Category: Integrative Healthcare

Traditional risk factors for osteoporosis

As most readers know, osteoporosis is a serious condition, which afflicts approximately seven percent of women aged fifty and older, another forty percent have reduced bone density.

There are several traditional risk factors for osteoporosis. Listed on the right are the modifiable and non-modifiable risk factors. (See Table 1)

 

Table 1
Traditional modifiable risk factors for osteoporosis:1	Traditional non-modifiable risk factors for osteoporosis:1
• Cigarette smoking	• White race
• Low body weight (<127 lb)	• Advanced age
• Estrogen or androgen deficiency	• Female sex
• Excessive alcohol intake	• Dementia
• Inadequate physical activity	• Poor health/frailty
• Medications (e.g., steroids, anti-seizure meds, hormone suppressants, vitamin A)	• Personal history of fracture as adult
• Chronic conditions (e.g., diabetes, thyroid, liver, or renal disease)	• History of fracture of first-degree relative

An overlooked risk factor—the average American diet

Research suggests that about 72% of calories of the average American’s diet come from foods that were not consumed by our recent hunter-gatherer ancestors. Consider that 23.9% come from grains (20.4% from refined grains), 18.6% from refined sugars, 17.6% from refined omega-6 seed oils (corn, soybean, sunflower, cottonseed, safflower, peanut, etc.), 10.6% from dairy, and about 1.4% come from alcohol.²

The remaining 28% come from a marginal intake of fruits, vegetables, nuts, and legumes, and a substantial intake of domestic, feedlot, grain-fed meat. We know that wild game is about 2-4% fat by weight, while modern feed-lot meat is 20-24% fat by weight. Essentially, this means that we are eating unhealthy, obese animals.³

In short, our diet in America today consists of grains, sugars, omega-6 fatty acids, trans fats, sugar, and obese meat, and is substantially deficient in fruits and vegetables. The outcome of this pattern of eating is a population that is prone to osteoporosis and other chronic diseases.

Omega-6 fatty acids and bone loss

Research suggests that the prostaglandin E2, which is formed from arachidonic acid (an omega-6 fatty acid) leads to the stimulation of bone degrading osteoclasts and the inhibition of bone building osteoblasts.^4,5,6

All grains and the seed oils mentioned earlier contain the omega-6 linoleic acid, which our bodies then convert into arachidonic acid. We also get arachidonic acid preformed in the obese meat we eat.

Foods that contain low levels of omega-6 fatty acids and appropriate levels of anti-inflammatory omega-3 fatty acids include green vegetables and grass fed animal products, as well as wild game.^2,3,7 Supplementation with omega-3 fatty acids from fish oil is also recommended.

 

Tissue acidity and bone loss

The pro-inflammatory American diet is also rich in foods that lower body pH into the acidic range, which leads to the resorption of alkaline bone minerals to increase pH back to an acceptable level.² Consider how prominent researchers in the field of diet and pH balance describe this problem: “Increasing evidence suggests that such persisting, albeit low-grade, acidosis, and the relentless operation of responding homeostatic mechanisms result in numerous injurious effects on the body, including dissolution of bone, muscle wasting, kidney stone formation, and damage to the kidney.”⁸

Which foods promote tissue acidity? First on the list is animal products (meat, fish, fowl, and eggs), which often leads people to condemn animal products—a grave mistake. Humans and other mammals have consumed animal products for thousands of years and maintained normal bone density. And this is because, other than animal products, humans ate only vegetation (fruits and vegetables), which is highly alkaline and served to counterbalance the acidity from meat.

Instead of eating an abundance of alkaline fruits and vegetables, we now consume acid producing grains, cheese, and soda with our meat. So, instead of buffering acidic meat with vegetables and fruit, we now increase the acid load, which leads to both bone and muscle loss as we age. And we have known for many years that, like omega-6 fatty acids, an acidic environment leads to the stimulation of bone degrading osteoclasts and the inhibition of bone building osteoblasts.⁹

In summary, foods that promote an acidic pH include meat, grains, cheese, and soda. Low fat cheese is thought to be the most acidic food of all. Foods that promote an alkaline pH include fruits, vegetables, potatoes, and nuts. Milk, cream, and legumes are essentially neutral, when it comes to their contribution to our acid/alkaline balance. The chloride in table salt, i.e., sodium chloride, is also acidic, which means that salt intake should be limited considerably.²

 

Supplementation for osteoporosis

The environment for optimal bone deposition can only be created by the appropriate diet, as described above. Supplementation without dietary changes is not likely to exert an appreciable effect on bone health.

