Back Pain Loss And Healthy Living Advice, By Dr. Joel Rosen

May, 2011

Sleep Disorders

By Dr. Joel Rosen

Poor sleep has been linked to a number of health conditions including mood disorders, fibromyalgia, obesity, chronic fatigue, headaches, increased pain, and reduced mental acuity. Between 50 million and 70 million Americans struggle with chronic sleep disorders, which cost the nation hundreds of billions of dollars every year in medical expenses, lost productivity, accidents, and other costs. There are more than 70 different sleep disorders that are generally classified into one of three categories; lack of sleep (insomnia), disturbed sleep (obstructive sleep apnea), and excessive sleep (narcolepsy).

The amount of sleep that a person needs to function normally depends on several factors (e.g., age). Infants sleep most of the day (about 16 hours); teenagers usually need about 9 hours a day; and adults need an average of 7 to 8 hours a day. Although elderly adults require about as much sleep as young adults, they usually sleep for shorter periods and spend less time in deep stages of sleep. About 50% of adults over the age of 65 have some type of sleep disorder, although it is not clear whether this is a normal part of aging or a result of medications that older people commonly use.

Sleep Cycles
There are two types of sleep. The first type of sleep is known as rapid eye movement or REM. The second is non-REM sleep. Non-REM sleep is further divided into four stages. During the REM cycle the eyes, while still closed, rapidly move back and forth. This is where dreaming takes place. The deeper Non- REM stage of sleep is crucial for over-all well being. Stages 1 and 2 of Non-REM sleep while important in maintaining the correct sleep cycle, don’t provide the restorative powers as compared to stages 3 and 4.

The Non-REM sleep cycle begins soon after we start to fall asleep. The first two stages of non-REM have a faster brain wave pattern (as measured with electroencephalogram or EEG) and are considered the lighter stages of sleep. As the brain activity begins to slow down we enter into stages 3 and 4 of non-REM sleep. This usually occurs one and a half hours after falling a sleep. The non-REM cycle is then interrupted by ten minutes of REM sleep. REM sleep elicits a flurry of brain activity. These cycles occur 5 to 6 times a night. The time spent in REM continues to grow and may last up to an hour in the last cycle of sleep. We dream during the REM cycle. It’s our dream cycle.

Traditional Treatments
Sleep disorders are usually treated with one of the following medications listed below. Some of these medications can be a great help in promoting deep restorative.

Sleep Medications that don’t Promote Deep Restorative Sleep:

• Gabitril (tiagabine) and Neurontin (abapentin).
• Zanaflex (tizanidine).
• Xanax (alprazolam), Ativan (lorazepam), Valium (diazepam), Tranxene (clorazepate dipotassium), Serax (oxazepam), Librium (chlordiazepoxide), and Restoril (temazepam).
• Soma (carisprodol).
• Klonopin (clonazepam).
pills6

Sleep Medications that do Promote Restorative Sleep

• Ambien
• Elavil
• Flexeril
• Trazadone

These medications do promote deep restorative sleep. However, they have potential side effects including flu-like symptoms, muscle aches, anxiety, depression, fatigue, short term memory loss; and usually start to lose their effectiveness over time. No one has an Ambien deficiency.

Melatonin Therapy

Melatonin is the primary hormone of the pineal gland and acts to regulate the body’s circadian rhythm, especially the sleep/wake cycle. When administered in pharmacological doses (1-3mgs), melatonin acts as a powerful sleep regulating agent that controls the circadian rhythm. A low dose of melatonin has also been shown to be effective in treating insomnia and jet lag. In a recent study, volunteers were either given a .3 mg or a 1 mg dose of melatonin or a placebo. Both levels of melatonin were effective at decreasing the time needed to fall asleep. The same area of the brain that releases melatonin also regulates serotonin production. Serotonin helps to produce melatonin. If you are deficient in serotonin, you’ll also be deficient in melatonin (can’t sleep). If you’re low in serotonin I recommend you start taking 5HTP before beginning Melatonin Therapy. To find out if you are low in serotonin please take the brain function questionnaire.

Melatonin is affected by a persons exposure to light. Melatonin levels start to rise as the sun goes down and drop off as the sun comes up. The retina (eyes) are extremely sensitive to changes in light. An increase in light that strikes the retina triggers a decrease in melatonin production. Conversely, limited exposure to light increases melatonin production. This explains why some individuals suffer from Seasonal Affective Disorder.

For patients who are having trouble falling asleep (and serotonin levels are normal) I recommend they begin with taking 3mg of sublingual melatonin at bed time and increase up to 9mg, if needed. For those who fall asleep but wake during the night, I recommend starting with 3mg of sublingual melatonin and if needed adding 3mg of timed release melatonin.

What Can Decrease Melatonin Levels?

• exposure to bright lights at night
• exposure to electromagnetic fields
• NSAIDs (Celebrex, Vioxx, Mobic, Alleve, Bextra,etc.)
• SSRIs, yes the very same antidepressants that many take for FMS, including Prozac, Zoloft, Celexa, Paxil, and Lexapro.
• anxiety meds (benzodiazepines) like Klonopin, Ativan, Xanax, Restoril, etc.
• anti-hypertensive meds (beta-blockers, adrenergics, and calcium channel blockers) including, Inderal, Toprol, Tenormin, Lorpressor, etc.
• steroids
• over 3 mg. of vitamin B12 in a day.
• caffeine
• alcohol
• tobacco
• evening exercise (for up to three hours afterwards)
• depression

Foods High in Melatonin:

• oats
• sweet corn
• rice
• Japenese radish
• tomatoes
• barley
• bananas
Drugs That Raise Melatonin Levels:
• fluvoxamine (Luvox)
• desipramine (Norpramin)
• most MAOIs
• St. John’s wort (acts as an MAOI and may help raise melatonin levels)

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May, 2011

Osteoporosis

By Dr. Joel Rosen

Osteopenia, Osteoporosis, Osteonecrosis

It’s estimated that between 1 and 3 women, and 1 in 12 men over the age 50 worldwide, suffer from the bone weakening disease known as osteoporosis. Osteoporosis occurs when there is an imbalance between bone reabsorption (osteoclast cells) and bone formation (osteoblast cells). Bone is a living tissue that undergoes constant transformation. At any given moment there are from 1-10 million sites where small segments of old bone are being broken-down (reabsorbed) and new bone is being laid down to replace it. When more old bone is destroyed than new bone laid down, bone loss occurs.

A generation ago, osteoporosis was only diagnosed after an elderly patient had either developed a spinal hump or broken a bone due to a minor fall. Prior to 1974, surveys showed that 77 percent of Americans had never heard of osteoporosis. In 1992 in an effort to reduce the incidence of osteoporosis fractures, The World Health Organization (WHO) held an international conference. Aided by new bone testing technology experts at the conference, which was sponsored by two large drug companies and a drug-company foundation, were charged with determining the normal bone density mass. The researchers turned to an analysis of women in Rochester, Minnesota, which showed that 16 percent of post-menopausal women in that city would sustain a hip fracture in their lifetime. Looking at years of bone-density scores, the WHO found that 16 percent of post-menopause women had bone –density readings of -2.5 or worse. So, under the new definition, anyone with a spinal fracture or a -2.5 T-score (bone density score), or worse, had osteoporosis. The committee went further and decided that scores between -1 and -2.5 were the boundaries of a new condition called osteopenia, or low bone mass.

In a single conference, one disease, osteoporosis, had been expanded from an elderly person with a fracture to anyone with a -2.5 T score. And another condition, osteopenia, was created.

Critics for the criteria for the diagnosis of osteoporosis began to emerge almost immediately. One rationally minded expert disagreed with the idea that randomized numbers could determine who did and who didn’t have a disease. Dr. Steven Cummings one of the world’s leading osteoporosis experts declared, “What patients had were measurements, not disease.” This is analogous to the idea that everyone with elevated cholesterol has heart disease.

Many have continued to argue that the concept of peak bone mass has been oversimplified. Peak bone mass can vary as much as 100% in women of the same age from different cultures. And peak bone mass seems to have minimal affect on fracture risk: for instance, Asian women have a lower bone mass than Western women but a lower fracture rate. Differences in ethnicity, diet, exercise, onset of puberty, and lifestyle make peak bone mass a very individual characteristic, hard to quantify — and not a good measure of bone health.

Never the less, once considered a rare disease associated with old ladies with a “dowagers hump,” osteoporosis has now become an epidemic with “experts” warning that half of all post-menopausal women are at risk.

How did osteoporosis go from a rare but serious disease to an epidemic that strikes fear in every middle-aged woman in America? One word, Merck.

Pharmaceutical giant Merck shrewdly launched an aggressive campaign to educate the public and their doctors that osteoporosis and the new disease known as osteopenia were now treatable with their new drug, Fosamax. Merck promoted portable bone-measuring devices that doctors could use in their offices. When Merck started, there were 750 dual-energy x-ray absorptiometry (DXA or DEXA) bone-measuring devices in the United States. Four years later, there were over 10,000 machines, which tested over 3.5 million people a year! The goal wasn’t to sell the drug to the elderly who actually had osteoporosis but to make it a primary care drug for the 40 million post-menopausal women. With sales of bisphosphonates approaching 5 billion dollars a year, the propaganda for these drugs now rival another once overly hyped drug for osteoporosis prevention, Premarin. These drugs were the number one prescribed drug therapy in America in 2001. Of course the results of The Women’s Health Initiative in 2002, which showed that while estrogen did reduce bone loss, it also increased the risk of breast cancer, blood clots, heart attack, and stroke sort of put a damper on estrogen therapy, to say the least. That same year there was an initial 80 percent drop in hormone therapy drug sales.

Sales of Fosamax and other bisphosphonates (Actonel and Boniva) increased 32 percent after the WHI study came out. These drugs do increase bone mass. However, they are also associated with numerous side effects including upper gastrointestinal pain and erosion, esophagitis, ulcers, skin rash, diffuse bone pain, and osteonecrosis (bone death) of the jaw.

Previously, bisphosphonates had been used in laundry soaps, fertilizer, and anticorrosives for the textile and oil industries. A 1993 report discovered that a small percentage of bisphosphonates users experienced serious eye problems that could lead to blindness. Merck’s clinical trial showed that as many as 33 percent of the participants reported blurred vision. Even more troubling, another study quoted on April 4, 2006, by United Press International, found more than 2,400 patients who were taking the injected form of bisphosphonates had suffered bone damage to their jaws since 2001. In addition to the 2,400 patients who were taking the injected form, the study found 120 patients taking the oral form of the drug who had been stricken with such incapacitating bone, joint, or muscle pain that some became bedridden and others required walkers, crutches or wheelchairs. We’ve uncovered about 1,000 patients (with jaw necrosis) in the past six to nine months alone, so the magnitude of the problem is just starting to be recognized,” Kenneth Hargreaves, of the University of Texas, reported to the Los Angeles Times. And we need to consider that the FDA estimates that only 10 percent of adverse drug events are ever reported. Rats given high doses developed thyroid and adrenal tumors. Fosamax also causes deficiencies of calcium, magnesium and vitamin D, all essential for the bone-building process.

Another commonly prescribed osteoporosis drug, Evista, is a selective estrogen receptor modulator. It is promoted as a safe way to increase estrogen without any of the side effects of hormone replacement therapy. But, of course there are side effects, which include hot flashes, leg cramps, flu-like symptoms, blood clots (heart attack and stroke), and peripheral edema.

The osteoporosis propaganda campaign has caused women to believe that they must take a drug to prevent being bent over with spinal fractures or succumbing to a life threatening hip fracture. No doubt, the prospect of having a broken bone due to osteoporosis is quite frightening. However the average age of hip fractures for a woman is 79. The lifetime risk of hip fracture for a white American female age 50 or older is 17.5 percent. Over a lifetime the risk for a vertebral fracture for this same group is estimated at 15 percent. Certainly these percentages should make us pause and take note. However, leading bone expert, and author of Better Bones, Better Body, Susan E. Brown, PhD, states: “Osteoporosis by itself does not cause bone fractures. This is documented simply by the fact that half of the population with thin osteoporitic bones in fact never fracture.” It is important to know that over 90 percent of hip fractures occur from falls, not weak bones. Falls cause fractures, not weak and crumbling osteoporitic bones.

In a 1989 edition of The Journal of the American Medical Association it was reported that the use of anti-anxiety drugs known as benzodiazepines (Klonopin, Ativan, Valium, Xanax and other tranquilizers) increased the risk for hip fracture by 70 percent.

Bone does not fracture due to thinness alone. A 1995 edition of the New England Journal of Medicine reported that in 65-year-old women with no previous history of a hip fracture, a number of other factors were more significant than bone density in predicting fractures, such as tranquilizer and sleeping pill use, poor coordination, poor vision and depth perception, low blood pressure, and lack of muscle strength.

Dr. Mark Helfand, a member of the U.S. National Institute of Health osteoporosis consensus panel comments: “I think even people who agree that osteoporosis is a serious health problem can still say it is being hyped. It is hyped. Most of what you can do to prevent osteoporosis later in life has nothing to do with getting a test or taking a drug.”

Drug therapy may be appropriate for those with advanced bone loss, especially since 20 percent of those age seventy or older with hip fractures never recover. But before starting on potentially dangerous drug therapy at the first sign of bone loss, patients need to be educated on the role nutrition plays in ensuring optimal bone health. There are at least 18 key bone-building nutrients essential for optimal bone health. Vitamins D, E, C, B12, K, folic acid, and minerals including boron, calcium, magnesium, copper, and zinc are needed for proper bone production and restoration. All of these nutrients have been shown to reduce and in some cases restore optimal bone mass.

I think patients would be better served by using prevention and optimal nutrition instead of taking a bone-eating prescription.

This is part two of a two part series on osteoporosis. While I don’t agree with the propaganda associated with osteoporosis, especially that every perimenopause and postmenopausal woman needs to be taking bisphosphanates (Fosamax, Actonel, Boniva), osteoporosis is an all-too-common condition that can be life-threatening for many elderly Americans. However, the majority of osteoporosis cases could have been prevented. This disease is similar in nature to so many other “Western diseases,” all associated with poor nutrition and health-robbing lifestyles. Bone is a living tissue that is constantly being broken down and rebuilt. Bone health is dependent on routine weight-bearing exercise, healthy habits (no smoking, moderate alcohol, caffeine, and sugar consumption, etc.) and an intricate interplay of over a dozen nutrients.

Children raised on a diet of Fruit Loops, “Lunchables,” soft drinks, and “Happy Meals,” don’t get the essential nutrients needed for optimal health. Few 12 to 19 year-olds consume the recommended amounts of certain nutrients. Adolescent girls consume only 14% of the Recommended Dietary Allowance (RDA) for calcium, 31% of vitamin A, and only 18% of the RDA for magnesium. Adolescent boys aren’t much better. Children consuming a typical nutrient-deficient Western diet are setting the stage for the onset of osteoporosis.

Soft drinks now make up one third of an adolescent’s daily beverage intake. This depletes bone-building calcium. Ninth and tenth grade girls who drink sodas have three times the risk of bone fractures compared with those who don’t drink carbonated beverages.

Fifty-six percent of 8-year-olds down soft drinks daily, and a third of teenage boys consume three or more cans of soda a day. The average teenager is getting 20 teaspoons of sugar a day from soft drinks alone. Teenage boys get 44% of their 34 teaspoons of sugar a day from soft drinks. Teenage girls get 40% of their 24 teaspoons of sugar from soft drinks. The U.S. Department of Agriculture (USDA) recommends that people eating 2,200 calories a day not eat more than 12 teaspoons a day of refined sugar. Sugar consumption upsets the natural homeostasis of calcium and phosphorus in the blood. Normally, these minerals exist in a precise ratio of ten to four. The excess serum calcium, which comes from the bones and teeth, cannot be fully utilized because phosphorus levels are too low. Calcium is excreted in the urine or stored in abnormal deposits such as kidney stones and gallstones. High fructose corn syrup, which is the predominate sugar in soft drinks, inhibits copper metabolism. A deficiency in copper leads to bone fragility, as well as many other unwanted health conditions. Other research suggests that high fructose corn syrup, which has climbed from zero consumption in 1966 to 62.6 pounds per person in 2001, alters the magnesium balance in the body, which in turn accelerates bone loss. An optimal level of magnesium, which helps with calcium absorption, is essential for bone formation. Studies have found that magnesium deficiency is associated with osteoporosis and bone fragility. An adequate magnesium intake results in increased bone mineral density.

