Category Archives: Disease

The Hippocratic Oath – Do Doctor’s Today Even Read It Much Less Practice It?

The Hippocratic Oath is something that every physician who graduates from medical school presumably takes. While most physicians follow a great proportion of this important pledge, there is one passage in the modern version created by the late Dr. Louis Lasagna that is rarely followed by those physicians practicing allopathic medicine. It reads, “I will prevent disease whenever I can, for prevention is preferable to cure.” Is that the way medicine is really being practiced in today’s world?  I think not and here is why.

The purple pill NexiumTM helps people with severe esophogeal acid reflux. These people suffer greatly from their disorder but by prescribing the drug without first making the sufferers change obvious bad habits are we really preventing disease? By denying the healing benefits of nutrients and proper eating do they also fail to fulfill their oath. Having been to a number of physicians over the years I really believe that it is not that they don’t want to prevent disease but that they cannot spend the time necessary to help their patients stop doing things that harm their health. There is plenty of blame to go around and here are my big three.

First off we should point our finger at the pharmaceutical industry and its focus on profits and selling drugs to overcome issues that can often times be treated by lifestyle and habit changes as well as low side effect nutritional supplements (note that I say low side effect not no side effect). Restless Leg Syndrome, while a serious issue is often times better treated with magnesium and well formulated electrolytes instead of the drug RequipTM which has numerous serious side effects. The way the pharmaceutical industry markets their drugs is a major reason why people look for a short cut drug instead of slower lifestyle changes.

Secondly, we need to blame our society as a whole where we eat bad foods and enormous supersized meals, cut back on funding physical education in our schools and take a laisse faire attitude towards health. This societal degredation is so reminiscent of the fall of the Roman Empire that it is just history repeating itself. So many physicians feed into this societal illness that they refuse to make their patients change their habits in fear of losing them.

Thirdly, we need to lay the ultimate blame on the individuals who allow themseslves to get caught up in the “blame others but not me” syndrome. From the moronic ex-judge who sued the dry cleaner for losing a pair of pants to the people who demand that their children get an antibiotic prescription for the flu. Each of us, and I am guilty at times, look for shortcuts, ways not to pay the required price for real health, not just the lack of disease. We all need to look in the mirror and assess what we need to do to get better and then do it. We need to follow our own personal Hippocratic Oath, something I will propose in my next blog.

Bisphosphonates vs. Nutrition for Osteoporosis? Part III

Here is the wrap-up of the three part series on osteoporosis by Dr. R. Keith McCormick whose Chiropractic practice can be found at 145 Old Amherst Rd. Belchertown, MA  01007 – Telephone # (413) 253-9777.  Enjoy the final installment of what I think is an important issue and should be shared with all of your friends and relatives, especially females who might be taking bisphosphonate drugs.

WHY USE NUTRITIONAL THERAPY BEFORE RESORTING TO DRUGS? Strategic nutritional therapy can reduce a patient’s fracture risk without the risks for adverse effects posed by drug therapy. It therefore makes clinical sense to first use nutritional therapy before resorting to pharmaceuticals. There are, of course, situations where a patient may have already sustained one or more fragility fractures or has been determined to be in imminent fracture risk and may require a combination of drug (such as teriparatide, the 1-34 amino acid segment of parathyroid hormone) and nutritional therapy. But in the clinical setting, there is often a window of time where the use of nutritional therapy can be used as a first choice.

Specific biomarkers shown to be related to bone health can be used to identify metabolic dysfunction that can be improved through nutrition. In addition, because osteoporosis is a catabolic disease with high correlation to diabetes, Alzheimer’s, and cardiovascular disease, improving these indicators may reduce etiopathologic mechanisms of other disease processes. Drug therapy as a first choice does nothing to improve a person’s overall health. It can only reduce fracture risk and that only possibly for a limited time period.

