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