The goal, then, for supplementation is to support the anti-inflammatory state created by diet. Accordingly, in addition to eating an anti-inflammatory diet, the following supplements are appropriate: multivitamin/mineral, magnesium, fish oil, vitamin D, and calcium hydroxyapatite.

Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession. He is on the postgraduate faculties of several chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient. He is also a faculty member at Palmer College of Chiropractic Florida, where he teaches nutrition and subluxation theories. He can be reached by e-mail at [email protected].

 

 

It’s been estimated that one in every three women, and one in every twelve men over the age fifty worldwide suffer from the bone weakening disease known as osteoporosis. Osteoporosis occurs when there is an imbalance between bone reabsorption (osteoclast cells) and bone formation (osteoblast cells). Bone is a living tissue that undergoes constant transformation. At any given moment, there are from one to ten million sites where small segments of old bone are being broken-down (reabsorbed) and new bone is being laid down to replace it. When more old bone is destroyed than new bone laid down, bone loss occurs. A generation ago, osteoporosis was only diagnosed after an elderly patient had either developed a spinal hump or broken a bone due to a minor fall. Prior to 1974, surveys showed that 77 percent of Americans had never heard of osteoporosis.

In 1992, in an effort to reduce the incidence of osteoporosis fractures, the World Health Organization (WHO) held an international conference, which was sponsored by two large drug companies and a drug-company foundation. Aided by new bone testing technology, experts at the conference were charged with determining the normal bone density mass. The researchers turned to an analysis of women in Rochester, Minnesota, which showed that 16 percent of post-menopausal women in that city would sustain a hip fracture in their lifetime. Looking at years of bone density scores, the WHO found that 16 percent of post-menopausal women had bone density readings of -2.5 or worse. So, under the new definition, anyone with a spinal fracture or a -2.5 T-score (bone density score) or worse had osteoporosis. The committee went further and decided that scores between -1 and -2.5 were the boundaries of a new condition, osteopenia, or low bone mass.

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

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

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

Nevertheless, once considered a rare disease associated with old ladies with a “dowagers hump,” osteoporosis has now become an epidemic with “experts” warning that half of all post-menopausal women are at risk.

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

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

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

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

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

The osteoporosis propaganda campaign has caused women to believe that they must take a drug to prevent being bent over with spinal fractures or succumbing to a life threatening hip fracture. No doubt, the prospect of having a broken bone due to osteoporosis is quite frightening. However, the average age of hip fractures for a woman is 79. The lifetime risk of hip fracture for a white American female age fifty or older is 17.5 percent. Over a lifetime, the risk of a vertebral fracture for this same group is estimated at 15 percent. Certainly these percentages should make us pause and take note.

However, leading bone expert, and author of Better Bones, Better Body, Susan E. Brown, PhD, states: “Osteoporosis, by itself, does not cause bone fractures. This is documented simply by the fact that half of the population with thin osteoporitic bones, in fact, never fracture.” It is important to know that over 90 percent of hip fractures occur from falls, not weak bones. Falls cause fractures, not weak and crumbling osteoporitic bones.

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

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

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

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

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

Rodger Murphree, D.C., has been in private practice since 1990. He is the founder and past clinic director for a large integrated medical practice located on the campus of Brookwood Hospital in Birmingham, Alabama. He is the author of Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome, Heart Disease: What Your Doctor Won’t Tell You, and Treating and Beating Anxiety and Depression with Orthomolecular Medicine. He can be reached at [email protected], 1-205-879-2383 or visit www.treatingandbeating.com.

Many folks on the run grab for a nutrition bar; sometimes called a meal replacement bar or energy bar. Others eat such bars as a snack. The calorie content for such bars typically ranges from 200-300 calories, and they can often be devoured in just a few bites, creating the gastric illusion that “little” food was consumed. Indeed, it is not difficult to eat 1000 calories worth of nutrition bars in a sitting.

