Newpharmablog. Health News

There is some inter-conversion between nutrients such as protein being converted to glucose (gluconeogenesis) for release into the bloodstream, but under normal conditions, the capacity to convert one nutrient into another for storage is very limited. Also, humans have little capacity to ‘waste’ extra energy by burning it off. This process, which has been termed luxuskonsumption, is common in animals such as rats but is very limited in humans. Therefore, the examination of each macronutrient as a separate entity is necessary and is summarised below.

Fat. Fat is handled very differently by the body compared to the other nutrients. Body fat stores are large and not actively controlled and fat intake has no influence on its own use as a fuel (oxidation) and very little influence on appetite. Fat (from the diet or adipose tissue) is the energy buffer for the body in that it makes up the difference between what the body obtains from non-fat calories and what it needs to keep functioning. It is the last priority as a fuel. Fat is therefore not balanced at all and in a sense the body is ‘blind’ to fat, both in the diet and in the fat stores when it comes to balancing up its energy needs. Excess fat is therefore the most powerful dietary promoter of weight gain.

Energy balance and fat balance are essentially equivalent. This means that on a day when a person has eaten 200kcal more than they have burned, about 200kcal of dietary fat will be stored as body fat. If a person is 200kcal under, the body will pull about 200kcal of fat out of the fat stores to make up the deficit.

Table 5.1 shows how carbohydrate and protein intakes are fully balanced or regulated (suppress appetite and promote their own oxidation), alcohol intake is only half balanced (promotes its own oxidation only), and fat is not balanced at all. As originally proposed by Professor J-P. Flatt from the University of Massachusetts, a high-fat diet therefore tends to lead to a passive over-consumption of calories which may become chronic because of the weak or absent metabolic controls on fat balance.’

All this implies that a reduction of fat in the diet is all that is required for reducing body fat. There are certain advantages and disadvantages of this approach, as opposed to the old notion of calorie counting. Reducing fat, for example, doesn’t feel like ‘dieting’ and is therefore much easier than total food restriction. However, there is a perception that a low-carbohydrate diet is more effective because much of the weight lost is fluid which occurs relatively quickly. In a low-fat diet, the loss is slower but is more likely to come from fat than fluids. The low-fat approach also allows large volumes of food to be eaten with a minimum of restrictions, hence not resulting in the problems of hunger which occur with normal ‘diets’. In general, this whole approach leads us away from the traditional notion of calorie counting to one of ad libitum low-fat eating—a much more practical and effective approach to fat loss.

*54\186\4*

Tuberculosis is a serious destructive infection of the lungs. In years past it was a significant cause of death in the community. But in recent times, with improved conditions and especially with improved forms of treatment, it is now rarely seen. However, it must never be dismissed, for it still exists in this country, and every year in recent times increasing numbers of cases have been diagnosed. Often cases may smoulder on for many weeks, months or years, undiagnosed simply because nobody ever thought to look for it.

The disease is transmitted from an individual with an active lesion in the lungs. It travels via droplets of moisture in the air, which are inhaled by another person; and the germ can then set up a slow insidious infection in the new victim. Most likely contact is an adult living in the same home, a parent, grandparent or domestic help. Many recent cases of migrants have been diagnosed, and they would appear to be particularly susceptible.

Early symptoms may be mild or often non-existent. Most cases are found by chance or when contacts of an adult patient are being checked out for possible spread of the disease. Vague general symptoms may be fatigue for no obvious reason, feeling generally off-colour, weight loss, lack of appetite. A cough, typical in adults, may be present in infants though is often absent in children.

Infections occurring in children under the age of three years may be serious. It may also be serious in adolescents, more so than at other periods of childhood.

