Author Archives: Alan Sault MD, ABHM


96The father of western medicine, Hippocrates, said: “Let your food be your medicine and let medicine be your food.” Good nutrition provides the building blocks the body needs to create healthy bone and tissue; and helps not only to cure ailments but prevent future ailments. (For example, nutrition plays an enormous role in cancer prevention and cure.) And of course it is possible to have good nourishment and at the same time enjoyable foods. The days of “health food” that was without color or taste are long gone. With good nutrition it is also possible to grow older without aging. Each individual is unique. Therefore, no single diet can fit everyone and it is the task of the physician and the patient working together to figure out an ideal eating program. It is good for both to remember that sometimes a specific diet for a specific purpose is necessary; but and a big but ( pun intended), that diet may be good only until the person is alleviated of the problem. After being better that same diet may not be appropriate for different reasons and a new diet may be the best route. As an aside I have found the same to be true with pharmaceuticals and supplements. When a person follows a healthy routine it is always a good idea for the healer after awhile to see if the benefits of the medicines are still necessary and beneficial. When the person is following a whole different life style they may not need what they originally needed. This is often over – looked by the healer and the client is kept on substances that they no longer need and the expense of them. In the case of pharmaceuticals this can even lead to grave side affects.

Again we must watch out for overdoing too much of certain foods, especially true of red meats and dairy. People can develop allergies from eating the same food all the time even if they never had an allergy to this food. There is a difference of intolerance to certain foods and a true allergy. Some people just cannot digest certain foods well and get gas, bloating etc when they eat them. Allergies have a more severe affect such as vomiting, headaches, dermatological reactions etc..

Certain “food myths” should be discussed, for example “all fats are bad for you”. Certain fats, such as the omega 3 fatty acids, are essential to our well-being. A certain amount of cholesterol is essential because its basic chemical structure is the basic building block of forming all the sex hormones, cortisol, aldosterone and vitamin D.  Too low of cholesterol in the body can alter all the latter productions and the symptoms that go with a decrease of them. (Please see my book or my blogs about cholesterol myths.

There are four premises for good nutrition: nutritious non-toxic foods (often referred to as whole foods or live foods), digestion, absorption, and elimination.

  1. Nutritious, non-toxic foods: An appropriate balance of protein, complex carbohydrates, healthy fats and plenty of water is the foundation of a healthy eating program, utilizing foods that are produced without artificial hormones or pesticides and now non GMO. Processed refined foods (referred to in holistic circles as the Standard American Diet or SAD & dead food) do not provide the vitamins and trace minerals that the body needs to form enzymes, hormones and building blocks to rejuvenate the body. It is not only the latter point I have discovered that brings on poor health. If one is eating “junk food” then they have no room for nutritional food. Sought of like the child that is permitted to eat sweets before dinner and then cannot eat their dinner. I also believe in whole grains which some physicians are against. Whole grains (non-GMO) if one is not a celiac person I believe are healthy. Even for a celiac person there are enough other grains to choose from besides rye, oats, barely and wheat. The physician must also consider celiac disease, which leads to an intolerance for products containing gluten. There are very accurate blood tests that can give the client an answer whether they are celiacs or not; of course one can also experiment by cutting gluten foods out of their diet for a month and see how they feel. I usually tell people to eat colors which gives them the vegetables and fruits of variety. Also, if it comes in a plastic bag it is probably a good hint that it is processed.

My belief is not to be too strict with diets in most cases. Why, because in general the client will not stick to it after a short time. At first the human is excited about a healthy diet and after a short while bored.  Certain items in specific cases must be eliminated, that is true: But most people want to enjoy life and eating is part of that joy. People eat not only for nutrition but also for social reasons and this needs to be remembered since it can be a stress reducer (until the bill arrives). Therefore, the healer must judge the personality of the client and work with this, which may includes a lot of of explanations.

  1. Digestion: This is the process by which food is broken down into a form which can be used by the body. Maldigestion due to inadequate digestive enzymes can lead to the discomfort of indigestion and other diseases because of needed nutrients not being supplied to the vital cells.. Some people can have an inadequate amount of stomach acid which very often is caused with aging; while some people can have none. This can be corrected with supplements such as adding hydrochloric acid with the meal routine (betaine HCL, pepsin).  One  can develop poor digestion by eating too fast. In fact, some people swallow so much air when drinking fast they they constantly feel bloated. This is called aerophagia. It is also seen with people that are stressed out either hyperventilating or/and gulp in air when crying (babies can get colic from crying so much and bottle feeding giving aerophagia). Another thing that affects the stomach are people that eat too much and are taking antacids so they can eat and eat. If the antacids happen to work for the person they are masking the natural message that what you are doing is not good for you. A similar situation is presented to the stomach when people take aspirin (any thing that is salicylic acid [salicylates] related) for pain. They are really taking an acid that as it is relieving the pain while it is eating the lining of the stomach to give one gastritis. It is one of the top causes for ulcers. some  ant – acids contain salicylates and even aluminum. The TV adds that show people “pigging out” and then using such and such antacids are a disgrace and shows how little marketing cares about a persons health.
  2. Absorption: It is often said that we are what we eat. It would be more accurate to say that we are what we absorb. If something is interfering with the absorption of good nutrients, even if we are following a healthy diet and taking supplements we do not derive the full benefit from them. The healthy natural food and the expensive supplements simply pass through the system and are eliminated. Malabsorption can be due to dysbiosis. Dysbiosis is the term for bad microbes of the intestine taking over the necessary good microbes of the intestine. There exists in the intestine 3 types of microbes. The good ones that help absorption and produce certain vitamins like some of the B vitamins and vitamin k. Then there are the “opportunistic” microbes lurking and waiting for when the good microbes are gone or diminished to fight them and take over. Then there are the plain nasty, bad microbes that flourish when opportunity lets them or they are introduced by oral means. So when the small intestine has an overgrowth of pathological flora it is called dysbiosis. The final result of this dysbiosis is leaky gut syndrome. When this is created the small intestine lets through its wall molecules that it should not, and blocks the nutritional molecules that it needs The good microbes were guarding our borders but defeated by antibiotics and poor nutrition. Also to be considered is the common possibility of having intestinal candidiasis (an overgrowth of yeast in the intestine). Both of these situations often happens when a person has been on antibiotics or steroids. Even if the event was years before the yeast flourished or dysbiosis developed and manifested symptoms. While these events are taking place the person may generate more gas as bloating, erudition (burping), flatus, feeling tired and full as if s/he just ate a big meal. This is why if I put a person on antibiotics I always and immediately also put them on probiotics – which is really just giving back the good bacteria. I actually suggest taking probiotics all the time because of the environmental toxins we swallow and the difficulty of escaping some junk foods continuously. Just a good thing to do.
  3. Elimination: Poor elimination is often the cause or result of unhappiness and/or intestinal pathology. Both constipation and loose bowel movements can be caused by not taking in the right foods and/or taking in the wrong foods (There is a difference in the latter two). Either way these can lead to dysbiosis, leaky gut syndrome and malnourishment.
  4. Poor nutrition:Nutritional counseling: Nutritional counseling for weight loss, muscle enhancement, disease cure and prevention, involves a personal and family history and identification of the client’s goals and the best way to achieve them. Fortunately, most problems can be corrected and one can age gracefully. The person must take responsibility without procrastination for their own health. A good healer can only guide you and be there for problem solving.
  5. Yoga: Big and taut muscles are great; but if your joints, tendons, ligaments are a limiting factor yoga is both restorative and preventive for arthritic problems.  Looking good is not good enough it is only part of the whole picture. But yoga also helps restorative properties not only to the joints and muscles but to your internal organs that are needed for good digestion. Yoga also alleviates a lot of stress, and stress is a big target to hit for proper digestion. This for the reasons that under stress most people eat or drink the wrong substances (and some do not eat). Also under stress when cortisol is released inappropriately it interferes with the stomach processing protein into amino acids that are essential for proper reparations of the bodies tissues and hormonal production. Stress is also pulling your blood supply into the muscles for flight or fight and taking this source from non-essential organs for flight or fight, the stomach being one.

