Sunday, February 28, 2016

Here is why your pills don’t work

By: Dr. Alan Christianson

You know how people talk about being thankful for major diseases because of some lesson they learned? Have you ever heard that and thought, “Yeah, right, I’d just as soon skip that lesson.” Here is one I’m glad I did learn, albeit the hard way.

I learned how to take pills. I planned a list of pre- and post-surgical supplements to help me repair and get the general anesthesia out of my brain. Since there were so many surgeries back to back, I didn’t want to miss a single pill. Most pills don’t work because we don’t take them regularly.

I’ve never taken large numbers of pills before and I really didn’t have a system. So, I read a few dozen papers on the topic of ‘medication adherence’ and built a system.

It amazed me what a problem this was. Would you believe that people who were told if they missed their pills that they would die of a stroke still could not take it regularly? The graph below represents how successful adults were with taking medication to prevent the risk of a second stroke. By two years out, most have quit their treatment. [1]

Some things that make it worse include how many pills you take and how often you take them. The graph below shows how adding pills lowers the odds of people regularly taking two different medications based on how many other pills they were taking. The line with the circles shows that only about 30% took both pills regularly, with regularly being defined as 80% of the time. [2]

How often you take pills can also be a factor. More than once daily is much harder than once daily; four times daily is the hardest of all. [3]

How can you do better? Create a weekly pill ritual for yourself. Since we are all creatures of habit, good and bad, you may as well use this fact to your advantage. Here is my ritual.

I set aside 15 minutes each Sunday afternoon at 4 pm. Another block can work but the idea is you want a period of time in your week in which nothing else important will intrude and you’re not pressured with other tasks or obligations.

Set this up as a recurrent event so it happens each week even if you don’t think about it.

Here is what to do with that 15 minutes:

1. Write – I created a list of non prescription and prescription pills I was taking. Include dosage, potency, how often to take, whether to take with or without food, how long to stay on, and what are they for. Below is a table with sample entries.

2. Review – Once the list was written, I did not have to rewrite it each week but I do review it and update it.

3. Refill – I check my supplies and reorder anything that was going to run out within the next two weeks or set a reminder to pick it up from my office the following day.

4. Restock – I refill my weekly pill box. I’ve got one that is just big enough for each day’s pills and allows me to take a few days worth of pills out separately so I don’t have to bring the whole box when I travel.
Pill organizer

An easy way is to set the bottles all on one side of it and move them one at a time to the other side as you place the pills in the bins. Sometimes they look the same and you can’t tell otherwise which ones you already put in yet and which ones you did not.

5. Remind – I do a pretty good job at my breakfast pills. If I don’t eat at home on a given evening, I’ll take the evening’s pills in my pocket or in a snack-sized bag. If you are not yet in a rhythm, find a reminder system and make sure it is set for the week. Lots of apps are available that do this well.

rxmindme

Look ahead and make sure your alarms are all set for the right times. Revise if your current system is not working for some reason.

If you really can’t remember, get a pill box with a built-in reminder.

pill organizer with alarm

Once you get this rhythm down you will find pills are no longer a source of stress. You might be amazed how much benefit you can get from simple steps when you are able to do them consistently.

Along with recovering faster than expected from surgery, I had a bonus win. My stylist told me my hair has gotten much thicker since I started this habit!

[1] Brown M.T., Bussell J.K. Medication adherence: WHO cares? Mayo Clin. Proc. 2011; 86:304–314.
[2] Brown M.T., Bussell J.K. Medication adherence: WHO cares? Mayo Clin. Proc. 2011; 86:304–314.
[3] Brown M.T., Bussell J.K. Medication adherence: WHO cares? Mayo Clin. Proc. 2011; 86:304–314.

(c) 2015- Integrative Health Care, PC

Would you like to use this article? You may as long as you use the following information along with the article:

Dr. Alan Christianson is an Arizona-based Naturopathic Physician who helps people overcome adrenal and thyroid disorders and achieve lasting fat loss. He authored the New York Times' bestselling Adrenal Reset Diet, and The Complete Idiot’s Guide to Thyroid Disease. Dr. Christianson is the founding physician behind Integrative Health.

Dr. Christianson can be reached at www.MyIntegrativeHealth.com, www.DrChristianson.com and 480-657-0003.

Sunday, February 21, 2016

Should You Be Taking Fish Oil?

By: Dr. Alan Christianson

IS FISH OIL HARMFUL?

One of my closest friends just asked me if I give my kids fish oil. He sent me a link to a video that was ripping on fish oil. It completely shocked me.

