Crashing the Airborne plane
Friday, March 14, 2008 | Permalink
I remember the first time I came across
Airborne at a regular grocery store. I was a little taken aback
that the box was so boldly asserting itself as a "miracle cold
buster". I figured that with that tall claim on the outside of the
box, they must have some good data to back it up or they'd be
eating their words.
Turns out they are eating their words for this advertising: they are offering refunds to people who bought it between May 2001 and November 2007 as part of a settlement for false advertising.
When I first saw Airborne, a quick look at the nutrition facts showed it had some reasonable stuff in it: a gram of vitamin C, a good bit of vitamin A, and a smattering of other nutrients and herbs. While the mix of nutrients seemed OK, I noticed that it has mineral oil (a petroleum product) as an ingredient and wasn't eager to buy it since. Later, my wife brought a tube of it home and I had a opportunity to look at the ingredients a little more closely. Besides mineral oil, it also has sucralose (the same stuff that's in Splenda), an artificial sweetener that may have some health effects. Not something I' d eagerly put in my body nor would I recommend it to others.
If they're making poor judgements about the non-nutritional ingredients in the product, why should I trust them about the nutritional ones (remembering that there is virtually no oversight of nutritional products: the FDA only looks into them if there is a complaint, and (besides being chronically underfunded) is too busy harassing (at the behest of Wyeth) compounding pharmacies for using a safe naturally occurring hormone in hormone preparations to do anything useful)? Seems like a good reason to get a refund for the tube that we've barely touched.
An interesting side note (in case I haven't made enough already) is whether this offering refunds really means anything since the tube already declares "100% Guaranteed Satisfaction", so they'd be potentially giving refunds to anyone who wants one already. Once again, the consumer gets precious little while the lawyers get a big chunk of the $23.3 million settlement.
Turns out they are eating their words for this advertising: they are offering refunds to people who bought it between May 2001 and November 2007 as part of a settlement for false advertising.
When I first saw Airborne, a quick look at the nutrition facts showed it had some reasonable stuff in it: a gram of vitamin C, a good bit of vitamin A, and a smattering of other nutrients and herbs. While the mix of nutrients seemed OK, I noticed that it has mineral oil (a petroleum product) as an ingredient and wasn't eager to buy it since. Later, my wife brought a tube of it home and I had a opportunity to look at the ingredients a little more closely. Besides mineral oil, it also has sucralose (the same stuff that's in Splenda), an artificial sweetener that may have some health effects. Not something I' d eagerly put in my body nor would I recommend it to others.
If they're making poor judgements about the non-nutritional ingredients in the product, why should I trust them about the nutritional ones (remembering that there is virtually no oversight of nutritional products: the FDA only looks into them if there is a complaint, and (besides being chronically underfunded) is too busy harassing (at the behest of Wyeth) compounding pharmacies for using a safe naturally occurring hormone in hormone preparations to do anything useful)? Seems like a good reason to get a refund for the tube that we've barely touched.
An interesting side note (in case I haven't made enough already) is whether this offering refunds really means anything since the tube already declares "100% Guaranteed Satisfaction", so they'd be potentially giving refunds to anyone who wants one already. Once again, the consumer gets precious little while the lawyers get a big chunk of the $23.3 million settlement.
Integrative Pediatrician new in
town
Wednesday, January 02, 2008
| Permalink
I had the pleasure the other night of
having dinner with Richard Linsk MD, a pediatrician who has
recently opened an office here in Ann Arbor on south Main street.
He's focusing on the treatment of autism and ASD, and does general
pediatrics. He used to be in the University of Michigan health
system, but as he started doing more treatment of autism he invoked
the ire of the systems' autism "specialists" (who don't seem to do
much more then sedate the kids) and has had to branch out on his
own.
In talking with him that evening, I came to appreciate his tremendous honesty. Not only is he honest about his own limitations (an unusual feat in most doctors), but his honest perception of the shortcomings of conventional treatment are what drove him to expand into functional medicine and other modalities.
During dinner, I realized that he was one of the pediatricians I had rotated with in medical school (over 8 years ago). He was working out of a small building with a couple other pediatricians and I ended up spending most of my time there with him. Something about him made me think I had the most to learn from him, and in retrospect I think some of it was his willingness to seek the truth despite the pressure of being harried with a full (over) load of patients and those annoying medical students.
In addition to his regular office visits, he offers HBOT in roomy chambers (that you can rent out) and single-reagent immunizations. His website is www.integrativepediatrics.net.
