This fall’s predicted resurgence of the Swine Flu seems to be all over the media right now. My office is already getting many calls from patients asking when our Swine Flu remedy will be available. Usually our homeopathic treatment is ready when the FDA-approved flu shot is ready, since it is manufactured from the same virus. We typically have it in the office by early October; but if the flu shot is delayed, our homeopathic remedy will be delayed as well.

Why offer a homeopathic remedy at all, when getting the flu shot seems simple and effective? First, there are certain people who absolutely should get the shot. The elderly, for example, or people with compromised immune systems, need that concentrated dose of the virus to boost their immunity quickly. But I have successfully treated the vast majority of my patients for decades with a homeopathic remedy, because it is just as effective and does not carry the risks and potential side-effects of the flu shot.

Basically, the flu shot gives a concentrated dose of the live flu virus to boost your immunity. But it carries risks of infection or adverse reaction – some people break out in hives, or actually get an abbreviated case of the flu. And for people with certain alergies, the flu shot carries an increased risk of side-effects. People allergic to eggs, for example, can’t get the shot at all.

The homeopathic remedy, in the form of pellets you place under your tongue, delivers a dilluted dose of the flu virus that gradually builds in the system and prevents infection. It carries no risk of actually getting the flu, and can be taken by anyone with allergies or other pre-existing conditions with virtually no chance of a bad reaction.

I’ll post again when I have a better idea of when this year’s remedy will be available; we will have it in our office and on the Apothecary website for people who want to order it online.

A patient came into my office today afraid to take an upcoming vacation to China. He’s got poor circulation, and just read about the recent study showing even more evidence that long-distance travel can double your risk of developing a fatal blood clot. Obviously, this is a hot topic, with travel at it’s peak; even in a struggling economy, those foregoing expensive plane flights are piling into the SUV and driving long distances to eke out a summer vacation.

The fact is that any long trip, whether it be on a plane or in a car, can dramatically increase your risk of developing deep-vein thrombosis, or DVT. DVT refers to blood pooling in the veins after prolonged periods of inactivity; it becomes deadly when a clot dislodges and travels to the lungs, restricting the flow of oxygenated blood-flow to the heart (known as a pulmonary embolism). There was that sad case some years ago of the war reporter, David Bloom, who died of a pulmonary embolism after spending months of flying with the US troops in cramped quarters. Preexisting conditions like a prior case of phlabitis, or taking certain medications like birth control pills, can increase that risk even more.

Luckily there are several preventive measures you can take to travel safely. First – no medication or supplement takes the place of standing up and stretching your legs every two hours. If you’re packed in the minivan headed to Yellowstone, be the hero, give into the kids’ pleas for a pit-stop, and do a few turns around the ice cream stand. When the in-flight movie is over and you’re reaching for your laptop, put it down and walk the plane aisle for a few minutes instead.

And there are several natural remedies that work to prevent clotting. I have my patients pre-medicate before long trips with 2 each of garlic and Vitamin E, and a fish oil tablet. If they have poor circulation, I will add 2 tablets of Ginkgo. All of these work beautifully as anti-clotting agents.

I recently had a patient come in who had six children, and several more pregnancies on top of that.  She’d nursed each child for many months. No surprise, perhaps, that she was seeing me for fatigue. Of course, lack of sleep and multiple demands on time and energy can contribute; but it cannot be overstated what a nutritional burden it is to be pregnant or nursing. For those nine months of pregnancy and however many months of nursing, a woman’s body is concentrating all nutrients into the placenta and, later, the breast milk. And it doesn’t have to take six pregnancies to cause nutrient depletion.

 Herbal supplements are an integral part of my practice, and are certainly relevant treatment here; but determining safe doses is critical for any woman potentially carrying and nursing a child. I treat women at all stages: they’re planning on conceiving someday, actively trying to conceive, pregnant, nursing a baby. For women hoping to get pregnant but not yet trying, I recommend increasing vitamin and mineral intake so that they are getting at least 100 mg of the B vitamins and maximum doses of vitamin D, magnesium, and other minerals. Those trying to get pregnant obviously need to avoid abnormally high doses of nutrients to protect the fetus; sometimes I will have a patient keep on the higher doses only when she is bleeding, under the assumption she hasn’t conceived. I’ll also have patients come in for IV vitamin infusions during such times.

Supplementing during pregnancy and even nursing months needs professional vigilance. I generally use a good-quality prenatal vitamin; some essential fatty acids; extra vitamin D, magnesium, and calcium; as well as some herbs known to help during pregnancy. Once a patient has stopped nursing, I usually do some nutritional testing to see what is out of balance, and try to correct that as soon as possible. I know from watching my patients (and my wife, years ago!) how important every bit of energy is when raising young children.

What do Egyptian pharaohs, Italian grandmothers, the ancient Greeks, and Gwyneth Paltrow have in common? They all have trusted the healing properties of cupping therapy. Although cupping is perhaps most commonly associated with Chinese medicine, it’s a practice that has roots all over the world, dating back thousands of years. I remember my Eastern European grandparents coming to this country with their set of bankes (cups), which I use in my practice to this day.

