. Over his lifetime he utilized 3 main posology methods to achieve this worthwhile goal.


Olfaction
Yes, having the patient smell the remedy. This may seem a bit unusual if you don’t know your neuroanatomy. There’s only one structure in the whole body that directly connects the outside world to the brain. That’s the olfactory nerve. In other words, the impact of what you smell reaches directly into the brain, no detours, and no rest stops.

Dry dose
Homeopathic medicines often come as small pellets made from milk sugar. They have been saturated with a homeopathic remedy and then allowed to dry. When properly made, 1 pellet, no matter how small, is 1 dose.

When I first started homeopathic training in 1982 the most common method of dosing was to give 1-3 pellets at one time and then wait for the response. Historically this method can be traced back to the 4th edition of “The Organon”, Dr. Samuel Hahnemann’s treatise on the practice of homeopathic medicine.

If your homeopath was trained as most homeopaths have been in the last 80 years this is the posology method that they used.


Pellet size
Why are some pellets a different size than another? This has to do with many factors. With the LM potency, by pharmaceutical definition the pellet size is #10. Which is approximately the size of a poppy seed. X and C potencies come in a variety of pellet sizes from #10 to #35 which is the size of a large BB.


Liquid dosing
Starting with the 5th edition of “The Organon” and continuing with the 6th and final edition, liquid dosing became the preferred method. Instead of using a dry pellet directly it is placed dissolved in a solution of water. This is the medicinal solution that is then used for a particular case.

There are many benefits to this approach. Most importantly one can modify the dose in a number of different ways:

Quantity—how much solution the single pellet is dissolved in.

Amount—how much is given at one time-drops, teaspoon, tablespoon, etc.

Number of succussions—the medicinal solution is succussed each time before taking a dose. This slightly increases the potency each time a dose is taken. This is critically important when the dose is repeated more than once.

Further dilution—when it is necessary to further dilute the medicinal solution you can easily go into the 1st glass, 2nd glass, etc.

I have been using LM potencies and dosing in liquid form since 1994.

 

COX-2 INHIBITORS NOT SAFER FOR STOMACH

Painkillers called cox-2 inhibitors have long been touted as safe for your stomach, but a new study says that's just not so.

There is no evidence to support the claims that these drugs are less harmful to the stomach lining than many traditional anti-inflammatory medications, such as aspirin, British researchers state in a report in the Dec. 3 2005 issue of the British Medical Journal.

In the study, researchers at the University of Nottingham looked at 367 general practices for cases of upper gastrointestinal events, such as stomach ulcer or bleeding. They matched cases with up to 10 control patients. For all patients, the researchers looked for prescriptions for anti-inflammatory drugs and aspirin in the three years before the study.

Of 9,407 patients, 45 percent had received a conventional non-steroidal anti-inflammatory drug (NSAID), and 10 percent had been given a cox-2 inhibitor, the newer generation of anti-inflammatory. Of 88,867 control subjects, 33 percent had been given an NSAID, and 6 percent had received a cox-2 inhibitor.

The researchers found an increased risk of gastrointestinal problems associated with using both cox-2 inhibitors and other NSAIDs. Even after adjusting the data to account for other factors, the risk remained significantly high for the cox-2 inhibitor rofecoxib (Vioxx) and the NSAIDs naproxen and diclofenac (Voltaren).

While cox-2 drugs were specifically designed to provide pain relief without the serious gastrointestinal side effects associated with the traditional NSAIDs, "we found no consistent evidence of enhanced safety against gastrointestinal events with any of the new cyclo-oxygenase-2 inhibitors [cox-2 inhibitors], compared with non-selective, nonsteroidal, anti-inflammatory drugs," the authors concluded.

One expert thinks this study confirms the increased dangers of gastrointestinal (GI) bleeding when a Cox-2 inhibitor and aspirin are used together.

"The fact that cox-2 inhibitor drug users had higher rates of adverse GI events than nonusers comes as no surprise to me," said Dr. A. Mark Fendrick, a professor of internal medicine and health management and policy at the University of Michigan. Fendrick is concerned most about the danger of mixing cox-2 inhibitors with aspirin. "Once again, this study confirms that the addition of aspirin to any NSAID, including cox-2 inhibitors, is a very dangerous combination," he said.

