Detailed summary-Saturday, June 26, 2004

DR. HOFFMAN: This is probably one of the biggest stories in medical news this week. It's a bird, it's a plane, it's superbaby. This is for real.
This week, the New England Journal of Medicine published an article about a kid who is now four and a half years old in Germany who represents a very unusual genetic anomaly. This is the first reported case of a child born with two sets of genes that promote tremendous muscle growth.
There are a lot of stories in the media about this. A story by Gina Kolata in the New York Times describes the situation. It says, the moment the little boy was born, the hospital staff knew there was something unusual about him. His muscles looked nothing like the soft, flabby, baby muscles like the other infants in the nursery. They were bulging and well defined, especially in the thighs and upper arms.
I've seen pictures of this kid and he really does look different. In fact, doctors were initially concerned about this little baby because he was jittery he was jerking his limbs, much like the way people sometimes involuntary jerk their legs when they're falling asleep. But it turns out he was just trying out his strong muscles.
The doctors thought it was epilepsy but after a couple of months, the jerking movements had subsided. The doctors wondered what was going on with this little kid and some ingenious physicians came up with a theory.
They remembered scientific studies working with mice showing that if there was a genetic mutation, the animals grew up lean and so muscular that they were referred to as mighty mice. And it's also known in raising cattle that there is a genetic marker for muscular cattle. They developed a strain known as Belgian Blue or double muscle cattle. These cattle are very hefty and lean.
The common denominator between the mighty mice, the double muscle cattle and this superbaby is that they had deletions of a certain gene called "myostatin" which is the gene that codes for the production of a protein called "myostatin". This gene wasn't activated.
Now, oftentimes people have just one set of the gene and usually that makes them better athletes. In fact, the mother was tested. She was strong. She had been a professional sprinter in the 100 meter dash. And she came from a strong family, her grandfather, a construction worker, had unloaded curb stones by hand, hefty stones weighing at least 330 pounds. He was legendary in the early twentieth century.
There was no information on the baby's father but presumably, mother and father each had one copy of the gene. And in the genetic combination that occurs when a baby is created, the baby got two sets of the mutation of the myostatin gene that allows rampant muscle growth.
The kid is now four and a half years old and there are pictures of him. He looks strong but he doesn't look that different than an ordinary child of that age. He hasn't gone through puberty either which often causes a muscle growth spurt in boys. But he's able to hold two six and a half pound weights horizontally with his arms extended.
That doesn't sound like much weight but that it is. When I do my shoulder exercises, I find ten or twelve or fifteen pounds is plenty. So this kid, four and a half years old, he's doing six and a half pounds. His muscles in his arms and legs are twice as big as the muscles of other children his age.
This ushers in a lot of possibilities because scientists are studying this mutation and they say it's going to be feasible to develop drugs or genetic treatments that will deplete myostatin the way it is being depleted in this kid.
In fact, one major drug company, Wyeth, is already pursuing this research and it's got the potential to help people with severe muscle diseases, perhaps muscular dystrophy, perhaps wasting diseases, perhaps even help the muscle decline that occurs from normal ageing or from cancer. But it also has the potential for providing athletes with that competitive edge.
And also while we have the antiaging and physical enhancement movement on the way, a lot of people are looking for something that's going to help them have bigger and better muscles. This is going to blow everything that's currently on the market totally away. It will make growth hormones paltry by comparison.
It has the potential to create superathletes in the future and that's where ethics come in. Will it be ethical to manipulate people's genetic potential in this fashion? Will these be considered drugs of abuse in the future, authorized for use in people who are sick but banned in athletes because those athletes who will be using them will be at a tremendous competitive advantage?
It's not so farfetched as it seems because it's likely that the technology will be there that will surmount whatever logistic challenges there are to implementing this type of therapy. The question is do we want it? Will this be good? And also the question remains, will this be good long term?
This kid is strong now but what will happen when he grows older? Will he be an athlete or body builder or will there be some sort of negative consequence to the unnatural mutation that allows him to have extraordinary muscle growth so early in life?
Superbaby is growing into a toddler in Berlin, Germany and the world is watching.

DR. HOFFMAN: Remember those commercials when we were growing up: "Wonder Bread helps build your body in 12 ways"? Well, I read a couple of articles here that suggest that maybe the opposite may be the case. Wonder Bread may help destroy your body in 12 ways. This is not news.
The late, great, Carlton Fredericks, radio broadcaster and expert on nutrition, used to do a riff on Wonder Bread where people would ask him about it and he would say, "Well, madam, Wonder Bread makes a wonderful way of cleaning off your counter tops. You can dust your furniture with it."
And I found Wonder Bread was useful for an unusual application. An entire shelf of glassware fell down in my kitchen which has a terracotta floor and I couldn't get the glass shards up. So I decided to buy a loaf of Wonder Bread and it was great for dabbing and swabbing the floor, picking up those tiny glass fragments. I didn't have the heart to feed the leftover Wonder Bread to the birds; I just got rid of it.

