Author Archives: Alan Sault MD, ABHM

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.

Preventive Medicine- it is not just taking supplements

heart preventive medicine

Too many people including healers think and believe that the term preventive medicine is taking supplements and other alternative treatments. Health is so much more then all the latter: The responsibility should be shared by the client and the healer whether s/he be in traditional medicine or alternative-complementary-holistic medicine.

I was not planning on writing on this topic but a situation came up. Two very close people to me went for a complete physical and came back feeling quite secure when the doctor reported to each of them that their health was good except that the sonogram showed mild fatty livers in each of them. No surprise since each of them drinks quite a bit. There were other discrepancies when I reviewed the laboratory reports but that is not an issue in this writing.

I will return to the above after my soliloquy on preventive medicine or the lack of it. For quite sometime now it has been obvious to me that it is easier for myself and the client to prevent illnesses rather then try and cure them. Obviously, it is also a lot cheaper for the individual and the insurance companies (but the opposite for the pharmaceutical companies). A mostly healthy life style is the way to live with exercise, live food and stress reduction activities. I say a mostly healthy life style because I find two things with being too strict with ourselves and my clients. One, too strict and the majority will give up their good intentions after a short time of doing what “the doctor ordered.” Two, there is a certain amount of fun in life that we want to have and some of these involve deviating from the path of towing the “gotta do this always for my health”. Three, but really true and important, is I find a lot of “health freaks” become neurotic over every thing they do so they will not get ill. Of course, the latter can lead to stress and can be a sickness in itself. Trying to be completely health-wise in a non-healthy world leads to stress, and stress I believe to be the main cause of disease. Therefore, a self defeating life style There is a possible four, which is what is stated today as the most healthy thing you should do to stay healthy may be proved wrong tomorrow. This is true also for so many pharmaceuticals. I can write a book and not a blog on these but you will come across many in my book and blogs. For now let us just take the example of aspirin which was pushed for so long even though doctors and the FDA knew it was a major cause for bleeding ulcers and its complications like death. Now the AMA is stating not to use it unless you have a cardiovascular condition. But if one believes that today’s health theory may change tomorrow, then one would do nothing to help themselves stay healthy. So lets not go along with that but just note it since one would have to read and study each scientific research article and who did the research to know if something was good or bad and then keep up with current advice about it. Let us hope that reading things like this will give the reader more forethought about spending money because it is advertised as being the health panacea.

So we follow a moderately healthy life style and then have to decide which supplements are best for us as individuals. First we must realize that supplements are just that – supplements. They are not a substitute at all for healthy, natural vitamins, minerals, proteins and healthy fats (omega 3s, mono and polyunsaturated fats and some moderate cholesterol intake. (See my blog A Word about Cholesterol). Then we have to watch our pocketbooks, and importantly who is toting the supplement that is the panacea to health. A supplement company should be able to produce a written document on their quality control system and of the item you desire. Another thing I have found that in general the supplements of pharmacies are not as good as those from a reputable company. for example, One-A-Day vitamins. There is no way that a vitamin taken once a day will have the healthy requirement of your body needs. To get the quantity of minerals and vitamins requires 3-4 capusles in the AM and 3-4 at night (in general). The one a day do not have enough for a gerble.

For instance, there are so many health drinks advertised that supposedly stop all ailments and give longer life (anti-aging) with the proof that such and such indigenous people use it. of course they do not state the life-style of these people which probably is different then the western life style. Seems we are back to the “snake-oil” days, but at least snake-oil usually had laudanum in it, an opiate. Well how about saving money and eating healthy food. The idea that a supplement cost more is better then ant-oxidants in live food to me is ludicrous. Ah, but then some people say “I use it and can see the difference.” Maybe they can because they are not getting it from their daily eating habits. Or, it could be the placebo effect which I have experienced with so many clients in my 40 years of medicine. Nothing wrong with the placebo effect. In fact, it is great if the person feels better and is really getting better and not masking an illness. This health expenditure holds true with all the plastic bottled water that people are consuming. Most of them will not make you healthier and some will actually have a long term negative affect on the body such as an electrolyte imbalance and the phthalates out gassing estrogen mimickers from the plastic. Use the Internet before thinking this advertised health water is good for me; do your own research, but not with advertisements. Unfortunately most municipal water tastes bad and is also polluted with “healthy ingredients” (sarcasm)

OK, Back to preventive medicine and the starting paragraph. This deviates from the way a lot of laypeople and healers view preventive medicine. We have a doctor reporting to clients (I dislike the word patient) that they have good health except for mild fatty livers. They go away confident that they are in good health except for the mild fatty liver. Wrong!! They are ill with a serious pathology. Now is the time to tell them this and for the physician and client to start healing the liver and causes before it progresses to the next stage. This is preventive medicine! The term border line disease is a disaster. The person needs health now. To me, it is like telling a woman you are a little bit pregnant. You are either pregnant or not.

