Feature highlights- April 10, 2004-April 24, 2004

Are you familiar with something called a rebounder?

DR. HOFFMAN: A rebounder is a form of exercise that doesn't take a lot of space. Actually, people don't necessarily have to have a lot of stamina to do it because it can be done gently. It's kind of like what the cheerleaders use to do their stunts. It's a mini trampoline. And the advantage of it in many medical conditions is that it tends to help lymphatic circulation. It helps the lymph circulate around in the body. It helps general circulation and it gives you a little bit of a workout.
It also seems to help lymphatic circulation, which is good for general detoxification and cancer. The thought is maybe this helps to mobilize the immune system or helps the body to detoxify after chemo or radiation treatments. And I guess it may play a role.
The problem with rebounders is that they do require some minimal vision and balance, so you don't want to say to your 93-year-old grandma who basically has trouble crossing the room, "Hey, I got a rebounder for you." because they might use it and slip and fall and break something. But even older individuals can use it and get used to it. And it's good for maintaining balance and equilibrium.

I suffer with diverticulitis

DR. HOFFMAN: In other words, like outpocketings in your intestinal tract which becomes infected from time to time?
CALLER: That's correct. Now, for several months I'm doing very well. I'm trying to heal this from the inside out. I've been on the vitamin therapy and I just want to ask your opinion about colloidal with silver -- is that advisable to take that with my history?
DR. HOFFMAN: There's a whole controversy with colloidal silver because silver compounds have been used a lot in -- especially in the 19th century and in the 20th century prior to the introduction of antibiotics -- as a way of treating and preventing infections. In fact, I don't know if it's still hospital practice, but until recently, it used to be the practice to put silver drops in the eyes of newborns to prevent the sequel of gonorrhea.
Gonorrhea can actually cause blindness as the baby goes through the birth passage, so the silver drops were designed to prevent that. But these days, gonorrhea is on the wane so it's less of an issue. So maybe they have figured out better ways to deal with that.
But anyway, the principle is that silver has an anti infective property. Generally, it's pretty safe but there were some reports that people who take colloidal silver have developed a blue tinge to their skin. It's a well-known medical condition called argyria, which is due to an overload of silver in the system. And these are pretty weird looking, unhappy individuals.
Now, a lot of the manufacturers of colloidal silver will say, "Hey, our stuff doesn't do that." Because when it's in the colloidal form, it doesn't get absorbed that way and yada yada yada. But the problem is you don't know. And I have been a little reluctant to tell patients to drink colloidal silver. I suggest it as a throat gargle that you can swish around in your mouth and spit out if you have a sore throat. Perhaps it's something you can put in a nasal douche that will run through your sinuses that ultimately gets spit out or expelled.
A good diet to follow for chronic diverticulitis is the Specific Carbohydrate Diet (www.scdiet.com and www.scdiet.org) -- it's a diet we use for Crohn's disease and ulcerative colitis. It helps to reduce infection in chronic diverticulitis. Also, there are certain herbs that are beneficial. Goldenseal is one of them although, Goldenseal is getting harder to find these days. It's a rare herb. Also, you can use the herb Gentian. And also, there's potent extracts of olive leaf extract and or EGCG now that have anti-infective properties. That, along with probiotics, --you put good bacteria back into the intestinal tract.
CALLER: I am taking acidophilus.
DR. HOFFMAN: That's good, you're on the right track.

I recently got offered a job and I have to go to take nicotine, urine, metabolic test for nicotine. The penalty is awful in the respect that it's for a health plan and I will be penalized pretty badly.

DR. HOFFMAN: In other words, there's a two tier plan where you have to pay more if they end up finding tobacco and residue in your urine or blood?
CALLER: I think it says urine on the lab sheet. So my question is, how long and I've been, I haven't been off nicotine too long --
DR. HOFFMAN: How long have you been off?
CALLER: Four days and I've been drinking like a crazy person -- water, lots of water, trying to cleanse my system.
DR. HOFFMAN: When's the test?
CALLER: Monday.
DR. HOFFMAN: Monday. I really don't think you're going to have a problem for this reason: Nicotine doesn't last very long in your system. The craving lasts, but if nicotine lasted a long time in your system, then you could get up in the morning, smoke a cigarette and then you'd be fine until 9:00 o'clock at night.
Nicotine levels are actually hard to maintain in your bloodstream, that's why people have to smoke every half an hour, 45 minutes to maintain a steady state of nicotine levels. The other factor that needs to be considered is when you do these tests, if this test was so sensitive that you could pick up tiny amounts of nicotine, you could walk through -- well in these days you can't walk through a bar or hotel lobby because smoking is mostly banned -- but you could be around a smoker and take the test a few hours later and significant amounts of cotinine, which is a metabolite of nicotine, would be found in your urine or your blood and they would disqualify you.
I think they set the limits on these tests a little higher so that passive smokers are exempted because otherwise that would be a real injustice if you're a nonsmoker and you're disqualified from an insurance program. You could scream bloody murder and hire a lawyer. But look, this is a good thing because the test is an incentive to you to withdraw from cigarettes, and I would say keep it up. I think you'll be okay for the test on Monday.

I'm calling because I have burning mouth syndrome. And I had mentioned this to my doctor and he wasn't really concerned about it. And I mentioned it to another skin specialist and she said she was going to check into it. And finally I went to a periodontist for other work and he said he heard of it and he knew of someone who specialized in it. But nobody has pursued it, and I haven't pursued it, but I've had it for like five years.