In talking with him that evening, I came to appreciate his tremendous honesty. Not only is he honest about his own limitations (an unusual feat in most doctors), but his honest perception of the shortcomings of conventional treatment are what drove him to expand into functional medicine and other modalities.
During dinner, I realized that he was one of the pediatricians I had rotated with in medical school (over 8 years ago). He was working out of a small building with a couple other pediatricians and I ended up spending most of my time there with him. Something about him made me think I had the most to learn from him, and in retrospect I think some of it was his willingness to seek the truth despite the pressure of being harried with a full (over) load of patients and those annoying medical students.
In addition to his regular office visits, he offers HBOT in roomy chambers (that you can rent out) and single-reagent immunizations. His website is www.integrativepediatrics.net.
It's raining lead!
Monday, November 05, 2007 | Permalink
It seems like the cascade of lead in
products on our store shelves never ends: paint, toys from China,
lunch boxes, supplements from China. Now we've got another source
of lead coming from right here in this country: lipstick. Of the
name-brand lipsticks tested over half had significant levels of
lead and a third of the lipsticks had more lead than is currently
allowed to be in candy (I didn't realize they allow lead in
candy...). You can read the full report here.
So, add this to the pile of sources of lead exposure and stir it with the research that came out last year showing that lead exposure at levels way below what was considered toxic increased heart attacks. How many other things does it impact? No one's done the research.
The best thing to do is protect yourself by minimizing your exposure, taking plenty of vitamin C and consider removing what lead there is with proven chelating agents.
So, add this to the pile of sources of lead exposure and stir it with the research that came out last year showing that lead exposure at levels way below what was considered toxic increased heart attacks. How many other things does it impact? No one's done the research.
The best thing to do is protect yourself by minimizing your exposure, taking plenty of vitamin C and consider removing what lead there is with proven chelating agents.
Vitamin D (again) reduces cancer
risk
Sunday, October 07, 2007 | Permalink
It's starting to get tedious. In
a recent article in the American Journal of Clinical
Nutrition,
Vitamin D (this time with calcium) reduces the risk of cancer (in a
group of >55 year old Nebraskans) over a 4 year period by 76%
(95% confidence interval 40-91%). At least they gave a useful
amount of vitamin D3 (1100iu/day). Interestingly, even calcium
(1500mg/day) alone showed a substantial lowering of risk, but it
wasn't significant.
Now, the important thing to appreciate is that this study was only 4 years and that your typical cancer will have been growing for several years before it is diagnosed. So, is this a reduction in the incidence of cancers (less cancers starting), slowing of growth (thus fewer showing up over the study), or stopping the cancers that had already begun? Frankly, with such a dramatic improvement, it could be all three.
Now, the important thing to appreciate is that this study was only 4 years and that your typical cancer will have been growing for several years before it is diagnosed. So, is this a reduction in the incidence of cancers (less cancers starting), slowing of growth (thus fewer showing up over the study), or stopping the cancers that had already begun? Frankly, with such a dramatic improvement, it could be all three.
Insurance companies reject
bioidentical hormones!
Sunday, September 09, 2007
| Permalink
I just got a note from
SaveMyMedicine.org about the latest way that insurance
companies are working to help the drug companies: by refusing to
pay for compounded hormones. You'd think they'd be smart enough to
see that by covering compounded bioidentical hormones they could be
saving themselves drastic amounts of money: Premarin or Prometrium
are about $45 a month each and testosterone gel or patches are
upwards of $200 a month, while compounded estrogen (usually a
combination of estrone, estradiol, and estriol), progesterone, or
testosterone each start at around $25 or so a month (they can go a
little higher at higher doses). Add the additional costs of higher
incidences of breast cancer in women taking Provera and they could
really be making out by supporting
bioidenticals.
Aetna's going to stop on October 1, while BCBS changed their policy back in May (note that BCBS cites an unscientific 2001 FDA study that even the FDA doesn't support).
As the note I got says: If you are an Aetna or BlueCross BlueShield customer, please contact your employer’s HR department and ask them to petition your health insurance company to reinstate coverage of bioidentical hormones and other compounded medicines. Remind them that healthy employees are productive employees and your health depends on these drugs. Your doctor has decided that compounded medicines such as bioidenticals are the best treatment option for you. Both your employer and your insurer have a responsibility to provide you with the medicines you need at a reasonable cost.
Aetna's going to stop on October 1, while BCBS changed their policy back in May (note that BCBS cites an unscientific 2001 FDA study that even the FDA doesn't support).