The latest government study shows a staggering 68% of Americans do not consume the recommended daily intake of magnesium. Even more frightening are data from this study showing that 19% of Americans do not consume even half of the government’s recommended daily intake of magnesium.

In contrast to the normal nutrient-depleted “Western Diet,” research shows that consumption of fruits and vegetables, especially dark green leafy vegetables, offer considerable protection from osteoporosis. These foods are a rich source of bone-building vitamins and minerals and include calcium, magnesium, boron, and vitamin K. Vitamin K helps facilitate the production of osteocalcin, the major non-collagan protein in bone. Osteocalcin keeps calcium molecules anchored within bone. Boron supplementation has been shown to reduce urinary calcium excretion by 44 percent. It’s also required to activate certain important bone building hormones like vitamin D and 17-beta-estradiol, the most active form of estrogen.

Of course, most kids won’t go near a green leafy vegetable. And adults aren’t much better. Less than 10 percent of Americans eat the minimum recommendation of two fruits and vegetables a day. And worse, only 51 percent eat at least one vegetable a day.

So unfortunately, most folks are setting themselves up for trouble.

Calcium intake is the cornerstone for osteoporosis prevention.

Several studies have shown that calcium can reduce bone loss and suppress bone turnover. Calcium supplementation alone doesn’t halt bone loss completely but does reduce calcium excretion by 30-50 percent. One study shows that postmenopausal women taking one gram of elemental calcium were four and half times less likely to fracture than those on placebo.

The absorption of calcium is dependant on stomach acid for ionization. Because gastric acid facilitates the absorption of insoluble ingested calcium, stomach acid reducing drugs including Tums, Zantac, Nexium, Pepcid, Prilosec, and Tagament increase the risk of bone loss.

The hypochlorhydria (low stomach acid) produced by these drugs leads to decreased calcium absorption, thereby increasing bone loss and fracture risk. Similarly, proton pump inhibiting drugs (PPIs), like Prevacid, increase the risk of hip fracture. Studies show the risk of hip fracture is directly related to the duration of PPI use, ranging from 22% for 1 year of use to 59% for 4 years of use, relative to nonuse.

You should know that corticosteroids, and most diuretics (Lasix, Dyazide, Maxzide, and others) also deplete calcium.

Until recently, hormone replacement therapy was considered the best way to prevent bone loss and osteoporosis. And true, several studies have shown that estrogen replacement therapy can reduce bone loss and reduce the risk of fracture. However, the benefits have to be weighed against recent evidence linking conventional estrogen replacement therapy to increased risk of breast cancer, stroke, heart attack, and blood clots.

Another, certainly safer, option is to use phytoestrogens. Phytoestrogens are estrogen-like compounds found in certain foods including fennel, celery, soy, nuts, whole grains, apples, and alfalfa. A semi-synthetic isoflavanoid, known as ipriflavone, is similar in structure to soy and has been approved for osteoporosis prevention in Japan, Hungary, and Italy. Studies show that ipriflavone, now available as a supplement in the U.S., increases bone density in individuals with osteoporosis.

Several studies show that progesterone stimulates proliferation of bone building osteoblast cells. But, like synthetic estrogen, progestins (synthetic progesterone) are associated with numerous potentially dangerous side effects.

A natural over-the-counter form of progesterone can be made from wild yams. Based on the pioneering work of John Lee, M.D., compounded progesterone cream has been safely used by thousands of women to reduce or prevent menopause symptoms – and to reverse osteoporosis.

Vitamin D, a hormone-like substance, is crucial for the absorption of calcium. The skin makes Vitamin D after exposure to sunlight or ultraviolet radiation, and vitamin D deficiency is widespread throughout the United States. In the winter, vitamin D levels often plummet. Less than 10% of adults 50 to 70 years old, and only about 2% of people over 70, were found to be getting the recommended amounts of vitamin D from food. Even when supplements were added into consideration, still only about 30% of people aged 50 to 70, and 10% of those over 70 were reaching the recommended vitamin D intake.

Individuals who wish to avoid osteoporosis would be wise eat more fruits and vegetables, maintain a consistent exercise program, avoid sodas, avoid health robbing habits (smoking, excess alcohol and sugar), and take a good optimal daily allowance multivitamin. Those females who want to reverse bone loss should take in addition to their multivitamin, extra calcium, magnesium, vitamin D, and one or more of ancillary treatments mentioned above (ipriflavone and natural progesterone).

But, we need to realize good health doesn’t come from a pill bottle, but from daily dietary choices made over a lifetime. I think I’ll have a green leafy salad with dinner tonight, how about you?

RECOMMENDED SUPPLEMENTS FOR OSTEO PROBLEMS

HIGH DOSE VITAMIN D

DYNACAL – An Extra strength natural calcium magnesium complex

BONE SUPPORT FORMULA – A great source of Calcium, Phosphorus, and Protein

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May, 2011

Irritable Bowel Syndrome

By Dr. Joel Rosen

Excuse Me, Can We Talk About Poop?

Not necessarily the best topic for a cocktail party, I agree. However, for over 40 million Americans who have been diagnosed with irritable bowel syndrome (IBS), bowel movements are an important topic. Some experts report that irritable bowel syndrome (IBS) affects approximately 10–20% of the general population. Irritable bowel syndrome is characterized by a group of symptoms in which abdominal pain or discomfort is associated with a change in bowel pattern, such as loose or more frequent bowel movements or diarrhea, and/or hard or less frequent bowel movements or constipation. Gender plays a clear role as more than 80 percent of IBS patients are women between 20 and 55 years old. The financial burden of IBS is high. In the United States IBS results in an estimated $8 billion in direct medical costs and $25 billion in indirect costs annually.
stomach ache

The criteria for diagnosing IBS is based on the newly modified Rome criteria (Rome II criteria) as the presence for at least 12 weeks (not necessarily consecutive) in the preceding 12 months of abdominal discomfort or pain that cannot be explained by a structural or biochemical abnormality and that has at least two of following three features: (1) pain is relieved with defecation, and its onset is associated (2) with a change in the frequency of bowel movements (diarrhea or constipation) or (3) with a change in the form of the stool (loose, watery, or pellet-like).
Some people with the disorder have constipation (IBS-C). Some have diarrhea (IBS-D). And some alternate back and forth between constipation and diarrhea (IBS-A). IBS symptoms result from what appears to be a disturbance in the interaction between the gut or intestines, the brain, and the autonomic nervous system that alters regulation of bowel motility (motor function) or sensory function.

Research has shown that the cause of IBS is related to neuroendocrine immune system dysfunction (brain and stomach hormones). This connection is largely mediated by the neurotransmitter serotonin. The brain and gut are connected through the neuroreceptors 5-hydroxytriptamine-3 (5-HT3) and 5-hydroxytriptamine-4 (5-HT4). These serotonin receptors regulate the perception of intestinal pain and the GI motility (contractions that move food through the intestinal tract). Therefore serotonin controls how fast or how slow food moves through the intestinal tract. In fact, there are more serotonin receptors in the intestinal tract than there are in the brain. Ninety percent of serotonin receptors are in the intestinal tract.

Research suggests that IBS patients have extra sensitive pain receptors in the gastrointestinal tract, which may be related to low levels of serotonin. Decreased levels of serotonin may help explain why people with IBS are likely to be anxious or depressed. Studies show that 54–94% of IBS patients meet the diagnostic criteria for depression, anxiety, or panic disorder.

Restoring optimal levels of serotonin has been the focus of traditional drug therapy. Zelnorm, a 5-HT4 receptor agonist, was once hailed as “the drug” for IBS-c (IBS with frequent constipation), has recently pulled from the market for its association with heart attacks and stroke. The percentage of patients taking Zelnorm that had serious and life-threatening side effects was 10 times higher than the percentage of patients taking a placebo.

Even before this drug was recalled due to cardiovascular risks, many experts warned that this drug was dangerous for it’s other potential side effects including severe liver impairment, severe kidney impairment, bowel obstruction, diarrhea, constipation, abdominal pain, headaches, abdominal adhesions, gallbladder disease, and back pain.

Lotrinex (Alosetron), a 5-HT3 agonist, is prescribed for IBS-d. Within 8 months of being on the market, reports of ischemic colitis (a life endangering situation in which the blood supply to the intestines is blocked) began to grow each day. Lotrinex was responsible for at least four deaths, probably many more. Many who took the drug reported severe abdominal pain from constipation. The drug was taken off the market. It is now back and available with strict prescribing guidelines. An editorial in The British Medical Journal suggests that as many as 2 million Americans will be eligible for the drug under the new guidelines. According to previous reported side effects, this would result in 2,000 cases of severe constipation, almost 6,000 cases of ischemic colitis, 11,000 surgical interventions, and at least 324 deaths.

Antispasmodics (Levsin, Levsinex, Bentyl, Donnatal, etc.) are routinely prescribed for the treatment of IBS symptoms. Potential side effects include bloating; blurred vision; clumsiness; constipation; decreased sweating; dizziness; drowsiness; dry mouth; excessive daytime drowsiness (“hangover effect”); feeling of a whirling motion; headache; light-headedness; nausea; nervousness; rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue agitation; confusion; diarrhea; difficulty focusing eyes; disorientation; exaggerated feeling of well-being; excitement; fainting; fast or irregular heartbeat; hallucinations; loss of coordination; loss of taste; memory loss; muscle pain; pounding in the chest; severe or persistent trouble sleeping; trouble urinating; unusual weakness; very slow breathing; vision changes; vomiting.
Why in the world would someone prescribe this crap? (Pun intended.) It is absurd to suggest that individuals with IBS have a drug deficiency. IBS is not a disease; it is a symptom of a compromised gastrointestinal system. Using potentially dangerous drugs to reduce symptoms, while ignoring natural and often more effective approaches, is typical of what is wrong with “cookbook” (symptom-focused) medicine.

Reversing IBS with nutritional therapyI find that IBS usually disappears rather quickly once my patient’s correct their poor eating habits (increase fiber, reduce simple sugars, caffeine and junk foods), uncover any hidden allergies when present, including gluten intolerance (Celiac disease), boost optimal stress coping chemicals (serotonin, magnesium, B-vitamins, etc.), restore bowel ecology (probiotics), and take digestive enzymes with their meals.

5HTPTo boost serotonin levels I recommend patients take, the amino acid responsible for making serotonin, known as 5-hydroxytryptophan (5HTP).
Patients should take 300-400mg a day with food.

Digestive enzymes
Most digestion and absorption takes place in the small intestine and is regulated by pancreatic enzymes (digestive) and bile. The pancreas aids in digestion by releasing proteolytic enzymes, which help break down proteins into amino acids. Natural digestive enzymes are found in raw fruits and vegetables. Processed foods are usually devoid of digestive enzymes. Over consumption of these processed foods can lead to digestive enzyme deficiencies. This may then lead to malabsorption and or intestinal permeability syndrome (bloating, gas, indigestion, diarrhea, constipation, and intestinal inflammation). To ensure proper digestion and absorption, I recommend taking pancreatic enzymes with each meal.

MagnesiumI always recommend people take a good optimal daily allowance multivitamin/mineral formula. Patients with IBS have depleted their stress coping chemicals and this not only leads to IBS but also prevents them from beating IBS. It is a vicious cycle that can only be broken by taking adequate amounts of essential vitamins and minerals. The mineral magnesium, which is involved in over 300 bodily processes, is particularly important for reversing the symptoms of IBS-c. Magnesium helps relax the smooth muscle of the colon (natural laxative) allowing normal bowel movements. While a diet high in nutritious fiber is important, magnesium is even more important. A magnesium deficiency not only causes constipation but can also lead to heart disease, mitral valve prolapse (MVP), depression, anxiety, chronic muscle pain, headaches, migraines, fatigue, and many other unwanted health conditions. Those with IBS-c may need up to 1,000mg of magnesium each day. While those with IBS-d, may need less than 500mg. I recommend patients begin with 500mg of magnesium a day.

Probiotics
The human intestines are inhabited by billions of beneficial bacteria. These bacteria, which are mostly located in the colon, aid in digestion by fermenting substances that were not digested in the small intestine and by breaking down any remaining nutrients. A healthy intestinal tract contains some 2-3 lb. of bacteria and other microorganisms, such as yeast, that normally don’t cause ay health problems. However, when the intestinal tract is repetitively exposed to toxic substances (antibiotics, steroids, NSAIDs, etc.), these microorganisms begin to proliferate and create an imbalance in the bowel flora. Harmful organisms like yeast and some normally dormant bacteria, begin to overtake the good bacteria. This is known as intestinal dysbiosis.
IBS and small-intestinal bacterial overgrowth may share similar symptoms. One study showed that 78% IBS participants had small-intestinal bacterial overgrowth. To aid in digestion and prevent intestinal dysbiosis, patients with IBS should take probiotics (Lactobacillus and Biidobacterium) on a daily basis.

This approach isn’t guaranteed to solve every case of IBS. However, in the majority of my patients, symptoms improve to such point that within a few weeks we can focus on more important topics, like “who is going to win American Idol?”

IBS Protocol
I’ve found that IBS symptoms usually disappear within two weeks of taking 300–400 mg. of 5HTP. I also urge you to take a digestive enzyme with each meal, and a good optimal daily allowance multivitamin/mineral formula with at least 500mg of magnesium. Once a person gets their serotonin levels up, IBS often goes away, never to return. This can be life-changing for many of my patients.

Questions

What if I’m taking 300mg of 5HTP, digestive enzymes, a good multivitamin and still have constipation?Magnesium is a natural muscle relaxant (relaxes the colon), so too much will cause loose bowel movements. My multivitamin/mineral formulas contain a minimum 500mg of magnesium chelate. This is usually enough to promote normal daily bowel movements. However, some individuals will need to increase their dose of magnesium in order to overcome problems with constipation. If you continue to have constipation, increase magnesium (use magnesium citrate or chelate) by 140–150 mg. daily (at dinner) until you begin to have normal daily bowel movements. Then stay on this extra magnesium. You find that after a few months of taking the supplements I recommend for FMS and CFS, you’ll be able to discontinue the extra magnesium.

What if I continue to have loose bowel movements?Low serotonin will cause loose bowel movements. Make sure you’re taking 300mg a day of 5HTP either at bedtime or with food I don’t reduce magnesium until the patient has been on 300 mg. of 5HTP for at least two weeks. If after two weeks of taking 300mg of 5HTP you continue to have daily loose bowel movements, then its time to explore the possibility that your taking to much magnesium. Magnesium is a natural muscle relaxant. It helps the bowels move, but if too much is taken, loose stools become a problem.

If you’re taking 300mg of 5HTP, digestive enzymes, and one of the multivitamin/mineral formulas and continue (or start) to have loose bowel movements then decrease the amount of magnesium you’re taking. To do this, simply cut your daily dose in half. If you’re taking one of the multivitamin formula packs, take one instead of two. If you’re taking 6 of the Basic Multivitamin/Mineral tablets a day reduce to 3 a day.

If the problem persists then start taking 3 probiotics a day on an empty stomach for 2-3 months. Please read more about probiotics below. I recommend you stay on one pack of CFS/Fibromyalgia Formula or an optimal daily dose multivitamin. The amino acids, vitamins, and especially the fish oil in the formula will help normalize your intestinal tract. Individuals with persistent IBS will need to treat their leaky gut. If you suspect you have a yeast overgrowth, you’ll need to treat this condition as well.

If you’d like to know more about our office or protocols please feel free to give us a call (M-F, 8-4 PM CST) Toll free 1-888-884-9577. Please visit our site www.treatingandbeating.com. For more information about Dr. Murphree please click here

Healthy Bowel Formula has helped hundreds of my patients eliminate their IBS, usually within a few days. I urge you to check out my new Healthy Bowel Formula.

