From The Doctor’s Desk: New Year Solutions

Is The Flu Shot As Good As Gold?

Ah, fall! The crisp, cool mornings, the return of football, and the sweeping changes of color found throughout the landscape. Fall is a welcome change after the long, hot Louisiana summer. With all of the wonderful changes that fall brings, there are a few unwelcome visitors. Just as we move past the summer heat, fall ushers in the cold and flu season.

Recently, I overhead a good friend of mine say that the flu vaccine is “as good as gold” and that as far as results, “the proof is in the pudding.” Not long after that, I saw an ad campaign for the flu vaccine with the tagline: “the value of wellness.”

So, I have to pose this question. With the upcoming cold and flu season, what is the best way to protect my family? How should I treat or even prevent the flu? Is the flu vaccine “as good as gold” and is the “proof” really “in the pudding?”

Today is the era of evidence-based medicine.  So, to answer these questions let’s see what the evidence shows.

Is the flu vaccine “as good as gold?”

The answer is no. While not surprising to me, I’m sure this comes as a surprise to you!  Let me show you the evidence.

A Cochrane analysis, “Vaccines for preventing influenza in healthy adults,” published in 2010 looked at over 70,000 adults ages 16-65 from 1966 to 2010. The objective was defined as: “identify, retrieve and assess all studies evaluating the effects of vaccines against influenza in healthy adults.”

The results may surprise you.

• Flu vaccine was found to be a very poor match (1%). Each year, the 3-strain flu vaccine is created in attempt to match the up coming viral strains.
• Flu vaccine only had a modest effect on reducing flu symptoms and days missed.
• No evidence was found that the flu vaccine affects complications. Complications were defined as pneumonia, hospitalization, and TRANSMISSION.

In my opinion, if you are a healthy adult, the flu vaccine is a waste of your time. But don’t worry; there are many scientifically proven preventive and therapeutic treatments available.  The problem is most are labeled “natural” or “alternative” so you may not have heard of their benefits.

Vitamin D

Hippocrates said, “Whoever wishes to investigate medicine properly should proceed thus: in the first place to consider the seasons of the year.” Vitamin D levels show an inverse relationship to the cold/flu incidence.

 Cannell JJ et al., in “Epidemic influenza and vitamin D,” showed that vitamin D levels reach their lowest levels during the winter months, often dropping by 24%. Below in “Epidemic influenza and vitamin D”, 2,000 IU daily versus 800 IU and placebo was shown to significantly reduce the incident of the cold/flu.

In addition to being preventative, vitamin D is active against ongoing infection. A recent study in the Journal of Virology, revealed that vitamin D has anti-viral properties. Because of its function in the innate immune system, vitamin D, a proven anti-viral, was suggested to be a primary method of treatment.

Probiotics

That’s right, a healthy gut equals a healthy immune system. In children with recurrent otitis media, 24 weeks of probiotics versus placebo was shown to reduce recurrent respiratory infections. Another study, revealed reduced otitis media recurrence in children given probiotics. Still another study revealed a reduction in fever, rhinorrhea, cough, days of antibiotics, and missed school days in children given probiotics daily for 6 months versus placebo.

How?  The current thought is that bacteria and viruses use a “biofilm” protective layer. This protects the virus or bacteria against the body’s immune attacks. This also appears to protect the offending virus/bacteria against administered therapies.

The importance of the gut to the immune system shouldn’t surprise us. It is estimated that 70% of the immune system is concentrated in the gastrointestinal system. In fact, we know that the route of delivery predicts the gut flora. Other events, including maternal steroids, antibiotics, and breast-feeding, can also alter the risk. Collectively, these early events can increase obesity risk.

Vitamin C

What do guinea pigs and people have in common? Their bodies don’t make vitamin C. That’s right, we humans, don’t make vitamin C. So, the only way our bodies get vitamin C is through our diet. Just like vitamin D, the majority of us don’t take in enough Vitamin C.

No therapies will have all positive studies, but therapy using vitamin C has a large body of evidence supporting its use against the common cold and flu. Vitamin C therapy came to prominence with Linus Pauling in the 1970’s. Linus Pauling was an advocate for Vitamin C therapy as an anti-viral therapy in the treatment of the common cold and flu. In his 1970 study, the incidence of colds were reduced by 45% and the duration of the colds were reduced by 63%. High dose IV vitamin C therapy has been shown to reduce the symptoms of the common cold and flu by 85% in a study of 715 people by Gorton and Jarvis. A study by Straten and Josling, showed that vitamin C reduced the incidence and the duration of cold symptoms. A large Cochrane review, showed a reduction of the severity and duration of cold symptoms with vitamin C therapy.

Furthermore, vitamin C has been shown to have many positive immunomodulatory effects. A study by Wintergerst, Magginini, and Hornig discussed many of the positive immune effects of vitamin C. And Harri Hemila in 2006, discussed the effects of vitamin C and the large body of evidence that show the positive effects it has on the immune system. The immune enhancement effects of vitamin C should be evident over the long-term. A study out of the European Journal of Clinical Nutrition in 2006 showed no change in severity or incidence of the common cold, BUT a 66% decrease in 3 or more colds over a 5-year period was seen; revealing just the long-term positive immune enhancing effect we were looking for. So the benefits are extensive, reaching beyond a therapy for the common cold and flu.

