Category: Medicine, Naturopathic
Writing, writing, writing. However, at least recently, it has been rather enjoyable. Like you might hurriedly turn the page of a good novel to see what is going to happen next, so I write The Genotype Diet -often rushing home after karate class or some other engagement just to get back to work and see what might organically follow what I had previously written. It may (or may not) surprise you when you read it, since it turns the entire field of nutrigenomics upside-down, substituting a low-technology, DIY approach for any and all of the high tech glossy stuff that passes for the field nowadays.
Now, I have no gripe with labs and lab testing, but as John Bastyr used to say almost three decades ago when one of us student clinicians would pony up with the latest sophisticated panel, "That's nice, but tests don't get anybody better."
A while back a lawyer friend showed me a very old cartoon of a cow, with one man holding the tail and another holding the horns. The guy holding the tail was labeled "plaintiff" and the guy holding the horns was labeled "defendant". In between, milking the cow, was a third guy, labeled "attorney".
Labs are sort of like that. The doctor looks intelligent and busy, the patient feels that something important is happening. But in reality, nine times out of ten, the only real winner is the lab. I'm constantly amazed at the reams of testing information that typically accompanies a new patient, and how often these tests would appear to have had no basis for being ordered in the first place. Wouldn't the patient have been better off getting a new sweater or some slacks rather than to be left with a photostat of some normal lab values --which most of the time no one bothers to explain to them anyway-- or to have paid good money for spurious or even questionable testing?
Also guys, c'mon, dump the normal test results from a decade ago. Although they may mean something to you, a normal lab result older than about six months is just about worthless to your doctor and forcing him or her to peruse them is apt to just cause something important to be missed. It's nice that your urine was healthy in 1986, but frankly, we're not very interested in that.
You'd think alternative doctors would be less seduced by fancy-pants testing but it seems to me that they are often more likely to order them. Perhaps it is some sort of insecurity, or a desire to look "doctorly". On the allopathic front, how many tests are ordered just so that if things come to some sort of litigation, one's proverbial gluteus maximus is covered. Of course the fact that Big Brother Insurance pays for it all adds to the carnival atmosphere.
I met a new patient recently who had reams of tests including the two most recent which showed a gradually increasing white cell count. However, apparently nobody had paid any attention to this. At first I thought it could be some sort of low grade infection, since she was a B non-secretor. But over the course of the interview she referred several times to a twinge on the right side of the abdomen, which made me think of perhaps a low grade appendicitis flare up. Nine times out of ten these resolve with a change in diet and supportive care, and right then and there nothing more needed to be done, so I just advised her to look for signs of an escalating problem, such as fever or severe cramps, and move on them.
Frankly, I think the over-reliance on obtuse lab testing erodes the doctor-patient relationship. Most patients would do better with a dose of reality, especially when it comes to an appreciation of their limitations.
I've oftened wondered about the practicality of having a full time practice, in addition to the writing and the research. Very few major physician authors continue to practice, perhaps out of a fear of possible greater legal exposure, or the lack of time, or maybe they just never really enjoyed it that much. I enjoy meeting people and especially have liked working with and teaching the new doctor preceptors that have been a constant part of the clinic this year. Most of the naturopaths that I personally admire are practitioners, not researchers or authors.
William Osler put this funny relationship into proper perspective when he wrote:
"He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all."
The last week has been quite hot and humid over here at D'Adamo World Headquarters. We've finally put in a â€˜deer-proof' fence around a bit of the property, so for the first time since we've moved here (perhaps a decade or so) I can plunk in a few plants and not be forced to view a scene of desolation and carnage the next morning. Apparently from a low of 27 in 1939, the number of deer in Connecticut has now risen to somewhere between one and two million, which is not surprising considering that their natural predator, the wolf, is long gone and the state is full of yummy suburban yards full of tasty treats.
We've put in a variety of things, which I hope to add to over the season. One plant I always try to use is Baptisia tinctoralis (Wild Indigo) which grows well, if slowly in these parts. Baptisia has always interested me in a medical manner, having many immuno-stimulatory polysaccharides, and a few fascinating alkaloids as well. It is one of the few natural products that are known to stimulate the anti-T (Thomsen-Freidenreich) antibody, which may help explain its long use in traditional medicine for the treatment of cancer.
Interestingly, Georg Springer's anti-T vaccine was partly composed of the typhoid vaccine; he felt that it amplified the effect of the other components. Baptisia has a long history of use by many cultures for treating typhoid fever.
The British Naturopathic Association had an editorial on the Blood Type Diet Theory. You can read it here, including an afterpiece by Tom Greenfield. The article is pretty flaccid and tries to be humorous, but I wonder about the appropriateness of editorializing about â€˜things' in a medical journal. Typically, medical journals editorialize about the results of research included in that issue, and often only to speculate on what further conclusions may be drawn from it. The major gripe the author seems to have is that Red Clover, another plant I'm going to plunk in my garden, is an â€˜avoid' for everyone. But that is only to keep it out of the hands of people who don't know how to use it. Hey guys! Knock! Knock!
