I’m been posting on wordpress for quite some time, and I’m going to be posting more on my own website. You can read the latest post on allergies here.
Maybe. In a small study researchers found that acupuncture increased Leptin levels. And it really was the acupuncture points, because patients receiving sham acupuncture didn’t get the same increases.
What I really like about the study was that researchers did the acupuncture with electoacupuncture. By using electricity rather than needles, the research opens the way to having patients see their acupuncturist a few times a month but continuing daily treatment with their own electoacupuncture machines. The machines are relatively simple to use if the point is marked on the body, are cheap, and typically run on a single nine volt battery.
One of the basic responses we should have to anything that makes us bleed, whether it be a knife, a nail, or a supplement, would be to take it out of our environment so that we stop bleeding.
But, while a knife and a nail are pretty straightforward, a supplement causing us to bleed can be confusing. Supplements are inherently “good for us” in the same way that many other things used to be good for us. If you read between the lines of supplement advertisements, all supplements can do is make you feel better. And if a little bit makes you feel better, then a lot should make you feel a lot better.
Supplements get this reputation because they fall into an odd blind spot in modern healthcare. No one taking a prescribed drug would think that swallowing the bottle would be a good idea. We respect the power and potential dangers of drugs. But a patient asking her doctor about a supplement will usually get either, “that doesn’t work,” or a shrug, “I don’t know anything about that.” The doctor thinks the patient won’t use the supplement without a recommendation, but the patient has just heard it might help from the manufacturer and it probably doesn’t work from her doctor. A common conclusion is that it is much less powerful than a drug and she’ll be safe using it even in large quantities.
In the absence of medical guidance, the patient will rely on the recommended dosages printed on the bottle. Most manufacturers are understanding that a patient may not want to spend her day swallowing pills, so they will limit the recommended dose to two or three tablets a day. But some recommend much more.
Standard Process is a very good manufacturer. I want to be clear that they jump through far more hoops than most and I’ve been impressed by the rigor of research behind their Mediherb brand. But, they are the most outrageous offenders when it comes to supplement dosage.
For example, individuals taking SP cleanse will consume seven capsules three times a day. And that is one of four different supplements they are expected to consume daily during Standard Processes’ twenty-one day cleanse. For a company that was founded on whole food as the basis for healing, that seems like a lot of supplements.
Admittedly, most Standard Process supplements only list one capsule per meal, but they are sold by practitioners who often prescribe much more. The practitioners are encouraged by Standard Processes’ own tapes to use the supplements in quantities that would be equal to if a patient was eating that organ meat or consuming that herb. That’s a lot of supplements.
My own difficulty with Standard Process began when I was researching Mad Cow Disease, and I wanted to know if Standard Process tested their products for prions. In response, I was told that Standard Process uses restaurant grade meat, which wasn’t terribly reassuring. I don’t know of many restaurants that intentionally add dried cow brain and other glands to their meals. When I checked again on the issue, Standard Process is still standing behind the recommendation of the USDA and doesn’t undergo any separate testing. My concern in this area was mirrored by many other manufacturers who took the step of only using glandular tissue from New Zealand. We in the U.S. do not live in a Mad Cow free zone, and in my research I’ve found disturbing reports of other prion diseases similar to Mad Cow.
But let’s get to the specific issue at hand. Standard Process has a glandular mix they call Symplex F, which they introduced in 1965. (page 109 of the product guide) That’s over fifty years on the market. But there have been no studies done. I’m not even asking for a human study, a rat study would do. After fifty years we have no idea what this complex does to human patients because Standard Process does not collect or publish any response to the compound.
Standard Process produces a proprietary mix of four glands, so we have no idea how much of any gland is involved. The idea of a proprietary secret patent formula is very prevalent in Chinese medicine, but in the U.S. more recently introduced products will list out the amounts of each gland. Let’s pick on the bovine ovary gland bit, because that the part of the mix is likely to cause bleeding. Since the quantity and activity level of the gland will vary from batch to batch, we wouldn’t know the activity level even if they listed out the exact amounts. Keep in mind that cows also go through dramatic hormonal shifts, particularly when transitioning from pregnancy to lactation. As far as we know, Standard Process is grinding all of those stages up together, but changes in the herd may alter the composition dramatically throughout the year.