Research shows that irritable bowel syndrome (IBS), colitis, spastic colon,or nervous stomach have a deficiency in essential nutrients needed to regulate normal bowel movements. Healthy Bowel Formula contains 150mg per packet of 5HTP (5-hydroxytrytophan) an amino acid responsible for manufacturing the neurotransmitter serotonin. Serotonin controls how fast or slow food move through the GI tract. Those with IBS have been shown to be low in serotonin. Magnesium is a natural muscle (colon) relaxant. Those who sufer with constipation and or IBS-A will usually find that by adding the right amount of magnesium, their symptoms greatly improve. The high dose digestive enzyme ensures that food stuff is properly broken down and absorbed. Digestive enzymes helps facilitate proper digestion and elimination.

There are 60 packets in each cannister. Each packet contains 5 capsules and one tablet

3 (50mg) 5HTP capsules for total of 150mg

1 coated high potency digestive enzyme tablet- Pancreatin 8X equivalent to 2400mg of pancreatin USP Lipase – 12,000 USP units Protease – 60,000 USP units Amylase – 60,000 USP units

2 magesium citrate capsules (150mg per capsule) providing total of 300mg of magnesium citrate

Cellulose, gelatin (capsule) and vegeatble stearate. Contains no yeast, sugar, gluten, wheat, soy, or artificial ingredients.

Dose is 1-2 packets a day with food.

Posted in Irritable Bowel Syndrome | 1 Comment

3 Comments

May, 2011

Intestinal Permeability

By Dr. Joel Rosen

Leaky Gut

Intestinal permeability occurs when the lining of the digestive tract becomes permeable (leaky) to toxins that cause chronic inflammation. Intestinal permeability allows toxins to leak out of the digestive tract and into the bloodstream. This triggers an autoimmune reaction that can create pain and inflammation in any of the body’s tissues. The use of nonsteroidal anti-inflammatory drugs, steroids, antibiotics, antihistamines, caffeine, alcohol, and other prescription and nonprescription drugs renders the intestinal mucosa permeable to toxins and undigested food particles.
intestines5

Intestinal permeability is associated with such illnesses as:

• Ankylosing spondylitis
• Rheumatoid arthritis
• Food allergies
• Crohn’s disease
• Eczema
• CFS
• IBS
• Cystic fibrosis
• Chronic hepatitis
• Autoimmune diseases

Studies show that most individuals with CFS are plagued with intestinal permeability. A treatment program for patients with CFS that reduced allergic foods and used nutritional supplements to increase liver detoxification pathways (phase I and phase II) yielded an 81.2% reduction in symptoms.

Testing and Treating Intestinal Permeability and Malabsorption
Intestinal permeability can be measured by using a special functional medicine test available from Great Smokies Laboratory. To order this test call 1-888-884-9577.

Intestinal Permeability Protocol
If you suspect you have malabsorption syndrome, intestinal permeability, or irritable bowel syndrome, take the following steps:

Take 3 probiotics a day on an empty stomach for 2 months.

• Start supplementing digestive enzymes.

• Treat and eliminate any parasite or yeast overgrowth. You should do this while you’re on the intestinal permeability elimination diet (see below).

• Immediately begin an elimination diet to pinpoint any food allergies. Pay particular attention to gluten, a protein found in most grains, because it can be very irritating to the intestinal lining.

• Make sure you’re taking fish oil, 1,000–2,000 mg. daily. The omega 3 fatty acids in fish oil help repair the intestinal tract. They also help reduce inflammation associated with leaky gut. One study showed that 2.7 grams daily put Crohn’s disease patients into remission.

The CFS/Fibromyalgia Formula contains 2,000mg of fish oil. If you’re taking this formula then there is no need to add additional fish oil supplements.

I place my patients on a special Leaky Gut formula.

I use a product especially developed for intestinal permeability known as Leaky Gut Formula. It has all the essential nutrients to help correct intestinal permeability.
Large amounts (6,000 mg.) of the amino acid glutamine, the primary fuel for intestinal cell function, are included to meet the high energy demands of the GI tract, liver, and immune system during periods of physiological stress. Glutamine also transports potentially toxic ammonia concentrations to the kidneys for excretion. Intestinal uptake of glutamine accounts for 40% of total body uptake. Chronic intestinal insults from Xenotoxins (NSAIDs, antibiotics, etc.) create a shortage of glutamine.

Acacia contributes soluble, non-bulking fiber that is readily fermentable into acetic, butyric, and propionic short-chain fatty acids that create a supportive environment for growth of beneficial Lactobacillus bacteria, assist water absorption, and support colonic cell function.

Nutraflora FOS supplies non-digestible fructooligosacharides to further encourage growth of beneficial microorganisms.

N-acetyl-D-glucosamine is used as a structural component of intestinal mucous secretions that protect intestinal tissues and help food pass through the GI tract.

Dosage: 6 capsules daily. Best taken between meals in divided doses. Can take along with probiotics.

The Intestinal Permeability Elimination Diet
If you suspect you have yeast overgrowth then I recommend you do the Elimination Diet at the same time you start the Yeast Overgrowth Diet. Please see the yeast diet in the chapter on yeast overgrowth. You should avoid all known and suspected food allergens. For two weeks, you should avoid all gluten-containing foods: wheat, barley, oats, millet, spelt, sourdough, and rye. This includes wheat flour, breads, taco shells, muffins, cereals, pastries, cakes, pizza, crackers, pasta, oatmeal, pretzels, and other flour based products. You should also avoid all dairy products, including milk, ice cream, cream, yogurt, and cheese. Butter is allowed. No sodas (Coke, Diet Coke, Pepsi, etc.). Reduce all caffeine consumption, including tea (green/herbal tea is allowed), coffee, chocolate, and cocoa. The less caffeine intake, the better. To help prevent withdrawal symptoms (headaches, mood disturbances, fatigue) slowly wean off caffeine. Start by eliminating one quarter of daily caffeine consumption.

For example: each serving of coffee, soda, diet soda, tea, and each chocolate bar equals one caffeine serving. If you consume four cups of coffee in the morning, three glasses of tea at lunch, and a diet Coke before dinner, you consume a total of eight servings of caffeine daily. You should begin by reducing your caffeine servings by one quarter (2 servings). This would still allow 6 servings a day. After 7 days, you should reduce your caffeine servings by another quarter (in this case, 1.5 servings). After another five days, you should reduce daily caffeine servings by half and then slowly discontinue all caffeine over a manageable period of time. It is not necessary for every patient to go off all caffeine; patients help themselves by reducing their intake to no more than one or two caffeine servings a day.

Reintroduction of Eliminated Food Groups
After one month start to reintroduce one item from the eliminated food group at a time. The day of the challenge, eat a few servings of the eliminated food group (Wheat: pasta, toast, crackers, bread, etc.) then wait three days and reintroduce another food group (Dairy: milk, cheese, ice cream, etc.) and again, eat a few servings. If after three days of challenging a food group, there’s no associated negative reaction (headaches, stomach pain, bloating, runny nose, congestion, muscle or joint pain, low moods, fatigue, heaviness, etc.) then start to slowly add these items back into the regular diet.

If you experience a negative reaction to any food within three days of challenging a specific group, you should discontinue that particular food group for another month and then repeat the process.

It’s best to stay on the elimination diet, probiotics and the Leaky Gut Formula for 1-2 months.

If you suspect you may have yeast overgrowth you should treat it during this time.

Posted in Intestinal Permeability | 3 Comments

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May, 2011

Do You Suffer With Hypothyroid?

By Dr. Joel Rosen

What exactly is hypothyroid?

It’s estimated that ONLY 1% of the population suffers from hypothyroidism. But, did you know that it is estimated by scientist, physicians, and researchers alike, that as many as 40% of the population suffers with hypothyroid?

The thyroid gland secretes thyroid hormone, and when not enough is produced, it is considered hypothyroid.

Since every cell in the body relies on having enough thyroid hormone, when there is not enough it, and the thyroid gland becomes dysfunctional, every cell in the body suffers.

That is why Hypothyroid disorders can cause so many problems.

Symptoms Associated with Hypothyroid

• fatigue (the most profound symptom)
• headache
• dry skin
• swelling
• weight gain
• cold hands and feet
• poor memory
• hair loss
• hoarseness
• nervousness
• depression
• joint and muscle pain
• burning or tingling sensations in the hands and/or feet (hypothyroid neuropathy)
• yellowing of skin from a build up of carotene (conversion of carotene to vitamin A is slowed by hypothyroidism)
• carpal tunnel syndrome
• problems with balance and equilibrium (unsteadiness or lack of coordination)
• constipation (from slowed metabolism)
• myxedema (nonpitting edema due to the deposition of mucin in the skin) around the ankles, below the eyes, and elsewhere
• obsevation of delayed Achilles tendon reflex test
• hypertension (high blood pressure)
• angina (chest pain)
• atherosclerosis (hardening of the arteries)
• hypercholesterolemia (high cholesterol)
• hyperhomocysteinenemia (a marker for heart disease)
• menstrual irregularities
• infertility
• PMS
• fibrocystic breast disease
• polycystic ovary syndrome
• reactive hypoglycemia
• psoariasis
• urticaria
• allergic rhinitis

A Short Course on Thyroid Hormones and Hypothyroid

The hypothalamus stimulates the pituitary gland (both are contained in the brain) to produce thyroid-stimulating hormone (TSH). TSH then stimulates the thyroid to produce and release thyroxine (T4). T4 is then converted into triiodthyronine (T3), which is vital for life and four times more active than T4. This conversion of T4 to T3 takes place in the cells. (T4 can also be converted into reverse T3, which is physiologically inactive.)

Euthyroid Syndrome
Euthyroid is a medical term for patients who have normal thyroid blood tests but have all the symptoms associated with hypothyroid:

fatigue,
low metabolism,
headache, etc.

Euthyroid patients often have a problem with T4 converting into active T3, even though blood tests show normal levels. Individuals might take synthetic thyroid hormones (like Synthroid, which contains T4 only), but since the T4 is not converting efficiently, they continue the symptoms of hypothyroid.

Many of my patients complain of hypothyroid or low thyroid symptoms. They relate that they, and sometimes their doctors, suspected a thyroid problem only to have their blood work return normal.

Most physicians, in this case, won’t recommend thyroid replacement therapy. Many don’t know about (or they choose to ignore) well-documented studies that show that low body temperature is indicative of hypothyroid in general, or euthyroid hypothyroidism.

Body Temperature, Metabolism, and Thyroid Hormones
Blood tests for thyroid function measure the amount of TSH, T4, and T3 in the bloodstream. But thyroid hormones don’t operate within the bloodstream; the action takes place in the cells themselves. thermometerhres2What good is a blood test that only shows what is racing around the bloodstream one second out of a day? It’s inadequate for measuring true thyroid hormone levels.

Self-test for Hypothyroid

Dr. Broda Barnes was the first to show that a low basal body temperature was associated with hypothyroid. His first study was published in 1942 and appeared in JAMA.

This study tracked 1,000 college students and showed that monitoring body temperature for thyroid function was a valid if not superior approach to other thyroid tests.

The test for low thyroid function, according to Dr. Barnes’s protocol, starts first thing in the morning. While still in bed, shake down and place the thermometer (preferably mercury; digital thermometers are not as accurate) under your arm and leave it there for 10 minutes. Record your temperature in a daily log. Women who are still having menstrual cycles should take their temperature after the third day of their period.

Post menopausal women can take their temperature on any day. A reading below the normal 97.2˚ strongly suggests hypothyroid. A reading above 97.6˚ may indicate hyperthyroidism (overactive thyroid). Add one degree to axillary (under arm) temperatures.

You can also use a digital thermometer if needed. I recommend you take your underarm temperature as described above and take your temperature under the tongue two hours after waking up in the morning. Don’t eat or drink anything ten minutes before taking your oral temperature.

Treatment for Hypothyroid, The Barnes Method
Dr. Barnes recommends patients take a desiccated glandular (derived from pigs) prescription medication known as Armour Thyroid, which was used before synthetic medications such as Synthroid were introduced.

Armour Thyroid and other prescription thyroid glandulars (including Nuthroid and Westhroid), contain both T4 and T3. Synthroid and other synthetic thyroid medications contain T4 only. Since some individuals have a difficult time converting inactive T4 to active T3, these medications may not work at the cellular level. Individuals may take T4 medications for years and never notice much improvement.

Wilson’s Syndrome
Wilson’s Syndrome was first described by E. Denis Wilson, MD. He was refining some of the pioneering clinical research first performed by Dr. Barnes.

Dr. Wilson showed that symptoms of low thyroid function or hypothyroid could be present with normal thyroid blood tests. The group of symptoms that he studied he called Wilson’s syndrome. These symptoms can include:

severe fatigue,
headache and migraine,
PMS,
easy weight gain,
fluid retention,
irritability,
anxiety,
panic attacks,
depression,
decreased memory and concentration,
hair loss, decreased sex drive,
unhealthy nails,
constipation,
irritable bowel syndrome,
dry skin,
dry hair,
cold and/or heat intolerance,
low self-esteem,
irregular periods,
chronic or repeated infections,
and many other complaints.

Hypothyroid, a lot of symptoms for such a little hormone problem, huh? Perhaps the greatest obstacle Dr. Wilson has had to overcome in his attempts to be recognized by mainstream medicine is the vast symptoms associated with Wilson’s Syndrome. Yet all these symptoms can be seen in hypothyroid patients.

Causes of Hypothyroid Function

The symptoms of Hypothyroid tend to come on or become worse after a major stressful event. Childbirth, divorce, death of a loved one, job or family stress, chronic illness, surgery, trauma, excessive dieting, and other stressful events can all lead to hypothyroidism.

Under significant physical, mental, or emotional stress the body slows down the metabolism by decreasing the amount of raw material (T4) that is converted to the active thyroid hormone (T3). This is done to conserve energy. However, when the stress is over, the metabolism is supposed to speed up and return to normal.

This process can become derailed by a buildup of reverse T3 (rT3) hormone. Reverse T3 can build to such high levels that it begins to start using up the enzyme that converts T4 to T3. The body may try to correct this by releasing more TSH and T4 only to have the levels of rT3 go even higher.

A vicious cycle is created where T4 is never converted into active T3. Certain nationalities are more likely to develop Wilson’s syndrome: those whose ancestors survived famine, such as Irish, American Indian, Scotch, Welsh, and Russian. Interestingly, those patients who are part Irish and part American Indian are the most prone of all. Women are also more likely than men to develop Wilson’s syndrome. One study showed that all the symptoms associated with FMS could be eliminated while the patient was taking high-doses (120 mcg.) of T3.

Thyroid Testing
Normal TSH Parameters ChangeAccording to the American Association of Clinical Endocrinologists (AACE) doctors have typically been basing their diagnoses on the “normal” range for the TSH test. The typical normal levels at most laboratories have fallen in the 0.5 to 5.0 range. The new guidelines narrow the range for acceptable thyroid function; the AACE is now encouraging doctors to consider thyroid treatment for patients who test the target TSH level of 0.3 to 3.04, a far narrower range.

The AACE believes the new range will result in proper diagnosis for millions of Americans who suffer from a mild thyroid disorder but have gone untreated until now.

At a press conference, Hossein Gharib, MD, FACE, and president of AACE, said: “This means that there are more people with minor thyroid abnormalities than previously perceived.” The AACE estimates that the new guidelines actually double the number of people who have abnormal thyroid function, bringing the total to as many as 27 million, up from 13 million thought to have the condition under the old guidelines.

I continue to have patient’s who have TSH levels above 3.04 yet below 5.0, who are told that their thyroid test is normal and that they don’t need thyroid replacement therapy.

When possible I attempt to get my patient’s primary care or endocrinologist to prescribe Armour thyroid. This is often difficult at the least and many times I simply recommend my patient’s take my new thyroid replacement glandular supplement known as Thyroid Boost.

Over the Counter Glandular Thyroid Supplements
The prescription thyroid glandular medications, Armour, Westhroid, and Nuthroid are the preferred method of treating low thyroid disorder. Dr Wilson’s timed-release prescription T3 therapy is another option. However, many of my patients have trouble getting their medical doctor to write them a prescription for one of these medications. If you have trouble getting your doctor to prescribe one of these medications then you should consider using the over-the-counter thyroid supplement I recommend to my patients. Over-the-counter thyroid glandular supplements can also be used to correct low thyroid function. Since these raw thyroid tissue concentrates contain T3, they can be used as a first line of treatment for low to moderate hypothyroid, euthyroid disorder, or Wilson’s syndrome.

