Fiber Facts Newsletter 2007

FHN Complementary Medicine Monthly Newsletter March 2007

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Fiber Facts ( you aren’t getting enough)

We all know the benefits of fiber! Fiber not only promotes health, it also helps reduce the risk for some chronic diseases. For instance, fiber prevents constipation, hemorrhoids and diverticulosis. Fiber is also linked to prevent some cancers especially colon and breast cancer. In addition, fiber may help lower the LDL cholesterol (the Bad cholesterol) and the total cholesterol therefore reducing the risk of heart disease. Furthermore, fiber can help lower blood sugar therefore help better manage diabetes.

The intake of crude fiber in the American diet was assessed for 7 time periods between 1909 and 1975 using food consumption and composition tables. Crude fiber intake dropped 28% from 6.8 g/day in 1909 to 4.9 g/day in 1957 to 1959 and has remained at that level until the present. The intake of fiber from vegetables has remained relatively constant from 1909 to 1975 while potatoes, fruit, cereals, dry peas, and dry bean consumption have declined. The trends shown for crude fiber consumption in the United States support the hypothesis that fiber intake has decreased coincidentally with increases in degenerative diseases.

Fiber falls into 2 broad catagories soluble and insoluble. Both soluble and insoluble fiber are undigested. They are therefore not absorbed into the bloodstream. Instead of being used for energy, fiber is excreted from our bodies. Soluble fiber forms a gel when mixed with liquid, while insoluble fiber does not. Insoluble fiber passes through our intestines largely intact, therefore bulks up the size and weight of the feces. Soluble fiber bind with fatty acids and prolong stomach emptying time so that sugar is released and absorbed more slowly.

The RDA of fiber is 25 grams. Sadly the average American diet contains between 1.7g to 10g per day. Obviously we need to do better. We need 5-6 servings of vegetables (potatoes don’t count and ketchup is not a vegetable) and 3-4 WHOLE grain servings per day to come close to that amount. The best source of fiber is your food. If you can’t or won’t eat that much you may need to supplement your fiber input. But not all fibers are the same…the fiber you take depends on what you need and what you are trying to accomplish.

Here are some ideas.

Wheat Bran Increase Fecal Bulk

Oat Bran Binds bile salts

Gums Laxative

Guar,legumes, psyllium, citrus rind, Bind steroids,delay gastric emptying,

Apple, onion skin, agar,carrageenan and remove heavy metals

Wheat , apple, Cabbage , Broccolli Antioxidant, anticarcinogenic

So start chewing for your health.

Drs. Glenn and Julie Smith

Complementary Medicine

Chidhood asthma and probiotics

FHN Complementary Medicine Monthly Newsletter February 2007

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Is there something parents can do to change whether their children will get asthma? Babies who received a course of antibiotics during the first six months of life are 2.5 times more likely than their peers to have developed asthma by age 7, according to a Henry Ford Health System study. And babies who took even one round broad-spectrum antibiotics were 8.9 times more likely to acquire asthma. The study, presented at the European Respiratory Society's September 2003 annual conference, and reported by Reuters Health, also demonstrated a link between infants antibiotic use and other allergic diseases such as eczema. Recent controlled studies showing that giving probiotics (active cultures of beneficial bacteria) lowers the risk of allergic disease suggest that these data point to antibiotics actively raising the risk.

A study in the Journal of Pediatrics (November 2004 Volume 145, Number 6) showed Children with atopic dermatitis (AD) have increased intestinal permeability, thought to be due to increased mucosal inflammation. The investigators demonstrated that administration of probiotics could reduce eczema in patients with AD.The trial also reviewed whether administration of probiotics could reduce gastrointestinal symptoms.

The investigators concluded that the gut mucosal barrier is less effective for patients with AD and can be improved with the use of probiotic bacteria and GI symptoms could be reduced. Antibiotics reduce the gut mucosal barrier. If antibiotics are important to give, ask for the most narrow-spectrum choice that would work (antibiotics that kill the desired bacteria, and as few of the bystander bacteria as practical). Whenever a child needs antibiotics, We suggest giving probiotics to replenish the diversity of beneficial bacteria.

