May 2006 PDF

A special  drug alert:

I know you won’t be surprised to hear me promote natural cures over prescription drugs. But the recent controversy over celebrated prescription drugs like Vioxx and Celebrex got me thinking about how many other drugs are now on the shelves that shouldn’t be.

So, inside this month’s newsletter, I’ve compiled a list of 10 drugs that you can do without, along with some natural remedies that you can’t.

Each drug on my list is different from the next. Some are popular favorites that doctors have prescribed for years. Others are slightly more obscure, and only useful in a small number of patients. Many are no different from other safer medications you could take for the same results and with less danger.

But they all have at least one thing in common: They could easily be taken off the market, and you wouldn’t suffer one bit from it.

How you can head off memory problems at your local mall, fishing hole, and supermarket

I hear it all the time. “Hey, Doc, I forget my keys and can’t remember names anymore. I think I’m getting Alzheimer’s disease!”

“Rest assured,” I reply. “If you’ve got Alzheimer’s you’ll be the last to know. It’s your family who picks it up.”

The fact is, most memory problems are a combination of poor attention habits, stress, and normal, age-related loss of brain function.

Let’s cut to the chase. You need smart, safe tips on how to preserve your memory. Well, here they are, based on the latest research, with a dose of common sense thrown in.

Shopping for better mental function

It turns out that you can shop for a stronger memory. Well, maybe not literally. But research has shown that you can increase your mental function by doing activities that demand attention by requiring interactive problem solving and mental calculation. Shopping does all of this.

If you hate malls and grocery stores, don’t worry. Many activities demand the same focus and interaction as shopping, without requiring a ton of money.

Try cards, board games, crosswords, puzzles, learning a new language, dancing, or playing a musical instrument (just to name a few). These things literally exercise your brain, making you mentally sharper, while preserving one of your mind’s most precious assets: your memory.

But protecting your memory may require more than just mental exercise. You may need to get physical, too.

Walk off your brain fog

Need I say more? Get moving.

A recent study found that walking decreases the risk of dementia by increasing the blood supply to your brain. Researchers observed a group of 2,257 men without dementia, monitoring their walking and exercise habits. When the study ended, scientists realized that the rate of dementia was 80 percent lower among the men who walked the most.

If a walk around the block bores you, many other exercises offer the same benefits. It’s like I always say: The best exercise for you is the exercise you’ll actually do.

Try hiking in a more rugged, tough terrain. Weight training at any age improves health and overall function. You could also try biking, swimming, gardening, chopping wood, or dancing. Take your pick.

Bust stress, boost IQ

Well, not exactly. But now that I have your attention, stress does increase levels of cortisol, a hormone made by the adrenal glands to fight the effects of stress on the body. Cortisol supports your body’s fight-or-flight reaction to a sudden threat. But chronically elevated levels of cortisol can cause several problems, including a noticeable deterioration of your short-term memory.

Cortisol gets into the hippocampus-your brain’s memory department-and gums up the way it works. The best way to prevent this is by reducing stress. How? That’s the easy-and relaxing-part.

Once again, start with a good hobby and regular exercise. Also, deep breathing, meditation, and prayer make excellent foundations for a successful stress-reduction program.

The benefits of these activities are twofold: Not only will you be more able to cope with the stress in your life, you’ll be decreasing the negative effects that stress has on your brain.

Ultimately, reducing stress is about calming down your responses to stressful things. But part of decreasing your stress may lie in how you deal with the cause. If you’re struggling with a lot of personal problems, regular psychotherapy or counseling may be the answer. It’s up to you.

The stress buster that boosts memory, too

I’ve talked about rhodiola rosea, or arctic root, before. This Russian herb is an adaptogen that helps your body adapt to stress and is known to improve memory. It has a long history of safe, effective use and solid research behind it.

Several promising studies demonstrate a clear improvement in the mental performance of folks taking rhodiola rosea while feeling stressed. Of particular interest is a study in which students taking a proofreading test made significantly fewer errors when given the herb. Other studies showed less mental and physical fatigue, improved memory, enhanced sense of well-being, and higher test scores.

Perhaps because rhodiola also reduces cortisol levels, I see good results in folks who are stressed out and tired all the time, but who don’t quite qualify as truly depressed and who don’t have an underactive thyroid.

For instance, my patient Megan was a mildly depressed 89-year-old grandmother with chronic fatigue and a notable lack of get-up-and-go in the morning. She refused to take an antidepressant, fearful of side effects. But after two weeks of taking 200 mg of rhodiola daily, she was back to her usual morning activities–an effect that has lasted so far.

