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

Carlston, M.D.
Family Practice and Complementary Medicine

www.carlstonmd.com

May 23, 2007

Dear Patients,

There has been another little flurry of articles questioning the value of vitamin supplementation. Vitamins are, by definition, nutrients that are essential for us to live. You would think from some of what you read that they are poison. The truth, as usual, lays somewhere near the middle ground.

Also on the topic of vitamins, my multiple vitamin will be available in 6-8 weeks. We are offering a 10% discount for those who preorder. If you are interested, send an email to [email protected].

If you are interested in doing your part to further medical research, take a look at the last item in this newsletter.

As the weather gets warm and sunny, I hope you have fun building up your vitamin D levels (while minimizing the sun damage)!

Best
Michael Carlston, MD
www.carlstonmd.com

Prostate Cancer and Vitamins
Prostate Cancer and Vitamins/Supplements #2
Statin Drugs and CoQ10
SHOULD YOU BE TESTED FOR CANCER? – Book Review
Homeopathic Patient Survey

Prostate Cancer and Vitamins
A survey of nearly 300,000 people included roughly 11,000 men with prostate cancer. 85% of the men with prostate cancer had average, localized disease. Remember that as men age past 50, the majority of us have prostate cancer, but most of the time it is not a concern because it is not aggressive and does not cause symptoms. The aggressive, spreading form of prostate cancer is the killer.

This survey found that men with advanced and fatal prostate cancer took more multiple vitamin pills than other people in the study. The authors decided this meant that taking too many multiple vitamins might be related.

There was no correlation between taking multiple vitamins and average prostate cancer. There was a correlation among men who had disease severe enough to cause symptoms and kill them.

My thoughts are many. First, I would expect men who feel sick to do something about it, like take vitamins. Second, if something causes a problem and the study is big enough, we should see some lesser effect from lesser exposure, not none. Third, generalizing all multiple vitamins as equal is quite sloppy scientifically. Finally, in partial agreement with the authors, dosage might (and should) make a difference. Disputing Mae West: too much of a good thing is not necessarily wonderful.

Prostate Cancer and Vitamins/Supplements #2
Another study of prostate cancer and a dietary component/supplement is more interesting because it was designed better and used blood levels rather than subjects’ recollections of what they ingested. Investigators collected data on 28,000 men between the ages of 55 and 74 who had no history of prostate cancer. The men had regular digital rectal examinations and blood work that included levels of lycopene and other carotenoids. They discovered 692 prostate cancers, some within the first year, and compared those men to 844 controls.

There was no correlation between blood levels of any of the carotenoids and prostate cancer, except between beta carotene and advanced prostate cancer. However, digging into the study thoroughly, even this finding is not as meaningful as it might seem at a glance.

This association just barely reached statistical significance, and the variation in beta carotene levels was dramatic. Blood levels in prostate cancer cases ranged from 6.5 to 46.3, with a median of 16, while controls ranged from 6.1. to 38.6, with a median of 15.2. While the median beta carotene level for subjects with the very highest levels of beta carotene (top 20%) averaged 6 times that in the lowest group, the risk of advanced prostate cancer was almost the same as that in the next to lowest range. The risk did not increase in direct proportion to blood levels. We would expect to see such a correlation if there were a causative relationship.

If this finding proves to be meaningful, and that is clearly suspect at this point, it will again raise questions in my mind about forms and dosages of carotenoids. For many years everyone has been obsessed with beta carotene forgetting that it is "beta" because there is an alpha, gamma, delta etc as well. So, why take mega doses of only one member of the family? If it is potent, shouldn’t excessive or unbalanced doses carry the potential for harm? Taking a spectrum of carotenoids, and in more moderate doses, is a much better idea. I've been advocating that approach for many years.

Finally, it is interesting to me that another recent study, by this same investigator, showing that taking selenium and multiple vitamin supplements reduced prostate cancer risk by 28-35%, received little publicity.

Statin Drugs and CoQ10
The statin drugs (Lipitor, Zocor, Pravachol, Lescol, Crestor, Altocor, Mevacor) are among the most commonly prescribed drugs in America. They were proposed as one component of a “Super Pill” that would fix all of our problems. Then a more rational medical researcher proposed a “Super Meal” instead, which would equal all of the “super pill” positives without the adverse effects. (see also http://www.carlstonmd.com/newsltrs/nl122104.htm)
Unfortunately, statins cause some pretty bad adverse effects – muscle and liver damage for example.

We have known for decades that CoQ10 is an important heart nutrient. For nearly as long, we have known that statins deplete the body of CoQ10. Hmmm. Giving CoQ10 to every patient we see taking statins is routine for those of us who prefer less invasive nutritional therapies. I remember a patient, long ago, who came to me with ongoing muscle aches brought on from taking a statin drug. Despite stopping the drug six months before, the pains and weakness persisted. I told him to take CoQ10. A week later his pain was gone, and not returned when I last spoke to him over a year later.

This approach was investigated in a small study recently. 32 patients with statin-induced muscle pain were divided into two groups. 18 were treated with 100 mg of CoQ10. Instead of CoQ10, 14 other received 400 iu of vitamin E. After 30 days pain severity was reduced by 40%, and pain interference with daily activity was reduced by 38% in those receiving CoQ10. There was no change in the vitamin E group. This difference was highly significant statistically (p<0.001) and clinically.

SHOULD YOU BE TESTED FOR CANCER? – Book Review
Perhaps the most powerful stimulus to action is fear. Although it is wise to be aware of risks, unfortunately that tendency can create its own set of problems and makes it easy to manipulate people. As many patients and doctors suffer from this malady, we often see this pattern in medicine. The best of intentions can become hazardous to your health when not reigned in by careful consideration. Often, just a little common sense is enough.

Whenever I find voices of reason in medicine, I treasure them. The book Should You Be Tested For Cancer? Maybe Not And Here’s Why by H. Gilbert Welch, MD, MPH is one such voice. The book discusses the rationale behind screening for cancer and logical flaws in the rationale. It is a very well-written, balanced appraisal of cancer screening. The book also educates readers about how to critically evaluate some types of medical research. I highly recommend it.

Homeopathic Patient Survey
As frequent readers know, I have been involved in clinical research for decades, because it is an excellent means of learning what helps patients and what does not. There is a survey of homeopathic patients underway, in which I encourage your participation.

Dear Homeopathic Patient:

We have created a national homeopathic patient survey which is designed to explore the nature of the homeopathic profession in the United States. We are hopeful that this will prove helpful in strengthening and promoting homeopathic medicine and help guide the homeopathic profession forward.

The survey will take about ten minutes of your time to complete. All responses will be kept strictly confidential. The aggregate results will be submitted to the AIH Journal, Homeopathy Today and the Similimum for publication on completion, early next year. We would also be happy to email you a copy of the results if you wish.

The survey is located at Survey Monkey and can be reached at http://www.surveymonkey.com/s.asp?u=902693334313. In filling out the survey, we don't need precise analysis, just your best rough estimates.

You can also mail us the results to AMCH, 2001 W. Camelback Suite 150, Phoenix, AZ, 85015.

We apologize if you have received this invitation in duplicate. We are attempting to cast as wide of a net as possible in reaching homeopathic patients. Please feel free to forward this to anyone who might be willing to participate.

Sincerely,
Todd Rowe MD, MD(H), CCH, DHt
President, American Medical College of Homeopathy
2001 W. Camelback, Suite 150, Phoenix, Arizona 85015
602-347-7950; 602-864-2949 (fax); www.AMCofH.org

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May 23, 2007

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