DR. HOFFMAN: Has this been properly diagnosed as such? Because there are a lot of reasons that you can have discomfort in your mouth. You can have some kind of infection like a yeast infection, which can cause inflammation. You might have a food allergy. It's also possible to have some sort of viral infection or even some pre-cancerous problem in your mouth that could cause you mouth pain. So you need expert diagnosis for this.
And when all is said and done and they really can't find anything, they say, well, "You have burning mouth syndrome." Sometimes it's as simple as that. People use cinnamon-flavored gums or various types of mouthwash that can cause reactive irritation in the mouth. But when all is said and done and everything has been checked, burning mouth syndrome is probably a nerve problem and it's not often recognized as such.
There's new thinking on this that suggests that you may be able to get some benefit from lipoic acid. This is a treatment. It's a supplement, it's available over the counter. Some new studies done in Germany, I believe, suggest that higher doses of lipoic acid can help the nerves in the mouth recover and reduce pain. This is the case with peripheral neuropathy or pain and numbness in the feet. That's treated with lipoic acid. And the dose that may be required is anywhere from 300 to as high as 3,000 milligrams of lipoic acid daily.
There's not a lot of research done on this and we're treating a few patients with this, but it's worth trying. For other types of mouth irritation -- if people simply have irritated tissue in their mouth -- I would suggest that you use something called DGL, especially if you have mouth sores or internal ulcerations, what are called apthous ulcers in the mouth.
DGL, which is a potent extract of licorice, has healing effects on ulcers in the stomach but also in the mouth. So you sucking on those lozenges can be helpful if there's mouth irritation.

I'd like to talk about statin drugs. I've taken Lipitor and in three, four days I've had problems.

DR. HOFFMAN: Tell us about the problems. What is often not mentioned -- they talk about this stuff like it's the cat's meow, it's like the solution to everything, they want to put it in the drinking water. And yet, a substantial percentage of people have problems with the statin drugs --
CALLER: So he put me on the Zocor for four to five weeks. I had the same problem. It took that long.
DR. HOFFMAN: Usually if you react to one statin, it's fairly likely you'll react to another, it may take longer.
CALLER: Is there anything else?
DR. HOFFMAN: Yeah. Once you've shown -- if you were my patient, and I had to put you on a statin, I would put you on one, perhaps I would try another. But if you showed consistent reactions to statins, then it's very unlikely you'll find one that you won't react to.
There are other cholesterol lowering medications. One new one is called Zetia, which lowers cholesterol. It does through a completely different mechanism so it shouldn't cause that problem. But there are a lot of natural ways to do it. I would have to know with you, what is your cholesterol?
CALLER: I don't know. She didn't give me either one. She said, "Let me worry about that."
DR. HOFFMAN: That is so wrong, that is just so wrong. Look, do you know your social security number? How many digits is that? And you don't have the brain to hold in your head the digits -- your cholesterol, your HDL, your LDL and maybe your triglycerides. That's not the way we want to handle these problems. It's kind of like going to a car dealer and say, "Hey, you're buying a car, don't you worry your little head about what kind of car we're going to get for you. We'll just get you a nice one." And we should not be doing that in medicine.
Look, I would have to go over how bad a problem it is. You may not need drugs in the first place, merely because there's a big imperative to put people on statins if they have heart disease. And I agree. If somebody's got blockage, maybe they are a candidate for statin.
Other things include diet, obviously, niacin is helpful, although niacin should be used under doctor's supervision; high doses of pantethine can lower cholesterol; chromium can raise your HDL; fish oil has a cholesterol lowering effect, especially on triglycerides. You can use chromium often to raise your HDL cholesterol. Are you exercising at all?
CALLER: No. I've had neuropathy and -- in my feet.
DR. HOFFMAN: That doesn't mean you can't get into a pool and do some sort of --
CALLER: Right. That would be it. And I wanted to mention Propax. I went on it and within five days, I'm able to squeeze my toes. He says it's unusual, but I say, "Well, I'm telling you, I don't have the shooting pains into the toes anymore."
DR. HOFFMAN: That's very exciting. And Propax contains a variety of vitamins and minerals. But I think it's the ingredients in Propax called NT factors that probably is helping you, it seems to help support the cell membrane function. The cell membrane is very important because a lot of people think, it's just a wall, it just keeps the fluid inside the cells because if there wasn't a cell membrane the fluid with leak out.
But actually, the cell membrane is very complex. It has to have the right composition of phospholipids and essential fatty acids because otherwise, it becomes inflexible. The ability of cells to communicate with other cells breaks down and you kind of get a power outage in your cells. And these phospholipids also influence the mitochondria, which are the energy-producing structures inside the cells.
And when I endorse a product, full disclosure. I endorse Propax in commercials on this program. Some of you may hear those commercials -- it works, it's beneficial, it's an energy enhancer and it relieves a lot of symptoms in patients with debilitating problems

I take pamelor --

DR. HOFFMAN: It's an antidepressant medication.
CALLER: -- and I'm wondering if EGCG is a blood thinner because I think that Pamelor has some blood thinning properties.
DR. HOFFMAN: Well, actually you're wrong on both counts. Pamelor does not thin the blood. Pamelor is actually an old-fashioned antidepressant. It's called a tricyclic antidepressant, those were before the SSRI's like Prozac and Zoloft and Paxil came along. That's not one of its properties. It can affect the heart in large doses but it does so in a different way.
EGCG, which is an ultra-potent extract of green tea, which I'm very big on these days, has been shown actually to thicken the blood but only in people who drink lots and lots of green tea. The EGCG that's for sale usually has extracted from it the vitamin K that may neutralize the effect of a blood thinner like Coumadin. So, many people are on Coumadin that need to worry about this effect. They shouldn't be drinking lots and lots of plain green tea. They can take purified extracts of green tea like EGCG from which the vitamin K has been removed. So there really shouldn't be a blood thinning effect or thickening effect from EGCG alone.
Recent good news on EGCG: It's a cancer fighter; it's a heart disease preventer; it seems to help the metabolism enabling people to have a higher rate of thermogenesis, which is fat burning. It does a lot of things, but a couple of new studies: One showing that EGCG inhibits the multiplication of leukemia cells, that's a big study. And another study showing that it prevents cervical cancer -- precancerous cells from transforming to cervical cancer. And it can be taken orally as pills and it can also be applied topically to the cervix as an ointment to prevent these cancerous transformations.
The news about EGCG just keeps getting better and there's not a week that goes by that there's not a new study suggesting that it's helpful for something or other.