If you look for bovine ovary online, you will see it being used to grow breasts, grow bottoms, and as a support for the transgender community. So doubling or tripling one’s dosage might be a very poor idea unless one is looking to alter one’s metabolism. But patients will take triple the dosage if it prescribed by their Standard Process salesperson. Most practitioners use muscle testing to prescribe, which is complicated in its results (separate post here). More appropriate blood testing is not commonly done.
Beyond simply avoiding taking too much supplemental bovine ovary, patients need to aware that other deficiencies can profoundly alter hormonal balances. Here in Maine we have a common Vitamin D deficiencies that can modify how the female hormones relate to the body. And essential fatty acids form both the basis of and the cushion for female hormonal metabolism in the body.
Typically what I have seen is that a practitioner will prescribe Standard Process using a method called applied kinesiology or arm testing. The practitioner will had a patient a bottle, tell them to hold their arm out, and then push down on the arm while calling out an amount of capsules. When the arm is strongest, that’s the number of capsules the patient needs.
Now, kinesiology is a very legitimate science. Applied kinesiology should be that science applied widely, but it’s come to mean only muscle-testing as a diagnostic tool. Again, testing muscles for strength and weakness is completely valid when assessing a strain or sprain. But it’s not as accurate a tool for diagnosis of supplement needs.
Let me say that I was a big fan of muscle testing as a diagnostic tool when I first encountered it. It seemed to work, and you could see a great many patients very quickly. Then I got an urinary tract infection and my applied kinesiology doc told me I had a kidney stone. I explained that the symptoms didn’t match a kidney stone, the onset didn’t match a kidney stone, and my urinalysis didn’t match a kidney stone. He was adamant that my arm strength trumped any other test. I left him, treated myself for a urinary tract infection, and never looked back.
When I researched muscle testing, I found that when the supplement was applied to the tongue of the patient, the test could be validated. At least it matched the blood tests when muscle testing was done for allergens. But evidently along the way someone thought that opening up the bottles was unhygienic and much more expensive. Which brought on the current model of someone holding the closed supplement bottle in their hands while being tested.
We’ve known for years that different practitioners have different results. Different practitioners can’t even agree on the strength or weakness of the muscles themselves. So it’s likely that different practitioners would come up with different results with supplements. But when blinded to what is being tested, practitioners cannot consistently use muscle testing to determine whether something is good or harmful to the patient. In the most recent study, the two female testers did test significantly higher than chance, but only for male patients. This odd result was dismissed by the researchers, who had already concluded that there was nothing there to test before they began.
Most practitioners engage in an open test with patients, in which both the practitioner and the patient are participants. So in combination the practitioner may be finding how many capsules the patient is willing to take or pay for rather than how many the patient needs. But since the patient is involved, the muscle test also tests likely compliance which does directly correlate with end results. Despite not being an accurate double-blind test, muscle testing may well tell a practitioner how successful his or her treatment will be.
It is this collaboration, a non-verbal discussion between the patient and the practitioner, which everyone should acknowledge is going on in clinical practice. As a patient returns for future visits, muscle testing may become increasingly accurate. The patient’s body now knows the product it will be ingesting and the patient herself has a better sense of what she can tolerate. Rather than disregarding muscle testing for diagnosis, doubting practitioners may well get a better sense of their patients’ compliance by having them stick out an arm and pressing down on it.
I had some difficulty believing that John Grisham would give away a book for free. But he really is, and he’s doing it for an alternative cancer therapy. Raising attention and money for focused ultrasound is his goal.
Since many of you simply came here for the book, here’s the link to the focused ultrasound foundation where you can get it. HERE
For the rest of us, what is the evidence for focused ultrasound as a cancer treatment? It depends. If the basic idea is to heat the tumor, then focused, prolonged ultrasound can definitely do that. But it does beg the question of why you’d use ultrasound to effectively “burn” a tumor when you might use radiation more effectively.
If the goal is to lower pain and prolong survival in otherwise hopeless metastatic cancer, then a small study of pancreatic cancer patients supports this use.
