EDITOR’S NOTE
A well-intended sympathizer of Integrative Health recently reminded me of an insidious issue that causes misunderstandings among skeptics. Her zeal for her companies’ Iodine is often seen as unrealistic and not science-based, which tends to confirm their suspicion that the entire field of Integrative Health is suspect. While everyone needs to make a living, I am afraid that the marketing department of supplement companies may at times claim benefits that are a bit too ambitious. Relying on these claims to promote products may backfire, especially among those we wish to “convert.”
We are all susceptible to this type of bias. Even mainstream doctors who reject Integrative Health concepts are; they tend to unquestionably believe Big Pharma’s claims, which are well known emphasize benefits and minimize problems in many of the studies they finance.[1] They are human, too. Being aware of these tendencies can help us better interpret any health claim. So, if you find yourself depending on the sales of whatever product you promote, it would be well to “curve your enthusiasm” and try to find impartial studies to back up your claims.
Hugo Rodier, MD
Iodine?
Taking Iodine chronically can lead to thyroid problems. It happened to me. This is well documented in the medical literature. Consequently, promoting Iodine supplementation over 100 mcg a day on a daily basis is not a good idea. Some practitioners use a skin absorption test to determine a lack of Iodine. This test has been shown to be inaccurate. Iodine deficiency used to be a concern before transportation of food from one region to another was not common. The main manifestation of Iodine deficiency is a goiter, or benign atrophy of the thyroid gland.
Adding Iodine salt to your meals is probably enough if you are not eating fish. This is recommended in Canada. Today, the main problem behind thyroid issues is endocrine disruptors, or chemicals in the environment that have a negative effect on our hormones, including the thyroid.[2]Consequently, eating as organic as possible, filtering our water and avoiding canned goods are some of the things you may do to minimize exposure.
For more information, including Potassium Iodine to protect the thyroid gland from nuclear radiation, visit MedlinePlus, a service of the National Institute of Health at http://nlm.nih.gov/medlineplus/druginfo/natural/3.5html?print=y.
Food allergies from acid-blocking drugs
We have reported several times that the purple pill and other acid blockers compromise the absorption of key nutrients like B vitamins and minerals, in addition to disrupting the delicate balance of organisms in the gut. The latter is an important factor in metabolizing food; consequently, a disruption of the gut flora has been linked to food allergies.[3]
Studies linking acid blockers to food allergies have been available for a while. A superb study published in 2005 on this topic came to my attention recently. Its impact and implications are enormous given the alarming increase in food allergies and intolerances. I am sure this is the reason why so many people get GERD or reflux. What is the common treatment? The purple pill. Do you see the problem here?
Over-processing of foods redolent with chemicals is also a problem. Add a suboptimal gut flora and you will have gut problems of all sorts. You may want to read my recently published book GUT HEALTH. The answers are strikingly simple: do an elimination diet, replace probiotics and digestive enzymes. Consider apple cider vinegar and cabbage juice; don’t eat so late at night, and, for those who can handle more, consider eliminating dairy and wheat. The latter was prominently featured in CBS News September 3rd 2012. Some people cannot eat grains anymore. Read the PALEO DIET. However, most people do fine with non-wheat whole grains.
Arthritis update
Pain is such an insidious problem that it does not hurt to review from time to time what we can do beyond medications that have significant side effects. Omega oils continue to get very good evidence that they are effective in lowering inflammation, especially in preventing it.[4] Here is a superb literature search courtesy of Jeffrey Bland’s Functional Medicine Update. It is include it in its totality to show, as it is our policy that those who continue to believe that Integrative Health has no evidence are likely to be influenced by other interests.
- Sawitzke AD, Shi H, Finco MF, et al. Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Ann Rheum Dis. 2010;69:1459-1464.
- Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006;354:795-808.
- Wu D, Meydani M, Leka LS, et al. Effect of dietary supplementation with black currant seed oil on the immune response of healthy elderly subjects. Am J Clin Nutr. 1999;70:536-543.
- Belch JJ, Ansell D, Madhok R, O’Dowd A, Sturrock RD. Effects of altering dietary essential fatty acids on requirements for non-steroidal anti-inflammatory drugs in patients with rheumatoid arthritis: a double blind placebo controlled study. Ann Rheum Dis. 1988;47:96-104.
- Pullman-Mooar S, Laposata M, Lem D, et al. Alteration of the cellular fatty acid profile and the production of eicosanoids in human monocytes by gamma-linolenic acid. Arthritis Rheum. 1990;33:1526-1533.
- Leventhal LJ, Boyce EG, Zurier RB. Treatment of rheumatoid arthritis with gammalinolenic acid. Ann Intern Med. 1993;119:867-873.
- Zurier RB, Rossetti RG, Jacobson EW, et al. Gamma-linolenic acid treatment of rheumatoid arthritis. A randomized, placebo-controlled trial. Arthritis Rheum. 1996;39:1808-1817.
- Safayhi H, Mack T, Sabieraj J, Anazodo MI, Subramanian LR, Ammon HP. Boswellic acids: novel, specific, nonredox inhibitors of 5-lipoxygenase. J Pharmacol Exp Ther. 1992;261:1143-1146.