In children under 2 the bifido bacterias predominate and should be in the probiotic that is given. After 2 years of age lactobacillus strains predominate and should be the majority of what is given.

Sincerely

Drs. Glenn and Julie Smith

Complementary Medicine

Migraines and Acupuncture January 2007

FHN Complementary Medicine Monthly Newsletter January 2007

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Migraines and Acupuncture

Those people that have ever suffered from migraines know how debilitating they can be. One of the standard prophylactic treatments is metoprolol (toprol). A study was recently done in Germany comparing the effectiveness of toprol to acupuncture for the PREVENTION of migraines.

In a randomized controlled multi-center trial involving 114 patients who experience migraine headaches, treatment with acupuncture over the course of 12 weeks was found to be as effective as standard prophylactic drug therapy for the prevention of migraine headaches. The study began with a 4 week pre-randomization period, in which subjects recorded information about their headaches in a headache diary. Subjects were randomized into one of two groups. Group1 received 8-15 acupuncture treatments over the course of 12 weeks. Group2 received the commonly used, first-line drug for migraine prophylaxis, metoprolol (brand names: Lopressor, Toprol-XL), 100-200 mg/d over the course of the same 12 week period. Subjects were followed up with for an additional 12 weeks following the intervention period. Outcomes were primarily assessed based on the difference in the number of days with migraines before randomization as compared to the number of days with migraine between weeks 9-12 after randomization. While only 2 subjects randomized to acupuncture dropped out of the study, 18 subjects randomized to drug therapy dropped out (7 experienced intolerable side effects, 1 experienced worsening of symptoms, 7 refused to take the drug). The percentage of subjects who experienced at least a 50% reduction in migraine attacks was 61% for subjects who received acupuncture and 49% for subjects who received metoprolol. Furthermore, subjects who received acupuncture experienced a 2.5 day reduction in the number of days with migraines, while subjects who received metoprolol experienced a reduction of 2.2 days.

This research certainly agrees with what we experience at Complementary Medicine. In addition to the acupuncture we add chiropractic care and nutritional support for very good migraine control.

Sincerely

Drs. Glenn and Julie Smith

Complementary Medicine

Gerd Alternatives December 2006

FHN Complementary Medicine Monthly Newsletter December 2006

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GERD Alternatives

With the holiday season approaching , some of us…… not all, might have a tendency to over eat causing a problem with those who have GERD. An interesting study was just published in the Journal of Pineal Research (2006; 41(3):195-200).

A total of 351 patients with symptoms of GERD were divided into two groups. One group was given 20mg of omeprazole (Prilosec) and one group was given a mixture of melatonin (6 mg), B-6 (25 mg), L tryptophan (200mg), B-12 (50 ug), methionine (100 mg), betaine (100mg), and folic acid (10mg). They had a pharmacy put all the ingredients in one capsule that was identical to the Prilosec. One capsule a day for 40 days was taken.

Results were measured by symptom score and endoscopic exam.

The results….. drum roll please. After 7 days the supplement group reported symptom relief and after 40 days, 100% of the supplement group reported total remission of symptoms. This compares to the omeprazole group that took 9 days for symptom relief and 65.7% had regression after 40 days. The supplement patients reported far fewer side effects, with the only side effect being somnolence.

Endoscopic studies showed complete healing of ulcers after 9months in the supplement group.

An interesting side study was done. After the study was over the 34% that failed on the drug arm were crossed over and given the supplements. 100% of that group reported all symptoms disappeared in 40 days. Some food for thought!!! Pun intended!

May you have a blessed and wonderful holiday season!

Drs. Glenn and Julie Smith

Complementary Medicine

Diabetic Neuropathies and Carnatine

FHN Complementary Medicine Monthly Newsletter October 2006

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Diabetic Neuropathies and Carnitine

Diabetic peripheral neuropathies (DN) can be extremely debilitating and difficult to deal with. The Townsend Newsletter just published this study which shows the use of carnitine in the treatment of diabetic neuropathies.

Some 1,257 patients with diabetic neuropathy were randomly assigned to receive, in double-blind fashion, placebo or acetyl-L-carnitine (ALC) at a dose of 500 or 1,000 mg

3 times a day for 1 year. Efficacy end points were sural nerve morphometry, nerve conduction velocities, vibration perception thresholds, clinical symptom scores, and a visual analogue scale for the most bothersome symptom, most notably pain.

