Acupuncture and Anxiety

In my practice, I’m always amazed at how effectively acupuncture is able to diminish the severity of anxiety, even for patients who experience panic attacks other extreme forms of this condition. A recent study measured the response of patients to acupuncture before operations, and how well it was able to reduce their anxiety levels. The results showed a marked decrease in anxiety levels after acupuncture was performed. Although this study applied exclusively to preopearative anxiety, it still demonstrates the efficacy of acupuncture in treating stress and anxiety. 

Please don’t be afraid to seek out acupuncture if you’re burdened by chronic stress, as you’re otherwise overlooking a proven treatment that could end up being very effective in your quest to destress.
“Comparing the treatment effectiveness of body acupuncture and auricular acupuncture in preoperative anxiety treatment,” Wu S, Liang J, et al, J Res Med Sci, 2011 Jan; 16(1): 39-42. (Address: Department of Psychology, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China).

Work Causes Heart Disease

People who regularly work long hours may be significantly increasing their risk of developing heart disease, the world’s biggest killer, British scientists said Monday.

Researchers said a long-term study showed that working more than 11 hours a day increased the risk of heart disease by 67 percent, compared with working a standard 7 to 8 hours a day.

They said the findings suggest that information on working hours — used alongside other factors like blood pressure, diabetes and smoking habits — could help doctors work out a patient’s risk of heart disease.

However, they also said it was not yet clear whether long working hours themselves contribute to heart disease risk, or whether they act as a “marker” of other factors that can harm heart health — like unhealthy eating habits, a lack of exercise or depression.

The study, published in the Annals of Internal Medicine journal, followed nearly 7,100 British workers for 11 years.

“Working long days is associated with a remarkable increase in risk of heart disease,” said Mika Kivimaki of Britain’s University College London, who led the research. He said it may be a “wake-up call for people who overwork themselves.”

Cardiovascular diseases such as heart attacks and strokes are the world’s largest killers, claiming around 17.1 million lives a year, according to the World Health Organization (WHO). Billions of dollars are spent every year on medical devices and drugs to treat them.

The findings of this study support previous research showing a link between working hours and heart disease.

For this study, men and women who worked full time and had no heart disease were selected, giving 7,095 participants.

The researchers collected data on heart risk factors like age, blood pressure, cholesterol, smoking and diabetes and also asked participants how many hours they worked — including work during the day and work brought home — on an average weekday.

During the 11-year study, 192 participants had heart attacks. Those who worked 11 hours or more a day were 67 percent more likely to have a heart attack than those with fewer hours.

Of course, heart disease is a multi-factorial issue, but those working more than 11 hours per day need to take even further precautions to lower their heart disease risk. Talk to your naturopathic doctor about laboratory studies that can help to identify numerous cardiovascular risk factors, so the proper steps can be taken to help prevent heart disease and stroke in the future. 

Elderberry and Infections

As many of my patients are already well aware, I often rely upon Elderberry extract, especially in the treatment of influenza and other viral infections. This recent study demonstrates evidence as to why this treatment is effective.

In a study designed to examine the effects of a standardized extract of black elderberry (Sambucus nigra L.) on 3 Gram-positive bacteria and one Gram-negative bacteria responsible for upper respiratory tract infections, as well as two different strains of influenza virus, the extract was found to possess antimicrobial activity against both Gram-positive bacteria of Streptococcus pyogenes and group C and G Streptococci, the Gram-negative bacteria Branhamella catarrhalis, and human pathogenic influenza viruses. The results of this study suggest that elderberry extract such as the one used in this study may be an effective tool for helping to combat various types of upper respiratory tract infections.


Reference: “Inhibitory activity of a standardized elderberry liquid extract against clinically-relevant human respiratory bacterial pathogens and influenza A and B viruses,” Krawitz C, Mraheil MA, et al, BMC Complement Altern Med, 2011 Feb 25; 11-16. (Address: Institute for Medical Microbiology, Justus-Liebig-University, Frankfurter Strasse 107, 35392 Giessen, Germany. E-mail: Stephan.Pleschka@mikro.bio.uni-giessen.de ).

The Definition of Holistic Medicine

I’m posting an article written by Dr. David Katz, as I think it is a fantastic summary of what I strive for in my own practice, which is to emphasize healing by relying on both clinical intuition and scientific research, as too much focus on one or the other is not in the best interest of the patient. 