For more information on rhodiola, go back and read the article, “Lose weight, boost energy, and more with the herbal breakthrough of the 21st century,” from the February 2006 issue. As a subscriber, you can download it for free on my Web site if you can’t find your own copy.

The gut-brain connection

Gluten sensitivity is a disorder in which your body reacts badly with foods that contain glutens, mostly grains such as wheat, barley, rye, and oats. I know it seems off the subject, but I bring it up because gluten-sensitive people face an increased risk for Alzheimer’s disease. Symptoms include diarrhea, bloating, gas, abdominal pain, fatigue, and occasional vomiting.

If you’re gluten sensitive and you don’t realize it, all that frequent exposure to gluten products compromises your gut’s barrier function-a defense mechanism that prevents toxins from leaking through your intestinal wall. When that defense mechanism fails, potentially dangerous substances can leak into your system and eventually find their way into your brain, which could cause dementia.

Gluten sensitivity is more common in folks with thyroid disease and diabetes, but even if those aren’t factors for you, it’s worth testing for if you have any of the symptoms I mentioned above.

Even if you’re not gluten sensitive, I recommend taking probiotics-friendly bacteria that support healthy digestive function. Try probiotic-containing foods such as yogurt, kefir-a fermented milk drink similar to yogurt, often flavored with salt or spices-sauerkraut, and fermented soys like tempeh and miso. If none of these foods appeal to you, you can always opt for probiotic supplements. I like the products from PB8, Jarrow, or New Chapter, and usually recommend taking two capsules, three times a day on an empty stomach.

What to eat, what to avoid

The development of Alzheimer’s disease is often associated with too much alcohol (though about one to six drinks a week can be healthy), too much saturated fat from meat and dairy, too much salt, and too many calories. Get the picture? Excess is dangerous.

Moderation is the key. Include healthy foods with antioxidants and trace minerals (your fruits and vegetables). Stick with unprocessed whole grains, lots of fruits and vegetables, healthy fats from olive or canola oil, nuts, moderate amounts of dairy and meat from natural sources, without added hormones or antibiotics. Foods like these protect your brain, your heart, and your whole body. They also slow down the aging process.

If there is one thing to avoid it’s packaged junk full of trans fats (usually labeled hydrogenated or partially hydrogenated oils). The body doesn’t know what to do with these lethal, man-made fats. They incorporate themselves into your cell membranes, including your brain cells, wrecking everything. Just say no!

Fish is by far the best brain food. The DPA and EHA omega-3 fats in fish are essential to healthy, functioning brain cells. But unless you’re eating fish several times a week, or organic, grass-fed meat and poultry, you’re probably not getting enough. I recommend taking a fish oil supplement in addition to upping your intake of food sources. Aim for a minimum of 1 gram of total DHA and EPA per day. Take 500 mg in the morning and again before bed.

Come to think of it, fishing may be the answer to preventing Alzhei-mer’s. You can shop for your gear, get away from it all, take deep breaths of the outdoor air and then go home and feast on your catch. But before you head to the nearest lake, there is one more thing you can try.

Supplements that work

In addition to fishing and shopping, there are a few supplements that can boost your memory and mental function. Here are some of the best options:

• Adequate vitamin B intake, extra daily vitamin C (500 mg), and vitamin E (400 IU) have been shown to help protect your memory. Most high-potency, two-a-day multivitamins cover all bases.
  
• Acetyl L-carnitine (500 to 1,000 mg a day), coenzyme Q10 (30 to 100 mg a day), and alpha lipoic acid (100 to 300 mg a day) all support the mitochondria function in your brain.

  Mitochondria are your cells’ little energy machines, which keep you sharp. They’re also a hot research topic these days.
  

• Phosphatidyl serine is a fatty substance naturally found in brain cells that can help people with mild cognitive impairment and early Alzheimer’s. I recommend 100 mg a day for prevention.
  
• Finally there’s ginkgo, which offers modest benefits to folks with Alzheimer’s and can help preserve memory function in healthy people. Try 80 mg three times per day. I like Nature’s Way Ginkgold. ACD

10 DRUGS you CAN DO WITHOUT

How to do more with less and stay out of trouble

It’s no secret. Large drug companies dominate our healthcare system. It’s a system out of balance, allowing hard cash to take precedence over honest cures.