Individuals taking synthetic prescription thyroid medicines (Synthroid, Levathyriod, etc.) may find that adding an over the counter T3 glandular supplement helps them feel better. A study by the New England Journal of Medicine showed that patients who received a combination of T4 and T3 were mentally sharper, less depressed, and feeling better overall than a control group who received T4 only. Potent, high quality thyroid glandular supplements are not easy to find.

Thyroid Blend

Thyroid Blend provides iodine and raw adrenal concentrates which may help with thyroid function. Thyroid Blend contains raw thyroid concentrate including thyroid hormones (Thyroxin, T4 free). This product is designed to help support T4 and boost T3 thyroid hormones.

Raw glandular concentrates are from South American or New Zealand farm raised, grass fed cattle. All batches are analyzed for any contaminants. Free of BSE.

Dosing
I start my patients on one Thyroid Blend twice a day. It is best to take on an empty stomach (30 minutes before or 90 minutes after eating). I encourage my patients not to take the second dose any later than 3 p.m. I have patients monitor their basal or oral temperatures (preferably with mercury thermometer). After two weeks, if their temperature is not going up, I have them increase the dose to two Thyroid Boost’s in the morning and one in the afternoon.

If their temperature still doesn’t increase to at least 98.0, I consider adding an additional Thyroid Boost in the afternoon (total of 4 a day). If their temperature continues to run low and their symptoms haven’t improved, it may be time to look for other areas that need attention, perhaps low adrenal function.

Thyroid Support Formula II
Along with Thyroid Blend, I often recommend my patients add an additional thyroid boosting formula. This formula, known as Thyroid Support Formula II accelerates the results typically seen when supplementing with Thyroid Boost alone. Thyroid Boost, along with Thyroid Support Formula, quickly elevates cellular metabolism, energy, increased mental function, and helps optimize thyroid function. Fatigue, weight gain, tingling in the hands and feet, depression and other symptoms associated with low thyroid are often reversed when my patients begin taking a T3-4 hormone or Thyroid Boost in combination with Thyroid Support Formula II.

I always recommend that my patients continue to monitor their temperatures once beginning hormones or Thyroid Blend with Thyroid Support Formula II. Their metabolism may increase rather quickly. This can lead to rapid weight loss if they’re taking more than they need. By monitoring their temperatures my patients can adjust their dose of Thyroid Boost and Thyroid Support so that they remain at optimal metabolic levels.

Because nutrition is involved in every aspect of thyroxine (T4) production, utilization, and conversion to triiodthyronine (T3) I always recommend my patients with hypothyroid take a good optimal daily allowance multivitamin. The mineral zinc, along with iodine, vitamins A, B2, B3, B6 and C, as well as the amino acid tyrosine, are all needed for the production of thyroxine (T4) hormone. Selenium is needed to convert T4 to T3. A selenium deficiency can cause thyroid dysfunction. These two formulas are wonderful when used together. I have just put them together into a Thyroid Jumpstart Package and this is the best way to get started getting better today.

Thyroid Jumpstart Package

Thyroid Blend Contains:

Iodine (from kelp) – 900mcg
Kelp -180mg
Raw Thyroid concentrate (Thyroxin, T4 free) – 60mg
Raw Adrenal concentrate -30mg
Raw Spleen concentrate -10mg
Raw Pituitary concentrate – 10mg

Thyroid Support Formula II Contains:

A synergistic combination of iodine containing seaweeds, and herbs which contain phytothyroidogenic, phyto-thyroid-receptor agonists, and other herbs designed to promote optimal function of thyroid hormones by maintaining the health of thyroid hormone producing tissues and by supporting the healthy function of tissues that respond to thyroid hormones. More Here.

Click Here to Purchase the Thyroid Jumpstart Package

Questions

I’m taking Synthroid or other prescription thyroid medication. Should I take the Thyroid Boost as well?If you’re taking a prescription thyroid medication and your temperature is running 97.8 or below, then yes you should consider adding Thyroid Boost. I’d recommend taking one Thyroid Boost in the A.M. and one in the early afternoon. Monitor your temperatures as outlined below and if your temperature rises above 98.2 then discontinue or reduce the Thyroid Boost.

If my lab tests are normal does this mean I don’t need thyroid medication? Blood tests aren’t very accurate. You may have hypothyroid (low thyroid) even if your blood tests are normal. I would recommend you go by temperature testing.

My doctor has me on Synthroid or Levathyroid. Should I switch to Armour or Nuthroid, or Westhroid?If you’ve been taking one of the T4 only synthetic prescription drugs and haven’t noticed much difference in your symptoms, fatigue, weight gain, hair loss, tingling in your hands or feet, etc., then yes, you should consider asking your doctor to try you on one of these T3-T4 combination drugs, like Armour.

What if I’m taking one of these combination drugs (Armour, Westhroid, or Nuthroid) but still have a low body temperature and symptoms of low thyroid?I’d recommend you ask you doctor to consider increasing your prescription medication. If this is not an option or doesn’t help then I suggest you start taking Thyroid Boost along with the prescription medication.

Basal Temperature TestingThe test for low thyroid function, according to Dr. Barnes’s protocol, starts first thing in the morning.

• While still in bed, shake down and place the thermometer (preferably mercury; digital thermometers are not as accurate) under your arm and leave it there for 10 minutes. Woman should not take their temperature on the first three days of her period. Menopausal women can take her temperature on any day.

• A reading below the normal 97.2º strongly suggests hypothyroid. A reading above 98.0º may indicate hyperthyroidism (overactive thyroid).

• Repeat these steps for seven days.

Oral Temperature testingTake your temperature with a mercury or digital thermometer two hours after waking up in the morning. Don’t eat or drink anything for ten minutes before taking your temperature under your tongue. Record your temperatures for one week. If your under tongue temperature is averages below 98.2 then you’re suffering from a low thyroid. Resources For more detailed information about thyroid disorders please see my book, Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome.

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May, 2011

Hypoglycemia

By Dr. Joel Rosen

Low Blood Sugar Protocol

Hypoglycemia is a complex set of symptoms caused by faulty carbohydrate metabolism. It’s also synonymous with low blood sugar. Normally, the body maintains blood sugar levels within a narrow range through the coordinated effort of several glands and their hormones. If these hormones, especially glucagon (from glucose) and insulin (produced in the pancreas), are thrown out of balance, hypoglycemia or type-2 diabetes can result.

Hypoglycemia (in people not taking insulin) is usually the result of consuming too many simple carbohydrates (sugars). “Syndrome X” describes a cluster of abnormalities that owe their existence largely to a high intake of refined carbohydrates leading to the development of hypoglycemia, excessive insulin secretion, and glucose intolerance. This condition is followed by decreased insulin sensitivity, elevated cholesterol levels, obesity, high blood pressure, and type-2 diabetes.

Numerous studies have demonstrated that depressed individuals have faulty glucose/insulin regulatory mechanisms. Other studies have clearly shown the relationship between low blood sugar and decreased mental acuity. Hypoglycemia has also been implicated as a major trigger for migraine headaches.

Hypoglycemia Diet
The following foods are not recommended for anyone with hypoglycemia or hypoadrenia tendencies: table sugar, maltose, honey, sucrose (fruit sugar), bananas, raisins, dates, fruit juices, apricots, beets, white flour, white potatoes, white rice, cooked corn, corn flakes, and cereals.
It’s best to combine protein, fat, and carbohydrate in each snack or meal. Avoiding simple sugars and consuming a balanced diet help stabilize blood sugar levels. Eating healthy snacks throughout the day can also help keep your blood sugar levels stable. One simple snack that combines protein, fat, and carbohydrate is a handful of nuts (such as cashews, almonds, walnuts, or pecans) along with an apple, pear, or whole wheat crackers.

Supplements to Combat Hypoglycemia
If you’re following my advice above, taking the CFS/Fibromyalgia Formula, adrenal cortex, drinking 70 ounces of water, avoiding simple sugars, and not skipping meals, you’ll probably not need any of the following supplements.

• Chromium is a trace mineral that helps reduce glucose-induced insulin secretion. Chromium works with insulin to facilitate the uptake of glucose into the cells. Glucose levels remain elevated in the absence of chromium. A normal dose is 200 mcg. Taken 30 minutes before or after meals, two–three times daily.

• Vitamin B3 (niacin) helps regulate blood sugar levels and may help alleviate the symptoms of hypoglycemia. This should be in your multivitamin and mineral formula.

• Magnesium levels must be sufficient in order to avoid hypoglycemic reactions. This should be in your multivitamin and mineral formula.

• Zinc levels must be sufficient in order to avoid hypoglycemic reactions. This should be in your multivitamin and mineral formula.

• L-Glutamine, an amino acid, helps regulate blood sugar levels. I’ve found it to be very effective in eliminating sugar cravings and hypoglycemic episodes. A normal dose is 500–1,000 mg. once or twice daily on an empty stomach.

• Gymnema sylvester is a climbing plant found in Asia and Africa. It’s used in Ayruvedic medicine, an indigenous healing practice from India, for the treatment of type-2 diabetes. Scientific studies have shown this herb to be a valuable addition in preventing the symptoms of hypoglycemia. It’s also routinely used to reduce sugar cravings.

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May, 2011

Heart Disease

By Dr. Joel Rosen

The Medical Myths of Heart Disease

Cardiovascular disease kills almost one million Americans each year. This number accounts for 41 percent of all deaths in the United States. In fact, cardiovascular disease claims more lives than the next eight leading causes of death combined, including cancer, accidents, and AIDS. And, despite an aggressive campaign launched by the American Heart Association to counter the epidemic of heart disease, one person dies every 33 seconds. For nearly four decades, we have relied on medical myths to guide us in our attempts to prevent and treat cardiovascular disease. We have been told to reduce our cholesterol, saturated-fat intake, and to take lipid-lowering medications. Unfortunately, these recommendations have been shown to actually increase the risk of premature death, strokes, heart attacks, anxiety and depression, suicide, senile dementia, and congestive heart failure.

Medical Myth Number One
Most health organizations and the public at-large are sold on the idea that high cholesterol is the main cause of arteriosclerosis and heart disease. However, a growing body of research is dispelling this medical myth. The prestigious medical journal, The Lancet, reported in 1994 that most individuals with coronary artery disease have normal cholesterol levels! Forty percent of all heart attacks occur in individuals with normal cholesterol levels. The Journal of the American Medical Association reports that there is no evidence linking high cholesterol levels in women with heart disease. In fact, low cholesterol levels, especially after the age of forty-five, increase the risk of heart attack, stroke, depression, and early death. As reported in The Journal of Cardiology, “low cholesterol increases the risk of a heart attack.” Yes, you read this correctly. Low cholesterol increases the risk of a heart attack. To cite the medical experts from the famous Framingham study: For each 1 mg/dl drop of cholesterol, there was an 11 percent increase in coronary and total mortality (death from all sources).

Your body needs cholesterol. Cholesterol makes up eight percent of brain-matter. It is essential for proper brain function. The importance of cholesterol is far reaching. Cholesterol is the precursor to Vitamin D and other hormones that are needed for sustaining a healthy life. Cholesterol is one of the key substances at nerve synapses needed to transmit information. Cholesterol helps regulate brain chemicals known as neurotransmitters. Low cholesterol can cause depression, fatigue and neurological disorders (nerve pain, tingling, and numbness). Individuals with low cholesterol are three times more likely to suffer from depression as normal adults. The lower the cholesterol, the more severe the depression.

Medical Myth Number Two
The American Heart Association recommends you follow a low-fat diet. Individuals are encouraged to eat polyunsaturated fats (vegetable oils) and avoid saturated fats (animal fats). They also recommend eating 11 servings of grain a day.
This is a recipe for disaster. Excess grain consumption leads to insulin resistance and increases inflammatory chemicals, the real cause of heart disease. Research shows that there is evidence that saturated fats are bad for your health, but there is plenty of evidence that saturated fats actually help prevent heart disease and strokes.

Medical Myth Number Three
Cholesterol-lowering drugs are a safe and effective way to prevent heart attacks and strokes. Over the last twenty years, the pharmaceutical companies have promoted cholesterol-lowering statin drugs with such fervor that they’ve become household names: Lipitor, Crestor, Vytorin, Zocor, and others. Sixteen million Americans take Lipitor, the most popular statin drug. Statin sales in the U.S. alone are over $12.5 billion a year.

No doubt, the statins lower cholesterol levels and perhaps do lower the risk of dying from a heart attack–at least in patients who already have had one–but the size of the effect is unimpressive. For instance, in one of the experiments, the CARE trial, the odds of escaping death from a heart attack in five years for a patient with manifest heart disease was 94.3 percent, which improved to 95.4 percent with statin treatment. This difference of 1.1 percent is surely not worth all the hype these medications have received, especially since the potential side effects from these drugs may include congestive heart failure.

The acknowledged side effects of statins include muscle pain and weakness, nerve damage, and a potentially fatal muscle-wasting disorder called rhabdomyolysis. One statin, Baycol, has been withdrawn because it was linked to 31 deaths from rhabdomyolysis. Interference with production of Co-Q10 by statin drugs is the most likely explanation. The heart is a muscle and it cannot work when deprived of the essential nutrient, Co-Q10. A deficiency of CoQ10 can lead to nerve damage and congestive heart failure.

While heart attacks have slightly declined, CHF (congestive heart failure) has more than doubled since Lipitor and other statins were first prescribed in 1987.

Taking statins for one year raised the risk of nerve damage by about 15 percent. Researchers studying CoQ10 have estimated that as little as a 25 percent reduction in bodily CoQ10 will trigger various disease processes, including high blood pressure, coronary artery disease, cancer, immune dysfunction, and fatigue.

NOTICE: On this page you’ll find some product links going to my new store. You will need to use the password JROSEN to use the new online VIP store. Please write this down. You only have to do it once and it will remember you after that. Thanks!

Password – JROSEN

CHECK OUT THE NEW JUMPSTART PACKAGE FOR A HEALTHY HEART HERE

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May, 2011

Fibromyalgia

By Dr. Joel Rosen

“We understand your fibromyalgia.”

Ever hear those words before? Will if you happen to suffer with fibromylagia, I’m willing to bet that you probably haven’t heard those words very often.

IF you just so happen to be fortunate to hear “we understand your fibromyalgia” or, “we understand your chronic fatigue“, it’s amazingly powerful, not to mention rare.

Because you fibromyalgia is a real illness that’s hard to “prove,” loved ones may secretly convict you of hypochondria or laziness. You may be told “fibromyalgia is all in your head.” You may be urged to exercise or lose weight or take antidepressants.

Physicians can be even worse about fibromylagia. If they believe fibromyalgia exists at all. Some don’t think that fibromylagia exist—their first impulse is to combat the symptoms of fibromyalgia with prescription drugs.

Patients often end up on a medical merry-go-round, seeing doctor after doctor after doctor. They end up more confused and disoriented than ever, often concluding, “Maybe I am crazy, after all.”

But take heart. As I treating musculoskeletal rehabilitative conditions as a chiropractic physician, I know what you’re going through as a fibromyalgia patient. I see a good number of patients suffering with fibromyalgia and CFS.

Fibromyalgia Solutions:

We don’t offer one-size-fits-all solutions, because every case is different. We take an integrated approach to treatment that combines the best of traditional and alternative medicine. Our goal is to get to the root of the problem, to help the body’s innate healing ability return to normal.

Note: Scroll down to bottom of page to see links to information and past newsletters about Fibromyalgia and CFS

About Fibromyalgia Syndrome Fibromyalgia syndrome (FMS) is an illness characterized by diffuse muscle pain, poor sleep, and unrelenting fatigue. Individuals with fibromyalgia may also experience headaches, anxiety, depression, poor memory, numbness and tingling in the extremities, cold hands and feet, irritable bowel syndrome, lowered immune function, and chemical sensitivities. Over 10 million Americans suffer with fibromyalgia; ninety percent of them are women between 25 and 45 years old.

Diagnostic tests are currently unavailable to confirm fibromyalgia. The diagnosis is usually reached after ruling out other conditions including neurological, autoimmune, endocrine, musculoskeletal, immunological, and mental disorders.

