Fragrant Tongues

BPA: Biting the hand that feeds you

2010-01-16T08:56:00.000-08:00

Bisphenol A. Not a word that rolls off the tongue at parties. Bisphenol A, also know as "BPA" is a plasticizer that was discovered in 1895. As early as 1936 studies showed that it is an endocrine disruptor and xenoestrogen. In other words, it acts like estrogen and alters sex hormone balance in the body. Since the first study in 1936, there have been thousands of animal studies and over 100 clinical studies demonstrating the harmful effects of BPA. (I touched on BPA in this blog)

BPA makes plastics hard but shatter proof, is used in tin can liners, hard water bottled (like Nalgene), compact disks, glasses, sealants and the vast majority of bottle bottles. It's everywhere, in everything and it leaches into whatever food or liquid is inside it.

A number of studies have shown that it increases the risk of abnormal development of genitalia is children because of the estrogen like effects. It has also been linked to cancer for the same reason and infertility problems in men.

Estrogen imbalances, either too high or low, can be linked to many functional disorders--imbalances where lab tests are normal, but a person is not completely well. For example, excess estrogen plays a role in emotional swings, in autimmune disorders like lupus, multiple sclerosis and even psoriasis, and ear, nose and throat complaints (especially tonsillitis and strep throat).

Estrogen levels that are suppressed (xenoestrogens, like birth control pills can end up reducing our body's ability to make natural estrogen) can lead to delayed brain development in children, low thyroid activity and memory and learning problems, including Alzheimer's disorder.

In my practice I pay close attention to estrogen imbalances and address them through an environmental analysis and medicinal plants which can be very helpful for the hormonal imbalances, as well as gentle detoxification.

Activists have been trying to get it banned for years, but the FDA said that they did not have enough evidence to ban it. They based this, according to a recent Washington Post article, on 2 articles funded by the American Chemistry Council, an industry lobbying group while ignoring the 100 clinical articles demonstrating BPA's dangers. Regarding the BPA ruling by the FDA in 2008, an FDA internal investigation criticized the FDA's own ruling. Read here and here.

The FDA has been influenced by industry groups and political money for far too long. For example, a medical device approved by the FDA in which all 4 congressmen from the device maker's state had received campaign contributions within 4 months before the device was approved.

I applaud the new vigor that the Oboma administration has given to the FDA and especially applaud its deputy commission, Dr. Sharfstein, a fellow pediatrician and the person behind the move to remove cough and cold medicines from the shelf for children under 2 years of age.

However the bottom line is that the watchdogs for our safety are so heavily influenced by the hand that feeds them, and so constrained by archane regulatory loop holes and bureaucratic red tape that it is up to use, as informed physicians and patients, to monitor our own environment and health.

Don't panic. There's been a small mistake in your life

2009-10-24T17:16:00.000-07:00

Biomedical medicine, often referred to as "allopathic" or "conventional" medicine, is based on the concept that as long as there is not organ damage or noticeable loss of function, you are not sick. So, you basically wait until someone is sick, then you treat them.

This is a passive form of medicine and part of the answer to this approach was to develop screening tests. This is a great idea. It's what we do in endobiogenic medicine all the time with the biology of functions lab tests. But, the way this has been done is to take one single factor that is considered to be "the" cause or "the" indicator of some disease--like a cancer--and measure that in everyone, or those determined to be at risk.

Unfortunately, by trying to be progressive, by trying to be preventative, this approach has suffered from the same reductionist tendencies that were problematic in the first place. For example, the idea that a microbe alone is the cause of an illness rather than the result of an imbalanced internal terrain.

In terms of prostate cancer, for example, Prostate specific antigen (PSA) was determined to be the cause that was specific and sensitive for prostate cancer. What my mentor and co-developer of the endobiogenic system, Dr. Jean Claude Lapraz has said for over 10 years is that PSA is not enough to be an indicator of prostate cancer, especially when it is only mildly or moderately elevated. It is only an indicator of prostate congestion and a disturbance in factors related to prostate growth. Now, why that prostate is enlarged is a different matter all together.

Dr. Otis Brawley, chief medical officer of the The American Cancer Society, had the bravery to admit,

“We don’t want people to panic,” said Dr. Otis Brawley, chief medical officer of the cancer society. “But I’m admitting that American medicine has over-promised when it comes to screening. The advantages to screening have been exaggerated.”

The article in the New York Times in which he is quoted goes on to say that screening for prostate and breast cancer has not prevented the more severe types of cancer which cause death, but has only increased diagnosed mild, local cancers, some of which are benign and will go away on their own. Unfortunately, with increased diagnosis of possibly benign cancers has come an increase in not so benign medical interventions, such as CT scan (read radiation exposure) biopsies.

Let me reiterate again the importance of having an integrative understanding of the myriad factors that can influence the development of a cancer. When a patient has a "fascinoma"--a fascinating finding to a physician with questionable clinical significance--from an imaging study, an executive health check up, body scan, etc.--it induces fear in them, but it does not clarify what it is, where it came from, why it is there and whether or not it is benign, potentially harmful or currently harmful.

The amazing thing about the biology of functions, the biological testing service of the endobiogenic method, is that it can answer all these questions in most cases of cancer. By evaluating all the factors that can cause a cancer to develop, and by taking a careful history and physical to understand the intervening factors, we can develop a very sophisticated understanding of how to understand an elevated PSA level, a suspicious lump in the breast, or a person's risk of cancer developing again.

A man I knew came to me because his doctors at the VA hospital found a fascinoma--a suspicious lump on a lung and his adrenal glands on a CT scan, quite by accident. They were very concerned that it may be a cancer given his long history of smoking. He categorically refused a biopsy. He came to me and we performed a biology of functions, which showed that it was not cancerous, but simply an overgrowth of a certain type of tissue due to a different non-cancerous pathology, which we treated with medical plants.

A woman was living with breast cancer for 14 years which she only treated with a lumpectomy and localized radiation one time, but never chemotherapy. She came to me in this state and we performed a biology of functions, which showed the cancer, but also indicated that it was like a crouching tiger ready to spring into a state of metastasis and spread beyond the local area that somehow her body had contained it in for all those years. We started a medical plan treatment plan which unfortunately she did not continue and she was diagnosed 3 months later with metastasis to the local lymph nodes and lungs.

In both cases, the biology of functions was clear and accurate to the cause and direction of a concerning situation. In the first case, we were able to avoid unnecessary intervention. In the second case, it has a grave result due to a lack of concerted action.

I am not saying that people should not receive blood screening for cancer. Quite the contrary. What I am saying is that screening needs to be based on understanding the factors (plural) that are involved in the risk for cancer in general, as well as particular cancers.

The biology of functions gives you a full cancer evaluation panel routinely, and for people who are cancer survivors, who have a strong family history of cancer, or who are generally very concerned about cancer, we measure important cancer antigens such as PSA, CEA, CA 15-3, CA 19-9 and CA 125 which can tell us about early disturbances in certain orgain systems, such as the prostate, ovaries, breasts, etc. but in general which hormonal system is playing the biggest role in general internal imbalance and where to put the emphasis of our treatment and preventative care.

Cancer: Silver Bullets and Silver Linings

2009-10-20T23:04:00.000-07:00

My cancer patients often send me links to cures they've found online, or articles they have read on pubmed, the free database of scientific publications. "Do you think this is good for me?" they ask. The answer is easy. It's always the same: "It all depends."

In some patients, a lack of oxidation and free radicals contributes to their cancer, in others, just the opposite. In some patients, a very active thyroid axis--drives the metabolic rate of a cancer. In others, hypothyroidism, signaled by a high TSH level, occurs a few weeks to a few months right before the diagnosis of cancer and plays a role, instead. It's important to understand the various factors that participate in the growth of a cancer.

There are three main factors. First and foremost is genetics. Some people have particular genetic coding that suppress natural anti-cancer activity in the body such as programmed cell death (apoptosis), or over-expresses pro-growth factors such as certain cytokines, or hormones such as estrogen or growth hormone. But every gene is expressed in a certain environment, internal or external, which influences if it is expressed and to what degree it is expressed. So, even when we speak of genetics, we must remmber that there are environmental influences that play a role.

As far as the internal environment, even if a person is not born with genetic factors that are "pro-cancerous" there are certain factors that influence the growth of cells. Broadly speaking we can talk about hormonal (endocrine), nervous system and immune-mediated factors.

Among the hormonal factors, perhaps estrogen plays the most important role because estrogen makes everything grow, not just cancer cells, and not just in women. Some women who use birth control pills, or bio-identical hormones later in life will put themselves at risk for uterine, cervical and breast cancers, especially if progesterone is not used to balance out the estrogen activity. If you like Russian roulette, then this is the way to go for you.

If you don't like the idea of being a statistic, then you should look for natural alternatives to balancing hormones or meeting lifestyle issues regarding birth control. The endobiogenic system I use in my clinic if very well suited to managing hormonal imbalances in women using medicinal plants rather than hormones.

Women who never give birth or breast feed are also at higher risk. Some women chose for religious or personal reasons not to, or cannot for biological reasons give birth or nurse. If you are in this group, consider being evaluated more closely using the endobiogenic approach as well.

