Dear Friends and Patients:
First of all, our staff and I want to say a THANK YOU for all of your referrals this past year. Our heartfelt wishes go out to you and your families and we hope you had a healthy and joyous holiday season. This issue of our Newsletter is a little delayed as there was a lot of late-breaking news I wanted to include. Many of you have been enjoying our quarterly newsletters which we also publish on www.prevent-doc.com. We appreciate the positive feedback we have been receiving. In this newsletter I am going to discuss some of the issues that have been raised about taking very high doses of supplements.
Just a few weeks after the Annals of Internal Medicine article came out, a study sponsored by the Department of Veterans Affairs was published in the JAMA (Journal of the American Medical Association) where over 600 elderly veterans were given high doses of vitamin E and this vitamin delayed the decline in daily living skills, such as making meals, getting dressed and holding a conversation. This is the first time any treatment has been shown to slow the course of dementia in mild-to-moderate Alzheimer’s disease.
Because multiple other studies presented at medical conferences I have attended showed a benefit of taking vitamins in terms of reduction in cancer and cardiovascular risk, I initially ignored the negative journal articles. Most of the studies quoted, but not all, were what are called meta-analyses. A meta-analysis refers to methods focused on contrasting and combining results from different studies, in the hope of identifying patterns among study results, sources of disagreement among those results, or other interesting relationships that may come to light in the context of multiple studies. This is a retrospective type of study and is not the same thing as a prospective study where one group of patients would be given a drug or vitamin, and a similar group would receive a placebo, and the outcomes determined at the conclusion of the study.
As we gain more and more medical knowledge the evidence is now suggesting aging is a far more complex process than exposure to free radicals and that there might be validity to a downside from taking too many antioxidants.
Dr. Harman tested his hypothesis by feeding mice antioxidants, and showed they lived longer. In 1969 researchers at Duke University discovered SOD (superoxide dismutase), an antioxidant enzyme produced inside the body. They hypothesized that SOD evolved to counter the effects of free radical accumulation. Over time, scientists had difficulty replicating some of Harman’s experimental results on a consistent basis.
Within mitrochondria a stream of electronically modified oxygen derivatives are continuously being formed and may not be as harmful as previously thought. In fact, after donating an electron, an antioxidant becomes a free radical, by definition, and some are capable of initiating chain reactions. Many vitamins and supplements classified as antioxidants are actually redox agents, meaning they act as antioxidants in some instances and pro-oxidants in others. Vitamin E and Vitamin C fit this category. So what we are finding is that antioxidants don’t “destroy” free radicals, they simple are involved in electron exchange.
In January 2013, researchers at the University of Manchester (Colorado State) found that oxygen free radicals aid rather than harm cell regeneration in tadpoles. Hydrogen peroxide is not only harmless to cells, but is actually the catalyst that makes it possible for tadpoles’ tails to completely regenerate in less than a week. This regeneration process was inhibited by antioxidants.
Exercise can increase oxygen consumption up to 15-20 fold over resting levels, which, in turn, generates vastly more free radicals. Exercise has been proven very beneficial to one’s overall health and longevity. Basically, a bout of exercise gives us a “dose” of free radicals.
High dose intravenous vitamin C works as a pro-oxidant and causes the generation of hydrogen peroxide by white blood cells. Dr. Levine at NIH (National Institutes of Health) determined in his research with vitamin C that this was the mechanism intravenous high dose vitamin C killed certain types of human cancer cells – through the production of hydrogen peroxide. This finding was published in recent medical journals. Going back to the 1960s and 1970s, a group at Baylor University Medical Center found that intra-arterial and intravenous administration of hydrogen peroxide would aid in killing cancer and pathogens, and aid in the regression of atherosclerotic plaque. Humans do not produce vitamin C, but many animals can. According to H.M. Howes, M.D., Ph.D, animals that produce 1 molecule of vitamin C also produce 1 molecule of hydrogen peroxide.
So as counter-intuitive as it may seen, there is growing evidence that taking antioxidants in excessive amounts may have a negative effect by countering the positive effects of pro-oxidants and free radical stress. What constitutes an “excessive amount” remains to be seen. In my opinion, what may be excessive for one person may be therapeutic for another. I do not subscribe to a “one size fits all” concept for medication dosing or supplement dosing.
We know large amounts of oxidative damage have indisputably been shown to cause cancer and organ damage, and plenty of evidence indicates that oxidative damage plays a role in some chronic conditions e.g. heart disease. We also know B vitamins and antioxidants are prescribed by ophthalmologists to treat certain types of macular degeneration. But what current evidence now shows is that free radicals may be beneficial in some contexts and dangerous in others. In my opinion, aging is a complex, multifactoral process that doesn’t have a single cause or a single cure. Taking mega-doses of antioxidants on a daily basis may not be wise and we need to remember a diet high in vegetables and fruits is not the same thing as taking a pill. Having said that, a significant number of Americans have poor dietary habits (e.g. a donut and coffee for breakfast) and taking a daily multivitamin is just insurance. At the Center we target nutritional therapies to correct deficiencies, using traditional labs, Spectracell intracellular nutritional testing, and hair analysis of minerals to help us determine deficiency states.
The committee members identified “threshold blood pressure” – that is levels at which treatment can begin, rather than defining at which blood pressure level hypertension begins. The committee members concluded their guidelines by adding “However, these recommendations are not a substitute for clinical judgment, and decisions about care must carefully consider and incorporate the clinical characteristics and circumstances of each individual patient.”