A person comes in with a blood sugar that is in the very high normal range. It should signal the physician that another test should be done to check why this is and not say it is still in the normal range. I get a fasting insulin along with the fasting sugar. If the fasting insulin is high that is a signal that there is a problem. Because the body will try to keep homeostasis (equilibrium) so the pancreas keeps putting out more and more insulin to get rid of the excess sugar either by forcing it into the cells or detouring it into fat (triglycerides). So the sugar looks within the normal “boxes” but only due to this compensation. Now is the time for the physician to treat the person so their sugar and insulin go down. Not when the overworked pancreas can no longer make insulin. Not when the person has symptoms and signs of insulin resistance, diabetes or the metabolic syndrome. This would be preventive medicine!

A woman comes in with the following symptoms and signs: cold when others are comfortable, lose of head hair and the outer 1/3 of her eyebrows, constipation, fatigue, gaining weight but working out, dry skin and her temperature is less then 96.4 Her lab reports (thyroid stimulating hormone=TSH) show that her thyroid is functioning within the normal range. So what! she is giving the classic symptoms and signs of hypothyroidism or/and adrenal fatigue. This should be followed up by the physician with further thyroid tests. Some holistic physicians would start treating this as hypothyroidism on a low dose (I hope natural) thyroid medicine. Then watch the client, get further tests and a better history especially about the family. This is preventive medicine! Not saying well it is not your thyroid since the labs are normal and putting the woman on menopausal pharmaceuticals and an antidepressant.

Prevention is not treating lab work as if it is the patient, but rather listening to the client’s symptoms, signs, history, using what the physician was trained to do. Think about the differential diagnosis; a list of diseases that it could be since the symptoms and signs are similar in so many diseases. Then treat the client and not the laboratory report. Explain to the client what the healers thought process is and get feed back from the client. The client too must take responsibility for getting and staying healthy. It is the patient teaching the physician and the physician teaching the client. The healer should be there as a teacher and as a life guard when necessary.

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

holisticsecondopinion.net/vampires

menopause compared to andropause (mens’ menopause

Symptoms of menopause compared to andropause (mens’ menopause)

Women                                                                                      Men

Anxiety                                                                                     Anxiety

Irritability                                                                                Irritability

Fatigue                                                                                    Fatigue

Loss of energy                                                                       Loss of energy

Poor concentration                                                              Poor concentration

Depression                                                                            Depression

Loss of muscle tone                                                             Loss of muscle tone

Decreased exercise tolerance                                            Decrease exercise tolerance                                                                                 tolerance

Prolonged recovery from exercise                                   Prolonged recovery  from exercise                                                                         from exercise

Little or no improvement with exercise                         Little or no improvement

Weight gain in spite of exercise                                      Weight gain in spite                                                                                       of exercise

Loss of memory                                                                 Loss of memory

Osteoporosis                                                                     Osteoporosis

Decreased                                                                          Decreased sexual  desire

Cardiac disease                                                                 Cardiac disease

Higher bad cholesterol                                                    Higher bad cholesterol

Hot flashes                                                                         Hot                                                                                     Some men get this

Night seats Night sweats                                                Some men get this

Prostate enlargement                                                     women don’t get this

Thyroid Dysfunction – the shape shifter dis-ease

Hypothyroidism

The thyroid hormone is one of the main hormones that stimulate the furnace of the cells to produce energy. Without it, or when the thyroid hormone is low, food cannot be used and is stored as fat. The most common signs of hypothyroidism are:

  • low temperature below 96.4 (depending who you read). But definitely feeling cold when everyone else is comfortable.
  • fatigue for unknown reason(s)
  • loss of hair and outer 1/3 of eyebrows
  • dry, scaly skin especially of the shins
  • constipation that is new for the person
  • weight gain even though the person is eating normally for themselves. Especially if they are working out to lose weight

The symptoms and signs of low thyroid production can masquerade as depression, menopause, and psychosomatic. The interpretation of reading the laboratory results can mislead the physician thereby masking this diagnosis of the hypothyroid problem. The main blood test used to diagnose this is abbreviated to TSH (thyroid stimulating hormone). TSH is what is ordered by the physician to see if you have a thyroid problem. The numbers that the physician looks at to see if you are in the normal range has been controversial for a long time. Depending on the lab the TSH range was.35-5.5 but has now been changed to .3-4.5. This because it was found that too many cases were being missed by a lot of doctors looking at a high in the normal of 5.5. Doctors have been debating for years whether to lower the upper limit of what is considered normal for TSH since so many people whose blood work shows their TSH close to this upper normal limit still have the symptoms and signs of a low thyroid. Unfortunately, the missed diagnosis of hypothyroidism because of misleading lab results is not the whole story. The Colorado Thyroid Disease Prevalence Study found that when tested for thyroid dysfunction 10% of the study’s 25,862 subjects had abnormal findings (high normal being 3.5). That figure, if extended to the general population nationally, would mean there are about 13 million people with undiagnosed thyroid abnormalities. And if, as recommended by many physicians, the upper limit of TSH for thyroid dysfunction were reduced  to 3, it would mean that 20% of the population is affected.

But when a busy physician takes a history of all the above symptoms and signs s/he may only hear depressed, tired and menopause and see lab results in the normal range. It would be in the patient’s best interest, I believe, to consider the signs and symptoms first and the blood work second.

