Archive for the 'Ask the Doctor' Category

Diabetes

Question: I am a 67-year-old retired white male with a history of diabetes for about 4 years. I have high blood pressure (in the 160/95 range), diminishing eyesight and tests are now showing of protein in urine. I’m probably 35-40 pounds overweight, and have been experiencing increasing fatigue and lethargy. Can you talk about my situation?

Answer: Yours seems to be the classic presentation of type II, or non-insulin-dependent diabetes. The typical story is onset in the 50s to 60s in a person who is significantly overweight. Diabetes often goes along with high blood pressure, both as a direct consequence of being overweight and as a result of the fact that excess insulin (the hallmark of type II diabetes) itself causes high blood pressure because it stimulates the retention of fluid in the body. The protein in the urine is a sign that the diabetes is affecting your kidneys and that they are starting to leak protein. This is usually a harbinger of advanced diabetes and if not corrected will eventually lead to compromised kidney function and the misery of regular dialysis treatment. The eyesight problem is also a direct consequence of the diabetes because diabetes leads to a deterioration of the small blood vessels everywhere in the body. This includes the retina, where one begins to see exudates or leaking of blood from the blood vessels of the eye into the retina. Eventually, this process will lead to further impairment of the vision, if it is not reversed. I have also found that many of my patients with this kind of advancing diabetes also complain of not feeling well in a non-specific sort of way. Often the complaint is fatigue, lethargy, or just a decreased joy in life.

Let me share a case history that is similar to yours. As is usual in these cases, my patient was on a number of drugs to address his health concerns. He was on an oral hypoglycemic agent to lower his blood sugar, a beta-blocker to lower his blood pressure (which incidentally raises the blood sugar), and an ACE inhibitor to lower the blood pressure and protect the kidneys. He believed that these drugs were contributing to his feeling unwell.

On his initial visit to me, in spite of these drugs, his blood pressure was 165/95, and his HgbA1c (a measure of the average blood sugar over the past six weeks) was 8.1 (normal is 5.5-6.5). He had been instructed in the American Diabetes Association diet which is calorie-restricted and fat-restricted and also universally reviled by the patients. Clearly, in spite of the best that Western medicine had to offer, he was not doing well.

I suggested a strict 60-70 gram per day carbohydrate intake while implementing a nourishing traditional diet to guide his food choices and food preparation. He was to eat plentifully of all the good fats and non-starchy vegetables without overeating protein (e.g., eat egg yolks in preference to egg whites, fatty fish instead of lean fish, cream instead of milk, etc.). He was not to limit his total food intake, but rather to strictly limit his carbohydrate consumption to the amount listed above. The patient also began taking a number of medicines which are my staples for treating patients with his constellation of troubles stemming from diabetes, including diaplex, gymnema, bilberry, and birch leaf tea, along with cod liver oil to supply 20,000 IU vitamin A daily.

In six months of strictly following this program the results were nothing short of remarkable (though actually predictable). He had lost 35 pounds without increasing his exercise, he felt much more energetic, he loved his food again, and he was off all conventional medicines. When I saw him at 6 months his blood pressure was 135/80, and there was no protein in his urine. The HgbA1c was 6.7 (almost normal) and he could sense his eyesight improving. Confirmation came when he had his checkup with his eye doctor, who produced an after picture showing that his retinal hemorrhages had healed considerably over the previous six months. The doctor commented that he had never seen such a thing.

This story shows that there is hope with diabetes and that with sound thinking and sound intervention much of the ravages of this illness can be prevented and treated.


Irritable Bowel Syndrome

Question: I am a 40-year-old woman who has suffered from abdominal pain and alternating constipation and diarrhea for at least the past five years. I have tried many diet changes, including adding more fiber to my diet, all with very little relief. Recently I had a full evaluation with a gastroenterologist who, after many tests, concluded that I have Irritable Bowel Syndrome. He prescribed a high-fiber diet, a fiber supplement and, to my surprise, an antidepressant. I am wondering whether this is the correct approach for me and why he would prescribe an antidepressant. I would not be depressed if my darn bowels would behave!

