September 2010 Health Newsletter

Cardioplex:  Vitamins and phytochemically-rich herbs to help maintain a healthy heart
Core Level Heart: Nutritional support of the cardiac muscles

Homocysteine Redux:  Nutritional support of the cardiac muscles

Calcium (citrate): Highly absorbable calcium; reduces the risk of osteoporosis, supports cardiovascular   and colon health
CoQ₁₀:  Energy for cardiovascular health
l-Carnitine:  Cardiovascular and endurance support

ADHS:  Supports normal cortisol levels
L-Carnitine HCL:  Plays a critical role in fat metabolism and eneygy productions, therefore supports healthy heart function.
Mg Zyme:  Magnesium support for proper cardiac support

PLEASE FEEL FREE TO CONTACT THE OFFICE REGARDING ADDITIONAL HEART HEALTH NUTRITIONAL SUPPORT OR ASK THE DOCTOR ON YOUR NEXT VISIT

Targeted acupuncture may offer women with major depression a safe and effective alternative to antidepressant medication, new research suggests.

Investigators at Stanford University School of Medicine in California found that women with major depressive disorder treated with depression-specific acupuncture had a 63% response rate after 12 sessions compared with a 44.3% response rate in 2 combined control groups who were treated with either acupuncture not known to help alleviate depressive symptoms or Swedish massage.

"Pregnancy just by its nature can bring out some underlying psychiatric and emotional issues ... but treatment of depression during pregnancy is critically important so that a woman can maintain her sense of well being and take good care of herself, her fetus and, someday, her child," study coauthor Deirdre Lyell, MD, Stanford University School of Medicine, said in a statement.

Led by Rachel Manber, PhD, the study was published in the March issue of Obstetrics & Gynecology.

Response Rates Significantly Higher

For the study, investigators randomized 150 women whose pregnancies were between 12 and 30 weeks of gestation and who met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for major depressive disorder and who scored at least 14 on the 17-item Hamilton Rating Scale for Depression.

Of the 141 women who eventually entered the study, 52 received depression-specific acupuncture, 49 received control acupuncture, and 49 others received Swedish massage.

Treatments were provided twice a week for the first 4 weeks and then weekly thereafter for 4 additional weeks, with each session lasting about 25 minutes.

The investigators found that response rates were significantly higher in women who received depression-specific acupuncture than for either control group. Response rates in women randomized to the 2 control interventions did not differ significantly from each other at 37.5% for the control acupuncture group vs 50% for the massage group.

On the other hand, remission rates did not differ significantly between women who received depression-specific acupuncture at 34.8% and the combined control groups at 29.5%. They also did not differ between those assigned to the control acupuncture group at 27.5% or the massage group at 31.2%.

Thirty-three of the study participants discontinued treatment before the study endpoint, 30% of them for reasons related to the pregnancy. Some women in both acupuncture groups reported transient discomfort at the point of needle insertion, and 1 woman experienced bleeding at the needle site.

Significantly fewer women who received massage reported any adverse effects compared with the 2 acupuncture groups.

Clinically Meaningful

The study authors point out that the benefits observed with depression-specific acupuncture can be considered "clinically meaningful" when assessed in a broader context of depression studies.

Although there are no randomized controlled trials of antidepressants being used during pregnancy, 1 randomized controlled trial found that interpersonal psychotherapy produced a 52% reduction in Hamilton Rating Scale for Depression scores and a 19% remission rate after 16 weeks of therapy, to which the currently study compares very favorably.

According to the study, antidepressant use during pregnancy doubled between 1999 and 2003, but many women are reluctant to take these medications because of safety concerns. In fact, in this particular study, 94% of the women involved expressed reluctance to take an antidepressant because of their pregnancy.

"Because there’s this concern about medication among pregnant women and their physicians, it’s important to find an alternative," said Dr. Manber.

Results from this study therefore suggest that this standardized acupuncture protocol could be considered a "viable treatment option" for depression during pregnancy, the investigators conclude.