Fibromyalgia patients have typically had the illness at least 7 years and have been seen by a dozen different doctors before they’re diagnosed with fibromyalgia.

In 1990 The American College of Rheumatology (ACR) first proposed the current criteria for defining fibromyalgia syndrome. The criteria include a history of widespread pain lasting more than 3 months and the presence of at least 11, out of a possible 18, tender points.

Fibromyalgia pain is considered to be widespread when it affects all four quadrants of the body; that is, you must have pain in both your right and left sides as well as above and below the waist to be diagnosed with fibromyalgia.

The American College of Rheumatology first proposed the current criteria for defining Fibromyalgia or FMS. The diagnosis requires that all three of the major criteria, and four or more of the minor criteria, be present:

Fibromyalgia Major Criteria:

1. Generalized aches or stiffness of at least three anatomical sites for at least three months 2. Six or more typical, reproducible tender points 3. Exclusion of other disorders that can cause similar symptoms

Fibromyalgia Minor Criteria:

1. Generalized fatigue 2. Chronic headache 3. Sleep disturbance 4. Neurological and psychological complaints 5. Numbing or tingling sensations 6. Irritable bowel syndrome 7. Variation of symptoms in relation to activity, stress, and weather changes 8. Depression

It’s reported that only 2% of the population meet all he criteria for fibromyalgia as defined by the American College of Rheumatology. This estimate is much too low. There are some problems with the ACR criteria.

The biggest being many individuals with Fibromyalgia meet some of the criteria but not all of it. Most of these individuals have other symptoms associated with FMS not explicitly outlined in the ACR criteria. They may have insomnia, irritable bowel, fatigue, mental confusion, and only 4 of the 18 trigger points. Or they may have insomnia, fatigue and 5 reproducible tender points.

Although the fibromyalgia minor criteria represent the most frequent and usual symptoms associated with FMS, it doesn’t account for all of the various conditions seen in FMS patients.

The following is a more detailed list of potential symptoms that fibromyalgia patients may experience:

Sleep disturbances: Sufferers may not feel refreshed, despite getting adequate amounts of sleep. They may also have difficulty falling asleep or staying asleep.
Stiffness: Body stiffness is present in most patients. Weather changes and remaining in one position for a long period of time contributes to the problem. Stiffness may also be present upon awakening.
Headaches and facial pain: Headaches may be caused by associated tenderness in the neck and shoulder area or soft tissue around the temporomandibular joint (TMJ).
Abdominal discomfort: Irritable bowel syndrome including such symptoms as digestive disturbances, abdominal pain and bloating, constipation, and diarrhea may be present. Irritable Bladder: An increase in urinary frequency and a greater urgency to urinate may be present.
Numbness or tingling: Known as parathesia, symptoms include a prickling or burning sensation in the extremities.
Chest Pain: Muscular pain at the point where the ribs meet the chest bone may occur.
Cognitive Disorders: The symptoms of cognitive disorders may vary from day to day. They can include “spaciness,” memory lapses, difficulty concentrating, word mix-ups when speaking or writing, and clumsiness.
Environmental Sensitivity: Sensitivities to light noise, odors, and weather are often present, as are allergic reactions to a variety of substances.
Disequilibrium: Difficulties in orientation may occur when standing, driving, or reading. Dizziness and balance problems may also be present.

What Causes Fibromyalgia? Research suggests fibromyalgia may be the result of:

• Trauma, especially whiplash injuries. • Hypothalamus-pituitary-adrenal axis (HPA) dysfunction. • Emotional/physical/mental stress. • Low thyroid function. • Low serotonin states. • Adrenal dysfunction. • Chronic viral, mycoplasma, and or bacterial infections. • Endocrine disorders. • Sleep disorders. The truth is we really don’t know for sure what causes fibromyalgia.

What We Do Know About Fibromyalgia

Fibromyalgia is now thought to arise from a miscommunication between the nerve impulses of the central nervous system. The neurons, which supply the brain, become more excitable, exaggerating the pain sensation. This over-amplification of pain is referred to as “central sensitization.”

Fibromyalgia patients have a reduction in their pain threshold (allodynia),brainblue an increased response to painful stimuli (hyperalgesia) and an increase in the duration of pain after nociceptor stimulation (persistent pain).

Individuals with fibromyalgia syndrome have low levels of serotonin, a 4-fold increase in nerve growth factor, and elevated levels of substance P. Nerve growth factor (NGF) is a member of a family of peptides known as the neurotrophins.

The exposure of nociceptive sensory neurons to NGF leads to up-regulation of substance P in sensory neurons. Substance P, the neuropeptide in spinal fluid, is a neurotransmitter that is released when axons are stimulated.

Increased levels of substance P increase the sensitivity of nerves to pain or heighten awareness of pain. Although it’s not fully understood, fibromyalgia patients have an imbalance of the hypothalamus-pituitary-adrenal (HPA) axis. This imbalance creates hormonal inconsistencies, which disrupt the body’s ability to maintain homeostasis.

Many of the most common fibromyalgia symptoms including widespread muscle pain, fatigue, poor sleep, gastrointestinal problems, and depression regularly occur in people with various neuroendocrine disorders, including those manifested by HPA dysfunction.

Researchers believe suppression of the HPA (quite likely from chronic stress), which results in lowering human growth hormone (HGH), dehydroepiandrosterone (DHEA), cortisol, and other hormones, is aggravated by the chronic pain and poor sleep associated with fibromyalgia. Hypothalamus-Pituitary-Adrenal Axis (HPA) Dysfunction

The main function of the hypothalamus is homeostasis, or maintaining the body’s status quo. The hypothalamus receives and transmits messages from the nervous system and hormonally through the circulatory system. Because of its broad sphere of influence, the hypothalamus could be considered the body’s master computer. The hypothalamus receives continuous input about the state of the body and must be able to initiate compensatory changes if anything drifts out of line.

The Hypothalamus regulates such bodily functions as:

1. Blood pressure – is often low in those with fibromyalgia. 2. Digestion – bloating, gas, indigestion, and reflux are common in FMS patients. 4. Circadian rhythms (sleep/wake cycle) – which is consistently disrupted in FMS. 6. Sex drive – loss of libido is a common complaint for FMS patients. 7. Body temperature – is often low in FMS patients. 8. Balance and coordination- FMS patients have balance and coordination problems. 9. Heart rate – mitral valve prolapse (MVP) and heart arrhythmias are a common finding in FMS patients. 10. Sweating – it’s not unusual for Fibromyalgia patients to experience excessive sweating. 11. Adrenal hormones – are consistently low in Fibromylaglia patients. 12. Thyroid hormones and metabolism-hypothyroid is a common finding in FMS patients.

Recent studies show that over 43% of FMS patients have low thyroid function. It’s estimated that those with Fibromyalgia are 10 to 250,000 times more likely to suffer from thyroid dysfunction.

A Vicious Cycle1. Chronic stress disrupts HPA homeostasis, leading to allodynia. 2. Chronic pain disrupts the circadian rhythm. 3. Dysfunction in the circadian rhythm results in poor sleep. 4. Poor sleep reduces growth hormone production, leading to poor repair of damaged muscle fibers, poor memory, fatigue, suppressed immune function, and more pain. 5. Increased pain further disrupts sleep and leads to depletion of stress coping chemicals including serotonin. 6. A reduction in serotonin causes an increase in the neurotransmitter, substance P. Substance P enhances pain receptors, creating even more pain. 7. Poor sleep and ongoing stress lead to fatigue, mood disorders, IBS and may cause thyroid dysfunction. 8. Chronic stress contributes to adrenal fatigue, decreased DHEA, and lowered resistance to stress. Decreased stress coping abilities then lead to lowered immune function. 9. Lowered blood volume from adrenal dysfunction (and resultant hypo-tension) leads to further fatigue.cellphonestresssm Stress and Fibromyalgia A survey by The Fibromyalgia Network reports that 62% of their respondents list physical or emotional stress as the initiating factor in their acquiring fibromyalgia.

I believe chronic stress is the underlying catalyst for the onset of HPA dysfunction and fibromyalgia. Several studies have demonstrated how chronic stress undermines the normal hypothalamic-pituitary-adrenal axis (HPA) function.

The Importance of a Good Night’s Sleep Studies have shown that individuals who were prevented from going into deep sleep for a period of a week develop the same symptoms associated with Fibromyalgia and CFS; diffuse pain, fatigue, depression, anxiety, irritability, stomach disturbances, and headaches.

Sleep deprivation markedly increases inflammatory cytokines (pain causing chemicals)—by a whopping 40%.

Therefore, restoring deep restorative sleep is one of the most important steps in beating fibromyalgia, if not the most important step of all. Serotonin Serotonin helps regulate sleep, digestion, pain, mood, and mental clarity. Serotonin helps:

1. Raise the pain threshold (have less pain), by blocking substance P. 2. You fall asleep and stay asleep through the night. 3. Regulate moods. “The happy hormone” reduces anxiety and reduces depression. 4. Reduce sugar cravings and over-eating. 5. Increase a person’s mental abilities. 6. Regulate normal gut motility (transportation of food-stuff) and reverse irritable bowel syndrome (IBS).

Surveys have shown that as many as 73% of Fibromyalgia patients have irritable bowel syndrome. You have more serotonin receptors in your intestinal tract than you do in your brain.

Emotionally stressful situations cause the body to release adrenaline, cortisol and insulin. These stress hormones stimulate the brain to secrete serotonin. Long term stress and poor dietary habits can deplete the body’s serotonin stores.

Tryptophan, 5 Hydroxytryptophan (5HTP) and Serotonin Tryptophan is one of eight essential amino acids. Tryptophan is absorbed from the gut into the bloodstream and then dispersed throughout the body. Ninety percent of tryptophan is used for protein synthesis, one percent is converted to serotonin, and the balance is used to make niacin.

In the formation of serotonin, tryptophan is hydroxylated to 5-hydroxy-tryptophan (5HTP) by tryptophan hydroxylase. 5HTP is converted to serotonin by the decarboxylase enzyme, which is vitamin B6 dependent. Tryptophan is transported across the blood-brain barrier via a transport molecule, which also carries leucine, isoleucine, and valine, and prefers leucine.

However, 5HTP easily crosses the blood-brain barrier and does not utilize this transport mechanism; thus, it does not compete for passage through the blood-brain barrier with these amino acids. And, unlike tryptophan, which is made from bacterial fermentation (and hence subject to contamination), 5HTP is derived from the West African plant Grifonia simplicifolia. In the body, 5HTP is converted directly in to serotonin.

It is not broken down by tryptophan pyrrolase, and does not have to compete for transport across the blood-brain barrier. Individuals with fibromyalgia have low levels of tryptophan, serotonin, and 5-HTP. Studies show that fibromyalgia patients have higher levels of metabolites in the kynurenine pathway, which diverts tryptophan away from serotonin production.

Selective Serotonin Reuptake Inhibitor (SSRI) Medications

Prescription antidepressants can be helpful. However, antidepressant drugs have potential side effects including anxiety, depression, fatigue, decreased sex drive, and disruption of normal circadian rhythms. SSRI’s are supposed to help a patient hang onto and use their naturally occurring stores of the brain chemical serotonin.

It’s like using a gasoline additive to help increase the efficiency of your cars fuel. Most of the patients I see with fibromyalgia are running on fumes and a gasoline additive won’t help.

Please keep in mind that several studies show that between 19-70% of those taking antidepressant medications do just as well by taking a placebo or sugar pill. I recommend my patients boost their serotonin levels by taking 5HTP.

5HTP and Depression Studies (including double-blind) comparing SSRI and tricyclic antidepressants to 5HTP have consistently shown that 5HTP is as good if not better than prescription medications in treating mood disorders. Furthermore, 5HTP doesn’t have some of the more troubling side effects associated with prescription medications.

5HTP and Sleep 5HTP has been shown to be beneficial in treating insomnia, especially in improving sleep quality by increasing REM sleep and increasing the body’s production of melatonin by 200%.

5HTP and Fibromyalgia Double-blind, placebo-controlled trials have shown that patients with FMS were able to see the following benefits from taking 5HTP:

• decreased pain. • improved sleep. • less tender points. • less morning stiffness. • less anxiety. • improved moods in general, including in those with clinical depression. • increased energy.

Irritable Bowel Syndrome, 5HTP, and Serotonin There are more serotonin receptors in the intestinal tract than there are in the brain. This is one reason people get butterflies in their stomach when they get nervous.

The brain and gut are connected through the neuroreceptors 5-hydroxytriptamine-3 (5-HT3) and 5-hydroxytriptamine-4 (5-HT4). These serotonin receptors regulate the perception of visceral pain and the gastrointestinal (GI) motility.

Serotonin controls how fast or how slow food moves through the intestinal tract. It’s common for the symptoms associated with IBS, diarrhea and constipation, to disappear within 1–2 weeks once serotonin levels are normalized with 5HTP replacement therapy.

Restoring Normal Adrenal Function for Fibromyalgia sufferers

Adrenal Fatigue The adrenals are a pair of pea-sized glands located atop each kidney. The adrenal gland consists of two sections: the medulla (inner portion) and the cortex (outer portion). The adrenal glands release certain hormones that allow us to be able to deal with immediate and long-term stress. These glands, and the hormones they release, allow us to be resilient to day-to-day stress.

Under-active adrenal glands are evident in about two-thirds of CFS patients. The majority of patients I see for chronic illnesses, including Fibromyalgia and CFS, are suffering from it. They have literally burned their stress-coping organ out. Amid years of poor sleep, unrelenting fatigue, chronic pain, excessive stimulants, poor diet, and relying on a plethora of prescription medications, the adrenal glands and the hormones they release have been used up. Once adrenal exhaustion sets in, it’s not long before the body begins to break down. Getting “stressed out” and staying “stressed out” is the beginning of chronic illness for most, if not all, of the FMS and CFS patients I evaluate.

An altered or dysfunctional cortisol control system may be THE cause of Fibromyalgia/Chronic Fatigue Syndrome.

We do know that adrenal fatigue is known to cause many of the same problems associated with Chronic Fatigue Syndrome and Fibromyalgia:

• hypoglycemia (low blood sugar) • hypo-tension(low blood pressure) • neural mediated hypo-tension (become dizzy when stand up) • fatigue • decreased mental acuity • low body temperature (a sign of low thyroid function) • decreased metabolism • a compromised immune system • decreased sense of well-being (depression) • weight loss • hyper-pigmentation (excess skin color changes) • loss of scalp hair • excess facial or body hair • vitiligo (changes in skin color) • auricular calcification (little calcium deposits in the ear lobe) • GI disturbances • nausea • vomiting • constipation • abdominal pain • diarrhea • crave salty foods • muscle or joint pains

Individuals with FMS and CFS who suffer from adrenal fatigue (99%) will find that their stress-coping abilities are shot. They don’t handle stress very well. They will try to avoid stressful situations. Stress will make their symptoms worse and cause them to have flare-ups. If they have a day when they feel good they may over do it (clean the house, paint the playroom, grocery shopping, etc.). Then, they usually crash the next day.

Therefore, restoring proper adrenal function is a crucial step in peeling away the layers of dysfunction associated with FMS and CFS. I believe that adrenal fatigue is a major contributory factor to the symptoms associated with FMS and CFS.

The Cortex The adrenal cortex is primarily associated with response to chronic stress (infections, prolonged exertion, prolonged mental, emotional, chemical, or physical stress). The hormones of the cortex are steroids. The main steroid is cortisol. Chronic over secretion of cortisol leads to adrenal exhaustion, which accelerates the downward spiral towards chronic poor health. Once in adrenal exhaustion your body can’t release enough cortisol to keep up with the daily demands. Eventually you become deficient in cortisol and then DHEA.

Chronic headaches, nausea, allergies, nagging injuries, fatigue, dizziness, hypo-tension, low body temperature, depression, low sex drive, chronic infections, and cold hands and feet are just some of the symptoms that occur with adrenal cortex exhaustion.