High androgens, growth hormone, insulin, Thyroid stimulating hormone (TSH) play important roles, but so does insufficient TSH. Many of these hormones can be stimulated by various nervous system, emotional and immune factors too. They are all inter-related, which is why you can have perfectly balanced estrogen activity and still be at risk for cancer. Slight imbalances in many hormones also put you at risk for cancerous cell growth.

Nervous system activity can get roled up with emotions. Emotions--expressed or suppressed--play a role in cancer too, although I am not saying that sad people or angry people or ungrateful people get cancer and that it's their fault. Plenty of nice people get cancer and plenty of mean people do not. Emotions cause a cascade of hormonal, nervous and immunological reactions in the body which in the right person can support unfettered growth of cells which can eventually become a cancer. It's just physiology, it's not a moral judgment.

Immune imbalances refer to cytokines and other mediators of inflammation, cell growth and blood vessel proliferation. Chronic infections with viruses and fungi are implicated here, but diet plays a role as does insulin and the thyroid system.

Congested or over-worked organs, such as the pancreas, liver, lymphatics, etc. can also play a role in cancer development or spread. So, regular drainage and detoxification of organs with fasts, diets, medicinal plants, homeopathic agents, aromatherapy, etc. are recommended.

The external environment also plays a role--probably and larger and larger role due to the growing toxin burden--in cancer development. Xenoestrogen from plastics and poultry raised on soy, radiation, heavy metals and other factors play a role. We should include chronic low grade infections here, too, like Epstein Bar Virus and Fungus.

Diet, of course can play a role too by influencing all of the above. Our food sources are filled with xenoestrogens, steroids, pesticides and antibiotics. We eat too many pro-inflammatory foods depleted of nutrients, low in omega-3's, stimulating high insulin responses which in turn stimulates more inflammation...

As you can see, there are many factors that can play a role in cancer risk. Some play a smaller role, some larger, but when added up, many small imbalances can create an environment that allows our cells to grow unfettered, which is what cancer is...which is why when my patients ask my about how to prevent cancer. They say, should I become a vegetarian? Participate in triathalons? Meditate? Do yoga? Avoid dairy? Stop hormone therapy...I say, "It depends."

In my practice I have taken care of vegetarians who should should be sainted for their benevolence but they get cancer, and I have grumpy alcoholics who don't get cancer. I have people who do yoga every day with high pre-cancerous activity and lazy slobs who don't have that risk.

There is no single prevention or cure for cancer, no silver bullet. The silver lining, though, is that by getting an individualized evaluation you can focus on what will help you reduce your risk of cancer. One person, one cancer treatment plan.

War on Cancer? Give peace a chance

2009-10-11T14:55:00.000-07:00

Forty years ago, Richard Nixon declared a war on cancer, and thus started the great money sink of cancer research, so says a recent New York Times article. The article lists all sorts of reasons--the doctors who stand to lose money from good cancer research, government bumbling, corporate collusion--the stuff I usually mention. But that's not really what my concern is here. Six paragraphs from the end of the article, the author says

In most studies researchers have not accounted for genetic differences in tumors.

Therein, as Hamlet said, lies the rub. [the full soliloquy is at the end of this post] Ironically, Hamlet was fretting about the misery of long life, not a shortened life expectancy from cancer or other ailments.

Cancer research has yielded a lot of interesting results, such as elucidating the mechanisms of cancer growth, activity, metabolism, etc. Cancer research, and the organization of cancer trial working groups--particularly in pediatric oncology has led to impressive reduction of mortality of certain pediatric cancers. For example, ALL (Acute lymphocytic leukemia) used to have a 90% mortality and now it is down to 10% except in certain high risk groups. Sadly, though, there has been no overall reduction in cancer death in the US. In fact, even as the death from certain cancers have been reduced, other cancers, once rare, have become quite common.

Where cancer research has been lacking, and I say this with all due humility about very, very smart and dedicated researchers, has been in creating a global, dynamic and integrated understanding of cancer vis-a-vis the entire physiology and psychology of the individual. I am not referring to looking "estrogen" receptors or genetic markers. These are trees in the forest but not the forest itself. Genes need to act in a certain environment and having a gene in no way dooms you to have cancer. Conversely, not having the gene does not get you off the hook. I have a patient who has had recurrent breast cancer. She had a genetic survey done which said she had a lower than average risk of ever getting breast cancer.

I would add that there are two related errors that most cancer research has suffered from. First, it has become so reductionist, so mired in the fine details of mechanism, of the "how", that it cannot ask "why did this cancer come about?" And by "why?" I mean both physiologically, emotionally and spiritually.

Second, cancer studies in petri dishes (in vitro) and animals (in vivo) are so contrived and so far removed from the complex, decades-long dysfunction experienced before a cancer comes about that it is difficult to translate this research to an individual person with all the epic events of their life--birth, fear, hope, love, loss, illness, environmental pollution...

Experimental cancer treatments--even those using "natural" treatments use dosing far beyond what could be used in treatment that ceases to be practical. Many of the new treatments being trialed by drug companies hold out the promise of extending life by a few weeks but at huge costs. The article in the Times explores this very thoroughly, so I won't do so here.

If we wish to have a new approach to cancer, we must begin with the most Socratic of exercises: defining terms before any discussion occurs. So, what is cancer? The great killer? The barbarian at the gate? The feared stalker? He who cannot be named? We don't even know how to discuss it. In polite conversation, we lower our voice when we speak about someone who has cancer, then continue at our normal tone. Even in medical circles, we would refer to cancer as "CA" in front of patients or on medical exam forms.

So, what is cancer? Quite simply, cancer is the dysregulated growth of our own cells. That's it. That's fundamentally the struggle of life: regulation, dysregulation, a return to regulation and balance. If we don't go back to balance and regulation, we die.

A tacit assumption of cancer immunology has been that tumors express non-self or "foreign" antigens. The recent identification of a handful of potentially immunogenic cancer antigens shows that they are not truly foreign. Although the boundary between self and non-self is not well-defined, this first look at cancer antigens fits more with a self/altered self paradigm than with the non-self paradigm for antigens recognized in infectious disease

I wish I said that, but it was Dr. Alan Houghton, Chairman of Immunology, Chief of Clinical Immunology, Memorial Sloan-Kettering Cancer Center and Head of Melanoma Disease Management, Cornell University in a 1994 article.

So, in many ways, we return to the play Hamlet, for cancer is like the character of Hamlet: the perpetual angst of adolescence asking "Who am I?" and unable to give a proper answer.

Cancer is not foreign to us. It is us. It is at some level, a confusion about who we are, why we are and where we are in time and space.

How pointless then, how nihilistic to declare war on ourselves. Isn't that how we got ourselves into this mess? So much hatred, anger, and destruction of our race, our country, our environment and now ourselves? Rather than a war on cancer, how about a space race to the furthest depths of our soul?

Addendum: Hamlet's Soliloquy

To be, or not to be: that is the question:
Whether 'tis nobler in the mind to suffer
The slings and arrows of outrageous fortune,
Or to take arms against a sea of troubles,
And by opposing end them? To die: to sleep;
No more; and by a sleep to say we end
The heart-ache and the thousand natural shocks
That flesh is heir to, 'tis a consummation
Devoutly to be wish'd. To die, to sleep;
To sleep: perchance to dream: ay, there's the rub;
For in that sleep of death what dreams may come
When we have shuffled off this mortal coil,
Must give us pause: there's the respect
That makes calamity of so long life
--Hamlet, in "Hamlet" by William Shakespeare

Probiotics: A tale of lemings and foxes

2009-10-05T15:58:00.000-07:00

Probiotics have been quite the hot topic for a number of years now. For a hundred years, health conscious Americans have been aware of the beneficial effects of friendly bacteria, and for thousands of years, so have most traditional cultures, who have at least one fermented food that is considered to be pluripotent in its health-inducing effects.

Probiotics are healthy microorganisms--mainly bacteria and a few fungi--that live in our bowel. They have many important roles, the most capital of which is establishing a healthy immune system. This is much more far reaching than avoiding a cold now and again. Immune imbalances play a role in many disorders from autism to arthritis, from Crohn's disease to cancer. Probiotics also help digest our food and generate B vitamins. They also help prevent aggressive organisms from invading our gut, or worse, our blood stream.

Sounds like everyone should be taking probiotics, right? Normally, I would tell you to eat fermented foods, like yogurt, kefir and kombucha, which are rich sources of probiotics. And, I am telling you to do that. They are an important way of establishing and maintaining a lifelong healthy ecosystem within the bowel. However, if you have an immune imbalance, it will take more than eating these great foods to reverse the disorder. That is where probiotic supplements come in.

Unfortunately, the multinational food companies have co opted the revolution and corporatized it. I have been told by a reliable source in the industry that what is sold as kefir (Turkicized Arabic for "makes you happy") does not resemble the real McCoy any more than Trix flavored yogurt (I'm not making this up) resembles what Nana made in Crete.

Dannon has patented strains of probiotics and even renamed subspecies to include their company or product name to make you think that they poses some rare and exclusive line of proprietary strains of bacteria. So people rushed like lemmings to consume anything from cookies to chocolate that say "probiotics" on the label (Dannon has been fined $35,000,000 for making unsubstantiated claims on its products). I don't know if anyone has tested this, but knowing what we do about how difficult it is to get probiotics to adhere to the bowel when taken in powdered form, and made the right way, most of the enhanced foods are virtually useless for improving bowel function.