WHAT FACTORS MUST BE CONSIDERED PRIOR TO PRESCRIBING A BISPHOSPHONATE?  All too often, physicians look at improving bone density with a bisphosphonate as being the means to an end, when in fact the bone loss is just one symptom within a system struggling against a catabolic tide of inflammation-induced destructive forces. Before a person is placed on bisphosphonates as a panacea for bone loss, many factors should and must be ruled out. These include vitamins D and K deficiency, hypercalcemia, mineral deficiencies, high oxidative stress, chronic systemic inflammation, chronic low-level metabolic acidosis, malabsorption syndromes such as celiac disease, food allergens leading to chronic systemic inflammation, and heavy-metal toxicity. Artificially increasing bone density with a bisphosphonate while leaving the catabolic fires of destruction to burn on is both shortsighted and irresponsible.

Because there are currently no adequate guidelines available, it is difficult to assess an individual’s true fracture risk. The best we can do is to assess the patient’s lifestyle and superimpose upon this their level of bone mineral density to make a judgment call as to their risk for fracture.  But laboratory tests can also be used to improve our assessment of risk and guide the application of a nutritional treatment program. These lab values include the resorption markers N-telopeptide and deoxypyridinoline, but other indirect markers such as morning urine pH, urine organic acids, chemistry screen, CBC, 24-hour urine calcium, TSH, anti-tissue transglutaminase, antigliadin antibodies, glucose, 25-hydroxyvitamin D, homocysteine, hsCRP, and others can also be used to assess fracture risk and overall health. When biomarkers are abnormal, they may reflect a rise in the patient’s risk for fracture. Prescribing a bisphosphonate before laboratory tests are obtained is not an optimal approach to improving a patient’s bone health.

In summary, when bisphosphonates are used before adequate laboratory evaluation and before appropriate strategic nutrition is used to reduce fracture risk, we have lost not only an important opportunity to normalize bone remodeling but a chance to reduce the catabolic forces of chronic inflammation and further disease.

Bisphosphonates vs. Nutrition for Osteoporosis? Part II

Here is part II of the three part series on Bisphosphonates versus Nutrition in the treatment of osteroporosis by Dr. R. Keith McCormick whose practice can be found in Belchertown, Massachusettes.

MICROFRACTURE RISK FROM LONG-TERM BISPHOSPHONATE USE?  Bisphosphonates interrupt the tightly coupled bone-renewing synchrony of osteoclasts that get rid of the old, worn, microfractured bone and the osteoblasts that form strong renewed bone. This reduction in bone turnover leads to skeletal ageing, and there are concerns that long-term bisphosphonate use (> 3 years) may lead to brittle bones and an increase in microfractures. This brittleness is due to altered mineralization properties such as a rise in mineralization homogeneity, which is not a feature of normal healthy bone.

In addition to altered mineralization from long-term use of bisphosphonates, adverse changes also occur within the bone’s non-mineral organic matrix, specifically within the collagen fibers. The “material properties” of collagen give it its strength, and this, in part, is dependent upon the formation through enzymatic mechanisms of structural cross-linking. These enzymatic cross-links hold the collagen fibers together and give them strength and also impart flexibility and toughness to bone. When cross-links are formed from non-enzymatic sources, such as through advanced glycation end products (AGEs) seen with chronic elevation of blood glucose in diabetes or in chronic oxidative stress, collagen integrity is sacrificed, bone becomes more brittle, and fracture risk increases. Bisphosphonate therapy, with reduced osteoclastic activity and bone turnover, leads to the accumulation of these non-enzymatic cross-links and may be of great concern to patients using bisphosphonates long term, especially those, such as diabetics, who are most susceptible to the formation of AGEs.

The extent to which these property changes, induced by long-term bisphosphonate use, influence fracture risk is, as yet, unresolved. But one can easily foresee that ageing bone, especially in a young individual who started taking bisphosphonates when he or she was 30, 40, or even 50 years old, may not end up as “healthy” bone.