Michael Thase, MD, University of Pennsylvania School of Medicine, cautions that findings from this study are preliminary, although they suggest that depression-specific acupuncture may have value in major depressive disorder in this patient population.

On the other hand, another study assessing depression-specific acupuncture in a broader population of men and women with major depressive disorder failed to find a significant effect from the modality, so evidence supporting acupuncture for the treatment of major depressive disorder is not consistent.

"Still there is reason to be cautious when prescribing antidepressants in pregnancy, and one has to weigh the pros and cons of using an antidepressant on an individual basis,” he told Medscape Psychiatry.

"If these promising findings are confirmed, it would be good to have another option to complement the focused forms of psychotherapy which are currently used for antenatal depression," he added.

The study was funded by the Agency for Healthcare Research and Quality. The study authors and Dr. Thase have disclosed no relevant financial relationships.

Obstet Gynecol. 2010;115:511-520.

In the 1992 presidential campaign, Bill Clinton was a heavy underdog to popular incumbent George H. W. Bush. Bush was considered unbeatable due to foreign policy successes including the end of the Cold War and routing Saddam Hussein in the first Gulf War. But Bush’s approval ratings, which had been in the 90 percent range, began to dip as his campaign ignored the economic recession. Clinton’s campaign manager James Carville’s now famous campaign slogan, "It’s the economy stupid," helped turn the tide and Bill Clinton became the forty-second American president.

Just like George Bush’s 1992 presidential campaign, today’s medical community continues to promote the medical myths associated with cholesterol while ignoring the real cause of cardiovascular disease, inflammation.

Conventional opinion and current medical dogma holds that low cholesterol, especially low LDL cholesterol, reduces the risk and incidence of heart disease and stroke. This belief is so entrenched in the medical community that the FDA now approves drugs to prevent heart disease, as it did with Zetia and Vytorin, solely on the evidence that they lower LDL cholesterol levels. Zetia has never been proven to reduce heart attacks, strokes or death. Statin drugs help reduce the risk of heart attack and stroke for those who’ve already had a cardiac event (one percent over placebo) but fail to reduce death in women, the elderly, men over the age of 47, and in men without cardiovascular risk factors.

A 2006 study in The Archives of Internal Medicine looked at seven trials of statin use in nearly 43,000 patients, mostly middle-aged men without heart disease. In that review, statins didn’t lower mortality.

Nor did they in a study known as Prosper, published in The Lancet in 2002, which studied statin use in people seventy and older. Nor did they in a 2004 review in The Journal of the American Medical Association, which looked at thirteen studies of nearly 20,000 women, both healthy and with established heart disease.

Despite a growing voice of reason, which became even louder after the recently released Enhance study, the cholesterol zealots continue to view cardiovascular disease with tunnel vision. This myopic vision fuels the cholesterol drug war which rages on as each pharmaceutical company seeks to gain economic gain in the 40 billion dollar a year lipid lowering drug market.

In an attempt to take on the cholesterol Goliath, Pfizer’s Lipitor (10 billion dollars in sales annually), Merck and Schering-Plough combined their cholesterol lowering drugs, Zocor and Zetia, to form the "super drug" known as Vytorin. Vytorin’s goal was to lower LDL cholesterol more than either drug could alone. Zetia lowers blood cholesterol by blocking the absorption of dietary cholesterol from the intestines. Zetia used alone is modestly effective in lowering LDL cholesterol by approximately 17 percent. Zocor alone lowers LDL levels by 36 percent—similar to Lipitor.

The hope was that by lowering LDL to dramatically low levels, Vytorin would do a better job of slowing the accumulation of fatty plaques in the arteries. Vytorin did, in fact, reduce LDL—by a whopping 51 percent (similar to AstraZeneca’s Crestor).

However, the two-year "Enhance" trial failed to prove that Vytorin is better than Zocor alone for slowing plaque accumulation; instead atherosclerosis worsened in those taking Vytorin.