I was hospitalized in February for two days with what they said was mild pancreatitis. Now, I've been on Axid, but today I have a lot of discomfort and I'm frightened that I don't want to have surgery but --

DR. HOFFMAN: I don't know what's going on with you that caused your pancreatitis, but usually it's some kind of blockage. And if they're talking surgery, it means they probably think that you've got gallstones that are causing your pancreas to flare up. And you have good company in John Ashcroft -- that happened to him recently. He's a young, vigorous man who did get in trouble with this. For a while, they had him in the intensive care unit. Maybe that's an extraordinary precaution for someone who's on the cabinet and part of our homeland security detail.
But pancreatitis can be very serious and the suggestion is that as much as you're averse to going under the knife, if the stones keep blocking your pancreatic duct, you will just keep getting episode after episode of pancreatitis. There's not much you can do naturally to make those stones go away, so deal with the stones and then we can address a preventive program for making sure you don't get stones in the future that can compromise your pancreatic function.

April 13, 2004

Aerobic activity fuels elderly brains, minds
Science News. February 21, 2004. Vol. 165. p.115

New virtual colonoscopy study disappoints
JAMA April 14, 2004

The dangers of second-hand TV: what you watch can affect your kids
By Tara Parker Pope. The Wall Street Journal. April 13, 2004
April 15, 2004

Spirituality helps older adults cope with illness
Journal of the American geriatrics Society, April 2004

Friends, lovers lower 2nd heart attack risk
Heart [British Medical Association˘s journal] April 12, 2004

Parental support has lifelong benefits
Psychology and Aging. March, 2004

Vitamin E can protect men from prostate cancer
US National Cancer Institute study, April 2004

April 16, 2004

More than 8 hours sleep too much of a good thing
Psychosomatic Medicine, March/April 2004

Exercise after breast cancer extends life
Michelle D. Holmes, Harvard Medical School. Presenting at the American Association for Cancer Research.

Magnetic therapy help alleviate stress disorder
American Journal of Psychiatry, March 2004

Lead levels high in some gunshot victims
American Journal of Epidemiology, April 2004

Critics say its unethical to use medical scans for marketing
BusinessWeek, April 19, 2004. p. 79-80

April 17, 2004

Monologue: fish

Americans have been a little ambivalent about fish and to ascertain Americans' attitudes towards fish, a company called Triomega -- they're a sponsor by the way-- and they make a very pure form of fish oil capsule providing omega-3 essential fatty acids -- they conducted a study of Americans because they wanted to find out whether Americans were eating enough fresh fish as recommended by the American Heart Association and other health organizations and if not, why? What were the obstacles towards implementation of an ideal diet containing heart-healthy, cancer-protective and joint-friendly fish oils? And they found out some interesting things.
As suspected, Americans are not eating enough heart-healthy, fresh fish rich in omega-3 essential fatty acids. Americans are less likely to eat fresh fish than many other foods. Here are some facts: Even though many Americans have been informed about the health benefits of eating fresh fish, only one in three has eaten fresh fish in the past seven days. Check yourself out -- have you eaten fish this week? Probably you listeners eat fish, we're preaching to the choir here.

But some of this is regional. It turns out that people in the midwest don't eat a lot of fish. People in Iowa, there's not a lot of fish, they're more likely to eat pork or beef or chicken, but not a lot of fish. By contrast, over the past seven days -- they did a seven-day recall -- more than twice as many Americans, 77 percent, have eaten steak or beef. Even more remarkable is that snack and junk foods are more likely to be eaten than fresh fish. Is that a surprise? Half of Americans have eaten cookies, 54 percent had pizza, 52 percent, over the past seven days as opposed to fish, 34 percent, and similar proportions have eaten French fries, that's 50 percent are potato chips 46 percent in the same time period.
Even among the minority of Americans who ate fresh fish in the previous seven days, most consumed only half of the recommended amount. Among those eating fresh fish the average level of consumption, only one time in the past seven days. We're supposed to have it at least twice a week.
Why are Americans avoiding fish? Well, half of survey respondents, 48 percent, said they worry about contaminants in fresh fish. And that's a real concern. PCBs in lake fish or mercury in ocean fish, this is a big problem. And women are more concerned than men, and rightly so because women of reproductive age, if they consume too much of the wrong type of fish -- say too much shark or too much swordfish -- there could be risk of mercury poisoning. If hubby comes home and he's caught all these wonderful fish in Lake Cochichewick, well, they better check the fishing advisories in that lake because maybe that lake is chock full of industrial chemicals. And sometimes it even says on fishing licenses: Don't eat more than one fish per season, or something like that -- especially for pregnant women.
Another obstacle to eating fish: 46 percent of Americans say they don't like the smell of fresh fish. That's just a smell aversion. 43 percent agree with the proposition that it's too expensive to eat fresh fish. 44 percent say that it's too hard to find. Well, that's no excuse for people who live on either the left or right coast of the United States.
Women, as I said, were more likely to worry about contaminants. And those living in north central region of the United States, like Minnesota, are significantly more likely than those living in other regions to agree that it's hard to find good, fresh fish. There's Mrs. Paul's fish sticks in the freezer section but you can't find fresh fish.
And here's an interesting one: By income and education -- under $25,000 in income only 25 percent have had fish in the past seven days; $75,000 or more, 46 percent. And there's an absolute correlation between income and eating fish. And by education, there's a big disparity too: high school or less, 29 percent; college graduate or higher, 45 percent. Look at the markets in some of the poor areas of the country, fish is barely available.

Facts about America's fish eating habits
www.triomega.com

Burns caused by steam inhalation for respiratory tract infections in children
BMJ. Vol 328, March 27, 2004. p. 757.