Homeopathy

Homeopathy goes back to the eighteenth century with Samuel Hahnemann, MD. In fact, it probably goes back even further. Hippocrates (400 BC) was quoted as saying, “through the like, disease is produced and through the application of the like, it is cured.” Homeopathy works by helping the body to heal itself first, before the powerful interventions of today’s therapies. These powerful interventions come with powerful side effects. The healing medical model of homeopathy fits the Hippocratic oath well, “First, do no harm.”

Homeopathy has been shown to be an effective addition in the treatment and prevention of the cold and flu. Homeopathy was shown to reduce the infection rate of cold and flu viruses by 20-40%. Long waits to see the doctor are very common in Europe and one study showed that homeopathy effectively reduces URI symptoms in children versus a waiting-list control. Finally, in a head-to-head study, homeopathy was shown to be more effective and had lower complication rates than antibiotics in children with recurrent acute rhinopharyngitis.

So how do we stay well?  

One thing is certain, wellness doesn’t come from the flu vaccine. Working with your body and allowing what God created to work as it was intended provides true wellness. Your body wants to protect and heal you. Why not give it a chance, first? No one therapy can provide 100% protection against the common cold and flu. However, these four recommendations, vitamin D, probiotics, vitamin C and homeopathy, have been shown through scientific evidence, to be worthy preventive and therapeutic tools for the upcoming cold and flu season.

 

 

Medical Care is Third Leading Cause of Death in U.S.

“I asked Chris Kresser to guest post on our blog because he has an interesting view on health and wellness and the issues that surround it. I believe that an individual’s greatest obstacle to health and wellness could actually be the drugs that they take. This article clearly reveals that.” – Dr. Nathan Goodyear

The popular perception that the U.S. has the highest quality of medical care in the world has been proven entirely false by several public heath studies and reports over the past few years.

The prestigious Journal of the American Medical Association published a study by Dr. Barbara Starfield, a medical doctor with a Master’s degree in Public Health, in 2000 which revealed the extremely poor performance of the United States health care system when compared to other industrialized countries (Japan, Sweden, Canada, France, Australia, Spain, Finland, the Netherlands, the United Kingdom, Denmark, Belgium and Germany).

In fact, the U.S. is ranked last or near last in several significant health care indicators:

• 13th (last) for low-birth-weight percentages
• 13th for neonatal mortality and infant mortality overall
• 11th for postneonatal mortality
• 13th for years of potential life lost (excluding external causes)
• 12th for life expectancy at 1 year for males, 11th for females
• 12th for life expectancy at 15 years for males, 10th for females

The most shocking revelation of her report is that iatrogentic damage (defined as a state of ill health or adverse effect resulting from medical treatment) is the third leading cause of death in the U.S., after heart disease and cancer.

Let me pause while you take that in.

This means that doctors and hospitals are responsible for more deaths each year than cerebrovascular disease, chronic respiratory diseases, accidents, diabetes, Alzheimer’s disease and pneumonia.

The combined effect of errors and adverse effects that occur because of iatrogenic damage includes:

• 12,000 deaths/year from unnecessary surgery
• 7,000 deaths/year from medication errors in hospitals
• 20,000 deaths/year from other errors in hospitals
• 80,000 deaths/year from nosocomial infections in hospitals
• 106,000 deaths a year from nonerror, adverse effects of medications

This amounts to a total of 225,000 deaths per year from iatrogenic causes. However, Starfield notes three important caveats in her study:

If these caveats are considered, the deaths due to iatrogenic causes would range from 230,000 to 284,000.

Starfield and her colleagues performed an analysis which took the caveats above into consideration and included adverse effects other than death. Their analysis concluded that between 4% and 18% of consecutive patients experience adverse effects in outpatient settings, with:

• 116 million extra physician visits
• 77 million extra prescriptions
• 17 million emergency department visits
• 8 million hospitalizations
• 3 million long-term admissions
• 199,000 additional deaths
• $77 billion in extra costs (equivalent to the aggregate cost of care of patients with diabetes

I want to make it clear that I am not condemning physicians in general. In fact, most of the doctors I’ve come into contact with in the course of my life have been competent and genuinely concerned about my welfare. In many ways physicians are just as victimized by the deficiencies of our health-care system as patients and consumers are. With increased patient loads and mandated time limits for patient visits set by HMOs, most doctors are doing the best they can to survive our broken and corrupt health-care system.

The Institute of Medicine’s report (“To Err is Human”) which Starfied and her colleagues analyzed isn’t the only study to expose the failures of the U.S. health-care system. The World Health Organization issued a report in 2000, using different indicators than the IOM report, that ranked the U.S. as 15th among 25 industrialized countries.

As Starfied points out, the “real explanation for relatively poor health in the United States is undoubtedly complex and multifactorial.” Two significant causes of our poor standing is over-reliance on technology and a poorly developed primary care infrastructure. The United States is second only to Japan in the availability of technological procedures such as MRIs and CAT scans. However, this has not translated into a higher standard of care, and in fact may be linked to the “cascade effect” where diagnostic procedures lead to more treatment (which as we have seen can lead to more deaths).