A low thyroid level is called hypothyroid or hypothyroidism. Hypothyroidism may also be caused by a poorly functioning adrenal gland, since too much or too little cortisol affects the thyroid hormone. The adrenal gland produces cortisol and adrenaline in response to stress, and powers the Stress Response that prepares the body to fight or flee. In the initial stages stress causes higher than normal levels of cortisol: When the stress is chronic the adrenals eventually wear down, a condition known as “adrenal fatigue,” and cortisol production drops below normal levels. Therefore there is not enough cortisol available to sensitize cell receptors to accept the hormone nor to convert the T4 to T3.

As we have seen, production of many hormones, including thyroid, is lowered when the body is stressed. The Stress Response at first triggers the adrenal gland to produce higher levels of cortisol, that signals the body to put all its energy into the systems that will help to fight or run – the large muscles. To do this it takes energy away from functions that are not essential to those life-saving activities such as the sex hormones, thyroid and the GI tract. In the case of chronic stress, the adrenal is overworked continuously and the cortisol production becomes less and this too results in hypothyroidism.

The machinery of the body functions on precise amounts of each chemical, some measured in billionths of a gram, and this includes the hormones. This precise amount for each hormone is known as the physiological quantity (for that particular hormone). All the hormones have to be available in the appropriate physiological quantity in order to function in harmony for optimum well-being. It is like a symphony with each musician playing exactly the right notes in harmony with all the others.

Many women entering menopause not only experience the effects of diminishing sex hormones but also have a thyroid problem. I believe the depression that accompanies both menopause and hypothyroidism comes also from the physical changes: constipation, hair loss, feeling cold, gaining weight, fatigue that disrupt one’s life. I believe that the thyroid should always be explored before starting pre and post-menopausal woment on antidepressants. OK, now, I want to introduce what can go wrong with the thyroid and why conventional treatment may not work or even make the hypothyroidism worse.

The thyroid gland is stimulated by a complex feedback system. The pituitary gland stimulates the thyroid to produce T4 (thyroxin). The pituitary gland then responds to a feedback to the amount of T4 whether to stop stimulating the thyroid gland (enough of it) or to keep stimulating it (too little). In other words, the pituitary is responding to the amount of the primary(T4) hormone produced by the thyroid.. However, T4 is inactive, and must convert to active T3 in order to do its job. The conversion from inactive T4 to active T3 requires the right amount of selenium and cortisol. If selenium and/or cortisol are lacking or levels are inadequate, the feedback of T4 to the pituitary gland can make the level of TSH appear normal, since the T4 is sending the message that all is okay. The physician reading the lab report sees that the TSH is within normal limits, even though the patient is deficient in T3. All this is made more simple and explained with diagrams for the layperson 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.

And the plot thickens. Under stress, T4 may convert into what is known as reverse T3 (rT3). The rT3 molecule is just like the T3 molecule , except that one of the three iodine ions is in the wrong position. This tricks the receptor sites of the cells. rT3 binds to the receptors, thus blocking any remaining real T3. But since the rT3 does not have the same active stimulating effect as T3 because it is not of the right molecular arrangement, it will not stimulate the thyroid’s metabolic functions in the cells. Therefore, prescribing T4 will not solve the problem. The more synthetic T4 a patient takes the more rT3 is produced and the patient’s condition either does not improve or gets worse. When the stress levels rise the same enzyme (iodinase enzyme) which is responsible for the conversion of T4 to T3 is also used for conversion of T4 to rT3. Therefore, there is not enough of the enzyme to convert to both reactive T3 and rT3. For some reason the conversion to rT3 takes precedence. As of today, it has not yet been explained why rT3 takes precedence.

let’s say the patient is being treated with synthetic or natural T3 but still does not feel well. It is possible that the T3 is not getting into the cell, because to get into the cell the T3 is again dependent on selenium and a physiological level of cortisol and these may be deficient. Or if the T3 does get into the cell it may not work if zinc levels are low, because here it is dependent on zinc for its performance on the mitochondria in the cell. Mitochondria are the multitude of little factories in the cells that produce energy.

So to summarize: it is possible for a physician to be fooled by lab work. In this case, T4 levels remain normal but are not being converted to the usable T3 or as just explained the T3 cannot be utilized. The feedback of the T4 from the thyroid is still telling the pituitary that all is okay and therefore the TSH remains normal. But if the patient has all the symptoms and signs of hypothyroidism, then I would say the heck with the lab work being in the normal limits. An rT3 test is needed here and maybe some other thyroid tests: T3, FT3 (F=functioning), T4, FT4 and an autoimmune profile for thyroid (It is a possibility that the body has formed antibodies against an aspect of the thyroid hormone or the receptors for it).

Another interesting theory is that when cortisol is low causing the gut does not absorb normally. This can lead to leaky gut syndrome, which means that certain large protein particles that are foreign to the body are absorbed, and other nutrients that the body requires are not absorbed, such as amino acids.

Tyrosine plus iodine are needed to make the thyroid hormone. Therefore, if one has the leaky gut syndrome it may mean that tyrosine, an amino acid, is not being produced by other amino acids it depends on for its productions.

This was a shortened version of a chapter in my book (Thyroid and stress). I do hope though it illustrates how many things that the thyroid hormone depends on. Stress is still the big factor to sabotage a properly working thyroid and needs to be addressed whether the person is on synthetic hormones or more bio-identical thyroid hormones. Of course a good diet, exercise, a physician you can relate to and takes their time evaluating you and your smile and laughter goes a long way.