Based on two studies, the writer implied that fish oil was bad for everyone. One of the studies was of poor quality fish oil products in New Zealand and was unpublished. The other questioned how well fish oil prevented second heart attacks in diabetics on multiple medications.

Yes, I do give my kids fish oil. Mind you, my son loves oysters and sardines, and my daughter loves sushi. Nonetheless, I consider it cheap insurance for their brains. A mackerel a day might keep the doctor away, but even kids who like seafood can use a little extra.

For kids, fish oil has been shown to:

improve cognitive function in school-aged children[1]
prevent childhood asthma[2]
lower risk of influenza[3]
improve ADHD[4]
reduce airborne allergies[5]

As an athlete in recovery, I also take fish oil. It’s been shown to reduce delayed onset of muscle soreness and allow for faster recovery from exercise.[6] It’s also been shown to lower inflammation, reduce muscle damage, and improve metabolism.[7] That means I get more out of exercise, recover faster, and am less apt to get sick or injured.

As a doctor who gives medical advice, I definitely recommend fish oil.

A group of Harvard researchers did a comprehensive review on the top 12 preventable causes of death in the United States. The eighth most powerful way to reduce your death risk was to consume adequate amounts of omega-3 fats.[8]

Along with reducing preventable death, fish oil supplementation has been shown to:

reduce the risk of mortality from cancer[9]
help weight loss[10]
lower triglycerides[11]
help collagen production[12]
reduce the risk of Alzheimer’s disease[13]
raise HDL (good cholesterol)[14]
help knee osteoarthritis[15]
prevent childhood asthma[16]
improve insulin sensitivity[17]
improve heart failure[18]
shorten hospitalization post-surgery[19]
lower blood pressure[20]
reduce postpartum depression[21]
improve rheumatoid arthritis[22]
lower breast cancer risk[23]
improve male fertility[24]
reduce psoriasis[25]
help bipolar mood disorders[26]
reduce anxiety[27]

How much fish oil should you take?

The average American consumes only 100–200 mg of omega-3 fats.[28] Most experts recommend a minimum of 500–1000 mg daily for basic health.[29]

For general health maintenance, I recommend 1000 mg of combined EPA and DHA. Dosage ranges for some conditions above were from 1000–20,000 mg.

How do you take fish oil?

Since the nutrients in fish oil are fat soluble, fish oil is best absorbed with a meal. The time of day is not important, and fish oil can be safely taken with other non-prescription compounds. Check with your doctor or pharmacist regarding combining fish oil with prescription medications.

What types of fish oil are best?

The triglyceride form is preferred over the ethyl ester form since it’s easier to absorb and less apt to form free radicals. Better types are distilled, filtered, and tested for contaminants like heavy metals, PCBs, and organopollutants.

What about omega-3 oils from algae, krill, or calamari?

These are safe and may be effective. The main disadvantage is they are less cost effective. Case in point: Krill oil averages 12 times the cost of fish oil in terms of cost per mg of EPA.[30] Most krill oil products require 10-20 gel caps for one day’s dose.

