How Many People Really Are
I reviewed the various problems regarding the current diagnostics and estimates
of number of people affected by Lyme disease. As far as surveillance, the CDC lists
the limitations of their methods on their website which includes:
under-reporting, lack of state funds to classify and monitor cases, different
times of closing of estimates per year (between the CDC and different states), changes
in case definitions throughout the years, and surveillance by county of
residence, not county of exposure. (So, is it really 300,000?) Due to the fact that
our biodiversity of deer, rodents, and mammalian creatures is declining due to
our environmental fingerprint, we will probably see a continued rise in cases
in the years to come.
Then, There's the Issue of Testing...
This is a huge controversy. Actually, for any
diagnosis and lab use, there are issues with validity and reliability. I discussed
that more in previous blog (http://dr-lobisco.com/the-problem-with-lab-numbers-labels/).
According to one article in the Journal
of Clinical Microbiology (1999), the following issues crop up in diagnosis
using the CDC's two-tier diagnostic system for Lyme disease. These can occur within and among different labs on
the immunoblot testing due to:
- Subjective interpretation by the lab
extract validity (measurements vary with different forms of B. burgdorferi and different antigens
can be read and misinterpreted due to their same molecular mass)
- The expression of the antigen is related to how it is cultured in the lab and the growth
phase of the critter, this can vary between labs and specimens
argue that this method is meant to be for surveillance only. In fact, the National
Notifiable Disease Surveillance Data System for Lyme Disease (Borellia burgdorferi) CSTE Position
Statement(s) states on the CDC site, "This surveillance case definition was
developed for national reporting of Lyme disease; it is not intended to be used
in clinical diagnosis." (https://wwwn.cdc.gov/nndss/conditions/lyme-disease/case-definition/2011/)
The Diagnosis Issues and More
diagnosis of Lyme disease is based on a test that many feel is inadequate.
Furthermore, even if the tests were 100% valid and reliable, different people
have different immune responses. This makes one single test relating to one aspect
of the immune response lacking in usefulness for many. I discussed why this
critter is so hard to catch previously. Here is a review of these factors:
agents with entry of the tick saliva, making it hard to detect at "first
phase, and antigenic variation makes the critter the "master of
disguises" using unique mechanisms to evade antibiotics and the immune
system's detection. Furthermore, most tests only look for one species, but
different species with differing genetics can lead to different symptoms and
differing immune responses (Borellia
garini, Borellia afezlii, Borellia hammseli, Borellia miyamotoi)!!
some evidence that Borellia is
becoming resistant to antibiotics in vitro, meaning the bug may be getting
smarter to our attempts to kill it.
seclusion which means not only can spirochetes and bacteria change forms and
trick our immune system, they can also hide in our bodies by binding to certain
substances in the body. This makes them "invisible" to the immune
5. Borellia can
secrete proteins to adhere to cells and pierce through their walls so they can
"hibernate." Then, they come out of hiding when the immune system least
bug has become so smart it can go around iron poor environments and thrive on
manganese. It can also produce a DNA base critical for its survival!
read more about this in this blog,
where I gave a brief summary of Lyme disease, its complex and various symptoms
(it is known as "the great
mimicker"), the problem with its "posse" of co-infections, the controversy
with treatment, and the existence of chronic Lyme disease (which I get into more below).
there are some new methods and tests for Lyme disease which offer some promise.
These new methods are evaluating the person's genomics, searching for the actual protein in
the serum (verses the immune response to it), a urinary antigen test, and more. I
wrote about some
of these on this site here. This may help with finding the critter faster, which
could prevent chronic issues. However, will it help with treatment? I do not
know for sure.
you can see there are a lot of "issues" and many factors involved for one
little bugger, right?
The Big One... Controversy That Is...
of chronic Lyme disease, there is a schism about this that runs pretty deep in society
and in medicine. It ranges from indifference or lack of knowledge of the
disease to those afflicted and suffering hopelessly. On the medical forefronts,
there are many "Lyme literate physicians" (LLMDs) who have education in the chronicity
of Lyme disease and dig into the treatment and pathology of the critter
with antibiotics and other methods. The opposing position is one in which some
physicians feel that Lyme cannot be chronic and that other factors are at play
related to the symptoms:
These facts would seem to support
that individuals with different genetic variations and immune robustness will
respond differently to an infection with the spirochete. Still, the
Infectious Disease Society of America (IDSA) does not believe in chronic Lyme
and typically will not treat a Lyme patient beyond acute management. On the
other hand, the International Lyme and Associated Diseases Society (ILADS)
group does believe that Lyme can and often persists beyond a few weeks, and are
willing to treat someone beyond the four-week period. These two groups
represent the schism in LD and differ in treatment.27
According to Interdisciplinary Perspectives on Infectious
Disease, the evidence for chronic Lyme Disease (CLD) is robust, 28-35
and recognizing it could facilitate efforts to avoid diagnostic delays of two
years and durations of illness 4.7-9 years...
the Centers for Disease Control (CDC) also acknowledges a chronic form of Lyme
disease called "Post-Treatment Lyme
Disease Syndrome." Their website states here:
Centers for Disease Control (CDC) also acknowledges a chronic form of Lyme
disease called "Post-Treatment Lyme Disease Syndrome." (http://www.cdc.gov/lyme/postlds/index.html)
The Power of Holism: A
Naturopathic and Functional Medicine Perspective
complexity in diagnosis, various symptomology, immune evasion by the critter,
and chronicity, many Lyme disease sufferers struggle with finding solutions and
physicians who will understand their concerns. My method is to treat the whole
person and balance their body, mind and spirit, not just go after the bug.
here to learn about a new model and integrative perspective on my homepage blog where I go into detail about treating the whole person versus killing the bug.
for Disease Control and Prevention. Lyme Disease. http://www.cdc.gov/lyme/
Clin Microbiol. 1999 Dec; 37(12): 3990-3996.
Infect Dis. 1997
Jul;25 Suppl 1:S31-4.
BMJ. 2007 Nov 3; 335(7626): 910-912. http://www.cdc.gov/lyme/resources/Halperin_2012_Chap4_JohnsonB.pdf
Dis Clin North Am.
2008 Jun; 22(2): 217-234.
APM: Immune Module. Lyme Disease. Rancho Mirage, CA. March 2015.
and Drug Resistance.
disease clinics of North America. 2008;22(2):217-234.
of Biological Chemistry, 2013.
ScienceDaily. March 21, 2013.
The Difference Between Quality Control and Standardization with Essential Oils
In my homepage blog, I discussed the importance of
essential oils quality and safety. Essential oils are regulated by their
intended use in the United States; therefore, they can be regulated under the category
of cosmetics, fragrances, or "others." This makes consistency and quality an
important consideration when using them for wellness purposes.
In this blog, I want to help you understand the
differences between standardization and quality more. Let's first look at an
industry which has both, pharmaceuticals. I reviewed several reasons previously
on how standard of care does not necessarily mean it
is without risk. For example, medications are regulated, have standardization,
yet still can lead to medical
effects, and toxicities.
In regards to safety of regulated, standardized, and approved drugs, the FDA
(Food and Drug Administration) states the following limitations on their own
site in approval of safety for drugs (bold emphasis mine):
provides guidance to companies during the various phases of the human clinical
trials. Even so, the number of people in
a clinical trial of a new drug is usually small in comparison to the number of
people who may take the drug if it reaches the market. This makes it
difficult to detect rare side effects.
though data from human trials are analyzed by a team of experts before a drug
is approved, it can be impossible to
anticipate all bad reactions--especially very rare safety risks--unless they
had also happened with use of a similar drug.
matters is the fact that after they are
approved, drugs are often taken by sick people who are on other medications at
the same time, making it difficult to predict how they will react to the drug.
And the drug's effect on the patient may change over the course of years.
are hundreds of thousands of adverse
events reported via MedWatch each year, but this reporting system is voluntary
and there are serious drug reactions that are never reported.