After all, keep in mind:

• Studies in major peer-reviewed journals are ghostwritten by drug company hired hands.
• Sophisticated, highly coached, and well-paid drug representatives crowd doctors’ offices, plying them with the latest, priciest “me-too” drugs-copies of medications already on the market.
• Spin-doctors massage research results to get the outcome they were aiming for from the beginning.
• Negative results from important studies are often deliberately withheld.
• There are more than 100,000 hospital deaths every year attributed to drugs prescribed correctly. And then there are deaths from prescription errors, which are now the second leading cause of preventable death in this country.

All of this said, you might think that I’m completely opposed to prescription drugs. Not by a long shot.

Prescribed by the right doctor, for the right reasons, prescription drugs can improve and save lives.

But when drugs with life-threatening side effects are used to treat nonfatal diseases, when new duplicate medicines show up offering no significant advantage over existing drugs, when drugs just don’t work very well in the first place, and when there are excellent, safer, natural alternatives, I say it’s time to “just say no!”

While some drugs truly benefit patients, there are still scores of drugs that are best taken off the shelves. I’ve chosen 10 that I think stand out. Here they are, with reasons why:

Crestor

This is a potent, new, cholesterol-lowering statin drug that can cause kidney and muscle damage at higher doses.

Furthermore, the evidence backing up Crestor is inferior when compared to its competitors, and the drugmaker’s own Web site acknowledges that no proof exists that this drug actually prevents heart attacks. This is a cynical attempt by Astra-Zeneca to cash in on the booming statin market. Skip it.

Meridia

Need to lose weight? Here, pop this risky pill and you might lose an extra 6 to 9 pounds in the next year and then regain the weight once you’ve stopped taking it.

Besides Meridia’s general lack of long-term effectiveness, this medication also substantially raises blood pressure and heart rate. The FDA medical officer who reviewed Meridia before its approval wrote, “Sibutramine [Meridia's technical name] has an unsatisfactory risk-benefit ratio, and therefore this reviewer recommends non-approval.”

Guess what? Meridia was approved anyway.

Ketek

This drug is similar to other macrolides, such as erythromycin, clarithromycin, and azithromycin-a group of antibiotics used to treat bacterial infections.

Ketek was approved for cases of strep throat and pneumonia that are resistant to these other macrolide drugs. But the evidence supporting Ketek is slim, and there is concern about liver, heart, and eye problems, which the drug’s manufacturer, Aventis, mentions on its Web site.

To quote the French prescription drug journal Prescrire International, “Telithromycin (Ketek) is a needless addition to the other macrolides.”

Zelnorm

This prescription drug is for constipation-predominant irritable bowel syndrome in women, and only for those under 65.

In fact, studies show only a marginal benefit that comes with significant costs, including an increased risk of diarrhea and colitis. These problems surfaced after FDA approval, and were followed by predictable drug company spin control.

Zelnorm might be okay for a very small number of tough-to-treat cases in the hands of an experienced gastroenterologist who has done a proper nutritional evaluation and given stress-reduction techniques a full trial. Otherwise, forget it.

Tricor

This drug lowers triglycerides and increases good HDL cholesterol in some folks. It is widely used because those problems go along with diabetes, which is epidemic.

While Tricor improves the numbers, the outcome data-such as whether it prevents heart disease and heart attacks-is very weak. Plus, Tricor is potentially dangerous when combined with the oft-prescribed statin drug Lipitor. In truth, fish oil does a better job, is much safer, and offers clearer health benefits. Pass on this one.

Zetia

This new drug lowers cholesterol by interfering with its absorption. Zetia is approved for treating excessively high cholesterol caused by heredity.

Unfortunately it’s being routinely used to play the “cholesterol numbers game” by bringing down the levels, although it has not yet been shown to actually reduce the risk of a heart attack or stroke. When used with popular statin drugs, however, there is increased risk of liver damage. Zetia definitely should not be used with the drugs Tricor or Lopid.

Ultram

Here’s a strange little drug if there ever was one.

Originally developed in Germany, Ultram has been touted in the United States as a non-addictive painkiller. Sorry, but I’ve seen dependence on and addiction to Ultram even in my small community, with an illegal street market to boot. Now, more and more reports are surfacing about the same problems in other places.

The biggest problem with Ultram is an increased risk of seizures, especially when it’s combined with SSRI antidepressants like Prozac, Zoloft, Paxil, Celexa, and Lexapro.

This is a misrepresented drug with clear risks and only modest benefits, at best. Avoid it.

Serzone

This antidepressant has already been withdrawn from drug markets in Europe, Canada, Australia, and New Zealand, thanks to reports that it increases the risk of liver failure.

Serzone could be useful to a few folks in the hands of an experienced psychiatrist. Otherwise, hands-off.