Merck and Schering-Plough suppressed this finding for twenty months.

The study results were not revealed until the two drug companies were pressured into doing so by an article in The New York Times and a Congressional inquiry. The marketers of Vytorin said they had nothing to hide. It’s hard to believe they weren’t just a little reluctant to publish their highly anticipated study. The news that Vytorin, which retails for $100 a month and did $2 billion in sales in 2007, was clinically inferior (perhaps even dangerous) to generic simvastatin (statin), costing less than $20 a month, obviously wasn’t what stockholders wanted to hear.

Merck and Schering-Plough are running full-page ads daily in the Times and Wall Street Journal, warning people not to be confused by a single study and to continue taking Vytorin. The advice was backed by the American Heart Association, which the Times reported receives nearly $2 million a year from Merck/Schering-Plough Pharmaceuticals.

Other LDL lowering drugs have bitten the dust in the last coupe of years as well.

Pfizer’s trial of its much-anticipated drug torcetrapib, which raised HDL, the good cholesterol, and lowered LDL, had to be stopped in 2006 because the drug caused heart attacks and strokes.

Estrogen replacement therapy, which is known to lower LDL cholesterol levels, failed to reduce the incidence of heart attack and stroke in clinical studies.

Ok, if cholesterol lowering isn’t the answer for everyone, why do statins help people with existing heart disease? Dr. James K. Liao of Brigham & Women’s Hospital in Cambridge, Massachusetts, has been investigating this question for over a decade. He suspects that statins have other biological effects. His research shows that statin drugs not only block cholesterol, but also an inflammation-generating enzyme known as rho-kinase.

When Liao reduced the rho-kinase levels in rats, they didn’t get heart disease. "Cholesterol lowering is not the reason for the benefit of statins," he concludes. Of course, there are dozens of inflammatory chemicals that play a role in triggering cardiovascular disease. Diet, health habits, our environment, even our personality may initiate inflammatory chemicals that perpetuate cardiovascular disease events.

Ralph Waldo Emerson once said, "People see only what they are prepared to see." As the evidence about inflammation and cardiovascular disease rises, will conventional medicine and the public at large be prepared to see that it’s not about lowering cholesterol but in reducing inflammation? Hopefully, "It’s the inflammation, stupid," will become a common slogan in the campaign to fight cardiovascular disease.

Shary’s corner
 
                       LIVE                        LOVE                          LAUGH
Every day can be filled with meaning.  Take a moment, just the amount of time you need to take a deep breath and exhale slowly, to ask yourself what is my dream, and how will I get there from here?
What can you stop doing or do differently to simplify your life and make it more meaningful?  What is truly important to you?  Do you give some time each week to your true priorities?
Why not fill your life with love and laughter whenever you can?  There is no greater gift than the gift of loving others.  There is nothing wrong with taking some time for self-care too.  Love your pet?  Love walking out in nature?  Make time for your passions and those things that add value to your life.  Your body, mind and soul will thank you.
Do you have a mission in life?
Dream it.
Think about it.
                      Talk about it.
                                                 Commit to it.

A recent literature review found some interesting evidence suggesting that chiropractic care may have certain benefits for those suffering from insomnia. In the review, researchers evaluated some 15 studies that met their criteria. Their findings suggested that many of the therapies utilized by certain chiropractors including cranial manipulation, physio and manual therapies as well as mind-body therapies may have benefits for insomnia sufferers. However, no studies have been directly conducted to specifically evaluate and support these findings but based on these previous studies, it may be worth additional investigation.

U.K. and Canadian scientists have found vitamin D to be even more so vital to health and well being than previously thought. Their new findings have revealed vitamin D as a direct influencer of more than 200 human genes. One such gene is related to both cancer and autoimmune diseases such as multiple sclerosis. According to scientists, vitamin D deficiency makes us susceptible to a wide host of diseases. Other diseases thought to be influenced by vitamin D deficiencies include rheumatoid arthritis, type 1 diabetes as well as dementia. Vitamin D is naturally produced in the body as a result of direct sun exposure to the skin. Vitamin D is also present in larger amounts in fish oils – a common source for most vitamin D supplements. It’s important to note that in larger quantities, vitamin D is also toxic. A number of experts recommend daily dosages of vitamin D ranging from 25 to 50 micrograms.