Of the seven countries in the top of the average health ranking, five have strong primary care infrastructures. Evidence indicates that the major benefit of health-care access accrues only when it facilitates receipt of primary care. (Starfield, 1998)

One might think that these sobering analyses of the U.S. health-care system would have lead to a public discussion and debate over how to address the shortcomings. Alas, both medical authorities and the general public alike are mostly unaware of this data, and we are no closer to a safe, accessible and effective health-care system today than we were eight years ago when these reports were published.

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This guest post was provided by Chris Kresser. Chris lives in Berkeley, CA and is a licensed acupuncturist and practitioner of integrative medicine. Chris writes a health and wellness blog that includes information on hypothyroidism, heart disease, diabetes, obesity, depression, natural childbirth and more. He began writing because it is his “sincere hope that the information on this blog will lead to greater health and well-being for you and those you love” [chriskresser.com]. Visit his blog or follow Chris on Twitter @ChrisKresser for more information on health, wellness and nutrition.

Why Doesn’t My Endocrinologist Know All Of This?

Historically, relying on a consensus statement to treat or not to treat a particular patient has been shown to result in poor care and, as such, society consensus statements and practice guidelines are considered to be worst level of evidence in support of a particular therapy or treatment. A number of organizations, including the World Health Organization and others, have ranked the strength and accuracy of various types of evidence used in the medical decision process. In all scoring systems, the highest strength of evidence is randomized control trials and meta-analyses, with lower scores for other types of evidence. All grading systems place consensus statements and expert opinion by respected authorities (societies) as the poorest level of evidence, because historically they have failed to adopt new concepts and treatments based on new knowledge or new-found understanding demonstrated in the medical literature (1-6).

For instance, a recent study published in the 2009 Journal of the American Medical Association studied the evidence supporting the practice guidelines and consensus statements published by the American College of Cardiology and the American Heart Association. It was found that only 11% of the recommendations, practice guidelines and consensus statements were based on quality evidence and over half were based on poor quality evidence that was little more than the panel’s opinion. The review also found that even the strongest (Class 1) recommendations, which are considered medical dogma, cited as a legal standards and often go unquestioned as medical fact, were only supported by high quality evidence 19% of the time and not revised based on new evidence (6).

Similarly, the Endocrine Society, the American Association of Clinical Endocrinologists and the American Thyroid Association also have a long history of guidelines and recommendations that are not supported by the medical literature and fail to adjust or abandon recommendations when new understanding and knowledge contradicts their recommendations. A case in point is the recommendation by these societies that a normal TSH adequately rules out thyroid dysfunction, despite massive amounts of literature that demonstrate this not to be the case (see Diagnosis of Hypothyroidism) or that T4 only replacement is adequate for most patients. A doctor who simply follows outdated society treatment guidelines that relies on a simple laboratory test and ignores the clinical aspects of a patient is not practicing evidence-based medicine. (1-7). Such doctors may be adequate as lab technicians, but as doctors and clinicians they fall short (1-7). This method of practice is consistently rebuked as improper and poor medicine, but has become the standard used by a large percentage of endocrinologists and physicians who feel medicine can be related to simply reading “normal” or “abnormal” in a laboratory column.

Discussing the lack of scientific basis of most medical society’s consensus statements and treatment guidelines in Internal Medicine News, Dr. Diana Petritti states, “Expert opinion and consensus statements can be quite misleading when used as the basis for a practice. Expert opinions imply that there is something that the experts know that clinician doesn’t know. I don’t think it’s always appreciated that it’s only opinion. There is a tendency to make guidelines and recommendations seem authoritative. I believe that physicians think that there is a great deal more behind authoritative recommendations than there might be when you lift the lid of the box and see what’s underneath(8).”

There has been significant concern by health care organizations and medical experts that physicians are placing too much reliance on consensus statements and failing to learn of new information presented in medical journals. Thus, they lack the ability to translate this new information into treatments for their patients. The concern is that doctors fail to practice evidence-based medicine, erroneously relying on what they have previously been taught and on “expert” societies instead of changing treatment philosophies based on new information as it becomes available. This is especially true for endocrinological conditions, where physicians are very resistant to changing old concepts of diagnosis and treatment — despite overwhelming evidence to the contrary — because it is not what they were taught in medical school and endocrinology residency.

This concern is particularly clear in an article published in the New England Journal of Medicine entitled “Clinical Research to Clinical Practice: Lost in Translation” (9). The article was written by Claude Lenfant, M.D., Director of National Heart, Lung and Blood Institute, and it is well supported. He states that there is great concern that doctors continue to rely on what they learned 20 years before and are uninformed about scientific findings. According to Dr. Lenfant, medical researchers, along with public officials and political leaders, are increasingly concerned about physicians’ inability to translate research findings in their medical practice to benefit their patients. He says that very few physicians learn about new discoveries from reading medical journals or by attending scientific conferences; thus, they lack the ability to translate new knowledge in the field into enhanced treatments for their patients. He states that a review of past medical discoveries reveals how excruciatingly slow the medical establishment is to adopt novel concepts, noting that even simple methods to improve medical quality are often met with fierce resistance. “Given the ever-growing sophistication of our scientific knowledge and the additional new discoveries that are likely in the future, many of us harbor an uneasy, but quite realistic suspicion that this gap between what we know about disease and what we do to prevent and treat them will become even wider. And it is not just recent research results that are not finding their way into clinical practice; there is plenty of evidence that ‘old’ research outcome have been lost in translation as well (1).”

