I promise not to mention Tax Day.  Well not again anyway.  After a slow series of newsletters the past 6 months I seem to be riding a high tide of information right now.  Although this newsletter is longish again, I've still held some things back for the next newsletter.  Another project will channel my writing for a bit and probably give you a rest so, don't despair.  I am Associate Editor for Pediatrics for a new medical journal, Seminars In Complementary Medicine, and I promised to provide an abstracted version of my chapter on homeopathic research from my textbook.  That deadline looms.

The office move is still unsettled.  A patient had come across a building would have been absolutely perfect in downtown Santa Rosa but we just could not work out the parking demands placed on a medical office by the city.  I will let you know when we get something sorted out.

My comments last newsletter encouraging donations to benefit those who would be suffering during and after the war brought this additional suggestion from a patient:

Since you mention food and "the hungry", are  you acquainted with  "www.thehungersite.com", "thebreastcancersite.com", "thechildrensite.com" and  "the-rainforestsite.com"?  Click on the right place for free and it helps  each individual program.  I do it every morning the first time I am at the  computer so I don't forget. Amazing how the amounts build up from people doing this.  At the bottom of the pages an amount is given of the totals.

Have a great spring!

Best

www.carlstonmd.com

• ASPIRIN & BREAST CANCER PREVENTION
• CHICKEN POX VACCINE MAY LEAD TO SHINGLES
• ANDROGRAPHIS
• TOPICAL GLUCOSAMINE FOR ARTHRITIS
• CANCER BLOOD TESTS
• WASTING DISEASE DEMENTIA DEER
• ANTIBACTERIAL OVERUSE
• VITAMIN D IN OSTEOPOROSIS AND CHILDREN
• ENVIRONMENTAL CHEMICALS

Next time:

Antidepressants - More than Placebo?

• Carnosine

Upcoming additions to the web site:

• Reading herb labels.
• Wellness and health prevention screening recommendations.

The wonder drug derived from willow bark by North American natives over past centuries looks better and better all the time.  Low doses of aspirin seem to be useful in the prevention of heart disease and colon cancer.  Now it looks as though we might be able to add breast cancer to the list.  A very large (ie probably reliable) study found that both aspirin and ibuprofen significantly reduced (20-40%) of breast cancer.  Acetaminophen (Tylenol) had no effect.  Ibuprofen's greater risk of long-term ill effects drops it down to second place in my opinion.  How much did they take to have this effect? - a standard dose 3 times a week.

Many of us mistrust vaccinations for a variety of reasons.  Our concerns are usually considered a reflection of our bias or irrational thought.  However, reality is often quite a bit more complicated than would warrant blind trust in vaccines.  Another example recently came to light.

Since the advent of the chicken pox vaccine, one of the "selling" points has been that it would prevent the painful and disabling disease shingles, which is a recurrence of infection by the same virus later in life.  A study of over 700 patients in London found that adults who were not repeatedly exposed to varicella virus (the cause of chicken pox and shingles) through contact with children carrying the virus were five times more likely to develop shingles.  Ooops.  Well maybe with time we will learn that chicken pox vaccination will decrease the risk of shingles for those kids when they grow up.  Then again ...?  Meanwhile, we know have the beginnings of a discussion about solving the new problem created by the chicken pox vaccine.  What is the proposed solution/boon to the vaccine manufacturer?  Vaccinating adults with the chicken pox vaccine.

Many of you know that I think often recommend an herb called andrographis instead of echinacea.  The reason I do so is that andrographis often helps boost immune function.  A series of studies of andrographis for upper respiratory viral illnesses look very positive with statistically significant benefits in all symptoms and accelerated recovery rates.  Andrographis is more difficult to find than echinacea but it seems worth the effort.  Animal studies suggest that andrographis may have contraceptive effects so pregnant women should not use it.

Surprising me, a recent study of patients with osteoarthritis found that those who rubbed a cream containing glucosamine on the effected joint had a significant reduction in pain.  Although I think highly of glucosamine, I was surprised because we don�t know how it can work through the skin.  Even more convincing to me than this study was my own experience.  Fortunately (?) I've had lots of injuries from which to learn what can benefit my patients.  I decided I should try it myself.  Every morning my knees hurt when I walk down the stairs.  The very first morning my knees felt fine.  I noticed it right away but couldn't figure out why I was better because I had forgotten I was testing the cream.  It seems to work, but may cause forgetfulness;)

One more thing.  My immediate benefit was more likely to be a result of other components of the cream I used.  Many of these creams have MSM or capsicin and the counterirritant (ie homeopathic) effects of these constituents will help immediately.  I plan to keep using it though because of the research and my own positive experience.

As a boy I loved the Star Trek television series.  Those of you who were Star Trek fans will undoubtedly remember the tricoder and its ability to instantly scan and diagnose human and alien ailments.  Today's medical diagnosis is certainly less efficient although I remember once at 3am in the emergency room having a senior resident teach me the "Star Trek physical" on an elderly demented nursing home resident with a fatal disease who unfortunately was going to need emergency surgery for a hernia.  He claimed that placing the stethoscope on one certain spot would allow us to listen to his heart, lungs and bowel sounds all at the same time so we could rush him to surgery (and be as lazy as possible at the same time).  The patient did fine but I was unimpressed by the Star Trek physical.

Medical diagnosis is improving towards that lofty goal, perhaps in baby steps but at least in ones that seemingly will give us good information with less discomfort for patients.  For some time we have been using blood tests for some cancers but these tests are notoriously unreliable.  Recent work looks like good tests for two of the most common cancers (colon and breast) might be just around the corner.  This would be really helpful in the case of breast cancer as current screening for breast cancer is very problematic.