An article here, is a study from the nutrition department at Tufts University in Boston. It says, many Americans are like a loaf of bread, soft with one side round. Their choice of bread may be part of the reason.
Some researchers said white bread and other refined grains seem to go to the gut and hang out as belly fat. This research showed that waist circumference was very much associated with this high, refined grains.
They looked at 459 people with a variety of eating habits and they found that the more refined grain they ate, the fatter they were. The belt size of the white bread group expanded about one half inch a year. And they suggest the reason for that is Syndrome X, a condition we're all familiar with. This is thanks to the work of Dr. Robert Atkins and Barry Sears and my talking about the Salad and Salmon Diet .
Here are even more insidious problems with consumption of wheat. We're expanding our definition of celiac disease. Celiac disease is an extreme intolerance to gluten, once thought rare, and now we're thinking that more and more people may be suffering from it.
Researchers in Israel write in the June issue of the Medical Journal Pediatrics that they're expanding the range of complication associated with gluten intolerance to include a broad range of neurological disorders. These neurological disorders include balance problems, epilepsy, chronic peripheral neuropathies and dementia. And in children, developmental delay, learning disorders and attention deficit disorder, headache and a condition called "hypotonia" which is a loss of proper muscle tone.
There may be a therapeutic benefit of the gluten-free diet even with patients with such conditions such as migraine, headaches, and ill-defined neurological disorders. And this is something we're seeing a lot of in our day-to-day practice.

DR. HOFFMAN: A big study this week has to do with smoking. A lot of people say, don't bother me, I'm smoking. And I'll live the way I want to live. And you know what? It doesn't make a big difference to me because at the end of it all, I'll probably live to 83, you'll live to 84, but I don't care because I enjoy my cigarettes. It's not such a big deal; I'll lose maybe a year of life. The difference isn't worth it. Why be so careful?
Like that expression, if I knew I was going to live that long I would have taken better care of myself.
Well this is a big study; it's a study that actually began in the 1950s. It's a 50-year update of the landmark 1954 paper which first conclusively linked smoking with lung cancer. So it's been going on since the 1950s.
It looks at nearly 35 thousand male British doctors. And the word on smoking is very bad because smoking, turns out, wipes ten years off your life. Quitting at 30 virtually eliminates the risk of dying prematurely. So the bad news is that smoking can reduce your lifespan but giving up at any age brings up benefits.
Giving up smoking at 50 halves your risk of dying prematurely. Half of those who fail to kick the habit will die as a result of smoking. A quarter of all smokers will die in middle age. So it could be more than ten years off your life.
The bad news, according to the lead researcher on this study from the University of Oxford is that smoking is even better than we thought at killing people. The good news is that stopping smoking gives you more extra years of life than we thought.
Stopping at ages 60, 50, 40 or 30 buys you respectively 3, 6, 9 or 10 years of life expectancy. So if you hear people offering these excuses: I'm 40, I've been smoking already for a long time, it's too late for me to stop. That's not true. Giving up at 40 means that just one year of life is lost on the average instead of ten.
And here's another way to put it. If you were born around 1915, that means you're somewhere in your 80s. A third of nonsmokers born around 1915 now live to between 70 and 90, so that's pretty good. But 7 percent of smokers born around 1915 will have a normal lifespan.
The problem is that here we're talking about a generation that was hard hit by smoking because it was introduced during war time. It was the solace to many military people, many women working on the assembly lines and it was all the vogue. It was portrayed in movies as something sexy and desirable. And now it's taken a terrible toll.

DR. HOFFMAN: The latest entry into the statin sweepstakes is a drug called "Crestor." And you've seen some of their ads and they're cleverly couched in almost Dr. Seuss-like rhymes, which make sense because their target audience grew up reading Dr. Seuss.
So it's kind of like a reassuring message of how you can help yourself with Crestor. But this popular statin is coming under intense fire from consumer groups. And part of the reason for this is that Crestor appears to be stronger and may cause more frequent side effects than other comparable statin medications.
I read an article and shared it with you on that program about a year ago, from the Lancet, England's leading medical magazine. They expressed some concern that we already have enough statin drugs out there. There's Prevachol, Zocor and Lipitor. Why do we need another statin? And besides, the side effect profile of this statin suggests that it might be more dangerous.
Crestor is a "me too" drug which attempts to capitalize on the fervor for providing statins. And it's also a little cheap, so HMOs and hospital formularies are more likely to pick it up.
But a consumer group, a public citizen's health research group in the guise of Dr. Sidney Wolfe, a frequent critic of medicine has petitioned the Food and Drug Administration to ban Crestor, saying it can cause serious harm.
The problem is a condition called rhabdomyalosis, a form of extreme muscle pain and deterioration which can ultimately affect the kidneys. And there have been some deaths. There have been 50 worldwide, 8 in Canada since the introduction of Crestor. And the concern is that Crestor may be too strong and have frequent side effects.
The company that makes it, AstraZeneca, says that conclusion is premature, but we need to take a look at this issue.