Alan J. Sault MD, ABHM-diplomat

The Placebo Effect

PlaceboMany years ago in the ER I proved to myself that the placebo affect is real. I had one person that was in the ER very often (who I called a frequent flier). After a few times I emptied samples and gave the plastic shells to her. I gave her specific instructions and also told her that they were of  high potency and therefore could be dangerous so follow my instructions. She always got better and would only come on my shift since I knew the right medication.

Switching to being an Holistic physician and seeing the results of hypnosis (and self hypnosis) and Interactive Guided Imagery taught me that illnesses can heal without drugs in many instances (BP for example). A lot depends if the person has a negative or positive outlook on either the ailment or life itself. It is known that exercise is equal to pills for mild to moderate depression. I believe this is so not only for the increased hormonal affect but due to the socialization of being with others and their energies; and also being proud of oneself for achievement.

Holistic medicine includes the triad of mind-body-spirit and finding the cause and not just alleviating an ailment whether with pharmaceuticals or alternative medicine. I believe one must note that alternative medicine in many instances is successful also due to the placebo affect it is not just allopathic pharmaceuticals that should be accused. There is a place for both allopathic & alternative medicine; but there is always a place for self-exploration of why one has acquired an illness and what they can do to not only cure or alleviate it but also to prevent future occurrences of it and others. This is why I stress the stress factor and the immune system in my book.  One must realize that it is not the stress but how we react to a stress. Also when a person starts to be pro-active with working on stress solutions they are modulating their life style and therefore their health (and working with the healer).

Part of the placebo effect is having confidence and respect for your healer. One that the client can relate and that takes the time to relate to the client. My theory is: the physician is teaching the client and the client is teaching the physician. The physician is their to guide and for being a life-guard when necessary.

The mind can keep us healthy and heal and the mind can make us sick. The choice and options are ours. It takes a lot of work to clean up our inner negativities and fears. I have been working on this for myself for > 40 years using self hypnosis and Interactive Guided Imagery (and slowly progressing – the dance of 2 steps forward and often one step back). I have treated many patients with chronic diseases including cancers for years and have seen the differences when a person is positive or negative. Even if they came to me with a late stage terminal disease prognosis but positive energies they can still die with quality of life playing with their grandchildren. Often with IV alternative treatments they avoid their death diagnosis. I was one of these 10 years ago. So often the physician tells a person that they have a 60% chance of dying and never gives the positive that they have a 40-50% chance of living. I often wonder if the death sentence that is proposed by the healer and the client goes and spends all their savings and then lives another 10-20 years; are they glad about the extension of life, or angry about not having any money due to a the death prognosis (or wrong diagnosis-it happens). I myself am fortunate since my wife is an expert in both hypnosis and Interactive Guided Imagery. For example,I have sent people to her after my interview that just wanted BP meds and have her do hypnosis (for free) on the person. So frequently they drop their BP because stress is the cause of the vascular problem. So we work from that point on with both my medical and her psychology.

Much of the above seems to get off the subject of the placebo effect but the point is that it is the mind  that cures  with a positive outlook on the treatment.  Therefore one can have both, a medicine (whether pharmaceutical or alternative) that helps plus the placebo effect. As an aside, sometimes giving a person a supplement or pharmaceutical does not cure them for two reasons: 1-they feel they have carte blanche to keep their harmful life style and the medicine will be the panacea: 2-They are alleviating a situation instead of finding the cause and working on this.  This is especially true for delving into stress and its relationship to dis-ease.

Alan J. Sault MD, ABHM-Diplomat

Author: “Emotional Vampires and Your Hormones: an holistic physician’s view on how stress affects your well-being and what you can do about it”



Because I have been an holistic MD for the last 25 years and anti – aging is one of my specialties, I have an interest in both exercise and nutrition. On the subject of exercising for health, it is impossible to separate nutrition, and stress. You can work out religiously but if you are not eating wisely the full health benefit is not reached, because the body is not receiving the nutrients it needs in order to build healthy tissue and the cellular components for energy renewal. By the same token, if you eat healthy foods but do not exercise the health benefits are diminished. Muscle has to work to maintain or increase its mass. Now if one is doing both of the latter but the routines of either one or both are resulting in stress this can also defeat progress and health. For this blog I will concentrate on exercise; the next blog will be on nutrition. Stress is always a factor in health to me. Not the stress itself but how we react to stress.

After years of abuse, both poor nutrition and lack of exercise can have chronic consequences on the body. This is especially true if proper nutrition has not been followed for long periods of time while the body was under physical stress, such as intense sports training. Mental stresses have similar negative effects because of the constant adrenal – cortisol response to mental stress. (Please refer to my other blogs on stress – A quick reminder is that the body – mind cannot discern between physical and mental stress. The response to both are equal to cause the same output of cortisol for flight or fight protection and the consequences of chronic stress.

I do believe that both aerobic exercise and resistance (weight) training are necessary to keep a healthy body. The resistance is necessary to build strong muscles and bones and to prevent osteoporosis deflating muscles and to keep strong tendons: the aerobic for cardiovascular health. I have  a lot of experience in both and now share my ideas and experience with patients. I find this helpful because many people are either afraid of starting or have no idea of how to start. Stretching both before and after exercise keeps the muscles toned and helps prevent injury. When I was teaching karate I would emphasize to the students that having big muscles is no advantage if the joints do not react properly and are prone to different types of tendon-joint injuries. This is especially true as one advances in age. Exercise does not have to be either strenuous nor boring. In fact, I like to call exercise “funacise.” Today there are many different types from which to choose. Some people would benefit from joining a gym so that the exercise is structured, the equipment is there and varied, instructors are available, and the possibility of a social atmosphere is present. The latter can be especially helpful for those that do not have the incentive to exercise and to those that have depression so they are with other people. (A caveat to this is the many scientifically based studies that demonstrate that exercise is as effective for mild to moderate depression as the pharmaceuticals).There are numerous classes offered in different forms of exercise. Other people prefer to exercise at home, using their own equipment and/or videos. The problem with this is that one may not be using proper form if no one is watching, correcting and teaching and therefore prone to cause injury. It can be beneficial to have an exercise partner so that you can keep each other’s motivation high as well as having time to enjoy the company of each other. The type of exercise that works for you is the one you enjoy. Once in the habit of your choice you may branch out to other forms. Sometimes motivation is diminished because of boredom of the same repetition each time. There is no reason for this. If it is aerobic exercise that one does for 20 minutes or more it is not necessary to do a continuation of the same exercise. One can do 5-10 minutes of bicycling and then switch to rowing or treadmill, Etc.. Of course you can do different aerobic exercises on different days or join certain classes of different types. Walking is still one of the best and least physically invasive forms of aerobics if the person is not a “dawdler.” Your favorite music will help as you can sing with it even if you have a voice no one else wishes to hear (my own personal experience). For myself, I like to combine weights and aerobic by not stopping lifting but rather go right into a different muscle group even if using light weights. This cuts down on the time I spend “funacising” to about 20 – 30 minutes with all the benefits of both. Of course, it is important first to learn good form so you do not injure yourself while trying to improve your health. For those that dislike exercising, especially resistance exercise, you can get around this and be finished quickly if you do the eccentric method. This is done by taking a light weight and doing the extension part very, very slowly. For example, biceps: lift up a weight you consider lighter then normal for yourself but let it down (with good form) to the count of 12 or more. You will ache after 3-5 reps. You can do this eccentric exercise for any group of muscles.

