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Dr. Gregory Pais, ND
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Home arrow Naturopathic News arrow Issue #44 - May 2006
Issue #44 - May 2006

Welcome to this issue of Naturopathic News, issue #44. 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.


GREAT NEWS
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BACKGROUND, TRAINING, EXPERIENCE
I first wrote extensively about my background and training in February 2005. For those of you who missed it the first time or have joined since, I thought it would be helpful to do so again.

The main impetus behind my decision to attend the National College of Naturopathic Medicine (NCNM) in Portland, Oregon was my focus on homeopathic training. At that point, 1988, I had worked with nutrition for 15 years, done bodywork for 14 years, and been an herbalist for 6 years. Like many practicing homeopaths, my desire to learn the art and science of homeopathy came about by being successfully treated homeopathically. Though I had worked with the major alternative healing modalities for years (including Traditional Chinese Medicine), once introduced to homeopathy I knew that it was the most powerful tool that I had experienced. The question was, where to get good training?

Unlike other practitioners content with correspondence courses I did not feel that a distance-learning situation was appropriate to fully study medicine. Plus, how could I truly learn the structure and function of the human organism by just reading a book? I felt that for me to offer powerful healing modalities like nutrition, homeopathic medicine, etc., I needed hands on medical training. Since the last medical school that taught homeopathy in the United States closed in the 1940s, I chose naturopathic medical school. The fundamental principles of naturopathy are similar in nature to the philosophy that underlies homeopathy. And it is much safer and much less obstructive to the healing process to give an herb or a supplement as opposed to falling back on conventional medicine.

The program at NCNM was 4 years of classroom and clinical training. In the 4200 hours that made up the requirement I took all of the homeopathic courses available (7 11-week quarters), and externship with practicing homeopaths (150 hours). I also worked in a homeopathic free clinic in downtown Portland for 3 semesters. I basically crammed in as much homeopathy as possible to go along with the anatomy, physiology, histology, gynecology, geriatrics, and all the other courses that make up modern day medical school. NCNM has one of the best homeopathic libraries in the country with masterpieces both modern and historical. In four years I made it through most of the several hundred homeopathic texts that were available, the dozens of homeopathic medical journals from the US and other countries, and an extensive collection of taped homeopathic seminars with some of the world's best homeopathic teachers. I had chosen NCNM because it had the best homeopathic department and the most extensive homeopathic library. I was the proverbial kid in the candy shop.

The principles and philosophy of homeopathy are not dried dicta with no application in daily practice. Every semester from second year on, including the summers, we spent an increasing number of hours in clinic. First under the strict supervision of the physicians on staff, but more and more on our own with their guidance and support. Working with patients is where you put the principles and philosophy into practice. We saw everything-Breast cancer, HIV, suicidal depression, herniated discs, etc. It was a great way to learn homeopathy-in the trenches.

No matter how good my training was, no matter how much homeopathy I had studied, despite the extensive background I already had, starting private practice was the true test. I graduated in 1992, passed my naturopathic medical board exams, and received my Oregon state naturopathic license. I ended up in Ft. Collins, CO where I practiced from 1993-1997. This is where I successfully treated my first case of multiple sclerosis, helped my first child patient diagnosed with Asperger's syndrome, weaned my first patient off Zoloft, and saw women comfortably deal with menopause without the need of prescription hormones. In some ways I had it easy (and still do). I had the power of naturopathic medicine 'watching my back'. 6-month-old baby with a fever-no problem-wet socks to the rescue. When one of my patients asked me to treat her 8-year-old son when he had pneumonia, homeopathy and hydrotherapy saw him through. Herbs, supplements, hydrotherapy, nutrition, I used it all where and when appropriate. And my patients got well-hundreds of them.

Professionally the time I spent in Ft. Collins was quite productive. In 1994, I decided to dedicate an entire year to using LM potencies. These potencies, though a part of homeopathy for 150 years were not well know or taught at that time. Many of my most difficult cases of serious pathology-ulcerative colitis, multiple sclerosis, etc., benefited by the expertise I gained in this area. By 1997 I felt ready to take my training to the next step. After studying the requisite materials I took the HANP board certification exam. DHANP stands for Diplomate of the Homeopathic Academy of Naturopathic Physicians. This is the national board certification in homeopathy for licensed naturopathic physicians. This certification represents a commitment to ongoing continuing education and a particular level of competency in homeopathic practice.