WHAT IS THE MOST SERIOUS POTENTIAL CONSEQUENCE OF BISPHOSPHONATE USE?  Concerns over the side effects from bisphosphonate use are obvious and valid. But serious side effects are relatively rare and they pale in comparison to another potentially devastating drawback from the unscrutinized, premature use of bisphosphonates for the treatment of osteoporosis. That is the failure to therapeutically address the chronic inflammation and metabolic dysfunction that is often not only the major underlying cause of bone loss but may also be a potential contributor to other disease processes not yet manifested. By using bisphosphonates to improve bone density, only one aspect of osteoporosis is being addressed. The underlying inflammation, a consistent contributor to all chronic degenerative disease processes, continues untreated.

Bisphosphonates vs. Nutrition for Osteoporosis? Part I

Dr. R. Keith McCormick, DC of Belchertown, MA, gave an insightful talk at the recent Boulderfest 2007 in which he described the realities of osteoporosis and the problems with the family of drugs being purveyed by the pharmaceutical industry known as bisphosphonates. In part one of a three part series, Dr. McCormick has been gracious enough to explain to my blog readers why bisphosphonates are NOT the right thing to do to prevent or treat osteoporosis.  Here is part 1.

Osteoporosis is a disease process characterized by skeletal weakening from low bone mass and a deterioration in micro-architectural quality. The physical and financial burden of this disease is substantial with over 50 percent of women and 13 percent of men in America destined to sustain an osteoporotic-related fracture within their lifetime. With these high-stakes costs it is important that our method of treatment is not only efficacious but also conducive to the patient’s over-all good health.

Bone health is naturally maintained in a person’s body by a balanced remodeling system that ensures continued replacement of old worn-out bone with strong new bone. During normal bone remodeling, the bone-forming cells (osteoblasts) produce enough new bone to replace that which was resorbed by the osteoclasts. It is when this coupled remodeling process is in balance that bone health is maintained. When the osteoclasts resorb excessive amounts of bone, remodeling becomes uncoupled and there is a net decrease in bone tissue. Drug therapy has therefore concentrated on reducing osteoclastic activity in an attempt to correct this imbalance that leads to bone loss. The antiresorptive agents, bisphosphonates, have become the most commonly used pharmaceuticals for this task. With less osteoclastic activity, remodeling slows and there is less bone loss. Most physicians and millions of patients who have taken bisphosphonates view them as harmless drugs that increase bone mineral density and reduce the risk of fractures. But after decades of use, concerns are now rising over the safety of bisphosphonates.

HOW DO BISPHOSPHONATES WORK?  Bisphosphonates are synthetic analogs of inorganic pyrophosphates (commonly used antiscaling or water-softening chemicals) that bind to the divalent calcium ion (Ca2+) in the hydroxyapaitite crystal of bone. It is here that nitrogen-containing bisphosphonates are able to decrease excessive osteoclast activity. They do so by repressing farnesyl diphosphate synthase, an enzyme important for the synthesis of osteoclast cell regulatory proteins. Without these proteins, osteoclasts can no longer function and bone resorption is substantially reduced. With decreased osteoclastic activity, resorption sites are reduced, which lessens the risk that a minor external mechanical load could impart a breakpoint strain leading to trabecular buckling and catastrophic structural failure. It is from this reduction in resorption sites that bisphosphonates are able to reduce fractures. From a glance, and from statistics showing that bisphosphonates reduce both vertebral and nonvertebral fractures, this seems a very positive therapeutic outcome. But is this mode of therapy improving the actual “health” of bone? And, are there drawbacks to these powerful drugs that must be considered before prescribing their use?

Tune in tomorrow for part II and Wednesday for the completion of this important series.

The Media Lies Continue – Antioxidant’s Do Help Reduce Cardiovascular Disease Risk

As I have pointed out in the past, the media seems to love to lie to the public about the benefits of nutritional supplements. Caleb Hellerman, a stalwart for media distortions with CNN wrote how there was no benefit to the use of supplements in the past, a clear distortion and lack of good reporting. Now the media jumped on one of the worst studies on antioxidants done to date. Their claim as I reported earlier, was that women gained no benefit from the supplementation of antioxidants like vitamin C and E. Turns out, that was a clear distortion of the findings of the study.