Because the nation's healthcare system is not
integrated, there is no standard way to track the adverse effects of a medicine
in any given health system or across different health systems. Health insurance databases can be helpful in this
regard, but they are only accurate as long as a patient has the same job and is
enrolled with the same insurance system since many people are insured through
their employer. This limits FDA's ability to monitor the safety of
medications taken over many years. However, FDA, through its Sentinel
Initiative, is currently working to develop capabilities to use data from
different health systems to better understand the safety of drugs in clinical
Interesting, isn't it?
in Essential Oils
Currently, there are some sets of standards and
certifications regulating essential oils through the agencies of ISO (which is
the International Organization for Standardization) and the Association
Française de Normalisation (AFNOR).
According to the ISO website: "ISO is an
independent, non-governmental international organization with a membership of
161 national standards bodies. Through its members,
it brings together experts to share knowledge and develop voluntary,
consensus-based, market relevant International Standards that support
innovation and provide solutions to global challenges."
AFNOR is the French national organization for
standardization and its International Organization for Standardization member
body. They develop their international standardization activities, information
provision, certification and training through a network members of the
association. According to their
the French standardization organization, directs and coordinates the
establishment of national standards (NF) and participation in the definition of
European standards (EN) and International standards (ISO and IEC). It is the
French member of European and international non-governmental standards
organizations such as CEN and CENELEC in Europe, and ISO and IEC
internationally. Thanks to the investment of all the players in the French economy,
AFNOR is one of the most influential members of these organizations,
strategically and technically.
Quality Caveat with Standards and Essential Oils
Unfortunately, ISO standards exist for only approximately
50 EOs. According to a source I had with one well known company, the ISO
standards for EOs were created, in most cases, because an AFNOR standard
existed. If an EO meets the ISO/AFNOR standard, it will probably be a high
quality oil; however, this is not always the case. There is a difference
between standards and quality. Standardizations can imply quality, but they
don't necessarily have. They can exist solely for consistency in labeling and
selling across manufacturers. The AFNOR does claim to seek to ensure quality.
To complicate matters more, different companies
consider different constituents as "quality" essential oils. This may make them
not "standardized" but still "quality" in regards to raw materials,
distillation technique, testing, manufacturing, and distribution.
The bottom line- know and trust your supplier and
ask about quality control, then do some of your own research.
more about essential oil safety on my homepage here and get more references.
Food and Drug Administration. Aromatherapy. FDA
Web site: http://www.fda.gov/Cosmetics/ProductsIngredients/Products/ucm127054.htm.
Accessed December 28, 2015.
Food and Drug Administration. Fragrances in
Cosmetics. FDA Web site:
Accessed December 28, 2015.
Food and Drug Administration. CFR - Code of Federal Regulations Title 21. FDA
Food and Drug Administration. How FDA Evaluates Regulated Products: Drugs.
FDA Web site: http://www.fda.gov/AboutFDA/Transparency/Basics/ucm269834.htm
Food and Drug
Administration. Pharmaceutical Quality/Manufacturing Standards (CGMP). FDA Web
International Standardization Organization. ISO/TC
54 - Essential oils. ISO Web site:
Association of French Normalization Organization.
Standards- All Published Standards. AFNOR Web site:
Association of French Normalization Organization. ISO 9001 Certification - Quality. AFNOR Web
Association of French Normalization Organization. Normes. AFNOR Web site: http://www.boutique.afnor.org/recherche/resultats/categorie/normes/ics/huiles-essentielles-71.100.60%20?utm_source=portail&utm_medium=referral&utm_campaign=editions.
In my homepage
blog, I discussed the flaws and biases in supplement and drug trials. This is
part II of the discussion.
A 2005 review tilted, "Why Most
Published Research Findings Are False," provides a good summary of factors that
influence conclusions of studies (bold emphasis mine):
increasing concern that most current published research findings are false. The
probability that a research claim is true may depend on study power and
bias, the number of other studies on the same question, and, importantly, the
ratio of true to no relationships among the relationships probed in each
scientific field. In this framework, a research finding is less likely
to be true when the studies conducted in a field are smaller; when effect sizes
are smaller; when there is a greater number and lesser preselection of tested
relationships; where there is greater flexibility in designs, definitions,
outcomes, and analytical modes; when there is greater financial and other
interest and prejudice; and when more teams are involved in a scientific field
in chase of statistical significance. Simulations show that for most study
designs and settings, it is more likely for a research claim to be false than
true. Moreover, for many current scientific fields, claimed research findings
may often be simply accurate measures of the prevailing bias. In this essay, I
discuss the implications of these problems for the conduct and interpretation
of research." (http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124)
So, Do We Ignore the Data?
No, no, and no...there's
ways to use this information to make informed decisions about what the "evidence"
is actually saying. But, it takes a lot of detective work. Most of my research and looking into studies
has come from my own review of studies reporting on biases and lessons learned
from my mentors and teachers. In no way am I methodology whiz, but I do have a
basic grasp of why our model and interpretations need to be interpreted with caution.
These are some of
the considerations that I always review when applying studies to my clients:
1. Read the
actual study and be wary of media spin. In one cross-sectional analysis of 130
studies of health news reported on google and found the following:
In total, 78% of the news did not
provide a full reference or electronic link to the scientific article. We found
at least one spin in 114 (88%) news items and 18 different types of spin in
news. These spin were mainly related to misleading reporting (59%) such as not
reporting adverse events that were reported in the scientific article (25%),
misleading interpretation (69%) such as claiming a causal effect despite
non-randomized study design (49%) and overgeneralization/misleading
extrapolation (41%) of the results such as extrapolating a beneficial effect
from an animal study to humans (21%). We also identified some new types of spin
such as highlighting a single patient experience for the success of a new
treatment instead of focusing on the group results. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608738/)
were the participants/what population was studied (differences in gender/ethnicity/health
status)? What were their characteristics? What was the dropout rate? Who was
excluded and why? What were the factors controlled for in the subjects?
Type of study:
Was it observational and correlational study which look for relationships
verses cause-and-effect or was it a case-control randomized trial? Was there a
control or was it a comparison trial? (Too much or too little control both have
weakness. For example, too much control prevents extrapolation of the
intervention to the real world and too little prevents interpretation that the
intervention caused the change.)
is the form of intervention? Was it the appropriate dosage? How long was the
study? How was it taken? What was the placebo effect?
3. Search the
results for inconsistencies:
How are the
results reported? For example, is it the use of an odds ratio, is it relative
or absolute risk? What is the NNT? Is the
p-value of significance truly reflective of compatible data with the
Do the charts
and statistics match the author's conclusions?
4. More can be found here for the geeks...
study interpretation (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3077477/)
to search for (http://www.ncbi.nlm.nih.gov/pubmed/18582622)
Design, analysis and interpretation of
method-comparison studies (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2944826/)
Quasi-experimental study designs (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1380192/)
Where to Go
1. Physicians and practitioners need to be honest about interventions and
be transparent about what they have experience with. Both parties should look
up the NNT and find a few studies to examine if the intervention is new.
2. Consumers and patients need to be aware that some of the studies and
standard of care physicians are using could be flawed. Don't just accept
treatment that isn't helping without studying the data or asking your doctor
for more information. Most importantly, look for if you're getting results with
an intervention (nutrient, herb, oil, supplement, medication) and use that in
your basis for the final decision.
Get the references
here on my homepage.
Gifts of Giving and Her Impact & Some Stress-Free Relief for Her
When you think of May, does it remind you of your mom? In case you forgot,
May 8th is the day to celebrate the important mother figures in our
lives. Unfortunately, in our society we can sometimes tend to blame our mom
more than praise her for certain traits and health issues.