But should focused ultrasound be used widely by the cancer population? The early data on prostate cancer is promising, but the whole paradigm around prostate cancer has changed recently. For breast cancer, there is difficulty determining clear margins and the dead cells are left in the breast after the treatment. In liver metastasis, focused ultrasound can be used to prolong survival. The same can be said for metastatic and difficult-to-remove tumors throughout the body. So focused ultrasound should be widely used in the palliative later stages of cancer as an alternative to radiation.(All studies here)
I’m not a big fan of “nano-bubbles” to enhance the effectiveness of focused ultrasound. Injecting a patient with something that you then want to vibrate seems like a poorly thought out scheme. But maybe the bubbles will increase the effect?
Far from promoting an “alternative cancer therapy” John Grisham is lighting a fire under oncologists to add a useful tool to their palliative quiver.
One of the most frustrating things in the world can be finding a food allergy. After months of searching, usually with several doctors involved, a parent may find the culprit. But then the work is just beginning. For years (decades?) later the parents have to monitor all food for contamination.
The issue is particularly bad with something like a corn allergy. Eliminating all corn and corn products from your child’s diet may simply not be enough. We live in an age where cheap corn has permeated our culture. Even something like extra virgin olive oil can be contaminated with corn oil. So what is a parent to do?
A good start is to use observation rather than lab testing to define an allergy. In testing children with visible skin allergy, researchers found that almost half had a food allergy, but many of these were not significantly elevated in labs. Parents and children may have been avoiding those foods, so the child’s immune system wasn’t as responsive. Occasionally a child may have a gut only immune response, giving a delay of one to three hours before vomiting or having explosive diarrhea.
But children may have another response to allergy: chronic constipation. In children tested for chronic constipation which resisted common laxatives, more that half were found to be allergic to foods. Many had more than one food allergy. At six months after eliminating the food, only a few children could tolerate the food. By the first year, almost all the children could tolerate the food, and all could tolerate a food challenge without symptoms after two years. These children were tested by skin test, which researchers noted had no relationship to the child’s blood immune IgE tests.
In my own practice, I’ve seen parents dab a bit of food on a child’s cheek if they are unsure. More times than not, a reactive food will leave an inflamed red mark in the first minute. For adults, only the thinnest skin might be reactive, but with a child the skin is still thinner and more reactive overall.
In terms of treatment, it may be possible to engage in a trial of oral immunotherapy, which should with supervision and may speed a child’s ability to tolerate a food more quickly.
Without intervention, the old adage that a child “outgrows the allergy” simply doesn’t hold up under scrutiny. Researchers found that around ten percent of U.S. adults had an allergic skin response, and guessed that far more children must have been reactive. But they found that the number of children with an allergic skin response was again around ten percent. So rather than outgrowing an allergic skin reaction: “childhood eczema could follow a chronic relapsing and remitting course throughout a patient’s lifetime, with flares triggered by changes in the environment, skin care, stress, or other factors.”
With Kratom, it’s hard to have it both ways. Either Kratom is a dangerous drug, and should be banned. Or Kratom is a weak herb and shouldn’t be. Which is it?
The New York Times came down on the side of Kratom being addictive. But they fail to make the claim stick, and even when looking for places that want to ban it, there doesn’t seem to be any proof of danger. The best anecdotal report that the NYT found in the U.S. is one person who might have committed suicide due to addiction yet was also being treated for depression?
Leaving the popular press, what do the medical journals have to say about Kratom?
Kratom (Mitragyna speciosa) is a tree in Southeast Asia. The fresh or dried leaves are chewed by farm laborers to increase energy and productivity. It’s also been used to help treat opiate addiction in Malaysia and Thailand. The difference is in the dosage, as a small dose can be very stimulating while a large dose can make someone feel like they are on opiates. Reports of the subjective effects of Kratom can vary from stimulating (1-5g) to sedating (5-15g) The length of effect ranges around four hours, and can vary depending on absorption and how rapidly the liver can clear the alkaloids.
But generalizing dosages and times can be very dangerous, as the chemical structure of Kratom varies widely. Thai Kratom is almost 66% purely of one alkaloid while Malaysian Kratom contains only 12% of that alkaloid (mitragynine).