Antiaging and testosterone

testosterone word in letterpressIt is obviously true that we all have to get older, but I believe we do not have to age. This last statement is true for aging physically, mentally and spiritually. I have been an M.D. 45years and doing anti-aging and holistic medicine for 25 years using Human Bio-identical Hormones (HBIH). These hormones are made by a compounding pharmacist for each individual according to the clients laboratory reports along with the client sitting for about 2 hours and telling me their symptoms and signs. Why? Because each person is an individual with their own unique physiology and listening to a client is as important (or as I think more important) as the laboratory tests.

There is so much scientific evidence based documentations on the benefits of hormone replacement therapy (HRT). Unfortunately, there exists so many myths about HRT. (please read blog on testosterone Myths). In this blog I will just explain the benefits of testosterone since progesterone and estrogen presentations have been written about so much and less about testosterone. I do have a blog on progesterone (Progesterone the brain protector). When I write about hormones I am referring only to Human Bio-identical Hormones.  a hormone with the exact molecular structure of that produced by the human ovaries and testes that nature has intended for our body’s use. They can be reproduced by a compounding pharmacist without changing the biochemical structure as is done with synthetic pharmaceutical hormones. It is the synthetic Testosterone which the media writes and talks about negatively without doing the research. The ivy league researchers and physicians also use synthetics instead of bio-identical hormones. There is a big difference between the two types of hormones. Also it is important that the dose be the physiological dose for the individual – that is the amount that nature intended for that individual person to function optimally; not the same pharmaceutical packaged dose for everyone.  The lack of testosterone in the male is called andropause (mens’ menopause) which can be equated to womens’ menopause. In fact, the symptoms and signs that the male has are very similar to the symptoms and sign of the menopausal female. (Except females do not get enlarged prostates). Some males even have hot flashes and night sweats. (See blog on Andropause compared to menopause)

So here are some facts about testosterone:

  • It has been shown that there exists 3-4 more testosterone receptors in the heart of males and females then in the male gonads (testosterone therefore is not just there to bother women). This means that it is heart protective since we know that nature always has a purpose and rarely creates biological states haphazardly.

  • Testosterone also helps stimulate the production of nitric oxide which is necessary to dilate the arteries. This helps prevent high blood pressure and for the male more consistent erections.

  • Testosterone is necessary to prevent osteoporosis. It is true for women that estrogen and progesterone help prevent osteoporosis but it is testosterone that really keeps the bones strong for both men and women That is why men do not get osteoporosis until they are much older then women. Men have been building strong bones and muscles for so long due to their higher amount of testosterone. (The Testosterone Syndrome by Eugene Shippen M.D.) Men can get osteoporosis eventually and therefore like women should after 60 get a bone density test. Even before this age if symptoms and signs suggest this deterioration is happening; such as loss of height, hunched back or even pain of the back or hips.

  • Testosterone is necessary for firm and strong muscles. This also means a flatter abdomen (not necessarily a six-pack). A 50 year old can work out hard in the Gym but if the foundation building blocks are not there (testosterone) they probably will not build hard muscles. Like a pretty house with a poor foundation eventually it will collapse even after many trials of repair.

  • Testosterone has now been shown to have receptors in the brain. Many studies have shown statistically the lower the testosterone level in men and women the more likely that these people get dementia. In fact, in one study they gave testosterone to Alzheimer men (synthetic in this study) and although it did not cure the Alzheimer Disease it dramatically slowed it down. (Pike, C., PhD. & et al (Dec. 20, 2006). “Testosterone therapy may prevent Alzheimer’s Disease.” Science Daily (abstract from the University of Southern California) & (Resnick, Susan PhD. & Moffat,Scott PhD.(2007). Low Testosterone Levels Linked to Alzheimer’s Disease in Older Men. Journal of Neurology.) They have also shown by using functional MRIs (fMRI) that testosterone is needed by the brain. These are MRIs that show different colors for the active and inactive parts of the brain. When testosterone is low it showed lower memory capacity in these areas. In fact, with really low testosterone levels these people were not able to fantasize.

  • Although I did not want to get into testosterone myths in this blog I know some people will have the question of testosterone causing prostate cancer. It has been evaluated by many prominent physicians and researchers that have come up with the same answer that testosterone does not cause prostate cancer but rather it is estrogen. This is because all fetuses start as females and have small uteri.  When the potential male fetus reaches a certain embryological maturity the prostate develops around the uteri (which remains inside the prostate called a utricle). It is estrogen that hits the utricle to cause the cancer as it would cause cancer of the uterus in a female. Also if testosterone was the cause of prostate cancer we would see more of it when males are young bucks with higher levels of testosterone then at the low testosterone levels when men are older and get prostate cancer. The argument against this is that is takes testosterone more then 50 years to cause the cancer. Well, if a man is more then 50 and it takes another 30-50 years for this to happen it will be happy years.There are numerous reasons why a male can build up too much estrogen but again this could be another blog or answer to FAQs.