[1] Stonehouse W, “Does consumption of LC omega-3 PUFA enhance cognitive performance in healthy school-aged children and throughout adulthood? Evidence from clinical trials,” Nutrients, 2014 Jul 22;6(7):2730-58, doi: 10.3390/nu6072730.
[2] Yang H, Xun P, He K, “Fish and fish oil intake in relation to risk of asthma: a systematic review and meta-analysis,” PLOS One, 2013 Nov 12;8(11):e80048, doi: 10.1371/journal.pone.0080048, eCollection 2013.
[3] Imai Y, “Role of omega-3 PUFA-derived mediators, the protectins, in influenza virus infection,” Biochimica et Biophysica Acta, 2015 Apr;1851(4):496-502, doi: 10.1016/j.bbalip.2015.01.006, Epub 2015 Jan 22.
[4] Gow RV, Hibbeln JR, Parletta, “Current evidence and future directions for research with omega-3 fatty acids and attention deficit hyperactivity disorder,” Current Opinion in Clinical Nutrition and Metabolic Care, 2015 Mar;18(2):133-8, doi: 10.1097/MCO.0000000000000140.
[5] Miyata J, Arita M,”Role of omega-3 fatty acids and their metabolites in asthma and allergic diseases,” Allergology International, 2015 Jan;64(1):27-34, doi: 10.1016/j.alit.2014.08.003, Epub 2014 Oct 27.
[6] Lembke P, Capodice J, Hebert K, Swenson T, “Influence of omega-3 (n3) index on performance and wellbeing in young adults after heavy eccentric exercise,” Journal of Sports Science and Medicine, 2014 Jan 20;13(1):151-6, eCollection 2014.
[7] Mickleborough TD, “Omega-3 polyunsaturated fatty acids in physical performance optimization,” International Journal of Sport Nutrition and Exercise Metabolism, 2013 Feb;23(1):83-96.
[8] Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, et al (2011), ”Correction: The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors,” PLOS Med, 8(1): 10.1371/annotation/0ef47acd-9dcc-4296-a897-872d182cde57.
[9] Bell GA, Kantor ED, Lampe JW, Kristal AR, Heckbert SR, White E, “Intake of long-chain ω-3 fatty acids from diet and supplements in relation to mortality,” American Journal of Epidemiology, 2014 Mar 15;179(6):710-20. doi: 10.1093/aje/kwt326. Epub 2014 Feb 3.
[10] Buckley JD, Howe PR, “Long-chain omega-3 polyunsaturated fatty acids may be beneficial for reducing obesity-a review,” Nutrients, 2010 Dec;2(12):1212-30, doi: 10.3390/nu2121212, Epub 2010 Dec 9.
[11] Narla R, Peck SB, Qiu KM, “FPIN's Clinical Inquiries. Fish oil for treatment of dyslipidemia,” American Family Physician, 2014 Feb 15;89(4):288, 290.
[12] Hankenson KD, Watkins BA, Schoenlein IA, Allen KG, Turek JJ, “Omega-3 fatty acids enhance ligament fibroblast collagen formation in association with changes in interleukin-6 production,”Proceedings of the Society for Experimental Biology and Medicine, 2000 Jan;223(1):88-95.
[13] Loef M, Walach H, “The omega-6/omega-3 ratio and dementia or cognitive decline: a systematic review on human studies and biological evidence,” Journal of Nutrition in Gerontology and Geriatrics, 2013;32(1):1-23, doi: 10.1080/21551197.2012.752335.
[14] Narla R, Peck SB, Qiu KM, “FPIN's Clinical Inquiries. Fish oil for treatment of dyslipidemia,” American Family Physician, 2014 Feb 15;89(4):288, 290.
[15] Peanpadungrat P, “Efficacy and Safety of Fish Oil in Treatment of Knee Osteoarthritis,”Journal of the Medical Association of Thailand, 2015 Apr;98 Suppl 3:S110-4.
[16] Yang H, Xun P, He K, “Fish and fish oil intake in relation to risk of asthma: a systematic review and meta-analysis,” PLOS One, 2013 Nov 12;8(11):e80048, doi: 10.1371/journal.pone.0080048. eCollection 2013.
[17] Wu JH, Cahill LE, Mozaffarian D, “Effect of fish oil on circulating adiponectin: a systematic review and meta-analysis of randomized controlled trials,” The Journal of Clinical Endocrinology and Metabolism, 2013 Jun;98(6):2451-9, doi: 10.1210/jc.2012-3899, Epub 2013 May 23.
[18] Xin W, Wei W, Li X, “Effects of fish oil supplementation on cardiac function in chronic heart failure: a meta-analysis of randomised controlled trials,” Heart, 2012 Nov;98(22):1620-5, doi: 10.1136/heartjnl-2012-302119, Epub 2012 Jul 3.
[19] Wei C, Hua J, Bin C, Klassen K, “Impact of lipid emulsion containing fish oil on outcomes of surgical patients: systematic review of randomized controlled trials from Europe and Asia,” Nutrition, 2010 May;26(5):474-81, doi: 10.1016/j.nut.2009.09.011, Epub 2010 Jan 29.
[20] Yang H, Kenny A, “The role of fish oil in hypertension,” Connecticut Medicine, 2007 Oct;71(9):533-8.
[21] Jans LA, Giltay EJ, Van der Does AJ, “The efficacy of n-3 fatty acids DHA and EPA (fish oil) for perinatal depression,” The British Journal of Nutrition, 2010 Dec;104(11):1577-85. doi: 10.1017/S0007114510004125, Epub 2010 Nov 16.
[22] James M, Proudman S, Cleland L, “Fish oil and rheumatoid arthritis: past, present and future,” The Proceedings of the Nutrition Society, 2010 Aug;69(3):316-23, doi: 10.1017/S0029665110001564, Epub 2010 May 28.
[23] Fabian CJ, Kimler BF, Hursting SD, “Omega-3 fatty acids for breast cancer prevention and survivorship,” Breast Cancer Research, 2015 May 4;17:62, doi: 10.1186/s13058-015-0571-6.
[24] Safarinejad MR, Safarinejad S, “The roles of omega-3 and omega-6 fatty acids in idiopathic male infertility,” Asian Journal of Andrology, 2012 Jul;14(4):514-5, doi: 10.1038/aja.2012.46, Epub 2012 Jun 4.
[25] Balbás GM, Regaña MS, Millet PU, “Study on the use of omega-3 fatty acids as a therapeutic supplement in treatment of psoriasis,” Clinical, Cosmetic and Investigational Dermatology, 2011;4:73-7, doi: 10.2147/CCID.S17220. Epub 2011 Jun 20.
[26] Fristad MA, Young AS, Vesco AT, Nader ES, Healy KZ, Gardner W, Wolfson HL, Arnold LE, “A Randomized Controlled Trial of Individual Family Psychoeducational Psychotherapy and Omega-3 Fatty Acids in Youth with Subsyndromal Bipolar Disorder,” Child Adolescent Psychopharmacology, 2015 Dec;25(10):764-74, doi: 10.1089/cap.2015.0132.
[27] Ross BM, “Omega-3 polyunsaturated fatty acids and anxiety disorders,” Prostaglandins, Leukotrienes, and Essential Fatty Acids, 2009 Nov-Dec;81(5-6):309-12, doi: 10.1016/j.plefa.2009.10.004, Epub 2009 Nov 10.
[28] Kris-Etherton PM, Taylor DS, Yu-Poth S, et al, “Polyunsaturated fatty acids in the food chain in the United States,” The American Journal of Clinical Nutrition, 2000; 71 (1 Suppl): 179S–188S.
[29] Meyer BJ, “Are we consuming enough long chain omega-3 polyunsaturated fatty acids for optimal health?” Prostaglandins, Prostaglandins, Leukotrienes, and Essential Fatty Acids, 2011 Nov;85(5):275-80, doi: 10.1016/j.plefa.2011.04.010, Epub 2011 May 14.
[30] “Product Review: Fish Oil and Omega-3 Fatty Acid Supplements Review (Including Krill, Algae, Calamari, Green-lipped Mussel Oil),” ConsumerLab.com, Accessed January 20, 2016, https://www.consumerlab.com/reviews/fish_oil_supplements_review/omega3.