 

Holistic Medicine: How To Define It

 

We are probably all familiar with things that are tough to define,
but that we recognize when we see them. No, I’m not planning on talking
about that one

The term I have in mind is: holistic.

I practice holistic medicine. Specifically, for the past decade, I have directed a rather unique clinic that provides what we call ‘evidence-based integrative care.’ We have published and presented details of the model.

People tend to have a strong sense of what holistic means, whether or not they can actually define it. Detractors see it as an indication of quackery
without looking past the label. Proponents embrace it as an emblem of
virtuous humanism. Holistic is good, and all else … less so.

But if that is really true — if holistic care is better (I’m among
those who believes it is) — then a workable definition is important.
First, so that people who want to sign up for holistic care — to give
it, or receive it — know what they are signing up for, exactly. And
second, and more importantly, because you can’t practice what you can’t
define. Unless we can say just what holistic care is, it can’t be
taught, tested, replicated, or improved.

The medical version of TheFreeDictionary tells
us that holistic care is: “a system of comprehensive or total patient
care that considers the physical, emotional, social, economic, and
spiritual needs of the person; his or her response to illness; and the
effect of the illness on the ability to meet self-care needs.”

I am comfortable with this in theory, but not in practice. In
practice, it begs the question: how, exactly, do you do that? What does
considering ‘physical, emotional, social, economic, and spiritual needs’
look like in a doctor/patient encounter? What is a clinician actually
supposed to do in a room with a patient so that the care that transpires
between them is holistically concordant with this definition?

Let’s acknowledge that platitudes don’t really help. Of course, a
holistic practitioner looks beyond a battered body part to the whole
body; looks beyond the body to the mind and spirit; looks beyond the
individual to the body politic of which they are an intimate part; and,
if responsible, looks at the body of pertinent scientific evidence as
well.

But a devotion to holism does not impart mystical prowess to
clinician, or patient. No one gets a magic wand that allows for a
complex array of medical problems to be fixed all at once. Holistic
care is, in fact, most important when it’s hardest to do — when there
is a lot that needs fixing. I suppose there may be a holistic way to
suture the finger of a healthy, young person lacerated while dicing
zucchini, but I doubt it would matter much. It does, however, matter a
great deal in complex cases of chronic illness, attendant despair,
social isolation, and hopelessness. And at such times, it’s really hard!

Here’s an illustration, based on any number of patients we’ve treated
over the years. Consider a woman of roughly 70, who comes to the
clinic ostensibly to get dietary advice because she wants to lose
weight. She is, indeed, obese — with a body mass index of 32. She has
high blood pressure and type 2 diabetes, and is on medication for these.
Her husband passed away 4 years ago, and she lives alone. She is
lonely, tends toward sadness, and is always tired. She sleeps poorly.

She eats in part because she is often hungry, in part to get
gratification she doesn’t get from other sources. She does not exercise
because she has arthritis that makes even walking painful. Her arthritis
has worsened as her weight has gone up, putting more strain on already
taxed hips and knees. Medication for her joint pains irritates her
stomach, and worsens her hypertension. There’s more, but you get the
idea.

I regret to say that medical practice propagates its own uncouth
vernacular, resorted to in part to relieve the pressure of 30 hour
shifts and life and death crises. Much of the slang is too shameful to
share, but one term is especially germane to a case such as the one
above: circling the drain. A complex array of medical, emotional and
social problems really can resemble a cascade in which each malady
worsens another, and the net effect is a downward spiral into despondent
disability. Circling the drain is crude, but apt.

I present the term here because it actually has hidden utility. If
you can descend one degenerating spiral at a time, you can reverse
engineer the process — and ascend the same way! In my view, that is
what holistic care — in its practical details — needs to be.

For the hypothetical case in question, and innumerable real people
like her, reversing a descent begins with one well prioritized move in
the other direction. So, for instance, it is likely that this woman has
markedly impaired sleep, due perhaps to sleep apnea. A test and
intervention to address this effectively may be the best first move for a
number of reasons.

Poor sleep can cause, and/or compound
depression; poor sleep invariably lowers pain thresholds, making things
hurt that otherwise might not, and things that would hurt anyway, hurt
more; poor sleep leads to unrestrained and emotional eating; poor sleep
leads to hormonal imbalances that foster hypertension, insulin
resistance, and weight gain; and poor sleep saps energy that might
otherwise be used for everything from social interactions, to exercise.