- Kulkarni RR, Patki PS, Jog VP, Gandage SG, Patwardhan B. Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study. J Ethnopharmacol. 1991;33:91-95.
- Chopra A, Patwardhan B, Lavin P, Chitre D, Polisson R. A clinical study of a herbal (ayurvedic) formulation in RA [abstract]. Arthritis Rheum. 1996;39:S283.
- Chopra A, Lavin P, Chitre D, Patwardhan B, Polisson R. A clinical study of ayurvedic (Asian Indian) medicine in OA knees [abstract]. Arthritis Rheum. 1998;41(Suppl):S198.
- Blonstein J. Control of swelling in boxing injuries. Practitioner. 1969;203:206.
- Ako H, Cheung AH, Matsuura PK. Isolation of a fibrinolysis enzyme activator from commercial bromelain. Arch Int Pharmacodyn Ther. 1981;254:157-167.
- Piscoya J, Rodriguez Z, Bustamante SA, Okuhama NN, Miller MJ, Sandoval M. Efficacy and safety of freeze-dried cat’s claw in osteoarthritis of the knee: mechanisms of action of the species Uncaria guianensis. Inflamm Res. 2001;50:442-448.
- Sandoval-Chacón M, Thompson JH, Zhang XJ, et al. Antiinflammatory actions of cat’s claw: the role of NF-kappaB. Aliment Pharmacol Ther. 1998;12:1279-1289.
- Rains C, Bryson HM. Topical capsaicin. A review of its pharmacological properties and therapeutic potential in post-herpetic neuralgia, diabetic neuropathy and osteoarthritis. Drugs Aging. 1995;7:317-328.
- Deal CL, Schnitzer TJ, Lipstein E, et al. Treatment of arthritis with topical capsaicin: a double-blind trial. Clin Ther. 1991;13:383-395.
- Choi JH, Choi JH, Kim DY, et al. Effects of SKI 306X, a new herbal agent, on proteoglycan degradation in cartilage explant culture and collagenase-induced rabbit osteoarthritis model. Osteoarthritis Cartilage. 2002;10:471-478.
- Ammon HP. [Boswellic acids (components of frankincense) as the active principle in treatment of chronic inflammatory diseases]. Wien Med Wochenschr. 2002;152:373-378.
- Soni KB, Kuttan R. Effect of oral curcumin administration on serum peroxides and cholesterol levels in human volunteers. Indian J Physiol Pharmacol. 1992;36:273-275.
- Jimenez RA, Willkens RF. Dimethyl sulfoxide: a perspective of its use in rheumatic diseases. J Lab Clin Med. 1982;100:489-500.
- Swanson BN. Medical use of dimethyl sulfoxide (DMSO). Rev Clin Basic Pharm. 1985;5:1-33.
- Jacob SW, Wood DC. Dimethyl sulfoxide (DMSO). Toxicology, pharmacology, and clinical experience. Am J Surg. 1967;114:414-426.
- Eberhardt R, Zwingers T, Hofmann R. [DMSO in patients with active gonarthrosis. A double-blind placebo controlled phase III study]. Fortschr Med. 1995;113:446-450.
- Makheja AN, Bailey JM. The active principle in feverfew. Lancet. 1981;2:1054.
- Capasso F. The effect of an aqueous extract of Tanacetum parthenium L. on arachidonic acid metabolism by rat peritoneal leucocytes. J Pharm Pharmacol. 1986;38:71-72.
- Srivastava KC, Mustafa T. Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders. Med Hypotheses. 1992;39:342-348.
- Gibson RG, Gibson SL, Conway V, Chappell D. Perna canaliculus in the treatment of arthritis. Practitioner. 1980;224:955-960.
- Audeval B, Bouchacourt P. Etude controle en double aveugle contra placebo de l’extrait de moule Perna canaliculus dans les gonarthrose. Gaz Med Fr. 1986;38:111-116.
- Caughey DE, Grigor RR, Caughey EB, Young P, Gow PJ, Stewart AW. Perna canaliculus in the treatment of rheumatoid arthritis. Eur J Rheumatol Inflamm. 1983;6:197-200.
- Singh BB, Mishra LC, Vinjamury SP, Aquilina N, Singh VJ, Shepard N. The effectiveness of Commiphora mukul for osteoarthritis of the knee: an outcomes study. Altern Ther Health Med. 2003;9:74-79.
- Lawrence RM. Methylsulfonylmethane (MSM): a double-blind study of its use in degenerative arthritis. International Journal of Anti-Aging Medicine. 1998;1:50.
- Murav’ev IuV, Venikova MS, Pleskovskaia GN, Riazantseva TA, Sigidin IaA. [Effect of dimethyl sulfoxide and dimethyl sulfone on a destructive process in the joints of mice with spontaneous arthritis]. Patol Fiziol Eksp Ter. 1991;37-39.
- Müller-Fassbender H. Double-blind clinical trial of S-adenosylmethionine versus ibuprofen in the treatment of osteoarthritis. Am J Med. 1987;83(5A):81-83.
