Fish oils and statins April 2006

FHN Complementary Medicine Monthly Newsletter April 2006

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There is something fishy about statins !

Ok now that I have your attention let’s talk about the study that was reported in the Arch of Intern Med/Vol165 April 11, 2005. The study was entitled “Effect of Different Antilipidemic Agents and Diets on Mortality”. This was a met analysis literature review of some 97 studies covering 137,140 individuals looking at mortality (not cholesterol numbers!) from certain interventions. Mortality was from all reasons cardiovascular and non cardiovascular.

The study looked at statins (35 trials), fibrates(ie Gemfibrozil) (17 trials), resins (ie QUESTRAN ) (8 trials),niacin (2 trials), n-3 fatty acids (ie fish oil)(14 trials), and dietary (17 trials).

Without getting mired down into the statistical minuscia that goes on with this type of study the authors conclusion:

STATINS ARE THE BEST….oh yea n-3 fatty acids did OK too.

So lets look at the results

Mortality rate for Statins was .87 (1.0 would be with no intervention). Another way of saying this would be there was a 13% reduction in mortality rate from all causes .

Mortality rate for N-3 fatty acids was .77. Or a 23% reduction in mortality rate.

It seems to me that the conclusion should have been n-3 fatty acids did the best at reducing mortality with Statins coming in ….third. That’s right resins had a .84 rate and they weren’t even mentioned in the conclusion.

The others results were 1.00 for fibrates, .96 niacin, and .97 for dietary.

When they considered deaths from only cardiovascular reasons, fatty acids still were the best at .68, Statins were .78, and resins were .70.

An interesting thing happened looking at non cardiovascular deaths, fibrates actually increased it! 1.13 (a 13% increase). They concluded that this needed more study.

What is the bottom line…..TAKE your fish oils.

Sincerely

Drs. Glenn and Julie Smith

CoQ10 February 2006 Newsletter

FHN Complementary Medicine Monthly Newsletter February 2006

www.mrdrpilot.blogspot.com

Enzyme CoQ10 (ubiquinone)

We have previously talked about Co Q 10 (October 2002 you can read it on the website above) as it relates to statin drugs. If you are taking a statin drug you have to be taking CoQ 10!!!!!

Let’s look at different reasons to take Co Q 10. Coenzyme Q10 is essentially a vitamin-like substance. CoQ10 is found in small amounts in a wide variety of foods and is synthesized in all tissues. The biosynthesis of CoQ10 from the amino acid tyrosine is a multistage process requiring at least eight vitamins and several trace elements. Coenzyme Q10 is the coenzyme for at least three mitochondrial enzymes as well as enzymes in other parts of the cell.

Because it is essential in the mitochondria of the cells to make energy let’s look at the type of cells that are most susceptible to deficiencies. Normal muscle cells of the body have around 200 mitochondria per cell, heart cells have around 5000 per cell. Needless to say heart function is absolutely dependent upon CoQ10. Cardiovascular diseases such as CHF , hypertension, ischemia, cardiomyopathies, etc. all respond to supplementation of CoQ10.

To be effective,blood levels must reach high enough levels. Several factors can effect how effectively CoQ10 supplementation works. These include fatty acids (take CoQ with fish oils), C,E, selenium, carnitine.

For those of you with hypertension CoQ in high enough doses (1mg/lb) might help reduce your dependence on meds or help stabilize the meds. you are taking.

Clinical research is now looking at CoQ’s role in cancer…..stay tuned.

Drs. Glenn and Julie Smith

Endometriosis TCM Style January 2006

FHN Complementary Medicine Monthly Newsletter January 2006
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Endometriosis from a TCM ( Traditional Chinese Medicine) perspective

Endometriosis is a painful, chronic disease that affects 5 1/2 million women and girls in the USA and Canada, and millions more worldwide. From a western medicine standpoint it occurs when endometrium tissue is found outside the uterus. (Abdomen, uterus, rectum, etc.) This misplaced tissue develops into growths or lesions which respond to the menstrual cycle in the same way that the tissue of the uterine lining does. This results in internal bleeding, breakdown of the blood and tissue from the lesions, and inflammation -- and can cause pain, infertility, scar tissue formation, adhesions, and bowel problems.
TCM looks at and describes disease processes from a perspective of what is not moving correctly through the body. Qi, blood, and body fluids ( ie lymph) are all fundamental substances that are vital for the functioning of the human body and organ systems. A lack of proper movement (stagnation in TCM lingo) leads to the pathology in the body.

