Archive for April, 2015

Are stress tests worth the cost and risk?

Doctor And Patient

Let’s call her Betty. She was excited about her planned trip to Florida to be with one of her daughters for Mother’s Day. That was until a 6 PM urgent call from her cardiologist’s office insisting on seeing her the next day. Of course, anxiety ensued and the flight to Florida was cancelled. Betty and her family started to hold their collective breath as they waited for the appointment the following afternoon. The reason given was to follow up on the results of a “nuclear stress test”. (The name sounds a bit as though they thought she’d visited the Fukushima meltdown.) It is actually a cardiac test procedure defined by the Mayo Clinic at this link where you can also learn the reasons given for its use. A monitored treadmill workout is a stress test commonly used to see how the heart performs. But, docs can also approximate that by injecting a radioactive indicator dye and a chemical to make the patient’s heart race.

Certainly there are serious situations where such a test is medically necessary. But, unless that is the case, knowing that the damage from radiation can accumulate forever, I am not keen on having that dye circulating thru my body (and brain). A heart-stressing drug is also not very appealing. Never mind any long-term concerns, the immediate risks of the nuclear stress test include heart attack and potentially fatal heart rhythm irregularities. (Irregular heartbeat is responsible for those sudden-death heart attacks in people who did not have any of what are considered the usual risk factors such as high cholesterol.*) They call those stress test effects “rare”, but they can’t predict who will have them. When something like that happens to you or a loved one, slim odds are not much comfort.

Flashback. Betty started having routine stress tests starting several years ago when had chest pains.* At the time, blood tests and an EKG did not show a heart attack, so perhaps we couldn’t blame the doc for exercising an “abundance of caution” and doing a stress test. The stress test also found nothing. But, Betty was now on a hamster wheel that she cannot easily get off of because routine tests are a legal safety net for doctors and the bread and butter income of cardiology. At an average cost of $3,800 (some as high as $10,900) the clinic has a powerful incentive to continue to recommend stress tests for years on end. (Health insurance coverage may blind us to these ridiculous costs, but they do increase our premiums.) We will not be told to stop testing because we are apparently healthy. The testing will continue until ultimately some sort of problem is identified.

It could be worth the worry, risk and expense if the nuclear stress tests are all that they are cracked up to be as a predictor of treatable heart disease and consistently saved lives. However, they may be no better than flipping a coin. According to this journal article, cardiology may be quietly moving away from the use of stress tests.

The truth is that most of us have something wrong that could be found if docs look hard enough–but that doesn’t mean it is a threat to our health. For example, detailed exams of the spines of folks who are pain-free and fully functional often reveal cracks in vertebrae and bulges in disks. They would likely never cause an issue. Overused diagnostic tests can not only themselves cause harm, but they also find things that aren’t there (false positives) or issues that don’t need to be fixed or that cannot be fixed or for which the treatment is worse than the disease. (…hence the debate over mammograms and PSA). Over–testing and over-treatment are major concerns of ethical experts in medicine today.

Return to the saga. Betty and three of her loving daughters (some took time off of work) arrived for the appointment. They waited an agonizing hour and a half, imagining the worst. If this appointment was so important that an immediate consultation was required, why didn’t the doctor see Betty? Instead a staff person did and asked “so what brings you in today?” It turns out that the “news” was just that the test showed a shadow of something…possibly a borderline scarring of the heart. But, it could have been a testing error and they weren’t sure, so Betty should keep coming back for more testing.
I want to know what in the heck they would have done if they had confirmed scarring of the heart. They certainly wouldn’t remove the scar because it is just healed tissue. Would they possibly blame the damage on “inflammation” and give her an anti-inflammatory drug to prevent more scarring?*
It seems we should give more thought to the question: “Are stress tests worth the cost and risk?” We probably should also read Sherry Rogers, MD’s book Is Your Cardiologist Killing You?

*Non-heart attack chest pains can be caused by severe indigestion or cramps in the pectoral muscles of the chest. The mineral magnesium relieves muscle cramps and it helps normalize irregular heartbeat (which is often found in conjunction with heart scarring). Magnesium is also anti-inflammatory. Most anti-inflammatory drugs on the other hand are hard on the GI Tract and often lead to prescriptions for an acid-blocker like Nexium. Those drugs in turn lower the body’s store of magnesium thereby increasing heart attack risk. If cardiologists want to save more lives, they should order red blood cell magnesium tests on their patients or go ahead and write a “prescription” for magnesium. Oops, that won’t pay the clinic’s rent.