This is a health advisory for parents. When I was a kid, I'd get a cold. And what my mom would do is get some Vicks VapoRub, put it in a pot, boil some water on the stove, put the boiling water in the pot with the Vicks VapoRub and then I would lean over it with a towel over my head.
Fortunately, I escaped the fate of some of the kids who were described in this article of the British Medical Journal of March 2004: Burns Caused by Steam Inhalation for Respiratory Tract Infections in Children. This is in Dublin. They saw seven children over just six months who sustained scalds directly associated with steam inhalation. Yeah, it's a good idea, and it's a good home remedy but the problem is that kids knock these pots over, they end up on their laps or worse yet, inhaling hot steam from boiling water can actually scald your face.
I remember the whole object of this. I would hold my head over the water as long as I could without it hurting -- that's pretty close to the threshold where serious burns can occur. They have this heart-rending picture of a kid who sustained facial scalding from steam inhalation, it's not a happy looking picture. And they're saying, don't do this. The alternative is to sit in the bathroom with a hot shower running, the child on your lap, read the child a story but to avoid techniques involving kettles or bowls of boiling water because of the dangers that are shown in this report.

California moves to ban smoking in prisons
Reuters. January 27, 2004

Strontium ranelate boosts bone density in elderly women
N Engl J Med 2004;350:459-468

Well, just like the newly discovered tenth planet of the solar system, way beyond Pluto, this is a nutrient that many of you probably haven't heard of, don't know much about. But it's an important mineral, and I think it's going to play a role in nutrition in the coming years and so it's timely to discuss it.
That nutrient is strontium

. Many of you haven't heard about strontium. If you heard about strontium, you like me might associate it with the scare in the 1950s. Boy that dates me, but I remember the scare as a child. There was a lot of radioactive testing in this country. And for a couple years around Thanksgiving time, they completely dumped the cranberry supply of this country. They said it was bad because it tested high for something called strontium-90.
Strontium-90 is a radioactive element that's a byproduct of nuclear testing and it's controversial now as to whether this really posed a danger, but it was a scare. And so strontium doesn't hold a lot of currency as something helpful for the body.
But just as there's radioactive iodine and normal iodine, there's radioactive carbon and normal carbon, there's just plain strontium. And what is strontium? Strontium, if you look in what's called the periodic table of elements -- that's how chemists categorize various substances -- it's in the same column as calcium. And like calcium, it performs a role in bones and in teeth.
Strontium may replace calcium in hydroxyapatite crystals of calcified tissues such as bones and teeth. And when there's strontium present, it imparts additional strength to these tissues. It's actually very common in the earth's crust. There's more strontium than carbon in the earth's crust and so it is not a rare or dangerous heavy metal like mercury, cadmium or lead.
Strontium has actually been used a lot in medicine. You, unbeknownst to yourself, are probably using strontium. If you've ever used a toothpaste like Sensodyne toothpaste -- Sensodyne is for people who have hot, cold sensitivity. And if you use Sensodyne, for some reason it makes you less sensitive to extremes of temperature. And toothpaste is devastating, but Sensodyne helps. It contains strontium nitrate. Strontium nitrate may help strengthen the surface of the teeth, plug holes in the enamel, which can allow temperature to affect nerves to the teeth.
Strontium is now being looked at in a very serious way as a treatment for osteoporosis. And as far back as the 1950s, experiments were done giving people various forms of strontium. In one study back in 1959, people were given strontium, 84 percent of the patients reported marked relief of bone pain. X-rays -- in those days they didn't have DEXA Scans to check bone density but they showed an increase in bone mass in 78 percent of the cases. This is early and crude technology so we're not sure. Back in the 80s, additional studies of something called strontium carbonate -- bone biopsy samples showed a 172 percent increase in the rate of bone formation after strontium and patients receiving strontium remarked that the pains in their bones had diminished and their ability to move around had improved.
So this has lead to a big trial in a serious medical journal. It was in the New England Journal of Medicine a couple of months ago looking at a substance called strontium ranelate and this is going to be a drug. But it doesn't have to be a drug because strontium is available as a natural mineral in other forms: Strontium carbonate, strontium citrate.
In this particular study, in addition to suffering fewer fractures, patients in the strontium group noticed a risk reduction of 49 percent in the first year of treatment of the 49 percent fewer fractures and 41 percent overall during the three year study period. That's pretty good. Their bone density in the spine increased by an average of 14 percent and in the hip, by an average of 8 percent. That's very comparable to drugs like Fosamax, Actonel, and so on.
And so strontium is coming to the fore as a very plausible therapy for osteoporosis when combined things like calcium, magnesium, vitamin D, ipriflavone , lysine, vitamin K, you need the whole arsenal of these things harnessed together.
Also, some information on strontium and cavities: Strontium seems to strengthen teeth. Strontium may also be helpful in osteoarthritis, it seems to help with cartilage formation. So while you're treating your osteoporosis, it may also have a beneficial effect on your osteoarthritis. You'll be hearing more and more about strontium.

Lung cancer rate jumps in women
By Amy Dockser Marcus. The Wall Street Journal. April 14, 2004