With that understanding endometriosis would fall into what TCM calls blood and fluid stagnation. TCM views blood formation starting with the food we eat and being acted on by the digestive system. So treatment for endometriosis has to start there. If we don’t have sufficient blood formation a stagnation occurs. Also in TCM if there is an improper formation function, body fluid formation is altered. Lymph becomes more viscous (thick) and masses/fibroids start to form.

So TCM would start to repair this function. First with replacing gut/ vaginal flora with acidophilus bacteria. Other foods that would be beneficial are spinach, lettuce, asparagus, eggplant, watercress, cucumber, turnip, food rich with chlorophyll, such as green leafy vegetables, grain grass and seaweeds, grapes, black grapes, black raspberries, red raspberries, pear, apple, mango, plum, cherries, fig, blueberries, white beans, black beans, adzuki beans, yellow beans, yellow bean sprouts, chestnuts, rice cooked for a long time, pearl barley, millet, tofu, milk, gelatin.
Meat: Small amounts of beef, organic liver.
Fish: Sardines.

Treatment is aimed at relieving the blood/fluid stagnation with acupuncture, herbs and mechanical stimulation. We have a high frequency lymph modality that can assist in moving the body fluid.

Many times as we restore these functions the symptoms disappear and normal function returns without the pain.

Sincerely


Drs. Glenn and Julie Smith
Complementary Medicine

Holiday Joy December 2005 Newsletter

FHN Complementary Medicine Monthly Newsletter December 2005

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Praise be to the Lord, to God our Savior, who daily bears our burdens. Psalm 68:19

As we approach the holiday season with all its’ busyness and hurrying around, let us take a minute to remember where we get our strength and the reason for the season. With all that has happened in the last year, with hurricanes, floods, war, etc. I am always humbled how God has moved through the various people at FHN to go out and help those people. We thank you for your sacrifice and for your service and pray that God continues to strengthen you.

We would also like to thank Dennis Hamilton for the great service he has done in his 20 years here. We wish him a full and healthy new stage of life!

Merry Christmas to all

Complemetary Medicine

Drs. Glenn and Julie Smith

Bone Density November 2005 Newsletter

FHN Complementary Medicine Monthly Newsletter November 2005

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Increasing Bone Density

Osteoporosis and bone fracture due to osteoporosis are a significant problem for people as we age or have bone loss due to drug therapy (ie steroids). Calcium (especially calcium apaitite) and Vit. D supplementation and exercise can help slow the loss and may show some moderate increases in density over time. For more severe cases osteoporosis drugs have been needed. Fosamax, Actonel, Bovina, etc. have been shown to reduce fractures by 40% , but in many cases have produced side effects. Those have included nausea, heartburn, GI problems, and in a few cases kidney failure.

So is there an alternative?

Sometimes something old becomes new again. Strontium! Strontium is a mineral (Sr) atomic weight of 87. (Not the radioactive Sr 90 of atomic weapon fears of the 1950’s).

Sr was used a hundred years ago for bone health but fell out a favor in the 1950’s. I guess people thought they would glow in the dark!

Recently studies looking at Strontium have shown it also can increase bone density in the 40% range over time. With one big advantage….. little to no side effects.

Studies show dosage ranges between 700 -1500 mg /day. Because Sr can interfere with calcium absorption it should be taken at a separate time from calcium ingestion.

Dosages at that level should be taken for 2-3 years for maximum bone density, unless you are on drugs that affect bone density and then continuous usage would be required .

Sincerely

Drs. Glenn and Julie Smith

Complemetary Medicne

Dark chocolate October 2005 Newsletter

FHN Complementary Medicine Monthly Newsletter October 2005

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Dark chocolate …it’s for you!