Dr. Lenfant discusses the fact that the proper practice of medicine involves the combination of medical knowledge, intuition and judgment and that physicians’ knowledge is lacking because they don’t keep up with the medical literature. He states that there is often a difference of opinion among physicians and reviewing entities, but that judgment and knowledge of the research pertaining to the patient’s condition is central to the responsible practice of medicine. “Enormous amounts of new knowledge are barreling down the information highway, but they are not arriving at the doorsteps of our patients. (9).”

These thoughts are echoed by physicians who have researched this issue as well, such as William Shankle, M.D., Professor, University of California, Irvine. He states, “Most doctors are practicing 10 to 20 years behind the available medical literature and continue to practice what they learned in medical school….There is a breakdown in the transfer of information from the research to the overwhelming majority of practicing physicians. Doctors do not seek to implement new treatments that are supported in the literature or change treatments that are not (10).”

This view is echoed by the Dean of Stanford University School of Medicine who states that in the absence of translational medicine the delivery of medical care would remain stagnant and uninformed by the tremendous progress taking place in science and medicine (11).

This concern has also received significant publicity in the mainstream media. An example is an article by Sidney Smith, M.D., former president of the American Heart Association, published in 2003 in the Wall Street Journal entitled “Too Many Patients Never Reap the Benefits of Great Research.” Dr. Smith is very critical of physicians for not seeking out available information and applying that information to their patients, arguing that doctors feel the best medicine is what they’ve been doing and thinking for years. They discount new research, Dr. Smith says, because it is not what they have been taught or practiced, and they refuse to admit that what they have been doing or thinking for many years is not the best medicine. He states, “A large part of the problem is the real resistance of physicians…; many of these independent-minded souls don’t like being told that science knows best, and the way they’ve always done things is second-rate (12).” The National Center for Policy Analysis also expresses concern for the lack of ability of physicians to translate medical therapies into practice (13).

A review published in The Annals of Internal Medicine found that there is clearly a problem of physicians not seeking to advance their knowledge by reviewing the current literature, believing proper care is what they learned in medical school or residency and not basing their treatments on the most current research. The review found that the longer a physician is in practice, the more inappropriate and substandard the care (14). Thus, it is not a surprise that the scientific evidence as expressed in the literature is often opposite to what is continually repeated as dogma by most physicians and those considered to be “experts.”

Another example is a study published in the Journal of the American Medical Informatics Association (15). In reviewing the study, the National Institute of Medicine reports that there is an unacceptable lag between the discovery of new treatment modalities and their acceptance into routine care: “The lag between the discovery of more effective forms of treatment and their incorporation into routine patient care averages 17 years.” (16) In response to this unacceptable lag, the Business and Professions Code passed an amendment relating to the healing arts. This amendment — CA Assembly Bill 592; An Act to Amend Section 2234.1 of the Business and Professions Code — states: Since the National Institute of Medicine has reported that it can take up to 17 years for a new best practice to reach the average physician and surgeon, it is prudent to give attention to new developments not only in general medical care but in the actual treatment of specific diseases, particularly those that are not yet broadly recognized [such as the concept of tissue hypothyroidism, chronic fatigue syndrome and fibromyalgia] (17).

The Principals of Medical Ethics adopted by the American Medical Association in 1980 states that a physician shall continue to study, apply, and advance scientific knowledge, make relevant information available to patients, colleagues, and the public (18). This has, unfortunately, been replaced with a goal of providing merely “adequate” care. The current insurance reimbursement system in the United States fosters this thinking, as the worst physicians are financially rewarded by insurance companies. While it is true that the best physicians are continually fighting to provide cutting edge treatments and superior care that the insurance companies deem not medically necessary, even these physicians eventually get worn down and are forced to capitulate to the current system that promotes substandard care.

This was clearly demonstrated in a study published in the March 2006 edition of The New England Journal of Medicine entitled “Who is at Greater Risk for Receiving Poor-Quality Health Care.” The study found that the majority of individuals received substandard, poor-quality care, and that there was no significant difference among different income levels or whether or not the individual was covered by insurance. It used to be the case that only those in low socioeconomic classes without insurance received poor-quality care. But insurance company restrictions on treatments and diagnostic procedures have made the same poor care afforded to those of low socioeconomic status the new standard-of-care for society at large (19). An example of this is a physician’s failing to spend the time to adequately assess a potential hypothyroid patient and instead simply does a TSH test.

Most physicians will satisfy their required amount of continuing medical education (CME) by going to a conference a year, usually at a highly desirable location that has skiing, golf, boating, etc. Physicians are rarely monitored as to whether or not they actually showed up for the lectures or went skiing instead. One must also understand that the majority of conferences organized by medical societies are in fact sponsored by pharmaceutical companies. These payments by pharmaceutical companies are called unrestricted grants, so that the society has free reign to do what they want with the money and thus can claim there is no influence of lecture content by the companies. The problem, however, is that if the society wants to continue getting these “unrestricted” grants, they must think twice about providing content that the sponsoring pharmaceutical company might disapprove of. Consequently, ground breaking research that goes against the status quo and does not support the drug industry receives little attention.