Results from a 2-year clinical trial have found large daily dosages of B vitamins can cut the rate of brain shrinkage in the elderly who suffer from memory problems in half. Researchers believe this may slow the progression towards dementia and thus be a treatment for those suffering from or at risk of suffering from Alzheimer’s disease. The dosage of vitamin B was administered in very high quantities - folate (also known as folic acid and vitamin B9) at 4 times the recommended daily dosage, vitamin B6 at 15 times the recommended dosage and vitamin B12 at 300 times the recommended dosage. B vitamins reduce plasma levels of homocysteine - an amino acid that is associated with not only an increased risk of Alzheimer’s disease, but also an increased risk of coronary heart disease, stroke and peripheral artery disease. It could be through these very large dosages that significantly lower blood levels of homocysteine result in less damage and shrinkage to the brain and its arterial supply. There is more research to be done but these new findings are very exciting and promising for the Alzheimer’s community.

The American Chiropractic Association (ACA) and the Association of Chiropractic Colleges (ACC) today commended Rep. Gene Green (D-Texas) and Rep. Lee Terry (R-Neb.) for introducing legislation in the U.S. House of Representatives that calls for the appointment of doctors of chiropractic (DCs) as officers in the U.S. Public Health Service (USPHS) Commissioned Corps. The bill, H.R. 6032, would include DCs in the Regular Corps and the Ready Reserve Corps, and would require the president, in consultation with the Surgeon General and the U.S. Secretary of Health and Human Services, to appoint no fewer than six DCs to the Commissioned Corps. Although the Commissioned Corps includes representatives from many diverse health care professions, no doctors of chiropractic have ever been appointed to serve—ACA and ACC have been working diligently with Reps. Green and Terry to advance this legislation, which specifically addresses this long-standing deficiency. The Commissioned Corps is an elite team of more than 6,000 well-trained, highly qualified public health professionals dedicated to delivering the nation’s public health promotion and disease prevention programs and advancing public health science. Officers in the Corps provide health care services in a variety of locations and venues, including care to members of the U.S. Coast Guard and at community health centers. “Both Rep. Green and Rep. Terry have been champions for improving access to quality health care, and are long-time supporters of the chiropractic profession’s role in delivering vital health services to our nation’s citizens,” said ACA President Rick McMichael, DC. “The services of doctors of chiropractic will be a tremendous value to the Commissioned Corps, and enacting this legislation will be another important milestone in the mission to fully integrate chiropractic care into the nation’s health care delivery system.” "Doctors of chiropractic already serve our nation's active-duty military and veterans with distinction and success,” said ACC President Frank Nicchi, DC. “H.R. 6032 will allow doctors of chiropractic to join forces with other health care providers in the fight against disease, poor health conditions and other threats during both non-emergency and emergency periods for our country. We extend our appreciation to Rep. Green and Rep. Terry for their bipartisan effort to introduce this long-overdue legislation.” H.R. 6032 has been referred to the House Committee on Energy and Commerce, which has jurisdiction over the USPHS. Reps. Green and Terry serve as senior members of that committee. ACA and ACC will soon initiate a range of grassroots activities to build support for this important legislation. To contact your Representative and urge them to cosponsor H.R. 6032, please visit the ACA Legislative Action Center. The American Chiropractic Association, based in Arlington, Va., is the largest professional association in the United States representing doctors of chiropractic. ACA promotes the highest standards of ethics and patient care, contributing to the health and well-being of millions of chiropractic patients. The Association of Chiropractic Colleges represents accredited chiropractic colleges in North America and seeks to advance chiropractic education, research and service.