Whether a focus on sleep is the right first step will vary with the
patient, of course. But let’s imagine that in this case it is a good
choice, as I have found it to be on a number of occasions. So, we
intervene accordingly — just to improve sleep. So far, this doesn’t
sound defensibly holistic. But it does sound like something the patient
might be able to tolerate.

But as soon as sleep does improve, the benefits start to accrue. Ms.
Patient has a bit less pain, a bit more energy, and a slightly more
hopeful outlook. So now that she has some more resources, we ask more of
her. We now need her to invest these benefits back into herself! Let’s
use that energy to start a gentle exercise regimen (water-based if need
be to avoid joint strain); initiate some social activity of interest to
get some stimulation and purpose reintroduced; and perhaps begin the
process of dietary improvements to address the weight loss goals
initially espoused. We might also start a course of massage therapy or
acupuncture to further alleviate joint pain, now that Ms. P believes
feeling better is possible.

A little exercise further improves energy, and sleep, and
self-esteem; and actually helps ease joint pain. Less pain further
improves energy, sleep — and willingness to exercise. Social engagement
— perhaps a church or civic group — confers gratification that no
longer needs to come from food. Hormonal rebalancing that occurs with
restoration of circadian rhythms alleviates constant hunger. Diet
improves. Medication doses are dialed down. Helpful supplements may be
started.

Weight loss starts. Energy goes up. Joint pain improves some more.
Physical activity becomes less and less problematic, and increases
incrementally. Energy and sleep improve further, weight loss picks up.
With more hope, and more opportunity to get out, Ms. P establishes, or
reestablishes social contacts that restore friendship and love to their
rightful place in her life. Her spirit rises, and with it, the energy
she has to invest back into her own vitality.

And so on — with many time consuming details left out, of course.
This may sound like wishful thinking — but it’s a rewarding reality I
have been privileged to help choreograph innumerable times over the past
decade.

If the erosion of health is a degenerating spiral, then its reclamation is a spiral staircase.
Which leads to the good news, and bad, about holistic care, practically
— and practicably — defined. The good news is that with real
dedication and a commitment to one another and the process, almost every
clinician and patient can find a way to ascend at least some distance
toward the heights of holistic vitality. The bad news is that I’ve yet
to see a helicopter fly in to get anyone there in one fell swoop. We all
need to be realistic. The climb is made one step at a time.

Dr. David L. Katz; www.davidkatzmd.com

PMS and Essential Fatty Acids

Yet another case of naturopathic medicine being way ahead of the curve when it comes to using treatments for years before they’re eventually “proven” effective. 
Up to 95% of women suffer from at least one PMS symptom, and more than a third of these women have PMS severe enough to interrupt their routine activities. Fortunately, a new study may offer a way for women to get some much-needed relief from monthly bouts of PMS.
PUFA vs. PMS
The exact causes of PMS aren’t known, but health experts suspect that certain essential dietary fats, called polyunsaturated fatty acids, or PUFAs, may play a role. Not getting enough of and the right types of PUFAs may worsen PMS symptoms.
Researchers set out to test this theory by enrolling 120 women into a six-month study. The study authors randomly selected the women to receive a daily 1- or 2-gram PUFA supplement, or a placebo (no fatty acids).
Blood levels of cholesterol and prolactin, a hormone produced in the body that may affect PMS, were tested before and after the study. The women kept symptom diaries to track the details and severity of their PMS from month to month.
After 6 months, the researchers found that compared with the initial PMS ratings:

• Women taking the PUFA supplements had significant decreases in PMS symptoms at three and six months.

• Women taking 2 grams of PUFAs, the highest amount given, experienced the largest decrease in PMS symptoms over time.

• Women taking the placebo h
ad a small decrease in PMS symptoms at three months, but no improvement of symptoms at six months.

None of the women in the study experienced significant changes in blood levels of cholesterol or prolactin. This suggests PUFA supplements do not raise cholesterol in otherwise healthy women experiencing PMS, nor exert their anti-PMS effects through changes in prolactin levels.

Getting your essential PUFAs

If you are interested in trying a PUFA supplement, keep the following tips in mind:

• Talk to your doctor about whether PUFA supplements are right for you. Dietary supplements can interfere with medications, so err on the side of caution when adding new supplements to your self-care routine.