RESULTS: Data showed significant improvements in sural nerve fiber numbers and regenerating nerve fiber clusters. Nerve conduction velocities and amplitudes did not improve, whereas vibration perception improved in the study. Pain as the most bothersome symptom showed significant improvement.

The 500 mg(tid) dose seem to work better for sural nerve regeneration and the 1000mg (tid) dose worked better on pain , which would point out the need for individual dosing and monitoring of the patient.

At Comp Med we use carnitine as part of a program for DN, which would include other nutritional interventions and the use of a pulsed LED red light array on the feet. This has the effect of increasing circulation to the periphery.

Sincerely

Drs. Glenn and Julie Smith

Complementary Med

Acupuncture for Nausea September 2006

FHN Complementary Medicine Monthly Newsletter September 2006

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Acupuncture and Postoperative Nausea and Vomiting

A recent article in Explore (2006;2(4):315-20) did a meta analysis of 24 hr postoperative nausea and vomiting in children. It concluded that acupuncture reduces vomiting in children equivalent to medications.

The study looked at 12 trials. All were effective in controlling vomiting. Three of the studies compared to medication intervention and were found to be equivocal.

The results of these studies are not surprising as acupuncture has been found to be effective in treatment of morning sickness nausea and vomiting in pregnant females.

Sloan Kettering Hospital routinely does pre and post operative acupuncture to help control nausea, vomiting and anxiety associated with surgery.

This study also looked at different methods of stimulation of the acupuncture points. acupuncture, acupressure, electricstim and laser. All were found to have efficacy, but acupuncture was found to be the most effective.

The acupuncture treatment usually involves placing the needles in the foot and wrist areas for 15-20 minutes one to two times a day. Many feel relief within 30 minutes of the initial treatment. Some may require multiple treatments to fully subside the vomiting.

So, you and your loved ones have another option for post surgical nausea and vomiting.

Sincerely,

Drs. Glenn and Julie Smith

Complementary Medicine

Trouble with Fosamax August 2006 Newsletter

FHN Complementary Medicine Monthly Newsletter August 2006

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Trouble with Fosamax

The June 28, 2006 JAMA (vol 295, No.24) reported that patients taking bisphosphanates (ie Fosamax, Boniva, Actonel, Zometa, etc.) have started to report an adverse event , osteo necrosis of the jaw. To date over 2000 cases have been reported, and the manufacturers have sent out letters of caution to physicians and dentists. At first they thought it was only in patients that were on high dose intravenous therapy as a part of cancer therapy, however cases have started to arise with normal oral dose patients. This has the FDA thinking that the problem may be a class effect. In addition to this some patients are reporting moderate to severe bone and joint pain.

So, while I recognize that this is preliminary, and that in the case of cancer treatment, this may be an acceptable risk, let’s look at other options.

First we need to establish the condition of the patients’ current bone density.

A baseline bone density test in appropriate age and risk patients is certainly warranted.

In addition we recommend that our patients do a bone resorption assessment (Genova Diagnostics). This is a urine test that measures two specific collagen fibers related to bone osteoclastic activity. These markers can very quickly change and are useful in determining both therapy efficacy and dosage.

A third lab test measuring 25 hydroxyvitamin D3 is useful in determining biological stores of the active vitamin D3. While Mayo lab puts the reference range at 25-80ng/ml we find that most people at risk need to be above 50ng/ml.

With these lab test results we would then dose and treat the patient with the following:

Calcium in the form of calcium hydroxyapitite. 1000-1500mg day

Boron 300 mcg/day

Vitamin D3 in doses of 400IU and up (depending on D3 levels)

Magnesium at least half of calcium levels

Retest the crosslink and D3 levels in 3 months to dose adjust.

Additionally, Lysine can help the cross linking fibers and strontium can be added for bone density.

We hope this will provide reasonable alternatives to the bisphophanates.

Sincerely,

Drs. Glenn and Julie Smith

Complementary Medicine

Magnesium to the Rescue July 2006

FHN Complementary Medicine Monthly Newsletter July 2006

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Magnesium to the rescue!