Although our mothers can affect our health outcomes, as I wrote about here, we do have
the power to modulate this... even at the level of genetics! It can also be
soothing to realize that regardless of the characteristics our mom provided in
her genes (and dads too) and personality, this combination makes us unique individuals.
We can use these experiences and knowledge to understand ourselves better, give
gratitude to our past, heal wounds for the future, and rise to better health.
Furthermore, the healing and profound power of a mother's
touch as something which is vital for optimal development. If someone
didn't receive it when we needed it, there are ways to soothe ourselves now
through understanding, epigenetics,
Regardless of if your mother was amazing (like I am fortunate to claim),
if you learned lessons from your parental relationship and grew, or if your mom
is no longer with you, celebrating love and the strong women in our lives is very
healing for our own physical health. In fact, you can read 10 science-based
reasons gratitude will benefit you
here. (Did you know "an attitude of gratitude" can even help student's
More on the Mom-Body Connection
A few studies this month also
highlighted the importance of mom's impact on our future generations. One study
showed that the risks associated with a later birth in moms was outweighed by
the environmental benefits. This means, a mom's attitude and here resources
impact her child's development. Science
Daily reported on this change as follows:
Both public health and social conditions have been
improving over time in many countries. Previous research on the relationship
between maternal age and child outcomes has ignored the importance of these
macro-level environmental changes over time. From the perspective of any
individual parent, delaying childbearing means having a child with a later
birth year. For example, a ten-year difference in maternal age is accompanied
by a decade of changes to social and environmental conditions. Taking this
perspective, this new MPIDR-study shows that when women delay childbearing to
older ages their children are healthier, taller, and more highly educated. It
shows that despite the risks associated with childbearing at older ages, which
are attributable to aging of the reproductive system, these risks are either
counterbalanced, or outweighed, by the positive changes to the environment in
the period during which the mother delayed her childbearing.
Still, it's not just about
money and environment. The gift of love is free. Science Daily also cited a study that showed that moms who nurtured
their little ones had babes with bigger brains:
Children whose mothers were nurturing during the
preschool years, as opposed to later in childhood, have more robust growth in
brain structures associated with learning, memory and stress response than
children with less supportive moms.
According to the study
researchers, the children of moms who were viewed as more nurturing exhibited growth
in the hippocampus region as determined by three MRI scans. This area in the
brain is associated with emotional regulation, memory, and learning. In this
study with 127 youths, emotional regulation was the key factor reported on for
It's Not Just Mom's Love- It's Community
Another recent study showed the
impact of children's friends and social connections on their stress. We all
health impacts of stress! The researchers indicated by studying different
aspects of the stress response, they had a better comprehensive view of how our
environment and connection modulates our physiology. Science Daily states:
For this focused study, Ponzi and Flinn chose a
sample of 40 children ranging in ages from 5 to 12 and who represented about 80
percent of the total children in the village. Each child was asked a series of
questions about their friends to measure their perceived density and closeness
of their social networks. Three samples of saliva were collected before, during
and after the interview and cortisol and alpha-amylase levels were measured.
"We found that, using the data we collected
from the one-on-one interviews, children who were stressed about the size and
density of their perceived social networks had elevated anticipatory cortisol
levels, and responded by secreting more alpha-amylase," Flinn said.
"Our study was in line with past research on stress, loneliness and social
support in adults, but we strengthened past research by applying it to
children. Future research should consider a multi-system approach like this one
to study cognitive and biological mechanisms underlying children's perception."
Supporting Mom's Health with Aromatherapy
Now, time to give our moms or
mother figures some hints on self-care, because they do so much for us! Here
are some abstracts on the use of essential oils and aromatherapy to soothe moms.
1. Improving Sleep During the Postpartum
What mom doesn't need more
sleep? This study in the Iranian Red Crescent Medical Journal evaluated
the impact of aromatherapy on moms in the postpartum period:
This study was a randomized clinical trial with the
control group. A total of 158 mothers in postpartum period (with certain
inclusion criteria) were enrolled in the study and assigned randomly to two
groups of control and intervention. Lavender fragrance (made by Barij Essence
Pharmaceutical Co.) was used by participants in the intervention group nightly
before sleeping. The fragrance was dropped on cotton balls, which were placed
on a cylindrical container at mothers' disposal. Keeping the container at a
projected distance of 20 cm, the participants inhaled 10 deep breaths and then
the container was placed beside their pillow until morning. This procedure was
done 4 times a week for 8 weeks. For the control group, the same intervention
was done with the placebo. The instrument for collecting data was Pittsburgh
sleep quality index, which was completed at the baseline, fourth, and eighth
weeks after the intervention. Data were analyzed using independent t test and
repeated measures analysis of variance calculated by SPSS16....
Considering the effects of aromatherapy on the improvement of mother's
sleep quality during postpartum period, aromatherapy has been suggested as a
non-pharmacological method for the improvement of the maternal health.
2. Calming Anxiety in Labor and Reducing
Blood Pressure Readings with Geranium
Methods: In study, was
carried out on 100 nulliparous women admitted to Bent al-Hoda Hospital in the
city of Bojnord in North Khorasan province of Iran during 2012-2013. The women
were randomly assigned to two groups of equal size, one experimental group
(geranium essential oil) and one control (placebo) group. Anxiety levels were
measured using Spielberger' questionnaire before and after intervention.
Physiological parameters (systolic and diastolic blood pressure, respiratory
rate, pulse rate) were also measured before and after intervention in both
groups. Data analysis was conducted using the x2 test, paired t-test,
Mann-Whitney U test, and Wilcox on test on SPSS 11.5.
Results: The mean
anxiety score decreased significantly after inhalation of the aroma of geranium
essential oil. There was also a significant decrease in diastolic blood
Conclusion: Aroma of
essential oil of geraniums can effectively reduce anxiety during labor and can
be recommended as a non-invasive anti-anxiety aid during childbirth.
3. Burnout Relief
A small randomized, controlled,
double-blind pilot study that included 14 participants was done to "determine the effectiveness of a mixture of
essential oils (peppermint, basil, and helichrysum) on mental exhaustion, or
moderate burnout (ME/MB) using a personal inhaler." The study from the Journal of Alternative and Complementary Medicine abstract reads:
DESIGN: This was a randomized, controlled,
double-blind pilot study. Data were collected 3 times a day for 3 weeks
(Monday-Friday). The first week was baseline for both groups, the second week
was intervention (aromatherapy or placebo), and the third week was washout...
INTERVENTIONS: Participants were randomized to
receive a personal inhaler containing either a mixture of essential oils or
rose water (as used in Indian cooking).
OUTCOME MEASURES: The outcome measures were a 0-10
scale with 10=worst feeling of burnout, 0=no feeling of burnout. There was a
qualitative questionnaire rating aroma and a questionnaire listing perceived
RESULTS: While both groups had a reduction in
perception of ME/MB, the aromatherapy group had a much greater reduction.
CONCLUSIONS: The results suggest that inhaling
essential oils may reduce the perceived level of mental fatigue/burnout.
Further research is warranted.
A One Sentence Summary
Therefore, our health can start
with our moms, be impacted by our own attitude and behaviors, and supported by
Catch the Latest News
This week, on my homepage, I
wrote about the need for change in healthcare from sick-care to well-care. Just
as I was in my writer's flow, an article on how Medical
Errors are the Third Cause of Death in the United States popped up in my inbox.
Serendipity!! You can read all about how this is connected to empowering
patients' health and changing our approach to medicine.
My blog also provides
lots of nerd-out opportunities for your skimming pleasure on the Top Holistic
and Integrative Health News for April 2016.
Be sure to read it here.
10 Reasons Why Gratitude is Healthy. Huffington Post.
July 12, 2014.
Journal of Personality and Social Psychology. 2003;
Gratitude and the Reduced Cost of Materialism in Adolescents.
J Happiness Stud. 2010; 12:289-302.
Advanced Maternal Age and
Offspring Outcomes: Reproductive Aging and Counterbalancing Period Trends. Population
and Development Review, 2016; 42 (1): 69.