Generally, cupping is most often used to relieve congestion, inflammation, or poor circulation. The practitioner creates suction either with a plunger, or with flame held briefly to the cup rim, and applies cups to the affected area (watch a session here).  In the case of poor circulation, the suction draws areas of microclotting to the skin surface and promotes better circulation throughout the deeper tissues. I have successfully cupped patients with asthma, muscle aches and spasm, arthritis, even digestive problems. 

So how does it feel? One patient with fibromyalgia whom I see regularly describes it as “a deep-tissue massage, like someone is accessing that soreness between my shoulders and massaging it away. It’s deeply relaxing, and I can feel my body detoxing.”

Anyone with circulation issues should check with their physician before pursuing cupping therapy, and pregnant women should avoid it completely. But the rest of us could learn a thing or two from our grandparents.

Many of my patients come to me with thyroid problems – so many that I am going to be launching an online community for people with thyroid issues (more on that later). Those that take ArmourThyroid almost all get the same response from their pharmacist: “You’re doctor’s an old-timer, isn’t he?” ArmourThyroid was prescribed much more often before there were synthetic treatments. But synthetics don’t work for everyone, and there are others who benefit from the extra thyroid support that ArmourThyroid gives.

Here’s the problem, though – the manufacturer, Forest Pharmeceuticals, has struggled with demand, and is experiencing yet another ”service interruption.” I called their toll-free number yesterday, and learned that many strengths are available. If you’re taking ArmourThyroid, it’s worth calling 866-927-3260 to get the facts, in case your pharmacy tells you they can’t fill your prescription.

If you’re thinking of alternatives, one medication I am prescribing more and more is Nature-Throid. You can read about it at their website,  www.nature-throid.com .

Most of my patients who are in pain simply want relief. They would take any medication if they could tolerate it, and if they were assured the drug was safe. But what makes some medications so potent can also make them tough to stomach (sometimes quite literally), as well as potentially dangerous.

A recent example – the FDA convened a joint advisory committee a few weeks ago to investigate acute liver failure and overdoses related to Acetaminophen (the primary ingredient in Tylenol, as well as in prescription Vicodin and Percaset). More than 400 people die and about 42,000 are hospitalized each year because of Acetaminophen overdoses. Why? Some people ignore the label instructions, but it’s thought that many more do not realize they are combining Acetominophen-based drugs: they take Tylenol with Vicodin, for example, and rapidly exceed the maximum daily intake.

But no matter the dose, Acetaminophen is hard on the liver, and people in chronic pain would do well to consider some alternatives. Fortunately there are many natural products that can be used for pain and inflammation safely and effectively, with research to prove it. Here are some of my favorites:

Proteolytic enzymes: these enzymes are taken between meals and are anti-inflammatory and therefore pain-relieving. They can also enhance the effectiveness of antibiotics and other pain relievers.

Omega III fatty acids: the EPA fatty acids in Omega III, which come from fish oil, make the anti-inflammatory hormones in our body. Multiple studies have indicated fish oil’s distinct anti-inflammatory effect on rheumatoid arthritis and other inflammatory conditions.

DL-Phenylalanine (DLPA): This form of a common immunoacid works by itself to lessen pain; it also enables narcotics to be used at a lower dose.

Curcumin: The active ingredient in turmeric, curcumin has a proven affect on inflammation and pain relief. It has also been used effectively in treating some forms of cancer.

Kaprex: this potent form of botanical medicine is largely an extract of hops. The extract (known as THIAA) has a direct effect on the prostaglandin E2, which is responsible for much of the inflammation in joints and other pain areas. Kaprex has been found to be at least as effective as pain relievers in cases of arthritis and other joint inflammations.

The latest study indicating red yeast rice’s ability to lower cholesterol levels surprised me – not because of the results (indeed it does work), but because the pharmaceutical companies have so much invested in statins, I’m surprised that a Chinese herbal remedy made it past the barricades!

First, if statins work to lower cholesterol, why go to an herbal supplement at all? Unfortunately, statins have a huge impact on the liver, and carry heavy side-effects. They block an enzyme (HMG-Co A reductase) that has more than one function in your body; so blocking it lowers cholesterol, but also often results in muscle ache and fatigue.

Red yeast rice actually contains a natural statin (Monacolin K – what Lovastatin, or Mevacor is made from). Other components of red rice yeast also have positive effects on cholesterol metabolism; furthermore, each of these components exists in a much lower amount than they would in a statin drug. The end result is a milder but still significant lowering of cholesterol, and a much lower instance of aches and fatigue.

When considering natural supplements in place of pharmaceutical medications, I operate by the 80/20 philosophy. About 80% of patients using medications can probably get the same or an acceptable result by using supplements. And, in general, the supplements will give about 20% of the side-effects of prescription meds. Now obviously there are patients who need to take statins; I am certainly not recommending that everyone get off statins.  But the majority of patients with high cholesterol can improve with an appropriate dose of red yeast rice. For those with high blood sugar and fat density around the waist, I also add niacin and fish oil.

Here’s another caveat, and I’m glad this has been stressed in every article I’ve read: not all red yeast rice supplements are what they say they are. The FDA is still choosing not to regulate nutritional supplements, and too many products on store shelves are contaminated. As with any herbal supplement, buy from a reputable source – preferably a medical professional.

