Saturday, December 13, 2008

Beta-Blockers are about to be discarded by doctors.

I’m very concerned with the direction our western (allopathic) medicine is going. In my naturopathic practice I’m very tolerant about drugs. Indeed I tell to my patients: “take the drugs your MD prescribes when you need them, but at the same time let’s work together so that you can get healthier and discontinue those drugs with the permission of your MD”. I used to be very upset and discontented when I was practicing as an MD and I received information that the drugs we were using were, after a close look, either ineffective for the conditions we used them for or had long term side effects that outweighed their positive effects. Such news stories, however, stopped bothering me; I just got to be “immunized” and dulled to them, because they came to me almost monthly.

Just to refresh your memory:

  1. Hormone Replacement Therapy (HRT) for menopausal females: I used to prescribe that left and right: for hypertension onset with menopause, for osteoporosis, to prevent cardio-vascular events, for mood swings, for skin changes…until one day we learned that it sent the rate of female cancer through the roof;

  1. Vioxx for pain. It almost tripled the rate of cardiovascular events;

  1. Antibiotics. I used to prescribe them just to see whether patients could get better. But after we created super-bugs (MRSA and untreatable Tb), I stopped. Antibiotics for H.pilory? Not anymore, now that we have come to believe that that bug actually protects patient from gastro-intestinal cancer;

  1. Fosamax for osteoporosis…;

  1. Blood glucose lowering medications…

The list could go on and on. But I added one more group of medications to this list 2 days ago, the group called beta-blockers. These have been used to treat elevated blood pressure. However, the latest review of the evidence about these drugs, presented in the August 14, 2007, issue of the Journal of the American College of Cardiology, finds that:

“Despite three decades of using beta-blockers for hypertension, the authors of the state-of-the-art paper noted that no study has shown that beta-blocker mono-therapy reduces morbidity or mortality in hypertensive patients, even when compared with placebo. Indeed, in some early trials, such as the British Medical Research Council study in the elderly, beta-blocker mono-therapy was not only ineffective, but whenever a beta-blocker was added to diuretics, the benefits of the antihypertensive therapy distinctly diminished”.

The bottom line: do not take beta-blockers

For me as a doctor several facts remain unclear:

1. If for 30 years morbidity and mortality for patients on beta-blockers was as high as on placebo, then why did we continue to prescribe it?

2. If the blood pressure was lowed in hypertensive patients to normal with beta-blockers (according to previous research data), but patients still had the same morbidity and mortality, then what was the cause of their cardiovascular event if it wasn’t high blood pressure? (We have thought in medicine that there is a direct correlation between high blood pressure and cardiovascular events: the higher your blood pressure, the higher the chance to have a stroke or heart attack).

Examples of beta-blockers: atenolol (brand name: Tenormin), metoprolol (brand names: Lopressor, Toprol XL) and propranolol (brand name: Inderal). Talk to your doctor and consider alternative treatments for hypertension. There are some safe and effective natural treatments; one may be the right one for you.

Tuesday, October 28, 2008

Flu and Cold Season are Once Again upon Us

It is almost impossible to differentiate cold from flu (also known as influenza). Sore throat, cough, and fever are symptoms common to both conditions. Practically speaking, there is no need to distinguish them, because treatment is the same: stay in bed if you feel tired; take aspirin (not for kids younger then 5 years old) or acetaminophen, if fever is higher then 102; drink plenty of water to prevent dehydration. People rarely die from flu, even though on day two and three you will probably feel that you will. People die from complications. For that reason the most vulnerable people, that is, the very old, very young, immune compromised patients and those with several chronic conditions, should seek medical supervision to prevent complications.

A few steps to prevent cold/flu

1. “Wash your hands!” This is the best sign I ever saw in public bathrooms. According to research, the best bacterium removers are:

  • Chlorhexidine gluconate (CHG) sold under name brands such as PrimaKare or Bactoshield, and triclosan, sold as Prevacare
  • Plain soap and water (without microbe-fighting chemicals)
  • Tap water alone

The best virus removers are:

  • Benzethonium chloride
  • Plain soap and water (without microbe-fighting chemicals)
  • Tap water alone.

