Author Archives: Alan Sault MD, ABHM

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.

Complementary, Alternative, Holistic: What’s the difference?

holistic medicine 


In popular usage, and in many academic circles, the terms complementary, alternative, and holistic, are often used interchangeably, but there are important differences between them and similarities.

Complementary medicine is, as it states, the use of other methods along with traditional western (allopathic) medicine.

Alternative medicine is when one breaks away from the conventional allopathic treatments and uses other types of treatments only, such as Ayurvedic medicine, herbs, acupuncture and so on.

Holistic medicine treats not only the specific physical symptoms of disease, but the whole patient by servicing the trinity of mind, body and spirit and as in complementary medicine may use traditional western and alternative. But holistic by far does favor natural medicine but uses allopathic medicine when the diagnosis requires to do so.

In my way of thinking the physician and patient are equal partners in the healing process. The patient should take responsibility for his or her own health and use the physician’s knowledge and experience as a guide and when necessary the physician as a life-guard. I consider the term integrative medicine to be synonymous with holistic medicine in that it seeks the appropriate combination of therapies for a particular patient and illness. Again, I repeat that most holistic physicians will integrate the aspect of mind-body-spirit.

The holistic physician needs to spend time with the patient, because a large part of a holistic practice is listening to what the patient is not saying, as well as what the patient is saying. This must be done with as much non-judgmental, unconditional love of which the physician is capable, since many illnesses are caused and prolonged by emotional stress. Holistic medicine has as its goal not only the alleviation of symptoms but also the creation of a healthy way of life.

There is the perception among some people that by serendipitously using botanicals and supplements they are living a healthy life style. True, they may be doing better than if they were not trying at all, but they may be headed for danger. Botanicals are medicines, and like any other medicine they can have side effects. Certain botanicals need to be taken in proper dosages, which may be different for different maladies.  Taking too much can cause toxic side effects; taking too little can mean there are no benefits. This also holds true for supplements. And just like a medical text, a botanical text does not take into account individual differences that must be evaluated by an educated, caring professional. Otherwise, if the client is not considered as an individual there is little difference between indiscriminately writing prescriptions for pharmaceuticals and recommending botanicals and supplements. Also consider this; sometimes a person needs a certain diet or supplement, or pharmaceutical, but this may have to be altered, changed, or just negated as the client changes their life style and gets better. Too often this is not considered and the client is kept on the same regimen for their life. This is expensive and could lead to unwanted side effects. Re-evaluation is important at different times to be judged by the practitioner and the client. This last statement is true for either western medicine or alternative medicine.

Developing the art of patience allows the physician to relate on all levels: mind, body and spirit. Sometimes botanicals, supplements, and allopathic drugs are not the answer. The answer may lie in alleviating the stress that is causing or giving energy to the illness. Sometimes the illness has something to teach the patient. All these things are a part of holistic medicine, which may require a referral to another professional with expertise in different types of mind, body and spiritual techniques. Again this is done with the informed consent of the client.

It is the patient teaching the physician and the physician teaching the patient that makes holistic medicine such a wonderful relationship devoted to the process of evolving and living  without disease.

For continuing information on this subject please enjoy reading my published Emotional Vampires and Your Hormones: an Holistic physician’s view of how stress affects your well-being and what to do about it.