Posted by: Christopher Maloney, Naturopathic Doctor | May 23, 2015

How Much Do You Know About Your Microbiome?

Quick, answer these questions:

1) By how much do the bacteria in your gut outnumber the cells in your body?

2) By how much does the DNA available to the bacteria in your gut outnumber your own DNA?

3) Do the bacteria in your gut have direct effects on mood using the vagal nerve?

4) How many of the species of the bacteria in your gut are uniquely yours, not even shared with your identical twin who lives in the same house?

5) What does it take to sterilize an area of all bacteria?

6) Can you have a healthy gut once you’ve been through a series of antibiotics?

7) Do your bacteria interact with the drugs you are taking?

My new book!

If you knew the answers to all these  questions, then you’ll be interested in my new book: Tending Your Internal Garden (published for those patients who just needed to know now). If you didn’t know the answers to all those questions, and especially if you think they aren’t important, then you need to read this book. It’s short, and may change the way you view the area between your chest and your bottom.

I think this subject is so important I’ve started a separate blog called The Microbiome and Health. Very exciting new insights are coming out all the time, and I’ll be sharing those as I come across them.

Posted by: Christopher Maloney, Naturopathic Doctor | May 19, 2015

Are You Paying For Unnecessary Cancer Testing?

There is some debate about cancer screening, but when the majority of women who have no cervix are still screened for cervical cancer, hopefully we can agree that we’re screening too much.

What does it mean when a doctor’s group needs to clarify the guidelines for doctors? It means that the guidelines aren’t based on the available evidence, and that we’re screening willy-nilly. To quote the LA Times article: “About 6 in 10 adults submitted to a colonoscopy more often than they needed to. One-third of men who got a PSA test to screen for prostate cancer couldn’t remember being asked by their doctor to do so.”

The paper published in the Annals of Internal Medicine tries to make things sound more balanced: “High-value strategies provide a degree of benefits that clearly justifies the harms and costs incurred; low-value screening provides limited or no benefits to justify the harms and costs.” In other words, some cancer screening is useful, other cancer screening is not.

For me, as a consumer, I’m not interested in getting “low value” testing. No testing for cancer is without dramatic stress. If that test will save my life or my patients’ life, I’m all for it. But if it won’t impact my patients’ lives positively, then what I’ve done is harm my patient by testing unnecessarily. No doctors who have been tested themselves recommend the sleepless nights of waiting and worrying.

The thing I like best about the new guidelines is the focus on not testing patients who have already got a serious illness and a lowered life expectancy. I’ve seen patients in heart failure who are still be told to come in for a prostate cancer screening. They make me almost as mad as the patients who are in end-stage cancer who are advised to go on statin drugs because their cholesterol is a little high. At some point, we are simply becoming silly, and harming those who rely on us to watch out for their best interests.

If you can’t read the slide below, go to the original here.

Posted by: Christopher Maloney, Naturopathic Doctor | May 11, 2015

Are You Paying For Unnecessary Healthcare?

One of the things about being sick is that you are vulnerable. Anyone, (yes-anyone- I see too many neighbor-marketed health solutions) who has anything to offer you seem plausible. But add a white coat and a big, shiny medical building, and we’re all buying. And buying. But what we’re getting may not give us anything of value. In Atul Gawande’s New Yorker article he says bluntly: “Millions of people are receiving drugs that aren’t helping them, operations that aren’t going to make them better, and scans and tests that do nothing beneficial for them, and often cause harm.”

Image result for overkill gawandeWhen we ask doctors to decide which procedures to do, they will always err on the side of too much. Doctors remember their mistakes, not the unnecessary testing they’ve done. One missed diagnosis haunts a doctor for decades, leading to untold thousands of unnecessary, “just-in-case” tests.

But every procedure, (yes-every procedure) has risks. So unnecessary can become fatal. Everyone has those horror stories, of the testing procedure or minor surgery that went terribly awry. What no one remembers is the much more common uncomfortable, painful, and lingering side effects from a mildly botched test: the massive bruise from a poor blood draw, the discomfort from a laparoscopy scar, the pain associated with most medical procedures that are supposed to make you feel better.

What can a patient do? Unfortunately, we need to educate ourselves. You don’t need a medical degree, you need to find someone with one. Have them do a little basic research. I answer questions on Quora, an online question site frequented by numerous doctors.  Or venture forth yourself. Ask your doctor for the most “up to date” research (which is a company who compiles research for doctors), get a medical dictionary and reading glasses, and slog through it. You’ll have questions, and getting those answers is the definition of informed consent.

