Thursday, February 19, 2009

In response to the NY Times article “Vitamin Pills: A False Hope?” published on February 16th 2009

This article was meant to be scandalous and grab the readers’ attention. Unfortunately, a lot of media attention is given to research studies that come out that appear to show evidence that goes against everything we believe. The appropriate way to look at research is to look at the entire body of evidence but it isn’t easy. This is what we hope doctors and other health experts are trained to do. Of course doctors are only human so have their predisposed ideas and beliefs and don’t always interpret the research with an unbiased eye. So one study comes out and he or she says, “See, I knew vitamins didn’t work!” I would like to shed some light on why this article was a waste of time and why vitamins, something most MD’s know very little about, actually do work, but in a different way then conventionally thought.

I will start by showing the gross misinformation regarding the studies cited as to why vitamins “don’t work”. The first study was conducted by the Women’s Health Initiative and apparently showed that vitamins don’t affect the risk of cancer or heart disease. The investigators happened to collect data of post-menopausal women, almost half of who were also randomly involved in other trials including hormone replacement therapy, which has a known association with hormone dependant cancers. The “participants” were not controlled by known scientific standards as to what vitamins they were taking or how much. A study whose results are meaningful amongst the large amount of data would have used a particular multi vitamin in a particular dose. The study was done for 8 years, this means that who knows what lifestyle factors were present during the majority of these women’s lives, most likely when the cancers and heart disease began to develop.

The second study cited was the Physician’s Health Study which showed small amounts (400 IU of vitamin E every other day and 500 mg of vitamin C per day) of vitamins do not prevent or treat heart disease in older men. Again, this is not a surprise since this small amount of vitamins is of little clinical use and cardiovascular disease takes a lifetime to develop.

The third study cited that had been published by JAMA was actually a well-done study. It showed that in men over 50, a five-year use of vitamin E and selenium did not reduce the risk of prostate cancer. However, considering that at autopsy over eighty percent of men have prostate cancer, I am not sure how this information helps us. As a physician I would never prescribe this as a solution for the prevention or treatment of prostate cancer.

Although there is a lot to learn in the world of high-dose vitamin therapies (orthomolecular medicine), one thing we learned from these studies is that anyone who thinks a multivitamin is a substitute for eating fresh fruits and vegetables is idealistic or uninformed. So why waste time trying to find out if that alone will cure anything? One point the article made about reductionistic perspectives was valid, which is why one pill of any kind, natural or otherwise will cure nothing. With professional guidance from someone who is trained in natural therapeutics including diet and nutrient therapy and botanical medicine, one can treat and/or reverse chronic disease. But you cannot wait until you are 50 to start taking the necessary steps for true health and expect any miracles.

I challenge the opposite to this dilemma; how does vitamin deficiency affect long-term health outcomes? Let’s look at the Standard American Diet (aka S.A.D.), or the beige diet: French fries, burger buns, pancakes, pasta, white bread, and dairy and animal products. The fact that these foods have had to become “fortified” speaks volumes about the nutritional value of our food supply. THIS is why multi vitamins are necessary, but they are not the answer to an unhealthy diet or lifestyle. Dr. Eric Klein holds a lot of titles for being so ignorant of the importance of vitamins in regards to health. Well, we have the answer: the highest obesity, diabetes, and heart disease rates in the world. We don’t need to research it; it is a statistical fact.

To end on a positive note, by far the only great point the article made was of the “possibility” that vitamins may not be the only beneficial constituent in vegetables. Could it be that all those bio-flavanoids (plant pigments), enzymes, beneficial bacteria, and other countless constituents in the plant material have an effect? There is a reason why every doctor on the planet says “eat more fruits and vegetables”, and its not because a study told them so. It is because its common sense.

Monday, February 9, 2009

More notes on SPA: Detoxification

This week I want to extend the discussion of SPA since it is a passion of mine. There are so many healing benefits to “taking the waters” but one of the most profound health benefits of a true spa are treatments that assist the body in detoxification. Detoxification is the process in which organs eliminate toxins and dangerous metabolites that arise from living in a not-so-perfect environment and eating a not-so-perfect diet. Over a lifetime we accumulate toxins, mostly in our fat cells. According to environmental medicine expert, Dr. Waltor Crinnion, only 250 of the 70,000 chemicals in daily use can be tested for. Dr. Crinnion has documented that every person in the U.S. is carrying deposits of xylene, dichlorobenzene, ethylphenol, styrene (VOC’s) in their fatty tissues. A study done by the U.S. Environmental Protection Agency in 1985 established that breath samples consistently contained VOCs and other chemicals. Perhaps the most disturbing yet is the Environmental Working Group’s findings of an average of 200 toxic chemicals in umbilical chord blood of newborns!

