August 2010 Health Newsletter

Cardioplex:  Vitamins and phytochemically-rich herbs to help maintain a healthy heart
Core Level Heart: Nutritional support of the cardiac muscles

Homocysteine Redux:  Nutritional support of the cardiac muscles

Calcium (citrate): Highly absorbable calcium; reduces the risk of osteoporosis, supports cardiovascular   and colon health
CoQ₁₀:  Energy for cardiovascular health
l-Carnitine:  Cardiovascular and endurance support

ADHS:  Supports normal cortisol levels
L-Carnitine HCL:  Plays a critical role in fat metabolism and eneygy productions, therefore supports healthy heart function.
Mg Zyme:  Magnesium support for proper cardiac support

PLEASE FEEL FREE TO CONTACT THE OFFICE REGARDING ADDITIONAL HEART HEALTH NUTRITIONAL SUPPORT OR ASK THE DOCTOR ON YOUR NEXT VISIT

Targeted acupuncture may offer women with major depression a safe and effective alternative to antidepressant medication, new research suggests.

Investigators at Stanford University School of Medicine in California found that women with major depressive disorder treated with depression-specific acupuncture had a 63% response rate after 12 sessions compared with a 44.3% response rate in 2 combined control groups who were treated with either acupuncture not known to help alleviate depressive symptoms or Swedish massage.

"Pregnancy just by its nature can bring out some underlying psychiatric and emotional issues ... but treatment of depression during pregnancy is critically important so that a woman can maintain her sense of well being and take good care of herself, her fetus and, someday, her child," study coauthor Deirdre Lyell, MD, Stanford University School of Medicine, said in a statement.

Led by Rachel Manber, PhD, the study was published in the March issue of Obstetrics & Gynecology.

Response Rates Significantly Higher

For the study, investigators randomized 150 women whose pregnancies were between 12 and 30 weeks of gestation and who met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for major depressive disorder and who scored at least 14 on the 17-item Hamilton Rating Scale for Depression.

Of the 141 women who eventually entered the study, 52 received depression-specific acupuncture, 49 received control acupuncture, and 49 others received Swedish massage.

Treatments were provided twice a week for the first 4 weeks and then weekly thereafter for 4 additional weeks, with each session lasting about 25 minutes.

The investigators found that response rates were significantly higher in women who received depression-specific acupuncture than for either control group. Response rates in women randomized to the 2 control interventions did not differ significantly from each other at 37.5% for the control acupuncture group vs 50% for the massage group.

On the other hand, remission rates did not differ significantly between women who received depression-specific acupuncture at 34.8% and the combined control groups at 29.5%. They also did not differ between those assigned to the control acupuncture group at 27.5% or the massage group at 31.2%.

Thirty-three of the study participants discontinued treatment before the study endpoint, 30% of them for reasons related to the pregnancy. Some women in both acupuncture groups reported transient discomfort at the point of needle insertion, and 1 woman experienced bleeding at the needle site.

Significantly fewer women who received massage reported any adverse effects compared with the 2 acupuncture groups.

Clinically Meaningful

The study authors point out that the benefits observed with depression-specific acupuncture can be considered "clinically meaningful" when assessed in a broader context of depression studies.

Although there are no randomized controlled trials of antidepressants being used during pregnancy, 1 randomized controlled trial found that interpersonal psychotherapy produced a 52% reduction in Hamilton Rating Scale for Depression scores and a 19% remission rate after 16 weeks of therapy, to which the currently study compares very favorably.

According to the study, antidepressant use during pregnancy doubled between 1999 and 2003, but many women are reluctant to take these medications because of safety concerns. In fact, in this particular study, 94% of the women involved expressed reluctance to take an antidepressant because of their pregnancy.

"Because there’s this concern about medication among pregnant women and their physicians, it’s important to find an alternative," said Dr. Manber.

Results from this study therefore suggest that this standardized acupuncture protocol could be considered a "viable treatment option" for depression during pregnancy, the investigators conclude.

Michael Thase, MD, University of Pennsylvania School of Medicine, cautions that findings from this study are preliminary, although they suggest that depression-specific acupuncture may have value in major depressive disorder in this patient population.

On the other hand, another study assessing depression-specific acupuncture in a broader population of men and women with major depressive disorder failed to find a significant effect from the modality, so evidence supporting acupuncture for the treatment of major depressive disorder is not consistent.

