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What’s New! – A Healthy Living Newsletter

July / August, 2002

It's summertime here in the Northwest and I've decided to combine the July and August newsletters, enjoy my family and work on my cookbook. My next newsletter will be in September. As always, if you have any book titles that you want me to review, please email me at drlawton@naturopathyonline.com.

Arthritis Action Program
An Integrated Plan of Traditional and Complementary Therapies
By Michael E. Weinblatt, M.D.

Harvard Medical School's Arthritis Action Program is paradoxically, one of the most direct and misleading books I have ever read. On the one hand, it gives great information about the mechanisms and treatments for the various types of arthritis.

On the other hand, its complementary section is marginal at best and there is minimal discussion about the side-effects of the long-term use of these drugs.

Yes, I'm a bit worked up. During the week I was reading this book, I had yet another patient on prednisone (a common drug for several types of arthritis) develop diabetes after having gained 50 lbs. I asked if her prescribing physician had mentioned that diabetes or weight gain was a potential side-effect from the long-term use of prednisone - and no, the physician hadn't. But let's get back to reviewing the book.

For the 1 out of 6 Americans who has arthritis and wants to use conventional medicine, this is an excellent book. Weinblatt covers the major and a few minor forms of arthritis by explaining the condition and detailing the treatment plan with the various categories of drugs. For example, an analgesic (e.g. acetaminophen, Ultram, Darvon, etc.) decreases pain but not inflammation. Since most forms of arthritis are inflammatory, this category of drug is the safest, but not necessarily the most effective. NSAIDs (non-steroidal anti-inflammatory drugs) (or new sources of aspirin in disguise) relieve pain at low doses and inflammation at higher doses.

He also includes little extras like "Questions to Ask About Your Health Insurance Coverage" when discussing the various drugs and a cost-and-performance analysis of the appropriate drugs. Celebrex based on a 200mg tablet a day, costs $871.20 a year, Vioxx at a comparable strength costs $727.20 a year and Ibuprofen costs $100.08.

Another excellent feature of the book are the exercise programs for the various types of arthritis. Clearly illustrated, the exercises are simple and effective.

What didn't I like about the book? For starters, Weinblatt states there is no scientifically supported "arthritis diet". And yet, there are dozens of studies showing the effectiveness of a vegetarian/vegan diet for several forms of arthritis. Meat and dairy contain arachodonic acid that contributes to pain and inflammation. Broccoli and beans don't cause inflammation. In fact, many foods decrease inflammation. When I have trouble convincing a patient that meat makes a difference in their pain level, I suggest that they keep a pain journal. They eat 2 days of a vegetarian diet followed by 2 days of heavy meat intake. My patients rarely consume meat on the 4th day as they generally have had a flare-up of pain after the heavy meat consumption.

Another point of contention with this book is with the discussion of DMARDs. DMARDs (disease-modifying anti-rheumatic drugs) described in this book as the "current backbone of treatment" (for rheumatoid arthritis), suppress the immune system. Once again, conventional and naturopathic medicine butts heads. While the immune system is clearly malfunctioning in rheumatoid arthritis - don't shoot it! Instead, strengthen and stabilize it. Once the immune system is suppressed, it leaves the person open to many forms of additional and serious illness.

One of my gravest concerns are the side-effects of these drugs. While these drugs often substantially decrease arthritic pain, the cost to the person's health can be high. For example, some of the commonly used drugs mentioned in the book cause weight gain. For someone with arthritis, additional weight adds to the stress on the arthritic joints, thus contributing to the problem. Also, over time these drugs affect the liver and kidneys leading to a host of subsequent problems. Drugs are not benign. And while they are appropriate in many cases, safer well-researched alternatives should be considered either as substitutes or to be taken in conjunction to decrease the amount of drugs being used..

As a conclusion to his book, Weinblatt suggests "the miracles of surgery" as a solution when the person has exhausted his/her other options. Two nights ago, on the evening news, a new study tested the effectiveness of the frequently performed arthoscopic knee surgery. They divided a group of candidates for the surgery into two groups. The first group actually received the surgery; while the second underwent a sham surgery. Both groups fared similarly in pain relief. A gentleman beamed on the TV, extremely grateful for pain relief, from a surgery that never happened. Does this make arthoscopic surgery unnecessary? Absolutely not. It may be exactly what the person needs. Just really explore all your options first.

Arthritis hits home in my family. My mom had rheumatoid arthritis and I had my first bout of arthritis as 26. Mom struggled going up and down stairs by the time she was 40. Her fingers were mishapened and her knees were perpetually inflammed. When I was 40, I was still hiking and playing ball with my kids. This morning I was out playing ball with my kids. I'm careful with my diet, don't overdue things, and have a back-up herbal anti-inflammatory tincture for short periods when diet and adequate sleep aren't enough - and I was treated with constitutional homeopathic medicine. I was fortunate to make the necessary lifestyle changes young enough to keep it under control. And that's my final point. If you have been recently diagnosed, hunt down a naturopath, herbalist, or Chinese herbalist. Find out all your options - and make some changes. If you've had arthritis for a while, stay on your medications, but look for ways to decrease them. There are no adverse long-term side-effects to maintaining a healthy lifestyle.