All right, let’s have some fun this month. At the risk of admitting that all the females have been correct about chocolate, especially around menstruation time, dark chocolate may be good for you!

A study published in Hypertension 2005;46(2):398-405 took dark chocolate and gave it to 20 patients with essential hypertension that had never been treated. The subjects were feed 100g/day of chocolate containing flavonols for 15 days. A second group were given 90 grams/ day of dark chocolate with out flavonols for 15 days. After a 7 day rest from chocolate ( wash out period) the subjects groups switched ( crossed over) and the non flavonol group now got the flavonols and vice versa.

The results…. the flavonol group lowered BP (systolic -11.5 ave and diastolic -8.5 ave.) , the non flavonol group did not. Interestingly enough the flavonol groups’ cholesterol came down as did there oral glucose tolerance test.

We have talked about other flavonols in the past such as quercetin. This is another example of whole foods having rich healing properties.

The darker the chocolate the better! I don’t want any I told you so’s!!

Sincerely

Drs. Glenn and Julie Smith

Complementary Medicine

Integrative Oncology September 2005 Newsletter

FHN Complementary Medicine Monthly Newsletter September 2005

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Integrative Oncology

Just got back from New York City and Memorial Sloan-Kettering Cancer Center (MSKCC) where I participated in a conference and did grand rounds with their Integrative Medicine Department. The conference was focused on Acupuncture in oncology, but MSKCC is doing multiple disciplines in the hospital from music therapy to massage, acupuncture to karate.

Currently MSKCC is using acupuncture at all stages of cancer care in conjunction with standard and investigational cancer treatments.

Acupuncture is being used for:

Pain control in all stages. They involve this early on and have found that use of traditional pain meds are substantially decreased. In addition they have found hospital stays are shortened.

Symptom relief from chemotherapy and radiation treatments. This is especially true of treatment of nausea and vomiting and neuropathy prevention and treatment.

Fatigue due to anemia and cytotoxicity.

Immune system modulation. Improving T-cell count and Lymph counts.

Help with urination and defecation after surgery.

MSKCC is doing some interesting research on acupuncture and herbs in oncology.

One of the projects involves using functional MRI while doing acupuncture and watching the areas of increased metabolic activity at various brain centers.

One project involves studying the use of the Chinese herb of Coptis in solid tumors.

Over the 7 year history of the integrative medicine department they have gone from 2 people to a department of over 50 and growing.

Some food for thought for FHN.

Sincerely

Dr. Glenn Smith

Complementary Medicine

August 2005 Newsletter Neurotransmitter Testing

FHN Complementary Medicine Monthly Newsletter August 2005

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Neurotransmitter Testing

Last month we talked about SSRI’s and TAAT (targeted amino acid therapy). One of the problems with the usage of SSRI’s or SNRI’s is picking the right one or titrating the right dose. Up to now that has been done by the clinical skill of the physician, which at times can be hit or miss. Assaying the brain levels has proven clinically difficult as CSF is not practical to obtain. There are several studies that have shown that HPLC testing of urine can be used to assay neurotransmitters with results that compare with CSF levels. A lab in Wisconsin ‘NeuroScience’ has started to offer this type of testing.

Knowing what the status of the individual neurotransmitters are can be invaluable in decided what class of antidepressant to use. Further targeted amino acid therapy can be added to address long term deficiencies.

Therapeutic doses can be titratated with additional testing after the start of a therapeutic regimen.

Up to now we have been talking about depression but the same approach can be used with other neurotransmitter sensitive problems such as ADD and ADHD.

Sincerely,

Drs. Glenn and Julie Smith

Complementary Medicine

Newsletter July 2005 SSRI's and TAAT

FHN Complementary Medicine Monthly Newsletter July 2005

www.mrdrpilot.blogspot.com

SSRI’s and TAAT

SSRI’s (and SNRI’s) have been well established in the medical community. In some patients they provide symptom relief for depression and anxiety related problems. However many patients fail to find the relief they are looking for on the meds, which may become ineffective over time even at higher doses. So let’s look at that issue.