Evidence-based medicine involves the synthesis of all available data when comparing therapeutic options for patients. Evidence-based medicine does not mean that data should be ignored until a randomized control trial of a particular size and duration is completed. A physician who tries to avoid the need of being a physician and is fine with just being a technician or health care provider will adamantly defend the “one-size fits all” method of diagnosis and treatment. But the best doctors who truly practice evidence-based medicine and not merely the perception of such will not rely on consensus statements to best provide their patients. Instead of relying on old dogma, the best physicians will seek out and translate both basic science results and clinical outcomes to decide on the safest, most efficacious treatment for their patients. Further, the best physicians will continually assess the current available data to decide which therapies are likely to carry the greatest benefits for patients and involve the lowest risks.

References

 

What is Functional Medicine?

The following guest post was written by Dr. Ron Grisanti, a board certified chiropractic orthopedist with a master’s degree in nutritional science from the University of Bridgeport. You can read more of Dr. Grisanti’s posts at www.FunctionalMedicineUniversity.com and www.Clinical-Rounds.com.

It’s a science-based, natural way to become healthy again

Functional Medicine is patient-centered medical healing at its best. Instead of looking at and treating health problems as isolated diseases, it treats individuals who may have bodily symptoms, imbalances and dysfunctions.

As the following graphic of an iceberg shows, a named disease such as diabetes, cancer, or fibromyalgia might be visible above the surface, but according to Functional Medicine, the cause lies in the altered physiology below the surface. Almost always, the cause of the disease and its symptoms is an underlying dysfunction and/or an imbalance of bodily systems.

If health care treats just the tip of the iceberg, it rarely leads to long-term relief and vibrancy. Identifying and treating the underlying root cause or causes, as Functional Medicine does, has a much better chance to successfully resolve a patient’s health challenge.

Using scientific principles, advanced diagnostic testing and treatments other than drugs or surgery, Functional Medicine restores balance in the body’s primary physiological processes. The goal: the patient’s lifelong optimal health.

How Functional Medicine Heals a Key Health Care Gap

Today’s health care system is in trouble because it applies a medical management model that works well for acute health problems to chronic health problems, where it is much less successful.

If you have a heart attack, accident, or sudden lung infection such as pneumonia, you certainly want a quick-thinking doctor to use all the quick-acting resources of modern medicine, such as life-saving technology, surgery and antibiotics. We are all grateful about such interventions.

However, jumping in with drugs, surgery and other acute care treatments too often does not succeed in helping those with chronic, debilitating ailments, such as diabetes, heart disease or arthritis. Another approach is needed.

The Two-Pronged Healing Approach of Functional Medicine

To battle chronic health conditions, Functional Medicine uses two scientifically grounded principles:

1. Add what’s lacking in the body to nudge its physiology back to a state of optimal functioning.
2. Remove anything that impedes the body from moving toward this optimal state of physiology.

Plainly put, your body naturally wants to be healthy. But things needed by the body to function at its best might be missing, or something might be standing in the way of its best functioning. Functional Medicine first identifies the factors responsible for the malfunctioning. Then it deals with those factors in a way appropriate to the patient’s particular situation.

Very often Functional Medicine practitioners use advanced laboratory testing to identify the root cause or causes of the patient’s health problem. Old-fashioned medical diagnosis helps too, in the form of listening carefully to the patient’s history of symptoms and asking questions about his or her activities and lifestyle.

For treatment, Functional Medicine practitioners use a combination of natural agents (supplements, herbs, nutraceuticals and homeopathics), nutritional and lifestyle changes, spiritual/emotional counseling, and pharmaceuticals, if necessary to prod a patient’s physiology back to an optimal state. In addition, educating the patient about their condition empowers them to take charge of their own health, ultimately leading to greater success in treatment.

Treating Symptoms Versus Treating the Person

In the dominant health care model today, medication is used to get rid of people’s symptoms. If the patient stops taking the medication, symptoms generally return.

Functional Medicine approaches health problems differently. Instead of masking the problem, it aims at restoring the body’s natural functioning. Although Functional Medicine practitioners may prescribe pharmaceuticals, they are used to gently nudge the patient’s physiology in a positive direction so the patient will no longer need them.

For example, conventional doctors would normally prescribe pharmaceuticals like Prilosec, Prevacid or Aciphex to treat acid reflux or heartburn. When the patient stops taking such drugs, the heartburn symptoms come back. In contrast, a Functional Medicine practitioner might find that a patient’s acid reflux is caused by Helicobacter pylori bacteria. Eradicating the Helicobacter pylori might very well lead to the end of heartburn symptoms, permanently.

It’s also important to note that in Functional Medicine, treatment for similar symptoms might vary tremendously for different patients, according to their medical history and results of laboratory tests. Factors that can come into play in producing the same symptoms include toxic chemicals, pathogenic bacteria, parasites, chronic viral pathogens, emotional poisons like anger, greed or envy, and structural factors such as tumors or cysts.

The Roots of Functional Medicine

You may be surprised to learn that Functional Medicine isn’t new. It actually represents a return to the roots of modern scientific medicine, captured in this statement by Sir William Osler, one of the first professors at Johns Hopkins University School of Medicine and later its Physician-in-Chief: “The good physician treats the disease; the great physician treats the patient who has the disease.”