There is a caveat to any form of exercise be it resistance or aerobic.! If you know you are an obsessive and/ or compulsive personality, or competitive personality you need to watch stressing yourself to the point of defeating the purpose of exercising. Why? Because exercising is to relax your mind as you become physically fit. It is not meditation but a form of moving meditation in the sense that you are escaping from the everyday stresses for the time that you are exercising. You do not need to add another stress to the day. When I was running a mile for each round that I fought I would get so aggravated if I did a poor time or was not progressing in my time/mile. This is competitive-obsession. My wife would ask me why do I run and I would say to relax – duh. When I would come home from my emergency-room shift and be “up- tight” and volatile before I was allowed to sit down and eat with my son and wife one or the other would say first go down to the basement and jump rope for half an hour-to-forty-five minutes. It worked every time to get rid of the ER mind trauma so I could enjoy my family meal.

When one starts to do resistance exercise they may get really severe muscle aches the first few times they are working out. Some refer to this as good aches “No pain, no gain.”. This latter is only true if you are going into this for body building and do not care about future osteoarthritis. DOMS (Delayed Onset Muscle Syndrome) is the proper term. They use to believe that these aches were due to lactic acid buildup from the workout. It is really the muscles healing from the nano tears that are a  result of a proper workout. It is the repairing and building up of the muscle. When it occurs be thankful and happy that your body is responding properly. They will not occur after you get through the beginners part except when you decide to start a new plateau or new type of funercise. Sometimes when you leave go of the exercise for a long time and start again DOMS will hit but for a shorter time. Do not forget that form for each muscle group is so important. Above all ”Do no harm!”

Some people tell me that they do not have time to exercise or even relax. Think of it this way; taking time for yourself is doing something.
I point out that they have time to be caretakers each day for their spouse, boss, children, etc, but not an half hour per day for themselves. This is sending a subconscious message to their brain that everybody else is worth their time but they feel they do not deserve time for themselves. “Today I will love myself enough to exercise.”

Alan J. Sault MD, ABHM-Diplomat

Author: Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it

Prostate Specific Antigen = PSA

prostatePSA is a subject that is often brought up to me during my seminars and with private consultations. To most men it is only initials for a test that states whether they have cancer, potentially have cancer, benign prostate hyperplasia (BPH=enlarged prostate) or they can be relieved to go home feeling free of prostate disease. The answers to these initials (PSA) are not complicated, but should be understood, so a discussion of the prostate can be discussed intelligently with the physician and most often relieve the client of unnecessary anxiety.

PSA (prostate specific antigen) is a protein that is produced almost exclusively by the cells of the prostate. Its function is to keep the prostate fluid (semen) watery so the sperm can swim. Another purpose of this protein is to dissolve the cervical mucous cap to allow the sperm to enter. Although present in large amounts in prostate tissue and semen, it has been detected in other body fluids and tissues. Interestingly PSA is found in concentrations of female ejaculate roughly equal to that found in male semen. It is also found in breast milk and amniotic fluid. Low concentrations of PSA have been identified in the urethral glands, endometrium (uterus lining), normal breast tissue and salivary gland tissue. In addition PSA is found in the serum of women with breast, lung, or uterine cancer and in some patients with renal cancer.

In the male PSA is normally found in the blood but at low levels (about 0-4ng/ml = nanograms/millimeter= one ng=one billionth of a gram). PSA levels can be increased by prostate infection- irritation, digital rectal examination (DRE), benign prostate hyperplasia (BPH), and recent ejaculation. All the latter can produce a false positive result. Ejaculations should therefore not be present for 24 hours before a PSA test and a DRE should not be done before blood is drawn for this test. Exercise within 24 hours of the PSA exam can also give e a false positive (high). There is also a urological debate whether the PSA normally goes up gradually with age and therefore different normals should be considered. The prostate gland generally increases in size and produces more PSA with increasing age; it is normal to have lower levels in young men and higher levels in older men. Age-specific PSA levels are as follows (age group, upper normal): (40 – 49years, 2.5), (50 – 59years, 3.5), (60 – 69years, 4.5), (70 – 79years, 6.5). But keep in mind that age related normals are still controversial and in practice the 0-4ng/ml is the gold standard.

So in the former paragraph one can see that besides from the cause of cancer and BPH the PSA can rise from other causes. I have already mentioned the PSA can rise just from having intercourse or any ejaculation before the blood serum is drawn or from exercising before the blood is drawn. It can also be elevated due to testosterone converting to the stronger testosterone, dihydrotestosterone (DHT). This latter can happen if the man is on an anti-aging regimen of taking testosterone and he is one of the rarer males that will convert the testosterone to DHT. It happens but the conversion can be stopped either with pharmaceutical intervention,with natural supplementation or with tweaking the testosterone regimen.

Increased levels of PSA may suggest the presence of prostate cancer. But if mildly elevated 7 out of 10 men will not have the prostate cancer. However, prostate cancer can also be present in the complete absence of an elevated PSA level, in which case the test result would be a false negative. Statistically 2.5 percent of men with prostate cancer will have a negative PSA. Obesity has been reported to reduce serum PSA levels; therefore, this can also give a false negative and delay early detection. This may explain the worse outcomes in obese men that have the pathology of prostate cancer but no symptoms, signs or elevated PSA.

Using the PSA test to screen men for prostate cancer is controversial because it is not yet known for certain whether this test actually saves lives. Moreover, it is not clear that the benefits of PSA screening outweigh the risks of follow up diagnostic tests and cancer treatments when the test is positive.. For example, the PSA test may detect small cancers that would never become life threatening. This situation, called over-diagnosis, puts men at risk of complications from unnecessary treatment. The procedure used to diagnose prostate cancer (prostate biopsy) may cause harmful side effects including bleeding and infection. Prostate cancer treatments, such as surgery and radiation therapy, may cause incontinence (inability to control urine flow),and erectile dysfunction (erections inadequate for intercourse), So the best way to use the serum PSA is to have a base line as an index to refer to for future PSA tests. If this baseline test is normal but the next test goes up about 2 points then suspicion should be heeded by the physician and the test repeated in 2-4 months along with watchful waiting. For example: If my PSA is 1.4 for the first test then one year latter it is 3.6 this is looking a little suspicious. Watchful waiting and a good history plus symptoms and signs that can raise the PSA should be questioned.

Then there still exists the debate at what age is the PSA elevated naturally. But I believe that the above paragraph with the PSA rising more then 2ng/ml in one year is a good indication that further testing and observation should be taken seriously. Also if the man is on testosterone this should be stopped for a few weeks and certain tests should be retaken and reviewed. There are some blood test markers for prostate cancer and a retesting of hormones if the man is on testosterone therapy. Then if so desired by the client and with the consultation of the physician testosterone can be restarted but possibly with a different regimen. There, are different ways of using the anti-aging testosterone that can be tailored to this situation and followed and as mentioned altered to stop testosterone converting to DHT. But in a different blog I will show the evidence based information of why testosterone is not the cause of prostate cancer but rather estrogen is the cause. Note that I only believe in bio-identical testosterone produced by a compounding pharmacist. By doing so I can have the testosterone made specifically for the individual and tweaked if necessary. Also, the body does not know what to do with synthetic hormones since the cells were evolved only for human bio-identical hormones.