As the note I got says: If you are an Aetna or BlueCross BlueShield customer, please contact your employer’s HR department and ask them to petition your health insurance company to reinstate coverage of bioidentical hormones and other compounded medicines. Remind them that healthy employees are productive employees and your health depends on these drugs. Your doctor has decided that compounded medicines such as bioidenticals are the best treatment option for you. Both your employer and your insurer have a responsibility to provide you with the medicines you need at a reasonable cost.
The HBOT that just won't stop
Monday, September 03, 2007
| Permalink
Alright, new there's even more stuff
I've found on hyperbarics and I hate to keep it to myself.
HBOTreatment.com carries a variety of mountains of info
on the utility of HBO, including this article (in PDF format) on HBO for multiple
sclerosis. In fact, this
page is a
catalog of articles on using HBO in a variety of disorders.
The AAHA (American Association for Hyperbaric Awareness) is seeking to advance the understanding of HBOT. Their website is worth a look (just be ready for the audio "Welcome!" when the page loads). The Hyperbaric Healing Institute has a few notes on using HBO for various disorders.
The AAHA (American Association for Hyperbaric Awareness) is seeking to advance the understanding of HBOT. Their website is worth a look (just be ready for the audio "Welcome!" when the page loads). The Hyperbaric Healing Institute has a few notes on using HBO for various disorders.
Even more on HBOT!
Thursday, August 23, 2007 | Permalink
Would you believe I got an email last
night about using hyperbaric oxygen in the military for al the
brain injured veterans we're getting these days? It's from
the American Association
for Health Freedom, who are supporting the
International Hyperbaric Medical Association
in seeking funding for treatment for 400
veterans.
In the background info for the
campaign, they
include this video of a 17 year old who suffered traumatic
brain injury in a high speed motor vehicle accident. After he was
discharged from a rehab canter for for failure to improve, he
underwent 90 HBOT sessions and made remarkable improvements. An
interesting thing to note in this video is that after the first 40
treatments he only makes minimal progression, but then things start
improving more quickly.
More on Hyperbarics
Monday, August 20, 2007 | Permalink
Every time I read more on the utility
of hyperbaric oxygen (HBOT), I'm more annoyed that it isn't being
used more frequently to treat some of the things it's really good
at: neurovascular diseases (MS, alzheimer's, etc.), ischemic
conditions (stroke, heart attack, sickle cell exacerbations). In
addition to the article I
mentioned last november, I've come across a couple
more: a
journal article about the successes of HBOT (and the politics holding it back)
and an article
about the unrelenting attacks on a physician who is using it to
successfully treat patients, as well as an article about the American Heart Association's
demonstration that HBOT is an effective treatment for heart
attack.
In fact, here's 13 benefits to the heart from HBOT (from that last article, please see it for the references):
1. Hyperbaric oxygen therapy applied to the heart during critical loss of oxygen exerts a remarkable defibrillating effect so that tremulous, rapid, ineffectual contractions are prevented; total death of the heart muscle cells is avoided; and abnormal dilation of the blood vessels with subsequent complications is controlled.1
2. Using HBOT in conjunction with various drugs enhances the effectiveness of both the oxygen and the drugs.2,3,4,5
3. Combining HBOT with drugs completely arrests or considerably reduces angina attacks in patients otherwise resistant to prolonged drug treatment.6,7,8.9
4. Patients with cardiac pain from ischemic heart disease experience total relief, along with disappearance of dyspnea (difficulty breathing), when they receive HBOT.10,11
5. Administering HBOT lowered elevated blood cholesterol in all 220 patients cited in a study conducted by the Russian internist Dr. S.A. Borukhov and her colleagues.12
6. HBOT normalized electrocardiograms in all patients in that same Soviet study.13
7. For diminished muscular power of the heart, HBO exerts long-term normalizing effects for circulating blood through the body.14
8. HBOT exerts antiarrhythmic action on the heart.15,16,17
9. HBOT increases heart patients' tolerance to hard work and taking on physical loads.18,19
10. HBO taken at three atmospheres of pressure (a pressure rarely used in the United States) protects any individual's heart from damages due to lack of oxygen.20
11. One's entire heart conduction system functions better from receiving HBO treatment (even when prophylactically administered).21
12. Without taking drugs of any kind, breathing oxygen under pressure stabilizes impaired fat metabolism and improves liver function for someone with ischemic heart disease.22
13. Due to its characteristic of mollifying stress and distress, HBO has long-term and short-term protective effects for a person with a heart problem.23
Finally, I just came across a virtual font of articles on HBOT written by Dr. R. A. Neubauer MD, including 2 articles specifically about the etiology of multiple sclerosis and the treatment of MS with HBOT (1, 2).
