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April, 2013 - VOL. 12, NO. 2  April, 2013
The Path Ahead: Persistent Organic Pollutants (POPs)—A Serious Clinical Concern
Joseph Pizzorno, ND
I am confident all of us are concerned about the ever increasing load of toxins in the environment and how this contributes to our patients’ ill health and disease burden. The first lecture I gave when founding Bastyr University in 1978(!) was entitled, “The Health Effects of Environmental Toxins.” This was a frustrating course to teach as I was confident environmental toxin load was a real problem, but there were at the time no useful textbooks. The academic and research resources were limited to high-level exposure such as that found in mining and industry and, in fact, the resources explicitly discounted the concept that the chronic low-level exposure seen in the general population was clinically relevant. Regular IMCJ readers will remember that I have addressed the issue of mercury toxicity in previous editorials, accompanied by vigorous letters-to-the-editor conversation. About 2 years ago after listening to a Jeff Bland, PhD, interview on Functional Medicine Update (now called Synthesis by Jeffery Bland), I was intrigued to hear of new research looking at not just the physiological effects of organic toxins, but also the systemic effects of the total body load of these chemicals. I was excited to see a large body of emerging research and alarmed by the seriousness of the correlations now being seen. After reading a lot of studies, I developed, with the aid of Joseph Katzinger, ND, a 90-minute lecture, which I have now given three times in North America. Following is what I found.
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April, 2013 - VOL. 12, NO. 2  April, 2013
National Institutes of Health Begins Funding Research That Focuses on Creating Health … plus more
John Weeks
The NIH Takes a Step Toward Health Creation The National Institutes of Health greeted the new year with a surprising announcement.1 The agency is funding public health researchers and clinical interventions that focus on creating health in individuals and populations. The funding announcement ran was called “Implementation and Dissemination in Health” and read: “This funding opportunity will encourage research grant applications that will identify, develop, evaluate, and refine effective and efficient methods, systems, infrastructures, and strategies to disseminate and implement research-tested health behavior change interventions, evidence-based prevention, early detection, diagnostic, treatment and management, and quality of life improvement services, and data monitoring and surveillance reporting tools into public health and clinical practice settings that focus on patient outcomes.” Fifteen of the NIH’s 28 institutes and centers, including the National Center for Complementary and Alternative Medicine (NCCAM), signed on to the initiative. Comment: This is a big deal, even if it represents just a fraction of the $30 billion allocated annually in the NIH budget. The lion’s share of NIH funding—and it’s a greedy lion—targets the kinds of pharmaceutical, device, and high-tech interventions that have led many to note that the agency would have been more aptly named the National Institutes of Disease. The NIH is rarely held accountable for its role in the enabling the disaster that is the $2.8-trillion US medical industry. Its steadfast commitment to the false purity of single agents to treat populations avoids the real world challenges of examining optimal care for chronic conditions. These recognize the multifactored etiologies of the most troubling of chronic conditions and utilize whole-person, individualized practices and team care, including community and family systems. When it empowers the bishops of single agent trials, the NIH not only “enables” our disease focus; the agency becomes a frank obstacle to health. This token program to live up to the NIH’s name is a step in the right direction for which the agency should be commended. Now let’s take the tokenism and make of it a Trojan horse to usher health creation into the house of medicine.