Answer: In a recent issue of the New England Journal of Medicine there was a major review article on the causes and treatment of Irritable Bowel Syndrome (IBS). The authors point out that 15 percent of American adults suffer from symptoms consistent with IBS. Previously, I have discussed a related issue, the causes and treatment of constipation. To recap, to have normally functioning bowels means that you should have at least one bowel movement per day and that you should feel that you have completely emptied your bowels at least once per day. There should be no discomfort with the bowel movements nor should there be abdominal cramps, bloating or excessive gas. If these symptoms are present, it is a clear sign of intestinal dysfunction.

For years, modern gastroenterology has put its whole emphasis on the fiber theory of bowel function which, briefly stated, is the theory that those who consume lots of fiber will have healthy bowel function. Fiber, by the way, is a term that encompasses the family of complex carbohydrates and other substances that are present mainly in the cell walls of plants used as foods. The term includes cellulose, gums, mucilages, pectins and lignins. Humans cannot digest fiber, but these substances are said to contribute to the health of the digestive tract.

As I discussed in the article on constipation, this theory is inadequate to explain the complex dynamic of healthy bowel function. Rather than focusing entirely on fiber, we should look at the intestines as a complex ecosystem. Like all ecosystems, the intestines are populated by a wide variety of organisms all of which interact with each other and with their host. Each organism needs to be fed and its waste products eliminated, and each individual organism and the organisms as a whole have a profound connection with the health or disease of their host.

When the bowel system shifts towards disease, we see very characteristic changes in the population of organisms inside the bowel and in the characteristics of the bowel wall itself. Inside the bowel, the numbers of beneficial bacteria decline while the amount of undigested or partially digested food stuff increases. Pathogenic bacteria and fungi proliferate along with the toxic by-products that these abnormal microorganisms produce. Undesirable changes begin to occur in the lining of the bowel, and in the small intestine the fine hairs or villi become disturbed and deformed. The passageways through which absorption of food occurs become altered and we see abnormal neurological functioning within the intestinal walls. The combination of all these changes result in the disturbing symptoms so familiar to the many sufferers of IBS.

For years, holistic physicians have maintained that the health of this bowel ecosystem is the key to the health of the entire person. Nearly one-quarter of all traditional herbal medicines are directed at improving bowel health. Many traditions describe the intricate, complex decisions that the bowels must go through in “deciding” which foods to absorb and which to pass on. The recent discovery that the bowel wall contains all of the same neurological processes and receptors that are found in the brain has turned the orthodox medical world on its head, but this discovery comes as no surprise to holistic practitioners.

The discovery of sense receptors in the bowel is the reason that your gastroenterologist has prescribed an antidepressant. While I do not agree with the antidepressant, that fact that your doctor has suggested it is a sign that orthodox medicine has finally admitted that bowel health involves some of the most complex higher “reasoning” known to science. Put another way, managing your internal ecosystem and deciding what to absorb and what to discard is an example, albeit subconscious, of higher mental functioning. We can achieve good bowel health and overcome IBS only if we understand and work with this complexity.

The first step in treating IBS is to adopt a diet based on the cookbook Nourishing Traditions. Not only will this diet provide you with enough fiber to stimulate healthy bowel movements but, more importantly, because the diet supplies plenty of healthy fats and lacto-fermented foods, it is virtually the only dietary approach that feeds the healthy organisms populating your inner ecosystem.

A few points in the diet are worth highlighting. First, the good bacteria in our bowels thrive on fat and are poisoned by simple sugars. The Nourishing Traditions approach provides ample fat intake and strictly limits the refined carbohydrates and sugars that so undermine our health. Second, IBS patients need to consume lacto-fermented foods daily, including condiments like sauerkraut and beverages like kefir and kvass. Lactobacillus plantarum, found on vegetable leaves, is perhaps the most beneficial microorganism in our bowels and its numbers are greatly increased during the fermentation process.

Third, the Nourishing Traditions approach calls for the soaking of all grains for 12-24 hours and this practice is essential for anyone suffering from the symptoms of IBS. There is a growing body of scientific literature that supports this traditional practice because we have discovered that unfermented grains contain chemicals that irritate and inflame the bowel wall, and can even cause it to spasm. The practice of consuming large amounts of whole grains and rough bran, which has been the cornerstone of treatment for constipation, can actually lead to IBS.