In fact, here's 13 benefits to the heart from HBOT (from that last article, please see it for the references):
1. Hyperbaric oxygen therapy applied to the heart during critical loss of oxygen exerts a remarkable defibrillating effect so that tremulous, rapid, ineffectual contractions are prevented; total death of the heart muscle cells is avoided; and abnormal dilation of the blood vessels with subsequent complications is controlled.1
2. Using HBOT in conjunction with various drugs enhances the effectiveness of both the oxygen and the drugs.2,3,4,5
3. Combining HBOT with drugs completely arrests or considerably reduces angina attacks in patients otherwise resistant to prolonged drug treatment.6,7,8.9
4. Patients with cardiac pain from ischemic heart disease experience total relief, along with disappearance of dyspnea (difficulty breathing), when they receive HBOT.10,11
5. Administering HBOT lowered elevated blood cholesterol in all 220 patients cited in a study conducted by the Russian internist Dr. S.A. Borukhov and her colleagues.12
6. HBOT normalized electrocardiograms in all patients in that same Soviet study.13
7. For diminished muscular power of the heart, HBO exerts long-term normalizing effects for circulating blood through the body.14
8. HBOT exerts antiarrhythmic action on the heart.15,16,17
9. HBOT increases heart patients' tolerance to hard work and taking on physical loads.18,19
10. HBO taken at three atmospheres of pressure (a pressure rarely used in the United States) protects any individual's heart from damages due to lack of oxygen.20
11. One's entire heart conduction system functions better from receiving HBO treatment (even when prophylactically administered).21
12. Without taking drugs of any kind, breathing oxygen under pressure stabilizes impaired fat metabolism and improves liver function for someone with ischemic heart disease.22
13. Due to its characteristic of mollifying stress and distress, HBO has long-term and short-term protective effects for a person with a heart problem.23
Finally, I just came across a virtual font of articles on HBOT written by Dr. R. A. Neubauer MD, including 2 articles specifically about the etiology of multiple sclerosis and the treatment of MS with HBOT (1, 2).
Who woulda thought? Folic acid is
effective.
Thursday, July 26, 2007 | Permalink
After the incessant drumbeat coming out
of the pharma-pumped media disparaging nutrition, a refreshing
article came out the other day: "Folic Acid May Lower Stroke Risk."
One of the key findings is
that there are greater improvements in risk in the people who took
it longer. This is, of course, obvious, since you can't expect to
starve yourself for months then have a good meal and be right back
to normal.
Of course, in order not to lose her professorship, dr. Carlsson (who is quoted in the article) has to say that it is premature to recommend a benign and inexpensive nutrient to prevent strokes in the population that shows the greatest reduction in stroke risk from folic acid supplementation (people who've never had strokes, "primary prevention").
Dr. Wang (one of the researchers) suggests that "people in the U.S. who eat healthy diets probably get enough folic acid in the foods they eat." Any guesses what fraction of the population would fall in to that category?
Of course, in order not to lose her professorship, dr. Carlsson (who is quoted in the article) has to say that it is premature to recommend a benign and inexpensive nutrient to prevent strokes in the population that shows the greatest reduction in stroke risk from folic acid supplementation (people who've never had strokes, "primary prevention").
Dr. Wang (one of the researchers) suggests that "people in the U.S. who eat healthy diets probably get enough folic acid in the foods they eat." Any guesses what fraction of the population would fall in to that category?
Most Americans obese by 2015?
Saturday, July 21, 2007 | Permalink
Epidemiologic Reviews just came out with news that not only are an alarming number of
Americans overweight and obese now, over half the American
population will be by 2015. They're actually predicting 75% of
adults and 24% of children will be overweight or obese.
What can you do to avoid becoming one of them or to leave their ranks? Diet and exercise are simple to say, but not so simple to do. It helps to have support and that why I've started offering First Line Therapy in my office. First Line Therapy is a research based lifestyle program to improve all your risk factors for chronic diseases (including obesity, heart disease, diabetes and more).
Call the office and find out how you can join our First Line Therapy program. We are enrolling more people starting in August.