Healthy Parents, Better Babies

A Couple's Guide to Natural Preconception Heath Care
By Francesca Naish and Janette Roberts
(The Crossing Press, Freedom, California 1999)

Recently, I was at an herbal conference with a group of naturopathic physicians, where I heard this book mentioned - and mentioned again and again.

Intrigued, I decided to read it. One of the foremost fertility authorities in Australia, Dr. Naish treats couples who have unsuccessfully gone the conventional route of fertility treatment and want to get back to basics - which is what this book is all about.

Healthy Parents, Better Babies is an immensely sensible, but a bit overwhelming book. It starts with the premise that prospective parents should be in optimal health before conceiving. Sounds obvious, but somehow, we've missed the boat on that one. Most people think if the pregnant woman doesn't smoke, drink or use drugs, and takes a prenatal multi-vitamin and mineral, then everything's fine. Not good enough. According to Naish and Roberts, to get the kind of baby that won't keep you up at night or send you running to the doctor's office for the first several years, you need to do more.

For starters, the father's health is as critical as the mother's. "American cancer researcher, Professor Bruce Ames, attributed many birth defects and cancers in children to fathers who smoke. He quoted research going back at least 50 years which shows that the majority of congenital defects are from the male line. German research has shown that if the father smokes heavily, the child is two and a half times as likely as the child of a non-smoking father to suffer some malformation." But before the male readers start feeling defensive, "Women who smoke during pregnancy have a greater risk of spontaneous abortion, premature birth, …hyperactivity,…as well as their babies suffering from increased incidence of congenital abnormalities." And we're not just talking tobacco. Statistically, men are equally as responsible for infertility as women.

In a similar vein, Healthy Parents, Better Babies discuss alcohol consumption, before, during and after pregnancy. There are many children born with mild and undiagnosed cases of Fetal Alcohol Syndrome. The authors suggest that mothers stop any alcohol intake until weaning as alcohol passes through breast milk.

One of her main points is that both parents have to start at least 4 months before conception to stop all bad lifestyle habits and adopt a healthy diet. The four months period is based on the time it takes for the formulation of sperm and the time period in which an egg is susceptible to damage before ovulation. Devoting a large portion of the book to good nutrition, Naish and Roberts explain how and why to eat healthily. For example, canned foods should be avoided because they can lose up to 80% of their nutrients. Packaged bread may say no additives, but the flour from which it was made actually contains a number of chemicals. The bread maker didn't add the chemicals so he doesn't need to put them on the label - they were already in the flour.

After discussing dietary recommendations, the authors take the reader methodically through ways to exercise, decrease environmental health risks and to improve emotional health. For example, a pregnant woman should decrease her exposure to a computer screen to no more than 4 hours a day. If that's not possible, use a laptop, get an anti-radiation screen, get green plants, and/or put a packet of Epsom Salts in a cotton or cardboard container in front of the screen. Evidently, the Epsom Salts absorb a significant amount of emitted radiation, but needs to be changed for fresh salts when it gets crumbly.

The final part of the book is devoted to the treatment of common gynecological conditions such as fibroids, endometriosis and PMS, describing diagnostic tests and the pros and cons of conventional fertility drugs. Clearly, the authors are bias. But the research they present does support their claims. Clomiphene citrate (Clomid, Milophene and Serophene), a common fertility drug has been clearly linked to ovarian cancer. "Other side-effects of this drug include 'exploding ovaries' subsequent polycystic ovarian syndrome and a host of hormone related side-effects such as nausea, gastrointestinal problems, thrush, and headaches."

Whether you are having trouble conceiving, or are a first time parent or going for a second, third or fourth child, the advice in this book is excellent. Healthy Parents, Better Babies is simply though forcefully, written - the passion of the two authors comes through loud and clear. Remember, you don't have to do everything in it. Even if you did 25%, you would have made a significant improvement in your future child's life.

Health tip:

Recently, Growth Hormone has been receiving a lot of attention in the press. Growth Hormone has some very specific medicinal uses. Unfortunately, some people are getting the impression that using Growth Hormone for non-medical reasons is safe. That's not the case.

Any unnecessary hormonal use (with the possible exception of melatonin) has its risks. While adverse reactions to GH use are rare, potentially its misuse could involve acromegaly (elongation of the feet, forehead and hands) or involve overgrowth of the elbows or jaw, thickening of the skin and a type of diabetes.

In one study, the authors write, "Since GH administration may also have an independent adverse effect on insulin sensitivity and could thus cause a theoretical worsening of cardiovascular risk, it is important to review the observed effects of GH administration on carbohydrate metabolism in practice." (Drug Saf 2002;25(3):199-212 Growth hormone therapy and its relationship to insulin resistance, glucose intolerance and diabetes mellitus: a review of recent evidence.)


To all the local readers, our office is now located at 11825 SW Greenburg Rd., Ste A2, Tigard, Or. 97223. Our phone number will remain the same.

Copyright 2002 Dr. Suzanne C. Lawton, LLC

 

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Snail Mail: Dr. Suzanne C. Lawton
11825 SW Greenburg Road, Suite A2
Tigard, Oregon 97223
503-443-2332