Dr. Haase & Mr. Why

Ok,  I am putting a line in the sand…   I predict the Institute of Medicine and the authors of the recent paper on Vitamin D could indirectly be responsible for excess deaths and increased disease as a result of people following their recommendations.    The report basically said that 600 IU of vitamin D is enough for everybody and every concern and that more than 4000 iU a day is dangerous.

Balderdash on both counts.

See the full commentary from Dr. Cannell below for more of the facts… now I will continue my rant…. 

This is a great example of how reactive the thinking in “medicine”  is and how we are having a hard time seeing the bigger picture of HEALTH rather than DISEASE.    You see,  Creating Health is very different than Treating Disease.   The IOM is working from a flawed paradigm that has largely caused our current health crisis.   They examine the data (likely not consciously)  like we should wait for a dysfunction to get so severe that we cannot ignore it any longer, name that dysfunction a “Disease” and now treat it with potent medications that often throw off-kilter the body’s own self-adaptive strategies.

These Treat-’em-and-street-’em approaches can be studied using a Randomized Trial (DBRPCT)  which assumes all people are “average and identical” so a single powerful (and often highly profitable patented) drug can be applied to all people (big market share).  This is even if that drug only makes a whiff of a difference that is impressively called statistically significant but is really nearly clinically meaningless.   All this is reinforced by our medical reimbursement system that pays us doctors to treat “Disease” and not to restore function… Too much positive reinforcement on the $$$ side of things to make many want to see change.   ….. Yea, that is a whole another series of posts to unpack those statements….  but the bottom line is the IOM is being REACTIVE instead of PROACTIVE in approaching this question and that approach is nested within a greater framework of the philosophy of the medical-industry in these times.

Finally just look at their darn name… the Institute of MEDICINE.    As long as we keep things “diseases” and don’t work earlier upstream in prevention and improvement of function the medical establishment will be forced to continue using last-ditch powerful medications, and thereby maintain control over the prescription pad and control over the money stream.    It is time to break the broken “Medical-Treatment System”  and replace it with true Health Care which focuses upon individual health-responsibility, and function and quality of life centered outcomes.    AND Don’t you DARE call what we currently have a  “Health Care System” because the payment structure for services and therefore most services themselves are not focused either on either health or care at present.

One clinical note.   I have been impressed with how much better Allergy Elimination Treatments proceed when an individual has enough vitamin D.    This makes good biochemical and physiological sense – as does taking fish oil – to improve the immune response to sublingual immunotherapy.   More on our approach to allergies at MaxWell Clinic.

Since Dr. Cannel has the right to speak on this topic at length given that he has dedicated the decade to fleshing out the story of Vitamin D in full I am reproducing his response to the IOM Vitamin D paper in full below.  Here is the link to the Vitamin D research counsil.

WHY is my kid bouncing off the wall?   Maybe he/she is toxic.   Seriously.   In a recent study of US children, those with higher levels of organophosphate (OPs) pesticide metabolites in their urine were more likely to have attention-deficit/hyperactivity disorder (ADHD) than children with lower levels, researchers report in the June issue of Pediatrics.

“Each 10-fold increase in urinary concentration of organophosphate metabolites was associated with a 55% to 72% increase in the odds of ADHD,” says lead study author Maryse F. Bouchard, PhD, of the Department of Environmental and Occupational Health, University of Montreal. ADHD is characterized by inattention, impulsivity and hyperactivity to the degree that the child has an impaired ability to learn and function at home and at school.

The Centers for Disease control says about three to seven percent of school-aged children suffer from ADHD, but it seems like more and more kids are being put on drugs to ‘calm them down’.  At MaxWell Clinic we have been doing more and more EEG neurofeedback and non-drug interventions to address this epidemic of attention and it is obvious that there is far more going on in the cause of this than just family history.   This is part of the “soup” of the brain that is being compromised.