Max-Planck-Gesellschaft. Children of older mothers do
better: The benefits associated with being born in a later year outweigh the
biological risks associated with being born to an older mother. ScienceDaily,
12 April 2016.
Washington University School of Medicine. Nurturing during
preschool years boosts child's brain growth: Mothers' support linked to robust
growth of brain area involved in learning, memory, stress response. ScienceDaily,
25 April 2016.
Luby JL, Belden A, Harms MP, Tillman R, Barch DM.
Preschool is a sensitive period for the influence of maternal support on the
trajectory of hippocampal development. PNAS.
University of Missouri-Columbia. Children react
physically to stress from their social networks: A 28-year study reveals that
the social relationships nurtured in childhood may have physiological
consequences. ScienceDaily. 2 May 2016.
Cortisol, salivary alpha-amylase and children's
perceptions of their social networks. Social Neuroscience, 2015; 11 (2):164.
Keshavarz Afshar M, Behboodi
Moghadam Z, Taghizadeh Z, Bekhradi R, Montazeri A, Mokhtari P. Lavender
Fragrance Essential Oil and the Quality of Sleep in Postpartum Women. Iranian
Red Crescent Medical Journal. 2015;17(4):e25880.
Fakari F, Tabatabaeichehr M, Kamali H, Rashidi Fakari F, Naseri M. Effect of
Inhalation of Aroma of Geranium Essence on Anxiety and Physiological Parameters
during First Stage of Labor in Nulliparous Women: a Randomized Clinical Trial. Journal of Caring Sciences.
Varney E, Buckle J. Effect of
inhaled essential oils on mental exhaustion and moderate burnout: a small pilot
study. J Altern Complement Med. 2013
Jan;19(1):69-71. doi: 10.1089/acm.2012.0089.
blog on my homepage discussed the downfalls of basing healthcare on diagnosis
and managing diseases and sickness symptoms. In it, I reviewed the importance
of individualizing treatment and considering the interplay between genes and
environment. In fact, I reported on a pivotal study that provided evidence that
even in those with a genetic mutation that could result in disorders such as
cystic fibrosis and Tay-Sachs disease, there were individuals found who were
healthy in spite of them.
We have a
current epidemic now in painkiller abuse. Recently, Health Day reported:
The Obama administration announced
Tuesday additional measures in its $1.1 billion funding request to expand
medication-based treatment for Americans addicted to prescription painkillers
President Barack Obama is scheduled to
propose the measures at the National Rx Drug Abuse & Heroin Summit in
Atlanta. The White House said the increased initiative could offer hope to tens
of thousands of Americans addicted to prescription painkillers, such as
OxyContin, Vicodin and Percocet, as well as illegal drugs like heroin.
reliance on medications to soothe our pain has financial and social implications.
For example, it has been shown that opioids may cause changes in the brain in a
small 2010 study, though the authors hypothesized this may be reversible:
Following the month of morphine
administration, reduced gray matter was observed in the right amygdala. The
amygdala, together with the hippocampus, drive reward-related learning
processes via modulatory influences on the nucleus accumbens [17, 21]. The
amygdala is involved in drug-induced associative learning, drug craving,
reinforcement, the development of dependence, and the experience of acute
withdrawal... Gray matter increase was widely-distributed throughout the brain and, in
contrast to regions demonstrating volumetric decrease, was located outside of
it isn't just a concern for heroin and other painkillers. Many are using common
over-the-counter medications to control pain that may have negative side
effects, such as harming the brain. According to a recent article in Science Daily:
It's been known for more than a
century that acetaminophen is an effective painkiller, but according to a new U
of T study it could also be impeding error-detection in the brain.
The research, authored by a team
including postdoctoral fellow Dan Randles and researchers from the University
of British Columbia, is the first neurological study to look at how
acetaminophen could be inhibiting the brain response associated with making
"Past research tells us physical
pain and social rejection share a neural process that we experience as
distress, and both have been traced to same part of the brain," says
Recent research has begun to show how
exactly acetaminophen inhibits pain, while behavioural studies suggest it may
also inhibit evaluative responses more generally. Randles own past research has
found that people are less reactive to uncertain situations when under the
effect of acetaminophen.
It's a sad
state in America when
interventions which may be effective and have positive side effects are
overlooked. For example, I discussed how
mindfulness practices can assist with low back pain. A 2013 study reviewed some
of the evidence on how meditation may affect pain processing looking at more
than just the physical aspect of pain perception:
The cognitive modulation of pain is
influenced by a number of factors ranging from attention, beliefs,
conditioning, expectations, mood, and the regulation of emotional responses to
noxious sensory events. Recently, mindfulness meditation has been found
attenuate pain through some of these mechanisms including enhanced cognitive
and emotional control, as well as altering the contextual evaluation of sensory
events. This review discusses the brain mechanisms involved in mindfulness
meditation-related pain relief across different meditative techniques,
expertise and training levels, experimental procedures, and neuroimaging
methodologies. Converging lines of neuroimaging evidence reveal that
mindfulness meditation-related pain relief is associated with unique appraisal
cognitive processes depending on expertise level and meditation tradition.
Moreover, it is postulated that mindfulness meditation-related pain relief may
share a common final pathway with other cognitive techniques in the modulation
recent study showed how mindfulness may also be helpful in emotional pain. HealthDay reported:
This study included 23 U.S. veterans
of the Iraq and Afghanistan wars who all received some form of group therapy.
After four months of weekly sessions, many had reductions in their PTSD
However, some of the participants
received mindfulness training, and only those veterans showed brain activity
changes that could be detected on functional MRI brain scans. Before
mindfulness training, when the veterans with PTSD were resting quietly, they
had extra activity in brain regions involved in responding to threats or
outside problems, the study authors said.
isolating and can have implications in other diseases, such as an increased
risk of heart disease. This cycle continues of not looking at the need for
connecting all the dots and the whack-a-mole medicine game of suppressing
may not ask you about another tool used in healing by more than half Americans-
prayer. Shouldn't faith and belief be factored in and incorporated into the art
of medicine along with the science? Maybe then we'd really have true holistic,
integrated, healthcare. I think it's coming, but we still have a way to go.
Augliere B. Mystery
factors protect lucky few from severe genetic disorders: Massive genomic study
picks up disease-linked mutations in otherwise healthy people. Nature. 11 April 2016. http://www.nature.com/news/mystery-factors-protect-lucky-few-from-severe-genetic-disorders-1.19719
Steele M. Obama
Administration Steps Up Efforts to Beat Painkiller, Heroin Epidemic. Health
Day. March 29, 2016. http://consumer.healthday.com/mental-health-information-25/addiction-news-6/obama-steps-up-efforts-to-beat-painkiller-heroin-epidemic-709474.html
Toronto. Is a popular painkiller hampering our ability to notice errors? ScienceDaily. 8 April 2016.
Chu LF, D'Arcy N, Trott K, Jastrzab LE, Mackey SC. Prescription opioid
analgesics rapidly change the human brain. Pain. 2011;152(8):1803-1810.
Rettner R. Mindfulness
Meditation May Reduce Low Back Pain. Huffington Post. March 24, 2016. http://www.huffingtonpost.com/entry/mindfulness-meditation-may-reduce-low-back-pain_us_56f4279de4b04c4c37619965
Zeidan F, Grant JA,
Brown CA, McHaffie JG, Coghill RC. Mindfulness meditation-related pain relief:
Evidence for unique brain mechanisms in the regulation of pain. Neuroscience
letters. 2012;520(2):165-173. doi:10.1016/j.neulet.2012.03.082.