Before moving on to other blog topics (like what it’s like to try and find your sunglasses after 6 weeks) I want to pick up where I left off before the holiday weekend, and touch on a few of the aspects of Lyme that make it challenging to treat. These are complcating factors that many doctors do not address; they give their Lyme patients rounds of antibiotics, and the patients don’t get better. Here’s what more doctors need to consider:

Neurotoxins: Lyme spirochetes can produce toxins that stay in the neurological system, causing chronic Lyme symptoms even after the disease is succcessfully treated. Dr. Ritchie Shoemaker outlines the diagnosis and treatment of these toxins on his website, www.biotoxins.info . In addition to these protocols, I help my patients detoxify by prescribing an algea called chlorella, as well as through the use of Far Infrared Saunas (FIRS). These saunas are portable, reasonably priced, and highly-effective at getting my patients to sweat – which is, of course, an excellent way to rid the body of toxins.

Co-infections: Deer ticks have become synonomous with Lyme Disease; but they can carry many other diseases that are passed along through the same bite that transfers the Lyme spirochete. Babesia, Bartonella, and Ehrlichea are the diseases I test for most commonly in my Lyme patients. Any positive result necessitates a tweaking of the antibiotics prescribed, particularly in the case of Babesia. Mycroplasma fermentans is another infection carried by deer ticks and frequently missed in diagnosis. Dr. Garth Nicholson of the Institute for Molecular Medicine has done very good work on these infections; you can read more on his website, www.immed.org .

Biofilm: you know that slimy feeling on your teeth when you wake up? That’s biofilm – a sticky matrix that bacteria form to protect and harbor them. The Lyme spirochete is a notorious former of biofilm (another reason why it’s tricky to eradicate). I will therefore often give patients proteolytic enzymes like Serraflazym and InflammaQuell, or EDTA suppositories, to help disrupt the biofilm and render antibiotic treatment more effective.

Enough, for now, of blogging about Lyme … but I’ll remain in the trenches, with many more Lyme Clinics scheduled over the next several months. I could double that amount and still do more.

People often come into our Lyme clinic under a cloud of doom. They’ve read on the internet that Lyme never really goes away, and that they are never going to feel normal. Of course, I immediately try and reassure them that this does not have to be the case; if properly treated, Lyme can go dormant for many years, or never flare again. It’s similar to herpes, a virus that stays in the neurological system and may never surface again, or it flares periodically and is treated.

The challenge in treating Lyme Disease is related to the challenge in diagnosing it. Since it’s mostly a clinical diagnosis, we look at history and symptoms first and then use lab tests to confirm our suspicions. Similarly, we have no magic blood test that tells us when to stop treatment; we must use the patient’s symptoms as our guide.  Here is an overview of medications and therapeutic treatments I have found to be highly effective:

 Antibiotics are the basis of Lyme treatment. Since spirochetes are resilliant, we use fairly high doses, and treat for a minumum of six weeks (and sometimes much longer – it’s not uncommon for me to have patients with chronic Lyme on antibiotics for 6-9 months a year). Click here to read more about my Lyme Disease antibiotic protocol.

IV Therapy is considered after other possibilities are exhausted. If it’s decided on, we usually will have a PICC line inserted surgically so that antibiotics can be given at home under a nurse’s supervision. We also use a “pulsed” regimen, treating 4-5 days a week with a break, and treating for a minimum of 12 weeks (read more here).

Although I have not seen much success with botanical medicine, there are several herbal medications that I use – most commonly, Cat’s Claw (Saventaro), Olive Leaf extract, and Artemesinin. I use these usually in combination, as a “step-down” regimen, when I am finishing a course of antibiotics.  Several herbal protocols (Cowden’s and Beuhner’s) are used by herbal practitioners; I have found them difficult to take and resulting in widely varying responses.

My practice has also seen very positive results from Hyberbaric Oxygen Therapy (HBOT) as a useful adjunct to medical treatment. Patients lie in the canvas tank while oxygen is pumped in under low pressure (1.3 ATA). The treatments, usually an hour-long, enliven the brain cells and enhance the healing process. We recommend 20-30 treatments, usually once or twice/week.

Finally, I always prescribe nutritional supplements to offset the negative affects of the disease and of the medications, as well as to aid in tissue repair and boost the immune system. The basics are a Lyme Transfer factor made from cholostrom, which boosts the immune system; Vitamin D, also to boost immunity; Serraflazyme to help break down the biofilm surrounding and harboring the spirochete; Fish Oil as an anti-inflammatory to promote healing; and Sacro B to offset an overgrowth of dangerous bacteria in the bowel (a possible side-effect of antibiotics).

For further discussion – it’s worth mentioning three complicating factors with chronic Lyme: the problem of co-infections, transmitted through the tick bite; the biofilm that surrounds and harbors the spirochete, potentially inhibiting treatment; and the toxins that the spirochete produces that stay in the neurological system, causing chronic symptoms even after the Lyme is successfully treated. More on that next Lyme post. Happy 4th to all.