My original post showed that the researchers did not look at the lifestyles of the study subjects which distorts the data. Today, I found out more dishonesty about the study which sickened me. Mike Adams points out that they included the data on the benefits of antioxidants from women who DID NOT TAKE the supplements. They showed no benefits to supplementation of vitamins C and E. NO KIDDING!  How can any self-respecting journal publish a piece a garbage like that?  And unless the media purposely distorts the truth, how could they publicize this?  The only reason I can see is the incestuous relationship they have with the advertising dollars from the pharmaceutical industry.  This is just another reason why pharmaceutical advertising must be banned.

Back to the study. What was revealed yet not reported by the media is that those women who actually took the supplements showed a clear benefit and reduction of cardiovascular disease. What did the media report? That there was no benefit despite the evidence that there was one. How dishonest is this? Antioxidants ARE beneficial. The truth is out there, but when money from the pharmaceutical industry clouds minds, the truth is often hidden.

Antioxidants and Health – More Headline Nonsense

In the upcoming Archives of Internal Medicine a study was published that seemingly negates the benefits of antioxidant nutrients, especially when it comes to the prevention of cardiovascular disease.  It was a large scale study with over 8,000 women being looked at over a greater than 9 year period and the findings were likely very accurate, that antioxidant supplements do not prevent coronary heart disease.  Problem is, the study has a few fatal flaws that never make it to the headlines. All the headlines focus on is that antioxidants don’t help prevent heart

What the pharmaceutical company funded media fails to highlight is that they researchers did not look at the lifestyles of the individuals taking the supplements. If you have someone who has a very oxidative lifestyle filled with alcohol, poor diet, and no exercise there is no doubt that antioxidant supplements, especially in the low doses they used in the study, will have little effect on coronary heart disease. What the headlines should have said is that we found little benefit to supplements if you don’t give a damn about your health. You can’t use supplements to overcome a bad lifestyle.

The bottom line here is that the headline is deceiving. What it should have said is that supplements may are not helpful to people who don’t care about their health. There are numerous studies to show benefits of antioxidants in human health and this one does little to deny that fact, what it does suggest is that antioxidants alone are not the answer. Total focus on lifestyle issues is the answer. Sorry public, no pills to overcome bad decisions.

Urine Organic Acid Testing – A Gateway to Optimal Health

Urine organic acid testing is an easy way of finding out how to achieve optimal health and to help ascertain what nutrients your body needs. Being healthy is not simply being “free of disease”, it is feeling vibrant, full of energy and having optimal brain function. Today’s medical world is so focused on disease and treating symptoms, we forget about feeling good.

Drugs, which in some cases are life giving, are mainly focused on covering up symptoms caused by diseases. Optimal nutrition is where you go for real health and the prevention of disease. My past 23 years of research has been on the use of laboratory testing to biochemically individualize nutritional supplementation and take it out of the world of guesswork.

Urine organic acid testing is a great way to go for many people as the test can be done through the comfort of your home and the results with proper interpretation, can make a world of difference in how you and your family feels. Health Director is the home of the best interpretation of these and many other functional laboratory tests. Tomorrow, I will be posting some sample reports for you to look at and then you can decide if this type of testing is right for you.

Vitamin D – When is a good thing too much?

Vitamin D, as many of my regular readers know, is one of my favorite supplements. Research keeps on coming on all the good results scientists keep coming up with.  Here is a small list from recently published articles:

Still, there are times when you can get too much of a good thing.  In the July 19th 2007 issue of the New England Journal of Medicine, a letter to the editor pointed out a case where a women developed a series of life threatening toxic effects from taking Solutions IE Ageless Formula II supplement from Aloe International which contained 186,906 IUs of vitamin D. The symptoms she suffered included nausea, fatigue, constipation, back pain, forgetfulness and vomiting. It is known that long-term daily vitamin D consumption of 40,000 IUs of vitamin D3 can cause hypercalcemia in health patients so the amount this women took was obscenely high.