SSRI’s block the reuptake of serotonin (SNRI’s block norepinephrine) from the synapse into the neuron allowing more serotonin to be available to bind with serotonin receptors. However, it is important to note that they do not add to the total serotonin supply in the body. Several studies have shown that SSRI functioning is dependent on serotonin stores in the body. In one study tryptophan (serotonin precurser) was removed dietarily from patients taking SSRI’s. Depressive symptoms worsened in that patient population.

So what is TAAT? TAAT stands for targeted amino acid therapy. As you can surmise from that last study, tryptophan supplementation in the form of 5 HT tryptophan can greatly enhance SSRI therapy. Other amino acids like tyrosine are used in the synthesis of epinephrine and norepinephrine, theanine helps with GABA which is the main inhibitory neurotransmitter. Different combinations of amino acids and herbs can help push different pathways of neurotransmitter synthesis.

SSRI and TAAT is a powerful combination in depression and anxiety. SSRI’s work to maintain increased synaptic neurotransmitter levels, while TAAT supplies amino acids for neurotransmitter synthesis thereby increasing supply.

Next month we will look at different testing that can help evaluate individual needs for amino acid and neurotransmitters.

Sincerely

Drs. Glenn and Julie Smith

Complementary Medicine

June 2005 Newsletter Celiac Diagnosis

FHN Complementary Medicine Monthly Newsletter June 2005

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Celiac Diagnosis

For those of you that have celiac disease the problem needs no introduction. Briefly celiac is an enteropathy of the small bowel, characterized by a sensitivity to the proteins in wheat , barley and rye. Symptoms can include chronic diarrhea, type I diabetes, abdominal distension, weight loss, dermatitis, anemia, autoimmune disorders, irritable bowel, miscarriage, and neurological symptoms.

Because of the many clinical presentations of the disorder the average time between symptom onset and diagnosis is 11 years! The gold standard to diagnosis is a tissue biopsy in the intestine.

Great Smokies Lab (GSDL) has developed a new celiac profile blood test that measures antibodies (IgA and IgG) Anti-Tissue Transglutaminase (tTG). These markers have been shown to be very specific for celiac disease that was later confirmed by biopsy.

If Iga-tTG is positive GSDL runs another marker , anti endomysial antibodies which help identify silent of latent forms of the disease.

Celiac disease is now considered the most common food intolerance world wide affecting about 1% of the population. This simple blood test may help shorten the detective work in discovering this problem.

Sincerely

Dr. Glenn and Julie Smith

Complementary Medicine

May 2005 Newsletter Hot Flashes! and chinese medicine

FHN Complementary Medicine Monthly Newsletter March 2005

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Hot Flashes! And Chinese medicine

This month lets talk about a problem that many women start to experience as they become perimenopausal….hot flashes. Many women have relied on hormonal replacement therapy ( HRT) to control the symptoms. With the advent of all the studies most have either stopped HRT or have substantially reduced the amount taken, rendering it less effective.

So let’s look at the problem from a TCM (traditional chinese medicine) approach. As most of you know the Chinese have a concept of yin and yang balance. Some qualities of Yin are:

Nurturing

Cold

Predominates at night

Is female in nature.

So it follows that if you have a lack of yin that there would be too much heat (lack of cold) that it would be worse at night and there would be some irritability (lack of nuturing).

One more concept in TCM before we can talk about how they would deal with hot flashes. Kidneys! In TCM kidneys :

Store of essence
Dominate human reproduction
Dominate water metabolism
Produces marrow for the brain and bone
Manufacture blood

It is not to hard to see that with these functions attributed to the kidney that they would be involved in the female hormonal/ reproductive system.

So one of the TCM diagnosis of hot flashes is Kidney Yin Deficiency.

Treatment involves nourishing the yin and tonifying the kidney. With a prescription called eight flavor tea.( It comes in pill form). As you might guess it has eight herbs in it. After 30- 45 days we should see some improvement.