There are three reasons by people do not get good results with probiotics. First, they don't use high enough doses. According to the clinical trials, effective doses range in the billions, not millions. Second, they don't use the right strains. Most people don't realize that we have hundreds of different bacteria living in our bowel, and it varies by our age, the seasons, and individual metabolic needs and phases of life, such as pregnancy and menopause. Some of these organisms help us digest carbohydrates, others proteins, others make vitamins or do many of these tasks, so, choosing the right strain depends on understanding where the deficiency lies.

Don't even get me started on the foxes guarding the hen house. The New York Times had an interesting article about probiotics and how many of the experts on the panel had ties to major companies promoting probiotics. I will say though that the author of the article had a good point in that clinical studies to date have tested about 50 different strains of bacteria and fungi and have shown specific strains to be helpful for specific disorders and it may not be correct to generalize these effects to all strains or other disorders not studies. The point is that you can't just take "probiotics" for health any more than you would eat "food" for health. The food you eat depends on the health goals you have in mind.

The third reason people may not get good results with probiotics is that they don't use them long enough, or, don't transition from probiotics to fermented foods as a daily part of their diet once the symptoms have gone away.

In my clinic, using probiotics is part of a larger assessment of the terrain of the digestive system and the health of the other organs that effect or are effected by the bowels, such as the pancreas, the gall bladder, the immune system, etc. There are quick ways to asses dysbiosis--imbalanced microbial ecology in the gut--and specific lab tests, too. We look at the immune system, the endocrine system, inflammation, and many other factors that interplay in a subtle dance between the gut and the rest of the body.

Don't fall pray to foxes promising you a healthy gut with diet-antioxidant-probiotic-decaffeinated-rain forest-chocolate cola. It took time to enter a state of imbalance and good treatments give the body time to return to balance through measured and prudent treatments.

October is cancer prevention month, so for the rest of this month, I'll be blogging about cancer.

Hand washing and white washing

2009-09-14T21:51:00.000-07:00

The New York Times reported today on the importance of hand washing to reduce the incidence of the swine flu. The article quoted a number of recent studies demonstrating that from preschool children to college students and washing with soap and water, or alcohol-based sanitizers, can substantially reduce the rate of both swine flu and other types of infectious diseases.

I don't want to underestimate the importance of cleanliness or downgrade the importance of washing one's hands. However this brings up an important bias which persists in the media not to mention in medical school, hospitals, and the entire basis of funding medical studies. That is to say, the systematic whitewashing of the concept of "terrain" when evaluating a person's risk of illness. Below is an excerpt from my new book, Medical Aromatherapy: the Aroma MD method, which teaches healthcare providers how to use essential oils to treat a variety of medical conditions:

Biological terrain is the sum of all the factors that affect the function of the body--the internal milieu. The concept of terrain allows us to evaluate all the factors that make a person, say, at risk of contracting an infection. For example, immunity is much more than infection fighting cells. The nervous system, the endocrine system, genetic factors, commensal organisms ("good bacteria"), and diet, all affect the quality of the immune system and its ability to protect the body from infection in a balanced manner. By addressing these factors, we allow the body to take advantage of its innate healing capacity to the fullest degree possible given its homeostatic state to affect a cure, and not just a treatment.

Biological Terrain is a key concept of health that has been present in Eastern medical systems for millennia. In the West in the late nineteenth century a number of intellectual ideas converged to create a concept of terrain based on a scientific observations and experimentation. Discovery of homeostatic regulatory mechanism such as pH, oxydo-reduction potential (rH), hormones, enzymes and the role of trace minerals created a rich, integrated and inter-related concept of le milieu interieur (internal environment) in which the body functions. At the same time, the effects of complex plant medicines were being described and an appreciation for essential plant oils was burgeoning as methods to treat disorders.

Simultaneous to these developments, reductionist concepts and treatments were being developed as well. These include the germ theory of Pasteur, which holds that microbes are the cause of infectious illness, circumventing the role of the terrain. The growth of the chemical-pharmaceutical industry lead to single-compound “pure” drugs to work on single receptors or single agents such as microbes. Professional medical monopolies and the codification of medical education served to control the propagation of ideas and determine scientific and medical orthodoxy, ultimately driving the concept of terrain and biological complexity out of the realm of scientifically accepted and funded concepts.

Like many other important systems-based concepts and truths based on a holistic understanding of the human body, the very institutions which sought to suppress the concept of terrain are currently the ones promoting the concept of terrain after 120 years. The prestigious Journal of the American medical Association's (JAMA) recently published an editorial speaking about the importance of systems-based medicine as a method to overcome the reductionist tendencies in medical education and health care system. Read this editorial carefully because it sums up the key points of the end of the endobiogenic system developed by Drs.Duraffourd and Lapraz of Paris, France.

So, what's wrong with just washing our hands? The problem lies in what is called the "hygiene hypothesis". The hygiene hypothesis is based on a number of observations published in peer-reviewed medical literature. Researchers have noted that the more a society reduces exposure to minor illnesses in childhood, the greater the incidence of autoimmune disorders such as asthma, allergies, multiple sclerosis, and cancer. It turns out that mild infections and exposure to healthy bacteria early in life helps develop, regulate and maintain a healthy immune system, quite the opposite of what we are normally taught and read about the media.

Unfortunately, the overall state of health of the average American is so compromised due to diet, environmental and emotional stress, toxins, and other attacks on the internal terrain, that hand washing is considered the best defense against infections. What I recommend for my patience in my clinic is the use of medical aromatherapy.

Essential oils affect the three key factors which affect the terrain for: they support healthy organ function and detoxification, they stimulate the immune system, and they are directly antimicrobial. When taken internally under medical guidance, used topically to massage or diffused into the air they are quite effective. Of course, a healthy diet based on a person's unique metabolic type, stress reduction, and support of key organs such as the liver, pancreas, adrenal gland and thyroid, or also an important part of my treatment philosophy.

Take a pepcid and sue me in the morning

2009-09-13T05:48:00.000-07:00

National Public Radio recently reported an interesting story about how taking heartburn medication can worsen heartburn. More amazingly, they reported on a recent study performed in Copenhagen in which healthy adults who were given heartburn medication for three months actually developed stomach diseases such as reflux and heartburn after stopping the medication. In other words the medication itself causes the disease it is supposed to be treating! Let me explain how this works.

When a receptors in the body is suppred with blocking medications the body reacts by increasing the number of receptors which are causing the "problem" in the first place. At some point in time, there was an increased need for the compound in the body that the receptor corresponds to which is why the number of receptors increased. In time, the need goes away, but the physiology gets "stuck"--and that's when maladptive state occurs. If you block the receptor but not the compound, the body simply makes more receptors because now the body is used to a certain level of function. If you reduce the compound, the body will reduce the number of receptors. It's a matter of simple feedback.

There are no bad receptors or bad hormones or bad physiology in the body. There is only homeostasis, imbalance, and the attempt to return to homeostasis.

When estrogen blocking drugs such as tamoxifen are used to treat estrogen positive cancers, studies show that there is a small but important risk of developing uterine cancer within 10 years of using the tamoxifen.

When a person has high blood pressure and you use a beta blocker to lower the blood pressure, the body actually increases the number of beta receptors. If you suddenly stop a beta blocker drug, you actually worsen the person's blood pressure.

Now to the topic of our blog: when a person has heartburn often times it is because they're making too much stomach acid. They're a number of hormones that are responsible for stimulating stomach acid production, So it's important to figure out are driving the increase in stomach acid, and why those hormones are being stimulated in the first place. Usually there's a good reason for the body reacting the way it does, and we should figure it out rather than outright suppressing it.

Usually stomach acid is increasing its because the body needs more nutrients due to some huge emotional or physical stress that is increasing metabolic activity somewhere else in the body. In this case, the stomach is an "innocent bystander". That is to say, the person is reacting to some type of stress, and he could be losing their job or having cancer, but the stress that they experience leads to all sorts of reactions in the body which require extra nutrients to meet the new metabolic demands from stress.

Stomach acid plays an important role in meeting this demand. For example, stomach acid helps break down food and allows for more efficient digestion in the small intestines. It serves as a defense mechanism against unhealthy bacteria that might try to enter the body through the stomach. For example, a recent study showed that people on acid blockers have an increased risk of pneumonia. Stomach acid improves calcium absorption, which helps with nervous system function and building bones and cell membrane activity. Antacids block calcium absorption long-term and long-term use of acid blockers can increase the risk of osteoporosis.

A holistic approach to medicine, such as the endobiogenic method used in my clinic, suggests that if we understand the whole person, their emotional state the stage of life that they are in, and their hormonal imbalances we can understand the true cause and continuation of illness--and then we'll know how to treat the person, not just the disease. Of course, that it goes without saying that their dietary habit must also be examined very carefully. I can tell you that my rate of using acid blocking medications is 0%.

If you want to correct the problem, look not only at the compound and its receptor the entire terrain or internal milieu of the person. In medicine as in mysticism, the answer lies within.