Another important saying by Osler is “If you listen carefully to the patient, they will tell you the diagnosis.” This encapsulates the importance placed in Functional Medicine on taking a thorough history from the patient.

Your Experience of Functional Medicine

We have titled this web site, “Your Medical Detective,” because patients often feel their Functional Medicine practitioner is leaving no stone unturned in their relentless research to pinpoint the causes of a particular patient’s symptoms.

When you consult a Functional Medicine practitioner, the first step is always your history. Practitioners are trained on how to unravel and make sense of a complicated story. Often clues in the story lead to the identification of key imbalances.

The next set of clues comes from a comprehensive physical examination, which includes many nearly forgotten examination procedures used by famous diagnosticians (both living and long gone), such as chapman reflex points, ankle brachial reflex and nail inspection.

The final set of clues comes from advanced laboratory testing. Innovative, cutting-edge lab tests help the practitioner look deeply into a patient’s physiology to identify how it has been compromised and how physiological balance can be restored.

After diagnosis and treatment, a Functional Medicine patient can expect his or her symptoms to diminish in severity, with a renewed sense of well-being and significant increase in health and vitality.

While there is no substitute for face-to-face treatment from a trained Functional Medicine practitioner, this site educates you on the Functional Medicine perspective and on the kinds of clues and treatments that may be key to restoring you to optimal health.

 

 

Vaccinations and Autism – Is The Verdict In?

You might have heard the recent proclamation of the “end to the vaccination and autism link debate.” This proclamation comes from new light shed on one of the studies compiled by Dr. Andrew Wakefield, a British surgeon and medical researcher whose research indicated a link between autism and the MMR (measles-mumps-rubella) vaccination.

Dr. Wakefield is accused of falsifying some of the data to manipulate his statistics to show more significance, a claim Wakefield categorically denies. If this study from Wakefield et al. was the only study that showed evidence of the harm of vaccines, then I would join the chorus. However, the evidence supporting the harmful effects of vaccinations are not just present in one article. The evidence is present in many articles.

Manipulation of the statistics and fabrication of data is nothing new in science. But as I stated in my previous post, Is Medicine Losing Its Way?, with regard to vaccinations, medicine lost its way a long time ago. Because of this, I and many other physicians continue to push for a physiologic-based practice paradigm. Physiology can’t be manipulated like statistical studies can.

Let’s get a little perspective.

What do we know about some recent statistics surrounding vaccinations?

• First, in 1983, children only received 10 vaccinations before school. At that point the autism rate was 1:10,000. Currently, children receive 36 vaccinations before entry to school and the rate of autism has climbed to 1:150. Coincidence? Not if you look at the physiology.
• In 2010/2011, the flu vaccine was pulled from the market in Australia due to seizures in children. (Click here for more information.)
• Japan no longer requires the Hepatitis B vaccine.
• A recent verdict of $22.5 million was awarded to a man who contracted polio from a polio vaccine given to his daughter.

Second, what we do know about the negative effects of vaccinations.

• Vaccines create long-standing immune suppression.
• There is an increased risk of infection with vaccinations, further increasing brain inflammation and damage to the developing brain.
• Vaccinations cause a shift to the Th2 part of the immune system for much longer than normal, an abnormal response creating increased risk of autoimmune disease.
• A child’s brain reacts differently than an adult’s and is much more sensitive to inflammation.
• Toxins accumulate in the body from vaccines which contain ionic mercury and aluminum.
• Toxic exposure creates excitotoxicity, damage done by chronic microglial activation in the brain resulting in brain inflammation, damage to the developing brain, and increases risk of seizures.
• The aluminum found in vaccines is thought to cause macrophage myofasciitis which can result in severe brain injury, muscle aches and pains, and weakness.
• Vaccinations cause an increased risk of Alzheimer’s and other neurodegenerative diseases such as ALS, Parkinson’s, and dementia.
• Vaccinations cause increased destruction of the brain’s protection mechanism: catalase, glutathione, peroxidase, Super Oxide Dismutase.
• Vaccines can be contaminated, up to 60% according to studies.

First, do no harm.

Lost in the debate of vaccinations, is the “art of medicine.” As quoted by all physicians as they take the Hippocratic oath, “I will remember that there is art to medicine, as well as a science,” and “I will not give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect.”  By endorsing the use of vaccinations, are we creating a new problem (increasing cases of autism) while ending another problem (reduced cases of polio, measles, mumps, rubella)?

As physicians, our oath was, and still is, to “first, do no harm.” As logic, thought, debate and questions are critical to learning, so we must continue to ask the tough questions. And one of those questions will continue to be whether there is a connection between autism and vaccinations. We must fulfill our charge to do no harm. Perhaps we should take another look at whether vaccinations are truly doing no harm.

The Hippocratic Oath:

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.

I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

And in case you are wondering, the answer to your question is no – my children no longer receive vaccinations.

For more insight into the autism debate, see Dr. Russell Blaylock’s court testimony on the dangers of vaccinations. Dr. Blaylock is a nationally recognized board-certified neurosurgeon, health practitioner, author and lecturer. He is the leading authority on excitotoxins and their effects on the brain and author of three books: Excitotoxins: The Taste That Kills, Health and Nutrition Secrets That Can Save Your Life, and Natural Strategies for Cancer Patients.