DR. HOFFMAN: Are you among the ten million women annually who get an unnecessary pap smear?
That was the startling conclusion of a report in the Journal of the American Medical Association this week. Going to the gynecologist and getting a pap smear was kind of like motherhood, apple pie and the pledge of allegiance, it's just something you do. But many women are getting unnecessary pap smears, and why is that?
Well, the reason is that if you have had a hysterectomy, you do not have a cervix, and yet you're being screened for cervical cancer. So that is kind of weird, it's stupid and what's worse, it may be dishonest. It's kind of like those people who arrive to do routine maintenance on your air conditioner system and they say, "Ma'am, I checked your air conditioner and I need to replace the "whatchamacallit" valve." And you say, "Whatever it takes." That will be $39.95, thank you very much.
And it turns out you never had a "whatchamacallit" valve or you didn't need a replacement of the "whatchamacallit" valve. But they decided that's just something that they're going to do and if they do it a hundred times a week, that's $39.95 times a hundred.
Research shows, according to the lead author here, we estimate that nearly ten million women without a cervix are currently being screened unnecessarily for cervical cancer. Now wait a minute, can you get cervical cancer if you don't have a cervix? The answer is no.
This is already an old theme because they're trying to cut unnecessary medical costs in this country. And yes, it is reasonable to get routine pap smears but they ought to check what's under the hood before they do the test and not just routinely administer it.
And already, in the early '90s, they pointed out there was a trend of overuse of this test. So they issued guidelines that state that if you had a hysterectomy, don't bother getting a pap smear on your nonexistent cervix. And what happened?
Well, in 1992 before the guideline was issued, 68.5 percent of women who had a hysterectomy got pap smears. So then they issued the guideline and that guideline was issued, I guess, in 1996. So now, six years after the guideline was issued, even more women are being screened. 69.1 percent of women who previously had a hysterectomy reported having had a pap smear in the previous three years.
So the conclusion is that the guidelines have been ignored by physicians, and to some extent women who present themselves annually for pap smear. But the doctor should have the ethics and knowledge to say, lady, you don't need pap smear. Well, look, you may need an internal exam.
Internal exams may be warranted even after hysterectomy but to the extra tests which costs you unnecessary money and costs your insurer unnecessary money and taxes the system, which is unnecessary, that is just unethical.

DR. HOFFMAN: The question is: To DEET or not to DEET, because there's the specter of West Nile Disease that has caused some problems in prior seasons and people are still concerned about Lyme Disease which affects 23,000 people annually.
So there's a big campaign that's sponsored by the Centers for Disease Control and Prevention that calls for more people to use DEET to battle mosquitoes. It's the "Fight the Bite" campaign and you're going to hear about it. You can plug in the words "fight the bite" into Google or into your computer browser and you'll get a whole lot of information urging you to apply DEET liberally this season.
But a lot of people are concerned about DEET. DEET, which is also known by the rather sinister sounding name Diethyltoluamide, has been used pretty safely since the 1940s. But consumers are still pretty wary about splashing a chemical on their skin or on the skin of their children.
There's an article about it in the Wall Street Journal. DEET problems have been linked with skin reactions, breathing problems and even seizures but mostly when used improperly when slathered on or reapplied frequently.
That's why experts often warn against using sunscreen and DEET combination products because DEET shouldn't be reapplied often, especially on kids who are more sensitive, whose skins are thinner and stand a greater chance of absorbing the product.
As we said, side effects are infrequent but we have to keep the problem in perspective, that West Nile disease is bad. There were 264 deaths last year but mostly, West Nile tends to effect seriously older or debilitated individuals. There are probably far more cases of West Nile but they're undetected or they may cause just transient malaise.
You can find out about West Nile in your state by going to the CDC website and find out if it's a big concern. But there are some alternatives.
In research of the New England Journal of Medicine a couple of years ago, researchers placed their repellant-covered arms into a cage of mosquitoes. You've seen these disgusting experiments. I wouldn't sign up for one of these because mosquitoes tend to go for me even more zealously than for other people. I might have whatever it is in your blood that they like.
A DEET product called "Deep Woods Off" kept mosquitoes away the longest, 301 minutes. But some of the non-DEET products made a pretty respectable showing. All of eucalyptus -- which is easy to obtain but does make you smell kind of like a newly-varnished cabinet.
All of eucalyptus at 30 percent stayed off a bite for 120 minutes. That's pretty good for most purposes unless you're going into a real bug-infested area or you're going to stay there or hike into the woods. Maybe you might want to go for the DEET product occasionally.
A product called "Bite Blocker" with 2 percent soybean oil kept bites away for 94.6 minutes. Unfortunately, citronella, a commonly used alternative to DEET, performed poorly keeping bugs away for less than 20 minutes. I tried citronella on the bugs in my yard out here near the water on Long Island and the mosquitoes just get high on it. They go, hmm, there's that citronella smell. There he is and he's out there and he's probably wearing shorts, go for it.
So the limitations on the use of DEET -- the American Academy of Pediatrics says that DEET products shouldn't be used on infants younger than two months. It's safe to use concentrations up to 30 percent on kids but don't let kids apply it and don't apply it to kids' faces because kids tend to stick their hands in their mouth and wipe stuff around on their faces.
So this is one of the ways to reduce the exposure to DEET. They interview a doctor in this, a father of three and a family physician in Toronto who says, questions remain about the impact of chemical exposure on a child's brain development. So he urges caution with DEET.
And particularly, since kids are generally at low risk for serious problems of West Nile they can be bitten by mosquitoes that have West Nile but generally, something about kids' immune system means less serious infections.
This guy named Robert Nevin -- Dr. Robert Nevin says, for me, it's not a dilemma. He buys a soybean-oil-based product for his kids. And the product in this country is called "Bite Blocker" with 2 percent soybean oil. It gives you roughly 40 percent of the protection that DEET can provide.