Treatment

Frequently lesions heal and are not discovered for a long time afterwards (probably on a chance chest X-ray indicating that T.B. had occurred). However, once detected, full and complete medical treatment is essential. This must be under the supervision of a major clinic, usually attached to a big hospital, geared for this problem. Today drug therapy has completely changed the outlook for patients with tuberculosis. Once a common fatal disease, chemotherapy can now completely reverse the disease and the outlook for the future. Nevertheless, adhering exactly to the regimen outlined by the doctors is essential.

*78\87\2*

Infants and children invariably go through stages of being shy, timid and fearful. Shyness usually starts early in life, frequently in the 5-6 month age group. The infant is starting to differentiate between people, starting to know who are strangers and who can be trusted. Some scepticism is good and is part of the natural protective element. If the condition is ridiculed or brought into prominence, particularly as the child becomes older, it will tend to worsen, not improve. Sensible handling by an understanding parent can often help the youngster overcome the problem.

Many children are naturally timid and fear such things as darkness, being left alone or deserted; they may fear being isolated, be scared of noises, animals or machines. The list is long. Fear is contagious. The more a person dwells on it, the worse it becomes. The reverse, happily, is also true. Courage and fortitude are also contagious and gradually improve with encouragement.

Treatment

Understanding by parents in these situations is essential. Most fears can be overcome, and so can shyness. All should be tolerated by parents, given understanding and help. Efforts should be made to increase the child’s confidence.

Showing a little girl that her fears are ungrounded, and that there is usually nothing to be fearful of, assists. For instance, darkness is simply the same as day with the light removed. She is safe by day, and she will similarly be safe by night. Supply a light in her room if her fears are great, and this will gradually let her know that darkness is not really the big bogey she had believed.

Etch words of comfort, safety, well-being and confidence into her subconscious mind as often as possible. Tell her reassuring stories, particularly at night when the fears may be at their highest level. Avoid disastrous stories in which danger or defeat are the main features.

*29\87\2*

Parkinson’s disease is named after the doctor who first identified it in the early nineteenth century. It is also known as paralysis agitans and shaking palsy. The disease, which affects the nervous system, has a slow onset and usually occurs in people over sixty, although some cases occur as early as forty.

Parkinson’s disease is caused by a degeneration of the basal ganglia of the brain, and particularly the corpus striatum and the substantia nigra. These areas of the brain regulate voluntary movement and in Parkinson’s disease there is a lack of the neurotransmitter dopamine. Debilitating symptoms appear when only twenty to thirty percent of dopamine neurons remain.

The sufferer may first notice mild tremors in the hands and involuntary nodding of the head. Bodily movements become slower and more difficult. As the disease progresses, stiffness and tremors increase until walking is reduced to a shuffle and the facial muscles become set in a fixed expression. While the intellect remains unaffected, mood swings do occur. Parkinson’s disease is more common in men than in women. The disease was either unknown or undiagnosed before the industrial revolution and its incidence has risen markedly in the last 170 years. The disease does not seem to have a genetic aspect, and the fact that it is more common in industrialised countries than developing nations has led some to believe that it may be caused or exacerbated by chemical pollution. Others claim that iodine deficiency and excessive sodium intake may be causal factors.

The treatment of Parkinson’s disease is essentially symptomatic. The drug Levodopa is administered to increase dopamine levels in the brain and thus reduce tremor. Because Levodopa has some potentially harmful side-effects, treatment with the drug is often only intermittent. Vitamin E is recommended to slow the progress of the disease and antioxidants are considered to be beneficial.

*28\69\2*

We are witnessing a burgeoning of interest in herbal medications, as well as evidence of St John’s Wort at work for men and women with a wide variety of different problems and in different situations. Some are taking it on their own, others at the recommendation of herbalists and practitioners of alternative medicine, and yet others, in numbers almost certain to increase, as part of the regimen set out for them by their doctors. What kind of people are using the herbal remedy? What sort of ailments are they treating with it and to what effect? These are some of the questions I have sought to answer in this chapter and the next.