The tragedy of this type of eating is many fold, and becomes readily obvious if we examine the fiber and potassium levels in a nutrition bar and several other foods (See Table 1). In a single Zone Perfect Bar we get 210 calories, 3 grams of fiber, and just 90 mg of potassium. People mistakenly believe this is a health food choice. Not really.

Consider that we should be eating over 50 grams of fiber per day if we look at historical eating patterns, which is significantly less than the 10-13 grams of fiber per 1000 calories that is recommended by the American Dietetic Association (ADA).¹

A look at Table 1 reveals that a mere 264 calories worth of broccoli gives us 27.6 grams of fiber, while 280 calories worth of romaine lettuce provides 35 grams of fiber. In contrast, if you were to consume 10 grams of fiber per 1000 calories and ate 3,000 calories per day, you would take in only 30 grams of fiber. One can only wonder how these estimates of fiber intake were developed by the ADA. Based on the numbers, we can envision that we are essentially being asked to avoid fiber-rich foods by the ADA in order to achieve the meager 10 grams of fiber per 1000 calories.

Consider, for example, if you decided to eat five Zone Perfect Bars, you would get 1050 calories, 15 grams of fiber, and 450 mg of potassium. This is obviously not a healthy diet; however, it does reflect the quality of food that one could consume to reach the unimpressive 20-35 grams of fiber recommended by the ADA.¹ Shockingly, the average American consumes about only 15 grams of fiber per day,¹ so the low levels suggested by the ADA would actually be an improvement.

The outcome of eating a fiber-free diet? Constipation is the biggest issue in the short term. Colon cancer is the long-term concern of going without fiber. And, in recent years, research has demonstrated that a state of chronic systemic inflammation develops due to low fiber intake.^2,3

As illustrated in Table 1, on a calorie-to-calorie basis, vegetables are the best source of fiber and fruit is the next best choice. Grains do not compare!

What about potassium? Back in 1990, I came across a magnificent text entitled The Regulation of Potassium Balance.⁴
We are told that, until recently, humans consumed some 7,500-11,000 mgs of potassium everyday. Now we consume about 2500 mg per day, which is about 75 percent less than we need.⁴ A look at Table 1 demonstrates that such values can be achieved only if we eat about 750 calories worth of vegetables and fruit each day.

The seriousness of our current low potassium intake should not be taken lightly. Insufficient potassium intake is known to create a pro-inflammatory state that is thought to be a driver of numerous diseases, such as diabetes, hypertension, stroke, kidney stones, osteoporosis, cancer, and heart disease.⁵ Correcting our deficiency in potassium involves the consuming of greater amounts of vegetables and fruit. We should never take potassium supplements.

As might be assumed, the diseases caused by low fiber and potassium intake can only be properly addressed by eating an appropriate diet. Supplements can be taken to support a diet that is rich in vegetables and fruit, and the best basic supplements to take would be a multivitamin, magnesium, fish oil, and vitamin D.

Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession. He is on the postgraduate faculties of several chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient. He is also a faculty member at Palmer College of Chiropractic Florida, where he teaches nutrition and subluxation theories. He can be reached by e-mail at [email protected].

 

Do you treat patients with fibromyalgia? If so, you’ve probably been tempted to think they’re all crazy. They forget their appointments, cancel at the first sign of bad weather, get lost on the way, show up on the wrong day, or at the wrong time. The new-patient visit can be a bit challenging, to say the least, especially for those doctors who have other patients to see that day. You can no sooner ask, “How are you doing,” before they deliver a rambling, time-consuming monologue about every illness, accident, and test they’ve had since birth. And, since the average fibromyalgia patient has seen twelve doctors and had the illness for seven years, they have piles and piles of paperwork—which, of course, they want you to review. They’ve got numerous complaints, including anxiety, depression, fatigue, chronic pain, insomnia, irritable bowel syndrome (IBS), mitral valve prolapse (MVP) syndrome, chronic sinusitis, tingling in their extremities, night sweats, chemical sensitivities, headaches, reflux, and other symptoms. Where do you start?