A study in the European Journal of Clinical Nutrition (2006 Jun 21 epub) just concluded an interesting study on Asthma in children and magnesium.

In a small scale (N=37) randomized , parallel , placebo controlled, double blind study asthmatic children and adolescent already receiving treatment with fluticasone, magnesium (300 mg/day) was added to the active group. The control group was given a placebo with the fluticasone. Intervention went on for two months. Salbutamol was available in both groups prn.

A metacholine challenge test (to induce an asthmatic response) was administered at beginning and end of the trial period. The results……….The magnesium group alone showed reduced reactivity to the metacholine, in addition skin sensitivity to known antigenic items reduced . Functional lung capacities remained the same in both.

I know that this is a small study but certainly bears a closer look.

Sincerely,

Drs. Glenn and Julie Smith

Complementary Medicine

Oxidatvie Stress June 2006 Newsletter

FHN Complementary Medicine Monthly Newsletter June 2006

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Oxidative Stress

The body constantly reacts with oxygen as part of the energy producing processes of cells. As a consequence of this activity, highly reactive molecules are produced known as free radicals. These interact with other molecules within the cell, which can cause oxidative damage to proteins, membranes and genes. This damage has been implicated in the cause of certain diseases and has an impact on the body's aging process.

The body must constantly “ deactivate” these free radicals ( Reactive oxygen species (ROS)) before they can cause damage.

Some of the nutritional elements that help in this process include vitamins C, E, folic acid, glutathione, N-acetyl cysteine (NAC), selenomethionine (SeM), alpha-lipoic acid, niacin, thiamin, Co-enzyme Q10, and green tea .

A recent study (using the equivalent of 4 cups of green tea per day) showed substantial reduction in all areas of oxidative stress. Green tea contains polyphenols and essential oils that strengthen blood vessels, protect vit C from oxygenation, help regulate thyroid hyperfunction, help prevent dental caries, and can inhibit tumor growth especially in the esophagus, stomach, and intestines.

So start drinking your green tea…let it step for about 5 minutes to get some of the good things out it and enjoy!!!

Drs. Glenn and Julie Smith

Complementary Medicine

Alpha Lipoic Acid May 2006 Newsletter

FHN Complementary Medicine Monthly Newsletter May 2006

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Alpha Lipoic Acid

Alpha Lipoic Acid (ALA) is an antioxidant, and is widely used in prevention of various diseases. Its main function is to increase production of glutathione, which helps dissolve toxic substances in the liver. Alpha lipoic acid can be found in small amounts in foods such as meats and veggies (ie. spinach). Alpha lipoic acid is also easily absorbed into the blood stream, and it can also cross the blood brain barrier.

Alpha Lipoic Acid has many benefits, and all types of people will benefit from taking ALA. ALA will be even more beneficial for individuals with some of the following conditions:

• Diabetes or higher than normal blood sugar levels
• Have high cholesterol levels
• Are affected by cataracts (in early stages)
• Cardiovascular problems such as hardening of arteries

There is a long list of benefits of Alpha Lipoic Acid, some have even gone so far as to call it the "ideal antioxidant".

One of the main benefits of ALA is the treatment of neuropathic pain. Alpha lipoic acid has been used for decades in Europe to counter nerve damage in people with diabetes (types 1 and 2). The neuropathy may be caused in part by free-radical damage to nerves resulting from poorly regulated blood sugar (glucose). As an antioxidant, alpha lipoic acid helps to block such damage. In addition, because of its effect on glucose metabolism, ALA may improve the glucose-lowering action of insulin. Which brings up a caution!! You may need to adjust your dosage of your meds as blood sugars drop.

Dosages have ranged from 100-3000 mg per day with 600-800 mg being the dosage most people found to be helpful in reducing the pain.

Alpha lipoic acid has few if any side effects. Doses between 50mg to 100mg, and higher, can cause nausea and upset stomachs. Excessive doses can even lead to low blood sugar. On the plus side, taking alpha lipoic acid can sometimes lead to a mild and relaxing feeling, and to a feeling of well-being.

Neuropathic pain can be extremely devastating; ALA may just help relieve some of that devastation.

Sincerely

Drs. Glenn and Julie Smith

Complementary Medicine

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

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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

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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