- Berger R, Nowak H. A new medical approach to the treatment of osteoarthritis. Report of an open phase IV study with ademetionine (Gumbaral). Am J Med. 1987;83(5A):84-88.
- Domljan Z, Vrhovac B, Dürrigl T, Pucar I. A double-blind trial of ademetionine vs naproxen in activated gonarthrosis. Int J Clin Pharmacol Ther Toxicol. 1989;27:329-333.
- Vetter G. Double-blind comparative clinical trial with S-adenosylmethionine and indomethacin in the treatment of osteoarthritis. Am J Med. 1987;83:78-80.
- Maccagno A, Di Giorgio EE, Caston OL, Sagasta CL. Double-blind controlled clinical trial of oral S-adenosylmethionine versus piroxicam in knee osteoarthritis. Am J Med. 1987;83(5A):72-77.
- Caruso I, Pietrogrande V. Italian double-blind multicenter study comparing S-adenosylmethionine, naproxen, and placebo in the treatment of degenerative joint disease. Am J Med. 1987;83(5A):66-71.
- Marcolongo R, Giordano N, Colombo B, et al. Double-blind multicentre study of the activity of S-adenosylmethionine in hip and knee osteoarthritis. Curr Ther Res. 1985;37:82-94.
- Glorioso S, Todesco S, Mazzi A, et al. Double-blind multicentre study of the activity of S-adenosylmethionine in hip and knee osteoarthritis. Int J Clin Pharmacol Res. 1985;5:39-49.
- Montrone F, Fumagalli M, Sarzi Puttini P, et al. Double-blind study of S-adenosyl-methionine versus placebo in hip and knee arthrosis. Clin Rheumatol. 1985;4:484-485.
- Deodhar SD, Sethi R, Srimal RC. Preliminary studies on antirheumatic activity of curcumin (diferuloyl methane). Ind J Med Res. 1980;71:632-634.
- Luskin FM, Newell KA, Griffith M, et al. A review of mind/body therapies in the treatment of musculoskeletal disorders with implications for the elderly. Altern Ther Health Med. 2000;6:46-56.
- White A, Foster NE, Cummings M, Barlas P. Acupuncture treatment for chronic knee pain: a systematic review. Rheumatology (Oxford). 2007;46:384-390.
- Witt CM, Jena S, Brinkhaus B, Liecker B, Wegscheider K, Willich SN. Acupuncture in patients with osteoarthritis of the knee or hip: a randomized, controlled trial with an additional nonrandomized arm. Arthritis Rheum. 2006;54:3485-3493.
- Ernst E, Lee MS. Acupuncture for rheumatic conditions: an overview of systematic reviews. Rheumatology (Oxford). 2010;49:1957-1961.
- Ezzo J, Hadhazy V, Birch S, et al. Acupuncture for osteoarthritis of the knee: a systematic review. Arthritis Rheum. 2001;44:819-825.
- Markow MJ, Secor ER. Acupuncture for the pain management of osteoarthritis of the knee. Techniques in Orthopaedics. 2003;18:33-36.
- Clement-Jones V, McLoughlin L, Tomlin S, Besser GM, Rees LH, Wen HL. Increased beta-endorphin but not met-enkephalin levels in human cerebrospinal fluid after acupuncture for recurrent pain. Lancet. 1980;2:946-949.
- Zhang Y, Neogi T, Chen C, Chaisson C, Hunter DJ, Choi HK. Cherry consumption and decreased risk of recurrent gout attacks. Arthritis Rheum. 2012;64:4004-4011.
- McCarthy GM, McCarty DJ. Effect of topical capsaicin in the therapy of painful osteoarthritis of the hands. J Rheumatol. 1992;19:604-607.
- Wang C, Schmid CH, Rones R, et al. A randomized trial of tai chi for fibromyalgia. N Engl J Med. 2010;363:743-754.
- Goldbach-Mansky R, Wilson M, Fleischmann R, et al. Comparison of Tripterygium wilfordii Hook F versus sulfasalazine in the treatment of rheumatoid arthritis: a randomized trial. Ann Intern Med. 2009;151:229-240.
- Einstein A. Cosmic Religion: With Other Opinions and Aphorisms. New York: Covici-Friede; 1931.
- Moseley JB, O’Malley K, Petersen NJ, et al. A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med. 2002;347:81-88.
[1] “Promoting More Conservative Prescribing.” JAMA 2009;301:865
[2] “The Impact of Endocrine Disruption: A Consensus Statement on the State of the Science,”
J. Environmental Health Perspectives 2012;121:a104The key concerns noted in the State of the Science of Endocrine Disrupting Chemicals – 2012 (http://www.who.int/ceh/publications/endocrine/en/index.html)
[3] “Probiotics and Prebiotics in Preventing Food Allergy and Eczema”
J. Curr Opin Allergy Clin Immunol. 2013;13(3):280
[4] “Long-term intake of dietary long-chain n-3 polyunsaturated fatty acids and risk of rheumatoid arthritis: a prospective cohort study of women,” J. Annals of Rheumatoid Disease Epub Aug 12th 2013