Finally, broth made from bones should be used liberally by all those suffering from IBS. It seems as though the specific amino acids in soup broth act as a kind of tonic for the bowel wall, perhaps by providing compounds that function like antidepressants, much like the serotonin drugs which you were prescribed.

These four steps constitute the dietary approach for IBS. I also add an herbal intervention to help speed up the recovery process. It is called Okra-Pepsin, made by Standard Process. The preparation includes okra, which is a very mucilaginous plant, digestive enzymes and allantoin, a substance typically found in comfrey leaves. Among herbalists, okra is considered a demulcent in that it soothes and nourishes the intestinal wall. The digestive enzymes aid with the digestion of the food, thereby making it less irritating to the intestinal lining. And the allantoin stimulates the regeneration of the cells that form the inner lining of the intestinal wall.

In addition, I will often prescribe old fashioned castor oil compresses for one hour, two to three times per week, over the abdomen. This therapy relaxes the bowels and aids elimination.

Finally, I encourage my patients to embark on a regular exercise program that includes abdominal muscle strengthening exercises.

This program of therapy should have your bowel function normalized by six weeks and provide a huge boost to your overall health. . . and in your outlook on life.

Hypothyroidism

Question: I am a 51-year-old female who has been recently diagnosed with hypothyroidism. I have recently passed through menopause, and besides a few hot flashes, the hormonal changes do not cause any symptoms. I have gained about 15 pounds in the last few years, feel more tired than a few years ago, especially after exercise, and have occasional trouble with insomnia, constipation and dry skin. My doctor has suggested I go on synthroid for the rest of my life. Is there any natural approach to my problem?

Answer: As you may know, hypothyroidism is a very common problem for women of your age. It is estimated that 10 to 15 percent of women older than 50 have at least some degree of low thyroid function. Hypothyroidism is not a benign disorder, because besides contributing to weight gain and lethargy, hypothyroidism also is a risk factor for coronary artery disease and breast cancer. The reason for this elevated risk is that, rather than being an isolated underproduction of a hormone, hypothyroidism means that your metabolism is slowing down– it is a sign of metabolic aging. Simply adding extra synthetic thyroid medicine does not reverse this metabolic aging; therefore, it is not a thorough treatment. What is needed is stimulation of your metabolism, not only to reverse this premature aging but also to stimulate the thyroid to produce more of its own hormone.

The first step is to adopt a diet based on the principles in Nourishing Traditions and The Schwarzbein Principle. In particular pay attention to the advice in Nourishing Traditions on soaking grains, using only healthy fats and oils and avoiding goitrogens, such as soy foods and raw cabbage. Avoiding excess carbohydrates, as suggested in The Schwarzbein Principle, will also help wake up your metabolism.

In addition, a combination of medicines from Standard Process can be used to successfully treat hypothyroidism. This method is appropriate when the Thyroid Stimulating Hormone (TSH) is under 8.0 (normal is about 0.3 – 4.8). I use organic iodine (1 tablet, two times per day) to supply extra iodine to the thyroid gland. Along with this I use cataplex F tablets (1-2, three times per day). Cataplex F contains extracts of the 2 essential fatty acids (linolenic and linoleic acids) plus arachidonic acid and other polyunsaturated fatty acids that are often low in people with hypothyroidism. The effect of these fats is to help transport the blood calcium (and probably other blood minerals) into the tissues, where it can be used to fuel metabolic and enzymatic processes. The source of these fats are flax seed oil, beef liver lipids and testicular extract. The third medicine I use is Standard Process thyrotrophin, the thyroid protomorphogen. I recommend 1-2 tablets, three times per day. Protomorphogens are specially prepared extracts of the nuclear material of the source gland, in this case bovine thyroid gland. Protomorphogens bind with and neutralize antibodies that can destroy our tissues and organs. In the case of hypothyroidism, often Hashimoto’s thyroiditis is involved, which is an autoimmune disorder of the thyroid gland. Neutralizing these attacking antibodies gives the gland a chance to rebuild itself by sheltering it from the attacking antibodies.