So further testing would include a free PSA. Most PSA in the blood is bound to serum proteins. A small amount is not protein bound and is called free PSA. In other words the PSA protein can exist in the blood by itself unattached, or it can join with other substances (protein) in the blood. When it is by itself, it is known as free PSA. With benign prostate conditions (such as BPH), there is more free PSA, while cancer produces more of the attached form and therefore, the free PSA is less then 25%. If a man’s attached PSA level is high but his free PSA level is less then 25% the presence of cancer is more likely. It is easiest to just remember that the free PSA should be above 25%.

Since this can be a confusing concept let me write it in another way. PSA, a protein produced by prostate gland cells, circulates through the body in two ways: either bound to other proteins or on its own. PSA traveling alone is called free PSA. The free-PSA test measures the percentage of unbound PSA; the PSA test measures the total of both free and bound PSA. About 75% of men with an elevated PSA do not have prostate cancer. a free PSA greater than 25% is more likely to have a benign condition than to have cancer, making a biopsy unnecessary. Men with a total PSA in the same range and a free PSA below 10% need to have a biopsy. More likely than not, they have prostate cancer ( Harvard Medical SchoolOriginally published April 2009; last reviewed March 21, 2011. )

So the tests that I do in the case of a rising PSA are:

  1. free PSA

  2. ultrasound

  3. repeat the PSA in 3-4 months making sure that events that could give a false positive have not happened.

  4. DRE-digital rectal exam or have the urologist do this since. I so often refer to them if there is a chance of serious pathology.

  5. IF the man is on testosterone the laboratory chemistry I order are:

    • testosterone free and total

    • estradiol

    • sex hormone binding globulin (SHBG)

    • another PSA and free PSA if the last one was more then 3-4 months

    • dihydrotestosterone (DHT)

    • if there is a suspicion because of signs or/& symptoms it warrants caution. I believe the best way to handle any doubt is to get another opinion from a urologist.

 Many men were diagnosed with, and treated for cancers that would not have been detected in their lifetime if they had not had screening and, as a consequence, were exposed to the potential harms of unnecessary treatments, such as surgery and radiation therapy . Here I am just stating results and not giving advice as to what each individual should do if there is a possibility of prostate cancer. This is up to the individual with guidance from their own physician. Just investigate all options before making a decision.

Scientists are also researching ways to improve the PSA test, hopefully to allow distinction between cancerous and benign conditions, as well as slow-growing cancers and fast-growing, the latter being potentially lethal cancers. These new tests that they are researching and developing are too numerous for this blog and they are still in investigative states. But the reader can investigate all these potential diagnostics via the Internet and should do so if they believe they have a problem since research and progress come about so fast. Too often physicians do not know all the research being done outside their expertise and area and it is up to the concerned client just to Google further information and bring it up to their physician.

I hope this short excursion into PSA helps those men that have anxiety about not understanding the PSA test.

Author: Alan J. Sault MD. ABHM-Diplomat Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your-well being and what you can do about it .

People not wanting to get better

placebo-effect-250x150When I was an Emergency Room physician and teaching (and a non-believer in holistic medicine which I practice now), I knew the importance of the placebo effect. But now I can see how the mind can create what I call a negative placebo effect.

There were times in the ER that I would take sample capsules and empty them and give them to a patient with the admonition to “be careful since these capsules are very potent pain killers.” I never had a complaint that the medicine did not work (and it was free since the empty capsules originated from the drug representatives samples).

The title of this article could be the antithesis of the placebo affect because there are people out there that for different reasons  do not want to get better and some even do not have any real pathology to cure. Maybe I should call this the “negative placebo affect.” I am not admonishing anyone in this article since there are different reasons for this; sometimes  subconscious reasons that the person may not even realize why they stay feeling sick. For example, I had a backward patient that under hypnosis the reason for his constant complaints became overt. The reason was that as a child having his tonsils out he remembers the family paid him a lot of attention as did the nurses and he got plenty of ice cream. Therefore, being sick or believing so he sought the same bonding and love from his parents.

Sometimes a person has anger issues with another close person (family or lover,etc) and being sick can give them freedom to be demanding or even getting even by making that person a servant to them out of guilt. Yes, it happens! Maybe another person is just tired of being the caregiver and the way out of this is to be taken care of by having headaches or some other dis-ease.

I have tracked down the causative agent in a few people that were getting sick on and off too often. It was the only way they could get some rest without feeling guilty about taking time off from work or from caring for other(s). Sometimes when they have programmed their subconscious mental level that they are sick they really become sick (and also from any one of the reasons above which can cause  stress that goes along with illnesses). It has happened to me as a child when I would lie about pretending to be sick to avoid school and then really getting a cold or sore-throat.

As an example, now that I am an Holistic MD I have noticed an alternative diagnostic test that may help uncover why a positive or negative placebo effect may be working on a client: the practice of kinesiology also called muscle testing. I certainly am not against this evaluation and have used it to some degree on clients and have had it used on me successfully and unsuccessfully. But I have found severalpossible flaws in this evaluation (as I have in blood testing also) that should be considered:

  1. It depends on the training of the person doing the kinesiology for several reasons:
  • They have to be able to dissociate their own energies when testing. This is really important if they have their own negative problems. This energy whether it is chronic or even just an event (like an argument with someone that day) can interfere with their own energies and therefore with the kinesiology testing validity. They have to be trained well enough in this technique that they can test and discern whether the client themselves wishes to test sick or negate each attempt by the kinestheolgist. In my 25 years as an Holistic physician I have found only two people with this capability of discernment
  •  There exists  some people that need to be sick on an subconscious level that will throw the testing in the direction that fills this need. Again, it takes a special healer kinestheolgist to recognize this and even bring it to the attention of the client.
  • As you will see in the next paragraph, I do not believe that any one test is conclusive for diagnosing a person. There are too many dis-eases with similar signs and symptoms that have to be thought of and ruled out by the healer. This is called the differential diagnosis and is a list of diseases with similar signs and symptoms. The healer (kinestheolgist) needs to be aware of the pitfalls of believing that one type of testing is the “end-all” and panacea for a diagnosis.
  • Unfortunately, I have found that healers that cannot write for labs and other licensed diagnostic techniques use muscle testing exclusively. Some have even just taken cursory courses in kinesiology and then believe they can diagnose their clients. I have also witnessed a physician that uses and relies on muscle testing as his primary source for putting people on supplements and even hormones. In fact, I have known him to take clients off their needed pharmaceuticals for serious chronic diseases with deleterious outcomes.

Now in my practice I do use blood and urine testing and sputum testing to help for a final diagnosis, but only as an adjunct to my 2–3 hours interview with the client. For example, if a thyroid blood test comes back within the normal limits; but the client tells me that they are losing their hair, always cold, gaining weight but exercising and not eating differently then before, fatigued constantly and that the outer 1/3 of their eyebrow has fallen out I strongly consider that they have a low thyroid condition (hypothyroid) in spite of the laboratory test. I may order other thyroid tests to rule out certain thyroid conditions that I did not originally test for like an autoimmune thyroid problem, but start treating the client on a low natural thyroid medicine. Not conventional I know but it has never failed me. The point is that I do not use just testing to come to a diagnosis but symptoms and signs, the interview and physical along with any tests I believe necessary.