In our testing of environmental toxins (which include organochlorine pesticides, PCB’s, VOC’s, parabens, phthalates, lead, mercury, and others) we are often shocked at the high body burdens present.    These compounds are by definition TOXIC, but because they occur in such great numbers and interact with each other over a long life-time and because each person’s genetics upon which they act are unique it is very hard to sort out the cause-and-effect nature of these things… Yet that does not excuse us from doing something about it!    I have given up on the cop-out that we need omniscience before action is taken.

Previous investigations of pesticides have focused on special groups with high levels of exposure, such as children from agricultural communities, and reported pesticides-related cognitive deficits (involving memory and attention), and behavioral problems. “This is the first study to link exposure to pesticides at levels common in the general population with adverse health effects,” noted Dr. Bouchard.

Dr. Goldstein, a specialist in child neurology with Western Neurological Associates in Salt Lake City, Utah, said the data on organophosphate pesticides and ADHD are similar to the data being developed 30 to 40 years ago with lead exposure, and it may turn out to be the same thing — that even small exposures (to organophosphate pesticides) are very harmful to kids.

People are commonly exposed to OP pesticides through eating fresh and processed vegetables, contacting pesticide-contaminated surfaces, breathing air near pesticide applications (both indoors and outdoors), and drinking pesticide-contaminated water.

Approximately 40 organophosphate pesticides are registered with the US Environmental Protection Agency (EPA). About 70% of insecticides (pesticides that kill insects) used in the United States are OP pesticides.

Peaches, apples, grapes, green beans, and pears are among those fruits and vegetables that are conventionally grown with OP pesticides and are most commonly eaten by children, according to FoodNews.org. A 2008 US study revealed detectable concentrations of the organophosphate malathion in 28% of frozen blueberry samples, 25% of strawberry samples, and 19% of celery samples.

Other top uses of OP pesticides include corn, cotton, wheat, other field crops, and for termite and mosquito control. Certain pest control products for cats and dogs contain OP compounds.

OPs of primary concern include: azinphos-methyl (product name Guthion,chlorpyrifos (products Lorsban and Dursban), diazinon (product name Spectracide), dichlorvos (DDVP), dimethoate, thephon, malathion, methamidophos, naled, and oxydemeton-methyl.
How can we limit exposure?

Because of the known dangers pesticides pose to humans, the U.S. EPA limits how much residue can stay on food. But “the new study shows it’s possible even tiny, allowable amounts of pesticide may affect brain chemistry,” warns Virginia Rauh, a PhD at Columbia University’s Center for Children’s Environmental Health who has studied prenatal exposures to pesticides. It seems prudent, therefore, to reduce pesticides exposure by reducing their use in agriculture.

Initial steps to take:

Change your mindset -  Organic foods don’t look as pretty because a few insects have taken a bite of them.   That is better than the fruit taking a bite out of your brain.   See the inner beauty of a not-so shiny apple that has been raised organically.

Choose organic produce, including frozen organic produce. A 2008 Emory University study found that in children who switched to organically grown fruits and vegetables, urine levels of pesticide compounds dropped to undetectable or close to undetectable levels.

Check the labels on any older pest control or gardening products in your household to make sure they do not contain chlorpyrifos (or Dursban, its trademarked name). If they do, contact your sanitation department for information on how to dispose of it as household hazardous waste, or check www.Earth911.org for information on hazardous waste disposal in your area.

Checking the label on pet care products. Avoid flea collars that list propoxur, tetrachlorvinphos, amitraz or carbaryl (recently cancelled for use in flea collars) as active ingredients. Instead, give your pet regular baths with a pesticide-free pet shampoo, and use a flea comb between baths; launder your pet’s bedding in hot water, and vacuum carpets regularly to eliminate flea eggs that could be hidden there. If you do need to use a chemical flea-control product, choose those dispensed in pill form as they usually contain the least toxic chemicals, and won’t leave a residue on your pet or in your home.

A good article at the Organic Authority has some more hints.  Leah Schuchter – who has interest in peri-natal wellness has this to say.

OK,  remember the commercials for Orlistat?  You know the ones.. the great weight loss drug that after a bunch of images of thin people dancing around with shining post-Viagra smiles plastered on their face THEN had to enumerate the side-effects of the medication… one of which was “oily rectal discharge”.