With this treatment, most patients report increased energy and, within a few months, the loss of about ten pounds. In six months your TSH should be back under 5. The treatment should be continued for two years or more. This treatment is less effective when the TSH reading is over 8.0, in which case thyroid hormone may be required. Most doctors use the synthetic hormone Synthroid, but natural thyroid hormone is available. Such treatment must be carried out under the supervision of a licensed health care professional. (526)

This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation

Polymyalgia Rheumatica

Question: I have been suffering for a number of years from muscle pain and weakness. The doctors say it is polymyalgia rheumatica. Taking prednisone helps a lot, but I know this drug has side effects. Is there anything that can be done for this condition besides just taking steroids or pain killers?

Answer: Polymyalgia rheumatica is a disease that occurs almost exclusively in people over 55 years of age. It is characterized by profound stiffness in the muscles–as opposed to the joints, as in rheumatoid arthritis–and severe muscle pain. Often there is pain in the joints as well. The pain may be accompanied by weakness and fatigue. The onset can be abrupt or it can creep up slowly over a few weeks. Usually within those few weeks, the patient suffers immensely from this condition.

The diagnosis of polymyalgia rheumatica is made on the basis of the above symptoms plus a very elevated sedimentation rate. The sed rate of the blood is a measure of the total inflammation in the body, and with polymyalgia it often goes to very high levels.

The cause of polymyalgia is unknown in conventional medicine. It is treated with high doses of the anti-inflammatory, adrenal hormone prednisone. As our questioner points out, the relief with prednisone is very quick, often within hours, and patients are usually grateful for this seemingly miraculous treatment. The difficulty with prednisone, of course, is not getting on it, but getting off it. Taking prednisone for prolonged periods of time, including the time needed to treat polymyalgia, will suppress the adrenal glands so much that it makes it very difficult to come off these medications. I’ve seen it take two years or more to successfully wean a patient off prednisone. During that time the well-known side effects of prednisone come into play. These include diabetes, cataracts, stomach ulcer, and many more. Clearly, another approach to this illness is needed.

Whenever a steroid drug like prednisone makes a condition better, at least temporarily, we can conclude that a basic cause of the condition is poor adrenal function. Therefore, it is helpful to incorporate dietary changes that support the adrenal gland. First and foremost is the elimination foods that stress the adrenal glands, like sugar, caffeine and nicotine. Then we must provide the raw materials with which the adrenal gland makes its many hormones. These are chiefly cholesterol, vitamin C, vitamin B6 and vitamin A. Raw milk products provide vitamins C and B6, and cod liver oil and butter from grass-fed cows provide vitamin A. Third, we can support the adrenal glands with adaptogenic herbs. These contain certain saponins that the body can turn into cortisone-like substances–they are called “adaptogenic” because they help the body adapt to stress. The two I use in my practice are ginseng and licorice.

This type of adrenal support can help the condition of polymyalgia rheumatica, but rarely does it completely relieve this illness. They do help–the pain is lessened–but the much-needed remission does not occur.

Recently, I have used a cleansing program to treat polymyalgia with very positive results. Various fasting or cleansing approaches have long been used for autoimmune and rheumatological diseases (such as polymyalgia) and no one is certain why they help, but that they do help is quite clear. In fact, this month’s issue of Alternative Therapies reports on six patients with a variety of serious autoimmune and rheumatological diseases, all of whom went into remission after a 2-3 week water fast.

Interestingly, the patients stay in remission, often for many months after the fast is completed, as though some change occurs in their organ function which lasts even after the fast is completed. I have found the same thing in my practice.

The two programs I have used are not so much fasting programs as they are cleansing programs. The difference being that in cleansing programs, the person takes in enough nutrients, fats and proteins to enable him or her to carry out an almost normal life during the fast. One such program is the Milk Cure described in the Summer 2002 issue of Wise Traditions. Another is a cleansing program from Standard Process. Through the Milk Cure, or through the herbs and powder of the Standard Process program, the patient can remain nourished, but the limited food intake allows the digestive system to rest, and the body to turn its attention to addressing other imbalances.

