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August, 2023 - VOL. 22, NO. 4  August, 2023
Unimportant Molecules and Medical Philosophy
Joseph Pizzorno, ND
In Parts 1 and 2 of my editorials on “Unimportant Molecules,” I reviewed the research on how modern agriculture has seriously distorted the food supply. In this editorial I showed how this oversimplification and lack of recognition of the importance of whole food molecules also illustrates the deep conceptual differences between the reductionistic medical interventionist model and the probabilistic nurturing model of health medicine. I believe we need both approaches, and by understanding the differences we can better integrate perspectives for the best patient outcomes.
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August, 2023 - VOL. 22, NO. 4  August, 2023
Letter to the Editor
Bethany Hays, MD
I read your article on masks and wanted to get back to you about my thought on that subject. I too read at least some of those articles. I think you conclusion is flawed because the studies are flawed. here are my thoughts
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August, 2023 - VOL. 22, NO. 4  August, 2023
Clinical Utility of Probiotics Therapy in Managing Mycotoxin Illness
Liam LaTouche, ND
For those dealing with a complex chronic illness—such as chronic fatigue syndrome, fibromyalgia, frequent infections, neuroendocrine disorders, and autoimmunity—mycotoxins are often overlooked, yet significant, silent killers that deteriorate various systems in the body. The symptoms caused by mycotoxins are often nonspecific and overlap many other health issues, and it’s common for standard test results from screening labs to either be normal or borderline abnormal. The subsequent band-aid approach to managing these symptoms may cause delays in proper treatment, potentially resulting in worsened outcomes.
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August, 2023 - VOL. 22, NO. 4  August, 2023
Coversation with Regina S. Druz, MD, MBA, MS, FACC
Sheldon Baker;  Regina S. Druz, MD, MBA, MS, FACC
Integrative Medicine: A Clinician’s Journal (IMCJ): Why should health professionals participate in this year’s AARM event? Regina Druz, MD, MBA, MS, FACC: We have managed to come to the era of convergence in medicine. A lot of practitioners who have been in alternative, functional, and integrative medicine spaces have been perceived as being on the fringe or periphery of medicine. Yet with recent scientific advances in genomics and metabolomics, we are coming to the point where conventional medicine is migrating out of its pharma intervention focus and now beginning to appreciate that there are opportunities in the integrative holistic approach. That’s what I would call a convergence. I hope that practitioners who are already practicing (in this arena) will be coming to this event to learn more, and health professionals who are not practicing it, but considering or have an interest, will attend to get their initial exposure to this practice model. 
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August, 2023 - VOL. 22, NO. 4  August, 2023
Nayan Patel, PharmD, Founder of Auro Wellness and CEO of Central Drugs Compounding Pharmacy
Sheldon Baker;  Nayan Patel, PharmD
Integrative Medicine: A Clinician’s Journal (IMCJ): What led you to studying glutathione? Nayan Patel, PharmD: In the late 90s, I was invited to work as a consultant on liposomal technology to make the vitamin C molecule much easier to work with. My partner and I perfected a system for pulverizing vitamin C into small molecules and a capsule pathway for swallowing it. But it was too cost prohibitive. People were not going to pay a lot of money for a vitamin C capsule. Even though the project was successful, it was abandoned by the company because the value of having vitamin C raised in your body was not enough. As my research partner and I had worked so hard on this project, we considered: what’s another mass antioxidant to which this work might be applied? So, from that project came our work on glutathione.
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August, 2023 - VOL. 22, NO. 4  August, 2023
Treatment of Epstein-Barr Induced Hepatitis with High Dose Intravenous Vitamin C: A Case Report
Leslie Fuller, ND;  Adriane L. Knorr, ND;  Ryan S. Wexler, ND, MSCR
Introduction: Vitamin C has been previously studied for use with acute and chronic Epstein-Barr Virus (EBV) and hepatitis C. However, it has never been evaluated for its impact on EBV induced hepatitis. In this case report, we present a patient’s history with EBV induced hepatitis treated with high dose vitamin C. Methods: A 36-year-old female presented to the National University of Natural Medicine Health Center with reactivated EBV-induced viral hepatitis. She reported severe fatigue, brain fog, maintenance and initiation insomnia, periocular hyperpigmentation, blurry vision, and decreased concentration. The patient’s diagnosis was confirmed with a diagnostic evaluation of her EBV titers and liver enzymes, all of which were elevated. After assessing for contraindications, the patient was treated with intravenous (IV) vitamin C starting at a 10g dose and increasing weekly for 3 weeks to a dose of 25g. Results: After 12 weeks of treatment with high dose IV vitamin C, as well as other immune-supportive nutrient therapy, the patient reported a decrease in fatigue severity, brain fog, vision disturbances, exercise limitations, and insomnia severity. Discussion: We recommend that physicians consider the administration of high-dose IV vitamin C for all concurrent cases of EBV and hepatitis in both acute and chronic conditions. As recognition of reactivated viral infections grows, high-dose IV vitamin C for other latent viral infections such as COVID-19, cytomegalovirus, herpes simplex, varicella zoster, and HIV should be considered.