You know that Americans are desperate to loose weight if they will accept “oily rectal discharge” as a stated side-effect.    This drug has been a blockbuster as it has now gone over-the-counter as Alli.   Now you no longer need your doctor’s help to enjoy oily discharge.

But wait, there’s MORE!   Now as a bonus you can get liver failure!    This is great for business if you are a transplant surgeon or a mortician.  In August the FDA learned..

WASHINGTON — The FDA said it has received 32 reports of serious liver injury — including six cases of liver failure — among users of diet drug orlistat, which is sold as a prescription drug under the trade name Xenical and as an over-the-counter diet aid under the name Alli.

So the FDA has now confirmed these reports and is now placing a warning on the box.   Good for them – to protect us from a drug that has no known benefit except short-term-weight-loss-from-oily-discharge.  Your tax dollars at work.

In two of the reported cases, the patients died from liver failure, and in three cases patients required liver transplantation.

According to the FDA’s statement, healthcare professionals should weigh the risks of the medications with the benefits of weight loss before recommending orlistat to their patients.

Just read that last statement again…  It might have some shred of helpfulness IF ORLISTAT WERE NOT OVER-THE-COUNTER as Alli !!

The tragedy of these type of medications is that they have the same effect as taking a battery out of a screaming fire-alarm.   Suppressing the symptoms without treating the cause.    There are solutions to weight loss that work long-term and do not endanger the very life you are trying to live better.  We advocate these at the MaxWell Clinic.

I have also had the privilege to write the forward on an amazing book on this subject that will be out in the next month.   It helps people to find those hidden causes of worsened weight and shape.  More to come on that when it hits the shelf.

So if you can get by with missing your oily discharge, then please throw away your Alli and Orlistat and use your liver for more enjoyable adventures.

So, THIS is why The Boss wants me to sleep…he has an agenda…Like number 1,2,3 & 4 on the left…and probably 5,6 & 7 as well.  Number 8 means HE has to work for ME.  WAKE UP CALL to the dangers of sleep deprivation!

“I told you that stuff wasn’t good for you.”  Even though I wanted to cry, I had to laugh.  Dr. Haase was talking about peanut butter, the kind choosy Moms choose.  A large jar of Extra Crunchy had fallen off my pantry shelf and onto my foot that morning, and once he’d determined that my two middle toes weren’t broken, the fun began.

Grace Vinson and Jennifer Hanley, our two nurse practitioners, joked that they’d hoped that it was my big toe so that they might have the opportunity to drill a hole in it to relieve the pressure, and though it wasn’t they both remarked “Your going to lose that nail,” right before the beginning of summer sandal season.  I watched it slowly turn deep purple throughout the day, and seriously, does anything hurt worse than smashing your toe?  Finally, Winnie Jones, our Clinical Director, reminded me of Ondamed, a pulsed electromagnetic biofeedback treatment that we offer here at the MaxWell Clinic.  I’d used it with great success to treat a large bruise on my arm last year, so off I went.  When I started, my entire nail was purple and my two middle toes were still throbbing.  After the treatment (20 minutes total), the pain was much better.  Next morning, I noticed that only half of the nail was now purple, and the pain was greatly reduced!  Over the next 3 days I gave myself 1 treatment a day.  Now 5 days later, my nail is still intact, and only about a small part of my nail is purple…oh, and I’m wearing a fabulous pair of heels with no pain whatsoever!

There are several pre-set programs (I used one for pain and one for tissue regeneration) for any number of things that we train patients to self-administer here at the clinic.  Ondamed works by “clearing” electromagnetic frequency imbalances in the body…in effect helping the body to heal itself.  You can find out more by visiting our website www.maxwellclinic.com, or the Ondamed website, www.ondamed.net.

Try it for yourself and see!  Oh, and Doc is right about the peanut butter…I’m switching to one without hydrogenated oils.
Diane R. Welker
Practice Administrator – MaxWell Clinic

If you have not seen this video, then take the 20 minutes to watch it.   It is necessary for our economic, physical, and social survival to make changes in the very way our economy works.     It is up to all of us to make this happen.