Back to the title of this article and my beliefs! If a person intermittently but often gets sick, or gets chronically sick without respite no matter how long they have been treated by others and myself I need to do certain things and go through certain thoughts.

  • Everything has been ruled out but the person is sick, fatigued may be no worse but certainly no better.
  • It is not unusual for the person for some reason to have at first made themselves believe they are ill for one of the reasons stated or one of which I have not thought. But this stress probably has brought down their immune system so that they either have now created the problems for real that they stated or another dis-ease. It is of course, in my experience that with stress the client is going to have more then just one dis-ease. This can be treated still by many holistic techniques such as specific natural intravenous techniques, hypnosis, guided imagery, exercise, especially nutrition and I even often recommend and give a list of funny videos as a prescription.
  • Go over their life style again: diet, exercise, stress

Permit me to go through a case study which may or may not apply to anybody else out there. It has to do with a client of mine that came in so fatigued that she could not function doing anything except bathroom obligations. She would be defined as a chronic fatigue patient since this had been going on for years and she saw many allopathic and integrative-complementary doctors and healers before being brought to me by her sister. All her laboratory results were normal including the complete blood count and no anemia was evident,etc. Her sister incidentally was an alternative practitioner . She not only took care of her older sister and also the mother who interestingly had similar symptoms of fatigue. In the family there is an older brother that did energy machine healing who was free of any similar problems. I treated the sister with IVs of colloidal silver, Mega Vitmins with extra B12 and folic acicd, and amino acid IVs  since her nutrition regimen was poor and she stated she was too exhausted to eat  even though her younger sister prepared the family meals. Treated her for weeks also with stress therapy. Finally I told her she needs someone that knew more then me and actually it would be helpful if the person was experienced in Chronic Fatigue Immune Disorder. She never got better. The sad part is her younger sister developed the same symptoms, again with a complete work-up and labs all normal. She became bed ridden and fatigued constantly and could not work neither.

I believe to this day that this case points to how a placebo-being the mind – can also be negative. I hope that it also points out that stress is the main culprit. if one takes allopathic or alternative treatments and does not search for the cause both treatments should be called alleviation and not cures.

Alan J. Sault MD, ABHM-Diplomat, Author: Emotional Vampires and Your Hormones: an holistic physician’s view on how stress affects your well-being and what you can do about it


Absorption the forgotten fact in eating well



Do you know anyone,yourself perhaps,who eats all the right things in the right proportions at the right times and still does not feel well?“You are what you eat!” is only a partially true statement – metaphysical considerations aside, and speaking only of the physical body, it would be more accurate to say that you are what you absorb. No matter how healthy, organic and well balanced your diet, and what and how many supplements you take, nothing is contributed to the body if it is not absorbed through the intestine into the blood and lymph systems. One of the real secrets to good health is having a healthy gut; an intestinal lining that can absorb necessary nutrients and block unhealthy molecules. Each of us carries in our intestines about 400 or more different species of microbes. Some of these are bad and some are good. There are also the in-between I call opportunists that take over when the good are killed off. Not so bad but not helpful. Sometimes the harmful bacteria over whelm the good bacteria and create the state known as dysbiosis. When this occurs, the good bacteria can no longer carry out their functions, such as making certain B vitamins and K vitamins, while the harmful opportunistic are free to perform negative; activities such as giving off dangerous toxins, and allowing; the re-absorption of estrogens that can contribute to certain cancers.

Dysbiosis can be caused by the way we eat (the Standard American Diet ( a.k.a. SAD) that is high in unhealthy fats and simple carbohydrates such as refined flour and sugar: and low in fiber and complex carbohydrates such as fresh fruits and vegetables: by environmental toxins, by stress, and by medications – especially antibiotics. If dysbiosis continues we can end up with leaky gut syndrome.

A leaky gut allows dangerous substances that should be passed out of the body to leak back into the system through the wall of the small intestine. One example of this is an intestinal yeast invasion. Yeast gives off at least 79 different toxins. Three of these can interfere with the neurotransmitter actylcholine and lead to foggy brain thinking. Other symptoms of dysbiosis are digestive problems such as bloating, gas,constipation or diarrhea, as well as irritable bowel problems.

There can also be systemic effects from the leaky gut syndrome. When foreign substances (antigens) that should be eliminated are getting into the blood, the body forms antibodies against them. If the molecular structure of the antigen is similar to that of another part of the body (organ, gland, blood vessels, joints) the result is an autoimmune disease, where the body’s own defenses attack the body instead of protecting it.

Leaky gut syndrome can be diagnosed through a thorough history and evaluation and confirmed with diagnostic testing. Once the diagnosis is made, there are curative natural treatments to remedy the situation, such as an appropriate liver-intestinal cleansing. I believe that both should be done at the same time since the liver and intestine are so interrelated in detoxifying the body. It may be important to take digestive enzymes or hydrochloric acid. It is too often overlooked that 50% of people over the age of 60 lack hydrochloric acid. Unfortunately a lot of the same symptoms occur with too little stomach acid as with too much, and the recommendation is often antacids. It is stomach acid that stimulates the gallbladder and pancreas to do their jobs. Stomach acids are also the first line of defense against pathological microbes that gain entry into the system via the digestive tract. Without proper digestion by the digestive juices absorption cannot take place.

Another cause of malabsorption in a fairly large percentage of our child and adult population is the often misdiagnosed celiac disease. Celiac disease is when a person cannot digest grains that contain gluten, such as wheat, oats (?), r;ye, and barley. These seem to act like a steam roller as they go through the small intestine flattening out the absorptive apparatus. Unfortunately, celiac disease is often not considered in the differential diagnoses of people with intestinal and systemic problems; such as weight loss, anemia, foul smelling stools, rashes, indigestion, abdominal discomfort, allergies and recently found neurological problems. Celiac may not even have signs nor symptoms in the intestinal tract and only cause neurological problems. Often it is the the educated patient who brings this possibility to the attention of the health care provider. Again, once an accurate diagnosis is made (there are easy blood tests) natural remedies and dietary chooses can give relief.

So while the advice of Hippocrates to “Let food be your medicine and let medicine be your food” is certainly excellent, it is also important to be sure that we create the optimal environment in order for the food/medicine to be effective.

Alan J. Sault MD, ABHM – Diplomat

Author: Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it

Negativity and Fear = Stress

FearFrequently I receive letters about fears and stress due to recent events and what to do about them mentally and physically. Trying not to engage our minds in negativity is important. It is about healing ourselves during these trying times by thinking positive thoughts or at least happy ones. Yeah, easier said then done! Some people have written to me of their fears about Ebola, terrorism and especially about so many health hazard caused by our modern life styles (pharmaceuticals, our adulterated foods, pesticides, etc.  The media enhances all of  these fears. For Ebola, some healers keep producing articles on what you should take to prohibit Ebola. Good! But the main thing is not to lower your immune system by fear and stress. Stress lowers your immunity! Losing sleep because of the fear also minimizes the immune system. All this may sound to some like spiritual voodoo but more and more evidence based science exists as to the brain-adrenal – immune – gut system having a direct relationship to our immune system and therefore disease and even the common illnesses like colds. For example, when I was in medical school (50 years ago) we did not realize that the gut was a huge part of our immune system creating what is called secretory immune globulins (sIgA): or that the gut produced hormones such as serotonin (a happy) hormone that we believed only the brain produced. There are many examples of the latter two that all seem to be down modulated by fear and stress. It is no wonder when a person says “It is just a gut feeling, or “I feel it in my gut.”

