Natural Medicine is Based on Science, Too!

Newsweek Gratuitously Targets CAM

I strongly agree with Jerry Adler in his editorial in this week's Newsweek Magazine that we should make health care decisions based on evidence. In fact, my whole career in the past 35 years has been to advance science-based natural medicine. Science does not belong to any one profession; it is a way of looking at the world to achieve reproducible results and maximize efficacy and safety. Unfortunately, Mr. Alder appears to have an anti-CAM rather than a pro-science agenda.

While he gleefully (and appropriately) gives examples of CAM (complementary and alternative medicine) therapy failures and unsubstantiated and outlandish claims, he ignores equally egregious examples of prescription drug failures, adverse drug reactions and intentional fraud found in conventional medicine. Why does he conveniently ignore the several articles the past year in the medical journals he so trusts that have documented numerous examples of research faked to make drug intervention trials look better and conscious efforts by pharmaceutical companies to avoid reporting adverse events?

Only a single example, the Vioxx tragedy, is estimated to have caused as many as 100,000 excess deaths. This single, properly prescribed and supposedly well-researched drug has, in my opinion, caused far more serious harm by several orders of magnitude than all CAM errors, contaminated or misadvertised products, and adverse events combined. As Mr. Alder so conveniently ignores, several state attorney generals have now sued Merck for intentional consumer fraud. And they are winning.

I don't want to appear to justify CAM failures by pointing out conventional medicine failures - neither is acceptable. As I tell my students and include in my many lectures; "We do research not to prove what we do works, but rather to get better." I am a "true believer" in the natural medicine approach to health. However, that does not mean that everything we believe is correct or that every therapy is safe and effective. The only way to know is to do objective research.

Happily, there are now hundreds of thousands of good quality studies published in peer reviewed journals evaluating CAM therapies. While most show efficacy and safety, some do not. Knowing the difference is how we get better. I could give so many examples. Let's look at just a few recent studies:

• A study of 42 healthy volunteers found that green tea phytonutrients increase activity of the enzymes that detoxify carcinogens.
• A placebo-controlled study of 297 children found that giving them drinks containing FDA-approved food colors resulted in hyperactive behavior.
• A study of 29 postmenopausal women who had suffered from at least 14 hot flushes each week experienced a 50% reduction in symptoms after consuming 1.4 ounces of crushed flax seeds per day.
• A study of 29,361 men found that those who ate more than a serving of either broccoli or cauliflower each week almost halved their risk of developing advanced-stage prostate cancer.
• A study of 889 patients found that drinking cranberry juice significantly boosts eradication of Helicobacter pylori (the bacterium responsible for ulcers and many digestive complaints) in women receiving triple therapy with the antibiotics omeprazole, amoxicillin and clarithromycin (OAC).
• A prospective study of 5,611 adults 60 years or older found that those who most closely followed a Mediterranean style diet decreased their overall mortality rate by 50% after 6 years.

The list is endless.

Mr. Adler's diatribe does a disservice to the over one hundred thousand CAM researchers and clinicians conscientiously studying this medicine and providing health care and the approximately half the population of the US who seek health care from state-licensed CAM professionals and use CAM products.

In this blog, we will continue our commitment to providing our understanding of the best research available. This means considering both negative and positive results.


References
Chow HH, Hakim IA, Vining DR, et al. Modulation of human glutathione s-transferases by polyphenon e intervention. Cancer Epidemiol Biomarkers Prev. 2007 Aug;16(8):1662-6.

McCann D, Barrett A, Cooper A, Crumpler D, Dalen L, Grimshaw K, Kitchin E, Lok K, Porteous L, Prince E, Sonuga-Barke E, Warner JO, Stevenson J. Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial. Lancet. 2007 Sep 5; [Epub ahead of print]

Pruthi S, Thompson SL, Novotny PJ, Barton DL, Kottschade LA, Tan AD, Sloan JA, Loprinzi CL. Pilot evaluation of flaxseed for the management of hot flashes. J Soc Integr Oncol. 2007 Summer;5(3):106-12

Kirsh VA, Peters U, Mayne ST, Subar AF, Chatterjee N, Johnson CC, Hayes RB; Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Prospective study of fruit and vegetable intake and risk of prostate cancer: J Natl Cancer Inst. 2007 Aug 1;99(15):1200-9. Epub 2007 Jul 24.

Masala G, Ceroti M, Pala V, et al. A dietary pattern rich in olive oil and raw vegetables is associated with lower mortality in Italian elderly subjects. Br J Nutr. 2007 Aug;98(2):406-15. Epub 2007 Apr 3.

Related Topics:

• Be Smart About Integrative Medicine
• Understanding Alternative Medicine

Technorati Tags: CAM, complementary and alternative medicine, integrative medicine, health and wellness

Functional Medicine Day: Autism Spectrum Disorder

Welcome to the Functional Medicine day. Today we are welcoming functional medicine doctors and interested health care consumers to discuss this cutting-edge approach to medicine. I am posting this interesting case to get the conversation started. [Note to visitors: To learn more about functional medicine, you can download this PDF file: What is functional medicine?]