Preidt R. Mindfulness
Training May Ease PTSD. HealthDay. April 1, 2016. http://consumer.healthday.com/cognitive-health-information-26/brain-health-news-80/mindfulness-training-can-ease-ptsd-709555.html
Reinburg S. Lonely,
Isolated People May Be Prone to Heart Disease, Stroke. Health Day. April 19,
Preidt R. Most
Americans Turn to Prayer for Healing, Survey Finds. Health Day. April 22, 2016.
Many of us heard that stress is "bad for us." It is
true that long-term, chronic stress can have many negative
effects on all systems of the body.1 In my current blog on my homepage, I
review what happens in the body when someone has an allergy or experiences respiratory
symptoms. I also discuss how the body's immune response is intricately
connected to all systems. In this blog, I review the connection between the
nervous and immune systems.
and Allergy Flares
A study with 179 university employees suffering
allergic symptoms and the influence of lifestyle factors on their manifestation
findings suggest that individuals with persistent emotional stress have more
frequent allergy flares. Furthermore, those with more flares have greater
Of course, there is also direct biochemical
evidence of this link.3-5 Modern Healthcare Practitioner reported on how stress can
impact immune function:
sympathetic fibers descend from the brain into both primary and secondary lymph
tissue. These fibers release substances that bind to receptors on white blood
cells. Second, the adrenal hormones epinephrine, norepinephrine and cortisol
bind to specific receptors on white blood cells and have regulatory effects on
their distribution and function. Finally, one's efforts to manage the demands
of stress often result in coping strategies that have a secondary negative
effect on the immune system - such as alcohol use or changes in sleeping
patterns. Thus behavior can be an important pathway linking stress with the
A two-part study was done to assess the effect
of stress on symptoms from exposure to a virus. The first part of the
experiment consisted of 125 men and 151 women. The subjects were quarantined
for 24 hours and then were given "nasal drops containing a low infectious dose
of either RV21 (N = 129) or RV39 (N = 147)."
In the second study, there were 39 men and 43 women
who were also quarantined and then given the virus strain, RV39. All
participants were paid $800 for getting infected.
The authors concluded the following in relationship
to glucocorticoid receptor resistance (GCR), which occurs as a result of
chronic stress hormones "hitting the receptors":
1: After covarying the control variables, those with recent exposure to a
long-term threatening stressful experience demonstrated GCR; and those with GCR
were at higher risk of subsequently developing a cold. Study 2: With the same
controls used in study 1, greater GCR predicted the production of more local proinflammatory
cytokines among infected subjects. These data provide support for a model
suggesting that prolonged stressors result in GCR, which, in turn, interferes
with appropriate regulation of inflammation. Because inflammation plays an
important role in the onset and progression of a wide range of diseases, this
model may have broad implications for understanding the role of stress in
There are various ways to mitigate the stress
response. I wrote about some overlooked ways here and
how essential oils not only impact stress through olfaction, but also
through biochemical responses. In other words, essential oils can modulate our
immune response while calming our brain.
In another article, Dr. Rosen also reviews some
integrative approaches to allergies. These include eating an anti-inflammatory
diet, the use of fish oil, and supportive herbals.7 These are all also important for
To read more about supporting your immune system,
make sure you check out my blog here.
1. American Psychological Association. Stress
Effects on the Body. http://www.apa.org/helpcenter/stress-body.aspx
2. Patterson AM, Yildiz VO, Klatt MD, Malarkey WB.
Perceived stress predicts allergy flares. Ann
Allergy Asthma Immunol. 2014 Apr;112(4):317-21
3. Labrix. Stress and Immune Function. Modern
Healthcare Practitioner. October 30, 2015. http://www.modernhcp.com/stress-and-immune-function/
4. Hussain D. Stress, Immunity, and Health: Research
Findings and Implications. International
Journal of Psychosocial Rehabilitation. 2010. 15(1) 94-100.
5. Segerstrom SC, Miller GE. Psychological Stress
and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry. Psychological bulletin.
6. Cohen S, Janicki-Deverts D, Doyle WJ, Miller GE,
Frank E, Rabin BS, Turner RB. Chronic stress, glucocorticoid receptor
resistance, inflammation, and disease risk. PNAS.
2012 109 (16) 5995-5999. doi:10.1073/pnas.1118355109
7. Rosen D. Seasonal Allergies: An Integrative
Approach to Atopic Disorders. Integrative Practitioner. http://www.integrativepractitioner.com/topics/environmental-health/seasonal-allergies-an-integrative-approach-to-atopic-disorders/
Last week, I
Integrative HealthCare May Save Medicine. Specifically, I reviewed how diet, lifestyle,
and supplements can modulate disease risk, yet they still seem to get the back
seat to conventional methods. This is unfortunate considering our current medical
approach is not producing a healthy America. In fact, our healthcare system ranks
last overall among many other industrialized nation, according to a recent
analysis published by the Common Wealth Funds. In regards to health care
spending, supply, utilization, prices, and health outcomes. The report states:
In 2013, the
U.S. spent far more on health care than these other countries. Higher spending
appeared to be largely driven by greater use of medical technology and higher
health care prices, rather than more frequent doctor visits or hospital
admissions. In contrast, U.S. spending on social services made up a relatively
small share of the economy relative to other countries. Despite spending more
on health care, Americans had poor health outcomes, including shorter life
expectancy and greater prevalence of chronic conditions."
The analysis reported health care spending at 17.1 percent of the U.S. GDP,
making our country devote at least 50 percent more of its economy to health
care than other countries.1
prevention is not about utilizing more screenings and diagnostics to find the
diseases earlier. This ignores the lifestyle processes that caused the
imbalances to begin with.2 It is well-known that many chronic
diseases are preventable through lifestyle. Harvard T.H. Chan of Public Health
Chronic diseases --including heart
disease, stroke, diabetes, and cancer-- account for some of the most common
health problems in the United States, according to statistics from the Centers
for Disease Control and Prevention (CDC). Yet many of these chronic diseases
are preventable, as they're linked to poor diet and lifestyle choices including
tobacco use, excessive alcohol consumption, and inadequate physical activity.3
The Best Technology to Remedy Results Can't
Effect Cause: A Short Look at Diet
In a recent
editorial in JAMA, Dr. Lustig commented on the decline in our lifespan and
quality of life in relationship to diet:
Obesity and poor-quality diet
predispose to all of the major chronic diseases, but these risks have been
mitigated over the past few decades by an increasingly powerful and expensive
array of treatments. To delay disease progression, millions of individuals in
the United States depend on medications to lower levels of cholesterol, blood
pressure, and blood glucose; surgical procedures to open or bypass blocked
arteries; and dialysis.
The data from the latest CDC report
suggest that a tipping point has been reached beyond which technological
advances may no longer compensate. Indeed, higher-resolution data show that
this trend has probably been under way for years.4
have shown how diet impacts many chronic disease outcomes.5-6 One
study even reported on the reversal of diabetes type 2 in a small study of 11
Normalisation of both beta cell
function and hepatic insulin sensitivity in type 2 diabetes was achieved by
dietary energy restriction alone. This was associated with decreased pancreatic
and liver triacylglycerol stores. The abnormalities underlying type 2 diabetes
are reversible by reducing dietary energy intake.5
upcoming two-part article series on the Natural Path, I review specifically
how diet and lifestyle can modulate health outcomes in more detail.