Lung cancer rate jumps in women. Remember those commercials -- you've come a long way baby. Well, you have come a long way because the number of new lung cancer cases diagnosed among men has decreased in recent years. The diagnoses among women climbed a surprising 60 percent between 1990 and 2003, that qualifies as an epidemic. That's not just an uptick, that's an amazing surge in cases of lung cancer.
Well, lung cancer deaths is a lagging indicator of the incidence of smoking in women which soared in the years after the Second World War. Women were liberated -- you know the Virginia Slims cigarette campaign, sexual liberation, do what you want. And now we're reaping the horrible toll of that liberation. 60 percent increase between 1990 and 2003. Many women will be surprised to know that more women will die this year from lung cancer than from breast cancer and ovarian cancer combined. It is the leading cause of cancer death among women.
And the conclusion is that women may be even more susceptible to the genetic damage caused by smoking than men. Maybe their lungs are more delicate. Maybe their detoxification pathways in their body are less able to get rid of horrendous chemicals that are introduced into the system than are those of men.
Who is more likely to get drunk if you drink a finite amount of liquor? Now, there are exceptions to the rule. There are women who can, quote, drink men under the table. They pride themselves in that ability. But in general, it's the men who have a higher capacity for toxic things like foods. And similarly, when it comes to carcinogenic chemicals that are discharged by cigarettes, men may actually have a better ability to sweep their lungs clean of this carcinogenic debris.
An estimated 68,500 women will die from lung cancer this year. 68,500 -- I don't mean to trivialize what's going on in the Middle East, but on my reckoning, there has been about 685 deaths among combat soldiers in Iraq as of this week. And that's a terrible toll. Multiply that toll by 100 and you've got the number of just women alone who will die this year of a single cancer, lung cancer.
Interestingly, for every lung cancer death about $1,200 is spent on research of the disease while $11,000 is devoted to breast cancer research. Breast cancer is a much more PC disease than lung cancer. Why? Because some people consider lung cancer sufferers -- they consider them pariahs. It's a self-inflicted disease; they smoke, they ran the risk. And hence, they're going to reap the horrible toll, or so society sees it that way.
This article from The Times suggests that they're a modern day class of lepers, ostracized for their character defects and impulse control problems. But especially in women, there's high instance of 10 to 15 percent about 20,000 new cases every year who have never smoked. What's going on with that? Could it be passive smoking? Is it that they're around smokers and thereby inherited some risk? Or is it that we just all live in a crummy environment, breathing bad air, eating food that is potentially toxic to our cells, causing cancers of many kinds to arise in the body, not necessarily associated with the risk of smoking?
Well, we don't know the answers. A high percentage of smokers get cancer but a lot of nonsmokers get lung cancer. This is the trend particularly in women and there's not a lot of advocacy here. There's a lot of breast cancer advocacy but not enough advocacy for lung cancer curers.
One reason that lung cancer has lagged behind other cancers may be that there's just not enough survivors to carry the torch. People succumb relatively quickly, unlike breast cancer where long term survivors are marching, walking, running for the cure. And lung cancer takes very few prisoners.

H.I.V. cases shut down pornography film industry
By Nick Madigan. The New York Times. April 17, 2004

I have type 2 diabetes and was told that I need an ACE Inhibitor and want to know if that's true. And if it is, is there a natural source?

DR. HOFFMAN: Well, this is an interesting new thing. If you have Type 2 diabetes, you're going to be hit from a couple of directions in terms of medication suggestions. You're going to be told: Number one, you need to be on a statin; and number two, you need to be on an ACE Inhibitor.
This is all well intentioned because the idea is that if you have a condition that already predisposes you highly to heart disease and stroke, then we need to protect you, fix your cholesterol, and, at the same time, not only just get your blood pressure normal but get it supernormal -- better than normal. And studies have actually shown that statins and ACE Inhibitors when given to diabetics, help them.

But the way I interpret this is if you have Type 2 diabetes, it's not so much that you should be taking two different additional medications, is that you should be getting on the stick to naturally control your cholesterol and naturally control your blood pressure. And so are you involved in that kind of process? Have you been dieting, exercising, using the right approach to control those things?

CALLER: Yes. He prescribed medication but I didn't get it filled --

DR. HOFFMAN: I'm not going to advocate that, I think you need to -- if you want to go the natural route, I think it behooves you to be upfront with your doctor and also work with health care professionals who could tell you whether you need the medication or if you're able to lose your training wheels and get off dependency on drugs.

I've been microwaving my vegetables for many years now and someone about ten years ago told me that there was no difficult -- or health problems and we get as much nutrition as seeming. Is that true?

DR. HOFFMAN: To a certain extent it is. But probably steaming, especially when you use a steamer platform, you put the vegetables over the water so the nutrients don't leak out as much in the water. That's probably more ideal than microwaving. What microwaving does is, it agitates particles, or molecules in the food and shakes them up. And in that shaking, heat is liberated and part of the shaking can cause nutrients to breakdown or degrade.
Now, that is not so much the case with short term cooking because it really doesn't take many minutes of microwaving to heat vegetables. But it may be more of the case if you make a roast or something that really take a fairly long time in a microwave.

Suggestion is that you diversify your portfolio. Do a little light sauteing in a healthy oil, like olive oil. Do some steaming. Use the microwave to warm food but don't necessarily use it to cook food because we don't know all the answers. More research needs to be done but I can't say that microwaving food creates carcinogens or deadly poisons but it possibly does interfere with the accessibility to certain fresh nutrients.

I fell in November of '03 and got home February of '04. I have been on a blood thinner since then and my doctor is continuing me on Plavix. I want to know, I want to use vitamin E and Gingko because also I take a lot of vitamins and I know that they're blood thinners -- is that correct?

DR. HOFFMAN: That's correct. They can have an additive effect on medications like Coumadin, aspirin, Plavix. So, yes. Look, it doesn't mean you can't take them. It means you have to take them cautiously and make sure there's no signs of excessive blood thinning such as nosebleeds, easy bruisability, things like that.

CALLER: So I can start taking them now?

DR. HOFFMAN: You can indeed. But I want you to be under the care of a health professional who can dialogue with you as to whether the blood thinning effects are too great. I think it's important for physicians to be trained in drug-nutrient interactions. There are many of them, but just because there are potential interactions does not mean we should wave our arms and say, "Don't even think of -- don't go there, it's unsafe, it's dangerous." No.

We need to be cautious and aware of the potential side effects. I've had a couple of patients who were on blood thinners, who take vitamin E or fish oil, and there are some signs that they need to reduce their level of these critical blood thinners and that should be done because there are additional benefits to these other natural things.

So I'm calling for awareness and not throwing the baby out with the bath water.

I have a question about a supplement called IC3. My question is: Can I take this as a risk reducer if I don't have any symptoms, and can I take this as a nursing mother?

DR. HOFFMAN: Those are good questions. IC3 stands for Indol-3-Carbinol and this is actually one of the helpful chemicals that is present in broccoli family, cabbage family, vegetables. Cabbage broccoli, Brussels sprouts and the like. And there are really a couple of forms that are sold commercially, one is I3C.