Although all of us are toxic, many do not experience symptoms until the burden overwhelms the body’s ability to detoxify on its own. This is why participating in a therapeutic cleanse or detox program at least once per year is a crucial part of staying healthy and improving the quality of your life. The specific organs of toxin elimination, also known as the “emunctories”, are the liver, skin, lymph, lungs, bowel, and kidneys. Besides going to a health spa here are some ways you can improve the detoxification process at home:

• Liver = Liver cleansing herbs such as Milk Thistle can be taken as a tea, liquid extract, or a pill. High nutrition helps the metabolic detoxification pathways of the liver function properly so always use a good quality multi vitamin/mineral. Castor oil packs over the liver (bottom right ribcage in the front) are important for any detoxification protocol.
• Skin = Sloughing off dead skin cells with exfoliation is critical to allow the skin to release toxins through the pores. Exercise also enhances detoxification through sweating. Try to rinse off directly after exercise so you don’t reabsorb any toxins released.
• Lymph = Unlike blood vessels, the vessels of the lymphatic system do not have a pump and therefore what moves lymph fluid through the body is the contraction of our muscles via strengthening exercise or with manual massage. Feather-light dry skin brushing is another way we can encourage the lymph to flow through its vast network of tiny vessels just under the skin. Always start with the arms and legs and move towards the heart where the lymph fluid drains.
• Lungs = Toxins are released through gas exchange in the lungs. Deep breathing exercises, aerobic exercise, Qi gong, meditation, and yoga all improve this exchange.
• Bowel = Eating a high fiber diet consisting of mostly fruits, vegetables, and whole grains helps to keep bowel movements regular. If we do not have at least 1 bowel movement per day we reabsorb many toxins through the lining of the bowel.
• Kidneys = Drinking half of your body weight in ounces of clean (ie; filtered) water per day is the best way to decrease the toxic load on the kidneys. Similarly to liver processing, many prescription medications are processed by the kidneys.

Other ways to improve detoxification include decreasing the toxic burden by eating organic foods and avoiding processed and packaged foods. Check out Dr. Crinnion’s article about eating organic. Perform daily home hydrotherapy treatments; alternate hot and cold/cool water spray or just end hot showers on cold/cool. This acts as a pump by dilating and constricting the blood vessels bringing nutrients in and toxins out. Getting regular massage is a wonderful detoxification tool as well as taking hot sea or Epsom salt baths, but drink plenty of water especially with these treatments. Movement is imperative for detoxification as well as all aspects of health so find the thing you enjoy and go out and play!

Don’t know where to start? Make an appointment with a Naturopathic Physician near you and get your health back on track! Extraordinary health requires fervent action!

Tuesday, February 3, 2009

Sanitas Per Aquas

This is an article I wrote previously for the popular NCNM journal, "The Student Naturopath". I wanted to share it again because it is something I am very passionate about. Thanks for indulging me, I hope you enjoy.

The ancient practice of the use of water as medicine has fluctuated throughout the centuries, barely resembling its popular use in spas today. The term 'spa' is thought to be derived from the phrase sanitas per aquas, which means health through water. Other names have been given to this practice such as balneotherapy, thalassotherapy, and hydropathy (hydrotherapy). The origins of the spa are found in Roman times where bathing was done for cleansing purposes. It was Hippocrates who first included bathing as part of a health program to restore the balance of bodily fluids. Bathing in public baths became commonplace.

After the fall of the Roman Empire, Christianity prohibited the use of medicinal bathing and allowed it only for prayer. During this period people went without bathing for years at a time. The first publication, a literature review, on the medicinal value of water occurred in 1553. A small number of spas existed during this time but by the 1700’s there was a French revival of spas. These spas consisted of natural hot springs for bathing, cold springs for drinking, healthy eating, purging, mud baths, and activities all under medical supervision.

The turn of the following century brought many developments in spa therapy by two people in particular: Priessnitz and Kneipp. The work of these practitioners led to the discovery that different temperatures and compositions of the water acted in different ways and they were able to individualize treatments for each patient. Kneipp also had a large impact on the people by bringing the water cure to everyone, not just the wealthy elite. He adhered to a holistic philosophy and incorporated other treatments into his program such as massage.

The popularization of the spa became apparent when hotels and guesthouses were developed around them which brought “health tourism” throughout Europe and North America. Because of this, the focus on health in spas lessened in favor of a more pleasurable social and leisure event.

With the exception of continental Europe, the last century witnessed the decline of medical spas and, more recently, the birth of the modern spa with its focus on beautification and anti-aging. An internet search of “medical spas” results in thousands of spas whose specialty is cosmetic surgery.

In North America the traditional practice of hydrotherapy is relegated to Naturopathic Physicians alone, many of whom do not have the facilities to perform these treatments on their patients. The use of water as a healing resource is being largely ignored today in medicine. Consequently, the vital force of our patients has weakened. I believe this is reflected in the fact that the average internal temperature of the human population is decreasing.

Naturopathic Physicians have an opportunity to resurrect this powerful healing modality that acts directly on the vital force. There are relatively few methods that have direct stimulatory effects on an individual’s vitality. With such a rich history and unlimited uses the simple and profound agent of water should not be allowed to slip through our fingers.