 

Toxic World

We live in a toxic world. There is no denying it. And concern over our exposure to toxins as a result of the BP Deepwater Horizon oil spill in the Gulf Coast are voiced to me on a daily basis.

Oil, however, is not the only toxin to which we can be exposed. Pesticides, insecticides, phthalates, and heavy metals are all toxins. Even prescription medicines are a source of toxins. Prescription drugs and their side effects are the third leading cause of death. They deplete us of vitamins and minerals and block metabolic pathways, the body’s internal communication highway. Vitamins, minerals, and even bioidentical hormones, if in excess, can be toxic to our bodies. The key is balance. When the body’s chemistry is balanced, then the body is able to work at its designed optimal level.

It’s obvious from the oil spill that toxins are a big issue. But what about reversing the damage done by toxins? Can it be done? Detoxification is a hot topic these days. The word toxin comes from the Greek word toxikon meaning arrow poison. This term was first introduced to medicine by Dr. Ludwig Briegger in 1888. Dr. Briegger determined that toxins equal poison to our body.

The idea of detoxification, however, goes back even further than the introduction of toxins to the medical vocabulary. It goes back to the creation of man. Every cell in our body performs detoxification. The most prominent detoxification organs are the liver, kidneys, and skin.

The idea of body cleansing (detoxification) goes back to the ancient Egyptians and Greeks. They understood that the body cannot continue to receive loads of toxins without eliminating them from the body. Remember, this was an Ancient Civilization, not yet exposed to the toxic world in which we currently live.

With the rise of modern civilization and Western medicine, physicians disregarded the idea of detoxification early in the 20^th century. However, the body of evidence supporting detoxification remains unchanged. Evidence supports the fact that we are exposed to many toxins and these toxins accumulate and overwhelm our God-given detoxification systems.

The oil spill impact. Let’s talk about the immediate and future affects of the oil spill. What can we expect as a result of this toxic exposure? We can expect a significant impact in three areas: water, food, and air.

Water. The impact on the waster is already evident in the large “dead zones” resulting from clouds of methane gas in the Gulf waters. Eventually, the impact will spread to the Gulf’s tributaries as well as our drinking water.

Food. The impact on our food is not yet determined. But we can already see the impact on the cost of Gulf seafood. Based on our current knowledge of mercury toxicity and the fish industry, it is also reasonable to extrapolate that their will be some kind of effects from the oil on seafood from the Gulf and its contributory waters.

Air. The impact on the air is not yet determined. But if we look at the increased risk of lung disease in the Exxon Valdez oil spill clean-up crews, we can assume there might be similar issues with clean-up crews of the BP Horizon oil spill. Suspicious evidence is already appearing in the crops of the lower Gulf Coast states.

The immediate impact on the Gulf region’s wildlife is evident to all. Look to the long-term impact on wildlife in Alaska for clues as to what the Gulf Coast region may face for years to come.

What if the cure is worse than the disease? Cleaning the oil spill with chemical dispersants may be worse than letting Mother Nature clean up the mess all on her own. Let’s look at the long-term results of cleanup for another oil spill.

The 1978 oil spill off the cost of Normandy was cleaned up two different ways due to the large size of the spill and the economic impact of the spill area. Some areas of the oil spill were treated with chemical dispersants, while others were left untreated. The untreated areas had recovered in five years. Yes, you read that correctly. The ecosystems of the untreated oil spill areas returned to normal in just five years. Now here’s the really interesting part. The areas treated with chemical dispersants are STILL recovering. What if that’s the case with the chemical dispersant-treated areas in the Gulf? Oil is a biological compound and will be consumed by bacteria — though the time frame may be long.

Now here’s the real kicker. The chemical dispersant used in the Gulf oil spill is the same used in the Exxon Valdez spill in 1989 and was banned in England. Yes, you read that correctly. It’s been banned. But BP (which stands for British Petroleum) used it to clean up the oil spill. Ironic, isn’t it. It was banned in England, but is it okay for us?

Here’s a frightening fact: no person directly associated with the cleanup of the Exxon Valdez oil spill is still alive today. In fact, the average age of death was 51. From that, I think it’s safe to say that the toxic exposure that Gulf Coast residents are receiving is not safe for the body.

In 20 years, we will look back and know the long-term effects of this toxic exposure. We will know what diseases developed and what the secondary effects were on our drinking water and our crops. If we are already toxic from everyday exposure to chemicals, pesticides, pharmaceuticals, etc., then what will be the result of the added toxins from the Gulf oil spill?

The bottom line? We should not wait. We need to detoxify our bodies. Toxins, whether man-made or man-induced, were not intended to be inside our bodies. It doesn’t take a Ph.D., M.D., D.O. (just fill in your letters) to understand that. It is just common sense.

We need to support the God-created detoxification systems already present in our bodies with proper cleansing, targeted nutrition, conscientious reduction of our exposure to toxins, and, when needed, medically-supervised detoxification programs.

Dr. Goodyear is a board certified and fellowship-trained Metabolic Specialist.