  • It has now been shown that testosterone does not cause clotting of the blood as  was once thought (but never proven). Because testosterone may mildly raise the hematocrit and hemoglobin that the blood was thickened and therefore clotting would occur. This elevation does not even occur in most males using bio-identical testosterone and when elevated they are still usually within the normal limits for a male.  This was all speculation. In the following research article testosterone clotting was shown not to be the case. (Smith, A. M. et al. (2005). “Testosterone Does Not Adversely Affect Fibrinogen or Tissue Plasminogen Activator (tPA) and Plasminogen Activator Inhibitor-1 (PAI-1) Levels in 46 Men with Chronic Angina.” European Journal of Endocrinology, 152 (2), 285-291.)

It is really a shame that testosterone has been vilified for such a long time because of traditional ignorance and not up-to-date healers. A lot of these myths are due to athletes and wanna be athletes taking huge doses of synthetic testosterone. It is true that any natural or unnatural product that is used in non-physiological doses can cause harm. That is why one goes to a physician that is up-to date, non-prejudicial about bio-identical hormones, and willing to listen to you and any new findings and questions that you have for him/her.

Choices are not easy for a client in choosing anti-aging hormones since there are so many prejudicial myths built up for so long in the medical community. That is one of the reasons I  have written 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). I present to the public medical information that is known but not promoted to let the person make their own educated decisions.

The Antibiotic Controversy

antibiotic controversyHaving been in medicine more then 45 years of which 25 of these in Holistic Medicine. I find there are a few thoughts that are being disregarded on the topic of antibiotics by both healers and the general public.  As an holistic MD I am against the indiscriminate use of antibiotics as has been done in the past and still persists in the present despite all the AMA warnings, but at least to a significantly lesser degree . As a rational and past ER MD I know that “to throw the baby out with the bath water” is as narrow minded and dangerous as the allopathic physicians’ negative view of the use and consideration of alternative-complimentary medicine.

People that have experienced life threatening illnesses such as mesenteric gangrene, or a burst appendix, felon of the finger or sepsis, etc. have appreciation for the antibiotic use. There is a place for the emergent use of antibiotics but not their abuse as history has presented to us. A simple UTI can be handled with colloidal silver IV &/or mannitol; but as a learned MD I do not want to put the client at risk of the possible sequel of glomerulnephritis or pyelonephritis and therefore an avoidable hospital admission & the consequences of an iatrogenic infection (and hospital food). If I use an antibiotic I double the dose (AM &PM) of the probiotic while on it and keep the client on this for a minimum of 30 days after the antibiotic course. Hopefully my clients take a probiotic every day for all their life.

For 25 years I have been successful treating advanced infections with the IV use of colloidal silver &/or H202, &/or high dose Vitamin C. Always with discretion & discussion with the client. I rarely use antibiotics but as stated when I believe it is necessary I discuss this choice with the client and explain why I believe it is necessary. I use IV therapy with my holistic choices since many people have dysbiosis or leaky gut syndrome and will not absorb via treatments done orally. This way I know my alternative treatment is in their blood and going to the infection or inflamed pathology. I have for example used colloidal silver IV and H202 IV to cure the flu in12-36 hours. There is a place for all our knowledge in healing when used correctly. The treatment must fit the individual client and disease and not just be a standard textbook treatment.

I suggest to people that they have a list of questions for their physician-client interaction because so often people are intimidated or nervous and forget what they wanted to ask. The physician should take the time to explain the answers to the client and having a list should make this an easier task for the healer.

Yes, there could be side affects to any pharmaceutical but also to alternative-complimentary therapies. There are also side effects of any serious pathology like sepsis or neurocyticercosis (a parasitic infestation of the brain) when not being treated with antibiotics. The side effects without proper antibiotics of some terrible diseases is death or disability. There are so many illnesses and diseases with similar symptoms and signs that it takes a lot of education for an MD, DO or ND to learn what is called the differential diagnoses (DD), or at least to know where to look for them,  when to look for them and when to refer. The DD cannot be learned in a 1-2 year alternative course. There are long residencies so the physician can actually see these diseases and keep learning from other experts. Continuous education for licensed MDs, DOs and NDs is very stringent and monitored. After all this education I believe the healer is ready to make a decision whether to use and practice alternative-complimentary therapies or allopathic or both together. At least the previous education gives the choice and knowledge to the healer to discuss options with the client as a partnership.

Be aware that my statements in no way are my feelings of support for the big pharmaceutical conglomerates; their villainous prices in the USA (compared for the same pharmaceuticals in other countries), their ways of advertising both via the media and to physicians. My opinions are only my very long experience of learning in both fields of medicine. I feel It is the physician teaching the patient and the patient teaching the physician.

But “do not throw the baby out with the bath water.”

Compliance = Responsibility

ComplianceMagnifying-GlassThere is a joined responsibility of the client (patient) and also the healer during treatment and prevention. I was talking to a friend the other day and asking him about the lab work that he was was supposed to have gotten and found he  was putting it off with various excuses , none of which were economic. Such as, I was too busy; while I know he starts his day at 9-10 AM and could be at the lab at 7:30 am. Yet, he wanted his physician to write him a prescription for a schedule II pharmaceutical which ethically, morally and in the practice of good medicine has to be followed by lab work between every 6-12 months.