I agree; they may be a brick short of a load. But, in their defense, you’d be crazy too if you went days without sleeping, had diffuse chronic pain, no energy, no life, and no hope. They’ve been bounced from one doctor to another, had dozens of tests, taken numerous drugs which didn’t help, and continue to get worse, year after year. The traditional drugs of choice, including, NSAID’s, antidepressants, anticonvulsant medications, muscle relaxants, tranquilizers, and pain medications, may provide short-term relief, yet their results are often fleeting and their side-effects detrimental. It’s not unusual for them to be taking twelve or more prescription drugs, many of which contribute to their erratic behavior.

The sleep drugs Ambien and Lunesta may cause short-term memory loss, fatigue, flu-like symptoms, and depression. Tricyclic antidepressants, including Trazadone and Elavil, may cause early-morning hangover, mental confusion, and lethargy. SSRI drugs may cause anxiety, depression, mental blunting, and lethargy. Klonopin and other benzodiazepines may cause depression, fatigue, and decreased mental function. Beta-blockers (Inderal and others) are commonly prescribed for MVP. These drugs may cause depression, as well as mental and physical fatigue.

Neurontin and Lyrica have potential side effects that include depression, somnolence, fatigue, thought disorders, fuzzy thinking, and ataxia. Zanaflex and other muscle relaxant drugs may cause mental confusion, speech disorder, lethargy, psychosis, and even hallucinations. All of these drugs are known to deplete at least one or more essential mood-dependant vitamins, minerals, or nutrients (B6, B12, CoQ10, folic acid, etc.). Individuals with fibromyalgia are also deficient in the brain chemicals which help regulate mood and mental function.

 

Neurotransmitter Deficiencies

 

Research shows that the majority of these patients are deficient in serotonin, dopamine, and norepinephrine. These three neurotransmitters are essential for optimal mood and mental function. Serotonin, also known as the “happy hormone,” helps regulate moods, sleep, digestion, bowel movements, pain, and mental clarity. Individuals with fibromyalgia have low levels of the amino acid tryptophan, as well as 5-hydroxytryptophan (5HTP), which are needed for the production of serotonin.

Ok, so these folks aren’t playing with a full deck, but how could they have so many health problems?

While we still don’t know for certain what causes fibromyalgia, we do know that fibromyalgia patients have an imbalance of the hypothalamus-pituitary-adrenal (HPA) axis. This imbalance creates far-reaching hormonal imbalances, which disrupt the body’s ability to maintain homeostasis. This can create a host of unwanted health conditions.

 

Hypothalamus-Pituitary-Adrenal Axis (HPA) Dysfunction

 

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

 

The Hypothalamus regulates such bodily functions as:

1. Blood pressure, which is often low in those with fibromyalgia.

2. Digestion—bloating, gas, indigestion, and reflux are common in FMS patients.

4. Circadian rhythms (sleep/wake cycle) are consistently disrupted in FMS.

5. Sex drive—loss of libido is a common complaint for FMS patients.

6. Body temperature, which is often low in FMS patients.

7. Balance and coordination—FMS patients often have balance and coordination problems.

8. Heart rate—mitral valve prolapse (MVP) and heart arrhythmias are a common finding in FMS patients.

9. Sweating—it’s not unusual for FMS patients to experience excessive sweating.

10. Adrenal hormones—are consistently low in FMS patients.

11. Thyroid hormones and metabolism—hypothyroid is a common finding in FMS patients.

Recent studies show that over 43 percent of FMS patients have low thyroid function. It’s estimated that those with FMS are 10 to 250,000 times more likely to suffer from thyroid dysfunction. Of course the symptoms of hypothyroid include mental fatigue, depression, and poor memory.

 

Stress Coping Savings Account

So what causes the HPA-axis to go haywire? After researching and specializing in the treatment of fibromyalgia for the last eleven years, I believe chronic stress is the underlying catalyst for the onset of HPA dysfunction and fibromyalgia. Several studies have demonstrated how chronic stress undermines the normal HPA function.