Another expert thinks this study shows that cox-2 inhibitors increase the danger of GI bleeding and ulcers when used in clinical practice. "These drugs were touted as prevention of adverse GI events, which is completely false," said Dr. Eric Matteson, a professor of medicine at the Mayo Clinic College of Medicine, in Rochester, Minn. "In actual practice, the utility of these drugs is very low in terms of reducing the risk for important GI side effects," he said.

Matteson believes this study highlights the GI dangers of using any of these drugs. "All NSAIDs increase your risk for stomach problems, including ulcers and bleeding, which can be serious and even fatal," he said. "This includes the Cox-2 drugs."

DR. PAIS’S REVIEW: How many more nails in the coffins of these drugs will it take before they are not pushed any more? Last year it was the revelation that at least 40,000 people died from cardiovascular problems (stroke, heart attack, etc) while using these drugs. Now we have another study (no, it’s not the first one) that demonstrates there was no protective benefit to the gut when using these drugs. As this was their big marketing ploy it makes you wonder why they ever were used in the first place. Especially as they were so much more expensive—Wait. Maybe that’s why they were pushed. Drug companies pushing expensive drugs that aren’t safe or effective. Say it ain’t true! The saddest commentary is all the people that deiced to keep taking these drugs anyway. Because they believed the ‘experts’ that there weren’t any other options.

 

DEADLY BACTERIAL ILLNESS APPEARS TO BE SPREADING

A deadly bacterial illness commonly seen in people on antibiotics appears to be growing more common -- even in patients not taking such drugs, according to a report published 12/1/05 in a federal health journal.

In another article in the New England Journal of Medicine, health officials said samples of the same bacterium taken from eight U.S. hospitals show it is mutating to become even more resistant to antibiotics.

"I don't want to scare people away from using antibiotics. ... But it's concerning, and we need to respond," said Dr. L. Clifford McDonald, an author of both articles and an epidemiologist at the federal Centers for Disease Control and Prevention.

"Hospitals need to be conducting surveillance and implementing control measures. And all of us need to realize the risk of antibiotic use may be increasing" as the bacteria continue to mutate, McDonald said.

The bacterium is Clostridium difficile, also known as C-diff. The germ is becoming a regular menace in hospitals and nursing homes, and last year it was blamed for 100 deaths over 18 months at a hospital in Quebec, Canada.

The article published in the CDC's Morbidity and Mortality Weekly Report focused on cases involving 33 otherwise healthy people that were reported since 2003 in Pennsylvania, Ohio, New Jersey, and New Hampshire. Most of the 33 hadn't been in a hospital within three months of getting sick, and eight said they hadn't taken any antibiotics in that span.

C-diff is found in the colon and can cause diarrhea and a more serious intestinal condition known as colitis. It is spread by spores in feces. The spores are difficult to kill with most conventional household cleaners. Even washing your hands with an antibacterial soap doesn't eliminate all the germs.

C-diff has grown resistant to certain antibiotics that work against other colon bacteria. The result: When patients take those antibiotics, particularly clindamycin, competing bacteria die off and C-diff explodes.

Ten of the 33 were otherwise healthy pregnant women or women who had recently given birth who had had brief hospital stays. The rest were people in the Philadelphia area who had not been in a hospital in the three months before their illness.

The New England Journal of Medicine article looked at C-diff samples taken between 2000 and 2003 from eight hospitals in six states -- Georgia, Illinois, Maine, New Jersey, Oregon, and Pennsylvania. The researchers found that a virulent strain of C-diff rarely seen before 2000 accounted for more than half of the samples taken in the hospitals. What's more, the BI strain -- as it is called -- seems to have built resistance to two of the newest antibiotics in the fluoroquinolones class commonly used in hospitals.

Much of the data was presented at a scientific meeting in Boston last year, McDonald said.

Another NEJM article looked at the occurrence of C-diff in 12 hospitals in Quebec. Researchers counted 1,703 patients with C-diff illnesses, and 422 died within 30 days of diagnosis. Exposure to fluoroquinolones and other antibiotics was clearly a risk for patients, according to the Canadian researchers who wrote the article.