Dr. Glenn and Julie Smith

Complementary Medicine

March 2005 Newsletter TCM Seminar Tui Na and Chi Gong

FHN Complementary Medicine Monthly Newsletter March 2005

www.mrdrpilot.blogspot.com

Traditional Chinese Medicine(TCM)

As some of you may have seen we are going to put on a seminar on Traditional Chinese medicine, using Chi Gong and Tui Na. The seminar is sold out for this weekend. If there is enough interest we may do a second one.

TCM was historically based on 7 pillars

· Acupuncture

· Medicine/Herbs

· Movement

· Manipulation

· Nutrition

• Astrology (western medicine from this time period also used astrology)
• Geomancy (Feng Shui)

Our seminar will take a look at two of these modalities, Chi Gong and Tui Na.

Chi Gong is a system of gentle but effective exercise, stimulating the chinese meridians with breathing, movement, and relaxation.

Qigong draws on many elements. It includes "regulating the body" through posture, "regulating the mind" through quiet, relaxation and concentration of one's mental activity," regulating the breath", self-massage and movement of the limbs.

Tui Na is Chinese massage and manipulation used to bring about organ tonification and healing.

Tuina (tui na) is well suited for the treatment of specific musculoskeletal disorders and chronic stress-related disorders of the digestive, respiratory and reproductive systems.

Tuina (Tui Na) methods include the use of hand techniques to massage the soft tissue (muscles and tendons) of the body, acupressure techniques to directly affect the flow of Qi , and manipulation techniques to realign the musculoskeletal and ligamentous relationships (bone-setting). External herbal poultices, compresses, liniments, and salves are also used to enhance the other therapeutic methods.

Drs. Glenn and Julie Smith

Newsletter February 2005 Magnesium and hs C reactive Protein

FHN Complementary Medicine Monthly Newsletter February 2005

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Your heart, magnesium , and hsC-Reactive Protein

With February being Heart Healthy Month let’s talk about two subjects. Magnesium and highly sensitive C-reactive Protein (hsCRP).

Highly sensitive C-reactive Protein (hsCRP) is a protein that increases during systemic inflammation. Most studies show that the higher the hs-CRP levels, the higher the risk of developing heart attack. In fact, scientific studies have found that the risk for heart attack in people in the upper third of hs-CRP levels is twice that of those whose hs-CRP is in the lower third. These prospective studies include men, women and the elderly. Recent studies also found an association between sudden cardiac death, peripheral arterial disease and hs-CRP. We at Complementary Medicine feel this relatively inexpensive test should be included with most of the cardiac risk screenings. (ie cholesterol )

There is another study that we need to look at regarding magnesium. Analysis showed that adults who ingested less than the RDA (400mg/day) of magnesium were 55% more likely to have elevated C-reactive protein levels compared with those who met the RDA for magnesium. After controlling for other variables, low magnesium intake was still significantly predictive of elevated C-reactive protein levels. Subgroups at highest risk for elevated C-reactive protein linked to low magnesium included those adults over 40, those with a body mass index over 25 kg/m², and those who consumed <50%>

Added together these two things are relatively easy to do and may have profound effects on your health!

In health,

Drs. Glenn and Julie Smith

Complementary Medicine

January 2005 Frequency Specific Microcurrent

FHN Complementary Medicine Monthly Newsletter January 2005

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NOT ALL CURRENT IS THE SAME –Frequency Specific Microcurrent

Most of you who have been to physical therapy or a chiropractor have experienced the use of electric current in one form or another. Bioelectric therapy has been around for over a hundred years and all of the different types have their use. In the last 25 years there has been a lot of research done on microcurrent ( a millionth of an amp( uA)) and different frequencies.

We need to know why microcurrent and frequency are important.

ATP production increases five times with currents from 50uA to 1000uA. With currents exceeding 1000uA ATP production leveled and with 5000uA ATP production was reduced. Microcurrent has also been shown to increase protein synthesis and amino acid transport.

The frequencies appear to work on the principle of biologic resonance. A singer can shatter a glass when the note resonates with the crystal structure of the glass. Microcurrent frequencies seem to be able to resonate with biologic tissue and change the structure of the tissue when the frequency is correct. Once the tissue is changed and stable it seems to be able to stay in the new configuration.