Not Enough DHEA The adrenal cortex, when healthy, produces adequate levels of dehydroepiandrosterone (DHEA). DHEA boosts:

• energy • sex drive • resistance to stress • self-defense mechanisms (immune system) • general well-being, and helps to raise: • cortisol levels • overall adrenal function • mood • cellular energy • mental acuity • muscle strength • stamina

DHEA and immune function The decrease in DHEA levels correlates with the general decline of cell-mediated immunity and increased incidence of cancer. DHEA protects the thymus gland, a major player in immune function. My fibromyalgia patient’s usually take a special adrenal cortex glandular supplement DHEA is notoriously low in FMS and CFS patients. Chronic stress initially causes the adrenals to release extra cortisol. Continuous stress raises cortisol to abnormally high levels. Then, the adrenal glands get to where they can’t keep up with the demand for more cortisol. As the cortisol levels continue to become depleted from on-going stress, the body attempts to counter this by releasing more DHEA. Eventually they can’t produce enough cortisol or DHEA. Aging makes holding on to DHEA even tougher. Even in healthy individuals, DHEA levels begin to drop after the age of 30. By age 70, they are at about 20% of their peak levels.

Stress and DHEA DHEA helps prevent the destruction of tryptophan (5HTP), which increases the production of serotonin. This helps provide added protection from chronic stress. Studies continue to show low DHEA to be a biological indicator of stress, aging, and age-related diseases including neurosis, depression, peptic ulcer, IBS, and others.

Digestive Enzymes Most individuals with fibromyalgia will complain of bloating, gas, and indigestion. Many of these folks will be placed on acid blocking prescription drugs for heartburn or reflux. However, these drugs can cause nutritional deficiencies since they prevent the absorption of certain essential vitamins and minerals. This may lead to symptoms of fatigue, increased pain, anxiety, and depression.

Most digestion and absorption takes place in the small intestine and is regulated by pancreatic enzymes and bile. The pancreas aids in digestion by releasing proteolytic enzymes, which help break down proteins into amino acids. It’s these amino acids which make the brain chemicals including serotonin, dopamine, and epinephrine.

These enzymes break down food-stuff and allow the smaller molecules and nutrients to be absorbed into the bloodstream. The enzymes may become deficient for a variety of reasons, including advancing age, excess sugar, deficient essential fatty acids, excessive trans-fatty acids, and overeating. Eating processed food also depletes normal pancreatic enzymes.

I also recommend that all of my fibromyalgia patients take a digestive enzyme with each meal.

Vitamin and Mineral Supplements Dr. Janet Travell, White House physician for Presidents John F. Kennedy and Lyndon B. Johnson, and Professor Emeritus of Internal Medicine at George Washington University cowrote Myofascial Pain and Dysfunction: The Trigger Point Manual, which is acknowledged as the authoritative work on muscle pain.

In one chapter alone, Dr. Travell and co-author, Dr. David Simons, referenced 317 studies showing that problems such as hormonal, vitamin, and mineral deficiencies can contribute to muscle pain and soreness, part of the hallmark symptoms for fibromyalgia pain.

There are numerous studies which show that individuals with fibromyalgia benefit from taking certain vitamins, minerals and fatty acids. The mineral magnesium, which acts as a natural muscle relaxant, is especially helpful in relieving many of the symptoms associated with fibromyalgia.

Malic acid, derived from apples, has been shown to reduce the chronic pain associated with fibromyalgia. Vitamins B6, B3, and B2 are needed to make the brain chemicals, including serotonin. Essential fatty acids (EFAs) help reduce inflammation, boost mood, and optimize the immune system.

I’ve developed a special vitamin/mineral formula for my fibromyalgia patients. I have a special “jumpstart” package which contains the Fibromyalgia/Chronic Fatigue Formula, the Adrenal Cortex Formula, the Digestive Enzymes, and the 5HTP formula. These are the nutritional supplements that I recommend for 98% of the patients I see with FMS and CFS, all in one money saving package.

For more information about my protocols please read my books, Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome, and The Patient’s Self-Help Manual for Beating Fibromyalgia and CFS.

I have a SUPER JUMPSTART PACKAGE for fibromyalgia sufferers that includes everything in the regular jumpstart package (FMS/CFS formula, Adrenal Cortex Formula, Digestive Enzymes, and 5HTP, PLUS both of the books I just mentioned containing over 500 pages of my protocols and information on treating and beating FMS and CFS – and, for a short time only, I’m adding my one hour cassette tape for free.

Traditional Drug Therapy for Fibromyalgia Unfortunately the traditional medical treatments for fibromyalgia have not been very effective. The traditional drugs of choice including , NSAIDS, antidepressants, muscle relaxants, tranquilizers, and pain medications may provide short-term relief, yet their results are often fleeting and their side-effects may cause more symptoms than they help. Conventional medical treatments for FMS and CFS is a controversial topic. Consider the following statements from The American College of Rheumatology:

Conventional medical therapies are ineffective and no better than a sugar pill for the treatment of Fibromyalgia.

“On tricyclic medications Amitriptyline (Elavil): Four controlled trials have evaluated the efficacy of Amitriptyline in Fibromyalgia… the longest trial showed NO benefit when compared to placebo. Furthermore, the overall degree of benefit was found to be relatively small in relevant outcomes such as improvement in pain, fatigue, and sleep.”

Of note, 95% of Amitriptyline (Elavil) treated patients experienced side-effects.

“Furthermore, use of anti-anxiety medications Benzodiazepines (Klonopin, Xanax etc.), corticosteroids (medrol dose packs, prednisone, etc.), and nonsteroidal anti-inflammatory agents (Mobic, Celebrex, Vioxx, Bextra, etc.), and pain medications have been shown to be ineffective and should be generally avoided.”

“And our best therapies Amitriptyline (Elavil) and Cyclobenzaprine (Flexeril) could not be distinguished from placebo after three months of therapy. Long-term, follow-up observations indicated that clinical findings for patients with FMS did not change appreciably after 15 years.”

WARNING – Consult your doctor before discontinuing any medications.

Nonsteroidal Anti-inflammatory Drugs (NSAIDs) –Vioxx, Celebrex, Bextra, ETC. NSAIDs can be helpful, especially when used for inflammation that comes from traumatic injuries (sprains, strains, accidents, etc.). They can be effective in relieving pain and inflammation associated with chronic pain syndromes, including all forms of arthritis and for some who suffer from FMS. However, long term use of these medications can cause a host of unwanted side effects. None of these medications actually correct the cause of pain. In fact, they can accelerate joint destruction and cause intestinal permeability (which leads to more inflammation). Nonsteroidal anti-inflammatories (NSAIDs) such as Bextra, Mobic, Ibuprofen, Daypro, Naprosyn, Celebrex, and Vioxx, can cause intestinal permeability. They cover up the symptoms but do not address the cause, and they can actually cause further joint destruction.pillsInternal memos show disagreement within the F.D.A. over a study by one of its own scientists, Dr. David Graham, who estimated Vioxx had been associated with more than 27,000 heart attacks or deaths linked to cardiac problems.

NSAIDs causes 10,000-20,000 Deaths a Year. A person taking NSAIDS is seven times more likely to be hospitalized for gastrointestinal adverse effects. The FDA estimates that 200,000 cases of gastric bleeding occur annually and that this leads to 10,000 to 20,000 deaths each year.

High Blood PressureNSAIDs can cause high blood pressure. In one study, 41% of those who had recently started on medication to lower their blood pressure were also taking NSAIDs. NSAIDs more than double a person’s risk of developing high blood pressure.

Sleep Medications – Ambien, Elavil, Flexeril, Trazadone, Restoril, Klonopin, Xanax, Ativan, and Sonata Ambien (zolpidem) is a short-acting drug that usually lasts for four–six hours. If a patient takes a half dose before bed, then he can take an additional half dose if needed four–six hours later. Even though the literature on Ambien suggests patients don’t build up a tolerance, many do. Some patient’s do well on Ambien; some build up a tolerance over a period of time needing higher and higher doses until the medicine no longer works. Does promote deep restorative sleep. Side Effects: Short term memory loss, fuzzy thinking, sedation or next day hang over, mood disorders (anxiety and depression), flu-like symptoms, muscle aches, and in-coordination. This drug, like most drugs, is processed by the liver, so those with sluggish liver function should use this medication with caution. Most common side effects include dizziness and diarrhea. Some patients complain of loss of coordination or concentration. Ambien has caused amnesia (short-term memory loss), but this happens mostly at doses exceeding 10 mg. Patients are cautioned against abruptly stopping the medicine, since withdrawal symptoms commonly occur. Ambien may cause fatigue, headache, anxiety, difficulty sleeping, and memory loss. Long-term use can result in back pain, flu-like symptoms, depression, constipation, upset stomach, joint pain, URI, sore throat, urinary infection, and heart palpitations.

Trazadone (desyrel) is an antidepressant that increases a person’s ability to hang on to serotonin. It reduces anxiety, and promotes deep sleep. I’ve found this drug to be quite helpful when 5HTP or melatonin doesn’t work. It can cause early morning hangover. Does promote deep restorative sleep.

Side Effects: Common side effects include upset stomach, constipation, bad taste in the mouth, heartburn, diarrhea, rash, rapid heartbeat, mental confusion, hostility, swelling in the arms or legs, dizziness, nightmares, drowsiness, and fatigue.

Elavil (amitriptyline) is an antidepressant that has become synonymous with treating FMS. It was one of the first drugs to be studied in the treatment of FMS. It can be very helpful in reducing the pain associated with FMS, but it has several potential side effects. It is also prone to lose its effectiveness over time. It does promote deep restorative sleep.

Side Effects: Elavil may cause weight gain, early morning hangover, neurally mediated hypo-tension (low blood pressure), depression, poor sleep, anxiety, and irregular heartbeat.

Flexeril (cyclobenzaprine) is a muscle relaxant chemically similar to the antidepressant Elavil. It is sometimes used as a sleep aid. Unlike many of the prescription medications for sleep, Flexeril does allow the patient to go into deep stage four (restorative) sleep. It is quite sedating. It does promote deep restorative sleep.

Side Effects: Side effects, including gastritis and a feeling of being hung-over or “out of touch,” prevent most patients from remaining on this drug for very long.

Baclofen (lioresal) is a muscle relaxant similar to the natural neurotransmitter GABA. Side effects include fatigue, drowsiness, low blood pressure, weakness, dizziness, nausea, headache, depression, weight gain, and insomnia. Baclofen does not promote deep, restorative sleep.

Sonata (zaleplon) is designed to last for only four hours; this helps prevent morning hangover. I’ve not found it to be very effective, though, since most of my patients have trouble sleeping through the night, not just with getting to sleep.

Zanaflex (tizanidine) is a muscle relaxant that has gained some popularity among physicians treating FMS. It is sedating and, like other muscle relaxers, can help with insomnia. But it doesn’t produce deep, restorative (delta-wave) sleep. It doesn’t help increase serotonin levels; it only tranquilizes the nervous system. For this reason alone it should be avoided.

Side Effects: Zanaflex is associated with numerous side-effects, including liver failure (at least three individuals have died from taking this medication), asthenia (weakness), somnolence (prolonged drowsiness or a trance-like condition that may continue for a number of days), dizziness, UTI (urinary tract infection), constipation, liver injury, elevated liver enzymes, vomiting, speech disorder, blurred vision, nervousness, hypo-tension, psychosis/hallucinations, bradycardia (slow heart action), pharyngitis (sore throat), and dykiensia (defect in voluntary movements). This stuff is poison!

Anti-anxiety medication or Benzodiazepines - Xanax, Klonopin, Ativan, Restoril, Busbar, Tranxene, Serax, Librium,Tegretol, Valium, Trileptal, Seraquel, Risperdal, and SymbaxThese medications are usually used as anti-anxiety medication. They’re addictive and patients build up a tolerance so that the drug eventually loses it’s effectiveness as a sleep aid.

These medications are loaded with side effects that cause further health problems (depression, fatigue, memory loss, “fibro fog” etc.) yet don’t promote deep, restorative sleep. Side effects associated with these medications include sleep disturbances (poor sleep), seizures, neuropsychiatric disturbances (mania, depression, suicide, etc.) tinnitus (ringing in the ears), transient memory loss (amnesia), dizziness, agitation (anxiety), disorientation, hypotension (low blood pressure), nausea, edema (fluid retention), ataxia (muscular in-coordination), tremors, sexual dysfunction (decreased desire and performance), asthenia (weakness), somnolence (prolonged drowsiness or a trance-like condition that may continue for a number of days), and headaches.

Neurontin, Gabitril and LyricaGABA inhibitors such as Gabitril (tiagabine) and Neurontin (gabapentin) are anticonvulsant medications originally used to control seizures. They are now being used to block nerve-related pain (neuralgia) including pain caused by herpes zoster. These medications are also being prescribed for chronic headaches (with some success). I’ve not found them to be helpful for the diffuse extremity pains associated with FMS. They don’t promote deep, restorative sleep and can cause many of the same symptoms associated with CFS and FMS, including fatigue, muscle aches, poor mental clarity (“fibro fog”), and mood disorders. Most patients can wean off these medications with no problems.

Side-Effects: There are several side effects associated with their use, including somnolence (prolonged drowsiness or a trance-like condition that may continue for a number of days), dizziness, weakness, fatigue, double vision, edema (fluid retention), ataxia (muscular in-coordination), thought disorder, possible long-term ophthalmic problems (abnormal eyeball movements and disorders), tremors, weight gain, back pain, constipation, muscle aches, memory loss, asthenia (weakness), depression, abnormal thinking, itching, involuntary muscle twitching, serious rash, and runny nose.

Don’t these side-effects sound like some of the symptoms associated with FMS and CFS?

Topamax (topiramate) is used primarily for adjunctive therapy tonoclonic seizures. It is also used for anxiety disorders. Side Effects: The side effects associated with this drug, especially the fatigue and low blood pressure, prevent patients from having any extra energy. Note: this exert from a letter from the manufacturers of Topamax (Ortho-McNeil Pharmaceutical, Inc.) to doctors: “Topamax: drug used to control epilepsy, off-label drug for anxiety or insomnia—may cause serious eye damage and/or blindness. As of August 17, 2001 there have been 23 reported cases: 22 in adults and one in pediatric patients. It is generally recognized that post-marketing data are subject to substantial under reporting.”

Beta Blockers – Inderal, Lorpressor, Tenormin, Torprol, Etc. Beta blockers, such as Inderal (propanol), Lorpressor (metoprlol), Tenormin (atenolol), and Torprol (metoprolol) are used for long-term management of angina (chest pain), mitral valve prolapse (MVP), heart arrhythmia (irregular heart beats), and hypertension (high blood pressure). Beta-blockers slow the heart rate, which reduces cardiac output. This leads to low blood pressure and fatigue. The brain and muscles aren’t getting enough blood and oxygen. This can lead to fuzzy thinking, poor memory, depression, anxiety, and physical fatigue.

Side Effects: According to Mark Houston, MD, associate clinical professor of medicine at Vanderbilt School of Medicine, side effects associated with beta-blockers include congestive heart failure (CHF), reduced cardiac output, fatigue, heart block, dizziness, depression, bradycardia (decreased heart beat and function), cold extremities, parathesia (a feeling of “pins and needles”), dyspnea (shortness of breath), drowsiness, lethargy, insomnia, headaches, poor memory, nausea, diarrhea, constipation, colitis, wheezing, bronchospasm, Raynaud’s Syndrome (burning, tingling, pain, numbness, or poor circulation in the hands and feet), claudication, hyperkalemia (muscle cramps), muscle fatigue, lowered libido, impotence, postural hypotension, raised triglycerides, lowered HDL, raised LDL, and hyperglycemia. Dr. Houston recommends Hawthorne berry as a natural beta-blocker alternative. Hawthorne berry is an ACE inhibitor; it works by inhibiting (blocking) the angiotensin-converting enzyme. This enzyme is what causes the constriction of arteries (raises blood pressure and heart contraction/rate). Recommended dose of Hawthorne berry is 160–900 mg. of standardized extract daily.

I have found that most people can wean off beta-blockers and other high blood-pressure medications by increasing their omega 3 (fish oil 6-9 grams ) and magnesium (700mg a day or up to bowel tolerance). Some individuals will also need to take timed release niacin (B3) at rather high doses.