Actos & Avandia

These are widely prescribed drugs for Type II diabetes. While they do a decent job of bringing your blood sugar levels into line, they are no better than other similar drugs.

Actos and Avandia work by increasing your body’s insulin sensitivity. Unfortunately they also often lead to weight gain. Even worse, this medication can exacerbate or even cause heart failure, along with fluid accumulation in the legs, ankles, and lungs. You also need to watch out for liver failure. Instead of taking these drugs, try Glucophage (metformin), which has the added advantage of causing weight loss instead of weight gain in most patients.

Premarin & Prempro

These widely publicized estrogen and progesterone hormone-replacement products are now associated with increased risks of heart problems and breast cancer.

Derived from the urine of penned- up pregnant mares, Premarin and Prempro are a chemical soup that includes a hodgepodge of substances, including a form of estrogen thought to cause cancer. With newer, cleaner, bio-identical formulations now available-including creams that don’t dump a big estrogen load on the liver-these two products are best avoided, except as a last resort. ACD

Snuff out the sniffles

It’s like clockwork. Every spring, my office becomes an orchestra of nose blowing and sniffing. Allergic rhinitis-what most people call the sniffles-is one of the most common problems in town. Many folks struggle for years, never finding adequate relief.

It doesn’t have to be that way. Over the years, I’ve found several thoughtful, broad-based, integrative approaches that can work wonders.

First, let’s define what we’re talking about. Allergies occur in people with genetic tendencies toward symptoms like runny noses, itchy eyes, and sneezing. Environ-mental triggers such as house dust, ragweed, and animal dander usually provoke those symptoms.

Here are some of my favorite common-sense tips for fighting allergies.

Reducing exposure

Seasonal triggers include trees and pollen in the spring, grasses in the summer, and weeds in the fall. Once allergens come out in full force, it won’t take long for them to invade your home, and when they do, sneezes and sniffles will surely follow.

Placing a HEPA filter in your main living area and in your bedroom can help. HEPA stands for “high-efficiency particulate air,” which is just a fancy way of saying it reduces airborne particles and allergens. These filters range in their capabilities and prices–some are very simple and inexpensive, while others have all sorts of bells and whistles and cost hundreds of dollars. My favorite filter-one that I use for my own allergies-is the Fresh Air machine. You can find one at www.freshairmachine.com, and it’s reasonably priced.

You can also minimize exposure to allergens and dust mites by encasing bedding and pillows with specially designed, breathable plastics. This may sound uncomfortable, but these coverings are lightweight and you can cover them with your regular sheets.

Also, because insects carry the pollen that often causes allergies to flare up, keeping your windows shut can keep those culprits out.

The saltwater cure

Daily sinus and throat rinses should be the cornerstone of good sinus health. They reduce symptoms and help prevent infections at a low cost with virtually no side effects.

Over-the-counter saline solutions like Ocean Spray (not the fruit juice), Salinex, and Sinus Survival are cheap and easy to use. Or go a step further and purchase a Waterpik with a Grossan nasal adaptor. The Waterpik was originally intended for dental rinsing until Dr. Murray Grossan, based in California, designed a nasal adapter, making the contraption into a nasal irrigation system. These devices cleanse the nasal passages, flushing out both germs and foreign particles while reducing symptoms. They’re definitely worth the cost and time when it comes to symptom relief.

You can pick up a Waterpik for about $50. Visit www.waterpik.com to locate your nearest Waterpik dealer. The nasal adaptor costs about $17 and can be purchased at www.alerg.com.

One of the more interesting solutions is the neti pot. This simple irrigation device originated in India and is now available in the United States. The neti pot is filled with warm, slightly salted water, and the spout of the pot is inserted into one nostril. By properly adjusting your head, water flows into one nostril and out of the other. Neti pots can be purchased online, and typically cost between $15 and $25.

Now, I know that the idea of putting a neti pot spout in your nose and actually flushing out your sniffles sounds uncomfortable and, to be honest, a little gross. Don’t worry. These devices are not painful, and, despite an initial strange sensation, about on par with getting water up your nose in a swimming pool. It’s uncomfortable at first, but worth the effort.

One tip: When making your own sinus rinse, use 1/4 teaspoon of salt, dissolved into a cup of warm water.

“Weeds” that won’t make you sneeze

If you just can’t stomach the idea of flooding your sinuses to flush out the congestion, there are a few herbs and supplements that can work too. Here are a few I like:

†” Quercetin-an antihistamine found in onions, apples, and green and black teas-is the most effective anti-allergic bioflavonoid. Smaller amounts can be found in leafy green vegetables and beans.