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August, 2023 - VOL. 22, NO. 4  August, 2023
Integrative Therapies for Magnesium and Calcium Deficiency in a Food Insecure, Autism Subject: A Case Report
Jasmine B. Hollywood, DCN, LDN, CNS, CRPS, ORDM
Introduction: Individuals facing homelessness with autism spectrum disorder (ASD) are at increased risk for food insecurity. Financial difficulties increase the demand to donate blood plasma to support hardship. Excessive blood plasma donations may lead to micronutrient deficiencies exacerbating deficits derived from poor food habits. Therapies that may support these populations in securing foods and improving lifestyle habits may be diet, supplements, nutrition education, and holistic lifestyle recovery support group. Case Description: A homeless, 31-yr-old Caucasian female with ASD presenting with magnesium and calcium deficiencies, and ten year history of blood plasma donations sought medical nutrition therapy. Over 6 months and in conjunction with physician prescriptions, interventions were augmented with magnesium and calcium supporting vegetables; reduction of dairy, fast foods, and ultra-processed foods; nutrition education and holistic lifestyle recovery support group. Upon final visit, the patient had remarkable improvement of nutrition knowledge and food budgeting, in-kitchen housing stability, food access, and stress reduction. Conclusion: Nutrition education improves nutrition knowledge and food budgeting facilitating food access, while holistic lifestyle recovery support groups can influence healthier living and stress reduction in homeless patients with ASD. Population-based clinical studies should be done to understand the role of these conjunctive therapies to support nutrition practice.
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August, 2023 - VOL. 22, NO. 4  August, 2023
Type 2 Diabetes Remission Through Intense Lifestyle Modification with Three-Year Follow-Up of an Elderly Male on High Insulin Dosage: A Case Report
Nidhi Kadam, PhD;  Maheshkumar Kuppusamy, PhD;  Pramod Tripathi, MBBS;  Venugopal Vijayakumar, PhD;  Anagha Vyawahare
An elderly obese male patient (60 yrs.) diagnosed Type 2 Diabetes (T2D) presented to our clinic. He was on 94 units of insulin and oral hypoglycemic agents during his initial consultation visit. After obtaining informed consent, he was enrolled into intense lifestyle modification program for a duration of six months, with a three-year follow-up after the intervention. The patient underwent complete remission losing 13 kg of body weight and also successfully clearing oral glucose tolerance tests (OGTT) for three consecutive years. We present three unique features in the current case report: (1) Elderly age of the patient (2) OGTT clearance along with normalisation of HbA1c, and (3) High initial insulin dosage at baseline. A few of the common positive predictors of T2D remission documented in earlier studies include younger age and minimal or low doses of insulin. The current case study shows that older age and higher dosage of insulin, it is possible to undergo complete T2D remission along with OGTT clearance through intense holistic lifestyle modification. Future experimental studies with adequate sample sizes would help substantiate our observation.
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August, 2023 - VOL. 22, NO. 4  August, 2023
Complex Presentations, Identification and Treatment of Mast Cell Activation Syndrome and Associated Conditions: A Case Report
Alexandra M. Quinn, ND
Mast Cell Activation Syndrome (MCAS) is only a recently recognized, multisystem disorder that has been historically underrecognized due its estimated high prevalence. Recognition, testing, and treatment all pose unique challenges to condition management. The condition warrants more concern due to its prevalence and under recognition. Of equal importance in this case is the overlap seen between conditions such as MCAS, gastric dysmotility often manifesting as small intestine bacterial overgrowth (SIBO), dysautonomia, joint hypermobility disorders such as hypermobile Ehlers Danlos Syndrome (h-EDS) or other hypermobility spectrum disorders (HSD), and autoimmunity. This case involves a 42 year-old female who initially presented to the clinic for chronic SIBO and associated gastrointestinal complaints. Upon further examination into the patient’s history and unique presentation as visits progressed, important factors affecting treatment considerations were discovered. The patient was ultimately deemed to have other associated conditions including a mast cell-mediated disorder as well as joint hypermobility due to her response to antihistamine and mast cell stabilizing agents. Final outcomes include immense improvement upon mast cell stabilization with ketotifen, and remission of SIBO with low-dose naltrexone (LDN). Although the patient did not undergo testing beyond a serum tryptase test, this case represents the importance of careful history taking and the role of clinical suspicion on patient outcomes.
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August, 2023 - VOL. 22, NO. 4  August, 2023
Heart Rate Variability Biofeedback as Adjunctive Treatment of Generalized Anxiety Disorder: A Case Report
Sarah JaeHwa Park, ND;  Maya Roth, ND
Introduction: Generalized anxiety disorder (GAD) is a common psychiatric disorder that can cause significant functional impairment to a patient’s life. Mind body therapies (MBT) have increasingly been used as an intervention to manage symptoms of anxiety. Heart rate variability (HRV) biofeedback is a specific MBT that utilizes real-time feedback on autonomic functioning to train the physiological stress response through diaphragmatic breathing. Case Presentation: A 39-year-old female was referred for a seven-week HRV biofeedback training protocol at Bastyr University Clinic for adjunctive treatment of GAD and depression. She had been taking citalopram for approximately four months prior to the first visit. Discussion/Conclusion: After completing the seven-week protocol, the patient’s anxiety improved from severe to mild, and her depression improved from mild to minimal. This improvement was maintained at a four-week follow-up, and eight weeks after the final visit she reported that her anxiety was no longer a concern to her. HRV biofeedback demonstrated to be an effective adjunctive treatment for GAD in this patient’s case; however further research is needed to elucidate the effects of HRV biofeedback in patients with GAD.
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