I like to use the analogy of being born with a stress-coping savings account. We have certain chemicals, vitamins, minerals, and hormones, like serotonin, dopamine, norepinephrine, and cortisol, that allow us to handle moment-to-moment, day-to-day, stress. The more stress we’re under, the more withdrawals we make. Individuals with fibromyalgia have made more withdrawals than deposits. Poor sleep, chronic stress, nutritional deficiencies, prescription drugs, and other stressors have taken their toll. The patient has bankrupted his/her account. This leads to the HPA-axis being overtaxed, and poor health follows. Fortunately, there are some tried-and-true nutritional protocols that can help build up the bankrupted stress-coping savings account. Reestablishing optimal neurotransmitters, especially serotonin and norepinephrine levels, is critical for these folks.

Double-blind, placebo-controlled trials have shown that patients with FMS were able to see the following benefits from increasing serotonin through 5HTP replacement therapy:

• Decreased pain

• Improved sleep

• Fewer tender points

• Less morning stiffness

• Less anxiety

• Improved moods, in general, including in those with clinical depression

• Increased energy.

There are more serotonin receptors in the intestinal tract than there are in the brain. This is one reason people get butterflies in their stomach when they get nervous. Serotonin controls how fast or how slow food moves through the intestinal tract. IBS symptoms, commonly seen in fibromyalgia, typically disappear rather quickly once serotonin levels are boosted. I have my patients with IBS take 300mg of 5HTP along with a good optimal daily allowance multivitamin (680mg of magnesium) and pancreatic digestive enzymes.

S-adenosyl-L-methionine (SAMe) increases the action of several neurotransmitters, including serotonin, norepinephrine and dopamine, by binding these hormones to their cell receptors. SAMe helps keep mitochondrial levels at peak levels, increases brain function, and has potent pain-blocking properties. Normally, the brain manufactures all the SAMe it needs from the amino acid methionine. However, patients with fibromyalgia have been shown to be deficient in this essential amino acid.

Studies involving FMS patients and SAMe have shown dramatic improvements in pain reduction. One study shows that patients taking SAMe for a period of six weeks had an improvement of 40 percent in pain reduction and 35 percent improvement in their depression. More than 100 peer-reviewed studies show SAMe to be a safe, effective, and fast-acting antidepressant.

Along with 5HTP and SAMe, I’ve found that a good optimal daily-allowance multivitamin with a free-form amino acid blend, fish oil, malic acid, and generous amounts of magnesium help reverse the “brain fog,” poor energy, chronic pain, mood disorders, and sleep disturbances so common in fibromyalgia.

The next time you encounter a fibromyalgia patient, please reassure them that, while you agree (as far as memory is concerned) they might not be the sharpest tool in the shed, with the right nutritional therapy, they may be able to at least remember their future appointments.

 

Rodger Murphree, D.C., has been in private practice since 1990. He is the founder and past clinic director for a large integrated medical practice located on the campus of Brookwood Hospital in Birmingham, Alabama. He is the author of Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome, Heart Disease: What Your Doctor Won’t Tell You, and Treating and Beating Anxiety and Depression with Orthomolecular Medicine. He can be reached at [email protected] or 1-205-879-2383.

References

1. Monthly Prescribing Reference Publication Nov 2005, New York NY

2. Ross Pelton, James B. LaValle, Ernest B. Hawkins. Drug-Induced Nutrient Depletion Handbook. Publisher: Lexi-Comp 2001.

3. Yunus m, et al., Interrelations of Biochemical Parameters and classification of FMS. Journal of Musc Pain 3(4);15-24, 1995.

4. Russell IJ, Vaeroy H, Javors M, Nyberg F. Cerebrospinal fluid biogenic amine metabolites in fibromyalgia/fibrositis syndrome and rheumatoid arthritis. Arthritis Rheum 1992;35:550-556.

5. Winberg S, Overli O, Lepage O. Suppression of aggression in rainbow trout (Oncorhynchus mykiss) by dietary L-tryptophan. J Exp Biol. 2001 Nov;204(Pt 22):3867-76.

6. Karl G. Henriksson, MD, PhD. Is Fibromyalgia a Central Pain State? Source: Journal: J of Musculoskeletal Pain, Vol. 10, No. 1/2,2002, pp. 45-57.