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April, 2013 - VOL. 12, NO. 2  April, 2013
Evaluating Clinical Response and Activity of Cyplexinol Osteoinductive Proteins in Osteoarthritis of the Hip and Knee: A Randomized, Controlled Trial
Richard Garian, DC, MS;  James J Scaffidi, BSc, DNM(c)
Context: Osteoarthritis (OA) is the most common form of arthritis, and it affects more than 20 million people in the United States. The most commonly affected joints are the hips and knees, and OA-related complications are the main reasons for total knee and hip replacements. The proteins in Cyplexinol have been used for the past 25 years by orthopedic surgeons to promote bone and cartilage growth. Objective: The study intended to investigate the efficacy and safety of a novel protein complex that contains bone morphogenetic protein (150 mg of Cyplexinol, Nature’s BMP-complex), for relieving pain and stiffness in participants with moderate to severe osteoarthritis (OA) of the hip or knee. Design: The study was a randomized, double-blind, placebo-controlled clinical trial. Setting: The author’s office and the study questionnaires were administered via phone. Participants: Participants were individuals 55 years and older who had been diagnosed with moderate-to-severe, osteoarthritis joint pain in the hip or knee (weight-bearing joints) and who had been symptomatic for at least 5 days a week for a minimum of 3 months. Intervention: The participants received either a single daily dose of 150 mg of Cyplexinol or of a placebo for a 12-week duration. Outcome Measures: Three primary endpoints—pain, stiffness, and quality of life (QOL)—were evaluated using the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index 3.1. Primary efficacy analyses were based on a one-way analysis of variance (ANOVA). Secondary endpoints were treatment compliance and adverse events. Results: Eighty-seven participants enrolled in the study. Treatment with 150 mg of Cyplexinol resulted in a significant decrease in pain and stiffness, together with an increase in QOL by week 12 in comparison to placebo treatment, which showed no significant improvement in symptoms. The a level was set at P < .0001 for the treatment group and P > .05 for the placebo group. For the WOMAC pain subscale, a significant effect of a 3.35 point increase (95% CI, 2.58-4.13; P < .0001) was observed for 150 mg of Cyplexinol at week 12 in comparison to a negative effect of -0.35 points (95% CI, -1.40-0.71; P > .05) for the placebo. The mean changes at week 12 for WOMAC stiffness were 2.95 points (95% CI, 1.94-3.97; P < .0001) for 150 mg of Cyplexinol and 0.18 points (95% CI, -0.82-1.19; P > .05) for the placebo. The mean changes at week 12 for WOMAC QOL were 3.12 points (95% CI, 2.38-3.86; P < .0001) for 150 mg of Cyplexinol and -0.40 points (95% CI, -2.034-1.24; P > .05) for the placebo. Conclusions: Cyplexinol treatment at 150 mg was statistically more effective than the placebo in treating the signs and symptoms of osteoarthritis in a weight-bearing joint (hip or knee). Treatment with 150 mg of Cyplexinol was shown to be a natural, safe, and effective way to increase QOL by decreasing common symptoms such as pain and stiffness.
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April, 2013 - VOL. 12, NO. 2  April, 2013
Phytopharmacology of Convolvulus plauricaulis
Sanjiv Duggal, MSc;  Amritpal Singh, MD Ayurveda
Ayurveda classifies Convolvulus pluricaulis Choisy (syn C microphyllus Sieb. ex Spreng) (Convolvulaceae) as a brain tonic or a nootropic substance (memory booster). In preclinical studies, C pluricaulis has demonstrated a wide range of pharmacological activities. This article summarizes phytopharmacological investigations that researchers have carried out on the plant.
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April, 2013 - VOL. 12, NO. 2  April, 2013
Integrative Approaches to Obesity Treatment
Jennifer C. Lovejoy, PhD
Over two-thirds of Americans are currently classified as overweight or obese, and obesity is the primary driver of noncommunicable diseases globally. The magnitude of this public health problem, as well as the personal desperation of many individuals who suffer from obesity, makes the development of safe and effective treatments a priority. Lifestyle approaches—nutrition, physical activity, and stress management—are the foundation of weight management, and evidence clearly indicates that an intensive lifestyle intervention is effective in producing sustained weight loss in a majority of the individuals who complete these programs. However, for many individuals, lifestyle alone is not enough. Use of dietary supplements and herbs, traditional Chinese medicine, and other integrative medicine approaches are common in dealing with obesity. This review summarizes the evidence for the effectiveness of some commonly used modalities from natural medicine for treating obesity as well as new obesity pharmacotherapies. Certain fiber supplements and green tea catechins appear to play a beneficial role in weight management in terms of dietary supplements, and acupuncture and other traditional techniques from Chinese medicine also have shown promising results.