Diabetes Care

2009-08-26T09:31:00.000-07:00

The way a people treat the body politics, is the way their medicine treats the body. Our country is constantly at war: war with other countries, a war on drugs, a war on poverty, a war on cancer, a war on diabetes. When it comes to diabetes, sugar is the enemy and we will stop at nothing to eradicate high blood sugar without thinking about why it was high in the first place.

Sugar is the enemy and dietitians aligned with the diabetes community recommended artificial sweeteners in place of sugar and honey and even fruit (!). It turns out that artificial sweeteners stimulate the same hormones that sugar does but to a greater degree and can actually cause you to gain more weight and experience inflammation.

To be sure, refined, white sugar is not healthy for you (but honey and fruit can help diabetics control their blood sugar, especially apples, pineapples and lemons). And for a diabetic, long term uncontrolled high blood sugar can lead to blindness, limb loss and kidney failure. But just using anti-blood sugar pills like Metformin have short term risks and may have long term health risks to patients like an increased risk of cancer or alzheimer's disease in susceptible people.

Since 2006, an expert panel recommended aggressive and rapid blood sugar control. According to a recent New York Times article, some of the experts had received money from pharmaceutical companies that make these very products that lower blood sugar. What is more, other experts (no strings attached to big pharma) had warned that there would be consequences to lowering blood sugar too quickly--and low and behold there was, like seizures and death--which led to the group pulling their expert recommendations.

Everything the body does has purpose at first, but over time if it gets stuck in a certain pattern, it no longer is helpful, but becomes harmful. For example, if you pound on a soda machine to get your money back, that makes sense, But if you do that for 6 hours with no money back and break your hand, that pounding no longer was helpful and became harmful.

The endobiogenic approach considers why a person has developed insulin resistance over time and what the body is trying to achieve. In my practice my goal is to balance the hormonal influences that caused the unhealthy management of sugar in the blood and support the body's ability to regain its natural healing power. Most the time, this can be done with some sensible dietary changes, herbal teas and medicinal plants. No strings attached to big pharma.

Hidden Dangers to your Child's Health

2009-04-03T11:25:00.000-07:00

Many of you are living a holistic life if you are reading this blog. You eat well, you buy organic when you can, you exercise, you work on stress reduction, etc. But for all your well deserved pats on the back, there is a hidden danger which seemingly is seldom mentioned in the popular press. The hidden danger to our children (and ourselves) from everyday cosmetics, shampoos and lotions.

There are many, many chemicals to be worried about, but I want to draw your attention to the ones that related to synthetic fragrances, as this is a blog that has to do with essential oils and medical aromatherapy after all.

Phthalates are a type of chemical that is used to soften plastics, as well as in paints. It is also used as a "fragrance extender." It's what makes synthetic fragrances last so long and seem so strong compared to essential oils. Unfortunately, phthalates are an endocrine disruptor. They bock testosterone activity. Many animal studies have shown that it can impair the development of normal male genitalia when a pregnant mother is exposed to phthalates. In humans, there has been a doubling of malformations of "boy parts" in the last two decades.

Phthalates do not stick to whatever they are used in, so, they leach out very readily. You can inhale them (like in the fragrances), you can swallow them when the plastic is chewed, and it can go through your skin. For example, a study published in the prestigious journal of the American Academy of Pediatrics, Pediatrics, demonstrated for the first time that even using a baby shampoo for a few minutes a child's head lead to absorption of phthalates. The smaller the child, the faster they absorbed the phthalates relative to their body weight.

The best way to avoid exposing your children to these types of toxins is to use fragrance free bath and beauty products. A nice thing that I like to do is to start with a simple base, say, of shampoo or lotion and add my own medical grade essential oils. These essential oils not only smell nice but have many important physical and physiological effects on the body. I've raise my children with aromatherapy and it is become an integral part of their life and their identity. For example once, when my daughter was five years old, she stubbed her toe in preschool. Her teacher came running to reassure her that her toe would be all right. Turning to her teacher to reassure her, my daughter said "don't worry, my father will put lavender essential oil on it and it will be all right".

Now as my children grow up, I'm teaching them how to choose the right essential oils to shield their wounds, help fight infections, and even to cook with. This is what I refer to as the "fragrant childhood." Check out my recent article in mothering magazine, entitled "the fragrant pregnancy". It talks about how medical aromatherapy can be used throughout conception pregnancy and delivery, and forms the basis for how essential oils can be incorporated into your families life.

Organic--but is it safe?

2009-03-04T21:40:00.000-08:00

The New York Times recently published an article entitled, "It’s Organic, but Does That Mean It’s Safer?" which raised questions about food safety related to the salmonella outbreak related to organically farmed foods.

It's important right from the outset of this blog to shatter the fantasies that we maintain about organic food as it is packaged and consumed in suburban America. The organic food industry is just that--another industry, another corporate enterprise. Many of the most visible organic food players are owned now by corporate suits like Kellogs (owns Kashi) and General Mills (owns Cascadian Farms), and Coca Cola (owns Honest Tea). What is more, the standards of organic food production allows for the use of artificial preservatives. Free range animals can be couped up except for a few hours a day when a tiny door is opened to a tine caged plot of dirt. If the chicken walks around or not is due to the vagaries of fate.

What is more, organic meats come from animals fed organic corn and organic soy beans which impart organic inflammatory products that acidify the blood and organic estrogen that may affect boys' fertility and possibly increase a woman's risk of breast and ovarian cancer in certain sub-groups. (Organic cancer anyone?)

Anything that is packaged, wrapped, or frozen is not going to be very good for you--even if it is organic. It still uses too much organic salt, too much organic fat and way too many resources like plastic wrappers, waxed paper cartons that will be thrown away and not recycled...

As a nation, we need to move beyond buzz words and sweet notions of where our food comes from how it arrives on our table. We need to become more involved in local agriculture, support regional growers and be willing to make more food ourselves from fresh ingredients. It is no longer sufficient to trust the government or big corporations to ensure not only the lack of danger but the wholesomeness of our food. For starters, everyone who is interested or passionate about food should read Michael Pollen's "Omnivore's Dilemma" (2007, Penguin paperback) which is a true eye-opener in this regard.

Adrenal Mood connection

2009-03-04T21:04:00.000-08:00

I recently returned from a show in New York that was for health care providers. My company, Aroma MD was exhibiting. Usually at these shows, our sleep product, Sweet Sleep is the hands down best seller. It seems like everyone could use a little more sleep these days. But what is interesting is that this time, our mood and adrenal product, Mood Master was the best seller--by far.

What's the connection between mood and the adrenal glands you may ask, or between adrenal health and sleep? It's all connected, and it's only getting worse.

Adrenal fatigue is fast becoming one of the biggest health problems or seemingly healthy people. Let me explain: There is a concept in European medicine, particularly in endobiogeny, that organs can be dysfunctional while all the blood tests and imaging studies are normal. I call this "functional dysfunction." This means that you can get by, but you're only running on 3 gears instead of 5. This is the classic example of when a doctor says "You're tests are fine. You're not sick" and you think "But I feel terrible. How can I have normal labs and not feel normal?" That's functional dysfunction.

The adrenal gland is the first responder to stress. It makes adrenaline and it makes your natural cortisol hormone. Stressors--from noise pollution like city traffic, or light pollution from city life or working night shifts, emotional and physical stress that go one too long start to exhaust the adrenal gland's ability to respond to stress.

When the adrenal gland is over-stimulated and it can't make enough cortisol or adrenaline, two things happen. First, you have a hard time using your blood sugar and keeping up energy levels. Fluctuating blood sugar levels lead to swings in emotions and concentration because blood sugar is the only fuel the brain can use, so if sugar levels are even slightly unsteady, so is your Brian function. When your body needs to grab more sugar from your food, it uses too much serotonin--your good mood brain transmitter--in the gut. This is because 95% of serotonin is used in the gut for digestion. Only 5% is used in the brain for mood. So, your gut steals serotonin from the brain for the gut and then you get depressed and you're tired.

The second thing that happens from adrenal over-stimulation is that you make too much DHEA, a hormone that in high levels puts people on edge and makes them quick to anger and reduces their tolerance levels. So now you're moody, tired, cranky and depressed.

The funny thing is, even though people feel tired with adrenal fatigue, they have a hard time sleeping because they get a second wind with an adrenaline burst late at night.

So, if you are getting dark circles under your eyes, have trouble getting started in the morning, or feel a brain fog until around 10AM, or feel uncontrollably tired between 2-4pm and have altered mood or depression, you may have adrenal fatigue and minor depression.

The key is to get a good night's sleep. That's where a natural sleep aid like Sweet Sleep is helpful. It naturally increases the hypnogenic factors that help you sleep at night, and reduces stress levels.

Mood Master helps in two ways:

ENERGY: Mood master contains energy-giving essential oils like grapefruit and clary sage. By taking over some of the role of adrenaline and resting part of the adrenal gland which lets it build up reserves. Over time, say 3-12 months, you should start to get more energy back and have steadier mood.
MOOD: Mood master contains mood-balancing essential oils like clary sage and clove, and anti-depressant essential oils like lavender and grapefruit. By improving mood, you reduce emotional stress and improve tolerance to external stressors.

Work with an experienced health care provider to help you manage your condition. You may need other supplements like vitamin C, which helps make nor-adrenaline, or SAMe, which helps make adrenaline, or B vitamins which help manage stress. There are also natural cortisol type plant products from the young shoots and buds of the sequoia and oak trees, or from dogwood and black current bud.