Stimulants – Adderall, Concerta, Cylert, Etc Stimulants such as Adderall (amphetamine), Concerta (methylphenidate), Cylert (pemoline), Dexedrine (dextroamphetamine sulfate), Focalin (dexmethylphenidate HCL), Metadate (methylphenidate), and Ritalin (methylphenidate) are use to increase adrenalin. They can be very helpful in increasing a person’s energy. But you may remember the saying “speed kills.” With the exception of Provigil, these medications are nothing more than various forms of amphetamines (“speed”). These drugs are incredibly hard on the adrenal glands (stress coping glands). Long-term use can cause adrenal fatigue or burnout at least and full blown Addison’s Disease (adrenal failure) at worst. The narcolepsy drug Provigil is being recommend for the fatigue associated with FMS and CFS. This medication is designed to keep a person from going to sleep. Yes, it can help wake you up in the morning and make you more alert. However, the reason you’re tired is because you’re not going into deep restorative sleep each night. However, this medication will interfere with your normal circadian rhythm (sleep wake cycle). The worse thing you can do is take a medication that interferes with your circadian rhythm. Anything that may disrupt your ability to go into deep sleep each night, should be avoided.

Side Effects: Side effects include: insomnia (big problem), Tourette’s syndrome (movement disorder consisting of grimaces, ticks, and involuntary outbursts), nervousness, unstable mood (anxiety, mania, depression, irritability, aggression, etc) tachycardia (rapid heartbeat), hypertension (high blood pressure), tics (abnormal muscle movements), psychosis (abnormal behavior), headaches, seizures, visual disturbances, anorexia (unwanted weight loss), aplastic anemia (arrested development of bone marrow), liver dysfunction, and blood dyscrasias (disease).

Antidepressants Prozac, Zoloft, Celexa, Paxil, Etc. Selective Serotonin Re-Uptake Inhibitors (SSRIs). SSRIs work by increasing the brain’s use of the neurotransmitter serotonin. Serotonin deficiency is linked to depression, lowered pain tolerance, poor sleep, and mental fatigue. All SSRIs are partially or wholly broken down in the liver. This can create liver dysfunction in some patients, so patients with a sluggish liver should be cautious in taking these medications.

Side Effects: Common side effects include headache, muscle pain, chest pain, anxiety, nervousness, sleeplessness, drowsiness, weakness, changes in sex drive, tremors, dry mouth, irritated stomach, loss of appetite, dizziness, nausea, rash, itching, weight gain, diarrhea, impotence, hair loss, dry skin, chest pain, bronchitis, abnormal heart beat, twitching, anemia, low blood sugar, and low thyroid.

Examples of SSRIs include Zoloft (sertraline), Paxil (paroxetine HCL), Celexa (citalopram), Prozac (fluoxetine), Luvox (fluvoxamine), etc.

Other Side Effects Noted for Antidepressants Harvard Medical School’s Dr. Joseph Glenmullen recently reported on the many dreadful side effects associated with conventional anti-depressant medications. These include neurological disorders, sexual dysfunction (in up to 60% of users), debilitating withdrawal symptoms (including hallucinations, electric shock–like sensations, dizziness, nausea, and anxiety), and decreased effectiveness in about 35% of long-term users.

Tricyclic Antidepressants Elavil, Pamelor, Doxepin, EtcTricyclic antidepressants block the hormones serotonin and norepinephrine. This produces a sedative effect. They also reduce the effects of the hormone acetylcholine. Like other antidepressant medications, these drugs are processed by the liver and can cause liver toxicity.

Side Effects: Common side effects include sedation, confusion, blurred vision, muscle spasms or tremors, dry mouth, convulsions, constipation, difficulty in urinating, and sensitivity to light. Examples of tricyclic antidepressants include Pamelor (nortriptyline) and Elavil (amitriptyline). Elavil is an antidepressant now synonymous with treating FMS. It was one of the first drugs to be studied in the treatment of FMS. It can be very helpful in reducing pain, but it has several potential unwanted side effects: weight gain, early morning hangover, neurally mediated hypotension (low blood pressure), and irregular heartbeat.

Prescription Medications Offer Little HopeA study conducted by the Mayo Foundation for Medical Education and Research demonstrates the need for FMS and CFS treatment beyond drug therapy. Thirty-nine patients with FMS were interviewed about their symptoms. Twenty-nine were interviewed again 10 years later. Of these 29 (mean age 55 at second interview), all had persistence of the same FMS symptoms. Moderate to severe pain or stiffness was reported in 55% of patients, moderate to a great deal of sleep difficulty was noted in 48%, and moderate to extreme fatigue was noted in 59%. These symptoms showed little change from earlier surveys. The surprising finding was that 79% of the patients were still taking medications to control symptoms. We can conclude that the medications weren’t making a significant impact.

I believe that an integrative approach which combines the judicious use of prescription drugs along with nutritional therapy offers the best hope for beating fibromyalgia syndrome.

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May, 2011

Indigestion

By Dr. Joel Rosen

Digestion and GI Disorders: Heartburn, Reflux, and GERD

I find that most of my patients who complain of GI problems are deficient in digestive enzymes. A deficiency in these enzymes prevents the body from breaking down and sufficiently absorbing food. Most digestion and absorption takes place in the small intestine and is regulated by pancreatic enzymes (digestive) and bile. The pancreas aids in digestion by releasing proteolytic enzymes, which help break down proteins into amino acids.
digestivetract

Raw, unprocessed foods contain their own digestive enzymes. When we eat these foods, we help spare our own pancreatic enzymes. However, eating processed foods requires our body to secrete extra amounts of pancreatic enzymes. Over time, processed foods deplete a persons own pancreatic enzyme stores.

Proteolytic enzymes also help regulate inflammatory reactions by reducing the amount of kinins in the body. Kinin is a tissue hormone capable of causing severe and painful inflammatory reactions. It is triggered by allergic foods or chemicals and can cause inflammation anywhere in the body, including the brain.

Bloating, Gas, and Indigestion ProtocolBloating, gas and indigestion may be signs of low stomach acid, deficient digestive enzymes (not able to break down and digest their food), bacterial or yeast overgrowth. Take a digestive enzyme with each meal. I recommend my patients use a potent pancreatic digestive enzyme formula that utilizes USP porcine-derived high-potency pancreatin for reliable and consistent enzyme activity.

If after one week you continue to have bloating gas or indigestion add 3 capsules of high dose probiotics (good bacteria, acidophilous, etc.). Probiotics should taken on an empty stomach. Usually one to two months of probiotic therapy is enough.

Heartburn, Reflux, and GERDOne estimate is that 40% of the US population has some degree of esophageal reflux, with 20% of adults complaining of weekly episodes of heartburn and 7–10% complaining of daily symptoms. Esophageal reflux occurs when the lower esophageal sphincter malfunctions, allowing the backward flow of acid, bile, and other contents from the stomach into the esophagus.

Gastritis (inflammation of the stomach itself), peptic or duodenal ulcers, and chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs) can result in reflux. A hiatal hernia and can also result in esophageal reflux.

The most obvious symptom of esophageal reflux is heartburn. It occurs after eating and can last from a few minutes to a few hours. Heartburn feels like a burning sensation in the pit of the stomach. The pain may also move up into the chest and throat. GERD (gastroesophageal reflux disease) can cause esophageal scarring or Barrett’s syndrome, a chronic irritation from acid-bile reflux that causes the normal esophageal lining cells to be replaced by precancerous cells. These cells are associated with an increased risk for development of cancer.

DiagnosisAn endoscopy test is used for the diagnosis of GERD. This test involves examining the esophagus through a flexible viewing tube, which can also take a biopsy to correctly identify acid reflux.

Conventional Treatment of GERDH2 antagonists (Tagament, Pepcid, Zantac, and Axid) and antacids (Tums, Maalox, etc.) are usually the first line of treatment. If these fail to work, then proton-pump inhibitor drugs (Nexium, Prevacid, or Prilosec) are initiated. However, many physicians now prescribe proton-pump inhibitor drugs as a first-line therapy. These medications block the absorption of zinc, folic acid, B12, calcium, and iron.

Long-term use of these medications can block all stomach acid (hydrochloric acid). The stomach needs hydrochloric acid to break down proteins for digestion. Failure to do this can lead to all sorts of problems, including intestinal permeability, anemia, fatigue, increased allergy disorders, depression, anxiety, and bacterial and yeast overgrowth.antacids

Are Antacids the Answer?No! First, the esophageal sphincter is stimulated to close by the release of stomach acids. When there’s not enough stomach acid present—because antacids have neutralized them—the esophageal sphincter may not close properly. This allows acid to travel back up into the esophagus and cause heartburn, also called esophageal reflux or gastro-esophageal reflux disease—GERD. GERD is usually treated by antacids, but antacids could make the GERD worse.

Second, the stomach needs an acidic environment for hydrochloric acid to turn the enzyme pepsinogen into pepsin. No acid equals no pepsin, which is needed for digestion, especially protein. No protein digestion means no amino acids. No amino acids, no neurotansmitters (serotonin, dopamine, norepinephrine, etc.).

Last, an acidic environment is one of the body’s first lines of defense, destroying viruses, parasites, yeast, and bacteria.

Achlorhydria (Low Stomach Acid) ProtocolNumerous studies have shown that acid secretion declines with advancing age. It’s been estimated that 50% of Americans over the age of 60 suffer from achlorhydria, a deficiency in hydrochloric acid. The resulting rise in stomach pH can cause many of the symptoms associated with FMS and CFS.

Low stomach may also cause the very same symptoms associated with GERD. Unless you’ve had an upper GI endoscopy, biopsy, or blood test that shows a definitive case of GERD or H.pylori, then you may be causing more problems be usibg antacid medications. For example, one study found that 34% of those with low stomach acid reported indigestion and excessive gas. Forty percent complained of fatigue. We need gastric acid and pepsin for optimal digestion of food, absorption of nutrients, and release of pancreatic enzymes. A hydrochloric-acid deficiency triggers a chain reaction of digestive disorders, including malabsorption. Foods may be incompletely digested and subsequently absorbed into the bloodstream, where they can lead to food allergies, triggering pain and inflammation throughout the body.

Some symptoms associated with achlorhydria:
• bloating
• gas
• indigestion
• heartburn
• distention after eating
• diarrhea
• constipation
• hair loss in women
• parasitic infections
• rectal itching
• malaise
• multiple food allergies
• nausea
• nausea after taking supplements
• restless legs
• sore or burning tongue
• dry mouth

Other associated signs
• abnormal intestinal flora
• chronic Candidiasis
• chronic intestinal parasites
• dilated capillaries in the cheeks and nose (in non-alcoholics)
• iron deficiency
• post-adolescent acne
• undigested food in the stool
• fingernails that are weak, peeling, and cracked

Diseases linked to low gastric acidity:
• vitiligo (skin disorder of milky white patches)
• urticaria (itching)
• Celiac disease
• asthma
• Addison’s disease
• chronic autoimmune disorders
• eczema
• psoriasis
• rosacea
• pernicious anemia
• lupus
• gastritis
• food allergies
• diabetes mellitus
• osteoporosis

Heartburn/GERD Protocol
If you’re suffering from heartburn, try the solutions below rather than antacids.

1. Take a pancreatic digestive enzyme with each meal. If you’ve been taking Nexium, Prevacid, Pepcid, Prevpac, Prilosec, Propulsid, Reglan, or Zantac for over three months, then you may have to stay on the medications along with taking digestive enzymes. Many of my patients have found that they don’t need these prescription medications once they start taking a good high potency digestive enzyme like the one I use in my practice.

2. If you continue to have problems with reflux even after taking digestive enzymes, then try taking Betaine with pepsin. See the information below.

Supplementing With Hydrochloric Acid
Adequate protein intake and a relaxed emotional state can help increase stomach acidity, but supplementation might also be necessary. Have your patients follow the guidelines below. I don’t recommend HCL for a patient who has been diagnosed with a peptic ulcer, because HCL can irritate sensitive tissue. It can also corrode teeth. Capsules should not be emptied into food or beverages. I recommend taking pancreatic enzymes along with HCL.

1. Take one capsule containing 600–650 mg. of hydrochloric acid, along with 100–200 mg. of pepsin, at the beginning of your meal. Continue taking one capsule with each meal for the next five days.

2. After five days, increase your dose to two capsules with each meal. Continue this dose for five days.

3. If you are experiencing no side effects (such as warmth, fullness, or other odd sensation in your stomach), increase your dose by one capsule each day until you do. Then reduce your dose by one capsule at your next meal.

4. Once you’ve established a comfortable per-meal dose (five capsules or fewer), continue at that level. As your stomach regains the ability to produce an adequate concentration of HCL, you will probably require fewer capsules. Listen to your body and reduce your dose as necessary. You may wish to reduce your number of capsules at smaller meals.

5. Be consistent. Individuals with low HCL and pepsin typically don’t respond as well to botanicals and supplements, so to maximize the benefits, keep up supplementation as directed.

Questions

I have bloating and gas that seems to be worse when I eat certain foods. Will taking digestive enzymes help this?
Digestive enzymes help you digest and utilize proteins, fats, and carbohydrates. You should notice that your bloating and gas are eliminated once you start taking digestive enzymes.

I’ve been diagnosed with GERD and have been taking Nexium (Prevacid, Zantac, Prilosec, etc.) for several months. Can I stop taking this medication and just take the digestive enzymes you recommend?
I would encourage you to try the digestive enzymes (with each meal) for a week or two and see if this alone prevents you from giving any reflux symptoms. The longer you’ve been on prescription medications for reflux the harder it becomes to discontinue them. However, you may find you don’t need the prescription medication once you start taking a digestive enzyme. If you continue to have reflux while taking the digestive enzyme, then try adding the betaine HCL with pepsin (see achlorhydria protocol) and probiotics (see below). If you continue to have a problem then you’ll need to go back on the prescription medication. If so then discontinue the betaine HCL with pepsin, but keep taking the digestive enzyme with each meal.

Treating with Diet and Eating Habits
Certain foods relax the esophageal sphincter and can make heartburn, reflux, and GERD worse. These foods include:
• fried, spicy, or fatty foods
• carbonated drinks
• citrus fruits
• peppermint
• chocolate
• coffee
• tea
• alcohol
• tomatoes
• garlic
• onions

You should also avoid lying down within three hours of eating and should eat smaller meals more frequently (perhaps four or five daily). You can also elevate the head of your bed about six inches (to facilitate keeping gastric contents in the stomach) and try sleeping on your side, which would remove pressure from the esophageal sphincter, helping to keep gastric contents from backing up. If you continue to have problems even after trying the recommendations then you should be tested for GERD and H. Pylori. Please ask your doctor if you’ve been tested for either of these conditions. If not I recommend you be tested.

Related Links:

Stomach Ulcers and H. Pylori

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1 Comment

May, 2011

Diabetes

By Dr. Joel Rosen

Over 19 million Americans suffer with type 2-diabetes. The U.S. Centers for Disease Control and Prevention (CDC) relates that the incidence of type 2 diabetes (formerly known as adult-onset diabetes) has risen by 33 percent in the past decade and three out of every fifty American adults currently have this diet-related condition.

It’s estimated that by the year 2010, some 40 percent of Americans 65 or older will have adult-onset diabetes. Complications related to diabetes are the sixth leading cause of death in the United States. Long-term outcome for those with the disease isn’t good.

People with type-2 diabetes have an average life expectancy 15 years less than those without diabetes. Heart disease and stroke account for about 65% of deaths in people with diabetes.

The risk of stroke is also found to be 2 to 4 times higher in people with diabetes. Unfortunately, the news has gone from bad to worse with the FDA’s warning about the dangers of two common diabetic drugs, Avandia and Actos.

A meta-analysis which looked at four long-term trials comprising 14,291 people, found that Avandia increased risk of heart attack by 42 percent and doubled the risk of heart failure. The Actos meta-analysis looked at nineteen trials comprising more than 16,000 patients. It found that Actos lowered the risk of heart attack, stroke, and death by 18 percent, but raised risk of heart failure by forty percent. Not good.

About 1 million Americans are currently taking Avandia, which sells between $90 and $170 for a one-month supply. Its U.S. sales topped $2.2 billion last year.

Dr. David Graham, a drug safety officer with the FDA’s Office of Surveillance and Epidemiology, estimates that Avandia has caused as many as 205,000 heart attacks and strokes, some of them fatal, between 1999 and 2006. Graham’s analysis indicates that since Avandia was approved, some 80,000 patients have died from the drug’s side effects. For every month that Avandia is sold, he said, 1,600 to 2,200 patients will suffer more of these events.