Frequency Specific Microcurrent ® utilizes these principles in treatment of many disorders. Some of which are:

· Chronic and Acute Spinal Pain

· Chronic and Acute Low Back and Neck Pain

· Orthopedic Injuries

· Fibromyalgia

· Myofascial Pain

· Tendon and Ligament Repair

· Fractures

· Edema/Lymphatic Drainage

· Shingles

· Irritable Bowel

Microcurrent changes muscle tissue, softens scar tissue, and increases circulation with the effect of removing long stored waste products and increasing cellular metabolism so quickly that there is sometimes a detoxification reaction after treatment. Some people have a similar reaction after a massage but the reaction after microcurrent is stronger because so much is accomplished in such a short period of time. This reaction is short lived (less than 24 hours) with water intake helping this process.

Microcurrent treatment is painless, increases speed of recovery, often promotes healing in conditions that have not responded to other treatment, and is cost effective. The effects are long lasting and the healing of tissue is more complete.

Sincerely

Drs. Glenn and Julie Smith

Complementary Medicine

December 2004

FHN Complementary Medicine Monthly Newsletter December 2004

“…let us not love with words or tongue but with actions and in truth.” 1 John 3:18

As we approach the business of this holiday season let’s remember the act of compassion, the time spent listening, the time holding that hand, last for more than the moment …in some cases into eternity.

May the Lord Bless you this holiday season.

From all of us at Complementary Medicine

Dr. Glenn, Dr. Julie, Dana, and Julie

November 2004 Newsletter Gastric Bypass

FHN Complementary Medicine Monthly Newsletter November 2004

Gastric Bypass Nutrition

The advent of the gastric bypass surgery for the treatment of obesity has brought about a whole new series of nutritional dilemmas. We are not going into the pros and cons of the procedures, but look at the type of things that need to be done post surgically.

There are several types of bypass surgeries currently being done, we are going to concentrate on the Roux-en-Y gastric bypass, as that is the procedure currently being performed here in Freeport.

In the Roux-en-Y gastric bypass - A small pouch is created to restrict food intake, and a Y shaped section of the intestine is attached to the pouch to allow food to bypass part of the intestine, (the duodenum and part of the jejunum). The bypass reduces the amounts of calories and nutrients the body is able to absorb.

In approximately 30% of patients a form of anemia develops. There are, however, other nutritional deficiencies that we need to consider. So let’s look at the function of some the areas we bypassed.

The small intestine consists of the duodenum, jejunum and ileum. The majority of carbohydrate and protein absorption takes place in the duodenum and jejunum. Fats and fat soluble vitamins, however are absorbed in the ileum. Bile salts are excreted from the liver into the duodenum; these are required for the absorption of long chain fatty acids and fat soluble vitamins in the ileum. Vitamin B12 binds to intrinsic factor (produced in the stomach) and is also absorbed in the terminal ileum.

Stomach absorbs 20% of the alcohol ingested, as well as some short-chain fatty acids.

Duodenum absorbs Vitamins A and B1, iron, calcium, glycerol, fatty acids, monoglycerides, amino acids, monosaccharides, and disaccharides.

Jejunum absorbs glucose, galactose, amino acids, glycerol and fatty acids, nonoglycerides, diglycerides, dipeptides, copper, zinc, potassium, calcium, magnesium, phosphorus, iodine, iron, fat-soluble Vitamins D, E, and K, most of the B complex, Vitamin C, and the rest of the alcohol.

The best-studied mechanisms of absorption are clearly for calcium and iron, deficiencies.

Active, transcellular absorption occurs only in the duodenum when calcium intake has been low. This process involves import of calcium into the enterocyte, transport across the cell, and export into extracellular fluid and blood. Calcium enters the intestinal epithelial cells through voltage-insensitive channels and is pumped out of the cell via a calcium-ATPase. So when we have bypassed this area this method of absorbtion no longer is viable.