Those feeling braver can venture onto pubmed themselves. Type your condition and the word “Cochrane” to get a listing of the reviews of all the studies regarding your condition. Print them out and write down your questions. If possible, send your questions ahead of you before the next appointment. When in doubt, get a second opinion from another, non-affiliated doctor. Sometimes one doctor will recommend something and another will recommend against it. Make up your own mind and remember that you can never ask a doctor to tell you not to get a test or procedure done. That’s a decision he or she can’t make without medical liability if something happens to you.. You can ask if they would have the procedure done themselves, given your circumstances. That might give you a more truthful answer. In the end, it is your healthcare.

Posted by: Christopher Maloney, Naturopathic Doctor | May 2, 2015

Ebola As A Sexually Transmitted Disease: AIDS Part II?

If you look at the WHO site for Ebola, it’s clear that we’ve known Ebola is transmitted sexually. On the site the WHO recommends: “Men who have recovered from the illness can still spread the virus to their partner through their semen for up to 7 weeks after recovery.” But that information is, unfortunately, wrong. A woman contracted Ebola and died, and the only contact with Ebola was  “sex with an Ebola survivor on March 7, five months after the survivor was discharged from a clinic. Health officials said previous studies showed the virus could be found in the semen of recovering men up to 82 days after the onset of symptoms. But the new finding suggests the virus can persist in seminal fluid for longer than previously recognized, and potentially lead to sexual transmission of the virus.”

So the recommendation is that anyone who has ever contracted Ebola will use contraceptives indefinitely. But we’ve seen how effective that recommendation has been with HIV infection. The same areas that have experienced Ebola are also continuing in crisis with HIV.

For those of us who do not live in Sub-Saharan Africa, Ebola has been only a minor scare. But HIV infection is not aImage result for HIV Africa map distant issue. It’s a very current one. And the most recent generations have grown up thinking of HIV and its associated AIDS as a chronic, controllable infection rather than the death sentence it was when it was first discovered. As a result, we are not seeing the same level of concern and our HIV numbers are not where they should be after decades with the illness.

Image result for HIV over 55 U.S. map

If we are going to treat Ebola as a possible sexually transmitted disease with an indefinite infectious period, then we are looking at a possible repetition of the HIV epidemic.

Image result for AIDs over 65 U.S. map

Posted by: Christopher Maloney, Naturopathic Doctor | April 26, 2015

Does The MIND Diet Prevent Alzheimer’s Disease?

I’m always excited by a breakthrough diet, so I was thrilled by Prevention’s report of a diet that halved the risk of Alzheimer’s Disease. This particular breakthrough is a hybrid of the Mediterranean diet and the DASH diet, both mainstays of modern healthy eating.

According to the Prevention article, even sort of following the MIND diet (which stands for Mediterranean-DASH Intervention for Neurodegenerative Delay, which spells MDIND to me) lowers your risk of Alzheimer’s by a third. That’s great news!

Now we get to the difference between an article selling magazines and an article telling about a study. If you look at the original study abstract, they followed less than a thousand people for less than five years, and they based the findings on a questionnaire.

Not as robust as we’d like, but let’s still look for the MIND Diet: Alzheimer’s Cure book coming to bookstores near you in time for Christmas. Except the original study didn’t say that. It said: “High adherence to all three diets (DASH, Mediterranean, or MIND) may reduce AD risk. Moderate adherence to the MIND diet may also decrease AD risk.” So all three diets help reduce Alzheimer’s Disease risk, but that won’t sell magazines, so we focus on the second sentence that says even moderately following the MIND diet may help.

We’d like to see a larger group of people follow this sort of diet for a longer time, but the reality is that we really have no good treatments for Alzheimer’s Disease. So, in the interest of lowering all of our Alzheimer’s Disease risks, and with a nod to Prevention for supplying the summary, here’s the list of the things you should do to get MINDful with your diet.

salmon

“Perfect MIND dieters eat:

  • At least 3 servings of whole grains a day
  • 6 servings of leafy greens a week plus one other veggie serving a day
  • 2 servings of berries a week
  • 1 serving of fish a week
  • 2 servings of poultry a week
  • 3 servings of legumes a week
  • 5 servings of nuts a week
  • A daily serving of alcohol, preferably red wine for its long list of health benefits
Posted by: Christopher Maloney, Naturopathic Doctor | April 14, 2015

Have You Ever Had Alice In Wonderland Syndrome?