 

 

For complete reference listing, please visit our website at: www.theamericanchiropractor.com

Two recent articles have dealt blows to the nutri-tional supplement market. Research suggests that neither supplemental policosanol nor garlic has a cholesterol lowering effect.^1,2 Neither outcome surprises me; in fact, I would have been surprised if either helped, and here is why….

In the policosanol trial there were 143 subjects (56 men and 87 women). The average age was 56 (the range was 23-78). The average body mass index was 27.3, which means that most were overweight. Approximately 75 percent of all subjects were overweight, and just less than 20 percent of all subjects were obese.

The word exercise was not mentioned in the article, so we have no idea about a key lifestyle factor; however, considering that so many subjects were overweight, it is likely that few exercised. Additionally, about 5 percent of subjects were smokers, and various medications were being taken. We are not given the total number of patients out of the 143 on medications, or how many were taking more than one medication. However, we are told that 15 percent were on beta-blockers, 10 percent on ACE inhibitors, 13 percent on thyroid hormones, and 13 percent on aspirin/NSAID’s. Other medications included additional anti-hypertensive agents, estrogen replacement, and anti-depressants.

We also know nothing about the quality of the subjects’ diets, just that they were consistent among subjects during the study trial. This omission is important, as dietary content influences cholesterol levels. It is estimated that the average American consumes about 150 pounds of sugar per year.³ We know that high-glycemic index foods (sugar and refined flour) lower HDL-cholesterol levels, and we know that trans-fat consumption lowers HDL and also raises atherogenic LDL-cholesterol levels.⁴

To put this dietary situation into better perspective, consider that about 75 percent of the average American’s caloric intake comes from dairy products, refined cereals, refined sugars and flours, refined vegetable oils, and alcohol.³ Few fresh vegetables and fruits are consumed, and the meat we eat today bears little resemblance to the wild game consumed by generations past. Only about 2-4 percent of wild game is fat by weight, with relatively high levels of omega-3 fatty acids. Our modern meat is about 20 percent to 25 percent fat by weight, much of which is saturated fat, and a raiser of total cholesterol levels. Our modern meat is also rich in n-6 fatty acids, with very little anti-inflammatory n-3’s.⁴

In short, our modern dietary pattern is recipe for high total cholesterol, high LDL, and low HDL. The problem from which most American’s suffer is a dietary express train to hypercholesterolemia, coronary artery disease, and other chronic inflammatory conditions. Accordingly, taking 10-80 mgs of policosanol should not be expected to appreciably influence this process. Similarly, taking garlic should also not be expected to have an appreciable effect.

If you were depressed by the recent findings about policosanol and garlic, this means that you likely view supplements as natural medications that can be swapped in the place of drugs. This thinking is terribly erroneous. High total cholesterol and LDL levels are two of the measurable manifestations of a lifestyle that is very unhealthy. We cannot counteract an unhealthy lifestyle with drugs or supplements. No supplement or medication can take the place of exercise and a diet that consists mainly of vegetation, fish, and lean meat. However, we can take supplements to support this diet, and our best basic options are a multivitamin/mineral, magnesium, fish oil, and vitamin D. Garlic and other herbs, like ginger, are still appropriate for consumption and supplementation; however, the purpose of ingesting such herbs should be to help reduce the inflammatory state, and not to “treat” high LDL levels.

Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession. He is on the postgraduate faculties of several chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient. He is also a faculty member at Palmer College of Chiropractic Florida, where he teaches nutrition and subluxation theories. He can be reached by e-mail at [email protected].

 

References

1. Berthold HK, Unverdorben S, Degenhardt R, Bulitta M, Gouni-Berthold I. Effect of policosanol on lipid levels among patients with hypercholesterolemia or combined hyperlipidemia: a randomized controlled trial. J Am Med Assoc 2006; 295:2262-69

2. Gardner CD, Lawson LD, Block E et al. Effect of raw garlic vs. commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia. Arch Intern Med 2007;167:346-53

3. Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the western diet: health implications for the 21^st century. Am J Clin Nutr. 2005; 81:341-54

4. O’Keefe JH Jr, Cordain L. Cardiovascular disease resulting from a diet and lifestyle at odds with our Paleolithic genome: how to become a 21st-century hunter-gatherer. Mayo Clin Proc 2004; 79(1):101-8