DR. PAIS’S REVIEW: This is yet another result of the ubiquitous and often unnecessary use of antibiotics over the last 20-25 years. We end up with pathological, resistant strains. The moral is, don’t use antibiotics unless they’re needed. Some of the conditions that lend themselves well to other approaches—ear infections, colds, urinary tract infections, sinus infections, some throat infections, some respiratory infections, and yeast infections.

 

POISONINGS FROM A PAIN RELIEVER

Despite more than a decade's worth of research showing that taking too much of a popular pain reliever can ruin the liver, the number of severe, unintentional poisonings from the drug is on the rise, a new study reports. The drug, acetaminophen, is best known under the brand name Tylenol. But many consumers don't realize that it is also found in widely varying doses in several hundred common cold remedies and combination pain relievers.

These compounds include Excedrin, Midol Teen Formula, Theraflu, Alka-Seltzer Plus Cold Medicine, and NyQuil Cold and Flu, as well as other over-the-counter drugs and many prescription narcotics, like Vicodin and Percocet.

The authors of the study, which is appearing in the December 2005 issue of Hepatology, say the combination of acetaminophen's quiet ubiquity in over-the-counter remedies and its pairing with narcotics in potentially addictive drugs like Vicodin and Percocet can make it too easy for some patients to swallow much more than the maximum recommended dose inadvertently.

"It's extremely frustrating to see people come into the hospital who felt fine several days ago, but now need a new liver," said Dr. Tim Davern, one of the authors and a gastroenterologist with the liver transplant program of the University of California at San Francisco. "Most had no idea that what they were taking could have that sort of effect."

Dr. Davern and a team of colleagues from other centers led by Dr. Anne Larson at the University of Washington Medical Center in Seattle, tracked the 662 consecutive patients who showed up with acute liver failure at 23 transplant centers across the United States from 1998 to 2003.

Acetaminophen poisoning was to blame in nearly half the patients, the scientists found. The proportion of cases linked to the drug rose to 51 percent in 2003 from 28 percent in 1998. "It's a grisly way to die," Dr. Davern said, adding that patients who survive sometimes suffer profound brain damage.

In at least 48 percent of the cases studied, the liver failed after a smaller, unintentional assault by the drug over several days. "I see some young women who have been suffering flu-like symptoms for the better part of a week, and not eating much," Dr. Davern said. "They start with Tylenol, and maybe add an over-the-counter flu medicine on top of that, and pretty soon they've been taking maybe six grams of acetaminophen a day for a number of days. In rare cases that can be enough to throw them into liver failure."

Each Extra Strength Tylenol tablet contains half a gram, or 500 milligrams, of acetaminophen, and arthritis-strength versions of the pain reliever contain 650 milligrams. One tablet of Midol Teen formula contains 500 milligrams of acetaminophen, as does one adult dose of NyQuil Cold and Flu. One dose of Tylenol Cold and Flu Severe contains 1,000 milligrams. The recommended maximum daily dose for adults is 4 grams, or 4,000 milligrams.

"Part of the problem is that the labeling on many of these drugs is still crummy," said Dr. William Lee, a liver specialist at the University of Texas Southwestern Medical Center in Dallas, who for years has been lobbying the Food and Drug Administration to make manufacturers put "acetaminophen" in large letters on the front of any package that contains it, so that as they reach for the bottle, patients will be more likely to pause and keep track of exactly how much they are swallowing.

Some companies have voluntarily added new warnings about acetaminophen's risk to the liver, and they should be given credit for that, said Dr. Charles Ganley, director of the F.D.A.'s Office of Nonprescription Products. "But labeling isn't where I would like it to be," Dr. Ganley added. "I urge consumers to read the label," she said. "Anything more than the recommended dose is an overdose." Dr. Lee said he was disturbed by a pattern: "that acetaminophen is always billed as the one to reach to for safety, probably even more so now, with other pain relievers pulled from the market."

Experts agree that a vast majority of people can safely take the four-gram daily maximum that labels recommend for adults - the equivalent of eight Extra Strength Tylenol spread across 24 hours - and some people swallow much more without harm.