But to my mind, an even more potent form of this useful chemical is something called DIM -- which stands for Diindolmethane . We use DIM a lot preventively in women and in men. I personally take two capsules of DIM every morning because, while women are at risk of hormonal cancers and may affect their breasts or their uterus, men too are at risk of adverse hormonal balance. And that can create an increased risk of prostate cancer. That's one of the most important parts of the body to protect in addition to your brain, your heart; you want to protect yourself from reproductive cancers.

And the way that IC3 and DIM work, they seem to have in general, an anti-cancer effect. They seem to help the body repair little defects in the genetic code which, if they get too advanced, can lead to an out-of-control proliferation of cells which we call cancer. So I guess they act as something that promotes detoxification or promotes correction of some of these little glitches that occur. Mutations occur all the time. They occur because of exposure to sunlight or exposure to chemicals or just the aging process. And chemicals like potent extract of broccoli or red wine or even chocolate, curcumin; these tend to slow the advancing of the mutations which can lead to cancer. That's number one.

Number two: From the standpoint of hormones, IC3 and DIM tend to create a more favorable hormonal profile in women and in men. And they do so by enhancing the production of a less carcinogenic type of estrogen. For that reason -- for example, when we have women on hormone replacements, some women do require hormone replacement therapy. They have terrible hot flashes at menopause and as a precaution, we'll put them on DIM to counteract the potential adverse effects of hormone administration.

By the way, DIM is great and IC3 is probably also great for prevention of the progression of precancerous lesions. I'll give you an example; abnormal pap smear, we give IC3 or DIM; Barrett's Esophagus, a precancerous lesion in the esophagus, we give IC3. There are some good studies that suggest that this chemical slows the transformation of precancerous lesions to cancer.

So yeah, you can take it. And while there's not a study showing what it does in pregnancy or nursing, I think it's very likely that through it's mode of action it will be proven safe. There's nothing to suspect that it will disrupt pregnancy or harm the fetus or create high levels of hormone production in a baby. And I think that's something that you can continue to take. But if you have any concerns, just don't take it for a few months while you're nursing and resume right after. It won't hurt you to take a break from it for a while.

Could you please tell me how you feel about compounding pharmacies as far as the ones that you have to mail away your prescriptions So it got me a little concerned.

DR. HOFFMAN: Tell me the source of that report so we can track it down and talk about it because, for the listening audience, let's explain what a compounding pharmacy is -- there are pharmacies and more and more we're getting away from the family pharmacies, the community pharmacies, we're getting into the big pharmacy chains where service is really nonexistent. Basically, you go there and it's hard to ask a question. Or if you ask a question they might give you a computer printout because frankly, communication skills aren't good. They are really depersonalized and what you get are just the commonly stocked medications.

If you say for example, and I've actually had this happen with a woman recently, she said look, "I've been using a certain type of vaginal cream that I need to take because after menopause my tissue got very dry. It's not estrogen but it's a soothing cream that helps me." But she looked at the label and the label said that this cream, which is supposed to be helpful, contains a chemical called methyl paraben.

Methyl paraben has been linked to breast cancer in a recent study. You know, we really have some concerns, I mean people aren't concerned about having methyl paraben in their shampoo or skin cream. We certainly don't want a woman to have to apply this daily to her vagina where it could easily be absorbed into her system and create a health problem. So we go to a compounding pharmacy. The compounding pharmacy said, "Let's take a look at it. Let's break it down. We can obtain the active chemical, the active medication in here and make up a special cream." It's going to cost more because they have to make a custom product here.

But we have this very often. We have some people who, for example, they rely on certain medications but they can't take the medications because they're allergic to the food coloring that makes the pill bright or they have difficulty with the fact that there may be gluten in the pill. Amazingly, they put gluten in a lot of medications and there are some people that have celiac disease. So compounding pharmacies fulfill a mission. They also help make us medication in special forms or with special flavoring, for example, if we want to give children medication, but adult medication is too strong. So we say, "Let's a make it a liquid and let's put it in with a natural bubble gum flavor or a natural cherry flavor." And that's what they do.

The compounding pharmacies that we use for our patients at the Hoffman center are great. They're very accommodating. I don't know how we would practice without them. One of the major compounders we use is Hopewell Pharmacy (www.hopewellrx.com) in Hopewell, New Jersey. And they are extremely dedicated. But the problem is, there's now an effort in this country to restrict pharmacies to just the big corporate entities or the standard allopathic pharmacies that only dispense conventional medication.

And I think it's like the battle between conventional medicine and alternative medicine. There may be some compounding pharmacies who don't adhere to the most stringent standards. All the ones that I know of, do. But there may be some that are worthy of greater regulation or frankly need to have their standards examined. But the vast majority of compounding pharmacies are extremely conscientious. They're really the personification of what the old-time pharmacy should be. You can talk to them, they'll talk to you. If the medication doesn't suit you in one form, they will do backflips to get you a medication that will work for you.

So I'm a big proponent of compounding pharmacies and I think it's like, there's another example of how big corporate entities sometimes exert a lot of pressure at the government level to -- it's a self-serving thing. They want to wipe out potential competition so they can reign unimpeded on the economic front.

This is kind of controversial about dental amalgams -- I presume I'm in good health, I don't know of anything, of course. I guess the mercury has been building up but I feel great. Would you recommend a person have them taken out?

DR. HOFFMAN: I generally do. And I actually put my money where my mouth is. A few years back I had a bunch of conventional silver fillings and there was nothing wrong with them but I went to my friend, the holistic dentist, and I said, "Take them out." I'm not sick. I don't have a problem. But I don't want to be exposed to these for another 10, 20, 30, 40 more years or whatever my allotted time is on Earth, so I had them taken out.