Food for Your Bones
In a recent study,
reported in Health Day, the Mediterranean Diet was linked to lower hip fracture
risk in women. This is important because many women fear osteoporosis and many chronic
diseases impact bone strength. Health Day reports:6
Eating a Mediterranean diet may at
least slightly lower an older woman's risk for hip fracture, a new study
suggests. Women who most closely followed a Mediterranean diet -- one high in
fruits, vegetables, nuts, legumes and whole grains -- had a 20 percent lower
risk for hip fractures compared to women who didn't follow this regimen, the
The Importance of Social Connections
social connection and one's environment has been found to impact disease
processes. Unfortunately, this is often ignored, yet social isolation and
depression have been shown to be independent risk factors for death from cardiac disease.7-8
study in JAMA reports:
In an impressive analysis based on
mortality data and deidentified tax records with more than 1.4 billion
person-year observations and nearly 7 million deaths among individuals living
in the United States during the 15 years between 1999 and 2014, Chetty et al
confirm the long-observed association between higher income and longer life
expectancy, as well as the recent increase in the gap in life expectancy between
the richest and poorest 5% of the US population.1
Looking specifically at the lowest income quartile, Chetty et al also found
little association between life expectancy and various measures of access to
medical care, physical environments, employment conditions, or levels of income
On the other hand, the authors found
significant geographic variations in life expectancy among those in the lowest
income quartile, including significant disadvantages conferred by the
prevalence of unhealthy behaviors, such as tobacco use and obesity, and
community characteristics, such as government expenditure levels and the
proportions of college graduates and immigrants. In this low-income group, life
expectancy variation by community ranged from a high of about a 4-year gain to
a low of a more than 2-year loss in life expectancy during the 15-year period.
Community is powerfully associated with life expectancy.9
the authors also state, "in the aggregate, medical care is not a strong
determinant of the health of populations."9
Franklin is quoted for saying, "An
ounce of prevention is worth a pound of cure." Therefore, it is time to
look at how our choices and lifestyle can impact our health by preventing the disease
process to begin with. This could save our nation from the downward health spiral it is
headed using the same ineffective approach. It is time for a truly integrative healthcare system. It can start with our own choices.
A Free Summit to Learn More
Join me on
May 16th-May 23rd for the Natural
Cancer Prevention Summit which includes 30+ experts that review all the
ways we can empower our health and BreakFree
from the viewpoint that we are victims of our body. In the summit, I discuss
essential oils, which I just blogged about here as well.
1. The Common
Wealth Fund. U.S. Health Care from a Global Perspective: Spending, Use of
Services, Prices, and Health in 13 Countries. 2015. http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-from-a-global-perspective/
2. Center for
Disease Control and Prevention (CDC). CDC Prevention Checklist. May 8, 2005. http://www.cdc.gov/prevention/
T.H. Chan of Public Health. Disease Prevention. http://www.hsph.harvard.edu/nutritionsource/disease-prevention/
4. Ludwig D.
Lifestyle Weighed Down by Diet. JAMA.
April 04, 2016. doi:10.1001/jama.2016.3829
index, glycemic load, and chronic disease risk--a meta-analysis of observational
studies. American Journal of Clinical
Nutrition. 2008. http://m.ajcn.nutrition.org/content/87/3/627.full
6. Lim EL, Hollingsworth KG, Aribisala BS, Chen
MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta
cell function in association with decreased pancreas and liver triacylglycerol.
Diabetologia. 2011;54(10):2506-2514. doi:10.1007/s00125-011-2204-7.
Diet May Help Lower Hip Fracture Risk in Older Women. Health Day. March 28,
E, Thomas SA, Liu F, Morton PG, Chapa D, Gottlieb SS. Relationship of
depression, anxiety, and social isolation to chronic heart failure outpatient
mortality. Am Heart J. 2006
J. Income, Life Expectancy, and Community Health: Underscoring the Opportunity.
JAMA. Published online April 10, 2016. doi:10.1001/jama.2016.4729.
I've written extensively
about the power
of our gut bugs for modulating our health and wellness. These little
critters have been found to impact everything from our mood to cancer risk.
However, with all the focus on our belly, many are forgetting that digestion
begins in the mouth. Did you know that we have a wide array of critter
residents there as well and some of them correlate to our belly bugs! Still,
there is much to be learned about what lies in our oral cavity.
a 2013 article in Pharmacology Research:
The human mouth harbours one of the
most diverse microbiomes in the human body, including viruses, fungi, protozoa,
archaea and bacteria. The bacteria are responsible for the two commonest
bacterial diseases of man: dental caries (tooth decay) and the periodontal
(gum) diseases. Archaea are restricted to a small number of species of
methanogens while around 1000 bacterial species have been found, with
representatives from the phyla Actinobacteria, Bacteroidetes, Firmicutes,
Proteobacteria, Spirochaetes, Synergistetes and Tenericutes and the uncultured
divisions GN02, SR1 and TM7. Around half of oral bacteria are as yet uncultured
and culture-independent methods have been successfully used to comprehensively
describe the oral bacterial community.
microbiota can serve a helpful function. One small study reported that these
little guys can help us with the production of nitric oxide. Cass Nelson
Dooley, a respected researcher in the oral microbiome states, "Certain oral
bacteria convert nitrate to nitrite from the leafy greens we eat in the diet.
Humans cannot do this biochemical step so we rely on oral bacteria to help us
make nitric oxide. Amazingly, these bacteria in the mouth may contribute up to
25% of systemic levels of nitric oxide. Veillonella and Actinomyces
appear to have the strongest nitrate-reducing activity. Given the important
role of nitric oxide in healthy cardiovascular function and blood pressure regulation,
we have to promote these bacteria by eating leafy greens and avoiding
antibacterial mouthwash, when possible."
The Bad Bugs in the Mouth
unhappy side, studies have connected some not-so-good mouth bacteria to various
disease processes. These include a link to heart disease (especially endocarditis),
respiratory infections, cancer, and even obesity.
a 2000 review:
Recently, it has been recognized that
oral infection, especially periodontitis, may affect the course and pathogenesis
of a number of systemic diseases, such as cardiovascular disease, bacterial
pneumonia, diabetes mellitus, and low birth weight. The purpose of this review
is to evaluate the current status of oral infections, especially periodontitis,
as a causal factor for systemic diseases. Three mechanisms or pathways linking
oral infections to secondary systemic effects have been proposed: (i)
metastatic spread of infection from the oral cavity as a result of transient
bacteremia, (ii) metastatic injury from the effects of circulating oral
microbial toxins, and (iii) metastatic inflammation caused by immunological
injury induced by oral microorganisms. Periodontitis as a major oral infection
may affect the host's susceptibility to systemic disease in three ways: by
shared risk factors; subgingival biofilms acting as reservoirs of gram-negative
bacteria; and the periodontium acting as a reservoir of inflammatory mediators.
Proposed evidence and mechanisms of the above odontogenic systemic diseases are
article in Health Day reported that
our mouth residents could also impact our brain:
In a new report, investigators
reviewed studies on oral health and cognition published between 1993 and 2013. Some
of the studies found that oral health indicators -- such as the number of teeth,
the number of cavities and the presence of gum disease -- was associated with a
higher risk of mental decline or dementia, while other studies did not find any
How to Have a Happy Mouth
What we eat
has a huge impact on our whole body microbiome. Here
is a link to a previous article on some ways to keep your mouth bugs happy and
you smiling. Furthermore, smoking was just recently found to affect our mouth microbiome-
could that be another reason why it is so bad for us?
Clarkea G, Borrea YE, Dianan TG, Cryana JF. Serotonin, tryptophan metabolism
and the brain-gut-microbiome axis. Behavioural Brain Research. 277(15): 32-48.
January 15, 2015. http://www.sciencedirect.com/science/article/pii/S0166432814004768
O'Mahony SM. The microbiome-gut-brain axis: from bowel to behavior.
Neurogastroenterol Motil. 2011 Mar;23(3):187-92. doi:
Labus J, Kilpatrick L, Zhiguo J, Stains J, Ebrat, B, et al. Consumption of
Fermented Milk Product With Probiotic Modulates Brain Activity.
Gastroenterology. 2013; 144 (7): 1394-1401.
Cowen P, Harner CJ, Tzortizis G, Errington S, Burnet PWJ. Prebiotic intake
reduces the waking cortisol response and alters emotional bias in healthy
volunteers. Psychopharmocology. December 2014.
may play a role in colorectal cancer. MNT. March 4 2014.