Here's the rub: Right for the wrong reasons

2009-01-25T20:27:00.000-08:00

MSNBC recently reported that Vick's vaporub may actually be harmful to young children. The case in interest was a grandparent who rubbed Vick's vaborub on their 18 month infant under the nostrils even the instructions say 1) don't put it under the nostrils, and 2)don't use in on infants or children under 24 months of age. I was interviewed for on online news service, Kaboose.com and you can read my comments here.

There are only two things that I don't like about Vick's vaporub. Unfortunately, it's the only two things that make Vick's vaporub Vick's vaporub. First, it's a petroleum based product. Do you really want to be rubbing toxic petroleum derivatives on your body? This stuff may cause cancer. Is that concerning to anyone?

The second thing I don't like is that Vick's vaporub uses three extracts from three essential oils: menthol from peppermint, camphor from camphor essential oil, and eucalyptol from eucalyptus essential oil. These compounds do really decrease cough, break up mucous and kill viruses. There are many, many, many studies that demonstrate that. If you read the case study I published on the use of essential oils in the intensive care unit, I've referenced it there.

When you use a whole essential oil, containing dozens of compounds, some of the compounds act like a partial antidote to the "main ingredient" which reduces harsh side effects when used properly.

Both menthol and eucalyptol--and for that matter peppermint and eucalyptus essential oils are too harsh for babies to tolerate. I have always warned against their use in this age group for the same reason as what happened to that toddler. There is a nerve in the nose--besides the smell nerve--that detects the smell of rotten, acrid or rancid smells--like rotten milk or spoiled meat. It causes the voice box to shutter and the airway to tight and secret mucous to protect itself from harm. Because these two oils are so strong, it stimulates not only the smell nerve, but also the this other nerve (the nasal branch of the trigeminal nerve). This is what caused the ferrets in the experiment and the baby rushed to the hospital to have a bad reaction.

The "expert" in the MSNBC article states:

“When you’re talking about an agent that does no good, your tolerance for harm is very low.”

but in adults, Vicks does improve the removal of mucous. Menthol does activate cold receptors and doesn't narrow airways--but so what? Do these experts think that suffering is better than feeling better because your brain thinks you can breathe easier? It's as if these guys have some type of schadenfreude in seeing people suffer in the real world? Peppermint essential oils, on the other hand does open up the airways, unlike menthol alone. Besides, pine essential oils like pine, spruce and balsam fir are much better and more gentle vasoconstrictors that open up airways.

The reason I made Flugon is because between adverse events from Vics (not to mention the petroleum!!!) and the deaths from over-the-counter cough and cold medications that the FDA overlooked for 50 years. I wanted a gentle but effective combination of essential oils that dissolves mucus, eases coughs, supports the immune system and has proven antiviral and antibacterial properties.

Essential oils--when used whole, in the right amount for the right age are amazingly effective in treating cold and flu symptoms in children and adults. The problem is that every chemical in this world can be a poison or panacea depending on the dose, the route given, the duration given, and the patient it's used on. The MSNBC article and the pseudo-scientific study they cited in ferrets only represents ballyhoo and sensationalism, which affects both media and medicine when there is an axe to grind and an agenda to pursue.

There is no alternative medicine, pt 2

2009-01-03T09:54:00.000-08:00

Just before the new year I discussed an article in the Wall Street Journal by Steve Salerno entitled "The touch that does not heal." Perhaps it was meant to be simply an amusing piece because it was published in the "arts and entertainment" section and not the business section or the science section. However, I must say that it turned out to be a comedy of errors.

In my previous post, I discussed the philosophical roots of the two main forms of medicine: the rationalist and empirical schools. Here, I want to discuss some of the other points that the author brings up.

Mr. Salerno says in his article:

...what was once a ragtag assortment of New Age nostrums has metastasized into a multibillion-dollar industry championed by dozens of lobbyists and their congressional sympathizers.

The last time I checked, a noble prize winners Crick, Watson and Pauling, Harvard-educated Andrew Weil, and others are not "ragtag." There are literally thousands of MD's, DO's and others practicing some type of integrative medicine that is beyond the restrictive, reductionist concepts of 17th century Europe.

As for choosing the word "metastasized"? It has taken over 100 years for the concept of nutritional supplementation to treat illnesses to really catch on. Pauling coined the term "orthomolecular medicine" in 1967 but it is only recently that august organizations such as the American Heart Association have actually come to recommend supplementation with omega-3 fatty acids and co-enzyme Q10 for congestive heart disease, lipid problems and other issues. It has taken over 40 years since the first discovery of the "molecules of emotions" until today to simply start to understand the physiology of emotions and its impact on health.

Again, Mr. Salerno writes,

Not by coincidence is CAM most avidly touted by a loose alliance of self-help gurus (Andrew Weil, Deepak Chopra, et al.) and veteran hucksters like erstwhile infomercial king Kevin Trudeau. Mr. Trudeau has been sued for deceptive business practices several times by the Federal Trade Commission. In 2004, the agency deemed his sins so egregious that it barred him from "appearing in, producing, or disseminating future infomercials that advertise any type of product, service, or program to the public.

Dr. Weil, whom I personally spent a month training with as a medical student, works at the University of Arizona and is program is training MD's and DO's in scientific-based integrative medicine. Dr. Chopra is an endocrinologist who runs a private medical center in Encinitas not too far from San Diego, California. I personally worked with the Bravewell collaborative, a group of academic physicians who run integrative medical centers and research projects out of such institutions as Duke University and Scripps Medical Clinic. Not exactly a loose collection of hucksters.

As for Mr. Trudeau, he is not a physician. He is a huckster, and to mention him with Drs. Weil and Chopra is really egregious and duplicitous because on a quick read it sounds like all three have been investigated for questionable dealings.

Finally, I want to point out Mr. Salerno's amusing comments about aromatherapy:

and aromatherapy, which relies on the supposed healing properties of about 40 "essential oils,"

There are over 100 clinical studies and thousands of scientific studies about the healing properties of essential oils. Just go to pubmed, the free database of the US Library of Medicine and type the terms "aromatherapy" or "oils, volatile" and read some of the abstracts yourself. If you want to see the clinical studies, type "AND human." You can also read some full articles here.

It's funny that he puts essential oils in quotation marks. That is, in deed what the organic hydrocarbon compounds are called: essential oils. I've spoken a lot already about essential oils, so, you can view my first post from 2008 to review the evidence.

To your health in the new year.

There is no alternative medicine, pt 1

2008-12-29T16:43:00.000-08:00

One Chris Salerno, a self-proclaimed sham watcher, wrote a scathing article in the Wall Street Journal recently. The thrust of the article was that any medicine that does not conform to today's standard's of scientific validity, and which does not have rigorous scientific validation is a sham. This article presents some very interesting biases that have plagued medical schools, hospitals and the National Institute of Health (the single largest investor in medical research in the world) for over 100 years.

Mr. Salerno quotes a former editor of the prestigious Journal of the American Medical Association (JAMA), Dr. Lundberg as saying, "There's no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data."

There is a monumental presumption of arrogance that Dr. Lundberg typifies and which has been falling apart at the seems for quite some time. What Dr. Lundberg, and the author by quoting him are saying is "It ain't medicine until I say it's medicine."

Au contraire, you may say. Surely, there must be some standards, right? Of course, there are standards, but when the people setting the standards used duplicity, the bully pulpit of government and economic sabotage, as the American Medical Association did in the late 1800's and early 1900's to become THE standard bearer of medicine, there is something wrong here.

Since the time of the Greeks, there has been a tug of war between the two schools of medicine: "rationalists" and "empiricists" and this continues even up until today. I will summarize it here, but for those who are really interested in this subject, I highly recommend Harris Coulter's Divided Legacy, volume IV.

Rationalists use deductive reasoning, meaning, they look at a big picture, break it down into its smaller parts, and then treat the parts. This is why we have diagnosis, that relies on symptoms. For example, a person comes to their doctor and says, "I'm depressed." The doctor asks some questions, and finds out that the person doesn't enjoy things they used to like, can't get out of bed, has increased appetite, trouble falling asleep at night, and has lost interest in sex. So, he prescribes an anti-depressant, a diet pill, a sleeping pill, and something for the sex issues. In this approach, depression is depression and once you're labeled as "depressed" you get an anti-depressant. End of discussion. Allopathic ("Western" or "Mainstream") medicine is best described this way.

Empiricists use inductive reasoning. This is where you take individual signs and build it up into a single diagnosis specific for that person. For example, in the case of depression, it is can be viewed as depression with loss of appetite, with increased appetite, with too much sleep or insomnia, etc. Each one is a separate illness and a single treatment may address all the symptoms which are related to each other. Homeopathy best fits this camp.

I was trained by the first school, the rationalist school, as all MD's and DO's are, but in truth, the more material science explores life at the level of hormones, and the vibratory, steiric and electromagnetic levels of receptor-chemical interaction, the more it validates what the empiricists were saying.

So, when Dr. Lundgren said that there is no "alternative medicine" he was right for the wrong reasons. There is only one type of medicine: a medicine that is an enterprise of healing not hurt, of health care not sick care, of prevention in its primacy, but which has answers for emergencies, a medicine that understands anatomy and physiology, but also appreciates the impact of emotions and spirit on the body. There is no alternative to healing and helping. It either works for an individual or it doesn't.