This is a long introduction on what is the role of the patient and the physician or healer. Of course this is my opinion! The client has the responsibility of following the physician’s requests or addressing the physician with questions of why the requests are necessary. I believe the physician has the responsibility of explaining why the steps of the treatment are necessary and what they mean. If the client does not agree after the explanations, in my mind he does not trust or agree with the expertise of the healer and should move on to healer which s/he feels more comfortable

I have experienced too many avoidable problems in medicine with physicians trying to be too accommodating and sacrificing what they know as good medical practice so that the patient can be accommodated. The healer is usually doing this with an open heart and empathy for the patient. But it is comparable to a parent not explaining to their child the consequences of doing or not doing an act and then not being forceful enough to enforce what is right for the child’s safety.

On the other hand, too often the client wants the convenience of the physician doing all the work for them and believing that the “pill popping” will make them better. Obviously this is false! The medicine or alternative treatments will help alleviate or cure the person but only if directions are followed by them and/or practiced by them . For example; an orthopedic surgeon can put a prosthetic shoulder in the patient but the patient has to dutifully follow through with the post surgical assigned program to get full beneficial range of motion.

It really bothers me if the physician or healer does not sit and explain the importance of their regimen for whatever the pathology with the attitude that the client is not smart enough to understand: but it also really bothers me when the client is nonchalant about the explanation and directions and believes that the responsibility is all on the healer. Ultimately it is the client that suffers physically and mentally when the healing is not as complete as possible. I find it helpful for the client to prepare a list of questions before the interview with the physician since often time is limited and also the client is nervous and forgets problems that s/he wants to have answers. This tactic helps the physician alleviate stress of the client and also get to know the client better.

So compliance is a two way avenue. The physician can only be a guide (and life-guard when necessary) for the client and not the full time caretaker. The medicine is so often only to relieve the symptoms and signs but not the panacea for wellness. The client is responsible for following advice or not with the knowledge that there are always options and also consequences for any action. The client also needs to practice good health regimens as much as they can to keep a good immune system

I hope this blog helped to enlighten some readers it was a good cleansing for me.

Adrenal Fatigue: symptoms and signs

 

-Adrenal-Fatigue S&SThis is a well organized short synopsis for the layperson to understand and be able to ask questions of those they seek for their healing. There are certain signs and symptoms that one should look for to see if low cortisol levels are developing. Keep in mind that at first the continuous, high cortisol levels are also dangerous to our well-being as I wrote about in my blog: What is Adrenal Fatigue.The physician also should have the following in their diagnostic differentiation because there are many illnesses with similar signs and symptoms so that diagnostic conclusions must be done carefully and by experienced healers. A person does not need to have all the listed symptoms and signs, only some to begin to think about stress and adrenal fatigue.

But first let us see what are the functions of  cortisol.

At healthy levels cortisol influences, regulates and moderates:

  • Blood sugar levels
  • Fat, protein and carbohydrate metabolism
  • Anti-inflammatory mechanisms (our immune system)
  • blood pressure
  • The central nervous system
  • Thyroid functioning

Elevated cortisol levels cause:

  •  Impaired cognitive functioning
  •  low thyroid and eventual hypothyroidism
  • Decreased bone density
  • Insomnia
  • Decreased muscle mass
  • Elevated blood pressure
  • Slower wound healing
  • Increased fat deposition which can lead to cardiovascular problems

Low cortisol levels cause

  • Foggy brain
  • Depression
  • Low blood sugar or hypoglycemia
  • Fatigue
  • Insomnia
  • Low blood pressure
  • Decreased immune function
  • Increased inflammation

The following are clues Adrenal Fatigue

1-morning fatigue where the person does not awaken easily and stays groggy until about 10AM.

2-from 10-12 feels awake especially after lunch,

3-starts getting a low about 2-4PM and then picks up again around 6PM,

4-with this burst they are tired again by 9-10 but if they remain up they get another energy burst until abut 1-2AM

5-best sleep is between 7-9AM,

6-during the day they need a lot of caffeine to keep going and

they  often crave salt and hyperventilate [frequent sighing and breaths]

7-liver spots [chloasma],

8-frequent colds and allergies

9-feelings of helplessness which causes more stress.

Clinical tests for adrenal fatigue:

  • Blood pressure drops >10mm/hg when going from supine to upright position.
  • The pupils cannot hold contraction when light is shone in the eyes.
  • Sergant’s sign=a line drawn on the abdomen remains white instead of turning red after a few minutes.
  • Rogoff’s sign= pain or tenderness over the adrenals when pressed. The adrenals are found below the posterior 12th rib. Just put the thumbs over them and let the patient breathe in and out.

Changes occur in carbohydrate, protein and fat metabolism, fluid and electrolyte balance, heart and cardiovascular system and sex drive. So this can lead to the below symptoms and signs. Listed also are some of the illnesses. Notice that so many of them are related to the depletion of hormones because without the proper carbohydrates, fats and protein (amino acids) the hormones cannot be made. Low cortisol also causes the intestine to promote leaky gut syndrome which does not allow normal nutrient absorption. This metabolic interference because of the adrenal influence of changing the carbohydrate, protein, fat metabolism and absorption can lead to other signs and symptoms that give clues to adrenal fatigue. But some of these can also go along with other pathologies, for example low thyroid (hypothyroidism). Low thyroid and adrenal fatigue very often comorbidities (they come on together). Hypothyroidism since the stomach cannot break down protein to amino acids so that the amino acid tyrosine cannot be made. Tyrosine hooks up with iodine to make T4. Also cortisone sensitizes the cell receptors to take in T3.