Rogers MA, Ruffin MT 4th, Schloss PD.The human gut microbiome as a screening
tool for colorectal cancer. Cancer Prev Res. 2014 Nov;7(11):1112-21. doi:
10.1158/1940-6207.CAPR-14-0129. Epub 2014 Aug 7.
linked to immune system cancer, lymphoma. MNT. July 17, 2013.
Maier I, Dang AT, Berry D, Liu J, Ruegger PM, Yang JI, Soto PA, Presley LL,
Reliene R, Westbrook AM, Wei B, Loy A, Chang C, Braun J, Borneman J, Schiestl
RH. Intestinal bacteria modify lymphoma incidence and latency by affecting
systemic inflammatory state, oxidative stress, and leukocyte genotoxicity.
Cancer Res. 2013 Jul 15;73(14):4222-32. doi: 10.1158/0008-5472.CAN-13-0022.
Wade WG. The
oral microbiome in health and disease. Pharmacol
Res. 2013 Mar;69(1):137-43. doi: 10.1016/j.phrs.2012.11.006. Epub 2012 Nov
Dooley, C. The Mouth-Body Connection: Why We Shouldn't Ignore the Oral
Microbiome. Ask the Dentist. November 18, 2015. http://askthedentist.com/oral-microbiome/
Andrade F, Vaksman Z, et al. Metagenomic analysis of nitrate-reducing bacteria
in the oral cavity: implications for nitric oxide homeostasis. PLoS ONE.
Preidt R. Is
Seniors' Dental Health Tied to Mental Health? Health Day. April 1, 2016. http://consumer.healthday.com/dental-and-oral-information-9/misc-dental-problem-news-174/could-dental-health-be-tied-to-mental-health-in-seniors-709520.html
Daily. How Bacteria Found in Mouth May Cause Colorectal Cancer.
Sciencedaily.com. August 14, 2013.
Health Day. Smoking
Triggers Big Changes in Mouth Bacteria, Study Finds. March 29, 2016. http://consumer.healthday.com/cancer-information-5/misc-tobacco-health-news-666/smoking-triggers-big-changes-in-mouth-bacteria-709469.html
Groppo D, Halem S, Carpino E. Is Obesity an Oral Bacterial Disease? Journal
of Dental Research. 2009;88(6):519-523. doi:10.1177/0022034509338353.
IS, Passos JS, Seixas da Cruz S. Respiratory disease and the role of oral
bacteria. Journal of Oral Microbiology.
Kolltveit KM, Tronstad L, Olsen I. Systemic Diseases Caused by Oral Infection. Clinical Microbiology Reviews.
Many Harms in Health Care
According to a recent study:
harm to patients is still too high in healthcare in the UK and across the globe
-- making safety a top healthcare priority for providers and policy makers
alike. These are the findings of two reports launched today by researchers from
Imperial College London. (Imperial College London. Too many avoidable errors in
patient care, says report: Avoidable harm to patients is still too high in
healthcare in the UK and across the globe. Science Daily. 7 March 2016)
I just wrote a blog about how we are stuck in a healthcare model that
isn't working. What is needed is true integration of medicine with access to different
tools and the formation of a therapeutic partnership between the patient and
the doctor. These are critical for our healthcare system to thrive. I also
reported on all the top health and integrative medicines in March, and, of
course, mentioning the release of my book,
BreakFree Medicine. (Read all about this here.)
Another of the big topics in the news was the epidemic of pain drug
abuse. Below are a few excerpts to summarize the issue and how integrative and
alternative therapies may be able to fill a gap.
to Cut Painkiller Drug Abuse
Earlier this month, the epidemic of painkiller drug abuse and the CDC
advisory was discussed:
stem an epidemic of drug abuse tied to prescription narcotic painkillers such
as Oxycontin, Percocet and Vicodin, federal officials on Tuesday issued tough
new prescribing guidelines to the nation's doctors.
advisory, from the U.S. Centers for Disease Control and Prevention, stresses
that doctors -- especially primary care physicians -- should try to avoid these
addictive "opioid" painkillers whenever possible for patients with
most forms of chronic pain. (Mundell and Reinburg. CDC Issues Tough New
Guidelines on Use of Prescription Painkillers. Health Day News. March 15, 2016.)
Warning on Opioid Drugs
Health Day recently
reported on a new warning on narcotics:
curb a national epidemic of prescription painkiller abuse, U.S. officials on
Tuesday announced that certain drugs will get new "boxed warnings"
about the dangers of misuse.
The move by
the U.S. Food and Drug Administration comes one week after the U.S. Centers for
Disease Control and Prevention announced tough new guidelines to doctors for
"opioid" drugs such as Oxycontin, Percocet and Vicodin. (Mundell and
Reinburg. FDA Orders Warning Labels on Prescription Narcotic Painkillers.
Health Day News. March 22, 2016. )
Generic Opioids Less Likely to Be Abused, FDA
Furthermore, in a recent report by Health
Day, the authors discuss another attempt to deter painkiller drug abuse:
their push to combat the nation's epidemic of prescription painkiller abuse,
U.S. officials on Thursday urged generic drug makers to take steps to redesign
potent drugs such as hydrocodone and oxycodone to make them harder to abuse.
and Drug Administration officials said they were encouraging the generic drug
industry to develop pain medicines with "abuse-deterrent properties."
For instance, this would make it harder to crush a tablet to snort the contents
or dissolve a capsule to inject its ingredients. (Reinburg. FDA Wants Generic
Narcotic Painkillers to Be Abuse-Deterrent. Health Day News. March 24, 2016.)
Meditation Can Help Pain and Fill the Gap
Two studies highlighted the role of the mind-body connection in
connecting meditation to improvements in pain. According to Science Daily:
In this randomized, double-blinded
study, 78 healthy, pain-free volunteers were divided into four groups for the
four-day (20 minutes per day) trial. The groups consisted of: meditation plus
naloxone; non-meditation control plus naloxone; meditation plus saline placebo;
or non-meditation control plus saline placebo...Zeidan found that the
participants' pain ratings were reduced by 24 percent from the baseline
measurement in the meditation group that received the naloxone. This is
important because it showed that even when the body's opioid receptors were
chemically blocked, meditation still was able to significantly reduce pain by
using a different pathway, he said. Pain ratings also were reduced by 21
percent in the meditation group that received the placebo-saline injection. (Wake Forest Baptist Medical Center.
Mindfulness meditation provides opioid-free pain relief, study finds. Science
Daily. 15 March 2016.)
Meditation for Pain 2
Health Day reports:
Meditation may work better than
painkillers when it comes to soothing chronic low back pain, a new clinical
trial suggests. The study found that a program called mindfulness-based stress
reduction (MBSR) beat standard medical care for managing low back pain.
After one year, people who attended
MBSR classes were more than 40 percent likely to show "meaningful"
improvements in their pain and daily activities compared to people who sought
conventional care for their aching backs. (Norton. Meditation May Help Ease Chronic Low Back Pain. Health Day News. March 22, 2016.)
Mood- Enhancing Approaches with
Drumming for Depression and Dropping
PLoS One Reports:
Growing numbers of mental health
organizations are developing community music-making interventions for service
users; however, to date there has been little research into their efficacy or
mechanisms of effect. This study was an exploratory examination of whether 10
weeks of group drumming could improve depression, anxiety and social resilience
among service users compared with a non-music control group (with participants
allocated to group by geographical location.) Significant improvements were
found in the drumming group but not the control group: by week 6 there were
decreases in depression (-2.14 SE 0.50 CI -3.16 to -1.11) and increases in
social resilience (7.69 SE 2.00 CI 3.60 to 11.78), and by week 10 these had
further improved (depression: -3.41 SE 0.62 CI -4.68 to -2.15; social
resilience: 10.59 SE 1.78 CI 6.94 to 14.24) alongside significant improvements
in anxiety (-2.21 SE 0.50 CI -3.24 to -1.19) and mental wellbeing (6.14 SE 0.92
CI 4.25 to 8.04). All significant changes were maintained at 3 months
follow-up. Furthermore, it is now recognised that many mental health conditions
are characterised by underlying inflammatory immune responses. Consequently,
participants in the drumming group also provided saliva samples to test for
cortisol and the cytokines interleukin (IL) 4, IL6, IL17, tumour necrosis
factor alpha (TNFα), and monocyte chemoattractant protein (MCP) 1. Across the
10 weeks there was a shift away from a pro-inflammatory towards an
anti-inflammatory immune profile. Consequently, this study demonstrates the
psychological benefits of group drumming and also suggests underlying biological
effects, supporting its therapeutic potential for mental health. (Fancourt D, Perkins R, Ascenso S,
Carvalho LA, Steptoe A, Williamon A. Effects of Group Drumming Interventions on
Anxiety, Depression, Social Resilience and Inflammatory Immune Response among
Mental Health Service Users. PLoS ONE.