DR. HOFFMAN: I'd like to share with you results of the introduction of a new supplement to the regimen I use for patients with arthritis. You know we're always looking for that thing that will give us the edge against encroaching joint pain. It's almost a universal problem as people get older.
And we already have an impressive arsenal. We've got glucosamine sulfate and chondroitin brought to us largely through the courtesy of Dr. Jason Theodosakis who has been a guest on this program. And we've talked about glucosamine and chondroitin a lot and other things that synergize with it.
Jason was also my guest at a recent expo, a health and fitness expo that many of you attended in Parsippany, New Jersey. And so it's only been a few months, actually only a few weeks that I've been using a new nutrient that Jason highly regards. We've had him on the program to talk about a product called "Avosoy."
Avosoy is a derivative of avocados and soy. And sorry, it won't help you if you just eat a lot of avocados and soy. This is a product that is extracted from the fiber of avocados and soy. It's sort of, deeply intertwined with the fiber and it's extracted through a proprietary method to deliver something called ASU, avocado soy unsaponifiables.
This is a product that is used in Europe, in France. It enjoys the status of a drug. If your doctor prescribed ASU for you in France, the national health care insurance will reimburse you for its use.
There are lots of scientific studies on it. Jason is very good and honest researcher and he wouldn't unleash something on the world of arthritis sufferers if it weren't well documented. But sometimes there's a little lag time between when people use this and the response.
But I had a phone conversation with a patient just this week that we put on Avosoy but it was kind of an act of desperation. I read the notes when I spoke to her on the phone and I was kind of dreading the phone call because I thought she was just going to complain that her pain was no better. And that's what she did at a previous visit.
In fact, this is a woman who is going to be getting a hip replacement. She has bad arthritis throughout her body and her hip is shot. She really needs an operation but she was complaining, couldn't we do anything more to reduce her pain. I said yeah, I guess you could go to a pain specialist; go on some really powerful drugs. But the drugs could be debilitating and addicting and we generally use nutritional medicine. And we've got things like glucosamine and finally, I said, take some Avosoy, give it a shot, you might feel better.
She's got to wait until August to get her surgery, that's a ways off. And so fully expecting that she would just continue complaining, I spoke to her on the phone and she said that within 48 hours of taking Avosoy, she noticed a tremendous effect on her pain, a lift in her mood. She was really surprised and I was surprised at how fast it took effect to reduce pain and inflammation.
I was extremely skeptical about whether this was going to help her because she has pretty advanced arthritis. I found this news very heartening. And I would encourage people who tried glucosamine for their arthritis to step up and investigate this new product. You can find out about it on our website and you can also get the full story at www.DRTHEO.com.
There's science behind it and I'm convinced that it really works to reduce inflammation and affect pain which could make a difference for you and your arthritis.

DR. HOFFMAN: What helps and what doesn't help in terms of warding off dementia and Alzheimer's disease?
Well, a couple of stories recently, one has to do with hormone replacement therapy. We were betting the ranch on hormone replacement therapy until a couple of years ago in terms of prevention of cardiovascular disease and osteoporosis. And even cognitive decline in women was sold as the veritable Ponce DeLeon fountain of youth.
And now we've found that its promise was exaggerated and here are new findings from the Women's Health Initiative Memory Study and they're not favorable to hormone replacement therapy. Hormone replacement therapy with estrogen alone does not decrease and may significantly increase the risk of dementia or mild impairment in postmenopausal women. So the suggestion is that at least with synthetic hormones, we're not doing the job. But what does work? Well, a simpler and less hazardous strategy. A combination of vitamin E and vitamin C supplements may reduce the risk of Alzheimer's disease.
Analysis of data from the mid-1990s show people taking a combination of vitamins E and C were 78 percent less likely to be diagnosed with Alzheimer's disease. I'll take that 78 percent less likely. During the follow-up period in the late 1990s people taking vitamins E and C had a 64 percent lower risk of developing Alzheimer's disease.
So that works for me. I'll keep taking my vitamin A and C as long was I can remember to.