Commercial antimicrobial soaps have fallen out of favor because they do not do the job as advertised.

2. Eat garlic and onion daily. Both contain allicin, a substance that will kill bugs, viruses and fungus. Allicin in high doses is stronger than prescription antibiotics and there is no resistance to allicin. Tip: eat raw garlic or onion with your food; if they taken on an empty stomach they may cause burning and stomach irritation.

3. If you are surrounded by sneezing and coughing people, use a NETI POT twice per day physically to clean the bugs out of your nose.

4. If you are coming down with a cold or the flu and can hardly get out of bed, just stay there for 1 or 2 days.

5. Make green tea with lemon and ginger and drink one cup every 3 hours. Lemon zest has the essential oil Lemolin; you can see it as a thin film on the surface of your tea. This oil has strong anti-bacterial, anti-viral and anti-fungal properties. Ginger is a “hot” Chinese root that causes vasodilation and will deliver the Lemolin into every cell of your body, where it will kill the invaders.

6. Use a chest rub or Chinese “Tiger Balm” to prevent colds from going down to your lower respiratory tract. Apply on your chest, throat, temples and behind your ears. This will improve blood circulation and will decrease congestion. These remedies contain menthol. Tip: wash your hands immediately after application. Menthol in the nose or eyes causes severe irritation.

7. Zink 30 mg/day. Higher doses may cause nausea.

8. Take supplements of vitamin D. Research shows that people deficient in vitamin D are prone to viral infections. Read here.

Now a few words about vaccination for flu. According to the CDC (Center for Disease Control), “each vaccine contains three influenza viruses-one A (H3N2) virus, one A (H1N1) virus, and one B virus. The viruses in the vaccine change each year based on international surveillance and scientists' estimations about which types and strains of viruses will circulate in a given year. We can speculate how good our scientists at estimation, but I know for sure that viruses mutate so fast that if you have one this week you may have his “brother” next week, and his “sister” next month. They have different genetic structures and require different immune responses. That is why some people could get sick several times during a year with very similar viruses. I recommend flu shots only for very old, sick people with several chronic conditions and immune compromised (cancer, HIV) patients.

WebMD states on October 7th, 2008: “Don't use over-the-counter pediatric cough and cold drugs in kids younger than 4”. If it is not good for kids, it can not be all that good for you either! Avoid these drugs.

As a naturopathic doctor I prescribe herbal medications. Some of them should be taken before cold and flu season starts, because they may need 2-3 weeks before you may see their effect: Eleuterococcus senticosus is an adaptogen; it will calm down an over-stimulated immune system and stimulate a weak one. Astragalus membranaceous will increase production of immune cells. Echinacea angustifolia andEchinacea purpurea will increase levels of interferon. Two other herbs that can be useful during the infection because their anti-bacterial or anti-viral properties are: Mahonia aquifolium andMelissa officinalis

Sometimes I do cupping in the office. This treatment stimulates the immune system and improves blood circulation to the lungs. It should be done 3-4 times after the first onset of a cold or flu to prevent pneumonia.

Patient’s back with cups and Patient’s back after cupping

Tuesday, August 12, 2008

Aerobic Exercise

Aerobic exercise, also known as cardio-vascular exercise, has many known benefits, and I’ll mention a few later. For now, let’s start with a definition: Cardio-vascular exercise means exercise that will make your heart rate go up so that your vessels will contract and relax periodically. Cardio stands for heart and vascular stands for blood vessels. We should all do this kind of exercise for one hour 5 times per week, according to American Medical Association.

Benefits of cardio-vascular exercise:

Blood glucose regulation: During exercise muscles use glucose that is in the blood stream as a primary source of energy. When that glucose is depleted, more glucose is released from storage in the liver. This is the simplest way to lower glucose level for patients with diabetes type2. Do not drink soft drinks or sweet Gatorade during exercise, as it will cancel its blood glucose lowering effect. Read here about importance of exercise in Diabetes type2. Read here

Vaso-dilation and lowering of blood pressure: During exercise the lining cells of vessels produce nitrous oxide, a substance very similar to nitroglycerin (a vasodilator). It causes natural vasodilatation / relaxation and drop in blood pressure. Daily exercise will insure constant production of nitrous oxide and steady low blood pressure. Read here

Cancer prevention: Increased daily physical activity has been associated with a significantly decreased risk of cancer in both men and women. Read more about that here: The blog summarizes many current research articles.