We have all experienced the flight or fight situation when it is chronic and not just  acute stress that causes fatigue &/or illnesses. In my 45 years of being an MD I also find people that are overly concerned about their physical and/or mental health. They spend a lot of money, time and effort jumping from one supplement & healer to the newest acclaimed healer or supplement. This overly concern about health stresses them with the fear that they could be healthier & negates their health efforts. The economics of the latter is often a source of stress, that is buying many supplements advertised (many without quality control) and jumping from one healer to another. This can also lead to a stress response that affects the adrenals and the immune system. I use many solutions. The easiest one for me is when fears and stress are interfering with me I picture a happy situation to replace the negative. For example: my granddaughter when she was about 3 walking with me she would hold her whole fist around one of my fingers. It was joyous.

Another caution I stress (no pun intended) is to stay away from negative people and make sure that you do not use negative language about situations and yourself. Being with positive and fun people really helps. I used to give my clients a list of funny films to watch like the Pink Panther. I have a lot of options in my book’s final chapter called How to kill a vampire.

It is not always the stress but the way we respond to the stress that causes our illnesses.

Alan Sault MD,ABHM : Emotional Vampires and your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it.





  1. Blood sugar levels: this relates back to the mists of time when cave man was faced with fight or flight dangers (for example a saber tooth tiger). The adrenal cortisol reaction stimulated the liver to pour out more sugar for fuel to accomplish the fight or flight; The latter is known as the Acute Stress Reaction (ASR). Unfortunately our modern life  turned this ASR into a Continuous Stress Reaction (CSR) but the adrenal – cortisol – sugar reaction is exactly the same. The problem is that the ASR ended and all went back to normal and the sugar was used. (Unless he did not get away, but then it ended his stress forever). With the CSR it never ends and the body does not return to its normal functioning and the sugar is not used. The evolution of ASR to CSR is in my book which is written for the layperson.

  2. The metabolism of fats and protein are converted to sugar in order to maintain blood sugar levels at physiological levels (what nature intended). This is called gluconeogenesis, which is converting protein & fats into glucose when necessary.

  3. Immune response of moderating the inflammation reactions. This includes the anti-inflammatory responses. For example, that is why they use cortisol medications to control so many medical conditions such as transplants, allergies and dermatitis of different types etc.

  4. Blood pressure moderator-a lot of this is due to the metabolic effect and the weight response by creating too much blood sugar under stress which will be stored as fat in organs and the blood vessels. The latter leading to hardening of the arteries. Again cortisol is responding to stress and therefore I suggest some of my blogs on stress. I have also written about aldosterone which is put out by the adrenals and affects the BP. It is inhibited when stress causes a surge of cortisol.

  5. Central nervous system activation

                                          II-Elevated Cortisol level

  1. Impaired cognitive performance: one reason for this is at first the stress reaction which includes adrenal-cortisol -liver-sugar-insulin response can lead to hypoglycemia. The brain needs the physiological quantity of blood sugar to function. Hypoglycemia can be a precursor of diabetes which causes so many pathologies one of them being hardening of the arteries which certainly affects blood flow to the brain. Because of the sugar surge stimulating an insulin surge the blood sugar can fall below the necessary homeostasis for a person. This is called a reactive hypoglycemia. Symptoms can be anger, hunger, fatigue, aggressiveness and depression.

  2. low thyroid output (hypothyroidism) an explanation is in my book: Emotional Vampires….but briefly cortisol is the fight-flight response hormone and stops digestions (which is not needed in fight – flight situation) and without gastric juices the breakdown of protein is  inhibited. Without protein breakdown amino acids cannot be produced.  Tyrosine, one of the amino acids is necessary for the thyroid hormones production. Cortisol in the exact physiological amount is needed to change the inactive T4 to the active T3.  Then exact physiological dose of cortisol is necessary to activate the cell receptors to allow T3 into the cells to metabolize for energy production.

  3. Decreased bone density-That is one of the reasons why there is warnings on taking cortisol  for too long. Cortisol inhibits the sex hormones which are the bone builders.  When cortisol is used for a long time it can lead to osteopenia – osteoporosis.

  4. May cause G.I. ulcers and shutting down ones own adrenal functioning. Again there is a black box warning from the FDA about the latter two side affects. Aspirin, NSAIDS (Non-Steroid Anti-inflammatory Drugs) and cortisol are the leading causes for bleeding ulcer hospital admission of the digestive system

  5. Insomnia: but also remember the person under stress does not get adequate sleep  and a vicious cycle is created leading to adrenal fatigue.

  6. Decreased muscle mass

  7. Increase blood pressure: again due to increase of sugar which causes Insulin Resistance thereby eventually converting the sugar to fat (triglycerides) which under certain conditions causes hardening of  the arteries and high BP.

  8. Slow wound healing

  9. An increase of fat deposition and therefore cardiovascular problems, due to stress and the continuous out put of sugar for flight or fight reaction. Being stressed and the adrenal cortisol response can sabotage any diet.

                                   III-Decreased cortisol levels

  1. Brain fog which is part of the Adrenal Fatigue Syndrome. Emotional Vampires…… In the book there is a lot about the antidepressants.  All the book is  evidence based medicine with a biography for  reference.  More and more evidence based science is coming out that it may be the high serotonin levels that the anti-depressants are causing that may be responsible for anxiety.

  2. Depression: of course with all these functions  of the body not functioning (sex hormones and digestion for example) plus insomnia.

  3. Blood sugar: low  hypoglycemia episodes or chronic hypoglycemia due to the eventual adrenal fatigue and the eventual pancreatic collapse

  4. Fatigue

  5. Insomnia

  6. Low blood pressure

  7. Low immune function with adrenal fatigue

  8. Increase of inflammation because of the inability to moderate the chemical blood cell reactions that cause inflammation.


It is also necessary to realize that at first stress causes high adrenal output of cortisol. When the stress (s) continue eventually the adrenal gland runs down and puts out little or no cortisol = Adrenal Fatigue.  The same is true for the pancreas. At first the pancreas releases a lot of insulin to keep up with the liver’s output of sugar. Eventually the cell receptors get fatigued and insulin resistance  begins. The pancreas once again trys to overcome this problem and puts out more and more insulin until like any engine just quits and we have diabetes.

This is all explained in understandable English with diagrams in my book: Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it.

Author: Alan J. Sault MD, ABHM – Diplomat



SUPERWOMANThe song I Am Woman says a lot about the strength of this gender. But what emotional and physical price do many women pay to do all the wonderful things that the song acknowledges and which very often men depend?

Client X has symptoms of fatigue, insomnia, weight gain , headaches and a series of minor illnesses. She denies being under stress and requests an antidepressant. A traditional allopathic physician would probably prescribe one. After all, she exhibits the classic symptoms of depression.

An holistic physician would not take, “No I’m not under stress,” at face value. We can better evaluate the cause of her symptoms when we take the time to listen to a client and learn something about how they live, and the challenges they face. Does she have all the above symptoms because of years of taking care of children, a husband, a job, and not getting much recognition? Is this an all-too-common “Superwoman” putting in 25-hour days and trying to lighten the load for everyone else? We may find she is dealing with the threat of unemployment, or a recalcitrant teenage child on drugs, or a parent with Alzheimer’ disease. The patient may have been living with all or some of these for some time and may not consider them particularly stressful – “It is my job.” But whether or not they are “normal,” these kinds of stresses do have an effect on the body’s system. The body reacts with the Acute Stress Response (ASR) but now it has become the Continuous Stress Response (CSR). Both put out the same adrenal hormones and cancel the non-essential functions for flight or fight. (see book: Emotional Vampires and Your Hormones……) The CSR causes many diseases due to the hormonal imbalance.