CALLER: What are the goals of these two tests and what's the difference? The tests are DHEA sulfate as compared to DHEA unconjugated.
I had a hysterectomy and both my ovaries were removed.
I'd like to check my hormonal activity now from the adrenals or the fat cells and I went to the lab. They said I could have free testosterone; the three major estrogens free; the progesterone, not; pregnenolone, not; and they offered me DHEA sulfate or unconjugated.
DR. HOFFMAN: It would be best, and you are an astute listener and I thank you for tuning into this program and educating yourself about this.
It would be helpful to get a physician to talk to yo who is familiar with natural hormone replacement therapy because you are an instance where it might -- and I'm just saying might -- be appropriate to consider balanced hormone replacement therapy with estrogen, progesterone, DHEA, and testosterone.
You're a special instance of having lost not only your uterus but also your ovaries so there's regular menopause which causes women a lot of problems but sometimes during regular menopause, your ovaries take over. You've lost your ovaries and this may cause you some problems.
But if you feel there are problems, I wouldn't get too obsessed over the numbers you find reflected in these tests. We use these tests to determine if a woman who has lost her ovaries due to surgery, they have unusually low levels of testosterone or DHEA, which is usually the case because the ovaries tend to provide a woman with a modicum of those hormones.
And the tests that you want are not DHEA unconjugated, you want DHEA sulfate, that's the test that's valid and useful. DHEA unconjugated is sometimes unreliable, sometimes labs will make a mistake and doctors ask for DHEA, they'll do that test. And I find it virtually useless.
It might be worthwhile to check your testosterone but there's no reason to check your progesterone and estrogen because they're going to be low. You've probably already gone through menopause and now you've had your ovaries taken out, they're just going to be low. And finding it out in a confirmation and a test is not that particularly useful.
If you want to monitor the effects of therapy that you're already on, then fine. If you're taking natural estrogen, natural progesterone, testosterone, DHEA , you need these tests.
Here are a couple of things about women who have had hysterectomy and DHEA. A study came out a couple of weeks ago that shows that women who have had their ovaries taken out often benefit from testosterone for sex drive but also for mood and attention and drive. There's often a letdown, a psychological drop-off even if there's not a change in libido or sex drive that occurs after this type of hysterectomy.
The other thing that came out just this last week is the measurement of DHEA sulfate, probably the single best test to perform in a woman to predict the likelihood of problems with sexual response. Now, I'm not saying that every woman that has a low DHEA has problems with sexual response or every woman who has a high or normal DHEA has a great sexual response.
But in terms of the correlation, DHEA seems to be one of the defining factors. That's why we looked at DHEA as maybe the female equivalent of Viagra, Levitra, and Cialis. After all, why should the guys have all the luck when it comes to interventions to restore sexual vitality?
If you're looking for a magic bullet in women, that might be in DHEA. The problem is I think DHEA should be measured and prescribed by a doctor and its use supervised. I'm not to keen on people self-medicating, running to the store and taking pills.

CALLER: I have a 26 year old daughter who has been diagnosed with impetigo. She has had it now, in less than a two-year period, six times.
DR. HOFFMAN: It's a skin infection usually with staph and it can cause itchy, crusty, uncomfortable and unsightly scabs, basically on the skin.
CALLER: Right. And she gets it always on the chin area and sometimes the glands are affected and sometimes they're not. She is an elementary school teacher. The first time she got it she was nowhere around little ones at all.
DR. HOFFMAN: I personally have not taken antibiotics very often in my life but for some reason, when I was working in the hospital around 25 years ago, I acquired a case of impetigo. I think it was because of the horrible bacteria that float around in hospitals.
And I treated myself immediately with antibiotics because I felt I had a responsibility to the patients in the hospital to get rid of the infection. And I think we have to treat her aggressively because she's around little kids. She needs to take oral antibiotics to knock this thing out.
You can also use a topical antibiotic called Bactroban. It's pretty good but it sometimes doesn't completely eradicate the staph. The problem is, staph is getting more resistant to many of our antibiotics and we like to use natural things to promote immunity.
I think the problem here is, partially exposure, but it's partially also she has a lowered immunity. She needs to take zinc, vitamin C , selenium, perhaps transfer factor, which is an ultra-potent extract of colostrum, to enhance her immune response.
Just this week there was a scientific report in one of the major medical journals about the effects of breast milk in terms of treating warts, another type of superficial skin infection.
So there are elements in breast milk, in colostrum, or in transfer factor that can enhance the immune response. It makes sense to use things like this, also probiotics , to normalize the intestinal flora. All those antibiotics, they actually help to restore immunity as well.
And there may be some issues related to diet that may have an interfering effect on her normal immune response.
So you may want to take a look at the amount of sugar she takes in or perhaps certain foods that create allergic reactions that set her up for this.