Asking WHY is important not just for understanding what creates health for our bodies, but our world as well.

Did you know there is a therapy that can profoundly improve not only the symptoms of allergy, but can re-educate the body to no longer be allergic? Crazy, but true.

The amazing therapy is called SLIT (Sub-Lingual Immuno-Therapy) and is essentially allergy shots administered as custom-formulated drops under the tongue at home, not in an allergist’s practice.

• They are cheaper than allergy shots.
• They are safer than allergy shots.
• They are very useful for treating molds – this is tough with allergy shots.
• They are VERY useful for treating food allergies – again, tough with allergy shots.
• Allergy drops can be administered at home, not taking time out of one’s busy schedule to go to the doctor’s office and sit there for 20 minutes after the shot is given.

Here is a comparison of shots vs. drops that I wrote last year.  And here is a piece describing just who can benefit from allergy drops.

We love to see our patients at the MaxWell Clinic start to enjoy the freedom and vitality that occur when allergies no longer occupy a major part of their life.   SLIT works to provide more healthy days.. and after all isn’t that a major goal of the profession of medicine…. it should be.

Yet, many established allergists do not utilize this remarkable therapy?   Why?  WHY don’t more allergists use this therapy? Dr. George Kroker the formerly angry allergist explains why dollars and pride are outweighing sense and practicality in his excellent 2 part blog on the adoption of SLIT by allergists – Liberally excerpted here…..  Thanks George!

On Accepting Sublingual Immunotherapy–A Denial of Reality…

In my last entry, I’ve written about the extensive history of SLIT–going back over one century…many, many years prior to the European literature,which largely began in the 1980s…Invariably, in any discussion about SLIT the one key question that arises is…

Why has recognition of this technique as a safe and efficacious treatment for allergic disease taken so long?

To my knowledge, there has never been a medical article that addresses that question…and it seems to be a perfect blog topic…so here goes…

Lack of American acceptance of SLIT as a viable treatment modality is probably because of several factors:

1. The “turf wars” between ENT’s and Allergists: Face it. The majority of early proponents of SLIT were not allergists. They were ENT physicians (Hansel, Pfeiffer), or non-ENT non-allergists (Dickey–a urologist by training). Medical history has a tendency to repeat itself…when Edward Jenner discovered vaccination for smallpox, his discovery was unrewarded by the medical establishment, largely because of bias against him–he was a rural general physician and his 1798 paper was rejected and never published by the medical establishment. Similarly, why would a board-certified allergist look kindly on a technique condoned–and discovered–as effective by his non-board certified colleagues??

2. The profound implications of SLIT–it’s potential to revolutionize the office practice of allergic disease: Let’s face it. As allergists, we can rapidly incorporate a new medication into our practice with minimal problems…but incorporation of SLIT into an office practice would take far more work, and (according to conventional wisdom), considerable financial risk. Technicians would have to be trained, and a doctor would have to be educated and confident of his success in using it…in the face of non-insurance coverage. The American allergist, before he/she dives into a SLIT-based practice, simply wants iron-clad, irrefutable, American-based evidence that SLIT is safe and effective. Anything less is simply unacceptable…Money can be made with SCIT, and with SLIT…well, insurance coverage just isn’t there…yet…so “let’s wait and see”, right?

3.The “tomato effect”. Allergists were trained during fellowship to believe that SLIT didn’t work, because…everyone knew it didn’t work. This is an example of “The Tomato Effect”, written about by Goodwin, JS & Goodwin JM, JAMA 251: 2387-2390, 1984. Briefly put, the tomato effect is defined whereby a potentially efficacious medical therapy is discounted because “it doesn’t make sense”. The conventional wisdom–common knowledge–is that “it just doesn’t work”. In 1560, the tomato was becoming a staple of the European diet, having been brought back from Peru. As the Goodwins put it,

“Of interest is that while this exotic fruit from South America was revolutionizing European eating habits, at the same time it was ignored/actively shunned in America.