Of course, this is an isolated instance and not the standard in the nutritional supplement business. This is an example though of why the industry needs to make sure it regularly checks each batch for quality. This is not being done unfortunately and the FDA was forced to step in and create a rule that the manufacturers of nutritional supplements must test their products. Some advocacy groups bristled at the thought of FDA control and rolled out the dreaded term CODEX to scare the public but sad to say, it was a necessary evil to bring some sanity to the nutritional supplement industry. I have personally seen products, like an electrolyte product on the market claiming 136 mgs of magnesium in each serving but when I checked out their label claim through an independent lab, they only had 32 mgs of magnesium. That is only one-third of the label claim. This same company has already been admonished twice by the FDA for other offenses (like selling a product that could cause miscarriages) yet they stay in business.

There are many good companies out there but consumers must be wary. Hopefully, the new regulations will mean better and safer products on the market.

Antibiotics + Infants = Asthma

Researchers, looking at medical records of 13,116 children from Manitoba and saw that infants who had more than four courses of antibiotics in the first year of their life were 1.5 times more likely to develop asthma by the age of 7 than kids who did not get the drugs.  This finding was published in the June issue of the journal Chest.

The authors offered two possibilities for this happening, first is that early exposure to toxins made by the infectious microbes may help an infant’s immune system to develop normally. Second is that the antibiotics may kill off the friendly bacteria in the gut which is also crucial in the developing immune system. If this is the case then adding probiotics to infants who have taken antibiotics may help them avoid developing asthma which is often times caused by a overreaction of the immune system.

Bottom line here is that the overuse of antibiotics is causing more health problems than physicians had originally expected. Patient’s who come into the physicians office with a virus, walk out with a useless antibiotic which causes bacteria to develop a resistance to that drug over time. Antibiotics used in animal food production which leeches into our water supplies is becoming a real problem in the U.S. It is time for the government to step in and start a massive education program to put a halt to this growing problem.

Nutrition Update

According to the journal Cancer Epidemiology, Biomarkers and Prevention, people who have hepatitis B may benefit from folic acid supplementation because it may protect them from the development of liver cancer which is common with people who have hepatitis B.

Coenzyme Q10 Supplementation May Protect Against Statin-Induced Liver Disease – At this point in time, with all of the research done about the need for Coenzyme Q10 and statin use, wouldn’t you think that every doctor in America would just put the two together for all of their patients?  Sad to say, they don’t. In Europe its mandatory, in the U.S. we have such an anti-supplement bias fueled by misdirected reporters that people may be developing life-threatening diseases because of it. This is just another study showing real benefits to CoEnzyme Q10 use.

High Dietary Vitamin B-6 Intake May Lower Colorectal Cancer Risk in Men – In a very large prospective cohort study (81,184 subjects) it was noted that those men in the highest quartile for B6 intake had a 31% decreased risk for developing colorectal cancer. For men who drank more than 150 grams of alcohol a week the benefits were even greater.

Vitamin B6, Conception, and Early Pregnancy Loss – In yet another human study, researchers have shown that those women with the highest plasma levels of vitamin had a higher level of conception and a lower level of early pregnancy termination (spotaneous miscarriage).

These three studies show how much human research is going on regarding the benefits of nutritional supplement. I bring this up because of communications I had with a reporter from CNN I lambasted in an earlier blog. I challenged him saying that I could produce ten human studies showing the benefits of supplements for every one negative study. Caleb, here is just a smattering of evidence for the use of supplements. Of course, they need to be done in a biochemically individualized manner but when you claim there are no known benefits to the use of nutritional supplements, you kind of lose all credibility.