Our move to Pennsylvania in 1988 saw our family's dream of country living fully realized. Steam Valley Fiber Farm, north of Williamsport, is home not only to us but also angora goats, Jacobs sheep, border collies, Maremma guardian dogs, ducks, chickens, and a large organic garden and fruit orchard. This way of life sustains me and has helped me provide the best in naturopathic and homeopathic care to my patients.

I hope this has given you a sense of the context that I work within. Where I've come from, the training I've been through, and what I bring to the table when you walk in the door.


ADHD DRUGS SEND THOUSANDS TO ERs
In a series of letters in the May 25 2006 issue of the New England Journal of Medicine, it was revealed that accidental overdoses and side effects from attention deficit drugs likely send thousands of children and adults to emergency rooms every year. This is the first national estimate of the problem.

Scientists at the U.S. Centers for Disease Control and Prevention estimated problems with the stimulant drugs drive nearly 3,100 people to ERs each year. Other patients had side effects, including potential cardiac problems such as chest pain, stroke, high blood pressure and fast heart rate.

Concerns over those effects have led some doctors to urge the Food and Drug Administration to require a "black box," its most serious warning, on package inserts for drugs such as Ritalin, Concerta, and Adderall.

An estimated 3.3 million Americans who are 19 or younger and nearly 1.5 million ages 20 and older are taking ADHD medicines. Ritalin is made by Novartis Pharmaceuticals Corp. of East Hanover, N.J.; Concerta by Johnson & Johnson of New Brunswick, N.J., and Adderall by Shire US Inc. of Newport, Ky.

Twenty-five deaths linked to ADHD drugs, 19 involving children, were reported to FDA from 1999 through 2003. Fifty-four other cases of serious heart problems, including heart attacks and strokes, were also reported. Some of the patients had prior heart problems.

Still, there hasn't been a clear estimate of the extent of side effects. The CDC report, while not a rigorous scientific study, attempts to provide that by using a new hospital surveillance network.

From August 2003 through December 2005, the researchers counted 188 ER visits for problems with the drugs at the 64 hospitals in the network, a representative sample of ERs monitored to spot drug side effects.

Doctors linked use of stimulant ADHD drugs to 73 patients with side effects or allergic reactions. Another 115 accidentally swallowed ADHD pills, including a month-old baby, or took too much.

Nearly 1 in 5 patients were admitted to the hospital, 1 in 5 needed stomach pumping or treatment with medicines, and 1 in 7 had cardiac symptoms. Sixteen percent of the side effects involved interaction with another drug.

Besides cardiac problems, common symptoms included abdominal pain, rashes and spasms, pain or weakness in muscles, according to Cohen. No patients died.

Extrapolating to all U.S. hospitals, the researchers estimated 3,075 ER visits occur each year.

This past February, an FDA drug safety advisory panel voted 8-7 for a black box warning. The next month, another FDA panel instead recommended data on cardiac and other risks go in a new "highlights" section the agency plans to add to the top of drug inserts.

Dr. Steven Nissen, cardiology chief at the Cleveland Clinic, who had pressed for a black box warning at the FDA panel meeting, said ADHD drugs are powerful stimulants and inherently risky. Nissen and other doctors say the drugs are being prescribed to some who don't need them.

DR. PAIS'S COMMENTS: The inherent bias in this kind of report is that there is no other treatment for the conglomeration of symptoms labeled as ADHD. Yet there are anecdotal reports and doctor success stories that show the positive effects of homeopathy and other natural therapies. None of my patients seeking care for labeled ADHD have gone to the ER, or had an allergic reaction, or suffered a heart attack or stroke.


NUTRITION TIED TO ASTHMA RISK
People with symptomatic asthma eat less fruit and consume less vitamin C and manganese than people who don't have the disease, a new study shows. The findings are reported in the medical journal Thorax.

The diets of 515 adults who had been diagnosed with asthma were compared 515 "controls" -- similar adults without the disease. All reported their food intake over a one-week period. One-third of the asthma patients reported having had no symptoms in the past 12 months.