What can you do to avoid becoming one of them or to leave their ranks? Diet and exercise are simple to say, but not so simple to do. It helps to have support and that why I've started offering First Line Therapy in my office. First Line Therapy is a research based lifestyle program to improve all your risk factors for chronic diseases (including obesity, heart disease, diabetes and more).
Call the office and find out how you can join our First Line Therapy program. We are enrolling more people starting in August.
Catching up with vitamin D
Thursday, July 19, 2007 | Permalink
A recent (June 29, 2007)
article points out that even in Hawaii, 11.1
hours/week of total body skin exposure (on average) is inadequate
to get 51% of the participants to have an adequate amount of
vitamin D (which they define as a level of 30 ng/ml, lower than I
like). As the lead author states, "This implies that the common
clinical recommendation to allow sun exposure to the hands and face
for 15 minutes may not ensure vitamin D sufficiency."
This echoes nicely what I've been telling patients for some time based on my own experience of having pale skin, walking to work and taking supplements with 400 iu of vitamin D3 daily and still having a level of only 23: "15 minutes of sun exposure to hands and face daily adequate? A lie. 400 iu daily adequate? A lie."
The article ends with a conservative recommendation of "treating vitamin D deficiency with vitamin D supplementation, "it seems prudent" to aim for a serum 25-hydroxyvitamin D concentration no greater than the maximum produced by natural UV exposure; i.e., approximately 60 ng/mL."
They don't mention that it commonly takes 2,000-4,000 iu daily of D3 to get anywhere near that level, a dose that will give doctors with no nutritional background fecal incontinence. This dose will not get anyone near the lowest toxicity level seen of 150.
So, this article adds to the stack of journal articles supporting higher levels of vitamin D, but will it catch on among conventional docs? Not unless there are vitamin D reps coming in with donuts and pens that say "Vitamin D3" on them. If we're lucky, however, I'm wrong and every doc will start checking vitamin D levels, then recommending adequate vitamin D supplementation (for pennies a day) and cut the rates of cancer and degenerative diseases by huge amounts (some estimates say 50% reduction in cancer with adequate vitamin D).
If you want to learn more about the benefits of vitamin D, the Vitamin D council (.com or .org) is a good resource.
This echoes nicely what I've been telling patients for some time based on my own experience of having pale skin, walking to work and taking supplements with 400 iu of vitamin D3 daily and still having a level of only 23: "15 minutes of sun exposure to hands and face daily adequate? A lie. 400 iu daily adequate? A lie."
The article ends with a conservative recommendation of "treating vitamin D deficiency with vitamin D supplementation, "it seems prudent" to aim for a serum 25-hydroxyvitamin D concentration no greater than the maximum produced by natural UV exposure; i.e., approximately 60 ng/mL."
They don't mention that it commonly takes 2,000-4,000 iu daily of D3 to get anywhere near that level, a dose that will give doctors with no nutritional background fecal incontinence. This dose will not get anyone near the lowest toxicity level seen of 150.
So, this article adds to the stack of journal articles supporting higher levels of vitamin D, but will it catch on among conventional docs? Not unless there are vitamin D reps coming in with donuts and pens that say "Vitamin D3" on them. If we're lucky, however, I'm wrong and every doc will start checking vitamin D levels, then recommending adequate vitamin D supplementation (for pennies a day) and cut the rates of cancer and degenerative diseases by huge amounts (some estimates say 50% reduction in cancer with adequate vitamin D).
If you want to learn more about the benefits of vitamin D, the Vitamin D council (.com or .org) is a good resource.
Challenge to mammography screening
before 50.
Tuesday, June 19, 2007 | Permalink
The American College of Physicians
noticed that all those mammograms in younger women may not be a
good idea. This article doesn't mention the downsides like
compression possibly rupturing tumor capsules or high radiation
exposure from mammograms (which increase the risk of breast cancer, particularly in
women at high risk). They did also admit that mammograms cannot prevent most
breast cancer deaths. So, the final recommendation is that women 40-49 should discuss it
with their doctors. If only more doctors knew about alternatives
like thermography.
BCBS limiting prescriptions?
Sunday, June 03, 2007 | Permalink
I got the Blue Cross "Physician Update"
the other day and noticed something alarming. In their quest to
reduce expenditures, they are trying to limit what they are
spending on prescriptions. Some of the things they are doing are
reasonable (using generics where reasonable), but one is
disturbing: "Enforcement to Exclude Off-Label Coverage", which
"Helps curb prescription drug misuse."