The side effect picture of Kratom can be serious. Reported side effects can include: “elevated blood pressure, nephrotoxic effects , impaired cognition and behaviour [42, 43], dependence potential , and hepatic failure [41, 44]. The onset of liver injury is described to occur within 2 to 8 weeks of starting regular use of kratom powder or tablets.” (complete review here).
While Kratom is currently legal in the United States, it’s banned in Thailand and Malaysia, (though one in ten Thai teens has tried it). The high rates of abuse in these countries makes it possible to study the long term effects of Kratom. “Many regular users declare their difficulty to abstain from kratom use and experiencing sharp unpleasant symptoms during abstinence periods . Physical withdrawal symptoms include anorexia, weight loss, decreased sexual drive, insomnia, muscle spasms and pain, aching in the muscles and bones, jerky movement of the limbs, watery eyes/nose, hot flushes, fever, decreased appetite, and diarrhoea [48, 54]. Psychological withdrawal symptoms commonly reported are nervousness, restlessness, tension, anger, hostility, aggression, and sadness [1, 54]. Long-term addicts are described to become thin and have skin pigmentation on their cheeks, due to the capacity of mitragynine to increase the production of melanocytes-stimulating substance [1, 46]. Regular ketum use is also reported to cause psychotic symptoms such as mental confusion, delusion, and hallucination .” (see review above)
It doesn’t sound to me like Kratom is safe or weak. Kratom sounds a lot like heroin, though heroin typically uses much lower doses to get the same effects (and withdrawal). I wouldn’t want anyone trying Kratom at a smoothie bar? Really? Would you like an opium pipe with that? Yes, I realize that it’s perfectly legal, and I also recall when Coke contained cocaine. Just because you can doesn’t mean you should.
The old model of the body was a single organ, the brain, ran everything. All body sensors ran up to the brain, which decided how to react. But the body’s organs may be talking directly to each other. In fact, they may be singing.
It’s a field called the human physiolome, network physiology, spearheaded by Plamen Ivanov of Boston University and Harvard Medical school. What he’s found so far is that the human heart and lungs are extremely flexible, adapting to each other’s rhythms. In a healthy interaction, the heart and lungs react to each other very quickly but maintain a time delay stability from reaction to reaction. They’re like jazz musicians, anticipating when the proper time is to come in and do their part.
When the time delay isn’t honored, bad things happen. People with sleep apnea don’t have a time delay. The heart and lungs seem to be working at random. So an early benefit of Ivanov’s research is showing that sleep apnea can be predicted from heart monitoring at home rather than going to a sleep clinic for lung monitoring.
But it isn’t just apnea patients with issues. All of us have issues with our rhythms during sleep. The deeper the sleep, the poorer our coordination. People who were woken up before they finished their sleep showed poorer coordination in the morning. Ivanov thinks this may help predict why more heart attacks occur in the morning.
Since the confirmed case of Zika Virus passing through sex in Texas, the CDC has issued a warning to pregnant mothers to avoid unprotected sex. They include every possibility, including oral transmission of the virus. But despite that warning, it may not be enough. If Zika Virus can be transmitted in the saliva as well as the blood (and it is found in both fluids) then unprotected sex is only one route of possible transmission.
Previously, I wrote that Zika Virus had been confirmed transmitted sexually, so it is nice to see that reconfirmed again. I’m never sure why it has to be reconfirmed inside the United States before we issue warnings.
With the new confirmation, the old maps of Zika Virus transmission in Africa take on new meaning. Think about the transmission as coming from mosquitoes or humans. Those mosquitoes needed to do a lot of traveling to make those leaps, but humans move from location to location. Since we’ve known that Zika Virus is found in the blood and saliva of humans for years now, it seems clear human transmission has been going on all along.
I think the reality we must face is that a disease like the Zika Virus doesn’t really enter our consciousness in the U.S. until it arrives in the U.S. It’s like we imagine we have a border that resists viral infection as well as immigration. How many other viruses are ravaging other countries now that we’re not being told about because they haven’t yet shown up in the U.S.?