But by eight grams in a single day, a significant number of people whose livers have been stressed by a virus, medication, alcohol, or other factors would run into serious trouble, Dr. Lee said. Without intervention, about half the people who swallowed a single dose of 12 to 15 grams could die.

How much alcohol over what time period is problematic? Recent research suggests the answer isn't simple. The package labels now warn anyone who drinks three or more drinks every day to consult a doctor before taking acetaminophen, but Dr. Lee thinks that people who are sober during the week but binge on weekends may be vulnerable, too.

The few days of fasting that can accompany a bad stomach bug also seem to increase the liver's vulnerability to acetaminophen. And though safe levels of the drug for large men may, in general, be higher than those for small women, obese people aren't protected; extra fat in the liver seems to prime the organ for further damage.

Nearly two-thirds of the people in the transplant center study who unintentionally poisoned themselves were taking one or another of the roughly 200 prescription drugs that contain acetaminophen plus an opiate. Among the most popularly prescribed drugs in this group include hydroconebitartrate plus acetaminophen, which is commonly sold as Vicodin, and oxycodone hydrochloride plus acetaminophen, better known as Percocet.

Some patients who take these drugs chronically soon find they need increasing mounts to achieve the same level of pain relief. Because the narcotic part of the compound can be addictive, its accompanying doses of acetaminophen climb sky high in lock step. The liver may keep pace with gradual increases of the drug initially, only to suddenly crash months later. It is the acetaminophen that kills the liver.

DR. PAIS’S REVIEW: There are 9.8 grams of acetaminophen in a 10-ounce bottle of NyQuil. Yet it stays on the market. Even though NyQuil is often used by juveniles for its alcohol content. Do you think that an herbal extract that had 2x the liver killing dose of an ingredient would be allowed to stay on the shelf?

 

EMERSON ECOLOGICS

I am often asked what supplements I recommend. Many of you have been surprised to discover that I favor food over pills; lifestyle changes over fads. I have been working with nutrition for 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 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 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 any of you would like to check out Emerson Ecologics online here is the address of their home page: http://www.emersonecologics.com/Main.asp Here you will find information on herbal products and nutritional supplements as well as product specials. If you have any questions about these items feel free to email me.

 

NEW OFFICE LOCATION

Dr. Solley has built a new, state-of-the-art facility and I have moved into my office there as of Monday, September 26, 2005. The new office address is 580 E. Third St., Williamsport, PA. This building is next to East End Lumber and across the street from Price Optical. My phone number remains 570-320-0747. My email address remains This e-mail address is being protected from spam bots, you need JavaScript enabled to view it ( This e-mail address is being protected from spam bots, you need JavaScript enabled to view it also works).

Coming from the West: Hwy. 220/180: Take the Faxon exit. Turn left at the first light (Shiffler Ave.). Then turn left at the next light (East Third St.). Go about 1 mile. On the left hand side (South side) of the street you will see a building with metal siding—this is 580 East Third St. It’s directly across from Price Optical. If you pass East End Lumber you just missed it.

Coming from the East: Hwy. 220/180: Take the Faxon exit. Turn left at the 2nd stoplight—East Third St. Go about 1 mile. On the left hand side (South side) of the street you will see a building with metal siding—this is 580 East Third St. It’s directly across from Price Optical. If you pass East End Lumber you just missed it.

Coming from the South: 15 North into Williamsport. The first electric light after crossing the bridge is Third St. Turn right. From this corner it is approximately 5 tenths of a mile (.5 mile) to my new office. It is on the right side (South side) of the street you will see a building with metal siding—this is 580 East Third St. It’s directly across from Price Optical. It’s the next building after East End Lumber.

Coming from the North: 15 South and take 220 North/180 East into Williamsport. Take the Faxon exit. Turn left at the first light (Shiffler Ave.). Then turn left at the next light (East Third St.). Go about 1 mile. On the left hand side (South side) of the street you will see a building with metal siding—this is 580 East Third St. It’s directly across from Price Optical. If you pass East End Lumber you just missed it.

 

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.

Happy New Year!
Gregory Pais, ND, DHANP