Michael Carlston, M.D. - Family Practice & Complementary Medicine

Carlston, M.D.
Family Practice and Complementary Medicine

www.carlstonmd.com

March 7, 2007

Dear Patients

I hope you have been enjoying the beautiful weather. Some of you have noticed that my redesigned website is up and running. Take a look if you have not seen it yet. Thanks to Rona McDonald of www.rmarix.com for her work.

There have been quite a few interesting health-related items popping up lately from a controversial publication about vitamins, to a mandatory cervical cancer vaccine, to my usual favorite vitamin D data. One of my patients requested that I comment on the cervical cancer vaccine controversy.

Best
Michael Carlston, MD
www.carlstonmd.com

Vitamin Supplementation
Cervical Cancer Vaccine
Early Autism Cases and Autism Genetic Predisposition
Eating Fish During Pregnancy Aids Child Development
Organic Baby Food Recall
Is It Old Age or Vitamin D Deficiency?

Vitamin Supplementation
Researchers in Copenhagen created a stir when they pooled data from a number of studies and wrote an article (published in the Journal of the American Medical Association) claiming that antioxidant supplementation may be fatally harmful to some people. Sadly, this is another example of excitable investigators running amok.

One of the “gods” of nutritional research, Meir Stampfer who chairs the Department of Epidemiology at Harvard, said "This study does not advance our understanding, and could easily lead to misinterpretation of the data". He also said that it would not get him to stop taking his daily multiple vitamin. The problem is that combining data from different studies can be extremely misleading, because the studies are designed so differently. To me it is like setting up two stereo systems running at the same time, one playing Mozart, the other Green Day, and then concluding that all music sounds horrible. If you consider each on its own merits, you are likely to arrive at a markedly different conclusion, recognizing that they communicate entirely different messages.

One of the many problems with this analysis is that the study included many people who were already sick with serious illnesses. Sick people tend to do things to get themselves better (including taking vitamins). So, the typical person taking vitamins is more likely than average to already have a serious medical condition they are hoping to alleviate by taking the MVM supplement.

Although the study has been severely criticized, I like it for one (possibly unexpected) reason. That is, I see far too many people who think that by taking a vitamin they can forget about eating well, exercising, learning to manage stress, etc., etc., etc. This is precisely the same attitude that leads too many Americans to pop prescription medication, because it is easier than taking care of themselves properly.

Yes, taking a good multiple vitamin mineral supplement is a wise thing to do. But do not think you can eat sugar, white flour, high fructose corn syrup …… and be healthy.

Cervical Cancer Vaccine
Cervical cancer is a significant health problem among young American women. I went to medical school with a woman who died then of cervical cancer. There are certain genital wart viruses that cause cervical cancer. The more sexual partners a woman has, the greater her likelihood of picking up one of the bad viruses. PAP smears are very useful, as they help us find precancerous and very early cervical cancer changes when it can be stopped with minimal treatments. 85% of American women who die from cervical cancer have NEVER had a PAP smear.

Although this is a significant health issue, I strongly feel that mandating a vaccine is unwarranted. We do not know what, if any, long-term ill effects this vaccine will create. Unlike many other contagious diseases, cervical cancer is not easily spread. It is only spread through sexual contact, and even then it is not highly transmissible. It should be a matter pf personal choice. A much better approach would be to recognize that 85% without PAP figure, and promote PAPs more vigorously.

Early Autism Cases and Autism Genetic Predisposition
Reviewing old records, it has come to light that mercury toxicity may have been a causative factor in the very first identified cases of autism. A Baltimore newspaper recently published an article investigating the first 11 cases of autism (http://www.citypaper.com/news/story.asp?id=13317). At least three of the eleven had extremely unusual exposures to mercury.

This, and the following item, add further to the mound of data suggesting that the body’s inability to cope with environmental toxicity is at the heart of many autism cases.

There has been evidence for some time that people with autism have abnormally limited glutamate function. This is a key messenger in brain function and effected by toxins, especially heavy metals. One question has been whether the abnormality is a consequence of the disease or a cause. New evidence from a large genetic analysis of families with two or more autistic family members found a pattern on chromosome 11 associated with the disease. I am very interested, because this location is one of the sites of genes producing glutamate.

Eating Fish During Pregnancy Aids Child Development
Sometimes we don’t know what to do because of conflicts between known facts. For example, fish have lots of oils and other nutrients important for neurologic functioning, but they also can contain PCBs and mercury, which are neurotoxins. Because there are so many unknown and interacting factors, the best way to learn the “truth” is to test the whole system. In other words, what happens when you eat fish?

American and English researchers conducted a lengthy study following nearly 12,000 women and their children, from pregnancy up until age eight. They found that the children of women who ate 12 ounces (3 servings) or more of fish a week achieved significantly better IQ, behavioral and developmental scores. This study was well-designed and controlled for nearly 30 known confounding factors. It is highly compelling.

Organic Baby Food Recall
Unfortunately nobody’s perfect. The following baby “breakfast” food (sounds like manufacturers have created a new niche there) has been recalled, because some are contaminated with botulism.

Earth’s Best Organic 2 Apple Peach Barley Wholesome Breakfast Baby Food UPC 23923-20223 EXP 14 SEP 08 A.

Also found in variety packs of Wholesome Breakfast UPC 23923-20295 EXP 13 SEP 08

Is It Old Age or Vitamin D Deficiency?
As we get older and find that even working our best to take care of ourselves is not enough, it is good to find something new which can help. We are learning that vitamin D deficiency is a big factor in many age-related infirmities, as well as disease.

The most reliable data from nutritional observational studies involve association between blood levels of a nutrient and relative risk of a problem (in other words, the greater the change in nutrient level, the greater the risk of the problem). There are a number of recent discoveries about this sort of risk. The National Health and Nutrition Survey III found such a connection between low levels of vitamin D and poor lung function in Americans over age 60. The same survey disclosed a link between low vitamin D levels and risk of developing macular degeneration. A study of 4,000 women over age 40 found that low levels of vitamin D were associated with urinary troubles (frequency, getting up at night, urgency). A small study demonstrated a link between declining mental abilities and low levels of vitamin D.

The best studies are interventional trials where subjects are exposed to some intervention, and then followed to learn what the effect is. As we age, we lose muscle mass even if we work at building it. A three year study of over 1,000 elderly men and women showed that those with even moderately low vitamin D levels were more than twice as likely to lose grip strength compared to those with normal D levels. Several studies has shown us that there is a strong correlation between vitamin D levels and the risk of falling.

Vitamin D might also be a significant contributor to the swallowing difficulties so common (nearly 40% of those over age 60) in the elderly.

All of these data must be considered in light of the knowledge that most of us are vitamin D deficient. A word to the wise…..

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March 7, 2007

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