Food safety – Ice cream to GMO’s

Supermarket

There is now a lot of empty space on grocery store shelves where the Blue Bell ice cream used to be. That is a bit sad for those of us for whom this brand was our favorite cheat. But, infinitely sadder is that families lost loved ones because of a disease attributed to Listeria bacteria in the ice cream. Listeria bacteria are the third-leading cause of deaths from food contamination. It is a bit of a puzzle how it came to contaminate the creamery since pasteurization is supposed to kill listeria and presumably Blue Bell would have made its ice cream from pasteurized milk.

The ultimate source of the various pathogens that affect our food supply is less mysterious. Campylobacter, Listeria, Salmonella, Staphylococcus aureus and E. coli are found in food products largely because of the farming and processing practices used by giant agribusiness. Animals are raised in unhealthy conditions and therefore become good homes for the bad bacteria. (Interestingly, cows fed on grass even for a couple of weeks are much less prone to harbor these bacteria.) You can’t even avoid the problem by becoming a vegetarian because manure from these animals is used as fertilizer and the farm runoff can also contaminate vegetable crops. Those problems are compounded by government inspections of producers, processors and manufacturers which are already inadequate and getting worse. (I discuss many of these problems in my upcoming book on probiotics.)

Animals are given antibiotics to fatten them and to prevent diseases that they might get from crowding. Antibiotics are even sprayed on plant crops. In both cases, these drugs create antibiotic-resistant strains and kill good bacteria that might otherwise later protect us. That brings me to an important point about humans.

Food contamination causes 3,000 deaths each year in the US. It is always reported in instances of these food-borne illnesses (just like with epidemics of contagious diseases) that those most affected are those who have weakened immune systems. Obviously, we should work on ours. One important part of that is to strengthen our probiotics because 70+ % of our immune system is in the gut! Also, those who block stomach acid with drugs for heartburn are removing their first line of defense.

The government should also be more concerned about another longer term food-borne threat: Genetically Modified Organisms—GMO crops. (This is another topic that I cover in my new book which I hope it will be out soon). There is growing evidence that these crops (mainly corn, soy, canola and sugar beets so far) are harmful as well as the herbicides typically used in conjunction with them. Learn more at NonGMOProject.org.

Unfortunately, there is such big money behind GMO’s that it is a battle to even get GMO products properly labeled. Join the fight. JustLabelIt.org is one effort. Food safety — ice cream to GMO’s, it is up to us. You can help by expressing your opinion to your elected officials. It is easy—just click the applicable links below to read a summary of the issue, look at the bill and/or just enter your zip code to take action:

Federal – Take action here. Read the bill here. This is a very bad bill that would override state’s rights to require labeling.
Alaska –  Listen to a hearing here.  Read the bill here.  Take action here.
Arizona –  Take action here. Read the bill here.  
Connecticut – Take action here.  Read the bill here.  
Florida – Take action here. Read the bill here.  
Hawaii – Take action here. Read the bill(s) here.  
Illinois – Take action here. Read the bill here.
Indiana – Take action here. Read the bill(s) here.  
Maine – Take action here. Read the bill here. A public hearing on the bill is scheduled for Thursday, April 30 at 12pm in Cross Building Room 214.   
Minnesota – Take action here. Read the bill(s) here.  
Missouri –  Take action here. Read the bill here.  
New York – Take action here. Read the bill(s) here.  
Oklahoma – Take action here. Read the bill(s) here.  
Oregon –  Take action here. Read the bill(s) here.  
TEXAS– Take action here. Read the bill here.  

Thanks to the National Health Freedom Coalition for this handy information and the work they do. And thank you, Dr. Oz for taking the risk to take a stand.

 

The Human Body Instruction Manual

cave folksWe depend on our cars which are expensive to replace. Therefore, we usually drive in the right gear, change the oil, use the correct fuel, rotate the tires, etc. We know what to do for the car because we have an instruction manual for it.

The closest thing we have to The Human Body Instruction Manual is to look back thousands of years to our “hunter / gatherer” ancestors. Although they were apparently gorgeous, humans did not live long then because sanitation was poor; there was no medical care in emergencies; the food supply was unpredictable and a hunter might end up being some creature’s dinner. And yet, we react to our environment and diet just as they did because our physiology and chemistry is still pretty much the same.

The health complaints and chronic diseases of modern life can be thought of as a gradual accumulation of minor insults from not following the instructions. We get too much of some things and too little of others. I could easily list a hundred examples, but here is just one for this week from the “too little” category.

Too little SUNSHINE:  We still desperately need the vitamin D that our skin produces in the sun. As you may know D is more of a hormone than a vitamin and every cell in the body needs it. Low levels of vitamin D are associated not just with osteoporosis, but also depression, diabetes, cancer, thyroid disease, loss of muscle strength and much more.