As research has shown, St John’s Wort can be effective in the treatment of major depression. Yet, just as with anti-depressants, its use and value very likely extend far beyond the confines of that single clinical syndrome. As the stories in this chapter illustrate, St John’s Wort, though mild in its side-effect profile, has powerful and far-reaching beneficial effects which makes it the gentle giant of our herbal pharmacopeia. Its value in the treatment of less severe problems – the heartaches, stresses and ailments of everyday life – are chronicled in the chapter that follows. Although I have changed the names and some identifying details to maintain the privacy of those described, the essential elements of their stories are authentic.

For the benefit of sceptics, perhaps it is fitting that our first story should be that of a man who was successfully treated for his depression without his knowledge. Meet Sam, a depressed solicitor, Sylvia his concerned wife, and her close friend, Louise, a woman of great resourcefulness who happens to be a patient of mine.

*4\75\2*

Barry Carter was a terror. At eight years of age, he had been a difficult child for as long as his parents could remember. For years he had thrown temper tantrums whenever he could not get his way, but when the family moved into a new house he became increasingly tired, listless, and irritable. When Barry started school that September, all his problems came to the fore. After three miserable months in school, at home, and in the neighborhood, Barry was brought to me.

That winter, Barry had gotten into the habit of kicking his mother in the shins and placing all responsibility for his problems on the poor woman. He terrorized and beat up his younger “playmates” both at school and on the street. The principal and other school officials declared that he not only was unreachable, but that his irritability, hyperactivity, and uncontrolled behavior disturbed the entire class. The school urged the parents to remove Barry from school and take him to a psychiatrist. Their theory was that Mrs. Carter had “rejected and dejected” her son. He was put on Ritalin, a drug often used to treat hyperactivity. The parents had tried this psychiatric route; they also had tried spanking him repeatedly. Nothing seemed to work.

Several interesting facts emerged from his history. One tell-tale clue was that Barry’s symptoms were always accentuated in winter. In particular, he had become increasingly disrespectful, hostile, and sassy since the beginning of the heating season. This suggested a chemical cause—particularly, something connected to the home heating system. Upon learning that an auxiliary gas-fired space heater had been installed in his bedroom the previous summer, it was recommended that he exchange rooms with his older sister. Although his behavior improved, he still remained too hyperactive and distraught to read with any comprehension.

By this point, the child and his mother were not even talking to each other. An experiment was tried, to see how the child would react to a new environment. He went with his grandmother, to stay in a hotel room, which was free of those environmental chemicals which frequently cause or perpetuate chronic symptoms.

Within the first three days of fasting, drinking only spring water, and taking no drugs, Barry’s pulse decreased from 90 to 70 (an increased pulse is often a sign of allergic reactions). Barry now read incessantly, the first time he had been able to do so in months. After completing a battery of food allergy tests, he returned to his home city, on good terms with his mother. Upon returning to school directly from the hotel, he apologized for his past behavior and asked for makeup work. However, that afternoon upon returning home for the first time, he developed a headache. By the following morning he was tired, listless, pale, and puffy around the eyes, and within three days had returned to his previous level. For example, upon arising he ripped his favorite Boy. Scout uniform to shreds, kicked the baby, and attacked his mother.

His parents removed the gas space-heater from his room but did not change the gas-fired hot-air system which heated the entire house. Thus, although his symptoms improved greatly that summer, they were back in full force when the heat was turned on again in the fall.

Changing the gas-fired system for an all-electric heating and cooking system brought about a complete change in Barry’s behavior. His hyperactive, irritable, and destructive traits disappeared. He remained quite well, only suffering relapses when exposed to other sources of gas outside the home, or to heavy smog or pollution.

He was suffering from the chemical-susceptibility problem, which was mainly exhibited as a plus-two hyperactive reaction to environmental chemicals, particularly gas.

*57\110\2*

One of the most ironic features of the chemical-susceptibility problem is that it is often begun, or at least perpetuated, by doctors themselves. To a large degree it can be considered an iatrogenic illness, that is, one that is induced by medical treatment.