Passive, paracellular absorption occurs in the jejunum and ileum, and, to a much lesser extent, in the colon when dietary calcium levels have been moderate or high. In this case, ionized calcium diffuses through tight junctions into the blood. Such transport depends on having HIGHER concentrations of free calcium in the intestinal lumen than in blood.

Iron is absorbed in the proximal duodenum. Efficient absorption requires an acidic environment, and antacids or other conditions that interfere with gastric acid secretion can interfere with iron absorption. Iron absorption seems to be enhanced by adequate vitamin C intake.

So with this in mind what do you do:

Take a good multiple vitamin to increase nutrient density.

Increase calcium to levels that will allow passive transport with an easily ionizable calcium ( ie calcitrate, gluconate, lactate….not carbonate)

Increase vitamin C to 500 mg /day

B1 and B12 are not going to absorb well so consider a sublingual source.

Vitamin A can improve hematological indicators and enhance the efficacy of iron supplementation.

A good organic source of iron.

Acidopholus Bacteria as the digestive bacteria (involving billions of cells) residing in the intestinal tract are an important source for several water-soluble vitamins, being renewed every four days.

EPA 3 Fish oils

These are the minimums that need to be done. Individually there may be other areas that may need to be addressed.

Sincerely

Dr. Glenn and Julie Smith

Complementary Medicine

October Newsletter 2004 Cox 2 Inhibiters

FHN Complementary Medicine Monthly Newsletter October 2004

Cox 2 inhibitors

Editors note: This was going to be my October newsletter before the news of Vioxx came out. Timing is everything.

Also, for those of you who are web savvy , we have a BLOG (weB LOG for those of you who aren’t) with all the old newsletters on it. Log on to www.mrdrpilot.blogspot.com

We often get asked if there is any alternative to the vioxx and celebrex that patients are taking for their arthritis pain. While they might be getting some pain relief many did not like the side effects of the drug. With the worst being GI and respiratory. The other problem are the studies that show long term use may actually increase the arthritic degeneration.

We have a product called Zyflamend that we have been using that is a combination of 10 herbs all with some cox 2 activity. Being whole herbs each one also have synergistic activity involved.

The herbs are listed as follows with some of the synergistic properties:

Holy Basil reduces inflammation and supports liver detox pathways by increasing glutithione S- transferase.

Tumeric anti inflammatory antioxidant. Also works with green tea in cell protection. (ie chondrocytes)

Ginger anti inflammatory and helps other herbs absorb.

Green Tea highly anti inflammatory and supports joint function

Rosemary anti inflammatory and supports liver detox function

Hu Zhang anti inflammatory and has reseratorol (the healthy ingredient in red wines.)

Barberry anti inflammatory ,cell protection and anti viral activity

Chinese Goldthread similar to Barberry

Oregano anti inflammatory supports normal platelet function

Scutellaria anti inflammatory , antioxidant and aids in detox pathways.

The herbs are in a capsule in an olive oil base.

Additionally to the joint pain usage there is a study with this product showing reduction in prostate inflammation and tumor reduction.

We hope this helps some of the pain management for people especially in light of the Vioxx news.

Sincerely

Drs. Glenn and Julie Smith

Complementary Medicine

September 2004 Newsletter

FHN Complementary Medicine Monthly Newsletter September 2004

Does Vit E Cause heart failure?

Vitamin E has had a long and controversial history as a potential treatment for heart disease. While there are some large scale studies that have shown Vit E to be beneficial, there are others that haven’t. The HOPE trial is the first to suggest that Vit E may actually increase certain types of heart disease.

All the studies for heart disease have used alpha tocopherol or dl alpha tocopherol. Vitamin E in nature has four isomers; alpha , beta, gamma, and delta tocopherols.

More and more research is showing that it is the gamma tocopherol that has cardioprotective effect. Furthermore large doses of alpha tocopherol results in a decline in serum gamma tocopherol. Epidemiological studies of natural (from food, mixed tocopherols) versus synthetic(alpha alone) Vit E have shown that natural works synthetic doesn’t.

So before you stop taking your Vit E try a mixed tocopherol in proportions that are found in food.