CALLER: I have a 14-month-old grandson who is 95 percent on the charts in height and weight. He's a very happy baby who is constantly sick, ear aches, croup, everything. And the doctor puts him on antibiotics, every different one you could imagine. And he has fevers 104, 105. Still, he's happy as can be.
But now we came to the point that the doctor is not prescribing it orally. Now he's getting shots of antibiotics. And she gives him -- he takes the Polyvisol and I'm really not too happy about all of these antibiotics. And I wonder what we could give him, some kind of a supplement or something?
DR. HOFFMAN: It's not about a supplement. Usually, kids have lots of infections. It could certainly be due to deficiencies in nutrients like zinc and vitamin A. But kids who grow well and take multivitamins in the United States are not usually, critically deficient in nutrients like selenium and zinc and vitamin A as we see in the third world.
We do give these kids additional vitamins. We give kids Transfer Factor because it may make up for deficits in breast feeding, which usually establishes early patterns of defense and immunity.
But the key in a kid like this, this kid is 95 percent of the growth norm. He eats everything and the problem is not that we've got a kid who is starving, where food restrictions might be problematic, we got a kid where we ought to do a trial of elimination of some of the common allergenic foods which set kids up for infection big time.
Kids get ear infections, the major culprits are wheat and dairy. And yeah, it's a big problem with a kid to pull him off of that. But kids of that age are too young to walk up to the counter in the supermarket and buy doughnuts and ice cream.
So this kind of restriction can be attempted and very often we see a tremendous change in the pattern of allergy. Taking probiotics is also helpful but, you're a grand parent, that's a tough place to be. And I don't know if your kids agree to the approach that we espouse here.
Are they willing at all to undertake a dietary change?
CALLER: They're not even willing to discuss it.
DR. HOFFMAN: That's the very typical situation. I get this all the time. You can bring a horse to water but you can't make him drink. But very often, grandparents' well intentioned views on this are very often repudiated.
So it's frustrating to you and there's nothing you can do about it unless your kids can be brought around to the viewpoint that there is a perspective to complementary medicine and alternative approaches to this, they have tremendous faith in the pediatrician.
They're happy that the kid is growing and frankly, I think that they're in denial about the potential for allergies to be creating and food and diet to be creating problems and this is a tough position for grandparents to be in. You can just share your views, try not to be too overbearing about it and eventually they may come to espouse some of the views that really make sense and are increasingly becoming a part of mainstream medicine.
But if it's all on deaf ears, it's not going to work.
DR. HOFFMAN: I have some additional advice regarding a familiar predicament, grandparents concerned about their kids. The grandparents that listen to this program, they believe, they buy into the whole theory that foods make a difference in the lives of kids. But they can't do anything about it because their kids are busy, practical folks who run to the pediatrician all the time, and it's tough.
It's tough being a parent telling your kid how to raise your grandkid. But if you want to get the information to your kids in a form that is not threatening, get a book called "Superimmunity for Kids" by my good colleague, Dr. Leo Galland. The book is still available, it's a perennial and it talks about the use of vitamins and supplements and diet changes.
I'm concerned about that kid, the kid is getting lots of antibiotics and yet, he's happy and yet, he's growing. But we're creating problems for the kid because it's shown -- a recent study at a major conference of international microbiologists shows that if you give mice antibiotics, they become more allergic.
Allergy leads to repeat infections. Repeated infections require more antibiotics. And it's a vicious cycle until we erode the health and immune system of our kids.