The vast majority of drugs are synthetic and almost all of these contain petrochemical derivatives. Not infrequently, a patient who is unknowingly susceptible to petrochemicals will go to a conventional doctor for treatment. Let us say that the patient’s problem is headache, caused by exposure to natural gas, synthetic fibers, and fumes.

The doctor diagnoses the headache as being stress-related, and tells the patient to try to relax more. In addition, he prescribes a pain-killer containing aspirin and other synthetic substances. When the patient takes this pain-killer, however, he may aggravate his already existing susceptibility to chemicals. In other words, instead of getting better, in the long run his headache problem may become worse. In addition, now he begins to suffer from mental confusion. Because of the increasing chemical load, he has moved, at least temporarily, from a minus-two category to a minus-three.

And so he returns to the physician, complaining of fatigue and possibly depression or “brain-fag,” as well as intensified headache. The physician, not seeing the root cause of the problem, prescribes stronger drugs and advises the patient to take a vacation or see a psychologist. The stronger drugs bring on other reactions and visits to other specialists, in a downward spiral of symptoms and misguided treatments. By this point, the effects of the original chemical exposures have become more burdensome, since chemicals react in a cumulative fashion.

The patient may suspect that the doctor’s prescription pad is the cause of some of his reactions, but he rarely suspects the full extent of problem. Consequently, even a cessation of all medication is unlikely to bring complete relief. The patient muddles along, with temporary improvements and persistent relapses in a generally downward course. The result is usually a frustrated physician and a patient who has become a very bitter dropout from the conventional medical system. This problem is especially serious because in recent years there an explosion in the use of drugs as medicines in industrialized countries. Sales of prescription drugs alone, at the wholesale level, total over $9 billion United States. This figure is practically double what it was a decade ago. Some of these drugs, of course, have been highly useful, even lifesaving, they have been misused and overprescribed, especially to those who are susceptible to their effects.

It is generally well known that drugs can, and often do have serious side effects. Usually, however, these well-publicized side effects are of the kind: they bring on an immediate and highly visible reaction. As with allergies to rarely eaten foods, allergies to uncommonly encountered drugs are fairly easy to detect. If a person with little exposure to penicillin develop an allergy to it, the physician who dispensed the medication can usually tell that a is taking place. Treatment then consists in finding an acceptable I and avoiding penicillin.

Acute reactions to drugs, however, are only the tip of the iceberg. Often a drug will initiate or complicate a general intolerance for synthetic chemicals in the patient. These reactions are difficult to detect, since they come On insidiously. Usually, neither the patient nor the physician connects the heightened symptoms with the drug. The effects of the drug merge into the general background of chemical exposures.

All drugs, no matter how innocent they seem, can have side effects. The reactions may be caused by the active agent in the drugs, but they also can caused by hidden ingredients such as flavorings, colorings, preservatives and excipients, which are binders used in the manufacturing process. Few people realize the complexity of most drugs or the number of ingredients they contain. The ingredients of pharmaceuticals are rarely given on the label. An investigation of one over-the-counter preparation of synthetic vitamins revealed the presence of dozens of chemicals. In addition to seventeen vitamins and minerals the pills contained calcium stearate as a lubricant, gelatin, sugar, sodium benzoate (a preservative), calcium stearate (a lubricant), calcium sulfate, wax, carnauba wax, sesame oil (polishing), Blue Dye N0 2, Yellow Jjj 5, Yellow Dye No. 6, titanium dioxide, polyvinyl pyrolidine, and edible white ink.

Many of these substances cause allergic reactions in susceptible individuals even in such minute amounts. So-called natural vitamins also contain many excipients and additives. While some of these are made from vegetable sources, one can develop susceptibilities to them as well. In general, I urge patients to get their needed vitamins through eating wholesome foods in rotation, according to the principles of the Rotary Diversified Diet.