However, I do think that the British naturopaths (by-and-large) â€˜get it' when it comes to the essence of what all this â€˜polymorphism stuff' means to the practitioner. A lot of the US naturopaths are still incredulous that one of their number could possibly come up with a discovery --the significance of which, if correct-- would have wide and far-reaching implications. Others think everyone should just be vegan and that would solve everything.
Typically when it arrives, like all medical folk, they then trip over themselves so as to not be â€˜the last.'
As I wrote on the Forums, a lot of ND's have the opposite of the â€˜not invented here syndrome,' which is the â€˜I can't believe it was invented here syndrome.'
In both cases, considering the enormous amount of woo-hoo, mumbo-jumbo fantasy that masquerades for â€˜cutting edge' alternative treatments and devices (if my office mail slot is to be believed) it certainly can't be the lack of science that is holding them back. If ideas, as Schopenhauer observed, do go through three phases (ridicule, rejection, acceptance) then we've still got some time. Unfortunately, often by the time you get to the â€˜acceptance' stage, all the fun has been sucked out of things.
Research-wise, this has been a busy week.
Traded emails with Dr. Linda Kim, whose with the Southwest College Research Department over the last two weeks. The microbial adhesion study and the clinical trial of blood type and endothelial dysfunction are on schedule and within budget. Enrollment will be completed for the clinical trial by 7/31 and experiments completed for the adhesion study by 9/30.
Had a wonderful meeting with Dr. Carlo Calabrese and Dr. Heather Zwickey over at the Helfgott Research Institute, which is associated with the National College of Naturopathic Medicine. We're hoping to develop a series of studies that can test the BTD across a variety of conditions and parameters. What is great about working with Carlo --whom I've know for decades-- is that he attracts the very best thinkers, and so much of the work with blood groups (which are really genes when you think of it) is high level math and statistics, and area in which I am not all that muscular.
Someone wrote me that the BTD was discussed in a book called "The Chemistry of Joyâ€?. I've not heard of it, but it's got a heck of a title.
Unless you happen to be named Joy.
Was asked to give a little chat 'about what it is like to have practiced naturopathic medicine for almost three decades' during a student lunch at The College of Naturopathic Medicine at The University of Bridgeport. The prime mover behind this was one of our clinic externs, Dori (center, turquoise top) who wanted to have the school membership benefit from my 'sage advice.'
'Sage' in naturopathic medicine usually translates into 'aging hippy.'
I only fleetingly touched on my work with blood groups, and that was actually kind of nice, since I could more reflect on what being a physican has meant to me, versus an author, provocateur, etc.
At the end we did gather all the externs and preceptors for a picture:
Me and the current 2006 D'Adamo Clinic Preceptors, Externs and Resident: (l-r) Michelle, Dori, Lauren, Julie, Ani and Samm.
What an honor it is to work with these people. What talent.
I recently come across a study that seemed to show that repeated sauna therapy improves impaired vascular endothelial function in a patients with coronary risk factors. In the study, sauna therapy was performed with a 60 degrees C far infrared-ray dry sauna for 15 minutes and then bed rest with a blanket for 30 minutes once a day for two weeks. Systolic blood pressure and increased urinary 8-epi-prostaglandin F(2alpha) levels in the sauna group were significantly lower than those in the non-sauna group. These results suggest that repeated sauna therapy may protect against oxidative stress, which leads to the prevention of atherosclerosis.
Studies of other syndromes treated using far infrared sauna include chronic fatigue syndrome, anorexia, fibromyalgia and depression.
Although it has not been proved beyond all reasonable doubt, I tend to believe that far infrared saunas may help eliminate many of the industrial toxins that accumulate in our bodies over a lifetime.
Over 100,000 xenobiotics ('man made' chemicals) now contaminate our food, water, and air --and there are another three new xenobiotics being created every day. Many of these xenobiotics are carcinogenic and quite a few also have estrogenic activity: a bad combination for the female breast.
Here is a woman naturopath's take on xenobiotics and breast tissue. Chilling.
Xenobiotics make their way into the body by ingestion, inhalation, or through the skin. Our detoxication systems are not always perfectly efficient, and some toxins do reach the circulation. The ones that are fat-soluble get stored in the fatty tissues and remain there pretty much indefinitely. For example, in 2005 the Associated Press reported that a toxic component of rocket fuel had been found in the breast milk of women in 18 states. The chemical, perchlorate, can impede adult metabolism and cause retardation in fetuses, among other things. It leaches into groundwater from various military facilities and from there into the body.
One of the most famous is dioxin, which is routinely the subject of a rather lame internet hoax about microwaving with saran wrap, but does enter our bodies through a variety of less questionable ways including, of all things, forest fires.