"Still there is reason to be cautious when prescribing antidepressants in pregnancy, and one has to weigh the pros and cons of using an antidepressant on an individual basis,” he told Medscape Psychiatry.

"If these promising findings are confirmed, it would be good to have another option to complement the focused forms of psychotherapy which are currently used for antenatal depression," he added.

The study was funded by the Agency for Healthcare Research and Quality. The study authors and Dr. Thase have disclosed no relevant financial relationships.

Obstet Gynecol. 2010;115:511-520.

In the 1992 presidential campaign, Bill Clinton was a heavy underdog to popular incumbent George H. W. Bush. Bush was considered unbeatable due to foreign policy successes including the end of the Cold War and routing Saddam Hussein in the first Gulf War. But Bush’s approval ratings, which had been in the 90 percent range, began to dip as his campaign ignored the economic recession. Clinton’s campaign manager James Carville’s now famous campaign slogan, "It’s the economy stupid," helped turn the tide and Bill Clinton became the forty-second American president.

Just like George Bush’s 1992 presidential campaign, today’s medical community continues to promote the medical myths associated with cholesterol while ignoring the real cause of cardiovascular disease, inflammation.

Conventional opinion and current medical dogma holds that low cholesterol, especially low LDL cholesterol, reduces the risk and incidence of heart disease and stroke. This belief is so entrenched in the medical community that the FDA now approves drugs to prevent heart disease, as it did with Zetia and Vytorin, solely on the evidence that they lower LDL cholesterol levels. Zetia has never been proven to reduce heart attacks, strokes or death. Statin drugs help reduce the risk of heart attack and stroke for those who’ve already had a cardiac event (one percent over placebo) but fail to reduce death in women, the elderly, men over the age of 47, and in men without cardiovascular risk factors.

A 2006 study in The Archives of Internal Medicine looked at seven trials of statin use in nearly 43,000 patients, mostly middle-aged men without heart disease. In that review, statins didn’t lower mortality.

Nor did they in a study known as Prosper, published in The Lancet in 2002, which studied statin use in people seventy and older. Nor did they in a 2004 review in The Journal of the American Medical Association, which looked at thirteen studies of nearly 20,000 women, both healthy and with established heart disease.

Despite a growing voice of reason, which became even louder after the recently released Enhance study, the cholesterol zealots continue to view cardiovascular disease with tunnel vision. This myopic vision fuels the cholesterol drug war which rages on as each pharmaceutical company seeks to gain economic gain in the 40 billion dollar a year lipid lowering drug market.

In an attempt to take on the cholesterol Goliath, Pfizer’s Lipitor (10 billion dollars in sales annually), Merck and Schering-Plough combined their cholesterol lowering drugs, Zocor and Zetia, to form the "super drug" known as Vytorin. Vytorin’s goal was to lower LDL cholesterol more than either drug could alone. Zetia lowers blood cholesterol by blocking the absorption of dietary cholesterol from the intestines. Zetia used alone is modestly effective in lowering LDL cholesterol by approximately 17 percent. Zocor alone lowers LDL levels by 36 percent—similar to Lipitor.

The hope was that by lowering LDL to dramatically low levels, Vytorin would do a better job of slowing the accumulation of fatty plaques in the arteries. Vytorin did, in fact, reduce LDL—by a whopping 51 percent (similar to AstraZeneca’s Crestor).

However, the two-year "Enhance" trial failed to prove that Vytorin is better than Zocor alone for slowing plaque accumulation; instead atherosclerosis worsened in those taking Vytorin.

Merck and Schering-Plough suppressed this finding for twenty months.

The study results were not revealed until the two drug companies were pressured into doing so by an article in The New York Times and a Congressional inquiry. The marketers of Vytorin said they had nothing to hide. It’s hard to believe they weren’t just a little reluctant to publish their highly anticipated study. The news that Vytorin, which retails for $100 a month and did $2 billion in sales in 2007, was clinically inferior (perhaps even dangerous) to generic simvastatin (statin), costing less than $20 a month, obviously wasn’t what stockholders wanted to hear.

Merck and Schering-Plough are running full-page ads daily in the Times and Wall Street Journal, warning people not to be confused by a single study and to continue taking Vytorin. The advice was backed by the American Heart Association, which the Times reported receives nearly $2 million a year from Merck/Schering-Plough Pharmaceuticals.

