Category Archives: Preventive Medicine

There is no agreement amongst child psychologists, psychiatrists and other experts on how to be the perfect parent. ( That of course, does not mean some do not write books about what to do to be a good parent). Each person, being infant to old age is different! Therefore, with the intentions of being a good parent,  anxiety and stress can be promoted in the developing youngster and extend into their adulthood from traumatic experiences in their childhood. This is labeled Adverse Childhood Experiences (ACE). This can happen for many reasons to a child too often without the parent (s) awareness or intention:

  1. abused physically, even if it is minor like grabbing; or verbally.
  2. Parents that are separated or divorced
  3. Alcoholism or drugs used by parents
  4. depressed parents or suicidal parent
  5. the child feeling inadequate when watching a loved one be abused
  6. being different and not understood, for ex: a child with ADHD
  7. Excessive arguing especially if there is shouting in the child’ ambience
  8. In other words anything that threatens a child’s security

As an holistic physician and spending a lot of time with each patient I finally learned that what pushes one persons buttons, the same action might not affect another. For instance, a person sitting across from me may be telling me something that they believe is causing them stress; while I am sitting there thinking silently what is the big deal about that event. But if they heard what I would claim causes my stress they may think “Big deal.” Each individual has their own buttons that sets off their stress, anger, and anxiety. Any button pushed for an individual can set off their “flight of fight” cortisol and adrenal hormones. This is true with children and especially teenagers. We read more and more about teenage depression and increasing suicides and especially indulging in drugs.

If it is a constant button pushing stimulus even youngsters  can end up with Adrenal Fatigue or one or more illnesses as discussed in earlier chapters.  But I have also found within myself and clients it can be a one time act or past experience that for some of us ruminates into adulthood and even older age. Of course, once we realize the buttons that do not have to be pushed anymore there are many ways to erase them. For me, and many of my clients this was via hypnosis, self-hypnosis, and different types of guiding imagery. All the latter with a qualified expert that is compassionate and certainly non-judgmental. We learn quickly that we do not need the childhood experience as a teenager nor adult. Some things can even be erased using hypnosis until the individual is ready to deal with the issue.

As is true with most of us it is a lesson to be learned with aging not to judge others by our own philosophies, political feelings, economic perceptions,etc and then projecting them onto anther individual or group. We all have our own agendas which should not be projected to others. And even these agendas often change with age – we do not have to be stagnant as our knowledge and experiences develop. This can also fit into the stress releasing act of not having expectations. Expectations can often be disappointing but goals and hopes can help us grow.


Too Much Knowledge – ? Fear

fear & knowledge

For a long time I have been wondering about the boundaries that separate knowledge from fear. I have given up on the news media because they generate fear and by not giving factual knowledge.  In general the egocentric commentators are no longer fact- investigative reporters. I can also apply this to our presidential candidates unfortunately. Having health information is really important but  it too can create scare tactics crossing the line of health to illness? We are just inundated with information about toxicity of foods, heavy metals, phatalates, etc..( See my blogs or read 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).  We are told that we should do this or take that  for our health or else. Yes it is necessary to have knowledge about how to protect our health. I just wonder how many of us due to this information end up with depression, anxiety & stress from being told that we are drowning in our environment (our foods, water, air).  All this stress can negate the good energies of trying to be healthy at each meal, in the grocery store or even drinking a glass of water. Maybe one of the solutions is what I am still learning; that there is no way of avoiding all of our environment toxicities & therefore stress from the environment (news media); and also some of the holistic healers that  preach doomsday if we are not taking  specific supplements (of which they sell the best).  One of these known holistic physicians I analyzed: all that he says he does with shopping and preparing healthy foods and then the exercises for his body and brain each day. I figured that he would need to be awake at least 24 hours/day; and then have another 7 – 8 hours to his day since he proclaims each individual should sleep 7-8 hours/day. Then start his day with meditation of some sort. Maybe he is not a parent raising children or having unexpected crises pop up! Also, onw must recognize that a lot of the suggestions of physicians and healers are good to know about, but each person is an individual. Generalizations are just that – generalizations. Most people know the basics of good health: exercise, nutritional live foods, stress relief programs that build a good self-image of oneself.  Yes, I know the last of these is difficult in these stressful times and that is one reason I wrote my book, because the last part of the title is so important:  ……..what you can do about it.

Remember it is not always the stress but how we respond to the stress. I try to surround myself with positive people and try to avoid the emotional vampires both human and external.  As far as environmental toxicities I do what I can by using organics within our economic means, and avoid buying Chinese products as much as we can (which saves a lot of money since most USA products come from China). If one did every health option presented by health experts we would be bankrupt, have more stress and no guarantee that we would not have an illness, disease, or accident. There are no guarantees in life (except taxes, death & political mayhem). Watching funny films & laughing is a great antidote. Each day I try to write down 3 positive things that I did well or that happened to me.

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.



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

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

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

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

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

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

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

Alan J. Sault MD, ABHM-diplomat

The Placebo Effect

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

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

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

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

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

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

Alan J. Sault MD, ABHM-Diplomat

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

Prostate Specific Antigen = PSA

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

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

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

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

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

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

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

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

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

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

  1. free PSA

  2. ultrasound

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

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

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

    • testosterone free and total

    • estradiol

    • sex hormone binding globulin (SHBG)

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

    • dihydrotestosterone (DHT)

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

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

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

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

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

People not wanting to get better

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

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

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

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

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

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

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

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

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

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

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

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

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


Absorption the forgotten fact in eating well



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

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

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

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

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

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

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

Alan J. Sault MD, ABHM – Diplomat

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

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.

Thyroid Dysfunction – the shape shifter dis-ease


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.