• The 2-gram PUFA supplements used in the study provided 420 mg of gamma linolenic acid, 350 mg of oleic acid, 690 mg of linoleic acid, 500 mg of other PUFAs, and 40 mg of vitamin E. Ask your doctor or dietitian to help you find a supplement with a similar mix of PUFAs.

• You can get more PUFAs from the food you eat as well. Try walnuts and other nuts and seeds, ground flaxseed, green leafy vegetables, tofu and other soy foods, and fatty fish, such as wild-caught salmon.

• Other lifestyle changes that may help ease PMS symptoms include getting enough sleep (seven to eight hours), exercising regularly, limiting intake of caffeine, alcohol, and sweets, and eating a healthy diet based around vegetables, fruit, whole grains, and legumes.

(Essential fatty acids for premenstrual syndrome and their effect on prolactin and total cholesterol levels: a randomized, double blind, placebo-controlled study. Accessed January 20, 2011; Available at: NewsRelease_Essential_oil pill_prevents_PMS.pdf)

PCOS Patients Benefit From Exercise and Acupuncture

Acupuncture and physical exercise improve hormone levels and menstrual bleeding pattern in women with polycystic ovary syndrome (PCOS), reveals research from the University of Gothenburg, Sweden. 

PCOS is a common disorder that affects up to 10% of all women of child-bearing age. Women with PCOS frequently have irregular ovulation and menstruation, with many small immature egg follicles in the ovaries. This causes the ovaries to produce more testosterone which, in turn, leads to troublesome hair growth and acneObesity, insulin resistance and cardiovascular disease are also widespread among these patients. 

In the current study, published in the American Journal of Physiology-Endocrinology and Metabolism, a group of women with PCOS were given acupuncture where the needles were stimulated both manually and with a weak electric current at a low frequency that was, to some extent, similar to muscular work. A second group was instructed to exercise at least three times a week, while a third group acted as controls. All were given information on the importance of regular exercise and a healthy diet. 

“The study shows that both acupuncture and exercise reduce high levels of testosterone and lead to more regular menstruation,” says docent associate professor Elisabet Stener-Victorin, who is responsible for the study. “Of the two treatments, the acupuncture proved more effective.” 

Although PCOS is a common disorder, researchers do not know exactly what causes it. “However, we’ve recently demonstrated that women with PCOS have a highly active sympathetic nervous system, the part that isn’t controlled by our will, and that both acupuncture and regular exercise reduced levels of activity in this system compared with the control group, which could be an explanation for the results.” 

In my experience, women I’ve seen with PCOS respond extraordinarily well to nutritional, botanical, and dietary interventions. Plus, conventional medical treatments tend to be very “piecemeal”, treating each component of PCOS as individual symptoms, rather than addressing the body as a whole. As this study confirms, exercise and acupuncture are other treatments that can be implemented to successfully reverse PCOS.  

Pesticides and Brain Development

Toddlers whose mothers breathed more of a chemical often present in insecticides during pregnancy had slower brain development, according to a study from New York City.

On average, women breathing the highest amounts of piperonyl butoxide, or PBO, had babies who scored 3.9 points lower on a mental development test at age three (85 points and above is considered normal).

These changes are about the same as those seen in kids with low-level lead exposure, according to Megan Horton, a researcher at Columbia University who worked on the study.

“It means that these kids might not do as well in school” later on, said Horton, whose findings appear in the journal Pediatrics.

Baby brains are extra vulnerable to toxic chemicals, because they are not fully formed.

“If you alter the blueprint, there may be lasting long-term consequences,” Horton explained.

She and her colleagues analyzed air samples from a few hundred pregnant women’s environments to track the levels of PBO and another chemical called permethrin. The two compounds are commonly found in bug sprays for indoor use.

Permethrin wasn’t tied to the toddlers’ mental skills. But among the 42 women who breathed the highest levels of PBO — around 4 parts per trillion — nearly half had a baby with a lower-than-normal mental development score.

“For these toxic chemicals, there’s probably no such thing as a safe level during pregnancy,” said Dr. Philip Landrigan, who heads the Children’s Environmental Health Center at the Mount Sinai School of Medicine in New York, and was not involved in the new study.

He suggested that pregnant women who have an insect problem should make sure more bugs can’t get in through measures such as caulking cracks in walls, and that all food is cleaned up.

“Instead of spraying,” he said, “use little baits like roach motels because it’s contained.”