The most frequently prescribed anti-depressants are the SSRI’s, (Selective Serotonin Re-uptake Inhibitors), which have the effect of increasing the blood levels of Serotonin, a hormone that creates a feeling of well-being. This latest generation of anti-depressants (for example Prozac, Zoloft, Celexa, Lexapro, to name only a few) at first appeared to be wonder drugs, without the nasty side effects of the previous generation of anti-depressants, the MAO inhibitors and tricyclics. But after many years of their use we are seeing that these drugs too can have side effects, such as weight gain, insomnia, sexual dysfunction and with some younger people suicide and/or aggressiveness. So patient X, after a few months on conventional anti-depressant treatment, may not feel much better, or may even feel worse due to the drug’s side effects which cause more anxieties. Realize also, that taking drugs only may alleviate the symptoms and signs and negate the cause: Putting a band-aid on a large laceration

All of our endocrine (hormone) system is interconnected. If one of our hormones, for example serotonin, is “out of whack,” then probably other hormones- in trying to compensate so that the body will be in homeostasis – have also reached compensatory dysfunction. For example, Patient X may do well on restoring her serotonin levels (preferably naturally), but because of the long-term stress and lack of sleep she may also have Adrenal Fatigue Syndrome. The adrenals put out many of our hormones, especially in stressful situations. Cortisol, for example, is produced in higher levels during periods of stress to help the situation (reacting as if in fight or fight) but eventually can be depleted (Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it. Then, because more glucose is needed to provide more energy to the cells to support the increased metabolic rate during continuous stressful situations, we get the involvement that an holistic physician would consider and discuss with the patient.

If a diagnosis of depression is made there are many options. It may be appropriate to refer this client to counseling. If she is the caregiver and problem solver and general fix-everything person in the family, she may benefit from having someone simply listen to her and give her their full attention. Perhaps she has a problem saying “no” and could benefit from some assertiveness training: or perhaps she has never considered that self nurture, can be nurturing everybody; it is not selfish but necessary. Counseling has been shown to be as effective as the SSRIs for mild to moderate depression and anxiety. So has exercise, which also has many other obvious benefits. Part of the benefit is that taking the time to exercise means taking the time for self-care. It also provides an outlet to be in a different social environment and interfacing with other people.

An holistic physician would consider hypothyroidism, alone or in conjunction with perimenopause or menopause. If there is some hormonal imbalance there is a range of clinically-proven botanicals to be considered that can have the same affect as expensive patented drugs without the side effects. Also appropriate human bio-identical hormone replacement often is the answer. But also consider stress interferes with estrogen, progesterone, testosterone, cortisol, aldosterone, digestion and thyroid. (Emotional Vampires and Your Hormones….)

Patient X can learn to take care of herself by learning how to better cope with stress, or by working through emotional challenges, and by taking the time for self nurture. In so doing, she has a good chance of not having to take medicines, whether they are prescription or botanicals. Either of the latter are reality only alleviating the depression and not curing the source. Until a person comes to a conclusion of how to deal with stress and also that they deserve to have self-nurture they will not be able to create the vibrant health that they deserve. When a client says to me that they do not have time for self-nurture I make them listen to what they just told me and explaining that they are sending a subconscious message that the kids, husband, boss,etc are worth her time but she is not worth at least 30 minutes per day.

Take time to nurture all aspects of your being: physical, Emotional, mental and spiritual. A joy-filled life is Your birthright : CLAIM IT!!!

Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it.”

Author: Alan J. Sault MD, ABHM

Metabolic Syndrome (Syndrome X)

Metabolic syndrome 

There are variations of this syndrome of course but these are the classic signs and symptoms.

  • hyperlipidemia (too many fats in the body especially saturated and partially hydrogenated)
  • high blood pressure
  • hyperinsulinemia (high insulin levels)
  • blood sugar high normal or higher
  • high triglycerides and LDL cholesterol (bad type) >150 triglycerides and > 100-125 LDL
  • low HDL cholesterol (good type) <50 for females – < for males60
  • a waist measurement in a man of more than 40 inches and a woman more than 35 inches.

The Metabolic Syndrome ( once known as Syndrome X), a stress-related disease that is becoming so prevalent in the western world that it is fast overtaking first place over AIDS. According to the 2002 census, about forty seven million Americans have Metabolic Syndrome; that is about one in four people. Metabolic Syndrome is also being seen in our children. At this point in time it is estimated that about one million teenagers have Metabolic Syndrome. This could be the first generation of children with a shorter life expectancy than their parents. Stressed parents tend to overfeed their children, perhaps in a misguided attempt to compensate for the parents being stressed and therefore more volatile. We tend to offer food as a panacea or a peace offering for hurt feelings or lack of quality time. And many stressed parents don’t have the time to shop for and cook live food (food with vitamins, minerals, complex carbohydrates and healthy fats.) Add to this the fact that many of our children play video games a lot more than baseball or football or soccer; and spend hours per day watching TV, while they are often also snacking on empty calorie foods. One can of soda can have as much as ten teaspoons of sugar, and it is not unusual for a young person to consume two or three of these a day. While much of the world suffers from the lack of food, we in the West are killing ourselves with an abundance of the wrong type of food.

And when we are under time pressure we tend to eat the worst kind of foods: fast food or processed food that are relatively inexpensive and easy, but are low in nutrition and high in the worst kinds of fat. I am sure we have all noticed that when we eat in restaurants often meals involve mammoth portions of everything. A caveat here about evolution: In the days of mist there was a survival gene for eating as much as possible when food was available to most mammals. They ate when they could and as much as possible since it was not unusual to go for long periods without finding adequate food. Unfortunately this gene exists still today in humans. That is why we need to be careful especially with buffets.

Tthe Metabolic Syndrome develops as a result of a high stress in life which introduces ( of should I say seduces) a lot of the following: a diet high in sugar or high fructose corn syrup (HFCS) which is worse then sugar, unhealthy fat (especially hydrogenated fat), overeating (especially foods low in nutrition), lack of exercise, and lack of down time.

Note that diabetes is often related to obesity and hypertension, which make up part of the Metabolic Syndrome. Many recent studies are now showing that high fructose corn syrup (HCFS) in so many foods is also a high contributing factor in raising uric acid which seems to play a major role in the symptoms of the metabolic syndrome according to Richard Johnson M.D. professor of Medicine from the Univ. of Colorado. In his excellent book, The Sugar Fix, Dr. Richard Johnson talks about the dangers of a diet high in fructose. Fructose raises uric acid, which contributes to: high blood pressure, obesity, inflammation in the arteries, heart disease, stroke and kidney disease. He also explains how when we eat fructose it doesn’t signal the brain that we have had enough food. In fact, other research has shown that rats given a sugar water solution will binge on it but not get fat, as they will reduce the amount of rat chow accordingly. However, give these rats a HFCS sweetened water solution and they will gain weight. This is still controversial but why take a risk?

Alcohol consumption can be another factor in the development of the Metabolic Syndrome. As we seek comfort and relief in our stress-saturated society many of us turn to alcohol (which has a high sugar content and high in calories) as well as the sugary pacifiers mentioned above and often consumed with the alcohol. The negative effects of sugar in the body go beyond the obvious weight gain, or rather feed into a complicated feedback mechanism that compounds the weight gain.