GlaxoSmithKline LLC, based in London, told the agency of the risk two years ago. Yet, the FDA failed to pass along the warning to the one million Americans who already take the drug. There’s probably $2.2 billion reasons why this information wasn’t made public until this year. Only after researchers at the Cleveland Clinic forced the FDA to take notice, did the word get out to the media.

Since three quarters of all diabetics die from heart disease related conditions, doesn’t it seem strange that the drugs doctors commonly recommend for controlling diabetes actually increase the incidence of cardiovascular related deaths?

I believe it does.

So does Gerald Del Pan, director of the Office of Surveillance and Epidemiology, who has voiced his concerns about Avandia by stating “Cardiovascular disease being the leading cause of death of people with diabetes, having a treatment that causes that is something that doesn’t make sense to me.”

It doesn’t make sense to me either. And to add fuel to the fire, recent evidence suggests thiazolidinediones are associated with an increased risk of peripheral fractures in post-menopausal women.

Other commonly used diabetic drugs known as sulfonylureas (DiaBeta, Micronase, Glynase, Diabinese, Glucatrol, Orinase, Tolinase, and Amyrel) are also associated with an increased risk of heart attack and strokes. Orinase has been shown to increase the risk for heart attack and stroke by 300 percent and increases the risk of death from all illnesses by 250 percent over those taking a sugar pill.

These drugs carry a warning label, which states, “The administration of oral hypoglycemic drugs has been reported to be associated with increased risk of cardiovascular mortality as compared with treatment with diet alone or diet plus insulin. ”Insulin sensitizers or enhancing drugs including Metformin (Glucophage) and Phenformin are known as biguanides. Metformin is now the most commonly prescribed oral anti-diabetic drug in the world.

It works by increasing insulin sensitivity in the liver. It also has a number of other beneficial effects, including weight loss, reduced cholesterol-triglyceride levels, and improved endothelial function.

Metformin is tolerated better than many other anti-diabetic prescription drugs. And I believe it to be the safest of the diabetes-drugs. However, it’s not without potential health risks. Those taking Metformin should be made aware that it’s associated with lactic acidosis.

Lactic acidosis is a rare but serious complication that can occur due to glucophage accumulation and is fatal 50% of the time. Phenformin was pulled from the market in 1977 due to an increased risk in developing lactic acidosis, Metformin has avoided being banned by the FDA and most doctors including myself believe this medicine is the safest of the diabetic drugs. Unfortunately Metformin doesn’t slow down the ravages of diabetes, namely arteriosclerosis and increased risk of heart attack, stroke, and heart disease.

Nutritional Supplements for Diabetes

I’ve discovered that my patients who follow my advice and take additional nutritional medicines along with their Metformin enjoy the best health. And even better, many of my patients are able to avoid or discontinue Metformin after following my advice below. You can read more about these life changing natural medicines by scrolling to bottom of page.

And by the way, before it was pulled from the market the warning bells rang loud and clear; Phenformin cousin of Metformin, was found to increase the risk of heart disease deaths by 300 percent. Once again like so many illnesses, once you get past the smoke and mirrors, the recommended medical “cure” is often worse than the illness. The type-2 diabetic now faces a dilemma. Do they suffer with the advances of unchecked diabetes, including risk of heart attack, stroke, and an increased risk of cardiovascular disease death? Or do they take conventional anti-diabetic drugs and increase their risk of heart attack, stroke, and death from cardiovascular disease?

What About Insulin?
What about insulin therapy you may ask? Good question. Before insulin therapy, type 1-diabetes meant a life of misery and premature death. Insulin is a life saving and therefore essential therapy for type 1 diabetes. The number of medical professionals advocating insulin therapy for type 2- diabetes continues to grow. However, its use isn’t without risk. Insulin stimulates weight gain, a known risk factor for cardiovascular disease. As patients on insulin therapy gain weight so do their requirements for increased insulin.

Please note:
The majority of patients, some ninety percent are non-insulin dependent type 2 diabetic, and suffer from poor diet, obesity, and inactivity, not from a lack of insulin. I encourage my patients with type 2- diabetes to try neutraceutical therapies instead. Certainly I recommend insulin therapy for those patients who need it but I also recommend they use the nutritional supplements below as well. Since patients who use insulin develop a tolerance for it and must use more and more over time (eventually becomes ineffective) -the goal for those using insulin should be to use the least amount as possible. Combining the appropriate nutritional medicine recommendations below along with insulin therapy helps to reduce the amount of insulin needed on a daily basis.

Neutraceuticals for Type 2-Diabetes

In the fight against type 2-diabetes there are dozens of safe and effective neutraceutical therapies. I’ll mention a few of my favorites below. Corosolic acid is found in the leaves of the banaba plant that grows in the Philippines. Subjects using a corosolic acid preparation called Glucotrim each day for two weeks experienced a 30 percent drop in blood sugar levels.

Researchers considered both levels of blood sugar reduction significant. Corosolic acid may be defined as a phyto-insulin or insulin-like plant extract. And how about this for a potential side effect, subjects receiving the corosolic acid seem to show an increased tendency toward weight loss (an average weight loss of 3.2 pounds).

Gymnema sylvestre, an Indian herb used in Ayurvedic medicine, lowers the 2-hour postprandial (after meal) plasma glucose (blood sugar) concentrations, by 13 percent (207 vs. 180mg/dl).
Gymnema Sylvestre research reveals that it lowers HbA1c from 10.1% to 9.3%.

This is as good if not better than common diabetic drugs. And with no side effects! Studies that show that alpha-lipoic acid (ALA) speeds the removal of glucose (sugar) from the blood of people with diabetes and that this antioxidant may prevent kidney damage associated with diabetes. And several studies suggest that treatment with ALA may help reduce pain, burning, itching, tingling, and numbness in people who have nerve damage caused by diabetes.

In several studies, the mineral biotin has been shown to enhance the performance of insulin. Biotin supplements can also increase the activity of an enzyme, glucokinase, which the liver uses early in the process of utilizing blood sugar. Biotin plays a valuable role in regulating blood sugar.

Chromium is an essential mineral for human nutrition and aids in the normal function of insulin. In 12 out of 15 controlled studies of people with impaired glucose tolerance, chromium supplementation was found to improve some measure of glucose utilization or to have beneficial effects on blood lipid profiles.

The type 2- diabetic dilemma – do they suffer with the advances of unchecked diabetes, including risk of heart attack, stroke, and an increased risk of cardiovascular disease death? Or do they take conventional anti-diabetic drugs and increase their risk of heart attack, stroke, and death from cardiovascular disease? – Now becomes clear.

Take the right drug (Metformin or insulin), only if you need it and begin taking safe all natural nutritional therapies that have been clinically proven to help prevent and reverse diabetes.

My Recommendations

I recommend my patients change their diet, avoid “white foods,” walk or exercise 30-60 minutes each day, take a good multivitamin/mineral

Click Here to Find a Great Selection of Multivitamins

1.Since diabetes increases the risk of cardiovascular disease, I always encourage my patients to take the Healthy Heart Multivitamin/mineral with CoQ10, L-Taurine, and Omega 3 fish oil.

Click Here for Healthy Heart Formula

2. I always recommend they begin taking the Diabetic Support Formula.

and last, but not least…

3. I suggest and many of my patients elect to take Slim N Trim. This product contains a standardized of white bean extract known as Phase 2.
It helps many of my patients lose weight, unhealthy blood fats, and reduce their blood sugar levels. Slim N Trim with Phase 2 – is a standardized extract of the white kidney bean. It promotes weight loss and improves glycemic control by reducing starch digestion. Phase 2 works in the intestine by temporarily inhibiting the activity of alpha amylase, the enzyme that breaks down starch into smaller glucose molecules. As a result, less starch is absorbed from a meal. In clinical studies, Phase 2 has been shown to lower after-meal blood sugar levels and promote loss of body fat. In two of the initial studies on Phase 2, participants were given a standardized meal containing 60 g of starch (four slices of white bread) and either a placebo or 1,500 mg of Phase 2 in a margarine spread. After the meal, participants who were given Phase 2 had an average 66-percent reduction in after-meal blood sugar levels compared to the placebo group. Participants given Phase 2 reported no adverse side effects in either study. An independent study conducted in Italy found supplementing with Phase 2 resulted in weight loss.

This double blind, placebo-controlled study involved 60 overweight individuals aged 25 to 45. Participants ate starchy foods during one of their primary meals and took either a Phase 2 supplement or placebo at that time. Researchers measured body weight, body fat percentage and hip, waist and thigh circumference. By the end of the 30-day period, participants who took the Phase 2 supplement lost an average of 6.5 pounds and 10.5 percent fat mass and had significant reductions in all body measurements compared to those in the placebo group, who lost little or no weight.

For more information or to order Slim N Trim, Click Here.

You can purchase these supplements separately Here…
Diabetic Support Formula
Slim N Trim
Healthy Heart Multivitamin/mineral with CoQ10, L-Taurine, and Omega 3 fish oil

References

1.American Diabetic Association Website. www.Diabetes.org

Van Dam RM, Rimm, EB, Willett WC, Stampfer MJ, Hu FB. Dietary patterns and risk for type 2 diabetes mellitus in U.S. men. Ann Intern Med. 2002;136:201-209.

2.Steven E. Nissen, M.D., and Kathy Wolski, M.P.H.

Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death from Cardiovascular Causes. N Engl J Med356(24):2457

2471, June 14 2007.

3.Wake Forest University Baptist Medical Center (2007, July 27). Diabetes Drugs Increase Risk Of Heart Failure, Research Shows.

4.How to Prevent and Treat Diabetes with Natural Medicine, Michael Murray, N.D.

Riverhead Books, New York, NY 10014, 2003.

5.Reversing Diabetes, Julian Whitaker, M.D.

Warner Books, New York, NY 10020, 2001 PG 77 and PG 89

6.Monthly Prescribing Guide October 2007. New York, NY 10001.

References continue

1.Van Dam RM, Rimm, EB, Willett WC, Stampfer MJ, Hu FB. Dietary patterns and risk for type 2 diabetes mellitus in U.S. men. Ann Intern Med. 2002;136:201-209.

2.Beckles GLA et al. American Diabetes Association. Diabetes Care. 1998;21(Suppl 2).

3.Colwell JA. Ann Intern Med. 1996;124(1pt2):131-135.

4.Abraira C et al. Diabetes Care. 1992;15:1560-1571.

5.Klein R et al. Am J Epidemiol. 1987;126:415-428.

6. Sheard NF. Moderate changes in weight and physical activity can prevent or delay the development of type 2 diabetes mellitus in susceptible individuals.

Nutr Rev. 2003 Feb;61(2):76–9.

7. Sedentary (N Engl J Med, 1991; 325: 147-52; Lancet, 1991; 338: 774-8; Am J Epidemiol, 1995; 41: 360-8

8. Cowie CC et al. Diabetes in America. 2nd ed.vol. 44, November ol. 44, November, References

9. How to Prevent and Treat Diabetes with Natural Medicine, Michael Murray. Riverhead Books, New York, NY 10014, 2003.

10. K. Cusi et al.Vanadyl Sulfate Improves Hepatic and Muscle Insulin Sensitivity in Type 2 Diabetes1.University of Texas Health Science Center (K.C., R.A.D.), San Antonio, Texas 78284; 11. Thompson KH, Orvig C, “Vanadium Compounds in the Treatment of Diabetes,” Met Ions Biol Syst. 2004;41:7:221-252..

12. Ametov AS, Barinov A, et al. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: The Sydney trial. Diabetes Care. 2003 Mar;26(3):770–6.

13. Broadhurst CL, Domenico P. Clinical studies on chromium picolinate supplementation in diabetes mellitus–a review. Diabetes Technol Ther. 2006;8(6):677-687.

Udani J, Hardy M, Madsen DC. “Blocking Carbohydrate Absorption and Weight Loss: A Clinical Trial Using Phase 2 Brand Proprietary Fractionated Bean Extract.” Alt Med Rev. 2004;9(2).

14.Udani J “A Novel Method of Lowering the Glycemic Index of White Bread Using a Proprietary White Bean Extract.” Diabetes Care. 2004 Nov;27(11):2701-6.

15.Vinson JA. “In Vivo Effectiveness of a Starch Absorption Blocker in a Double-Blind Placebo-Controlled Study with Normal Human Subjects.” University of Scranton, September 2001.

16.Vinson JA. “In Vivo Effectiveness of a Starch Absorption Blocker in a Double-Blind Placebo-Controlled Study with Normal College-Age Subjects.” University of Scranton, November 2001.

17.Vinson JA. “Dose Response Human Study of Amylase Inactivator with Normal Subjects Given a Full Meal.” University of Scranton, May 2002.

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References

1.American Diabetic Association Website. www.Diabetes.org

Van Dam RM, Rimm, EB, Willett WC, Stampfer MJ, Hu FB. Dietary patterns and risk for type 2 diabetes mellitus in U.S. men. Ann Intern Med. 2002;136:201-209.

2.Steven E. Nissen, M.D., and Kathy Wolski, M.P.H.

Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death from Cardiovascular Causes. N Engl J Med356(24):2457

2471, June 14 2007.

3.Wake Forest University Baptist Medical Center (2007, July 27). Diabetes Drugs Increase Risk Of Heart Failure, Research Shows.

4.How to Prevent and Treat Diabetes with Natural Medicine, Michael Murray, N.D.

Riverhead Books, New York, NY 10014, 2003.

5.Reversing Diabetes, Julian Whitaker, M.D.

Warner Books, New York, NY 10020, 2001 PG 77 and PG 89

6.Monthly Prescribing Guide October 2007. New York, NY 10001.

References continue

1.Van Dam RM, Rimm, EB, Willett WC, Stampfer MJ, Hu FB. Dietary patterns and risk for type 2 diabetes mellitus in U.S. men. Ann Intern Med. 2002;136:201-209.

2.Beckles GLA et al. American Diabetes Association. Diabetes Care. 1998;21(Suppl 2).

3.Colwell JA. Ann Intern Med. 1996;124(1pt2):131-135.

4.Abraira C et al. Diabetes Care. 1992;15:1560-1571.

5.Klein R et al. Am J Epidemiol. 1987;126:415-428.

6. Sheard NF. Moderate changes in weight and physical activity can prevent or delay the development of type 2 diabetes mellitus in susceptible individuals.

Nutr Rev. 2003 Feb;61(2):76–9.

7. Sedentary (N Engl J Med, 1991; 325: 147-52; Lancet, 1991; 338: 774-8; Am J Epidemiol, 1995; 41: 360-8

8. Cowie CC et al. Diabetes in America. 2nd ed.vol. 44, November ol. 44, November, References

9. How to Prevent and Treat Diabetes with Natural Medicine, Michael Murray. Riverhead Books, New York, NY 10014, 2003.

12. Ametov AS, Barinov A, et al. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: The Sydney trial. Diabetes Care. 2003 Mar;26(3):770–6.

13. Broadhurst CL, Domenico P. Clinical studies on chromium picolinate supplementation in diabetes mellitus–a review. Diabetes Technol Ther. 2006;8(6):677-687.

Udani J, Hardy M, Madsen DC. “Blocking Carbohydrate Absorption and Weight Loss: A Clinical Trial Using Phase 2 Brand Proprietary Fractionated Bean Extract.” Alt Med Rev. 2004;9(2).

14.Udani J “A Novel Method of Lowering the Glycemic Index of White Bread Using a Proprietary White Bean Extract.” Diabetes Care. 2004 Nov;27(11):2701-6.

15.Vinson JA. “In Vivo Effectiveness of a Starch Absorption Blocker in a Double-Blind Placebo-Controlled Study with Normal Human Subjects.” University of Scranton, September 2001.

16.Vinson JA. “In Vivo Effectiveness of a Starch Absorption Blocker in a Double-Blind Placebo-Controlled Study with Normal College-Age Subjects.” University of Scranton, November 2001.

17.Vinson JA. “Dose Response Human Study of Amylase Inactivator with Normal Subjects Given a Full Meal.” University of Scranton, May 2002.

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