Additional Potential Problems of Adrenal Fatigue

Feeling tired despite sufficient hours of sleep, always fatigued
Insomnia
Weight gain
Depression
Hair loss
Acne
Reliance on stimulants like caffeine
Cravings for carbohydrates or sugars, hypoglycemia
Cravings for salt
Poor immune function
Intolerance to cold
Hypotension
Fibromyalgia
Hypothyroidism
Chronic fatigue Immune Disease Syndrome (CFIDS)

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Progesterone – the Brain Protector

progesteroneBefore we get into the title of this blog I wish the reader to understand the difference of what the FDA considers progesterone and what is the true progesterone. The FDA considers progestin to be a true human hormone. This is completely false! The hormone that is provided by nature is progesterone which has a similar but different biochemical configuration then the synthetic progestin. The pharmaceutical companies cannot patent a natural substance so they substitute the biochemical configuration of natural substances (in this case progesterone) for profit. Their combination of synthetic estrogen and progestin was causing so many cardiovascular and cancer problems that it was evident that this combination was very hazardous to a woman’s health. So the Woman’s Health Initiative Study had to be terminated and not finished. Of course, the FDA did not pull this combination off the market and did not investigate the possibility of using true progesterone since economically their pharmaceutical colleagues would suffer. This incorrect usage of interchanging progestin with the natural progesterone has caused fear in some women to the dangers of hormone usage. Anyway this could be another blog in itself and maybe it will be if there is enough interest in the WHI study.

Most of the readers already know the job of progesterone of being an important woman’s hormone in the menstrual cycle and for gestation. So I will not take up the space with the known. I am going to enumerate other findings of progesterone just so the reader can either comment to me or do their own homework of researching these incredible findings

      1. It was found that women that had serious cerebral injury (called Traumatic Brain Injury [TBI]) and were hospitalized got out of the hospital on the average of 3 days earlier if they were on progesterone then women who were not on progesterone. For along time there was no answer to why this was. These TBI injuries in women are more and more common due to our involvement in wars, sports, and accidents . I presume that TBI always existed in large numbers but was not being diagnosed in the past, maybe because our technology is so much better today.

      2. It was then found that progesterone was needed along with cholesterol and omega 3s to produce the myelin sheath (the coating surrounding the cerebral nerves called neurons). This is similar to the insulation around an electric cord. Because of the coating the transfer of signals down the nerve is incredible faster then if the coating did not exist or was damaged. For more on TBI and Progesterone one can go to the internet and just look up this subject. One of the latest is by Miles Cekic in Future Neurology 2010:5. You can see from these articles that progesterone may be a source for curing certain demyelinating diseases (diseases with the myelin sheath involved) or at least in conjunction with other resources in men as well as woman. I believe it would also be worth investigating using progesterone in trials of diseases that have no cure but are known to be demyelinating diseases such as Multiple Sclerosis.

      3. For numerous years – thanks to John Lee M.D. We have known that progesterone and estrogen were important to prevent osteopenia and osteoporosis in women. Why these were not used more frequently then the pharmaceuticals is obvious. But I would like to add that I have found that testosterone in low doses is necessary to prevent and alleviate both former conditions; but still in conjunction with estrogen and progesterone. I have written on this topic in the testosterone blog and in my book (Emotional Vampires and your Hormones; an holistic physicians view of how stress affects your well-being and what you can do about it). Testosterone in natural physiological dosage for women is important for anti-aging. An informed physician can calculate the correct dosage for each individual so that side affects will not exist or the dosage can be minimally tweaked to prevent unwanted side affects.

young brunette sleeping at working time.

In the mists of time the acute stress response protected our survival. For example, it readied us for fight or flight from a saber tooth tiger. Our blood pressure went up, our heart and respirations were quickened; and our non-essential functions (hormones,digestive system) were stopped since one does not need them to fight or flight. All the previous adrenal-cortisol stress reactions are to get more blood, sugar and oxygen to the needed leg and arm muscles and brain for the flight or fight response. All this took minutes and then all went back to normal. One either escaped or not. If it was the latter then there was never stress again. The exact same cortisol stress-response occurs today but now it is a continuous stress response,7days a week, 24 hours/day. The stress response depends on the adrenal glands putting out cortisol for the flight -fight response to occur.  Though we have evolved in many ways there is no stress distinction between an acute or chronic stress response. The adrenal-cortisol reaction is the same for both!

When we have the adrenal glands working overtime due to chronic stress situations at first the cortisol output is high. When high the cortisol depresses the output of many of the  hormones and the digestive system since these are not necessary for flight or fight. The adrenal glands eventually wear out like any machine that is continuously abused. Therefore, the hormones of the adrenal glands, cortisol, adrenaline, and DHEA cannot be produced. This is similar to when the pancreas is forced to put out insulin all the time due to an high output of blood sugar for fuel for the flight-fight response. Cortisol stimulates the liver to utilize the liver’s glucose stores by putting the sugar into the blood for fuel.