Weight reduction. When cardio-vascular exercise has been paired with the Mediterranean diet, the weight reduction is significant and long lasting. Read here

Here are a few simple rules to remember:

1. Bring your heart rate up slowly during exercise. I recommend to my patients that they spend 15 minutes to warm up, 30 minutes of exercise with maximum heart rate for your age and 15 minutes to cool down to your resting heart rate.

2. The intensity of cardio-vascular exercise is measured by the heart rate. During aerobic exercise you have to bring your heart rate to a maximum point or its highest rate for your age. The formula for calculating your maximum heart rate point is: (220-age) x 0.6. For example, if you are 60 years old, your maximum heart rate, during cardio-vascular exercise, will be 96 beats per minute: (220-60) x 0.6 = 96beats/min.

Sunday, June 29, 2008

To take or not to take supplements.

Often I tell to my patients that the food they eat could be their biggest enemy. Food, however, should be their best medicine. Despite this, I also take multi-vitamins and mineral supplements in the form of pills, and that sometimes surprises my clients. This is my multi-vitamins

I explain that I do that for two reasons:

(1) In American agricultural practice, soil for growing fruits and vegetables is depleted of nutrients and these are not restored properly.

(2) Fruits and vegetables are delivered from different parts of country, sometimes from abroad, and time between harvest and purchase can be weeks or even a month. Many vitamins have short lives, measured in hours or days.

Knowing this, I advocate use of natural supplements.

Today Baycrest published the results of a very small preliminary trial that involved only 16 adults with type 2 diabetes who were not regularly taking antioxidant supplements. Patients attended three weekly sessions that involved consuming a different test meal on each visit. One meal consisted of high fat foods (a Danish pastry, cheddar cheese and yogurt with added whipped cream); the second meal consisted of only water; and the third test meal was the same high-fat meal plus vitamin C (1000 mg) and E (800 IU) supplements.

“Researchers found that vitamin supplementation consistently improved recall scores relative to the meal alone. Participants who ate the high fat meal without vitamin supplements showed significantly more forgetfulness of words and paragraph information in immediate and time delay recall tests, relative to those who had the water meal or the meal with antioxidant vitamins. Those on water meal and meal with vitamins showed similar levels in cognitive performance.”

Because study was small, the authors emphasize that their findings obviously require further replication in much larger trials. “Future studies will also need to look at how the antioxidant vitamins may be working and whether vitamins are directly targeting oxidative stress reactions or triggering an independent memory-enhancing ability which is simply masking the detrimental effects.” I also would like to see if fresh fruits and vegetables will have effect similar to vitamins if taken in conjunction with meals.

It is important that this study was not financially supported by vitamin or pharmaceutical companies!!

Read more about this study here

Friday, May 9, 2008

Food Sensitivity and Allergies: Alternative Treatments

This is a quick summery of possible treatment for patients with food sensitivities and environmental allergies

Food sensitivities can express themselves through psoriasis, eczema, acne, joints pain, indigestion, and other symptoms. If you think you may be sensitive to a particular food, identify it and eliminate the whole food group it from your diet for 3-4 weeks. For example: if milk is a problem, then eliminate dairy products: milk, ice cream, sour cream, butter. You have to be very careful to eliminate everything from that group. For example, in eliminating dairy you may have to also eliminate many bread products, because most bread recipes call for dry milk. During that 3-4 week period restore the integrity of digestive tract with Glutamine and probiotics.

Environmental allergies express themselves as stuffed nose, postnasal drip with cough or watery eyes, and snoring, among other symptoms. Identify the cause with an allergy test and then eliminate the allergen if possible. For example, in the case of dust allergy you may have to get rid off rugs and carpets and buy hypoallergenic pillows and mattress covers. If mold is a problem, treat the mold in your basement and stay away from food molds such as blue cheese and blue cheese salad dressing.