Serotonin receptors in the body accept the sugar as if it were serotonin, The job of serotonin is to keep us calm. (That is why serotonin modifiers are prescribed for sufferers of depression and bipolar disorder. The medications are called Selective Serotonin Re-uptake Inhibitors [SSRIs]; they inhibit the re-absorption of serotonin, so that serotonin levels in the blood remain higher, keeping the mood elevated. Consumption of alcohol and sugar provides a similar serotonin effect, but because the serotonin receptors are being tied up by the sugar, thereby leaving more serotonin in the blood and not on the receptors. The sugar is short lived and therefore more is required to counteract the down feeling leading to binging on processed snacks.

So let’s review the role of insulin in the stress response and therefore in the Metabolic Syndrome.

The stress response releases more cortisol from the adrenals. The cortisol tells the liver that we are under attack and need fuel to cope with the situation, to fight or to run. The liver obliges by dumping its stores of sugar (the fuel) into the blood stream. The elevated blood sugar levels tell the pancreas that more insulin is needed so that the sugar can get into the cells to function. (this is all explained in more but simple detail in the book: Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it).

If we are indeed fighting someone or running away, all well and good. We fight or run, and then everything goes back to normal and the fuel (sugar) is used up and not produced in more great quantities. But when the stress is chronic, when it is constant or in very frequent bursts, the constant outpouring of sugar from the liver into the blood causes a constant outpouring of insulin into the blood from the pancreas. The insulin receptors of the cells cannot handle all that sugar, so it is deposited as fat for future use. This is how stress can sabotage even the most committed dedication to a weight loss diet and exercise program. This fat is deposited in men in the abdominal area, and in women at first in the buttocks and thighs and eventually in the abdomen.

If this insulin output keeps going, eventually the cell receptors for insulin get tired of being hit and start to resist. This is the stage of insulin resistance that is pre-diabetic. The pancreas, in an effort to get the sugar into the cells where it can do some good, puts out higher and higher amounts of insulin, and the cells continue to resist it. The sugar cannot get into the cells and remains in the blood. Eventually the blood sugar levels rise to the disease we call diabetes II. It is not that a diabetic has too little sugar; it is just that the sugar is not in the right place: the cells.

Insulin, like all hormones, does its job efficiently only if it is in natures physiological quantities. At high levels the insulin itself is toxic to the arteries. When the body’s cells do not receive the proper glucose (sugar)—because insulin resistance is keeping it locked out of the cells so that it stays in the blood — they cannot function properly. As we have seen, nature turns a lot of the excess sugar into triglycerides (fat). The arterial cells, especially the inner lining that is called the endothelium, are going through the same trauma as other cells in the body in regard to the high fats floating through the blood. The fat, especially the LDL or bad fats, seeps into the endothelium.

This fat should not be there and is therefore considered an invasion of the endothelium. The body’s response to invasion is to mobilize the immune system, which in this case releases an army of white blood cells known as “macrophages.” The macrophages ingest the LDL, oxidize, and die. When dead they become a toxic hazard inside the endothelium. This signals other macrophages to come and clean up the mess and the same thing happens to them. (They are now called “foam cells” because they are so bloated with fat.). Eventually, there is such a build-up that the internal arterial circumference is compromised, narrowing the blood passage and elevating the blood pressure. Eventually this build-up compromises the integrity of the arterial wall, so that the fat seeps out, causing fatty streaks and hardening of the artery, leading to still higher blood pressure and restriction of blood flow.

So, the stress response due to financial pressure, or to an unruly teenager, or to any combination of the myriad stresses that are a fact of modern life— especially when combined with a stress-related high sugar diet, set in motion a cascade of events that promotes hardening of the arteries (atherosclerosis). This is why people with diabetes have 3-4 times the problems of atherosclerosis than those without. This brings on hypertension and peripheral artery disease (PAD) with all of their attendant complications to the organs and tissues of the body, including heart attacks and strokes.

Do not get depressed if you seem to fit into this category since this is all reversible. Even hardening of the arteries can be alleviated or reversed. Yes it can! The first thing one should do is find a physician that believes in a holistic attack on the Metabolic Syndrome. Three organizations that you can contact for the latter are #1-The American Integrative-Holistic Medical Association: #2 The American College for the Advancement of Medicine: #3 The American Holistic Medical Association. I do suggest that you interview for a short period any healer since being alternative, complementary or holistic (see my blog on the differences) may not give immediate knowledge nor the right personality for you.

Then certain laboratory tests should be done that are not conventionally done.

  • Fasting insulin level along with a fasting blood sugar. Very important! This is because a blood sugar can be in the normal (usually high normal) range; but this could be because the insulin level is high keeping it within the normal range. I consider this to be pre-diabetes which is much easier and healthy to treat then overt diabetes II. If the sugar level is high then an HgAiC is necessary which notes whether the sugar is constantly high over the last 3 months.

  • Cholesterol panel

  • Marker for inflammation such as C-reactive protein, ESR (Erythrocyte Sedimentation Rate, homocystiene. Whichever your doctor prefers or all of them.

  • Uric acid since this is now being thought to be quite the villain for cardiovascular problems especially with people that are in the Metabolic Syndrome category.

I believe that you should be taking care of the stress in your life either by alleviating it or reacting to it in a different manner then the past. It is stress that brought you to this point. My personal preference is through hypnosis and interactive guided imagery. Both you can learn to do on your own after being taught by a therapist that gives unconditional love and is non-judgmental.

I am not presenting here the medicinal solutions, whether they are allopathic or alternative. I have used botanicals along with lifestyle change for clients for many years with successful results. But I know, from my own health challenges and those of my patients, that if one wishes to get to the cause of dis-ease stress management is mandatory. It is not always the stress but how we respond to a stress!Yoga, meditation, sports and exercise can give relief and relaxation, but ultimately the cause needs to be uncovered and dealt with. I would prefer someone who also practices hypnosis and/or interactive guided imagery. (You can check the website of the Academy for Guided Imagery for a qualified practitioner near you:

Hypnosis and imagery are tools that allow access to the deeper levels of the mind, and can not only get to the core of the problem relatively quickly and cheaply but also recruit the vast resources of the deeper levels of the mind to offer solutions.

There is a place and need at times for pharmaceuticals but I believe these usually should be a last resort, or used as a temporary remedy to give relief while we make the necessary adjustments to lifestyle and seek understanding and healthier solutions to the sources of stress in our lives. But whichever road you choose to travel, I believe that with the Metabolic Syndrome with all the imbalances we are discussing — the most beneficial path is to get to the reason why this is happening, and learn how to change those circumstances. Metabolic Syndrome is a set up for many potential serious illnesses: arteriosclerosis, cardiovascular disease, stroke and diabetes with all of its co-morbidities, and yes even Alzheimer’s Disease. People with Metabolic Syndrome have a seventy percent greater chance of developing Alzheimer’ Disease than those without it.

So what I am stressing here (no pun intended) is that there are many things one can do to improve physical health and quality of life. But always, one has to include ways of alleviating the everyday vampires of stress, along with diet, exercise and the silver bullet of learning to relax. Easier said then done. I am still working on this last point and find it invigorating when I neutralize another emotional vampire. But I need help; luckily for me my wife is in the field of stress management. What, did you think I just know all this stuff!

Alan J. Sault MD, ABHM

Author: Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it.