I read a lot of medical literature, and finding Alice In Wonderland Syndrome was a treat. The illness is described as: “bizarre perceptions of size and shapes of a patient’s body and illusions of changes in the forms, dimensions, and motions of objects.”

The total disturbance is described as a metamorphopsia, which can occur from imbalances in the brain. Lewis Carroll (really called Charles Dodgson) is thought to have possibly suffered from these during migraine attacks first documented in 1856. It would be fitting if the author was the first person diagnosed with Alice In Wonderland Syndrome.

More recently, a case of Alice In Wonderland Syndrome has been documented in a child with Lyme disease, which is a disturbing thought as we move into tick season in Maine.

Posted by: Christopher Maloney, Naturopathic Doctor | April 12, 2015

Is the Pineal Gland Really A Third Eye?

It’s rare to find something truly rare and amazing in medical literature. But the idea that researchers could transplant a tadpole pineal gland and have it turn into a normal eye counts as one of the oddest things I’ve read recently. Adding Vitamin A helped it grow, but the idea that a gland could become an eyeball is pretty bizarre. (More here).

When you look farther, the pineal gland is responsible for creating an inner rhythm in the absence of light. That makes it responsible for the basic rhythms of our lives, including our immune responses. Not bad for a little gland that had pretty much been written off as incidental.

Posted by: Christopher Maloney, Naturopathic Doctor | April 7, 2015

What Can We Do for Female Hair Loss?

It’s frustrating to try and find decent studies for female hair loss. Because it tends to not be only partial rather than complete, so many more studies are done on males. Here’s the summary: 68% of women on these supplements had hair regrowth compared to 28% in the control group over a period of six months. The supplements were: ” a daily dose of 460 mg fish oil (exact amounts of eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA] were not specified), 460 mg blackcurrant seed oil, 5 mg vitamin E, 30 mg vitamin C, and 1 mg lycopene. ” The underlying issue seems to be a decrease of inflammation.

Here’s the study report: click here. And here’s the original abstract: click here.

Posted by: Christopher Maloney, Naturopathic Doctor | March 22, 2015

Does Round Up Weed Killer (Glyphosate) Cause Cancer?

According to the EPA, we don’t know if drinking Round Up (glyphosate) in your water will cause cancer. We do know that the use of Round Up in the U.S. has tripled since 1986. Back then we were only spraying six million pounds onto our crops, and now we’re spraying eighteen million pounds a year.

If you believe the manufacturers and prominent blogger Steve Novella, glyphosate is completely safe. Anyone telling you differently must be an anti-GMO propagandist. To back himself up, Steve points to all the research done that show that glyphosate itself doesn’t seem to cause cancer. Steve places himself firmly in the same camp as Round Up salespeople, who will drink glyphosate in sales pitches just to prove how safe it is.

Unfortunately for Steve and Round Up’s salespeople, glyphosate is not sold as an individual product but as a mixture. As I point out in my post on whether Round Up causes Celiac, it is not the single chemical but the combination product that causes the issue.

As an additional challenge to the glyphosate issue, Steve points to a Snopes blog post debunking any use of glyphosate on wheat crops at harvest. According to the individual farmers writing in to Snopes, this never happens. But when you go to the manufacturer’s website, they are promoting the use of glyphosate on crops at harvest. The European site notes that even 12% of reluctant German farmers are following their recommendations. A glance at that chart shows that not just wheat is getting the preharvest spraying (barley and beans get more).

Now the UN has joined in the discussion, reclassifying glyphosate as a carcinogen. Don’t be surprised if that doesn’t change the opinion of the manufacturer or bloggers like Steve. Both will argue that the evidence does not support the conclusion. Within their argument will be statements like: “conclusions of regulatory competent authorities were also dismissed” implying that the people who came to any other conclusion might not be as competent.

For those not familiar with the people involved, the World Health Organization has an International Agency for Research on Cancer. To find that glyphosate was a possible carcinogen: “a Working Group of 17 experts from 11 countries” met for a week and discussed all the available evidence. Chances are that they were competent and made the right decision: “the agent is probably carcinogenic to humans. This category is used when there is limited evidence of carcinogenicity in humans and sufficient evidence of carcinogenicity in experimental animals.”