Asthma patients ate an average of 132.1 grams of fruit daily, compared to 149.1 grams for healthy controls. Those who ate at least 46.3 grams of citrus daily had about half the risk of having asthma with symptoms compared to those who ate no citrus fruit at all. Lower intake of both vitamin C and manganese were tied to an increased risk of symptomatic asthma, while symptomatic asthma patients had significantly lower levels of plasma vitamin C than healthy controls.

The researchers concluded: "These findings may be of public health importance in understanding the apparent increase in the prevalence of asthma."
Thorax, May 2006.

DR. PAIS'S COMMENTS: The importance of Vit. C (with bioflavonoids) cannot be overstated. Manganese is only the tip of the iceberg when it comes to looking at other related nutrients. This most recent research is further confirmation of the nutritional aspects of this disease. Caregivers need to be informed and then advise their patients to make these simple yet powerful changes.


OMEGA-3 ESSENTIAL FATTY ACIDS FOR NECK AND BACK PAIN
In a study involving 250 patients diagnosed by a neurosurgeon with nonsurgical neck or back pain, daily supplementation with omega-3 fatty acids was found to significantly alleviate pain and reduce the need for prescription NSAID (non-steroidal anti-inflammatory) medications. At the start of the study, all subjects were taking prescription NSAID medication. Subjects were asked to take daily fish oil supplements totaling 2,400 mg/day omega-3 fatty acids (EPA and DHA) for the first two weeks. They were then asked to cut the dose in half, to 1,200 mg/day. Results from questionnaires filled out by half of the subjects (125) after an average of 75 days on fish oil reported significant improvements in pain, as compared with prior to fish oil supplementation

60% of subjects reported improvements in overall pain; 60% reported improvements in joint pain; 59% reported discontinuing their NSAID medications; 80% reported satisfaction with their improvement; and 88% reported that they would continue taking the fish oil supplement. No significant side effects were reported. Although the study was not placebo-controlled, these results suggest the safety and effectiveness of omega-3 fatty acids in the treatment of nonsurgical neck or back pain.

The authors point out that their findings mirror the results from other controlled trials that have showed the effectiveness of omega-3 fatty acids as compared to ibuprofen, for the treatment of arthritic pain.

"Omega-3 fatty acids (fish oil) as an anti-inflammatory: An alternative to nonsteroidal anti-inflammatory drugs for discogenic pain" Maroon JC, Bost JW, Surg Neurol, 2006; 65(4): 326-31

DR. PAIS'S COMMENTS: Given the prevalence of back and neck pain, and the side effects and complications associated with the use of NSAIDs (such as gastric ulcers and myocardial infarction), it only makes sense to look for safe alternatives like omega-3 essential fatty acids. Just remember, the quality of many fish oil supplements is highly suspect, causing more harm then good.


SUICIDE RISK AND PAXIL
The antidepressant Paxil may raise the risk of suicidal behavior in young adults, GlaxoSmithKline and the Food and Drug Administration warned in a May12 2006 letter to doctors.

A recent analysis of clinical trial data on nearly 15,000 patients treated with both Paxil and dummy pills revealed a higher frequency of suicidal behavior in young adults treated with the drug, according to the letter. The FDA reported that there were 11 suicide attempts among the patients given Paxil in the trials. Just one of the dummy pill patients attempted suicide. Eight of the 11 attempts were made by patients between the ages of 18 and 30. All trial patients suffered from psychiatric disorders, including major depression.

In the letter to doctors, Dr. John E. Kraus, the company's director of clinical development for clinical psychiatry in North America, said GlaxoSmithKline PLC continues to believe the drug's benefits outweigh its risks.

The FDA stressed that all patients, especially young adults and those who are improving, should be carefully monitored when treated with Paxil.

In 2004, the FDA ordered strong warnings about the pediatric risk of suicidal tendencies put on antidepressant labels, and began analyzing whether adults face a similar risk.

DR. PAIS'S COMMENTS: It's a sad commentary on the state of medicine that a group of drugs known to increase the risk of suicide in depressed patients is considered to have an acceptable risk/benefit profile. I know of no homeopathic medicine that has ever been even remotely considered to increase the risk of suicide in depressed patients.