So what does this mean? For one thing, many people who had drug treatment started because of mild elevations in systolic blood pressure are now in an “over-treatment” category and patients who had high-normal values and were being treated for so-called “pre-hypertension,” a condition never officially sanctioned for treatment, are also being over-treated.
In patients with kidney disease and/or diabetes, the authors similarly stated we lack evidence for the right targets and so they settled on a goal of less than 140/90. This is a change for some people whose physicians may have been using a target of less than 130 systolic for these patients. The authors noted that the 130 systolic recommendation does not have evidence to base it on.
A second issue that came out of the panel report was there is insufficient medical evidence to support a systolic pressure threshold for placing people younger than 60 on anti-hypertensive drugs. This lack of medical evidence did not stop the authors from expressing an opinion to stay with the current threshold of 140 mmHg. for systolic in this age group, even though it is based on opinion and not evidence. The panel did indicate the diastolic blood pressure (bottom number) should be less than 90 for people age 30 and older, and there is scientific evidence to support this recommendation.
Another important conclusion is that drug therapy, while lowering blood pressure, does not necessarily mean you have reduced someone’s risk for a heart attack or stroke, even though we know hypertension is a risk factor for these events. This conclusion was based on findings from several studies where patients with mildly elevated blood pressures that were lowered failed to reduce risk – this was a surprising finding. Please note there is no question that drug treatment of very high blood pressure levels is beneficial.
From my standpoint, the good news from this panel was the authors were led to be more conservative in their recommendations for drug treatment and they also emphasized the importance of a healthy diet, weight control and exercise. At the Center, we have found in some hypertensive patients the addition of magnesium supplements, potassium gluconate, and/or an herbal product called Natural Blood Pressure relief will lower blood pressure. We have also found stress reduction is very important, as is making sure a person’s home blood pressure machine is calibrated in an accurate manner.
Current research is now shedding new light for some fibromyalgia patients. A study from the journal Pain, published in June 2013, reports that almost half of a small group of fibromyalgia patients they tested were found to have damage to nerve fibers in their skin and other evidence of a disease called small-fiber polyneuropathy (SFPN). Small-fiber polyneuropathy is a type of peripheral neuropathy (nerve pain) that occurs from damage to the small unmyelinated peripheral nerve fibers. Although it is characterized by severe pain attacks that typically begin in the hands and/or feet, some people initially experience a more generalized, whole-body pain.
Magnesium can be used intravenously for a very rapid and powerful effect. Our experience has shown an acute migraine attack can often be broken by intravenous magnesium sulfate or chloride. It is also very helpful for settling down fibromyalgia pain, which has a muscle and nerve component. Unlike oral magnesium, where high doses cause bowel upset or diarrhea (e.g. Milk of Magnesia effect), IV magnesium bypasses the gut and is very well tolerated at higher than oral doses. It has an added benefit of also calming a person. Mr. R was given a series of two Magnesium Chloride IVs with complete relief of muscle pains by the end of each IV (0 out of 10 pain scale rating). His pre-treatment pain level was 4 out of 10.The pain relief lasted for several more days.
There is a growing interest among traditional physicians in using magnesium for cardiovacular disease, diabetes and hypertension. For decades, intravenous magnesium sulfate has been used in the treatment of pregnant females with pre-eclampsia or eclampsia (characterized by elevated blood pressure and seizures). Among most integrative physicians, magnesium is used for pain management. This is not an FDA (Food and Drug Administration) approved or recognized therapy. The reason magnesium can help muscle pain is clear – it helps muscles “relax.” Why magnesium helps neurogenic pain (nerve pain conditions) is less clear.
A major mechanism of pain is the excessive stimulation of a brain chemical called “NMDA” or N-methyl-D-aspartate. Magnesium seems to settle down NMDA without the toxicity of drugs. There are a number of drugs that block the NMDA receptor providing analgesia in nerve pain. These include dextromethorphan (a cough suppressant, but at higher doses than those needed to block cough), ketamine (an anesthetic), and amantadine (an anti-viral drug and Parkinson’s disease drug). A double-blinded randomized controlled study showing the value of sequential intravenous and oral magnesium therapy with chronic low back pain with a neuropathic component was published in the journal Anaesthesia, 2013;68:260-266.
I was fortunate to find out about her and learn from her over a decade ago. I flew out to Los Angeles to meet her and to take one of her teaching courses. We offer this therapy to our patients. For the past 10 years using this therapy at the Center our experience has been very positive where most patients either reduce or completely eliminate allergy symptoms. Dr. Nambudripad has published a number of books on the subject, including her best-known publication Say Good-bye to Illness, where she goes into great detail on this subject. I would encourage anyone with allergies or even unexplained symptoms to read this book. We carry a few copies at the Center.
Mrs. M is a 42 y.o. female patient who has allergies to foods and environmental factors. Her mother was also a patient who underwent NAET treatments with me successfully for treatment of her allergies. After screening Mrs. M for positive reactions to NAET allergen vials, she was found to be allergic to a number of foods, including sugar mix. Within a day of receiving a treatment to sugar mix, she had a sense of “calm” that she hadn’t felt in years.
My oldest son Mike had a severe allergy to poultry since he was a toddler. If he ate one bite of chicken or turkey, or a spoon of chicken soup, he would break out in a rash and his throat and lips would swell up; he would also vomit. I always had to keep adrenaline around for emergencies. He was the first patient I treated with NAET therapy, and he has been eating poultry without any adverse reactions since his first treatment over 13 years ago.