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April, 2013 - VOL. 12, NO. 2  April, 2013
Association Between Headache and Sensitivities to Gluten and Dairy
David Perlmutter, MD, FACN, ABIHM;  Aristo Vojdani, PhD, MSc, CLS
Dietary factors are known triggers for migraine headaches. The most commonly implicated foods are wheat and dairy products. We present a case study of a patient with a 30-year history of debilitating migraine headaches who showed no benefit from various pharmaceutical interventions. Special panels for gluten and cross-reactive foods and a multiple autoimmune reactivity screen revealed significantly high levels of antibodies against wheat proteomes, transglutaminase, and dairy-related antigens. The implementation of a gluten-free and dairy-free diet resulted in an amelioration of the migraine headache symptomatology, and the clinical improvements correlated with a significant decline in the levels of a majority of the previously elevated antibodies. This finding indicates that diet plays a significant role in a subgroup of patients with migraine headaches.
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April, 2013 - VOL. 12, NO. 2  April, 2013
Combining Prolotherapy and Platelet-rich Plasma Therapy for Joint Repair in a Case of Anterior Cruciate Ligament Disruption
Michael Cronin, ND
Proliferation therapy (prolotherapy) and platelet-rich plasma (PRP) are effective treatments that support the body’s own healing processes. These therapies, when performed with precision and in combination with careful patient assessment and dietary measures that support tissue repair, have significant potential to reduce current and future morbidity resulting from injury and from chronic degenerative conditions. This article reports the case of a 25-year-old male with anterior cruciate ligament disruption who was treated with a combination of dextrose prolotherapy and PRP with dietary/supplement support. After two prolotherapy treatments and six PRP treatments performed in series in the course of 1 year, the patient’s ligament has healed, as confirmed by magnetic resonance imaging. Surrounding tissue that also presented with damage, which was confirmed by MRI at the patient’s initial examination, was also shown to have healed. The patient was pleased enough with the results of this therapy that he initiated treatment of several other injured joints.
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April, 2013 - VOL. 12, NO. 2  April, 2013
Endothelial Dysfunction and the Preventative Approach to Cardiovascular Disease: An Interview With Mark C. Houston, MD, MS, ABAARM, FACP, FAHA, FASH
Karen Burnett
Mark C. Houston, MD, MS, ABAARM, FACP, FAHA, FASH, is associate clinical professor of medicine at Vanderbilt University School of Medicine; director of the Hypertension Institute and Vascular Biology; and medical director of the Division of Human Nutrition at Saint Thomas Medical Group, Saint Thomas Hospital in Nashville, Tennessee. He is also on the faculty of the University of South Florida for the Functional and Metabolic Medicine Fellowship. He is chief medical officer for Destination Medical Centres in the United States, which is part of MVP Holdings, LLC. He is triple board certified by the American Board of Internal Medicine, the American Society of Hypertension (ASH), and the American Board of Anti-Aging and Regenerative Medicine (ABAARM). He also has a master of science degree in human nutrition. Dr Houston has presented over 10 000 lectures nationally and internationally and has published more than 200 articles and scientific abstracts in peer reviewed medical journals. He is on the consulting editorial board for many medical journals and is editor-in-chief for JANA (Journal of the American Nutraceutical Association). He is an author and teacher and is active in clinical research.
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April, 2013 - VOL. 12, NO. 2  April, 2013
BackTalk: Can Happiness Ever Be a Warm Gun?
Bill Benda, MD
The topic of today’s integrative lesson is … guns. Wait a minute—this is a medical journal, not some checkout line rag. Why in the world are we going to discuss firearms? Well, there are several reasons. First, the topic and its associated tragedies are finally on the media table. Second, if we are to claim to be an indispensable part of health care, we have to address the vital issues of the day (I’ve been pushing for years to debate issues such as abortion, end-of-life choices, and our own professional hypocrisies, but all we seem to care about is whether chocolate is a health food). And third, my own involvement and education in the realm of weaponry is a direct result of naturopathic medicine. That’s right—naturopathic medicine. A little background here—I am a child of the hippie sixties, a lifelong liberal who has spent 35 years in emergency medicine, with the first 6 as a paramedic on the streets of South Florida. I’ve spent the last 20 years working in our prison system as well, and have pretty much been antigun given the slaughter and social devastation I’ve witnessed. But about 3 years ago, when I was teaching a course at Southwest College of Naturopathic Medicine, a faculty member and her fiancée, both prior police people, invited me to the Scottsdale Gun Club for a little target practice. Given that I had personally wiped out countless sandlot Nazi storm troopers back in my childhood days, I thought this would be fun.
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