2016; 11(3): e0151136. doi:10.1371/journal.pone.0151136)
Combining Exercise and Meditation for
Mens Journal reports:
Regular aerobic exercise and
meditation are both proven mood boosters, but done together, they're extra
effective at combating depression. In the first study ever to examine the two
therapies in tandem, the combination approach reduced symptoms of clinical
depression by an astounding 40 percent. (Junttti, M.The Insane Power of Combining
Exercise and Meditation. Mens Journal. 2016.
Summary: The example of pain abuse (and how this can
lead to mood issues) is one way to demonstrate how integrative medicine may
fill a gap in conventional medicine. Rather than just placing warnings on bottles,
perhaps it's time to look at the root causes of pain and alternative tools to
assist those suffering. After all, according to a headline in Health Day, "Nearly All U.S. Doctors 'Overprescribe' Addictive Narcotic Painkillers:
Survey." (Health Day News. March 25, 2016)
Exercise and movement have been demonstrated to be very effective for
In my homepage blog, I review the many factors involved in cognitive
health and preventing dementia risk. In this blog, I review the impact of
exercise on the brain.
In a review of literature, the authors sought to examine the evidence
of the "cognitive neuroprotective effect of exercise." The authors reported the
following: significant results with exercise and brain health including reduced
risk of dementia and mild cognitive impairment, better cognitive scores in
those already with dementia, a positive association of aerobic exercise in
healthy adults and cognitive scores, a larger hippocampal volume and better
spatial memory in a randomized trial of seniors using aerobic exercise. Other
randomized trials in seniors showed attenuation of gray matter volume loss with
aerobic exercise. There were also cross-sectional studies to support the effect
of exercise on hippocampal and gray matter in seniors. Furthermore, functional
magnetic resonance imaging displayed improved connectivity after 6 to 12 months
of exercise. As if the above wasn't enough, the authors continue on with more
support of exercise for the brain:
studies indicate that exercise facilitates neuroplasticity via a variety of
biomechanisms, with improved learning outcomes. Induction of brain neurotrophic
factors by exercise has been confirmed in multiple animal studies, with
indirect evidence for this process in humans. Besides a brain neuroprotective
effect, physical exercise may also attenuate cognitive decline via mitigation
of cerebrovascular risk, including the contribution of small vessel disease to
dementia. Exercise should not be overlooked as an important therapeutic
analysis of literature, researchers reported that exercise has a protective
effect on aging and cognitive decline. They believed that more studies were
needed to determine preservation of function, yet it may be a matter of finding
better ways to measure how exercise impacts the brain beyond preservation. There
was actually an earlier study that demonstrated reduced mortality risk in Alzheimer's
This was a population-based study of 357 New Yorkers sixty-five years or
older in which researchers prospectively assessed standard neurological and
neuropsychological evaluations (every ~1.5 years). The purpose was to determine
the association between physical activity (PA) and Alzheimer's disease
progression risk. The researchers weighted in the effect of light, moderate,
and severe exercise. They found that during the approximate 5 year follow up,
those who were physically active had a lower mortality risk, even among those
diagnosed with Alzheimer's. Adjusting for APOE genotype, smoking, other
diseases, and cognitive performance didn't affect the association. The authors
Exercise may affect not only risk for
AD but also subsequent disease duration: more PA is associated with prolonged
survival in AD.28
In a cross-sectional study in four U.S. states with 9,344 women 65 years
old or older, researchers sought to determine the association between physical
activity during lifespan and cognitive impairment. The authors found physical
activity was associated with lower prevalence of cognitive impairment, with
teenage activity most strongly associated with lower odds. Still, those who
became active later in life also had lower risk than the sedentary. 29
National Long Term Care Survey (NLTCS) level of exercise was measured at
baseline (1994) and cognitive impairment was compared at baseline and 5-10
years at follow up.
10-year follow-up, the number of different types of exercises performed was
inversely associated with the onset of cognitive impairment (p=0.002) as was
the number of exercise sessions lasting at least 20 minutes (p=0.007).
results from NLTCS data provide evidence supporting the potential for exercise
to lower the risk of dementia. 30
Clinic Study of Aging, a population-based-case-control study of 1,324
non-demented subjects completed a questionnaire on physical exercise. The
authors assessed frequency and intensity of physical exercise. Interestingly,
the authors only found a positive association with moderate intensity exercise.31
with twenty-one subjects used a combination of training exercises in
coordination exercises and cognitive training. After 13 weeks, changes were
observed in connectivity in the visual cortex, premotor area, and cingulate
gyrus, supporting the impact on brain health. The authors concluded:
Premotor area and cingulate gyrus were
also affected. We can conclude that the constant challenge of unfamiliar
combinations of coordination tasks, combined with visual perception and working
memory demands, seems to induce brain plasticity expressed in enhanced
connectivity strength of brain regions due to coactivation.32
here to read the continuation of my blog on Eating, Exercise, and Essential
Oils for Brain Health.
C. Why Is Physical Activity So Good for Your Brain? Exercise improves the
structure, function, and connectivity of your brain. Psychology Today. Sep 22,
JE, Geda YE, Graff-Radford NR, Petersen RC. Physical Exercise as a Preventive
or Disease-Modifying Treatment of Dementia and Brain Aging. Mayo Clinic
Proceedings. 2011;86(9):876-884. doi:10.4065/mcp.2011.0252.
27. Duzel E,
van Praag H, Sendtner M. Can physical exercise in old age improve memory and
hippocampal function? Brain. 2016;139(3):662-673. doi:10.1093/brain/awv407.
N, Luchsinger JA, Brickman AM, et al. Physical Activity and Alzheimer's disease
course. The American journal of geriatric psychiatry : official journal of the American Association for
Geriatric Psychiatry. 2011;19(5):471-481. doi:10.1097/JGP.0b013e3181eb00a9.
LE, Barnes DE, Lui L-Y, Yaffe K. Physical Activity Over the Life Course and its
Association with Cognitive Performance and Impairment in Old Age. Journal of
the American Geriatrics Society. 2010;58(7):1322-1326.
MK, Ewbank DC, Wang H, Trojanowski JQ. Exercise and cognition: Results from the
National Long Term Care Survey. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2010;6(6):448-455.
31. Geda YE,
Roberts RO, Knopman DS, et al. Physical Exercise and Mild Cognitive Impairment:
A Population-Based Study. Archives of neurology. 2010;67(1):80-86.
T, Cardinale V, Dehn S, Ruf M, Ende G. The Exercising Brain: Changes in
Functional Connectivity Induced by an Integrated Multimodal Cognitive and
Whole-Body Coordination Training. Neural Plasticity. 2016;2016:8240894.
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As a New York State Licensed Aesthetician, New York State Licensed Nail Specialist, and the Director of Living Well Healing Arts Center & Spa, Reisa combines her love of spa services and healing arts to achieve optimum skin and nail health, create greater overall wellness and bring forth our optimal, individual beauty.
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