VITAMIN D AND RHEUMATOID ARTHRITIS

Women with the highest levels of vitamin D intake are about one third less likely to develop rheumatoid arthritis (RA) than women with the lowest levels, findings from a new study suggest.

Although vitamin D is best known for its role in building bones, it also has effects on the immune system, as reported in the May 2006issue of Arthritis and Rheumatism.

To determine the effect of vitamin D intake on rheumatoid arthritis risk, data was analyzed from nearly 30,000 women, between 55 and 69 years of age, who participated in the Iowa Women's Health Study.

All of the women were rheumatoid arthritis-free at study entry in 1986, and vitamin D intake was ascertained through food frequency questionnaires.

During the 11-year follow-up period, 152 confirmed cases of rheumatoid arthritis were identified, the investigators report.

Both dietary and supplemental vitamin D intake were inversely linked with rheumatoid arthritis risk, the authors found. High dietary (at least 290 IU/day) and supplemental (at least 400 IU/day) intake were associated with 28 percent and 34 percent reductions, respectively, in the risk of rheumatoid arthritis.

DR. PAIS'S COMMENTS: It is very likely that Vitamin D deficiency is the most common vitamin deficiency in this country. Given that everybody has been told to stay out of the sun for the last 20 years it's no surprise. More and more these days I'm recommending that certain patients have a Vitamin D test done (25(OH)D, also called 25-hydroxyvitamin D). I've yet to see one test result come back within the healthy range.


VITAMIN SUPPLEMENTS ARE SAFE
An independent panel of university faculty, medical researchers, and physicians experienced in nutritional therapeutics says that vitamin supplements are exceptionally safe for the public. A May 2006 report by the expert Vitamin Safety Review Panel rebuts a recent US National Institutes of Health report that attempted to cast doubt on food supplement safety.

"Over half of all Americans take vitamins every day," said Andrew Saul, Assistant Editor of the Journal of Orthomolecular Medicine. "One cannot help but ask, where are the bodies? The NIH panel ignored pharmaceutical drug dangers, while concentrating on unfounded concerns over your daily multivitamins. This indicates bias."

According to statistics compiled annually by the American Association of Poison Control Centers, multivitamins kill no one. Gross overdose of iron (not a vitamin) has been associated with perhaps two deaths per year. On the other hand, in 2003, there were 59 deaths from aspirin alone. That is a death rate nearly thirty times higher than that attributed to iron supplements. There were still more deaths from aspirin in combination with other pharmaceutical products. In 2003, two people died from caffeine. Three people died from dishwashing detergent. There was also a death from "Cream/lotion/makeup," a death from granular laundry detergent, and one death from table salt.

On the other hand, says the Vitamin Safety Review Panel, there is not one death per year from any vitamin in the alphabet. Not from A, B's, C, D or E. Michael Janson, MD, said, "In decades of people taking a wide variety of dietary supplements, few adverse effects have been noted, and zero deaths as a result of the dietary supplements. There is far more risk to public health from people stopping their vitamin supplements than from people taking them."

Another Vitamin Safety Review panelist is Abram Hoffer, MD, who also has a PhD in nutritional biochemistry. Dr Hoffer said, "Vitamin supplements are extraordinarily safe and effective. This is based on fifty years of clinical experience without seeing any life-threatening side effects and no deaths. It is pharmaceutical drugs that are dangerous. Perhaps the US Food and Drug Administration is getting tired of all the bad news about drugs, so instead they are going after nutritional supplements."

Carolyn Dean, ND, MD, agrees. "784,000 people are dying annually, prematurely, due to modern medicine," she said. "These are statistics from peer-reviewed journals and government databases."

Watson WA, Litovitz TL, Klein-Schwartz W, Rodgers GC Jr, Youniss J, Reid N, Rouse WG, Rembert RS, Borys D. 2003 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 2004 Sep;22(5):335-404.

DR. PAIS'S COMMENTS: For those of you who saw the NIH report this should bring some perspective. It's absurd to compare the safety of vitamin supplements with drugs. Drugs kill thousands of people every year. Vitamin supplements don't. Enough said.


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 (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