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In this issue:
Meow,
New Research Methods Needed for Complex
Health Conditions
of Real Patients
No one stands behind science more than the Co-op, but sometimes keeping up
with the studies on what’s “good” and “bad” is enough to make a kat twitch.
Whether studies caution that calcium and vitamin D do nothing to prevent
osteoporosis or bellow that vitamin E is linked to higher death rates, staying
informed on the latest scientific research can be, quite frankly, quite
dismaying.
What’s the rub? Well, most studies rely on traditional clinical research
methods, which focus on a single variable (like the introduction of a supplement
or drug or particular therapy). The good news is that this approach is intended
to provide evidence for the safety and efficacy of various unproven treatment
methods. The bad news is that in only considering one specific variable, the
consequence is often leaving out important contributing factors. Some of those
factors include:
1. The context of the care visit (including the physical setting and the
quality of relationship between physician and patient)
2. Lifestyle practices (diet, nutrition, exercise, stress, and other
variables)
3. Genetic differences (gender, ethnicity, family history)
Humans are just not as simple as a single variable, and health care
practitioners are taking note.
According to Mark Hyman, M.D., in a recent editorial for
Alternative Therapies in Health & Medicine
(Vol. 12, No. 3), the trouble with clinical testing methods is the focus on
studying groups versus individuals and on single diseases and interventions
versus more realistic situations found in most patients which include a variety
of care approaches.
As David Mant, M.D., of Oxford University, wrote in a much-quoted Lancet
article:
“The paradox of the clinical trial is that it is the best way to assess
whether an intervention works, but is arguably the worst way to assess who will
benefit from it.”
Dr. Mant went on to note that a randomized clinical trial leaves a real
“evidence gap” with respect to treating specific individuals. These evidence
gaps include:
• Approaches that are more comprehensive in nature and involve
educational, dietary, and lifestyle interventions are the least studied,
even though healthcare practitioners integrate multiple treatments. The
result? Real-world treatment scenarios don’t map to the single interventions
being studied.
• Patients with more than one condition are excluded from clinical trials
-- making the findings of studies least useful to those most in need: those
with chronic, complex, and multiple illnesses.
• Non-drug interventions are rarely studied at all.
Hyman, Mant, and others are calling for a greater emphasis on studying whole
“systems” relating to clinical outcomes – including diet exercise habits,
genetics, other forms of care, etc. -- rather than researching single variables
at a time.
And, we would posit that more research is needed on how these “other forms of
care” -- including pharmaceutical doses of nutritional agents -- affect patients
who are hospitalized, taking multiple drugs, and suffer from the complications
of multiple conditions.
Alas, studies take a lot of money and results that confirm the benefits of
injections of B vitamins, intravenous administration of massive vitamin C, the
addition of omega-3 fatty acids and antioxidants such as quercitrin, and the
like – well, they would yield no home-run profits for study sponsors.
Read more on omega-3 fatty acids and quercitrin in treating bowel
inflammation in a
recent animal study.
For an excellent reference on the
pharmacologic use of ascorbic acid in treating cancer (Mark Levine’s NIH
study reference, compliments of
Dr. Hugo Rodier).
For some related links from Integrative Cancer Therapies:
•
The effect of antioxidants on patients receiving radiotherapy
•
Editorial on antioxidants for cancer patients
This kat will continue to share references as they come to our attention.
Integrating Complementary Therapies in a
Hospital Setting -- More Research Required
Why all this interest in clinical trials and efficacy assessments?
Imagine being suddenly in the hospital for an unexpected abdominal surgery,
after losing weight inexplicably for some time. Think about the many drugs that
would be coursing through your IV and the relatively few nutrients coming in
after surgery. Consider the stress on your body and emotions if you were in the
ICU without so much as an hour of peace and rest for weeks instead of hours.
Imagine being treated for a nasty infection with multiple antibiotics, which
knock out the friendly bacteria as well as the hostile bacteria. It’s not a
pretty picture.
That’s precisely what happened to Cindy’s and Stephen’s dad, who is 72. He
was admitted to the hospital with a terrible case of peritonitis and suffered
from pneumonia after surgery.
In intensive care for almost three weeks and being fed by IV for much of that
time, malnourishment was a major problem.
Cindy contacted integrative pharmacist,
Mike Ciell, to get information on using pharmacologic doses of vitamin C
(ascorbic acid) intravenously. Vitamin C, as many of you know, supports the
immune system as well as collagen production (which is important for wound
healing, neurotransmitters, adrenals, etc.).
Cindy’s interest was not in abandoning traditional therapies being provided,
but in integrating a nutritional therapy with which Mike has been having
tremendous success at his clinic in Tampa, FL.
The attending physician was quite open to the treatment, but insisted on
receiving supporting evidence from clinical trials performed, ideally in a
hospital setting -- she was worried about losing her license for what many in
her field would consider “alternative” and thus not acceptable treatment.