“The reason tomatoes were not accepted until relatively recently in North America is simple: they were poisonous. Everyone knew they were poisonous, at least everyone in North America. “Not until 1820, when Robert Gibbon Johnson ate a tomato on the steps of the courthouse in Salem, New Jersey, and survived, did the people of America begin, grudgingly, we suspect, to consume tomatoes…”

4. If SLIT is accepted, we have a technique safe enough that potentially even non-allergists will do it and create increased competition for the allergist. This gets into my “hidden agenda” blog post from earlier. To the trained allergist using SCIT, there is only one solution to the dilemma of having a form of immunotherapy that is simply “too safe”…and that is to “spin” SLIT to make it as dangerous as possible…this benefits the allergist–since it keeps the treatment “in his camp”. No one but the board-certified allergist would dare to do it (pretty much like injection immunotherapy presently). Presentations and studies by American allergists will therefore be overly cautious and negative in their portrayal of the benefits of SLIT…

In short, the American allergist (unlike their European counterpart), comes with psychological “baggage” of years past regarding inherent bias against SLIT (a technique largely proposed by non-allergists), and a fear about maintaining financial security when adopting this technique and giving up SCIT. Instead of objectively looking at European studies and aggressively pursuing SLIT, we employ a strong “denial of reality”–a defensive, fearful posture–we think “if we just don’t think about SLIT, it’ll go away”…And we employ tired, worn arguments (i.e., “it’s not FDA approved, we don’t have American studies…”) that don’t even make rational sense (after all those of us who use SLIT use FDA approved extracts in an off-label useage–something perfectly legal).

It’s hard to be creative and innovative when you’re fearful, and that’s just the place where the American Allergist is…now, more than any other time in our history, the American Allergist needs to be resourceful, creative, and innovative. Not fearful. Our attitude with SLIT is but one example of something that needs to be changed…and soon.

Later, Dude

Thanks, George!   Keep up the great work & keep answering the question of “WHY?”

Colon Cancer is a serious illness which is effectively found, and often treated by screening colonoscopy….  and yes, sticking your bum out and looking inside makes for the type of uncomfortable conversation that easily makes it the Butt of many jokes.  Ha.  Couldn’t help that. 

Peter Yarrow of Peter, Paul & Mary has teamed up with CBS to deliver a serious health message to CBS viewers and audiences beyond: be screened for colon cancer.   Thanks to KevinMD.com for passing on this tidbit!

And because there always need to be a bit of balance…  after that sweet, happy ballad… here is Bill Connolly’s hilarious description of his Colonoscopy prep in the UK.   It is pretty crude, but hey, what do you expect given the subject matter… there… you are warned… proceed at your own risk.     After you have laughed a good laugh, suck it up and call your doctor to arrange a colonoscopy – it could truly save your life.

Did you know that withdrawal from many drugs CAUSES the same symptoms the drugs were prescribed to TREAT?

• Anti-depressant medication withdrawal often cause acute depression and all kinds of other wacky symptoms.
• Anti-anxiety medication withdrawal often causes severe anxiety – even worse than the initial symptoms.
• AND Anti-ACID drugs used to treat GERD or heartburn – upon withdrawal – will often cause WORSE heartburn than what the person originally experienced when starting the medications.

This has been an observation of mine for years, and the reason I harp that we must look for, and address the underlying CAUSES of dysfunction and disease as opposed to suppressing meaningful symptoms with powerful new-to-nature drugs on a regular basis.     Drugs often blow away the “smoke” of the symptom while letting the “fire” of the underlying abnormality rage on.

A study in Gastroenterology has deeply vindicated my position.     It showed concvincingly that a Proton-Pump Inhibitor (PPI) , or “purple pill” or specifically in this case esomeprazole (Nexium) when given to HEALTHY people without any heartburn whatsoever for an 8 week period caused often severe heartburn, dyspepsia, and GERD symptom in 44% of these people when the medication was stopped!    In most of these individuals the symptoms persisted for greater than the 4 week follow-up period!   There is no reason that other PPI’s such as Prilosec, Protonix, Aciphex, or Prevacid would be expected to act any differently.