Just to give you an idea how intertwined some of these issues can become: vitamin D is thought to lower cholesterol, blood pressure and atherosclerosis. For even more reasons, low levels are associated with worsened cardiovascular outcomes. If a person is put on a statin-type cholesterol-lowering drug, a lack of D may worsen side effects such as muscle weakness. One potential side effect of statins is heartburn. If a person with heartburn is given an acid-blocking drug (as described in my book on acid reflux), one side effect can be low magnesium. (Even the FDA warns about that.) Among 300 other things, magnesium is important to keep the heart beating regularly.

We’ve been advised to limit sun exposure to avoid skin cancer and besides, most of us are too busy to be outside long enough. Sunscreen and tinted windows block the D-forming rays if we do venture out. Foods are not a good source. The D we want is D3, but what is usually added to milk is D2. To achieve optimum blood levels (perhaps 50-70 ng/L) usually takes D3 supplementation of at least 5,000 IU a day. Those with very dark skin need to work even harder at building blood levels because they are naturally protected from even accidental sun exposure. Vitamin D is very safe–the risk is in being too low. Learn more on this page in our Library and this one and at the non-profit VitaminDCouncil.org.

ADD, Autism and Dyslexia

Boy Screaming And Blocking Ears

If you know a child or an adult with any of these issues, please check out our new Library page of information and resources.

FDA threat to homeopathy

alternative medicine and homeopathy

Well, I missed my chance to send a good April Fools’ Day email yesterday. I could have satirically announced that the American Medical Association and our government finally realized that non-toxic non-invasive natural remedies like nutritional therapies and homeopathy are much better first steps in healing most complaints (especially chronic conditions) than drugs and surgery. Then I would have said, “April Fools!”

As it turns out, there actually is a joke here, but a sick one headed in the opposite direction. As reported in this short GreenMedInfo.com article, the Food and Drug Administration (FDA ) is suddenly interested in Homeopathy and has announced a public hearing. With limited seating and only 3 weeks’ notice (in government terms that is NO notice) which gives insufficient time to rally opposition, it smells like a kangaroo court. (…and one where the kangaroo pens have not been cleaned in a long time.)

Government seems to have a (perhaps willful) lack of understanding about and antipathy for complimentary therapies in general. Not long ago mainstream medicine ridiculed acupuncture mercilessly, but they did not go after it aggressively. Homeopathy seems to be a much more direct threat to the financial interest of pharmaceutical industry that controls medical practice, education and regulation in the US. The FDA threat to homeopathy seems menacing.

The agency’s “interest” was supposedly aroused because homeopathy has now become big business. That bothers me on the face of it. Homeopathy has been safely practiced for 200 years and regulated by the FDA for 40. FDA wasn’t concerned that a relatively small number of licensed practitioners used the homeopathic remedies. They apparently didn’t care about the many of us consumers, chiropractors, athletes and massage therapists that have long used Arnica Montana for strains and minor injuries or about the cosmetic surgeons who found it of benefit in reducing swelling and bruising. The FDA started to perk up when Zicam spray, Cold-EEZE lozenges and Oscillococcinum for colds and flu gained market share (because they work). Could it be that the growing use of homeopathy is now viewed as a sizable financial threat to the pharmaceutical industry that is the agency’s reason to be?

Never mind that homeopathy is routinely used in Europe, India and other countries and is often reimbursed by insurance and even government health plans—there is also science. On the radio show we recently talked about homeoprophylaxis, a well-studied safer alternative for vaccines. There are also clinical studies showing that this form of energy medicine works in other applications. Of course, those with no knowledge of energy medicine find it very easy to mock homeopathy because it isn’t based on the same principle as pharmaceutical drugs. Many of the critics have a financial interest in opposing homeopathy, but even if they are just mired in outdated dogma, do we want these myopic control freaks to foster regulations that limits our freedom of access?

The FDA has no incentive to listen to the public or to powerless alternative practitioners. However, Congress controls their funding, so we need to let our legislators know our feelings. Click here to find out who represents you in DC. Simply enter your zip code and it will show you pictures, facts and their addresses, including email.

In case you are not familiar with Homeopathy, remedies contain the energetic message of certain substances, but not the original toxic molecules. The signals they send to our cells actually work in a somewhat similar way to the immunizations of which orthodoxy is so fond. Here is a link to some basic information about the field. This link is to a very interesting book on the history of homeopathy and the celebrities (queens, athletes and movie stars) that use it.

Even if the critics were right (and they clearly are not) and homeopathics offered only a placebo effect, that is a powerful force. Consumers using homeopathy for everyday complaints are at least protected from the side effects of typically over-prescribed medication with chemicals that have never been found on the planet before. Obviously, we do want all types of remedies regulated to assure safety and prevent fraudulent practices. If FDA was doing that in a fair unbiased manner that recognized the benefits of homeopathy, I wouldn’t have a complaint.


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