Cortisol is a hormone that normally is secreted from the adrenal glands between 6-10 AM. The secretion time span depends on the person’s genetics and habits of time of rising. Theoretically it is put out to help the person awaken by stimulating an energy burst of glucose (sugar). Cortisol has many functions but here we are concerned with stress.

If he/she remains in stress and the adrenal glands persistently secrete cortisol we get into a potentially pathological state. At first the cortisol stays high all the time in order to stimulate the liver to put out sugar for fuel so the person can “fight or flight.” The high sugar levels stimulate the pancreas to put out insulin constantly to push the sugar into the cells via the cells receptors, which let the sugar enter the cells. There are a few sequels to this scenario. First the cells cannot use all the sugar that the cortisol-liver (sugar)-insulin axis delivers continuously, so it pushes it into storage as fat [triglycerides]. This gets deposited in women in the thighs and buttocks and then the abdomen. In men it is usually first deposited in the abdomen and then the other areas. Another thing that can happen to some people is the insulin surge may drop the blood sugar too much so they get what is called a reactive hypoglycemia ( This is not a true hypoglycemia). This makes the person hungry, lethargic, angry-aggressive and sleepy. This hypoglycemia is an added stress to the already ongoing stress. More stress! If stress continues to stimulate the adrenal glands and therefore high cortisol levels the adrenal gland fatigues out and produces low levels of cortisol or none. Now we have true adrenal fatigue. Also the receptors on the cells for insulin get tired of being consistently hit with insulin and develop a resistance to the insulin. The sugar stays in the blood causing high blood sugar. So the pancreas puts out more insulin to push the perceived needed sugar into the cells. This vicious cycle continues causing more cell receptor resistance evolving which we call Insulin Resistance. This is the first step to diabetes melitus (Diabetes II) and the Metabolic Syndrome [once called Syndrome X]. This fact is so important that I wrote a chapter in my book dedicated to diabetes and the metabolic syndrome.

This constant outpouring of cortisol can lead to numerous other problems that are not being addressed in the conventional medical world. One is the problem of osteopenia and osteoporosis. It is known that high night cortisol levels lead to bone absorption. For example, there is a warning that is posted on corticosteroid medications [ex. Prednisone]. It states that people on cortisol-like medications producing high cortisol levels can develop osteopenia, osteoporosis and stomach-intestinal ulcers.  Instead of investigating a stress causation and therefore high cortisol levels for why the person has osteopenia or osteoporosis the physician puts them on calcium, vitamin D and sometimes synthetic hormones.

If he/she does nothing to alleviate the stress situation eventually more breakdowns in the body occur. First the pancreas cannot keep putting out insulin constantly so it just runs dry and one has full-blown diabetes II. Similarly, the adrenal gland cannot keep putting out cortisol and it runs dry, so no more cortisol. And not mentioned yet is that while the adrenal gland is putting out cortisol it cannot at the same time put out DHEA (dihydroepiandrosterone) which cells need as an anabolic [building] hormone. Cortisol is a catabolic [breaking down] hormone. DHEA hormone is also a backup for making testosterone and estrogen when a person cannot produce it due to other problems such as aging. This lack of production of DHEA is very important as another body builder and energy stimulant. It is also an adjunct in the production of testosterone and estrogen especially in peri-menopausal and menopausal females.

In summary: cortisol when being abnormally secreted from the adrenal gland constantly due to stress is known as the death hormone. This is because it was created for the periodic fleeting flight or fight encounter. To enhance this response a lot of the other hormones are diminished by the cortisol since they are not needed to run or fight. These hormones include, estrogen, testosterone, progesterone, aldosterone (BP control) and thyroid hormone. Cortisol also shuts down the non-essential digestive system, raises blood pressure and heart rate. Prescription corticosteroids are used for allergies since they block the immune  response. Well so does high cortisol levels do to stress leaving the person without a good immune system and therefore illnesses to microbe infections. Just think of the illnesses that can occur without well functioning hormones,  digestive system and immune system. Another blog coming will soon give more functions and the symptoms and signs of Adrenal Fatigue Syndrome.

No wonder a person feels terrible and starts getting different illnesses when under stress. All these hormones are necessary for ones well being and anti-aging and they need to be in a state of homeostasis (balanced). In fact, sometimes the person believes that the prescribed hormone by the physician is not working; in reality it is, but it is the person that is still not doing anything about their stress. Therefore, they are counteracting a lot of the good affects of the prescribed hormone solution whether it is one of the sex hormones or thyroid or insulin by resisting seeing a counselor for stress. (See the blog on “Stress and your well-being”).

I believe in testing ones cortisol levels by a saliva test. Testing this way is for several reasons. Cortisol by nature changes its day-night production output (diurnal production). It is high in the AM and then by noon it is dropping and by evening it is down and even lower at midnight. It starts to go up again about 5-6 AM so that it can wake one up with a sugar spurt. A blood test would tell you the cortisol level at one particular time and not give the healer the knowledge of this diurnal trend which is needed in the diagnosis of one of the two stages of adrenal fatigue- too high or too low. Having blood drawn for some people is a stress and theoretically can cause an elevation of the cortisol level. Also with the right saliva test you get a calculation of the DHEA levels which is important in the adrenal fatigue diagnosis. It is important to know the DHEA level and compare this to the cortisol in order to really help the client.