"Off-label use" means using a drug for something other than what the FDA approved it. Keflex (cephalexin) is an antibiotic that has an approved use (the manufacturer did studies to show a benefit for) bacterial infections. There is a common off-label use for preventing bacterial cardiac infections in people who could get them from dental procedures (it is used for this in people who are allergic to penicillin, the usual medication for this).
In addition to the incredibly common off-label prescribing all physicians do, alternative doctors are prone to use things for off-label uses that aren't so common: Omacor (fish oil) for reducing joint pain, Clomid (clomiphene) for increasing low testosterone in men, low-dose naltrexone (LDN) as an immune stimulant in all kinds of diseases (MS, pancreatic cancer, rheumatoid arthritis...), etc. Indeed, it is the innovative use of current medications that drives progress and benefits patients without increasing costs.
Now BCBS seems to be saying that they will know better then the doctor what is appropriate for the patient. Maybe they are the ones practicing medicine without a license?
If you combine this with their threatening to take me off their PPO for "over-utilizing" (spending more than the average 6-15 min appt with patients and getting thorough testing on people), they're not my favorite insurance company right now.
"Off-label use" means using a drug for something other than what the FDA approved it. Keflex (cephalexin) is an antibiotic that has an approved use (the manufacturer did studies to show a benefit for) bacterial infections. There is a common off-label use for preventing bacterial cardiac infections in people who could get them from dental procedures (it is used for this in people who are allergic to penicillin, the usual medication for this).
In addition to the incredibly common off-label prescribing all physicians do, alternative doctors are prone to use things for off-label uses that aren't so common: Omacor (fish oil) for reducing joint pain, Clomid (clomiphene) for increasing low testosterone in men, low-dose naltrexone (LDN) as an immune stimulant in all kinds of diseases (MS, pancreatic cancer, rheumatoid arthritis...), etc. Indeed, it is the innovative use of current medications that drives progress and benefits patients without increasing costs.
Now BCBS seems to be saying that they will know better then the doctor what is appropriate for the patient. Maybe they are the ones practicing medicine without a license?
If you combine this with their threatening to take me off their PPO for "over-utilizing" (spending more than the average 6-15 min appt with patients and getting thorough testing on people), they're not my favorite insurance company right now.
Hormones and cardiovascular
risk
Saturday, March 17, 2007 | Permalink
Sometimes I'm disappointed by the
journals. Circulation recently had an article on reducing women's
risk of cardiovascular risk, in which hormone replacement was
listed as class III (not useful/effective, may cause harm). A
summary of the article in Medscape breaks down the variation in
risk:
So, there is risk in the standard hormone treatment of oral estrogen and progestins (synthetic progesterone-like molecules): each raises the risk of a clot 4-fold. However, it also shows that transdermal estrogen doesn't increase the risk and may lower it and that progesterone similarly doesn't raise the risk. Using bioidentical hormones in a smart manner, then doesn't raise the risk and likely lowers it going from this article.
Sadly, they also list folic acid and antioxidants in the same class that says "may cause harm". Clearly, no one has died from antioxidants or folic acid. There has been a limited number of studies showing some increase in risk with fractionated antioxidants (beta-carotene or alpha-tocopherol alone) in certain circumstances, so it is important to get use full-spectrum antioxidants when using higher doses (mixed carotenoids with selenium or mixed tocopherols).
Sadly, newspapers often pick up these articles without any background and trumpet it as fact. It pays to read in more depth, and be cautious about people who paint all hormone replacement with the same brush: there are clear differences in risk between approaches, and this is why I do not use oral estrogen at all.
Researchers found that "route, type, and dose" of hormone therapy matters, in the Estrogen and Thromboembolism and Risk Study (ESTHER), a multicenter study conducted in 8 hospitals in France that included 271 cases and 610 controls. Compared with nonusers, oral estrogen users had an odds ratio of 4.2 (95% confidence interval [CI], 1.5 - 11.6) and 0.09 [this is probably a typo and the risk should be 0.9] (95% CI, 0.4 - 2.3) for transdermal estrogen. Norpregnane derivatives were linked to a 4-fold increase in venous thromboembolism; but there was no risk for venous thromboembolism with micronized progesterone and pregnane derivatives in the study.
So, there is risk in the standard hormone treatment of oral estrogen and progestins (synthetic progesterone-like molecules): each raises the risk of a clot 4-fold. However, it also shows that transdermal estrogen doesn't increase the risk and may lower it and that progesterone similarly doesn't raise the risk. Using bioidentical hormones in a smart manner, then doesn't raise the risk and likely lowers it going from this article.