This substance naturally keeps your immune cells from releasing histamine and heparin, both major causes of allergic symptoms. Try 1,000 to 2,000 mg of quercetin, one to three times a day. Jarrow, Now Foods, Source Naturals, and Solgar all offer quality products.

” Stinging nettle (Urtica dioica) is a revered folk remedy for treating asthma and bronchitis. It can also slow down a runny nose and calm sneezing. Take one or two capsules, usually 600 to 800 mgs each, two to four times a day. I like the Nature’s Way product.

” Butterbur (Petasites hybridus) is an effective antihistamine that’s great for hay fever, without causing drowsiness. Try 50 mg two to three times a day. Petadolex is an established and reliable gel-cap formulation of butterbur. It’s available in health-food stores, and there are a lot of Internet sources.

” Grape seed extract is a potent antioxidant and natural anti-histamine that you can add to daily doses of vitamin C (250 mg) and vitamin E with mixed tocopherols (200 IU), which you should already be taking. I use it myself.

Take 50 to 100 mgs daily. I like Activin, a grape seed extract produced by Dry Creek Nutrition, but there are a wide variety of other good products, including Nature’s Made, Vitamin World, Puritans’ Pride, Twin Labs, and Nature’s Way.

The sweet smell of relief

I know Vicks VapoRub  doesn’t sound very scientific, but it works to relieve annoying congestion that typically comes along with allergies. It contains eucalyptus, menthol, and camphor, all of which gently shrink the tiny, swollen blood vessels in your nasal passages. Some products that contain anise and fennel also work.

As a bonus, products containing these substances don’t cause drowsiness or lightheadedness like so many other over-the-counter allergy and cold medications. Even better, these remedies are widely available and inexpensive. Try them for temporary relief, in conjunction with the other remedies described above.

Chicken soup for the nose

There is one more tried-and-true remedy that I always tell my patients to load up on when the sniffles strike: chicken soup. Guess what? It has real, anti-inflammatory effects that have been demonstrated in scientific experiments.ACD

The doctor’s orders for getting rid of your sniffles:

1) Reduce your exposure to allergens with specially designed mattress and pillow covers and a HEPA air filter. And don’t forget to keep those windows and doors shut too. It will keep the allergens-and the critters carrying them-outside where they belong.

2) Rinse your sinuses daily with warm saltwater. If you’re really serious about unclogging your sinuses, consider a neti pot or a Waterpik with a special Grossan nasal adapter.

3) Work on reducing your underlying allergic tendencies by taking fish oil and probiotics.

4) Add grape seed extract to your daily vitamin program for an antioxidant boost.

5) Try quercetin, stinging nettle, or butterbur individually or together. It may take some experimenting, but it’s well worth it to work with a doctor who will help you find out what works for you.

6) Vicks VapoRub (or your choice of inhaled aromatics including camphor, menthol, eucalyptus, fennel, and anise) can help clear your nasal passages, so that you can breathe a little easier while waiting for long-term cures to kick in.

7) Don’t forget your chicken soup!

YOUR QUESTIONS ANSWERED

The down-and-dirty truth about antibacterial soaps

Q.I know hand washing prevents the spread of germs and colds. But I’m confused about the differences between regular soap, antibacterial soaps, and alcohol-based hand rubs. Is one better than the others? Are there any products I should avoid? What do you recommend?

–R.G., Cadiz, OH

A.This may come as a surprise, but washing your hands with regular soap doesn’t actually kill germs. Instead, it loosens and helps remove the bacteria.

Although antibacterial soaps are supposed to kill bacteria, they aren’t any more effective than regular soap and water. In fact, antibacterial products can lead to the development of bacteria that are resistant to antimicrobial agents, making them harder to kill in the future. You’re better off avoiding antibacterial soaps.

Alcohol-based hand rubs or sanitizers are extremely effective at killing germs, don’t require water, and are an excellent alternative to soap and water. Because few people really take the time to wash their hands properly, sanitizers and hand rubs generally do a much better job at killing germs and preventing the spread of disease. One shortcoming, though, is that they aren’t very effective at washing away dirt and debris. You may want to wash your hands with regular soap first, and then apply an alcohol-based sanitizer.

Be careful when purchasing these sanitizers-there is a difference between antibacterial rubs and alcohol rubs. There are also excellent products available now with moisturizers that result in less skin dryness than washing with soap and water.

If you want to thoroughly wash your hands, remember to use soap and water for 15 seconds, then apply an alcohol-based sanitizer.

The text contained herein does not constitute medical advice. America’s Country Doctor advises that you consult your own physician before acting on any recommendations contained within this publication.