From the Doctor’s Desk: Salivary Hormone Testing Backed by Science

Testing hormones through saliva is backed by science. But don’t take my word for it. In fact, it is well supported in the medical literature and is the right thing to do.  Below are links to several abstracts regarding salivary hormone testing. Read them for yourself and learn about the science behind this form of hormone testing.

• Belkien LD, Bordt J, Moller P, Hano R, Nieschlag E. Estradiol in saliva for monitoring follicular stimulation in an in vitro fertilization program. Fertil Steril 1985;44:322.
• Bolaji II, Tallon DF, O’Dwyer E, Fottrell PF. Assessment of bioavailability of oral micronized progesterone using a salivary progesterone enzymeimmunoassay. Gynecol Endocrinol 1993;7:101-110.
• Campbell BC, Ellison PT. Menstrual variation in salivary testosterone among regularly cycling women. Horm Res 1992;37:132-136.
• Aardal-Eriksson E, Karlberg BE, Holm AC. Salivary cortisol- and alternative to serum cortisol determinations in dynamic function tests. Clin Chem Lab Med 1998;36:215-222.

These articles are published in well-respected journals; and if you notice, they are not recent.  Salivary testing of hormones has been well published in the medical literature for some time now.

Here are a few quotes from these studies:

• “…salivary cortisol may be used as an alternative parameter in dynamic endocrine tests.”
• “…assessment of ovarian function…can be performed precisely with the saliva estradiol assay.”
• “…saliva collection has provided the medical and research community with an excellent medium for the monitoring of plasma steroid levels.”

Nowhere else in medicine do we blindly treat people without assessing a baseline and post treatment level(s). Balance is the key; not one individual hormone. Unfortunately, the medical field is very slow to learn and change.

From The Doctor’s Desk: Wrinkles and Hearts

“If wrinkles must be written on our brows, let them not be written upon the heart. The spirit should never grow old.” — James A. Garfield, 20th President of the United States.

I read that quote by President Garfield the other day and it occurred to me how important his statement was in my practice of medicine. What causes wrinkles? What causes the spirit to grow old? What can damage the heart? The answer is stress. Stress is not something that just exists. Stress is not just a term used to describe forces applied as in engineering. Stress is real and it affects our hearts. Stress kills.

What impact does stress have on the health of our heart?

• 43% of all adults suffer stress related adverse health effects.
• 75-90% of all visits to primary care physicians are stress-related.
• Stress is directly linked to heart disease according to a new study from University College London.

The interesting thing about stress? It’s not just external. Stress is both external and internal. There is stress of day-to-day life. And then there is the silent physiologic stress. The internal stress occurs in the form of obesity, food sensitivity, and inflammation to name a few.

How is stress affecting you? Ask your heart. Focus on keeping your heart healthy by limiting and relieving your stress this Valentine’s Day. While we can’t always eliminate the causes of stress in our life, we can control how we allow it to affect us!

My recommendations?

• Make good food choices to give your body the right kind of energy that lasts and helps you work and feel better.
• Get regular exercise. It boosts your metabolism, fights fatigue, and even elevates your mood helping you to cope with stress more effectively.
• Take time to meditate and pray.
• Take a break and relax whether it’s a soak in the tub or a good book.

Take care of your heart. That’s the best gift you can give those you love!

Related articles by Zemanta

• Marcia G. Yerman: A New Recipe for Heart Health (huffingtonpost.com)
• Bill Clinton says lack of sleep added to heart problem (ctv.ca)
• Easy Tips for Reducing Stress (dirjournal.com)
• Stress `can cause heart damage’ (telegraph.co.uk)

From the Doctor’s Desk: Research Shows Vitamin D Insufficiency Linked To Cancer

Inadequate sunlight exposure has been linked to many cancers. (Click here for article.)

• Breast
• Colon
• Ovary
• Prostate
• Bladder
• Esophagus
• Kidney
• Lung
• Pancreas
• Rectum
• Stomach
• Uterus
• Non-Hodgkins Lymphoma

Recent research suggests that vitamin D therapy can prevent cancer.  Another article suggested that Vitamin D levels greater than 55 ng/ml would prevent 60,000 cases of colorectal cancer and 85,000 cases of breast cancer in North America. The same article projected that 250,000 cases of colorectal cancer and 350,000 cases of breast cancer world wide would be prevented each year.  In fact, the American Journal of Clinical Nutrition recently showed a 77% reduction in breast, ovarian, colorectal cancers as well as lymphoma and leukemia just by normalizing the amount of Vitamin D in a patient’s body.

Vitamin D Therapy Another Cog In The Wheel of Wellness.

I practice Integrative and Functional Medicine and this research supports my approach. By replacing exactly what the body needs, in this case Vitamin D, my patients can improve their bone health, improve symptoms in a myriad of other conditions, and possibly even prevent cancer in their bodies. No anti-depressants, no relaxants, no harmful medications, and no side effects. Our focus is treating the cause of symptoms and, as a result, providing true health and wellness.

Related articles by Zemanta and others:

• How Much Vitamin D Should You Be Taking? (health.usnews.com)
• http://www.womentowomen.com/healthynutrition/vitamind.aspx
• Why Black People Need More Vitamin D
• 5 Ways Vitamin D Could Save Your Life (abcnews.go.com)

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