Sadly, they also list folic acid and antioxidants in the same class that says "may cause harm". Clearly, no one has died from antioxidants or folic acid. There has been a limited number of studies showing some increase in risk with fractionated antioxidants (beta-carotene or alpha-tocopherol alone) in certain circumstances, so it is important to get use full-spectrum antioxidants when using higher doses (mixed carotenoids with selenium or mixed tocopherols).
Sadly, newspapers often pick up these articles without any background and trumpet it as fact. It pays to read in more depth, and be cautious about people who paint all hormone replacement with the same brush: there are clear differences in risk between approaches, and this is why I do not use oral estrogen at all.
Wrong about echinacea
Sunday, January 21, 2007 | Permalink
It looks like I was wrong about
echinacea. I had been saying that it is an effective anti-viral and
immune-stimulatory herb hat should only be used for 2 weeks at a
time. Now, after reading some more definitive research, I see that it is not only OK to take
echinacea on a continual basis, but it actually is beneficial to
take it this way. Therefore, my old adage that any company that
puts echinacea into a daily vitamin doesn't know what they're doing
and should be regarded with suspicion is wrong. This is a perfectly
reasonable thing to include in a multivitamin, and (as demonstrated
in the article on echinacea) may well extend life-spans. The
research on mice showed a increase in survival in mice at any age,
increasing with the age of the mice.
However, this doesn't mean that any old kind of echinacea will do the trick: other research shows that it is the alkylamides that are responsible for the anti-inflammatory effects and the polysaccharides and glycoproteins are responsible for the immune-stimulating effects, while the echinacosides and other things that OTC echinacea products are typically standardized for don't seem to have much activity, though the phenolic compounds do seem to help keep the alkylamides from degrading. Also, the dried plant materials lose potency quickly, so good echinacea doesn't come in a powder (unless you take massive amounts).
Also, I finally found the answer for which part of the echinacea (E. Augustifolia seems like the best, and E. Purpurea may be close, but E. Palladia isn't very good) to use when:
Roots harvested in the fall have the anti-inflammatory effects that are good for colds (typically the body will have already eliminated the virus before you start showing symptoms, so the inflammation is just part of the mopping-up process and there is no role for antibiotics at this point especially since colds are caused by a virus which wouldn't be affected by antibiotics even if they were still present despite your doctor having given you antibiotics in the past for a cold - this is an example of bad medicine from listening to too many drug reps and not reading any research or even just about any current literature on treatment of the common cold, but forgive my digression).
When the flowers are in early maturity, the aerial parts contain the immune-strengthening compounds that are good for keeping infections from starting in the first place.
So, I apologize to all the companies I had maligned for putting echinacea in their multivitamins (though they'd better check to see they're putting the right things in there) and especially to everyone who had heard my talks and also had it stuck in their heads the wrong way. It is for them that I am putting this in plain text so we call all get it straight once and for all.
However, this doesn't mean that any old kind of echinacea will do the trick: other research shows that it is the alkylamides that are responsible for the anti-inflammatory effects and the polysaccharides and glycoproteins are responsible for the immune-stimulating effects, while the echinacosides and other things that OTC echinacea products are typically standardized for don't seem to have much activity, though the phenolic compounds do seem to help keep the alkylamides from degrading. Also, the dried plant materials lose potency quickly, so good echinacea doesn't come in a powder (unless you take massive amounts).
Also, I finally found the answer for which part of the echinacea (E. Augustifolia seems like the best, and E. Purpurea may be close, but E. Palladia isn't very good) to use when:
Roots harvested in the fall have the anti-inflammatory effects that are good for colds (typically the body will have already eliminated the virus before you start showing symptoms, so the inflammation is just part of the mopping-up process and there is no role for antibiotics at this point especially since colds are caused by a virus which wouldn't be affected by antibiotics even if they were still present despite your doctor having given you antibiotics in the past for a cold - this is an example of bad medicine from listening to too many drug reps and not reading any research or even just about any current literature on treatment of the common cold, but forgive my digression).
When the flowers are in early maturity, the aerial parts contain the immune-strengthening compounds that are good for keeping infections from starting in the first place.
So, I apologize to all the companies I had maligned for putting echinacea in their multivitamins (though they'd better check to see they're putting the right things in there) and especially to everyone who had heard my talks and also had it stuck in their heads the wrong way. It is for them that I am putting this in plain text so we call all get it straight once and for all.