CALLER: I have kidney disease, nephritis, and I'm just wondering if there are any supplements I can take.
DR. HOFFMAN: What kind of nephritis do you have? Nephritis is the broad category of kidney inflammation.
CALLER: One kidney is not functioning at all and the other one is down pretty far.
DR. HOFFMAN: Do you know what your creatinine is?
CALLER: I've been tested, it's about 25 percent.
DR. HOFFMAN: Do you remember a score like three or something like that?
CALLER: Between two and three.
DR. HOFFMAN: So what happens here is that you may be on your way to dialysis. They probably talked to you about that issue and there are ways of stalling your progression towards dialysis.
Now, there's a buzz these days about how bad the high protein diet is for you. And there's kind of like an Atkins counter-attack going on, suggesting that ordinary people, if they eat too much protein, they're going to destroy their kidneys. Well that's not the case.
Generally, studies show that even generous amounts of protein that are on high protein diets don't cause ordinary people to prematurely lose their kidney function. But if you already have a kidney disease and you consume tons of protein, that's not good.
So you need to be on some modest degree of protein restriction. That does not mean to go on a no-protein diet. It's actually been shown that people who do that do not slow the progression towards dialysis and kidney failure and they actually do themselves some harm because not having adequate protein in your body impairs cellular repair and just creates a lot of havoc.
So modest protein consumption may be somewhere in the order of 30 to 50 grams per day, that's less than usual. Also, fish oil, that's very helpful for slowing the progression towards kidney failure. Certain studies show it has an anti-inflammatory effect.
Also, if you are describing an earlier phase of nephritis, identifying foods which can attack your immune system is a very useful strategy. I'm not sure at this point we can stall the eventual shut down of your remaining kidney, but in earlier stages of nephritis, this is a very, very useful way to go.
We do this often in kids and young adults who had the beginnings of kidney inflammation. And by identifying foods that may attack the immune system, setting up an autoimmune attack on the kidneys, we can do a lot of good. So those are the main things.
If your kidneys are in a failing state, you may need additional levels of CoQ10 and carnitine. They seem to be particularly depleted in people with end stage renal disease or patients who are on dialysis. And you have to be careful about your consumption of excess amounts of magnesium and potassium because if too much of those things accumulate, your kidneys are not filtering adequately.
So look to restricting some of your natural supplements that contain these things. Measure your levels of magnesium and potassium to make sure they're not going sky high.
An experienced nutritionist knows how to deal with this type of situation. It's one of the most common situations found in clinical nutrition. It's practiced by hospital-based nutritionists and they can work out a diet that will work well for you.

CALLER: I am currently on 640 milligrams of saw palmetto. I'm just curious if there's any conflict with several heart medications I'm on, Toprol 50 milligrams, and Crestor 10 milligrams.
DR. HOFFMAN: Yes, you're on the very medication that I talked about earlier. The Crestor medication you use to lower cholesterol.
Have you noticed any changes in your energy level, how you feel, any aches and pains in you're legs that are unusual?
CALLER: Not at all.
DR. HOFFMAN: I think that it's great that you're sharing it with our audience. Not everybody has necessarily adverse experiences with Crestor
. I would recommend if you take Crestor however, make sure you take coenzyme Q10, at least a hundred milligrams per day because these medications eat up coenzyme Q10. And that may actually put you at greater risk of heart problems. I mean, at the same time they protect your arteries we don't want your CoQ-10 levels to decline.
No, saw palmetto should be fine; it doesn't interact with those medications at all. And any guy who is over the age of 50 should be taking -- what are you taking, 640 milligrams?
CALLER: 640 milligrams.
DR. HOFFMAN: Beautiful. You're on target because that's an aggressive dose of standardized extract of saw palmetto. And it's called the phytosterolic extract of saw palmetto. It can protect your prostate because you don't want that to cause you trouble.

CALLER: I'm 23 years old, I have had colitis for 2 years with no relief and that was determined by colonoscopy two years ago.
I've been on asacol; I've been off and on prednisone for a month at a time and then off for a while.
DR. HOFFMAN: Have you tried dietary approaches to this?
CALLER: Not directly, no.
DR. HOFFMAN: Okay, so listen up because this is for all of our listeners who have ulcerative colitis or Crohn's disease or family members who have these conditions. Even diverticulitis will respond and certain forms of irritable bowel syndrome. It's something called the "specific carbohydrate diet." You can find out about it at the website SCDIET.com or .org -- both those sites.
And there's a book called "Breaking the Vicious Cycle" and it's by a lady named, Elaine Gottschall. I actually wrote the forward to the latest edition of that book. It's a book that outlines a dietary approach. It's a stringent dietary approach but it's worth trying for a period of four to six months to see if you get a good response.
Most patients with ulcerative colitis or Crohn's Disease improve with that. Also, nutrients like fish oil are beneficial. High doses of folic acid, probiotics can be helpful, boswellin

, curcumin, these are natural anti-inflammatories and a whole lot of other nutrients.
But don't try this on your own. It's best with a serious disease like colitis to get guidance from a nutritionally-oriented doctor. But the diet you can try on your own. Give it a shot and see if it helps you and if it does, share it in a few months with the rest of your Health Talk listeners.