The first examination of the role of additives in drug reactions was carried out by Dr. Stephen D. Lockey of the Lancaster General Hospital in 1948. Dr. Lockey reported four cases of hives and three cases of asthma caused by additives in drugs. Lockey’s patients became sick when they were given various pharmaceutical preparations which contained petrochemical products. When they were given pure preparations, without these petrochemical additives, they did not become sick. A 58-year-old woman, for example, with a long history of allergies, had frequent attacks of rash and itching. It was eventually learned that these attacks came within half an hour after she had taken synthetic vitamins and an estrogen, a drug used to counteract the effects of the menopause. The only thing that the two capsules had in common was that they both contained Yellow Dye No. 5, a Food and Drug Administration approved coloring. When this patient washed the dye off the two capsules, she was able to use the pills without trouble.

Another patient, a 53-year-old man, took one teaspoonful of elixir of Phenobarbital. This brought on an attack of itching, hives, and swelling around the mouth. The drug preparation was colored with the now-banned Red Dye No. 2. In fact, any drug or food containing this dye brought on the same symptoms. The man was able, however, to take sodium phenobarbital tablets without trouble, since the pill form of the drug did not contain any dye.’

These are not isolated cases. In my first study of this topic in 1952, I found that over fifty percent of chemically susceptible patients reacted to aspirin and that, in a slightly different group, fifty percent reacted to sulfonamide. This was before the extent of the chemical-susceptibility problem had been worked out and, in particular, before the natural-gas problem was realized to exist. Most chemically susceptible patients are susceptible to synthetic drugs and, in general, the more advanced and long-standing the problem, the greater the number of drugs which are related to such problems.

Although it is best to obtain vitamins from fresh organic food, it should be noted that chemically susceptible patients who take supplements generally react worse to synthetically derived vitamins than to those of natural origin. This is so despite the fact that the two substances seem to have identical chemical structures. Vitamins prepared from food sources may also cause allergic reactions. For instance, Vitamin B1 prepared from wheat often reacts specifically. Vitamin C may cause reactions in some patients allergic to corn, as the synthetic product is made from com sugar.

In sum, reactions to drugs in susceptible people may occur to the active chemical ingredients, their bases, artificial colors, scents, preservatives, or other chemical ingredients or contaminants. In view of the number of such possibilities, involving both synthetic and natural ingredients, it is often difficult to trace reactions to the responsible material or materials. At times, combinations of ingredients and circumstances give rise to reactions.

*27\110\2*

A dislocated hip occurs when the thigh bone is out of its proper place in the hip socket. Before or after birth, a baby’s hip socket may develop too shallowly. Eventually, the thigh bone (femur) dislocates from the socket, either before or at the time the child begins to stand and walk. The condition may occur on one side or on both sides. The cause is not certain, although some cases seem to be inherited. Other cases seem to be caused by an abnormal position of the infant’s legs in the uterus before birth.

If the hip condition is not diagnosed until after dislocation has occurred, correcting it is more difficult. If it is not corrected before the child walks, the child will limp if the dislocation is in only one hip. The child will waddle if the dislocation is on both sides.

Signs and symptoms

If the condition is in only one hip, parents may notice that the infant moves one leg more than the other. The folds of the buttocks or the creases on the sides of the groin may not match. A child who is already walking may limp or waddle.

Home care

There is no home treatment until the condition is identified by a doctor. Dislocation of the hip(s) is a disabling condition if not treated early and properly. If you see any signs of hip problems, see your doctor as soon as possible.

Precautions

• Be sure that your baby is thoroughly examined (while completely undressed) at regular visits to the doctor. Your doctor should examine the hips at each visit until the baby is older than one year.

• If the child’s legs are not the same (in size, shape, position, or movement), tell your doctor.

Medical treatment

Your baby should be carefully examined for dislocated hips during each checkup. A doctor will suspect dislocation if any of the early signs and symptoms appear. The doctor will then check the ability of the thighs to be rotated outward. The doctor will also listen for a “clunking” sound which a dislocated hip makes when put through a certain series of movements. Your doctor will order X rays of both hips if the disorder is suspected.