Unfortunately; you can not get rid of trees and grasses in spring and summer. Here are some possible treatments:

  1. Clean your nose, using a neti-pot twice per day. This tool may look weird at first, but if I have learned to use it, so can you. Even kids in my practice have learned to use it.
  2. Take Vitamin C up to 3 g/day for short period of time.
  3. Quercetin and nettle is a good combination of herbs to prevent degradation of mast cells, which contain granules of histamine and heparin. When mast cell is broken, histamine spilled out, that creates local inflammation. Heparin is anti-coagulant that insures constant blood and mast cells flow to the side of inflammation. MD often prescribe anti-histamine drug.

4. Take vitamins A and E. Although no randomized controlled trials show that they work, lack of those vitamins may cause hyperactive immune system. Also Vitamin A is responsible for normal reproduction of epithelial cell which are normal lining in the nose and throat and are definitely suffering during an allergy season.

  1. Glycyrrhiza glabra or licorice will increase your internal level of cortisol, which will decrease inflammation. This herb may raise your blood pressure. DO NOT TAKE IT WITHOUT SUPERVISION OF YOUR NATUROPATHIC DOCTOR.
  2. Sage will decrease mucus production
  3. Try acupuncture
  4. You may also try homeopathic remedies:

Natrum muriaticum for sneezing, watery eyes, clear nasal discharge.

Nux vomica for stuffed or runny nose especially at night.

Sabadilla for sneeze attack.

Allium cepa for watery eyes and clear nasal discharge that irritates area under the nose.

There are also combination remedies for dogs and cats, dandruff, pollen and many other allergens.

Stay healthy.

Wednesday, April 23, 2008

Sleep hygiene

Sleep problems are quite common in my practice. Interestingly, most of my patients know why they have the problem. They tell me they stay up too late, or interrupt sleep by taking stimulating drugs such as cold medicines, or by having thoughts related to work. Or they over-stimulate themselves before bedtime with late-night activities such as television. Here are few tips everyone should follow.

Regular Bedtime:
Go to bed at about the same time every night, but only when you are tired. Set your alarm clock to awaken you at the same time every morning--including weekends and regardless of the amount of sleep you have had. If you have a poor night's sleep, don't linger in bed or oversleep the next day. If you awaken before it is time to rise, get out of bed and start your day.

Avoid napping.
If you nap throughout the day, it is no wonder that you will not be able to sleep at night. Napping is allowed for older people only, if they can limit them-self to 20-30minutes maximum and if they have no difficulties going to sleep at night and maintaining sleep through the night.

Avoid caffeine 6 hours before bedtime.
This includes caffeinated beverages such as coffee, tea and sodas, as well as chocolate. Herbal teas such as Chamomile are great substitutes. Drink them at least 1.5 hours before bedtime; otherwise your urinary bladder will wake you up.

Regular exercise is helpful in getting a good night’s sleep, but not if it is done right before bedtime. Vigorous exercise before sleep can delay sleep. You cannot force yourself to sleep by exercising during that same day. Morning exercise also has little beneficial effect on sleep. The best time to exercise is in the afternoon or early evening. Even then, “it probably won't help you sleep unless you exercise on a regular schedule,” according to
The word “regular” is key when it comes to exercise.

Avoid heavy, spicy, or sugary foods 4 hours before bedtime.
These can affect your ability to stay asleep. Spicy food is stimulating. Heavy food will put you to sleep, but will also wake you up or cause unrestfull sleep. One of my patients put it this way: “I woke up thinking that a big turkey and a small elephant were sitting on my chest”

Use comfortable bedding.
Uncomfortable bedding can prevent good sleep. Evaluate whether or not this is a source of your problem, and make appropriate changes. Sometimes a leg pillow may help.

Find a comfortable temperature setting for sleeping and keep the room well ventilated. If your bedroom is too cold or too hot, it can keep you awake. A cool (not cold) bedroom is often the most conducive to sleep.

Reserve the bed for sleep and sex.
Don't use your bed as an office, workroom or recreation room. Let your body "know" that your bed is associated with sleeping.