This means HEALTHY people now have a new long-term problem due to taking this medication (some forms are now over the counter).    That sounds like a problem to me.  This opinion article reflects my concerns and gives a nice review of the full scope of the problem.  Now, it is certain that these drugs truly benefit some individuals long term (meaning that the benefit they provide over-weighs the detriments they induce) , and I am also certain they are massively overused.  Especially since there are so many effective cause-focused approaches available.

So what has occurred is the rise of a highly profitable class of  medications that help initially, but now we know that many patients are assured of feeling even worse when they stop that medication.    Sounds like a great business plan. 

Another problem is that in real life healthy people don’t take medications – sick people do.   People with heartburn and reflux.       But allow me to ask…  WHY do they have these symptoms?    The presence of these powerful drugs that so quickly and completely removes symptoms have seduced patients into thinking that the problem is that they have a “purple pill” deficiency as a cause of their symptoms, and has equally seduced doctors into believing they are doing the best for their patient because the symptoms go away.

This twin seduction of  doctor and patient closing their eyes to a bigger problem because of a quick fix is the same problem that leads to narcotic addiction, stimulant addiction, sleeping pill addiction, etc.    I currently live in the state that has had the dubious honor of prescribing the most lortab (a potent narcotic) per capita of any state in the union.   Is that because Tennesseans hurt more than people in other states…. obviously not.   The answer is complex … like most truths, but at the center of the problem is the culture we have together developed that cure comes in the form of a drug that will block, inhibit, or short-circuit a normal function of the body.

On the national scale this situation presents a larger problem because 5% of the developed world is taking this EXPENSIVE medication class.  That is a lot of health-care dollars that you and I needlessly pay.

So what are some causes of the severe reflux and heartburn that some people encounter?   My fingers don’t go fast enough to cover all I want to say, but let’s think of some big-bucket causes.   Certain foods can loosen the sphincter that separates the stomach from the esophagus – coffee, chocolate, milk, and sugar are the biggest culprits in the scientific literature, but I can tell you many foods can cause it.   Many foods can cause sensitivities or allergies that will have as a symptom heartburn (remember another class of medications used to treat acid issues are H-2 blockers… the “H” stands for histamine which is a major chemical in the allergy cascade).  Emotional stress both chronic and acute definitely contributes,  Small bowel bacterial overgrowth,  yeast overgrowth or sensitivity, parasite infection, Poor diet leading to inflammation, recent anti-biotic use, recent viral infections, Hiatal hernia (which I have witnessed respond to visceral manipulation in several of my patients), hormone imbalance, Celiac disease, some toxins, some commonly used medications.

WHY is the most important question we can ask when we have a symptom… our body is giving us an early warning that something is not right, and we then get the opportunity to investigate, address the cause and potentially gain side-benefits in other areas of our health from our cause-focused intervention.

WHY may find the cause is actually a LACK of adequate stomach acid leading to poor digestion, bloating, and all kinds of skin problems.    WHY may lead to the understanding that eating machine-poop instead of real-food does not adequately fuel our lives and help in the attainment of our highest life purposes.   WHY may give the bravery to re-claim your life choices as your own, and give the opportunity for you to start living your life your way.   WHY may lead to you seek a comprehensive evaluation which could identify that weak link in your chain that would shorten your life otherwise.  WHY could get you to the cause of persistent weight gain… and lead to remarkable weight loss.   I have witnessed all these things.   Good stuff that WHY.

Find the Root Cause and give the Right Treatment.

It is my opinion that with the exceptions of acute ulcer healing, erosive esophagitis and Zollinger-Ellis Syndrome we should be very cautions in prescribing these Proton Pump Inhibitors for anything over 1-2 weeks.  Now that rebound acid secretion has been demonstrated to induce symptoms, we are probably obliged to inform patients about rebound acid hyper-secretion and its potential effects.   There is evidence for these meds contributing to dysfunctional long-term gut function, osteoporosis, mal-digestion of  proteins, inhibition of vitamin B12 absorption, and significantly thinning your pocketbook if you take them personally, or if you pay taxes for other individuals to unnecessarily take them life-long.