Drs. Glenn and Julie Smith

Complementary Medicine

August 2004 Newsletter

FHN Complementary Medicine Monthly Newsletter August 2004

Chronic Fatigue and Thyroid Medications

At Complementary Medicine we see a lot of patients that are fatigued, chronically and otherwise. Many of them have normal TSH levels and some are already taking a levothyroid product. Some are even taking a combination of levothyroid and T3 therapy.

We work with those patients from a nutraceutical standpoint (containing no active thyroid hormone) many times supporting the adrenal gland function. While we have success with some of those patients there are times when some don’t respond.

So let’s talk TSH and ….Armour Thyroid, I can hear gnashing of teeth already.

While TSH has become the ”Standard” for thyroid function measurement I don’t believe it tells the whole story. Interestingly enough the American Association of Clinical Endocrinologists has recommended that the upper limit of TSH be changed from 5.0 to 3.04mU/L. Which means that over 15% of the population who were formally “normal” are overnight hypothyroid. If the TSH is normal and we still have clinical symptoms we need to look farther, including running a reverse T3 along with T4 , T3, Anti TG, and Anti TPO. In addition determining basal metabolic rate (basal temps, or electronic measurement) will add light to the picture.

As I stated before a percentage of the population don’t get symptomatically better using the current T3 and T4 analogs, even when the TSH returns to normal. For those who don’t get better Broda Barnes M.D. has found that over 80% felt better using Armour thyroid. So let’s look at some of the objections to Armour thyroid.

It’s hard to dose because of variations between natural thyroid sources.

That may have been true 50 years ago, however manufacturing processes and quality control methods now produce a product that is consistent dose to dose. In fact a study of two year old product still was consistent with the initial assay.

Using T3 containing preparations causes serum T3 concentration to rise to supraphysiological levels.

In the dosages found in normal desiccated thyroid (9mcg T3 per 60 mg ) this has not been found to be the case. It was found that the T3 levels only rose marginally high when the total thyroid dosage was too high. Cutting back on the total dose took care of the problems.

So what’s the bottom line of this newsletter? We are not advocating using armour thyroid for every one. In fact in thyroid suppressive therapy this does not work well.

We are saying that, in some cases, where clinical symptoms warrant Armour may solve the problem. Of course the patient needs to be closely monitored by their physician to make sure that the dose is correct.

July 2004 Newsletter

FHN Complementary Medicine Monthly Newsletter July 2004

Leaky Gut!!!

One of the factors that natural medicine looks at while assessing health is the permeability of the intestinal wall. AKA….leaky gut. Leaky gut can cause symptoms ranging from indigestion, heartburn, gas, bloating, constipation, diarrhea, to allergies, anemia, fatigue, arthritis, eczema, and more serious autoimmune diseases.

In leaky gut the small intestine wall becomes inflamed causing a breach in the “tight junctions” between the cells of the gut wall and damage to the cells ability to passively diffuse nutrients through them. These two kinds of damage can allow for larger molecules to pass through the gut causing a cascade of immune and inflammation responses to occur and (in the case of loss of cellular diffusion) nutrient deficiencies even though you are taking all your supplements and ”eating right” !

As this “cascade “ of inflammation continues we start to see joint pain (arthritis) and muscle pain (myofascitis and fibromyalgia), and even asthma.

So what causes this all to start?

There are two major causes

1. Overgrowth of pathogenic bacteria, parasites, and fungi.

2. Use of NSAIDS, antibiotics, corticol steroids, and hormone therapy.

At Complementary Medicine we use a urine test to assess the degree of permeability. We have you ingest a small molecule sugar and a large molecule sugar. One is normally diffused through the cell and one is usually blocked at the cell junctions. We then measure excretion in the urine to assess gut function.

Treatment can vary depending on the cause ( i.e. bacteria ,etc.) But in general we are going to restore normal gut flora with pro and prebiotics, help gut cellular energy with L-glutamine and butyric acid and supplement with enzymes and natural anti-inflammatories.

Sixty percent of human antibodies are produced in the intestine. It is important for your health that it works correctly.

Sincerely

Drs. Glenn and Julie Smith

Complementary Medicine