And I think that the major downside to having them taken out is the expense. If you can afford it, do it. If it's going to make you broke -- you have to work three extra jobs -- don't. If you have such extensive dental work that the process is going to leave you with less ability to chew and eat, then don't do it. And don't do it, above all, if you go to any old dentist and the dentist says, "Yeah, I'll take them out. Why not? I can charge you a fee for taking them out, and putting in something new. I haven't done it before but I'll try it." Do it with a dentist who is experienced in this technique because if you don't do it right, it will actually release more mercury into your system and that may take years and years or maybe last forever in your tissue. So do it carefully with an experienced dentist.

My question is, is an omega-3 from fish oil or flax oil any better to take than flax seed?

DR. HOFFMAN: That's a great question. Last summer there was a study, suggesting that Americans don't eat enough fish and various reasons for that; availability, expense, taste preference, convenience. And this study was sponsored by the makers of Triomega, which I think is one of the best omega-3 supplements on the market. It is free of contaminants and obviates the concerns that some people have with eating fish.

If you don't like the flavor of fish, take a fish oil capsule. If you're concerned about mercury toxicity from your tuna, take a fish oil capsule. Say you're a vegetarian -- radical vegetarian -- you don't want to eat anything with a face on it, you want it from a plant source, well, flax seed does contain omega-3 fatty acids but it does not contain EPA.

And EPA is the premier anti-inflammatory, heart-disease preventive, cancer preventive, brain-healthy omega-3 fatty acid. And what you get from flax seed oil is that precursor or building block. And depending on your genes, your metabolism, your state of health, you can to some extent convert the oils in flax seed oil to useful EPA. But some people do not do so efficiently. Most people don't get that much production of EPA from flax seed oil. I've kind of backed away a little bit from recommending flax seed oil because I think it's less valuable than omega-3 fatty acids from supplements or oily fish.

The key benefit from flax seed is in the seed and that is a dark material called lignan. Lignan has demonstrable cardiovascular preventive effects but it also has cancer preventive effects. Some studies suggest that flax lignan is particularly useful in preventing and even in treating prostate cancer.

Go for the seeds, not for the oil and if you want omega-3 oil, use fish oil or eat oily fish.

I'm 48 years old and I'm addicted to sugar carbohydrates. I've been trying to get off them for years and wonder if you have a system that you think works?

DR. HOFFMAN: That's what I hear all day long.

CALLER: I have a hundred pounds to lose.

DR. HOFFMAN: I think that's important that you mention that. When you're craving sugar and you're carrying a hundred pounds of extra weight, it's those fat cells talking to your brain and saying, "Bring it on. I need sugar, carbs and calories."

There's tremendous demand that's created by excess fat cells and that's a vicious cycle. Part of it is related to insulin. If you overproduce insulin -- what does insulin do? It drives your blood sugar down. When you have low blood sugar, that's a signal that it's time to eat. Did you ever have a big meal and at the end of the meal say, "I'm stuffed" and then they bring out the dessert tray and you say, "All right, I need that dessert"? Well, you don't really need that dessert because you've eaten maybe 1200 calories in that meal and that's adequate.

But the fact that you have eaten triggers a tremendous surge of insulin. It starts driving your blood sugar down and therefore you crave the sweets. With that knowledge of that physiology what we need to do is give you some things to sensitize your body to insulin, to make your insulin work better. Chromium is helpful. We may also want to use gymnema, which is an herb that has the nickname "sugar destroyer". We could also use alpha lipoic acid, fish oil is helpful too for optimizing insulin function.

We also have to have you go through -- frankly, there's no way around it. How do you give up cigarettes; how do you give up coffee; how do you get off heroin for that matter -- you have to go through some withdrawal. You have to stare that green monster in the face and get through the period of time with a lot of support because there is no such thing as a carbohydrate patch. There are nicotine patches, but so far no carbopatches that I know of that can deliver sugar through the skin. Well, even if it did, you'd gain wait. So you have to go through a period of withdrawal.

Then there are other patients who say, "Look, you put me on a diet. You put me on a program and I feel good. The first few days, I felt really crummy. I had low energy. I felt flat. I was hungry and irritable but, I was going to call you but then I said, I want to keep doing this." And then after five days, or a week, two weeks, three weeks, sometimes six weeks, they emerge in the clear blue sky from freedom of cravings, unnatural cravings from carbohydrates. If you're carrying that extra weight, you don't need to be eating. You can actually live off your reserves for a while. And so you have to go through that withdrawal.

And the other thing that you can use, and it works on the brain -- we use neurotransmitter support. Neurotransmitter support, especially with things that help build up serotonin in the brain, helps to attenuate sugar craving. We use a mixture of tyrosine, 5-hydroxytryptophan, a special formula that helps people with mood problems, sleep problems, chronic sugar craving problems, PMS. It is very helpful as an adjunct to your willpower, which you will need under these circumstances. Part of it is behavioral. Part of it's physiological support.

And I am constantly in quest of better techniques: hypnosis, biofeedback, exercise relaxation, yoga spirituality, prayer, join the church choir. Whatever

April 19, 2004

Baby boomers embrace popular arthritis remedy
www.vitapharmica.com

Jim Catalup, McDonald's chief, is dead at 60

H. pylori eradication prolonged rebound acid secretion
Gastroenterology 2004;126-980-988

Lycopene linked to reduction in fibroid tumors
http://www.dsmnutritionalsproducts.com

April 21, 2004

Nymox gains U.S. Patent for saliva cholesterol test
www.nymox.com

Voice surgery sounds good
Dr. V. Leroy Young, chairman American Society of Plastic Surgeons

CDC Obesity report could provide basis for MD law suits
http://banzhaf.net

Sensors seeking "Dirty Bombs" often pinpoint patients instead
By Christopher Windham. The Wall Street Journal. April 21, 2004. Page B1

April 23, 2004

Need medical help conceiving? Relax, study says
Fertility and Sterility, April 2004

Males not needed; mouse born from unfertilized egg
Nature, April 22, 2004; 428:860-864

Lawn chemicals linked to dog cancer-U.S. study
Journal of the American Veterinary Medicine Association, April 15, 2004