Tuesday, January 27, 2009

Modern Medicine: A Guide to the Future of Medicine (Part 2)

We are now at a crossroads of tradition and convention. An overwhelming majority of people have used natural remedies, and recommended by whom? Magazine articles, their neighbor, or other helpful but unqualified health practitioners. The public demands and deserves true experts in health and disease to co-ordinate care and design treatment plans according to nationally accepted standards. The problem is conventional, allopathic practitioners are untrained in natural modalities and most are unaware of the Nutraceutical world which encompasses professional, pharmaceutical grade (or higher quality) nutritional and botanical medicines among others.

Most Naturopathic Doctors decidedly prescribe therapies in the order of least to most invasive. The first non-invasive therapy is listening. Many patients complain of not being listened to. In their defense the current health system does not allow doctors time to sit with and listen to their patients let alone find the cause of their suffering. They only have time to act as match-makers of symptoms with drugs.

Slowly people are catching on. Fourteen states recognize Naturopathic Physicians (Naturopathic Doctor or ND) as primary care physicians or safe practitioners who have a broad scope of practice and these laws protect the public from health advisors who do not have the education or training to give such advice. Just because something is natural does not mean it is safe in any amount or without possible negative side-effects or interactions.

As we transition into this historical phenomenon of the modern doctor one must differentiate between two types of Naturopaths; those who studied at a school, college, or internet course that is not accredited by the Council on Naturopathic Medical Education (CNME) which do not include any medical training or clinical internship and those who studied at one of six CNME accredited Naturopathic Medical colleges in North America. These medical colleges or universities are nationally accredited and consist of four to six years of rigorous study in the classroom, preceptoring with other physicians, and hundreds of hours practicing in busy teaching clinics.

Naturopathic medical curricula meet or exceed the standard (allopathic) medical curricula of all other highly respected medical colleges. Studies include the basic human sciences; anatomy, physiology, biochemistry, and pathology, as well as focused study in the “ologies”; neurology, urology, oncology, etc. Students are taught from the Merck Manual, the Bible of conventional medicine and learn pharmacology of prescription drugs, many of which are within the scope of practice of an ND and are prescribed by them if and when the case arises.

In addition to all of this, naturopathic philosophy and history are taught, and the seemingly infinite number of natural modalities known to human kind. These include, but are by no means limited to; botanical medicine, homeopathy, nutritional medicine, hydrotherapy, exercise prescription, lifestyle counseling, health education, physical medicine (manual manipulation), dietary prescription, energy medicine, mind-body medicine, etc. Licensed Naturopaths sit for two sets of board exams to further ensure that they are indeed ready to begin the real world education of practicing as a doctor.

 Naturopaths are filling a crucial role in modern medicine and setting examples. Many Medical schools are now scrambling to open “natural medicine” branches in their medical programs such as the one at Harvard School of Medicine. With the initiation of the governmentally defined field of Complimentary and Alternative Medicine (CAM), a new integration of world medicine is being born. The U.S, it would seem, is finally breaking the convention of steadfast rigidity in what the American Medical Association has clung to as the definition of medicine. We are opening our arms to the possibility of other ideas about medicine, passed down to us as gifts, that were, at times, right under our feet all along.

Monday, January 19, 2009

Modern Medicine: A Guide to the Future of Medicine (Part I)

Naturopathic medicine is the art and science of natural medicine that was originally developed over 100 years ago. The practice of naturopathy is based on thousands of years of knowledge of plant medicine combined with a philosophy of healing and modern, evidence-based natural therapeutics.

I am a Naturopathic physician, a licensed, primary care doctor who specializes in natural medicine. I identify and correct the underlying causes of chronic disease. An ND is trained in general medicine similarly to the MD including the basic medical sciences, diagnostics, physical examination, and laboratory testing. In Washington, and in many of the 14 states where it is regulated, naturopathic medicine is complete primary care medicine requiring no other interventions except in the case a patient desires it or it is deemed medically necessary to refer to another specialist or in an emergency situation.

As technology in medicine progresses, natural traditions in medicine continue, passed down from generations and borrowed from cultures.  These traditions are oblivious to whether or not people “believe” in them for they are not part of a religion. They are part of history.  People used traditional remedies for a health complaint or illness and it cured them.   Most doctors now days have excised that word from their vocabulary.

More than fifty percent of today's pharmaceuticals are synthetic or altered versions of something found in nature so that a company could patent it and charge larger sums of money to make bigger profits. This is illustrated beautifully in National Geographic's "Nature's Medicine; Plants that Heal". Any pharmacist, doctor, or other medical professional who thinks natural "remedies" don't work do not know the history of their own medicine.

Natural therapies can have miraculous actions especially when you did not think it was going to be effective. Those who have been waiting in vain until the proper research study came along to “prove” its efficacy and not acknowledging its history are being left behind. However, medicine alone, natural or otherwise, is not the answer.

At the forefront of modern medicine are the world’s most highly trained practitioners of these Natural therapies who also uphold the gold standards in medicine pertaining to diagnostics and responsible patient care.The pendulum has swung once again, I introduce to you the Modern Doctor; the Naturopathic Physician.