Autism is a growing concern, with increasing numbers of children being diagnosed, especially boys. Incidence of autism is now about 1/166, which represents about a tenfold increase in the past 2 decades, although the numbers vary according to researcher. The causes are not yet fully determined, but we do know that, as typical of most diseases, autism is multifactorial.

The main causes appear to be mitochondrial dysfunction, detoxification dysfunction and intestinal fungal overgrowth. This latter cause, according to autism expert Sid Baker, MD, occurs in about 1/3 of cases with aggressive antifungal therapy resulting in complete remission in many.¹ Nutrients reported to help autistic children include magnesium, vitamins B2 and A, and medium chain fatty acids. There have been reports that many autistic children have problems eliminating heavy metals, especially mercury.

Case Study

This child, now seven, was first brought to see me at age two. His mother reported that she had seen some symptoms at age 1 (repetitive behaviors), but they disappeared when they removed nuts from his diet. He was growing normally and apparently meeting milestones until age two when he started to get physically weak. This was first noticed when he became unable to climb the gym set at the park which he had climbed with no problems many times before.

Relevant family history is that his parents (mother 49, father 55) were supposedly infertile ( >12 known miscarriages). Unexpectedly, his mother maintained her pregnancy and successfully vaginally delivered him and his fraternal twin. His problems are not surprising considering the history of unsuccessful pregnancies and parents' age well beyond optimal. His fraternal brother is relatively normal, although he does suffer from migraine headaches and food allergies.

Screening blood tests (which showed elevated serum lactic acid) and evaluation of developmental landmarks by a pediatrician resulted in a presumptive diagnosis of autistic spectrum disorder. Conventional care offered little hope, so his parents sought help elsewhere. An elevated lactic acid can be an indication of mitochondrial deficit, so I initially put him on high levels of vitamin B2 and modest levels vitamin B1, Mg, creatine, acetyl-L-carnitine, NAC, glutathione, lipoic acid, and CoQ10 -- a combination of nutrients that would promote energy metabolism while bolstering mitochondrial antioxidant defenses. Later, after doing a urinary organic acids profile, we refined his supplement program and had his mother start giving him medium chain fatty acids (two grams per day). These fatty acids from coconut oil are more easily metabolized by the mitochondria for energy production. The results were remarkable: he became much stronger, and his autistic symptoms all resolved.

Although he is not cured, his metabolic function has been much improved; however, if he stops taking the supplements, he quickly starts to deteriorate. Activation of his mitochondria requires 100 mg/d of B2 (about 50 times the RDI).

His health is not perfect; he is still somewhat physically fragile, and I know we haven't found or fixed all his problems. But if you met and talked with him, you would only see a bright, engaging boy, a bit small for his age.

Interestingly, in reviewing this with his mother before posting his story on the blog, she now feels that his apparent developmental deficiencies were all due to muscle weakness rather than mental issues. Her comment:

Brent (not his name) was having problems learning to read, and he would ask me, "Mom is that an "i" or an "l", or is that an "h" or an "n", and I was very concerned thinking he was slipping mentally, as he should have known this without any problem at this stage. But I would notice at other times he could read words easily, especially if they were listed rather than in sentence form. I also noticed the longer he tried to read a book, the worse his word recognition or decoding became. I was talking with a counselor at his school, and she explained it is much harder for the eyes to track horizontally between each small word and that the eye muscles have to develop the coordination and strength. When she said muscle strength, I knew immediately Brent's problem was eye muscle weakness, not loss of mental function. I explained the problem to him; we changed how he reads, and he got his self confidence back and is now decoding and reading quite well. So, he obviously has muscle weakness throughout his body. The other very obvious place being his swallowing difficulties.

I can understand how a mother would not want her child to be diagnosed as autistic. And autism syndrome covers a wide range of dysfunction, ranging from mild to severe. She may be right that most, if not all, of Brent's developmental problems could be explained by muscle weakness secondary to mitochondrial dysfunction. As we progressively restored his mitochondrial function, his muscles began developing again, and his physical and mental deficiencies eventually resolved.

The problem with an autism spectrum disorder diagnosis is that there is no specific confirmatory lab test--it is more a diagnosis by exclusion. If we had not caught this early and normalized his mitochondrial function, it is highly likely it would have resulted in (further?) neurological damage and converted his presumptive diagnosis into full manifestation.

Regardless of the diagnosis, Brent clearly has a significant mitochondrial defect that resulted in serious problems, most all of which we were able to resolve with a sophisticated nutritional intervention.

Related Topics:

• WebMD Video: Spotting Autism Early
• WebMD Video: Autism Diet

¹ Editor's Note: The successes reported by Dr. Baker as a result of alternative treatments have not yet been supported by scientific studies.


Technorati Tags: functional medicine, autism, autism spectrum disorder, integrative medicine, alternative medicine