CALLER: About three years ago I had a bone density test done and it came back that I had osteoporosis. I'm 54 now so I was 51 then. And the doctor said, let's hold off on taking any medicine because you're young and let's see what's going on.
DR. HOFFMAN: I like that part about you being young at 54 because I'm coming up to be 52 and I like when people say that folks our age are young.
CALLER: I just had another one done with another doctor and it came back as osteopenia.
DR. HOFFMAN: And in just a very short period of time you went from one category to another.
CALLER: Is that weird.
DR. HOFFMAN: No, I think it means this is subject to interpretation. And the doctor who looked at it the first time may have made a more dire assessment of your problem than the second doctor. That's presuming the second doctor is correct.
But there's a tendency for doctors to exaggerate the severity of bone loss. And I think it's for the same reason that a lot of doctors are now putting people on statin drugs when their cholesterol is barely elevated.
We're sort of extending the definition of disease in this country. It used to be that you had a cholesterol of 250 they say, well, you're fine, at 300 we'll do something. Now, if your cholesterol is 201, you go on a statin and similarly, when you have slight declines in bone density, they throw the term of osteoporosis at you when it's not really accurate. You may have osteopenia which is some degree of loss.
But anyway, you probably want to do something about this.
CALLER: He suggested that I go on Fosamax.
DR. HOFFMAN: Well, you can go on Fosamax and you can go on Actonel. And these drugs work pretty well to enhance bone density. I have some of my patients on them.
But recently, there was an article in one of the major medical journals that says, hey, we've been using this stuff for around ten years and we have experience. And the question is, after these things have been in use for about ten years given a person takes them for ten years, what then? Do your bones get stronger and stronger and stronger?
There's some question that about after ten years of use of these medications that their usefulness may be behind them because the increase in bone density that you see may not parallel an increase in bone strength. It doesn't make sense to a lot of people. They think the denser your bones are the better.
But things that are very dense sometimes are fragile. Concrete is very dense but you if hit it with a sledgehammer, you smash it. I think these medications are safe for use over a conservative period of time but there are also some natural things that I think are very important.
You need calcium. You need vitamin D . You should get your levels of vitamin D tested. And we've gone over nutrients like boron and lysine and ipriflavone and the importance of other co-minerals like magnesium glycinate . But there's a couple that I want to share information with you on.
One is vitamin K. Vitamin K is very important. We're now using an ultra-potent form of vitamin K called menatetrenone. You don't have to know the name of that, it's active vitamin K that works astonishingly well for bone. There are some studies that show that vitamin K really has the potential to fight osteoporosis. It's prescribed as an osteoporosis fighting medication in Japan. And women with fractures have only half as much vitamin K2 as women who don't have fractures. Where women consume more vitamin K2 there were far fewer fractures in a lot of studies.
Another nutrient that's very helpful is strontium . Strontium, recently subject of a study in the New England Journal of Medicine, reduced bone fractures in a matter of a couple years by an astonishing percentage. 41 percent decrease for people in fractures and a real significant increase in bone density on the Dexascan that you underwent.
So those are, I think there are some really good natural ways to go and many women don't have good tolerance of medications like Fosamax they have heartburn and gastrointestinal irritation. So there are really good natural alternatives that are developing and men should think about this problem too because it's not just a problem confined to women, men get it later but it can be even more severe.

CALLER: I suffer from chronic fatigue and fibromyalgia and one of my biggest problems is sleep. I work really early in the morning. I'm up at four. I never seem to get a full night's sleep. I end up waking up in the middle of the night.
DR. HOFFMAN: This is a big problem with fibromyalgia. Some people believe it's primarily a disorder of sleep where people become extremely fatigued and debilitated. And part of proper treatment of this condition is sleep management, is having you take the lightest possible natural things and even medications that will help you resume natural patterns of sleep.
I'm not against use of medications but we like to use things like melatonin. Higher doses of magnesium help to relax you. Sometimes things like 5-HTP or L-tryptophan can be used to help you sleep better and relax you.
Another pointer is when men experience this type of insomnia accompanied by fatigue and muscle aches it's very important to check their hormones. You may have a decline in your testosterone levels or in your levels of the critical adrenal hormone called DHEA . And by giving them back to you in natural form, in creams or oral supplements or patches, this may actually increase your well-being, deepen your sleep and help to turn this condition around.
For some of our patients the magnesium has to be intravenous, it has a more profound effect on muscle aches and fatigue. It literally works on the brain to relax you.
So there are a variety of approaches. See a nutritionally-oriented physician by you who is familiar with natural approaches to this or get the book "From Fatigued to Fantastic" by Dr. Jacob Teitelbaum. It's a book we frequently refer to and he's been a frequent guest on this program. He's an expert on both conventional and natural treatments for the condition of fibromyalgia.

CALLER: A couple months ago I had atrial fibrillation and they put me on Coumadin. And on that CR protein test, C-Reactive protein, they said I was slightly high in the third quartile. So I'm on cholesterol, green tea, fish oil and vitamin E.
Now what about the fish oil and the vitamin E and the Coumadin blood thinner? Would that complement, would that be okay?
DR. HOFFMAN: First of all, you have to be a little careful with green tea extracts. They have to be free from vitamin K because that can cause your bleeding time to decrease, in other words, make you more prone to blood clots.
The vitamin E and the fish oil take you in the opposite direction, they actually thin the blood. But I think with the frequent testing that you'll undergo being on Coumadin that you could take modest amounts of fish oil and vitamin E and you will not run into trouble.
The EGCG which is the extract of green tea that we use is actually free of significant amounts of vitamin K and can be safely used with Coumadin as long as you monitor your protime with your doctor.