The diagnosis is not usually made at birth, but the condition becomes more obvious with passing months. As soon as the diagnosis is made, you should consult an orthopedic specialist. If the hip is not yet dislocated, the doctor will treat the child with a special pillow positioned to keep the thighs spread or with a body splint or cast. If the hip is already dislocated, surgery may be required.

If both you and your doctor are alert, the problem can be noticed early. Early diagnosis is the key to easier treatment and perfect, permanent results.

*52/84/5*

If you wait for something funny to happen to lift your spirits and lengthen your life, you may be frowning a long time. In these serious times, you have to be proactive about soliciting joyfulness, says Dr. Lee Berk of Loma Linda University School of Medicine. “You have to push your behavior,” he says. “When you do, your brain chemistry will change and your emotions will follow.”

For just such down-in-the-dumps situations, he suggests keeping a well-stocked arsenal of laugh-makers on hand. His humor apothecary would include:

* A joke book. Anything by Dave Barry or Rodney Dangerfield. But really, select the humor that humors you.

* A collection of comedy videos, such as any of Robin Williams’s live performances. But again, it’s your call.

* Funny films. Once again, the choice is yours. Dark humor like The War of the Roses might fit the bill on certain occasions, while National Lampoon’s Animal House or the Marx Brothers golden oldies could elicit guffaws on others.

* A little red clown’s nose. For real. Go buy one at a costume shop. Put it on and look in the mirror. If that doesn’t crack you up, nothing will. As for wearing it in public, we take no responsibility for the repercussions.

* Mad magazine. Is there a man alive who secretly or quite publicly did not go through pre-and post-adolescence reading the borders of Mad behind his biology textbook? And, now more than ever, we could all learn from Alfred E. Neuman’s motto: “What, me worry?”

*59/36/5*

Normally, if you are to have an operation for breast cancer, you will be admitted to hospital the day before, to allow time for blood tests and a chest X-ray to be done. Bone scans, liver scans and other specialized ’screening’ investigations are no longer carried out for all patients.

There has been a trend over the last few years to move away from the very radical operations performed at the beginning of this century and well into the 1950s and 1960s. These operations included removal not only of the breast but also of the muscles of the chest wall and all the draining lymph nodes. It was thought that removal of all the lymphatic drainage gave a better chance of cure. With the introduction of radiotherapy and the realization that such excision was not necessary for all women, there was a trend towards much smaller operations including conservation of the breast. Nevertheless, there is a very wide spectrum of treatment from a surgeon’s point of view – and many conflicting ideas.

Wide lump excision

A modification of this operation used to be known as a segmental quadrantectomy.

A wide lump excision involves the removal of the cancerous lump together with at least a 2-cm (3/4-inch) margin of normal breast tissue, and usually an ellipse of skin from over the lump. Some lymph nodes are also removed from the armpit for staging to give some idea of whether the disease has spread beyond the breast. A separate incision may be needed for this.

Wide lump excisions are really only useful for small cancers, up to 2 cm (3/4 inch) in size, in the upper outer quadrant of the breast. This method tends to have rather poor cosmetic results for the removal of larger lumps, or lumps in other quadrants of the breast.

The operation performed on its own with no adjuvant treatment is associated with a high rate of recurrent cancer in the wound or around the scar. It has, however, been shown unequivocally that this operation combined with ‘field’ radiotherapy to the remaining breast tissue and to the lymphatic drainage in the armpit, above the collar bone and by the breastbone, is equivalent to doing a mastectomy. Conservative treatment of this sort can leave a very acceptable result, with a normal-looking and normal-feeling breast and nipple.

When wide lump excisions are performed for lumps in the centre or in the lower or inner half of the breast, they can give very disfiguring cosmetic results, except perhaps in a very large breast.

*38/39/5*