While Mike was recommending 50 grams of ascorbic acid, along with B’s, zinc,
magnesium, and calcium, information on the “Myers
cocktail,” on which this therapy is based, indicates less than a quarter
of this dosage.
The attending physician and hospital pharmacist could not be convinced to use
a sterile water IV, but instead opted to give intramuscular injections every
four hours (3 grams at a time), and only did this for a few days, during which
time the acute infection did finally come under control and after which Cindy’s
and Stephen’s dad actually started to make progress.
There are many more details, but the moral to this story is that if you ever
think you will want a less-than-conventional treatment in the hospital, you
should do your research and start educating your physician early, sharing
research evidence from published clinical trials and/or peer-reviewed journal
articles. Web sites with anecdotal information – even from doctors using
complementary treatments is not enough in most cases.
It’s a lot of work for a layperson if a patient is already in the hospital,
even when you have good integrative practitioners as friends and a relatively
open physician within the hospital setting. Cindy recently moved her dad to
Utah, where she can oversee his care daily.
For those of you who want to drop a line to Cindy, she’s at
cindy@ourhealthcoop.com.
Keeping Joints Comfortable as Summer
Action Revs Up!
Summer’s here and even the most loyal couch potatoes stir with
these inviting longer days. Unfortunately, just a wee bit of overdoing it -- in
the garden, on the golf course, or at the tennis courts -- can quickly spell
stiffness and pain.
In 2005, 66 million, or nearly one-third of all adults, were living with some
form of arthritis. The term arthritis actually includes over 100 different
conditions that affect areas in or around joints. More than half those affected
are, gasp, under age 65. And, half of arthritis sufferers think nothing can be
done to help them.
However, there are many things that increase comfort and flexibility. Getting
around without joint discomfort requires two basic approaches: reducing or
eliminating inflammation in tissues and maintaining healthy cartilage.
Some things to consider?
• Weight: Maintaining a healthy weight is essential to
having healthy joints. Every extra pound you gain puts four times the stress
on your knees, creating inflammation potential. The flip side is that even a
small amount of weight loss will give your knees and hips relief. Research
has shown that losing as little as 11 pounds may cut your risk of
osteoarthritis of the knee by 50 percent!
• Exercise: Along those same lines, exercise can lessen pain,
increase range of movement, and reduce fatigue to help you feel better
overall. It was once thought best to keep arthritis pain sufferers off their
feet, but research has shown just the opposite, with exercise in moderation
being key.
• Diet: Eating healthily, which means getting foods with plenty of
vitamins, nutrients, and fiber, can help bones and joints with the
structural support they need to stay strong. It’s also important to avoid
pro-inflammatory diets - sugars, refined flours, milk, and processed oils
that are rich in omega-6 fatty acids. At the same time, it’s important to
eat plenty of anti-inflammatory foods (e.g., fresh fruits, vegetables, nuts,
seeds, and omega-3 fatty acids from fish and flaxseed oil).
• Supplements: When it comes to keeping healthy cartilage,
glucosamine and chondroitin have loyal followings – among both humans and
canines alike. Glucosamine stimulates cartilage-building enzymes, while
chondroitin helps joints hold water and inhibits joint destruction. And,
when you want to keep inflammation at bay, powerful antioxidants curcumin
and boswellia are ayurvedic herbs of choice, while MSM is a perennial
favorite for relieving pressure at the cellular level. Fish oil contributes
those handy anti-inflammatory omega-3 fatty acids that support more than
just the creaky old joints!
For more information on our products, such as Joint Complex, Arthro 3, and
Fish Oil, check out our
healthy bones and
joints page!
Welcome New Marketing Director -- Tess Beasley
Comes Back to the Co-op
Thank you to those of you who chimed in to wish Kelly McKibbin well on her
nursing school adventure and wedding.
And with no further delay, we’d like to re-introduce you to Tess Beasley, our
new Marketing Director. Tess worked for the Co-op a few years back as a
cherub-faced researcher helping this kat answer questions from our fair members.
These days, Tess is all grown up and has just returned from San Francisco to
join the Co-op again in Utah. Tess had this to share about her return:
“In some ways, it feels like I never left. I’ve carried
member stories with me and have been referring people to the Co-op every
chance I’ve gotten. The Co-op community is so unique and so fun. How lucky
am I to work in a place where humor is one of the job requirements?!”
And, for those of you skeptics who wonder what a 23 year-old might know about
healthy aging, be prepared to be surprised.
For more on Tess and how she made her way back to the Co-op,
click here.
That’s it for now.
Still purringly yours,
Guido
Guido Housemouser
Chief Kat and Community Manager
Our Health Co-op
931 Village Blvd
Suite 905-480
West Palm Beach, FL 33409
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