Hyperbaric Oxygen and the "noncovered
conditions"
Tuesday, November 14, 2006
| Permalink
Hyperbaric Oxygen Therapy (HBOT) is
quite useful for a number of conditions, though the medicare laws
have a curious and unusual statement about HBOT: a non-covered
conditions list. Most therapies' entries in the medicare laws don't
even list covered conditions, so why does this specifically name 22
conditions as being "non-covered"? This is especially interesting
because the 22 conditions are all clearly effectively treated by
HBOT.
The last issue of Hyperbaric Medicine Today has an interesting article about how this happened. You can go read it yourself at http://www.hbomedtoday.com/PDF/HBOMT_8.pdf The article starts on page 7, you'll have to scroll down to it in the acrobat file yourself. Interesting reading.
If you'd like to read some information about HBOT by physicians who use it, try here. You can read a (relatively) short bibliography of research on HBOT here.
Here is the medicaid list of noncovered conditions:
1. Cutaneous, decubitus, and stasis ulcers
2. Chronic peripheral vascular insufficiency
3. Anaerobic septicemia and infection other than clostridial
4. Skin burns (thermal)
5. Senility
6. Myocardial infarction
7. Cardiogenic shock
8. Sickle cell anemia
9. Acute thermal and chemical pulmonary damage, i.e., smoke inhalation with pulmonary insufficiency
10. Acute or chronic cerebral vascular insufficiency
11. Hepatic necrosis
12. Aerobic septicemia
13. Nonvascular causes of chronic brain syndrome (Pick's disease, Alzheimer's disease, Korsakoff's disease)
14. Tetanus
15. Systemic aerobic infection
16. Organ transplantation.
17. Organ storage.
18. Pulmonary emphysema
19. Exceptional blood loss anemia
20. Multiple Sclerosis
21. Arthritic Diseases
22. Acute cerebral edema
As the author of the "noncovered conditions" list points out, there is no law against using HBOT for these conditions, they are merely off-label uses for HBOT. There are also articles about using HBOT for migraine and Lyme disease (which medicare presumably won't cover either, nor, by extension, would insurance companies). And since I have a special interest in MS, I dug up this page which is the beginning of a discussion on HBOT for MS.
Why do I take this interest in HBOT? I managed to get my hands on a modest chamber and have been looking into using it therapeutically.
The last issue of Hyperbaric Medicine Today has an interesting article about how this happened. You can go read it yourself at http://www.hbomedtoday.com/PDF/HBOMT_8.pdf The article starts on page 7, you'll have to scroll down to it in the acrobat file yourself. Interesting reading.
If you'd like to read some information about HBOT by physicians who use it, try here. You can read a (relatively) short bibliography of research on HBOT here.
Here is the medicaid list of noncovered conditions:
1. Cutaneous, decubitus, and stasis ulcers
2. Chronic peripheral vascular insufficiency
3. Anaerobic septicemia and infection other than clostridial
4. Skin burns (thermal)
5. Senility
6. Myocardial infarction
7. Cardiogenic shock
8. Sickle cell anemia
9. Acute thermal and chemical pulmonary damage, i.e., smoke inhalation with pulmonary insufficiency
10. Acute or chronic cerebral vascular insufficiency
11. Hepatic necrosis
12. Aerobic septicemia
13. Nonvascular causes of chronic brain syndrome (Pick's disease, Alzheimer's disease, Korsakoff's disease)
14. Tetanus
15. Systemic aerobic infection
16. Organ transplantation.
17. Organ storage.
18. Pulmonary emphysema
19. Exceptional blood loss anemia
20. Multiple Sclerosis
21. Arthritic Diseases
22. Acute cerebral edema
As the author of the "noncovered conditions" list points out, there is no law against using HBOT for these conditions, they are merely off-label uses for HBOT. There are also articles about using HBOT for migraine and Lyme disease (which medicare presumably won't cover either, nor, by extension, would insurance companies). And since I have a special interest in MS, I dug up this page which is the beginning of a discussion on HBOT for MS.
Why do I take this interest in HBOT? I managed to get my hands on a modest chamber and have been looking into using it therapeutically.
Bad reporting on flawed studies
Tuesday, October 10, 2006 | Permalink
Thorne Research came out with
an
editorial that
nicely summarizes the problems with some of the recent, well
publicized, studies that can be construed to show that supplements
are ineffective. However, looking at the actual studies clearly
shows they do work. For the full story, read the
article.