The lack of caring by busy MD's cannot make up for cure. In fact, because of the pressures put on doctors, they are forced to peg people into tidy little diagnoses and just give them some pill and get them out the door. This is why people are seeking "alternatives"--alternatives to factory medicine.

Let me give you a real example. I woman told me she was diagnosed with a thyroid problem and fatigue. She had the thyroid removed, which gave her a new disease: celiac's disease. She was given one drug for her fatigue, which gave her side effects, so they gave her another drug, which gave her side effects, so they prescribed a third drug to deal with the side effects of the second drug. Is this the medicine for which there is no alternative?

In my practice, I spend 60-90 minutes on the first visit because, as Hippocrates said over 2500 years ago, "The person who has the disease is more important than the disease the person has."

As a final note, "alternative" medicine is one of those colonial terms given by the medical establishment, like a dictator calling every dissenting voice "upstarts and rebels."

The term "complimentary" medicine came about by peace makers and medical "diplomats" if you will, who said, "Maybe this stuff isn't so bad. We should at least take a look at it." They thought, "Hey, we can use some zinc and antibiotics for colds, or massage therapy and Prozac when a person is depressed. The one compliments the other," hence "complimentary medicine. This was the uncle Tom approach. The house negro, if you will, the one who was good and compliant and tried to explain all the "alternative" therapies with purely biomechanical explanations that pleased his master at the NIH and prestigious medical schools.

Now, there is "integrative medicine" which was an addage coined by MD's and DO's who were not afraid to admit that they believed in vibrational medicine, acupuncture, and surgery at the same time, and wanted to integrate both approaches--rational and empirical--as two equals in a "power sharing agreement" if you will.

This is a really good start, but it is still not integrative because many of these MD's are still using a organ-based approach and a symptoms based approach and treating every symptom their patient has using a bag full of vitamins, herbs, massage and supplement in place of a bag full of prescription medication. Truly integrative medicine requires the ability to look at the causative factors of disease--the ultimate cause--and take an approach that restores the entire body to equilibrium by crafting a truly individualized plan to treat body, mind and spirit from the cell to the soul.

In part 2, I will take one a few of the more outlandish statements that Mr. Salerno made in his article.

Fresh Air: A report on Asthma Medications

2008-12-09T14:44:00.000-08:00

The New York Times reported that the FDA published a warning about the use of combination asthma medication in children. These medications combine a beta-agonist that opens the airways with a steroid, that reduces swelling. Advair and Symbicort are the best selling versions of these drugs.

The FDA has been expressing its concern for some years now (read it here) that children who uses these medications are at risk of dying as a result of it. Other studies have shown that even using "rescue inhalers" like albuterol frequently increases the risk of dying and can actually worsen wheezing.

Over 10 years ago, the FDA expressed concern about the risk of death related to the use of Serevent, its maker, GlaxcoSmithKline did an internal study which is refused to publish the results of. It then took this potentially dangerous product and combined it with a steroid to get Advair now the biggest selling drug in its class. Then, in 2003, years later, it published the report which said that the FDA was right on this.

Aromatherapy can be amazingly effectively for treating mild asthma flare-ups in addition to treating the problems of asthma. For flare-ups, I nebulize the essential oils directly into the lungs. This should be arranged with a doctor experiences in this type of treatment. The convenient thing about aromatherapy is that it is effective inhaled on the skin (rub it on the chest for mild asthma flare ups) and taken internally.

I like to use a medical aromatherapy product called Aroma Aid as a compliment to my total treatment plan for Asthma. It contains lavender essential oil, which reduce histamine release that leads to swelling in the airways. It also has frankincense essential oil, which has a naturally occurring compound (leukotriene inhibitor) similar to medications like Singulair, without the side effects that those medications have. This decreases the cascade of inflammation. To deal with mucous and inflammation, Aroma Aid has peppermint essential oil.

DO NOT STOP ANY TREATMENT BEFORE CONSULTING WITH YOUR DOCTOR. IT IS IMPORTANT TO HAVE A PLAN TO DEAL WITH ASTHMA EMERGENCIES BEFORE STARTING TO DEAL WITH THE ROOT CAUSES OF ASTHMA. Here is a passage from my soon-to-be-published book, "Natural Cures for your child's cold and flu":

Asthma has become a national epidemic in the United States. There are many powerful medications to treat the symptoms of asthma and they can be life saving and give good relief of the discomforts of asthma. If you are interested in trying to reduce the number of asthma attacks your child suffers from go Natural treatments, below. They usually take a few months to reach their peak effects, so, continue with the treatment plan your doctor has worked out with you.

A treatment plan is more than a prescription for medication. It should include a clear, step-by-step treatment plan which includes “peak flows” for kids who are old enough to check how deep a breath they can take. For example, It would say: “If Miguel’s peak flow is less than 200, start giving him albuterol every 4 hours. If his peak flow is less than 180, start steroids and give the albuterol every 3 hours. If his peak flow is less than 150, please call my office, and go to an urgent care center or emergency department immediately.

Ultimately, it's important that the causes of your child's asthma are addressed, not just his or her symptoms. Children who suffer from asthma can have too much inflammation, too much mucous, or tight airways, or, a combination of all three factors. These factors themselves, arise from an imbalance in natural steroids, of a diet high in unhealthy foods, stress, a deficiency in key nutrients, like selenium, magnesium or vitamin C can play a role too.

To ensure that your child gets the best care possible, a pediatrician with experience in integrative medicine, or, a naturopath experienced in the care of children should be consulted to address diet, lifestyle, stress and other issues related to your child's health.

Lecture Update: First Aid with Aromatherapy

2008-11-22T09:30:00.000-08:00

It's my passion to educate people on the value and joys of medical aromatherapy. To that end, it's been a busy week, so you'll excuse my delay in posting a blog.

I lectured at PANGEA, 2008 in New York City. I participated in a panel discussion on natural first aid treatments for the family. It was a fantastic panel and I was honored to sit with them. There was Aviva Jill Rohm, an herbalist and midwife of over 20 years experience, now in her final year of medical school at Yale University School of Medicine. She spoke about herbal approaches to first aid. There was Donielle Wilson, a superb naturopath and homeopathy. She spoke about homeoapthy for first aid. There was David Riley, a medical doctor, very fine homeopath and pioneer in integrative medicine (and yoga instructor!). He was the moderator and added some gems about homeopathy...And there was me. I spoke about aromatherapy and first aid.

As life tends to have that literary, ironic hue to it times, my son needed some first aid the night I was preparing for my talk. He got a black eye. It was only 15 minutes after his face was hit with the lid of a garbage can with its own agenda it his eye was swollen and bruised.

I quickly made a cold compress using hydrolats (floral waters). Hydrolats are the water-extract of plants that come from making essential oils ( you could say that essential oils are the oil-based extract left from making hydrolats). Hydrolats are the "other aromatherapy." Rose water is the best known hydrolat.

I took a sturdy paper towel and liberally soaked it with helichrysum and pine hydrolats. I put it on his face and put a bag of ice over his eye. After 20 minutes we took it off and looked at his face. He was so upset! The bruise had completely subsided and the swelling was greatly improved. He said, "Noooooo! I wanted a black eye on Monday to show my friends. Dad, now I won't look like I got hurt!" After the initial compress, we started arnica homeopathic and continued the helichrysum and pine internally--1 tablespoon combined with 4 oz of water twice per day. When I returned from New York 4 days later there was not even a trace of bruising or swelling.

This story is a great example of how medical aromatherapy is an important part but not the ONLY treatment modality to be used. It's just that it's very convenient and easy to easy and incredibly effective, and, with acute injury, it works faster than any other treatment I know.

Medical Quality Essential Oils

2008-11-12T17:58:00.000-08:00

Medical aromatherapy is the science of using essential oils for health and healing. Medical aromatherapy has a 5000 year old history going back to the ancient Egyptians. Internal usage of essential oils is a safe and effective means of curing many illnesses and dysfunctions in the body, in children and adults if a safe concentration (1-10%) of the right essential oils is used. But most importantly, the right quality of essential oil must be used--medical quality.

Listen to a short, 3 minute discussion of medical quality essential oils here:

It's really important to know the quality of your essential oils because many companies that use essential oils in their products, including many reputable companies, do not know how to tell a quality essential oil from an adulterated one. You can, though with a sensitive nose.

When you smell an essential oil or a shampoo, soap, etc. that claims to have "pure" essential oils, pay attention to the feeling around your jaw and up the side of your head. If your jaw tightens up, or you feel a slight headache, or like there is a vice around your head, that essential oils has been adulterated--cut with a synthetic version of one of the naturally occurring compounds in that oil to "boost" the scent.

The most common oils they do this too are:

Lavender
Jasmine
Neroli
Citrus oils (Orange, Grapefruit, Lemon, Lime, Tangerine, Bergamot, etc.)
Clove

Even more concerning than these cut oils are fragrance oils, sometimes listed:

fragrance
parfum
fragrance oil.