Eliminate distractions:
get rid of noise and light as much as possible. Animals, even your favorite cat or dog who loves to sleep with you, should be kept out of your bedroom. My old dog used to snore and had dreams of running, and he moved so vigorously that he rearranged small pieces of furniture at night.

To do list before bed time:

Have light snack. Turkey is good, because it is very high in L-Tryptophan.

Practice relaxation techniques.

Keep a piece of paper by the bed so you can immediately write down “important things” that need to be done tomorrow and then “forget “about them till morning.

Establish pre-sleep rituals, such as cool shower or a few minutes of light reading.

If not sleepy in 20-30 minutes get up, go into another room, and read until sleepy.

Avoid sleep medications by all possible means!
Benzodiazepines (commonly prescribed sleep medication) tend to be very addictive. Some doctors are more conservative about prescribing them, but others give them freely, especially to older patients. Insomnia cannot be corrected with pills. At best, sleeping pills have only limited usefulness. They provide a temporary solution to insomnia.
The older you get, the more you tend to absorb and excrete all medications more slowly. Your nervous system may also be more sensitive, which, in turn, may increase the effects of combining drugs.

Sleeping pills may cause older people to stumble or fall, feel groggy or hung-over, or appear forgetful and senile. Casual overmedication killed both of my in-laws, but what was worse, it put my father –in-law into a psychiatric word before he died, due to faulty diagnosis of his poor mental condition. Please check the medications your parents and grand-parents are taking, and make sure that both you and your loved ones understand the purpose of medication, dose levels, and side effects and contra-indications.

Herbs and nutritional supplements to try
Valerian or Passionflower in the form of teas or tinctures;
Melatonin 3 mg to induce sleep;
GABA (Gamma-aminobutyric acid), an inhibitory neurotransmitter;
L-Tryptophan, 500 mg before bedtime.

Stay helthy.

Monday, March 24, 2008

Test results of drinking water from Associated Press (AP) report.

I located some useful information regarding the recent Associated Press (AP) report about the pharmaceutical drugs detected in our public drinking water supply.

Water providers rarely disclose results of pharmaceutical screenings unless pressed, AP found. For example, the head of a group representing major California suppliers said the public "doesn't know how to interpret the information" and might be unduly alarmed.
I feel really calm, safe and well cared for after that statement!

Any way, here are some results:

• Officials in Philadelphia said testing there discovered 56 pharmaceuticals or byproducts in treated drinking water, including medicines for pain, infection, high cholesterol, asthma, epilepsy, mental illness and heart problems. Sixty-three pharmaceuticals or byproducts were found in the city's watersheds.

• Anti-epileptic and anti-anxiety medications were detected in a portion of the treated drinking water for 18.5 million people in Southern California.

• A sex hormone was detected in San Francisco's drinking water.

• Three medications, including an antibiotic, were found in drinking water in Tucson.

• Antibiotics were found in Denver's water supply.

The situation is likely worse than suggested by the positive test results in the major population centers documented by AP. The federal government doesn't require any testing and hasn't set safety limits for drugs in water. Of the 62 major water providers contacted, the drinking water for only 28 was tested. Colorado Springs was among the cities that do not do such testing.

Some providers screen only for one or two pharmaceuticals, leaving open the possibility that others are present.

For more information, see:

Thursday, February 21, 2008

Coffee or Tea? It’s Your Choice!

During my last presentation at Borders in Stamford CT on topic of cancer, discussion moved into “coffee territory”. Suddenly, room became divided into two camps: those for coffee vs. those against it. I remained neutral, because while coffee has a lot of anti-oxidants, it is very stimulating and I’m not sure that we need more stimulants in our lives.

Personally, I bend in the direction of tea for only one reason: I want my skin look young and healthy. When I stopped drinking coffee about 3 years ago my skin became brighter, less dehydrated and less wrinkled.

Pros and Cons of Tea:

Tea is full of antioxidants that improve concentration and gently boost energy. The free-radical-inhibiting property of tea is more potent than that of vitamin E, and tea is a proven preventive and treatment for atherosclerosis (hardening of the arteries). The polyphenols in tea, especially the catechins, are powerful antioxidants that help ward off diabetes and cancer.