Other LDL lowering drugs have bitten the dust in the last coupe of years as well.

Pfizer’s trial of its much-anticipated drug torcetrapib, which raised HDL, the good cholesterol, and lowered LDL, had to be stopped in 2006 because the drug caused heart attacks and strokes.

Estrogen replacement therapy, which is known to lower LDL cholesterol levels, failed to reduce the incidence of heart attack and stroke in clinical studies.

Ok, if cholesterol lowering isn’t the answer for everyone, why do statins help people with existing heart disease? Dr. James K. Liao of Brigham & Women’s Hospital in Cambridge, Massachusetts, has been investigating this question for over a decade. He suspects that statins have other biological effects. His research shows that statin drugs not only block cholesterol, but also an inflammation-generating enzyme known as rho-kinase.

When Liao reduced the rho-kinase levels in rats, they didn’t get heart disease. "Cholesterol lowering is not the reason for the benefit of statins," he concludes. Of course, there are dozens of inflammatory chemicals that play a role in triggering cardiovascular disease. Diet, health habits, our environment, even our personality may initiate inflammatory chemicals that perpetuate cardiovascular disease events.

Ralph Waldo Emerson once said, "People see only what they are prepared to see." As the evidence about inflammation and cardiovascular disease rises, will conventional medicine and the public at large be prepared to see that it’s not about lowering cholesterol but in reducing inflammation? Hopefully, "It’s the inflammation, stupid," will become a common slogan in the campaign to fight cardiovascular disease.

Shary’s corner
 
                       LIVE                        LOVE                          LAUGH
Every day can be filled with meaning.  Take a moment, just the amount of time you need to take a deep breath and exhale slowly, to ask yourself what is my dream, and how will I get there from here?
What can you stop doing or do differently to simplify your life and make it more meaningful?  What is truly important to you?  Do you give some time each week to your true priorities?
Why not fill your life with love and laughter whenever you can?  There is no greater gift than the gift of loving others.  There is nothing wrong with taking some time for self-care too.  Love your pet?  Love walking out in nature?  Make time for your passions and those things that add value to your life.  Your body, mind and soul will thank you.
Do you have a mission in life?
Dream it.
Think about it.
                      Talk about it.
                                                 Commit to it.

Japanese researchers have found home-based exercises to be more effective in the treatment of chronic low back pain than prescribed NSAIDs (nonsteroidal anti-inflammatory drugs). While NSAIDs can reduce inflammation and pain, they are a form of passive care that fails to address functionality issues such as limited motion, muscular weakness and muscular imbalances, not to mention the many negative side effects associated with NSAID use. Home-based exercises are not only natural and far safer, they specifically address functional issues and deficiencies in a proactive manner. And thus, it goes to reason that both men and women (mean age of approx. 42 years) who participated in the home-based exercises versus the NSAIDs during the 12-month study experienced more significant improvements in both reported low back pain and overall disability.

New research indicates vitamin D may be effective at reducing infections and colds. In this new study, researchers found that a group of young military men who supplemented with 400 IU’s (international units) daily for 6 months versus those who supplemented with a placebo experienced a significantly higher likelihood of having no days missed from work due to a respiratory illness. Moreover, of those taking the vitamin D supplement half remained healthy during the 6-month study as compared with approximately just one third of those taking the placebo. While more studies are needed, this new research does appear to indicate some benefits of vitamin D in reducing sickness or at least, the severity of sickness. It should be noted that vitamin D when taken in higher dosages is toxic and negative side effects can and do occur beyond 2,000 IU’s per day.

Antidepressants are commonly prescribed to those suffering from autism. However, past research hasn’t been able to provide evidence that antidepressants are actually useful for those diagnosed with autism. A recent U.S. government funded study reported that antidepressants, more specifically Celexa, was no better than a placebo for improving repetitive behaviors in children with autism. Researchers have now completed a new review of this study along with six other related studies present in the medical literature. Their findings – there was no evidence that antidepressants were any better than a placebo at reducing repetitive behaviors or any other symptoms in children suffering from autism. According to the researchers who conducted this recent scientific review of medical literature, there is no basis for recommending the routine use of antidepressants in the treatment of austism.