Often times, they contain BPA (bis-phenol A) an endocrine disruptor that can cause damage to the human body in serious ways. Infants and children are the most susceptible to this because they have more surface area of skin relative to their weight. In fact, a recent study in the journal Pediatrics found that when infants, children and adults used lotions and shampoo containing BPA as "fragrance" it was absorbed through their skin, into the blood--just from a few minutes of exposure.

Now, I know that you know that the big guys use this stuff shamelessly in their "kids" lines, but I'm very disappointed to see that many of the "eco" and "green" companies fall trap to the Medusa of fragrance oils--even after they spent money using cheap essential oils.

Caveat emptor. Read your labels carefully and be well.

PS: BPA is in baby bottles, water bottles and lots of other products. Please look for BPA free products whenever possible.

Free at last: a short story about heart transplantation

2008-11-11T13:46:00.000-08:00

I am posting this story about a patient I took care of while I was at Stanford University, where heart transplantation was first performed in humans. I am posting this as a follow up to my previous posting about Hannah Jones, the 13 year old girl in England who turned down a heart transplant due to a failing heart from the side effects of chemotherapy (Major minor: children's right to chose).

Free at last

Snip. She cut another paisley triangle, neatly stacking it next to the calico squares. “It keeps me busy,” she explained as I walked in to glance at the monitor. “I’m making a quilt for my first grandchild born just last week. I haven’t seen him yet.” She looked at her son, up at the monitor, then at me. It was almost midnight and I had come in to check on Luke before midnight rounds. His blood pressure was still too low but hadn’t changed in the last few hours. Not better, not worse; stably unstable. This oxymoron made sense in my world. It just did.

The last of eight children, he was the baby, the tall, pale one who always stood next to his mother in family pictures. He needed a heart and double lung transplant to survive. They had come from a small town in Nebraska to free him from a life of illness. When he was transplanted, Luke’s mother was ecstatic. But her joy lay in the sadness of others—she knew what had to happen for her son to have received a “donated” heart—and that troubled her. She saw two teenagers who had received hearts around the same time as Luke leave the ICU after a few days while her son languished here for weeks. Her sadness lay in the joy of others and that troubled her too—but to that she’d never admit.

It had been a rocky course from the beginning for Luke. His kidneys shut down from low blood pressure and infections. He was hooked up to a dialysis machine on his second day back from the operation. He was extubated, re-intubated, re-extubated, and intubated over and over again with a breathing tube because he was not even strong enough to breathe on his own and have his heart pump at the same time. Then he became infected again with God-knows-what. It wasn’t responding to any class of antibiotic we had on hand.

“We want everything done. But we don’t want him to suffer.” His mother would say to me. At this point, they were mutually exclusive requests, but that made sense in her world. It just did.

She and her husband came to learn our lingo and could infer a lot from the monitors and my face without us needing to utter words. They learned the semiotics of a raised eyebrow and stroked beard with and without cocked head. A glance at the vitals flow sheet with a “humph” was the most intolerable and I found a brief commentary to be de rigueur to put them at ease.

With each successive week, we spoke less and less about monitors and medications. Instead, at their request, we started talking basic physiology. I found myself explaining nine years of medical education in 15 minute sermons using metaphors of pipes, pumps and flowers. Then, our conversations became personal. I was seeing them more than my own wife and children and they hadn’t seen their other seven children or parishioners in weeks. We were both working shifts in order to take care of Luke. They alternated six hours on, six hours off at the bedside. As for myself, I was doing thirty hours on, eighteen hours off.

Setting her scissors down, she began to tell me how difficult it had been to raise eight children and be a minister’s wife. It was a life of sacrifice and she was content to live it only because she saw it as God’s will. It was a life lived in denial of comfort or privacy. She could never call her husband her own because he was wedded to his parish too. I laughed and told her that a physician’s wife had it no better.

The whirring of the dialysis machine filled a momentary silence; then she continued.

“I miss my home so badly, doctor. I miss having just one moment of privacy. Once, last week, I just wanted to go somewhere and cry. All the sleep rooms were occupied, someone was in the bathroom, and the family lounge was full of people. My husband came up to me and put a blanket over our heads and said, ‘Here’s our private space.’ And I cried until I couldn’t cry any more.”

Our conversation drifted to religion and she began complaining about those “liberal Christians”. I wondered if she knew or cared that I was Muslim. It didn’t matter to me either way. She was a mother. I was a father. That was commonalty enough for me. Birth has no creed, illness has no dogma, and sorrow is the universal paean of death.

She gathered up the strips of clothe and turned to me like a school girl at penance. “Doctor, I feel that Luke is suffering. I feel that he’s trapped in there. We thought that this transplant would free him from a life of constantly being ill.” I found myself playing minister and counseled her to be patient, saying “It will, it will.”

The next morning, considering Luke’s condition and his parent’s concern for his suffering, the decision was made to de-escalate care, a euphemism for “pulling the plug”. Curtains drawn, the door was closed and the cacophony of the ICU gave way to a heavy silence. One by one the machines were turned off until the whirs and beeps were replaced by whimpers and sighs. The breathing tube was removed. The pressure medicines stopped. Heavily sedated, Luke lay in a state between two states. Like snow drifting in a waning December wind, he laid somewhere between heaven and earth. After 18 years of suffering, 2 weeks of waiting, 3 weeks of struggle and 4 minutes of peace, it was over.

Bereft of clerical counsel, I hugged the reverend, letting the tears fall from his face unto my shoulder. Consoling his mother I said, “The suffering’s over. He’s free. Free at last.”

A major minor: children's right to choose their medical fate

2008-11-11T12:59:00.000-08:00

The Associated Press reported today that a 13 year old British girl, Hannah Jones, was granted the right to refuse a heart transplant. (Watch an interview with her here) She was diagnosed with AML, a form of leukemia when she was 4 year old. The chemotherapy she received has a known side effect of causing cardiomyopathy--a weakness of the heart muscle--which she did in fact develop. The heart was declining in function to the point that her medical team recommended a heart transplant.

For a 70 year old with a failing heart, a heart transplant that extends their quantity and quality of life for 3 years or 5 years can be a significant and worthwhile intervention. But what about in children? Children outlive their heart transplants and have to be retransplanted over and over again if they don't die of cancer from the immunosuppressive drugs, or, from arrythmias or infections. (I've seen all of this happen to these sweet children). Of course, many leave in a few days from the hospital and live 10 worry free years before they experience the least bit of trouble, and the amazing dedication of the transplant surgeons, nurses, immunologists and everyone else must be recognized.

Working in the intensive care unit with these patients, the decision can be agonizing. Sometimes, the children don't survive the first week or two after the operation and they die in the hospital, often times alone, or, away from most of their friends and family. You can read a short story I wrote about such a patient called "Free at least" in the next blog. Make sure you have a hanki ready.

The case of Ms. Hannah Jones went to court because one physician insisted that she have the transplant despite the family's careful and thoughtful consultation with their medical team and Hannah's clear articulation of her reasons against the operation.

When we speak about the welfare of the child we need to consider not only their physical welfare, but their emotional, spiritual and family welfare too. In my experience, children with life-long illnesses, like cystic fibrosis, cancer, and congenital heart disease, are wise beyond their years in understanding the precarious nature of life and death and the difference between prolonging life and prolonging death.

In these situations, where the child has a terminal or life long illness, their life is not imminently at risk, they are able to understand the consequences of their decision, and it is not being made at the request of the parents or due to financial hardships, the child's request to not continue medical treatment in light of other aspects of their well-being should be respected.

These are not easy decisions, and tears stream my face as I think of the families I worked over the years whose children have made those difficult decisions and the losses that the parents carry with them all their lives. Sometimes, when things don't go as suspected, the medical team tries to resuscitate the child and in some hospitals, parents are not allowed to be present (although this is rare in the pediatric intensive care unit at this point). Even if parents can watch, they are just watching their child die with no ability to hold their hand or say "I love you."

The only thing worse than a child dieing is a child dieing without dignity, without their parents holding them and loving them for one final embrace. That's why it's so important that children like Hannah be allowed to express their understanding of their illness and discuss it with her parents and doctors before a tragic downturn occurs.

You can read my articles on pediatric medical ethics from the Islamic perspective here and on death rituals when a children die here.

PANGEA lecture: Aromatherapy for First Aid

2008-11-10T17:36:00.000-08:00

I'll be speaking in New York City on November 15, 2008 at the Marriott Downtown in Manhattan. The topic is Natural treatments for First Aid: a panel discussion. I'll be speaking about the role of essential oils and medical aromatherapy. Come back and look for my article, which I'll post on my blog, and, here.

The venue is PANGEA, a pediatric integrative medicine conference for healthcare practitioners who take care of children, including medical doctors, naturopaths, chiropracters, homeopaths, herbalists and others.

Go here to learn about the conference, here to learn about the parent organization, the Integrative Pediatric Council. If you are a parent, you can read my friend and founder of the IPC, Dr. Larry Rosen's fantastic blog and find an integrative pediatrician for your child.

Kamyar Hedayat

Standardized Failure: A cautionary tale of standardized extracts

2008-11-04T10:46:00.001-08:00

CONCERN
The trade paper, Natural Product Insider, published a report today, November 4, 2008, about the widespread adulteration of Ginkgo biloba supplements (75% of tested supplements). The adulteration came in the form of "boosting" the count of certain "active" compounds using other plant extracts instead of using high quality Ginkgo leaves.