The main component of the Standard Process cleansing program is a powder that contains a small amount of whey protein and a lot of herbal extracts, plus flax seed meal. The powder is mixed with olive oil and taken several times per day. A supplement containing liver and detoxifying herbs is also given as well as a green food extract or wheat grass. During the fast, the patient can also eat raw fruits and vegetables and drink water. After the three-week fast, I recommend a transition diet of bone broth, raw butter, cooked vegetables and fruit, soaked grains, and sprouted seeds and nuts. This fast should only be carried out under the supervision of a qualified practitioner who is familiar with Standard Process products.

I have had dramatic results using the Standard Process program. Used for polymyalgia, the pain and stiffness begin to recede and then disappear completely. I have also had excellent results with psoriasis and rheumatoid arthritis.

This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Fall 2002

Chronic Mucus

Question: I am a forty-year-old woman with laryngitis and a cough which produces yellow-green sputum. My current bout has now gone on for about 1 month, but it has been recurrent for a year. A year ago when I started a new job at a software company that had been the site of a chemical reprocessing factory. Soon after working there I had four different bouts of what was called “sinusitis.” Each time I had green mucus from my nose, pain in my sinus areas, and headaches. Each time I was given an antibiotic, which partially helped with the symptoms. Now the doctors are suggesting a month of antibiotics and prednisone and I am wondering whether there is another choice for me?

Answer: This is a situation I deal with frequently in my practice and one that suggests a very different understanding of infections from the current paradigm. According to the infectious theory of disease, you are the unfortunate victim of a tenacious bacterial infection that has created your distressing symptoms. Current medical theory considers the presence of green mucus as proof that your symptoms are caused by bacteria. The facts in your case, and in many others I have encountered, suggest a completely different explanation.

Consider this: your problem started soon after assuming a new job, one in which you were undoubtedly exposed to noxious chemicals that posed a significant threat to your well-being. The body, in response to any foreign body exposure, attempts to flush the toxic chemicals out. (Think of what happens when you get a splinter in your finger. Eventually you form pus to remove the splinter.) There is only one way to do this if the toxins cannot be thoroughly metabolized and excreted through the bowels and urine, and that is to produce mucus and “flush” the poisons out. The bacteria in the mucus, far from being the cause of the problem, act to “biodegrade” or metabolize these poisons. This is no different from the fact that bacteria or algae emerge in ponds or lakes that have been polluted, not as an “infection,” but to “biodegrade” these toxic elements. Seen in this light the bacteria are part of the therapy, not part of the problem. The mucus is the flushing out of poisons, not a “disease.” That there is accompanying pain and distress in no way changes the facts of the case.

That this explanation gives a more realistic picture of events is shown by what has happened in your case. Whenever you tried to eliminate the mucus and the bacteria without treating the cause, the symptoms came back. Eventually, as always happens, your body will either give up and “accept” the toxic chemicals. Instead of residing in the more superficial structures of the body, such as the sinuses, they will move into the deeper structures, such as the lungs. This is a “bad” progression of events.

It is interesting to me that the nature of the mucus, whether green, brown or clear, is not a reflection of a certain type of infection as we are taught, but actually tells us about the nature of that which we are flushing out. If it is toxic chemicals, as in your case, the mucus is “nasty” or green. If your body is flushing out more harmless stuff like pollen or cat hair, then the mucus is clear.

The solution to your problem is to help your body flush out the mucus–only this will restore you to health. To do this, you must stop exposing yourself to these chemicals. At the same time, you must give your body the nutrients it needs to detoxify. All the elements of a nutrient-dense diet have a part to play, but none is more important than vitamin A. Toxins produce undesirable effects because they disrupt vitamin A pathways. This means taking cod liver oil on a regular basis, eating liver once a week and consuming plenty of butter, whole milk products and eggs from pastured animals. Gelatin-rich bone broths support the liver and help it detoxify. These foods can even provide protection in the event that you are unable to change your job.

Adequate protein and fat are also essential. The body actually can get rid of toxins much more easily when the diet is rich in whole animal foods.

An herb that works very well to heal “green mucus disease” is goldenseal. I recommend goldenseal tablets from Mediherb, one tablet 2 times per day for one month.

This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Summer 2003

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