As a weight loss tool, tea is a zero-calorie beverage.

Tea is a wonderful way to flush the body and replace fluids.
On average, a cup of black tea contains about one third of the caffeine you would get from the same cup of coffee. Green tea contains about one sixth of that amount.

Pros and Cons of Coffee:

Many people reach for coffee the first thing every morning. Without question, many people get a positive jolt. But over time coffee actually depletes their vitality, "borrowing" energy that they didn't have in the first place.

Caffeine acts as a central nervous system stimulant. It may cause stress, anxiety, a racing mind, and even insomnia, working against your attempts to relax the body and calm the mind; it will also raise your blood pressure.

Research shows that coffee is full of anti-oxidants (phenolic compounds). They may decrease the rate of atherosclerosis, because of coffee induces an increase in the resistance of LDL to oxidative modification, probably as a result of the incorporation of coffee's phenolic acids into LDL.

Stay healthy.

Tuesday, January 15, 2008

Recently a patient, Janice, told me that the antibiotic fluoroquinolone, (sold under the names Cipro and Levaguin) had caused a tendon rupture in someone she knew and should be labeled by the FDA with a “black box” warning as a dangerous drug. The FDA has not responded to the demand of the injured patient.

Janice was concerned that doctors won’t tell you about this side effect, because they probably don’t even know about it; and that there is a large conflict of interest when it comes to publicizing bad news about drugs because the FDA gets funding from the drug industry.

I share these concerns, and want to add that it is not in the interest of big pharma to do long term studies of possible side effects. The results are well known: Vioxx, Hormone Replacement Therapy for females, prescription cough medicines for children -- all of these are now well marked in our minds as dangerous.

All drugs are potentially dangerous. If you read about the possible side effects of aspirin in the PDR, you would never take it. Tendon rupture is a minor side effect of fluoroquinolones, compared to others -- stroke and seizures.

Powerful synthetic drugs should be used only when safe and effective natural treatments including life style and diet changes, exercise, vitamins, minerals and mild botanical medicines have failed. Only then are the ‘wonder drugs’ a blessing.

Americans believe they can “fix” their health problems by taking a pill their doctor prescribes. They don’t consider that doctors are products of modern ‘scientific’ medical schools that do not teach about nutritional or botanical medicine and pay only lip service to life-style issues and patient compliance in treatment regimes. The standard treatments in the medical community involve powerful drugs with correspondingly powerful side effects. Doctors learn about new treatments from pharmaceutical company agents, many of whom are themselves doctors earning big bucks touting the latest and most expensive drugs to their colleagues.

When people turn to safe, effective, inexpensive nutritional and botanical treatments, they become healthier while the pharmaceutical companies go broke. The more drugs you take, the healthier the pharmaceutical companies become.

Your health is your responsibility!

I frequently have to treat patients suffering from the side effects of their doctor-prescribed medications.

Here is one example: a patient recently came to me complaining of persistent memory loss. Although physically and mental active, he is, under his doctor’s ‘care,’ taking Aricept, a medicine for Alzheimer's disease. I learned from the patient that he is also taking Alprazolam, a powerful sedative drug. The dose was doubled 6 month ago, because he was unable to fall asleep until 2 or 3 am when taking a smaller dose. He drinks his last cup of coffee each day at 6 or 7pm (how can he expect to fall asleep at midnight after that is a mystery) and sleeps till noon. Alprazolam disables inhibitory neurons; when given to cats in large doses for more than a year, many brain cells died. Taking large doses of Alprazopam on a regular base is simply not a good idea!

The sensible solution : no coffee after 1 pm, bed time at 10 pm, start slowly cutting back on the Alpazolam (if one suddenly stops taking this drug, withdrawal reactions including seizures may occur). In three days the patient reported that he was able to fall asleep at 11pm and wake without difficulty at 8 am. My next step is to wean him from Aricept as well. Once his sleep is regulated without Alprazolam, he will no longer need memory support.

Go to this web-side and read about side effects of medications you are taking: