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Dr. Gregory Pais, ND
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Home arrow Naturopathic News arrow Issue #45 - June 2006
Issue #45 - June 2006

Welcome to this issue of Naturopathic News, issue #45. 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.

In a 2-year, prospective, multicenter, cohort study involving 3,981 patients who chose to receive homeopathic treatment, findings indicate that homeopathic treatment may have a beneficial role in the long-term care of patients with chronic diseases.

The patients included 2,851 adults (29% men, mean age: 42.5 years) and 1,130 children (52% boys, mean age: 6.5 years) receiving homeopathic treatment from 103 physicians in primary care practices in Germany and Switzerland. Independently of their physicians, patients rated the severity of their complaints on a numeric rating scale (0--no complaints, 10--maximum severity) at baseline and after 3, 12, and 24 months. Physician assessments and quality of life were also assessed at baseline, and after 3, 12, and 24 months.

97% of the patient diagnoses were chronic with an average duration of 8.8 years, where the most frequent diagnoses were allergic rhinitis in men, migraine in women, and atopic dermatitis in children. Patient assessments of disease severity significantly decreased from 6.2 in adults, (6.1 in children) at baseline to 2.2 (2.2 in children) after 24 months; physician assessments showed similar results. Quality of life significantly improved in adults and children at 24 months compared to baseline, but no changes were observed in adolescents. Additionally, greater disease severity and younger age at baseline were predictive factors of better therapeutic effects of homeopathic treatment.

Thus, the findings of this study indicate that disease severity and quality of life improved in patients undergoing long-term treatment with homeopathy, and suggests that homeopathic therapy may play a beneficial role in the long-term care of patients with chronic diseases.

Homeopathic medical practice: long-term results of a cohort study with 3981 patients, Witt CM, Ludtke R, et al, BMC Public Health, 2005; 5: 115.
DR. PAIS'S COMMENTS: This is an exciting study. It affirms what thousands of homeopathic practitioners and tens of millions of patients already know—Homeopathy Works! Even better, 'greater disease severity' was a better predictor of therapeutic success. In other words, the worse you are the more successful homeopathy will be for you. I don't think the results with adolescents are truly reflective of any lack on homeopathy's part. It's more representative of how necessary it is to personalize and individualize homeopathic care.

An article titled "Bisphosphonate-associated Osteonecrosis of the Jaws and Endodontic Treatment: Two Case Reports," in the October 2004 issue of the Journal of Endodontics (JOE), a publication of the American Association of Endodontists (AAE), suggests patients using bisphosphonates as part of their cancer treatment or for bone diseases such as osteoporosis and Paget's disease, are at risk of experiencing a painful, disfiguring condition known as osteonecrosis of the jaw, a disease that leads to the breakdown of the bone. Osteonecrosis literally means 'death of bone' (osteo = bone, necrosis = death).

Initial symptoms include burning, tingling or localized pain in the jaw, and may lead to more serious complications, such as infections and jawbone degeneration. Patients who think they may be experiencing symptoms of osteonecrosis of the jaw should seek counsel from their general physicians and oncologists, and inform their dentists, endodontists, and other dental professionals that they are undergoing treatment with bisphosphonates.

The latest generation of bisphosphonates includes alendronate (Fosamax); pamidronate (Aredia); and zoledronate (Zometa).

The article indicates that at the same time bisphosphonates affect bone, in areas weakened by disease or as a side effect of treatment, some patients taking bisphosphonates may experience the bone degeneration in the lower and upper jawbones. As there are a large number of patients around the world using bisphosphonates for prevention or treatment of osteoporosis, dentists may be dealing with a significant potential complication.

The article suggests that problems in some patients using bisphosphonates may be triggered by a dental procedure, such as a tooth extraction, or could occur spontaneously.

To prevent complications, the article suggests that those who take bisphosphonates seek counsel from their medical and dental providers before any elective dental procedures, and that any non-elective dental work, especially extractions, which, the article notes appear to precipitate the majority of this condition be done before starting bisphosphonate therapy.

It is estimated that among the 500,000 American cancer patients who take the drugs because their disease is affecting their bones, 1 to 10 percent may develop the problem. As for the millions of osteoporosis patients, no one knows how much they are affected. Some oral surgeons have dozens of cases.

Even if patients stop taking bisphosphonate drugs, they are not free of them. Bisphosphonates remain in bone for years, and no one knows how long the osteonecrosis risk remains. Some doctors and dentists suggest stopping the drugs for a few months before and after an invasive dental procedure. Others say six months to a year may be better. As for what happened to patients who developed the condition, oral surgeons say some got better but many did not.

The story of bisphosphonates began in 2003 with a letter in The Journal of Oral Maxillofacial Surgery calling osteonecrosis of the jaw "a growing epidemic." Its author, Dr. Robert E. Marx, chief of oral and maxillofacial surgery at the University of Miami, reported on 36 patients who had received intravenous bisphosphonates. All had "painful bone exposure," as is typical with the condition, and "were unresponsive to surgical or medical treatments," Dr. Marx wrote. "The common denominator," he said in a telephone interview, "was that they all had cancer. Then we started looking at their treatment. The one common thread was bisphosphonates."

Meanwhile, another oral and maxillofacial surgeon, Dr. Salvatore Ruggiero of Long Island Jewish Hospital, was gathering his own data. At first he saw patients with breast cancer or multiple myeloma who arrived with exposed bone in their mouths.

"It looks like a piece of ivory with little tiny holes in it," Dr. Ruggiero said. "The one drug they were all on was bisphosphonates." He tried scraping away the dead bone and letting it heal, but that only made things worse. "We were creating a larger bone wound that didn't heal," Dr. Ruggiero said. Dr. Ruggiero and others then began noticing something new: osteoporosis patients taking bisphosphonate pills who had developed osteonecrosis of the jaw. In 2004, he published a report on 63 patients - 56 with cancer, the rest with osteoporosis.

"The pharmaceutical industry has every desire that a patient who starts on a bisphosphonate would take it for life," said Dr. Robert Gagel of the M. D. Anderson Cancer Center in Houston. "The bone community, of which I am a member, has always been a bit suspicious of that viewpoint."
DR. PAIS'S COMMENTS: Over the years the story of the bisphosphonate group of drugs, Fosamax being the most well known, has been increasingly full of holes. There have been clinical reports about lack of efficacy after 1-2 year's dosage. And some hard to find reports that bone structure after Fosamax use was not as sound as originally thought.

Instead of looking at Fosamax first I suggest that you be tested for Vit. D deficiency. Vitamin D is probably the most common vitamin deficiency that I see in my practice. If body levels are below optimum it makes sense to address this and see the effects on bone health. Optimal 25-hydroxyvitamin D values are: 45-50 ng/ml. Anything less than this may need nutritional supplementation depending on your symptoms and health history. Don't just take 'extra' Vit. D on your own as too much can cause problems.

A type of screening called magnetic resonance spectroscopy may reduce the need for biopsies of breast abnormalities by 58%.

Researchers at the Memorial Sloan-Kettering Cancer Center in New York City found that when MR spectroscopy was conducted in addition to MRI screening for breast abnormalities, 23 out of the 40 masses would not have needed biopsy -- and all of the cancers would have been caught.

"All cancers in this study were identified with MR spectroscopy. There were no false-negative results," said lead researcher Dr. Lia Bartella. "With the addition of MR spectroscopy to our breast MRI exam, we found that the number of biopsies recommended on the basis of MRI findings decreased significantly. These results should encourage more women to take this potentially lifesaving test."

In the study, 56 patients with 57 breast abnormalities were screened in three ways: first using standard MRIs, then with MR spectroscopy, and finally by biopsy. "Breast tumors have elevated levels of choline compounds, which are a marker of an active tumor," Bartella said. "By performing a brief (only 10 additional minutes) MR spectroscopy procedure after an MRI scan, we can see which tumors show elevated choline levels, and therefore which lesions are likely malignant. This eliminates the need for biopsy to find out what the tumor is made of."

As reported in the June 2006 issue of Radiology, biopsy results confirmed 31 malignancies and 26 benign masses. After results of all three tests were compared, all 31 malignant masses were correctly identified using MR spectroscopy (100 percent sensitivity), 23 of 26 benign masses identified with MR spectroscopy (88 percent sensitivity). The three incorrectly diagnosed masses showed higher levels of choline on the MR spectroscopy, but were discovered to be benign upon biopsy.

"MR spectroscopy is fast and well-tolerated, and could be readily incorporated into a breast MRI examination," said Bartella. "By reducing the number of benign biopsies recommended at MRI, the use of MR spectroscopy will not only reduce patient morbidity, but will save unnecessary anxiety, cost and time for both the patient and the medical staff."
DR. PAIS'S COMMENTS: I thought this was an interesting story due to the potential this technology has for reducing unnecessary breast biopsies. Many practitioners have been ambivalent concerning the risk/benefit of breast biopsies. The risk being that cancer cells would spread from a previously encapsulated tumor once the biopsy was performed. What’s exciting here is that there is no radiation exposure with this technology. Which means that unlike the standard mammogram (which exposes your breast to ionizing radiation) there is no increased breast cancer risk by using this technique.


Two studies presented at the 97th meeting of the American Association for Cancer Research (AACR) suggest a major role of vitamin D in the prevention of breast cancer. Several risk factors have been associated with an increased incidence of breast cancer. These include a positive family history of breast cancer, an early age at first menstrual cycle, and a late age at menopause (the risk increases with a higher number of menstrual cycles). Additional risk factors include a late age at the birth of the first child, the use of hormone replacement therapy, the use of oral contraceptives, a high-fat diet, and obesity.

While the role of vitamin D in breast cancer incidence has not been well explored, some epidemiological studies suggest that vitamin D deficiency increases the incidence of breast cancer. Researchers from the Samuel Lunefeld Research Institute in Toronto suggest that exposure to high levels of vitamin D during childhood and early adulthood is associated with a reduced incidence of breast cancer.(1) These researchers compared sun exposure and consumption of vitamin D in 576 patients with breast cancer to 1,135 women without breast cancer. Results of this study were adjusted for age, ethnicity, and education, having a first-degree relative with breast cancer, early breast-feeding, age at menarche, and age at first birth. They reported that women who worked in an outdoor job between the ages of 10 and 19 years had a 40% reduction in the incidence of breast cancer, and frequent sun exposure between the ages of 10 and 29 years of age was associated with a 35% reduction in the incidence of breast cancer. These authors suggested that these exposures during critical growth of breast tissues could be of major importance.

Researchers from the University of California at San Diego suggest that increasing doses of vitamin D to three-times the current average for Americans may lower the incidence of breast cancer.(2) These researchers evaluated the association between breast cancer recurrence and levels of 25-hydroxyvitamin D in 1,760 women.

They identified a level of 25-hydroxyvitamin D (52 nanograms/ml) that was associated with a 50% reduction in the incidence of breast cancer. In order to achieve these levels, these authors suggested that a woman would have to consume 1,000 IU or more of vitamin D per day. They also stated that typical Americans only consume approximately 320 IU per day. They also stated that toxic levels of vitamin D are in excess of 3,800 IU per day. As well, they stressed that a higher intake is needed to compensate for lack of sun exposure in many women.
(1) Knight JA, Lesosky MR, Barnett H, et al. Potential reduction in breast cancer risk associated with vitamin D. Proceedings of the 97th AACR meeting, April 1-5, 2006.
(2) Garland CF, Mohr SB,Gorham ED, et al. Evidence of need for increased vitamin D fortification of good based on pooled analysis of studies of serum 25-hydroxyvitamin D and breast cancer. Proceedings of the 97th AACR meeting, April 1-5, 2006.
DR. PAIS'S COMMENTS: These and other data strongly suggest that the diet of Americans is deficient in Vitamin D at levels that are preventative of malignancy. All those years people have stayed out of the sun are catching up with us. When it comes to nutrition related health issues conventional medicine just can’t get it right. This has the potential to be the biggest boondoggle since they told everybody to eat margarine 35 years ago.

Starting this summer, there will be a lot more food labeled as organic on Wal-Mart's shelves, DON'T BE FOOLED.

Most of the nation's major food producers are hard at work developing organic versions of their best-selling products, like Kellogg's Rice Krispies, and Kraft's macaroni and cheese.

Why the sudden activity? In large part because Wal-Mart wants to sell more organic food - and because of its size and power, Wal-Mart usually gets what it wants. Wal-Mart has decided that offering more 'organic' food will help make it a lot more money as it can charge a premium for these items. In other words, food for profit, not for people.

Wal-Mart's efforts will ultimately hurt organic farmers, will lower standards for the production of organic food, and will undercut the environmental benefits of organic farming. And some nutritionists question the health benefits of the new organic products. "It's better for the planet, but not from a nutritional standpoint," said Marion Nestle, a professor of nutrition, food studies and public health at New York University. "It's a ploy to be able to charge more for junk food."

There are many reasons to buy true organically grown food. It is a healthier choice for you and your children when you eat it and better for the environment when it's grown. Organic food - whether produce, meat or grain - must be grown without pesticides, herbicides, insecticides, chemical fertilizers, hormones, and antibiotics. Before it is sold, the food cannot be treated with artificial preservatives, flavors, or colors, among other things.

While organic food is still just 2.4 percent of the overall food industry, it has been growing at least 15 percent a year for the last 10 years. Currently valued at $14 billion, the organic food business is expected to increase to $23 billion over the next three years.

But Wal-Mart's new push worries Ronnie Cummins, national director of the Organic Consumers Association, an advocacy group that lobbies for strict standards and the preservation of small organic farms. He said Wal-Mart did not care about the principles behind organic agriculture and would ultimately drive down prices and squeeze organic farmers. "This model of one size fits all and lowest prices possible doesn't work in organic," Mr. Cummins said. "Their business model is going to wreck organic the way it's wrecking retail stores, driving out all competitors." Part of the problem, Mr. Cummins said, is that Wal-Mart is making a push into organics at a time there is already heavy demand and not enough supply. "They're going to end up outsourcing from overseas and places like China," he said, "where you've got very dubious organic standards and labor conditions that are contrary to what any organic consumer would consider equitable."

Large-scale organic farming will not use the crop-rotation practices of the small farms, hurting the fields and reducing the nutritional benefits of organic food. Organic agriculture arose in the 1970's as a reaction to large-scale farms that confined animals and the increased use of pesticides and chemical fertilizers on crops. These conventional agricultural practices are harmful to the environment and to human health.
DR. PAIS'S COMMENTS: Junk is junk whether it's labeled as 'organic' or not. If there's a lot of sugar or salt in a product, or it's made with white flour, it matters little if the sugar or the flour is organic. The food industry has continued to try to gut the organic standards that were passed a few years ago. Factory raised animal foods won't be much more nutritious than their non-organic counterparts, no matter how organic the label proclaims. Be an informed consumer, don't be suckered in by Wal-Mart and others company's efforts to co-opt organic. You can depend on my newsletter and my website to keep you informed about this issue in the months ahead.

The number of children taking antipsychotic medicines increased 73% 2001-2005, far outpacing the increase in adults, according to a Medco Health Solutions Inc. report released on May 2. Use of the new class of drugs known as atypical antipsychotics by people 19 and younger skyrocketed 80 percent in the same time period.

These powerful drugs are for individuals with serious psychosis such as schizophrenia so there is some concern the medicines may not always be prescribed appropriately, said Dr. Amita Dasmanapatra, senior director of medical affairs at Medco. She said it is possible that some doctors are prescribing the drugs for children with behavioral problems, which would be better controlled by other means. Additionally, the atypical antipsychotics aren't approved for use in children.

The number of children on antipsychotics rose to 6.6 per 1,000 in 2005 from 3.81 per thousand in 2001. In contrast, 11 adults per 1,000 were taking one of the drugs. The increase in the number of adults taking antipsychotics rose 13% in the four years ended in 2005.

In 2003, The U.S. Food and Drug Administration asked manufacturers of atypical antipsychotics to add warning labels describing the increased risk of high blood sugar and diabetes. The drugs include Eli Lilly & Co.'s Zyprexa, AstraZeneca PLC's Seroquel, Bristol-Myers Squibb Co.'s Abilify and Pfizer Inc.'s Geodon.

Also, last year the FDA determined that elderly patients with dementia that were being treated with atypical antipsychotics had an increased risk of death. The FDA asked manufacturers to include a warning on the drugs' label about the risk, and note that the drugs are not approved to treat behavioral problems in patients with dementia.
DR. PAIS'S COMMENTS: There are several upsetting parts to this story. First, is the fact that drug use in this age group has increased so much. Second, these drugs aren't approved for use in this group of patients. Worse of all, these drugs may not be prescribed on their proper indications. Abraham Hoffer MD has documented thousands of cases of schizophrenia and similar diagnoses successful treatment with nutrition. Why are these drugs being considered before nutrition?

Back in May the headlines certainly sounded promising: "Bottlers agree to a school ban on sweet drinks" said the New York Times, "Companies pulling sodas out of school" claimed the Associated Press. Many other news stories around the country gave the impression that the beverage industry was acting in the best interests of children and all soda would disappear from schools forever.

Problem is, nothing could be further from the truth. On May 3, Big Cola announced yet another voluntary school sales policy. We don't even know all the details of this secretly negotiated deal. What we do know is that this new policy is completely voluntary, which means it's unenforceable, with no accountability. We are told that the "goal" is to implement the guidelines in 75% of schools by the 2008-09 school year, with the rest coming on board a year later. It's questionable how realistic achieving this goal really is given the long lead-in time.

From a health standpoint, the deal is a disaster. Diet soda full of artificial sweeteners, sports drinks high in sugar, and other empty-calorie beverages with zero nutritional value, are still allowed in high schools. On top of the products there's the advertising. From sports bags to school supplies kids are bombarded with soft drink marketing. This is really a shell game. Make it look like you're doing something, but ensure that you have access to your market.

Another problem is that this announcement could potentially undermine ongoing grassroots efforts, state legislation, and other enforceable policies that are actually trying to empty the soda machines and permanently remove them from our schools.
DR. PAIS'S COMMENTS: Zero nutritional value, empty calories, inordinate amounts of sugar, use of toxic sugar substitutes, and the list goes on. Why do we allow this crap in our schools in the first place? It's a sorry commentary on economic priorities that school systems have to prostitute kid's health to have enough money to pay for supplies.

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

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