To me, this has been obvious all along, but in light of this information, I would disagree with using even “contained” pesticides, as there is still an exposure risk. Pregnant or not, this is further proof that pesticides promote serious neurological complications, and should be avoided at all costs. If you absolutely must use pesticides, make sure you wear gloves, a ventilator, and other protective gear to limit your exposure as much as possible. If you have been exposed to pesticides in the past, there are tests that can be performed to assess the levels in your system. Treatments can then be implemented to help your body excrete these harmful toxins. 

SOURCE: http://bit.ly/gZSdEU Pediatrics, online February 7, 2011.

Diet Soda and Heart Disease

As many of my patients know, I often discourage the use of diet sodas and other sources of artificial sweeteners. The reasons for this are numerous, but here is yet another suggestion that diet soft drinks may not be the best choice: 

http://www.latimes.com/health/boostershots/lat-heb-dietsodastrokeheartattack20110209,0,4324389.story

Supplements Shown To Reduce Breast Cancer Risk

In a randomized, placebo-controlled study involving 47 premenopausal and 49 postmenopausal women, results indicate that supplementation with a herbal formula may reduce the risk of breast cancer. The women were randomized to placebo or supplementation with a mixture of HMR lignan, indole-3-carbinol, calcium glucarate, milk thistle, Schisandra chinesis and stinging nettle, for a period of 28 days. At intervention end, a significant increase in urinary 2-OHE concentration and a trend toward an increase in 2:16alpha-OHE ratio was observed in the herbal group (Meaning that the “more harmful” form of estrogen was significantly diminished after use of this herb/nutrient combination).


While this proves that various supplements can certainly be beneficial in the prevention of breast cancer, 2 of the main ingredients (HMR lignan and indole-3-carbinol) can be found in flax seeds and cruciferous vegetables, respectively. Therefore, I would encourage all women to incorporate these foods into their diet on a regular basis, as well as supplementing with some of the herbs and nutrients mentioned above.

Source: “Effects of A Breast-Health Herbal Formula Supplement on Estrogen Metabolism in Pre- and Post-Menopausal Women not Taking Hormonal Contraceptives or Supplements: A Randomized Controlled Trial,” Laidlaw M, Sepkovic DW, et al, Breast Cancer (Auckl), 2010; 4: 85-95.

Vegetarian Source of Essential Fats

In the first study to investigate the effect of the omega-3 DHA (docosahexaneoic acid) derived from algae, researchers found that people suffering from age-related decline in their thinking (cognition) could get a memory boost by supplementing with the extract.
DHA is a fatty acid found in high concentrations in some fish. Together with other fish-derived oils, DHA is believed to help slow the rate of cognitive decline in people with mild impairment, but it has never been studied on its own.
As the world’s population continues to age, health issues related to aging bodies and brains are becoming more common. Many population-based studies have noted the association between lower DHA levels and cognitive decline in healthy people and those with Alzheimer’s disease.
According to the journal Alzheimer’s and Dementia, the new study was led by doctors at Martek Biosciences Corporation, the company that manufactures the algal DHA supplement used in this study. A total of 437 people aged 55 or older with age-related cognitive decline completed the 24-week study. Half of them were given 900 mg per day of DHA from the algae, Schizochytrium sp.; the rest were given a matching placebo.
Tests were given before and after the supplementation period to measure memory, learning, attention, problem solving, and skills involved with decision making and abstract thinking (executive function skills).
Anti-aging for the brain
The ability to recollect past experiences (episodic memory) and learning in the DHA group significantly improved. People with lower scores at the study outset seemed to benefit the most, as did those with a family history of dementia and those taking cholesterol-lowering medications, “suggesting that potential genetic and cardiovascular factors may influence the effects of DHA on cognition,” the team commented. There was also a significant decrease in heart rate associated with DHA supplementation.
Working memory–that which is used to store and manage information–was not affected, nor was executive function. Participants reported no adverse side effects related to treatment.
Use it, don’t lose it
Try these tips to help keep your mind spry.
• Get moving. Physical exercise helps keep the mind and body young by protecting brain tissue from age-related damage and by keeping the heart healthy.
• Stay involved. People who connect with others through church, volunteering, travel, and leisure activities are doing their brains a favor. Staying socially engaged reduces stress and helps keep the mind sharp.
• Eat right. Diets rich in brightly-colored fruits and vegetables and lean protein (especially fish) help ward off brain-damaging free radicals, preserving tip top brain function.
 (Alzheimers Dement 2010;456-64)