The Food and Drug Administration cleared the antidepressant drug Prozac in 1988. Within two years of its debut, Prozac was the number-one antidepressant drug. New York magazine called it a “wonder drug.” The March 1990 issue of Newsweek had a picture Prozac on its cover. By 1994, it had become the fastest-growing prescription drug in America, with sales over $1.2 billion. Two other selective serotonin re-uptake inhibiting (SSRI) drugs, Paxil and Zoloft, had almost equal sales. In 1998, these three medications accounted for over $4 billion in annual sales. And, prescriptions for antidepressant-drug therapy have nearly tripled in the last decade, reaching $37 billion in sales in 2003.

One in three doctor visits by women now involve a prescription for an antidepressant medication. And one in ten American women take at least one antidepressant drug. Americans now spend more money on antidepressants than the Gross National Product of two-thirds of the world’s countries.

It may surprise you to know that the FDA approved Eli Lilly’s Prozac based on three studies involving 286 patients over a period of six weeks. Of the fourteen studies submitted for review, only three proved that Prozac was more effective than a placebo or an older antidepressant. Almost half of the studies show that up to 70 percent of those taking SSRI antidepressant medications do just as well by taking a placebo or sugar pill. And, the other half, show that overall improvement was minimal. Individuals on SSRI drugs increased their Hamilton Rating Scale by two points compared to those on placebo.

For the record, I do believe these medications can be helpful. I’ve witnessed first hand how they have benefited family, friends, and patients. However, the indiscriminate use of these overly hyped, potentially dangerous drugs has become all too common. Consider that the fastest growth spurt for antidepressant drugs has been in preschoolers, ages two to four. In 2003, more than one million American children were taking an antidepressant medication.

This is rather alarming, since the FDA has warned that antidepressants increase the risk of suicide in those under age eighteen. Just as alarming is the fact that many of the SSRI drugs have proven to be ineffective (worthless) in the treatment of adolescent depression. Courtroom documents reveal this little email gem from GlaxoSmithKline: “Essentially, the study (concerning Paxil) did not really show it was effective in treating adolescent depression, which is not something we want to publicize.”

If I were Joe America, I sure would want to know whether the antidepressant I was considering for my teenage son was: 1. effective, and 2. safe. Wouldn’t you?

Other SRRI drugs have been found to be just as dangerous. Zoloft has been linked to suicidal tendencies. The pediatric studies involving Zoloft show it to be no more than 10 percent more effective than placebo. And, side effects occurred three hundred times more in those taking Zoloft than those taking a placebo.

In December of 2006, the agency gave advanced notice of its new findings: Antidepressants, all of them, according to the FDA, cause increased suicidality in young adults. Suicide occurs more than twice as much with antidepressants than with sugar pills in individuals under age twenty-five. This statistic is even more scandalous when you learn that Eli Lilly knew from its earliest trials, in1985, that Prozac increased the risk of suicide by as much as 12 to 1 over placebo or older antidepressants.

Individuals, age twenty-five and above, who take SSRI drugs should know that they aren’t immune from suicidal risk or the numerous side effects associated with these drugs. Common side effects include anxiety, depression, headache, muscle pain, chest pain, nervousness, sleeplessness, drowsiness, weakness, changes in sex drive, tremors, dry mouth, irritated stomach, loss of appetite, dizziness, nausea, rash, itching, weight gain, diarrhea, impotence, hair loss, dry skin, chest pain, bronchitis, abnormal heart beat, twitching, anemia, low blood sugar, and low thyroid.

Prozac, alone, has been associated with over 1,734 suicide deaths and over 28,000 adverse reactions. The FDA estimates that only 1-5 percent of negative drug reactions are ever reported. With this in mind, it is reasonable to suspect that Prozac may be associated with 156,060 suicide deaths and 2,520,000 adverse reactions! Researchers agree that the SSRI drugs are all similar in nature so that they share many, if not all, of the same potential side effects. Essentially, individuals who take Celexa, Paxil, Lexapro, and Zoloft are all in the same boat. Unfortunately, many of the side effects elicited from these medications are never uncovered.