Three factors came together to form the perfect storm. 1) Ginkgo has a well-deserved reputation for improving circulation and cognitive function. With an aging population in Western countries, the demand for Ginkgo has only grown. 2) The German Commission E, a sort of FDA for natural products, set minimum standards active compounds in Ginkgo extracts. Setting standards for natural products forces a dynamic growth cycles to conform to static demands, and 3) Unscrupulous manufacturers of raw material get on the band wagon to provide supplement makers with "what they want" at any cost. No comment.

EXAMINATION
Let's consider factor number 2: Standardization. The attempt to "standardize" plant products to contain a minimum amount of a certain "active" ingredient comes from an attempt to consider plants as drugs in their own right, control their quality and protect consumers to ensure that they receive a quality product.

All these goals are noble and important. Unfortunately, they represent a form of medical colonialism. Like the old colonial powers of the past, who made native people dress and eat and walk and think like them before they would "accept" them as being civilized or respectable, the predominant academic, scientific, industrial and legal organs of medicine insist on fitting natural products into their reductionist concepts of what the definition of "drug" before they will accept natural healing products as legitimate: the attitude of "I will tolerate you when I can control you."

According to this school of thought, a drug is a single compound that works at a single receptor site. The more of that compound you have, the more of an effect you will have. Time and time again, drug and supplement manufacturers have been surprised at the results. In the case of natural supplements, St. John's Wort for depression is a good example. Researchers jumped to conclusions about hypericin being the active compound in St. John's wort and hundreds of studies were performed using standardized extracts vs. anti-depressants. The studies had mixed results as far as St. John's Wort's effectiveness for mild depression. Currently, scientists think that maybe other compounds are "more active" than hypericin. This is the problem with following the fallacy of active compounds in plants.

In the case of synthetic drugs, Vioxx and Celebrex causing heart attacks, or statins increasing the risk for suicide, or in my sub-speciality of critical care, of nitric oxide inhibitors increasing death from septic shock are all good examples. The spectacular disasters in the form of loss of human life have come about due to a failure to create a holistic understanding of how the body works, why it works the way that it does and what the meaning of illness is.

The aggressiveness and forcefulness of synthetic medications--critical care relies on them for its very existence--is impressive for the extremes of disease. I am not proposing that synthetic drugs are all bad, or natural products are all good. Everything has its place. And sometimes, they have a place together. Read my research on essential oils in the intensive care unit here.

On the spectrum of illness, most people's health issues can be framed as sub-optimal vs. optimal, not disease vs. no disease. So, this idea of what a drug is is good in theory, but it does not match how the body works, or how plants work for that matter. Most people, most the time, need gentle recallibration, not sudden suppression or increase in bodily functions.

The body is a complex, dynamic organism which is not static and passive, waiting for Bayer to invent aspirin. It's a self-regulating, self-healing organism with multiple, redundant pathways of compensation. Plants are polymodal multichemical products--in other words, they have many compounds in them that work in many different ways. Plants have an "intelligence" about them in that they interact with the body and there is a "dance" a back and forth of subtle increases and decreases, of feedback and promotion which occurs.

It is a fallacy to say that one compound is the active compound in a drug, because many, many compounds do different things in the body. What is amazing about plants--and this holds true for essential oils--is that they often contain compounds which do the opposite of the intended effect of the plant, but to a smaller degree. They contain base compounds which can become active compounds if the body needs it, or, be flushed out of the system unused. Plants come with their own antidotes to lower the incidence of side effects and over doses. It would be like every capsule of Tylenol coming with its antidote for overdose, N-acetyl cysteine (NAC). If only humans were as smart as the natural world.

CASE OF AROMATHERAPY AND ESSENTIAL OILS
When you examine the research on essential oils, many interesting observations come to light. For example, there are many instances where the whole essential oil, say, of Clove (Syzygium aromaticum), is more effective than its "active" component in head to head studies for pain control even though the whole oil has less of the "active" component. More importantly, a single essential oil, again, say, clove, not only killls the bacteria, but is anti-inflammatory, stimulates the immune system, and increases emunctory organ activity and detoxification at the same time.

Drs. Jean Claude Lapraz and Christian Duraffourd in the 1970's performed experiments with essential oils and infectious disease to examine the efficacy of various chemical components of essential oils. They performed "aromatograms"--evaluation of the killing power of essential oils in the lab against certain bacteria. What they found was that in this case, oils like Oregano, Thyme ct. thymol, Clove and Cinnamon were the most effective against a range of bacteria. This is to be expected because of the high amount of phenolic compounds in them.

However, much to their surprise, in clinical usage, "gentler" essential oils such as Thyme ct. linalool, lavender and geranium were more effective than the more "powerful" essential oils. The reason for this was that in the body, the essential oils not only directly killed bacteria, but stimulated the body's natural immunity in many different ways. In other words, it is the "terrain" of the body--how the body is functioning or malfunctioning--that determines how effective an appropriately chosen plant product is, not the specific amount a particular compound.

Others studies have shown that "gentler" essential oils used together have an amazing synergy with a significant antibacterial effect without the risk of the stronger compounds in essential oils like oregano.

CONCLUSION
Plant products--phytotherapy--involves complex, dynamic, multi-chemical substances that interact with an equally complex and dynamic living organism--your body. There is no need to standardize natural products to certain levels of this compound or that compound because the whole plant, in the whole body, will have the effect that it needs to have, which is greater than its effect on one cell receptor in the body. Standardizing natural supplements only increases the tendency towards fraud and deception to meet an artificial standard of "potency" and pigeon-holes plants into the category of synthetic pharmaceuticals.

To read more about essential oils and review their clinical effects, go here. for general articles, and here for scientific articles.

No one hangs themselves after smelling lavender: SSRI's and suicide

2008-11-03T11:45:00.000-08:00

CONCERN
The supreme court is currently considering a case against the drug manufacturer Wyeth regarding product liability. At risk is the a consumer's ability to sue the makers of faulty goods or dangerous medication. The pharmaceutical industry has been notorious for its after-market cover-ups of clinical data which revealed that their products were ineffective at best, and dangerous at worst. While this is not what the particular court case is about, it does bring up an important point about pharmaceutical products and just how safe they are.

Products such as Vioxx and Celebrex come to mind, the block buster arthritis medicines that turned out to increase the risk of heart attacks. In the case of anti-depressants, these medications are being used in children in increasing numbers, despite the risk of suicide and mania.

RESPONSE
Medical aromatherapy, the clinical use of plant essential oils, offers hope for people struggling with minor depression or occasional mood swings. Forget whatever comes to mind when you hear the term aromatherapy, such as candles and bath salts. Medical aromatherapy uses REAL essential oils, not synthetic fragrance oils, to cure body, mind and soul.

Essential oils work in three ways:

1) The smell (olfactory) nerve in the nose connects directly to the deep part of the brain that controls all hormones (hypothalamus) and emotions (limbic system), instantaneously affecting everything from stress levels, to memory, to attention.

2) By inhaling the essential oils, they go through the lungs like gas anesthesia and enter the blood stream

3) Through the skin they enter the blood stream and affect cellular activity

4) By ingesting them, they enter the blood stream and effect cellular activity

EVIDENCE
For example, a number of clinical trials from around the world have shown that essential oils, and tincture extracts of plants (containing essential oils) are effective for depression when compared against standard pharmaceutical treatments (double-blind placebo control trials) with almost no side effects: lavender essential oil massage, citrus essential oils, lavender tincture, saffron tincture.

PRACTICAL SOLUTION
I find that a combination of medical quality essential oils is the most effective way to keep your mood up and treat mild depression. Internal usage of essential oils can be safe and effective when used under the guidance of a trained medical aromatherapist, or when using prediluted essential oils. In general, 1 drop of pure essential oils per day is more than enough for mild depression and can work in a short as 3-4 days. As with any medical condition, discuss it with your health care practitioner first and do not stop any current treatments abruptly. Depression lasting more than 6 weeks, or affecting your ability to work is more serious and can be treated with essential oils under the close supervision of a medical aromatherapist.

MORE INFORMATION
95% of serotonin is made in the gut, and 90% is used there for digestion, which is why many people with depression have digestive troubles--over-eating or under-eating. When serotonin levels are low in the brain, the gut sends some up to the brain in platelets to help it out. Lavender is a very good anti-depressant which also reduces stress levels and stress hormones without being sedating. It helps increase serotonin levels for the brain by reducing the use of serotonin in the gut.

Holy Basil, also known as Tulsi, is also very good and works by focusing the mind while relaxing the body. Holy basil seems to increase nor epinephrine levels.

Grapefruit gives a feeling of brightness and motivation while also increasing dopamine and nor epinephrine levels.

Clary sage is a good support for depression because it supports the adrenal gland to deal with stress and balances the nerves and hormones to bring stress levels down a notch.

Sweet Basil is also effective, but its strong after taste can be difficult to tolerate unless using a capsule. Even then, it should be diluted with olive oil and taken between meals.

CONCLUSION
No one ever hung themselves after smelling or ingesting lavender, unlike SSRI anti-depressants. For mild depression in children and adults, medical quality essential oils, inhaled, massaged or ingested can be effective with little to no side effects.