What does that mean for the average consumer? “Glyphosate has been detected in the air during spraying, in water, and in food.The general population is exposed primarily through residence near sprayed areas, home use, and diet, and the level that has been observed is generally low.”

What about what we eat? Chances are that it will another twenty years before Round Up is pulled from the shelves. But it’s residue will be ongoing, and we have seen a huge increase in its use since that introduction of glyphosate-resistant, genetically modified crops.

Before we focus entirely on wheat, glyphosate is also recommended on a variety of other crops. While Germany’s use of glyphosate at harvest is low, the manufacturers estimate that in the UK: “glyphosate is used on 78% of oilseed rape to facilitate harvest.” For those not familiar with rape seed, we commonly think of it as canola oil. While the manufacturer claims no absorption takes place, they do say: “residual traces can sometimes remain on the surface of seed heads and pods.” While these traces would be low for the grains, they would be much more concentrated in an oil taken from compressed grains. Who produces most of the world’s canola? Maine’s neighbor, Canada.

While glyphosate breaks down in the field, at frozen temperatures it remains for well over a year on most crops. The same analysis found differences in the estimated amount of residue in some U.S. and UK crops. Grain residue was generally higher than that found on other agricultural products.

Even if a crop is not sprayed with glyphosate, nearby crop spraying can affect a crop. Idaho potato farmers (Idaho produces most of the U.S. canola crop) are complaining about glyphosate drift that affects their potato crops.

With the recent ruling, we’ll likely see a shift to another weed killer over time. But currently agriculture is largely dependent on what it previously viewed as a harmless chemical. Maybe we’ll get to a point where we realize that such a thing doesn’t exist. All chemicals powerful enough to affect our planet are powerful enough to harm it when used improperly.

Posted by: Christopher Maloney, Naturopathic Doctor | March 15, 2015

Will Vitamin C and Hyaluronic Acid Promoted By Dr. Oz (Reflection, Rovelle) Reverse Winkles?

I’ve seen the ads and promotions, as well as shots of Dr. Oz showing reversals in wrinkles, so what’s the scoop on these compounds and products?

Not surprisingly, pubmed is fuller of Botox treatments, surgeries and lasers, not vitamin C and hyaluronic acid. But that could be simply because there’s a lot more money in doing something to wrinkles rather than having people fix their own at home.

Beautiful Ageing face eyes

Photo courtesy of Lifelonghealthplanning.com

Vitamin C searches get switched to vitamin A, because there are so many more studies on retinoids and their ability to peel off outer layers and make the skin appear more youthful. A recent study of very high dose vitamin C (as ascorbic acid, 23%) showed benefit in a small study of 20 Chinese women. 75% of them noticed a difference and there were no serious side effects. It confirms an earlier 2001 study of baby boomers that showed improvement after twelve weeks. Notably, none of the baby boomers complained of inflammation.

Hyaluronic acid has been used for injecting into wrinkles, and that seems to work pretty well to fill out crow’s feet. Most of the studies are on injecting the acid, but applying the acid also seems to help with wrinkle depth and skin elasticity.

Are these products the most effective on the market? No. The most effective means of getting rid of wrinkles using a topical is a 0.05% tretinoin cream. A lower dose cream of the same, either 0.01% or 0.001% of tetinoin, was not effective. And the effect of the cream was in direct relation to the amount of inflammatory side effects: “A dose-response relationship was evident for both effectiveness and skin irritation.” The stronger the acid, the stronger the effect, and the stronger the side effects.

Both vitamin C (ascorbic acid) and Hyaluronic acid fall into the lower range of the treatments you can use to strip away the outer layer of your skin. Those seeking rapid results would find lasers or chemical peels more speedy and more prone to making you look like you used sandpaper on your face for a few weeks. But if you want a slower, gentler acidic wash, either acid may do the trick.

So, let’s all get these products, yes? Perhaps. Certainly it makes sense to apply something to your skin if you are concerned about wrinkles. A reasonable use of moisturizer can benefit the skin, but we should be clear that the wrinkle resolution from an acid is likely to be more rapid skin turnover from a slight chemical burn rather than something like feeding the skin.

The trouble is that same logic can be extended to never smiling, which is certain to enforce those laugh lines. Perhaps we need to recognize that wrinkles are the visible evidence that we have lived, and lived well. Bring wrinkles back into vogue as a demonstration of  courage, an acceptance of aging, and a recognition of the cycles of life.

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