Practical Observations

A case in point is generalized muscle spasms, aches, and pains, which are common side effects of SSRI drugs. These spasms may occur in the neck, shoulders, or lower back. (This particular side effect can often complicate matters when I treat some of my chronic back pain or fibromyalgia patients.) Sleep disturbances, either insomnia or somnolence, have been reported in about 25 percent of patients taking serotonin re-uptake inhibitors.

Could your patient’s insomnia be due to their SSRI medication? Rarely, if ever, is the patient encouraged to wean off of their antidepressant to see if it is, in fact, causing their poor sleep–which, of course, increases their risk of other health problems (fibromyalgia, chronic pain, lowered immune function, weight gain, adrenal fatigue, etc.).

Since Mrs. Jones is having problems falling asleep, her family doctor prescribes Ambien. And, while she is able to sleep better, Ambien may cause short-term memory loss, flu-like symptoms, “brain fog,” early-morning fatigue, and more depression. No problem—a little Aderrall will get her going in the morning. A couple of months later, she begins to have anxiety and panic attacks. No fear—Xanax is here. And, on it goes. Meanwhile, none of the consulting doctors ever suspect the SSRI drug as being the originator of this chain of events. This scenario is all too common.

Just as concerning are the studies which show that using these drugs causes the brain to release less and less serotonin. SSRI drugs work by blocking the removal of serotonin from its synapse. Over time, the brain tries to compensate by shutting down the nerves that produce the neurotransmitter. This is known as down-regulation. Eventually, the brain begins to reduce the number of serotonin receptors—up to 40-60 percent in some parts of the brain—until they literally disappear from the brain. This is one of the reasons, besides the drug simply not working, that patients often switch from one antidepressant to another. And, unfortunately, the reduction of serotonin receptors may become permanent. If so, the patient is most likely doomed to a life of anxiety, depression, and poor health.

Patients who stop their mood-disorder drugs may experience an assortment of unwanted side effects. The possible withdrawal symptoms include severe depression, anxiety, agitation, dizziness, spinning sensations, swaying, difficulty walking, nausea, vomiting, upset stomach, flu-like symptoms, lethargy, muscle pain, tingling or electric shock sensations, and sleep disturbances.

Patients may falsely feel that the increased feelings of depression and/or anxiety are because they still need their mood-disorder drug. However, they may not actually need the drug but, like an alcoholic who stops drinking, they often feel worse before they feel better. There are reports of antidepressant-related withdrawal symptoms lasting two to three months after discontinuing the medication. Withdrawal symptoms of benzodiazepines (Xanax, Ativan, etc.) may last up to one year.

The Silver Lining

Fortunately, there is a happy ending to this story. There are a number of safe and effective nutritional therapies to help patients beat their mood disorders. I prefer to use amino acids which, when combined with essential vitamins and minerals, are the raw ingredients that make the neurotransmitters. The amino acid tryptophan, or 5-hydroxytryptophan (5HTP), turns into serotonin. Studies comparing 5HTP to SSRI’s and older antidepressants have consistently shown that 5HTP is as good, if not better, than the prescription drugs.

There are over 100 peer-reviewed studies showing that S-adenosyl-methionine (SAMe) is a safe and effective antidepressant. It increases the action of several neurotransmitters including serotonin, norepinephrine, and dopamine. A review of twenty-three randomized double-blind, placebo-controlled studies involving 1,757 people with mild to moderate depression shows that the herb St. John’s Wort was nearly three times superior to placebo (certainly better than most prescription drug trials) in relieving depressive symptoms.

Perhaps its time we start correcting nutritional insufficiencies instead of treating Prozac deficiencies.

Dr. Murphree is a board certified nutritional specialist and chiropractic physician who has been in private practice since 1990. He is the founder and past clinic director for a large integrated medical practice located on the campus of Brookwood Hospital in Birmingham, Alabama. He is the author of five books for patients and doctors.

In 2002, Dr. Murphree sold his medical practice and now maintains a busy solo practice specializing in fibromyalgia, chronic fatigue syndrome, heart disease, mood disorders, and other chronic illnesses.

He can be reached toll free at 1-888-884-9577 or at 1-205-879-2383; by email at [email protected]; or visit www.TreatingandBeating.com.

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