As many of you know I have been agonizing over the devastating potential of prion induced disease for well over a decade now.  Remember Mad Cow Disease (variant Creutzfeld -Jacob Disease) is caused by prions which are misshapen proteins occurring in animal tissues.  Prions are both infectious and then passed on genetically.  When there are enough prions around, normal proteins change their shape to that of the prions much like a scary science fiction plot.  We know that many animals can suffer from prion disease.  For years I predicted that a scientist at UCSF would earn a Nobel Prize for his discovery of prions despite his enduring years of ridicule. 

My concern has been that prions might cause other diseases, less dramatic probably than one which rather suddenly leads to dementia and death.  Unfortunately there is growing suspicions that my fears might be realized.

One point is that some now believe that prion disease could play a role in various chronic diseases like diabetes, heart disease and arthritis.

Another matter has to do with Wisconsin deer.  Chronic Wasting Disease is a prion induced illness first discovered in deer and elk populations in Colorado and Wyoming and since recognized in Western Canada, New Mexico, Oklahoma, Kansas, Nebraska, Montana, South Dakota Wisconsin and most recently in Minnesota.  The problem has reached crisis proportions in Wisconsin where the government has worked with hunters to kill every deer in a large portion of the state (7,200 so far) in hopes of stopping the epidemic.  They have continued to reassure hunters that there is no evidence of human transmission.  However that seems no longer to be the case.  The Centers for Disease Control recently published a series of case reports involving three hunters who attended wild game feasts together at a cabin in Wisconsin all of whom had died of Creutzfeld -Jacob Disease.  This extremely improbable coincidence, having 3 men die of such a rare disease is highly suspicious, particularly given what is known about these diseases.  Surprisingly only one of the three men tested positive for prions.  The question then becomes whether we can rely on the testing or should we heighten our concern.  Needless to say I won't be reverting to eating venison when I visit Minnesota in the future.

One more thing we have learned adds to the confusion and maybe lightens the gloom.  Prion diseases are most likely among cannibals.  Epidemics of Creutzfeld-Jacob Disease among cannibalistic tribes in New Guinea early in the 20^th century were Western Medicines first introduction to the disease.  We have recently learned that a little bit of cannibalism might give a mix of prions - some bad mixed with the good, that may decrease the likelihood of developing the disease.  I have no idea what use this information can be at this point and will disavow immediately any apparent recommendation of cannibalism amongst my patients.

Some months ago I reported to you about the growing problem of surface water contamination with prescription medications passing through our bodies unaltered.  The growing ecological repercussions are very concerning.  Much like those concerns we now know we have a problem from household use of antibacterial chemicals. The recent rage for antibacterial everything from hand soaps to toothpaste to socks is foolish overkill.  Using what is necessary and no more, is the heart of wisdom.

A recent study suggests that vitamin D may be more important in preventing osteoporosis than calcium.  Patients over 65 who received a single dose of vitamin D (100,000 iu) once a month reduced their risk of fracture by one quarter.  This effect is comparable to studies that have used similar doses of vitamin D in combination with calcium although patients in this study did not receive calcium supplements.

This vitamin dosage is approximately equal to 800 iu daily.  Sunshine of course is another excellent way to get your self vitamin D.

Over the past several years it has become evident that elderly Americans are quite deficient in vitamin D.  We are also learning that infants and teenagers often don't get enough of this nutrient either.

As American industrial use of chemicals bloomed in the past century we have been bathed in an increasingly complex environmental chemical soup.  The overwhelming majority of these chemicals are new to the human body so we know little or nothing about their health effects.  Simultaneously we are observing changes in reproduction, genetic abnormalities, immune dysfunction and cancers in all animals (including us).  Is there a link?

One such chemical, bisphenol A, was developed in the 1930's as a synthetic estrogen.  When DES was found to be more powerful and so "better" for the purposes of investigators at that time, bisphenol A was temporarily abandoned.  Later, scientists discovered it could be used as a polymer to form certain plastics - especially polycarbonates.  Now it is used in baby bottles, refrigerator shelving, tooth sealants, fire retardants, pesticides, lined metal food cans, kitchen utensils, nail polish, Cds, thermal fax paper etc etc.

Well it still appears to act as an estrogen as well.  Recent evidence is that it has effects on prostate growth, onset of puberty in girls, endometriosis, sperm counts and chromosomal effects as well.  The chromosomal effect is that is changes the division of chromosomes so that one daughter cell will have increased numbers (like in Down's Syndrome).  Since the widespread use of this chemical there has been no change in the rate of Down's Syndrome. 

While that is reassuring, it could be that other chromosomal abnormalities result from bisphenol A exposure or other problems as noted above.  Just as with similar information coming to light about another chemical (DORC) used in nonstick cookware and stain-free fabrics we know too little to determine if we should be very concerned or not at all.  I always try to take this sort of information with a grain of salt.  It seems wise to limit your exposure and live as healthily as you can.  That way you give your body as much chance as possible to fix the inevitable damage accumulated from the many things from sunlight to PCBs that destroy our bodies.

On that note - another possibly reassuring oddity is the recent discovery that people living in the British Isles a thousand years ago had higher levels of dioxin exposure than any other known society at any point in time.  Turn out that burning that peat from the bogs in the cool damp climate generated a tremendous amount of atmospheric dioxin.