April 24, 2004

Monologue: softdrinks and children

Here's an important study because this has been, I think, the biggest cover-up since the hazards of smoking were denied and then acknowledged: Yeah, smoking really is bad for you. We can no longer hold back the flood gates.
And then it was the debate about secondhand smoking and now documents are coming to light saying that the smoking industry, the tobacco industry, conducted or orchestrated a rear guard action. They knew that, eventually, they would have to admit that secondhand smoke was bad and they would have to ban smoking in public places but they resisted that for a long time. They tried it on scientists and experts say, "That's junk science and we don't really know that being in a smoking environment is bad for you" and, of course, we found out that it's true.
Now, the battle lines are drawn about soft drinks and sugar. This is actually a drama that's unfolding on the world stage as the World Health Organization is debating endlessly back and forth whether it should provide a recommendation that people reduce their intake of simple or refined carbohydrates. It's a pretty simple proposition: Reduce your sugar, reduce your soft drinks and we're going to reduce a world wide epidemic of obesity that probably is going to kill more people, certainly kill more people than AIDS or polio, or malaria. This is a world-wide problem because not just Americans are getting fat but people in the third world are now starting to develop diseases that were unheard of -- heart disease and diabetes.
Well, the proposition is that if kids took in less soft drinks that maybe we could stem the tide of childhood obesity which is now threatening our future. An estimated 17.6 million children younger than five years old are overweight, according to the World Health Organization. In the United States the number of overweight children has doubled and the number of overweight adolescents has trebled since 1980. According to the U.S. surgeon general we're seeing record incidents of childhood diabetes.
So what are we going to do about it? Well, what about taking some of the soft drinks out of schools, the vending machines? What about telling kids that they shouldn't drink soda or highly sugary fruit drinks? Notice they're called fruit drinks. They're sort of vaguely resembling fruit juice, but they just have fruit flavoring, lots of it, artificial and interesting colors, not really fruit drinks. They're loaded with high fructose corn syrup. And even guzzling fruit juice, a lot of kids suck down that orange juice. Did you ever buy your kid a gallon of orange juice, and it's gone? The kid keeps opening up the refrigerator door, and pretty soon they usually leave about a quarter of an inch for you because they don't want to really finish it.
Here's the hypothesis: Get rid of the fizzy drinks. Fizzy drinks in England is the equivalent of soda. Ditch the fizz, is the message that they're trying to promote in Great Britain.
Here's a study from the British Medical Journal from this week. They looked at 650 school children ages 7 to 11 and they divided them in half. Half of the youngsters cut their consumption of soda by half a glass a day. Just half a glass a day, they just drank less, they didn't even stop. The other half, the control group, drank just about what they were drinking. They averaged about two glasses of soda every three days. What if we could get our kids to drink just two glasses of soda every three days -- some of our kids are drinking a lot more than that. They're going through quarts of it.
By the end of the school year, with this not very radical intervention, the percentage of overweight and obese children in the control group had gone up. Well, of course it went up. They just kept drinking the same thing that they were drinking. And it fell in the children who cut the soda.
The findings reported in a British Medical Journal, they say, this is a cheap intervention. No big deal. It doesn't take a major starvation diet to prevent people from becoming overweight or obese. Instead of consuming carbonated drinks, the children were encouraged to drink diluted fruit juices or water. What a concept, drinking water. Mom, that doesn't taste good -- well you're just thirsty, and maybe you could drink water. What a concept.
And so this intervention is now being widely suggested that kids just simply drink less. Now, what's the industry doing in response to this? There's an entity called the NFPA, the National Food Processors Association. Here's how they're responding to the new information that maybe, just maybe, we're consuming too much sugar and too much in the way of refined carbohydrates. Well, there was an article on this in the American Journal of Clinical Nutrition saying, that's why we're seeing diabetes in kids.
And here's a rebuttal issued as an official statement of the National Food Processors Association of America. It went out as a big press release because they want everybody to know about this, they say, the article in the American Journal of Clinical Nutrition is quote, incorrect and misleading. It is incorrect. I'm reading here a quote; it's incorrect and even misleading to suggest that the consumption of a specific food or food ingredient is the cause of obesity and the rising rate of type 2 diabetes in this country. Consumers need to know that excess calories from any source could contribute to increased weight in the absence of physical activity. This is an example of weasel words. This is obfuscation and confusion that is being promoted by the National Food Processors Association. They're saying there's no such thing as a bad food. You can eat -- oh, just have a broad spectrum; have a little junk food; a little good food; mix it all up.
The big thing -- this is what they're saying -- all foods can fit into healthful balanced diets. They're saying there's no such thing as a bad calorie. To manage weight, you must balance calories consumed against energy expended -- that's the old saw. It doesn't matter whether you have the calories as a fat or carbohydrate, just exercise the calories away.
NFPA is the voice of the five hundred billion dollar food processing industry on scientific and public policy issues involving food safety, food security, nutrition technical and regulatory matters. You better believe it because they have big lobbyists up there in Washington and in consumer affairs.
Come on guys, I know this is a rear guard action. You're going to lose this argument and you're just trying to delay the implementation of a rollback on the amount of sugar in soft drinks that especially kids can consume -- maybe regulations on aggressive advertising campaigns that target kids. And, do you really need quarts of Gatorade and Coke if you're going to take the dog for a walk? Is that the message we want to give Americans as we get fatter and fatter and sicker and sicker and our entire youth generation becomes susceptible to degenerative disease?
Compromising our future, our security, our very national security, our economy; let's take a more responsible stand guys because we need to improve the diet of Americans.

Commentary on refined carbohydrates and Type 2 diabetes in American Journal of Clinical Nutrition "incorrect and misleading" says NFPA
http://www.nfpa-food.org

Ditching soda cuts childhood obesity: study
British Medical Journal, April 24, 2004

Walnuts can improve your circulation. A big study looking at walnut consumption suggests that you can actually improve circulation by consuming walnuts. The amount of walnuts necessary to achieve this is approximately 1.5 to 2.5 ounces of walnuts per day