Are your meds helping or hurting?

By: Dr. Alan Christianson

It’s no surprise medications can cause side effects. Commercials have made us numb to them. Still, we rarely hear how dangerous common medications can be, even for those who carefully follow the directions.

RETHINK YOUR MEDS
I’ve been blessed to have a patient population I enjoy spending my time with. Doug was no exception. I had cared for him, his wife, and their adult daughter for over a decade. One day, Doug came to see me because his back hurt. I noticed he was also retaining fluid; his face was puffy. The pain didn’t seem to feel worse when he bent or moved—it just always hurt. I had a small suspicion his kidneys were a culprit, so I did a simple urine test. I had examined Doug and done blood tests just over a year prior, and he had no signs of kidney problems.

The urine test showed his kidneys were not filtering protein at all. A few more tests confirmed Doug was in late-stage kidney failure. He spent four months on dialysis in hopes of receiving a kidney transplant. It never came, and he died just before his 51st birthday.

The nephrologist who treated Doug attributed his death to ibuprofen use.

Doug didn’t mention it to me, but he’d developed tendonitis and was regularly taking ibuprofen for several months. He never exceeded the recommended dosages. The first sign of there being a problem was his fluid retention. By then, it was too late. Kidneys can lose 80% of their working cells, called glomeruli, before there is any symptom or measurable change in function.

In the last decade, the rate of death from prescription medications has gone up 2.8 times.

Both prescription and over-the-counter medications have become a leading cause of early mortality, and the trend is only worsening.

Below is a quick list of the top offenders. If you see any of these names in your medicine chest, please work hard to explore your options.

Over-the-Counter Medications

NSAIDS

Generic                                   Brand Name(s)
Ibuprofen                                  Advil, Motrin
Naproxen sodium               Aleve
Aspirin                                      Ascriptin, Bayer, Ecotrin

Acetaminophen

Generic Brand Name(s)
Acetaminophen Tylenol

Antihistamine/Sedatives

Generic Brand Name(s)
Diphenhydramine Benadryl, Tylenol PM, Advil PM

Prescription Medications

Sleep Aids

Generic                                   Brand Name(s)
Zolpidem                            Ambien, Intermezzo
Eszopiclone                          Lunesta
Ramelteon                           Rozerem
Zaleplon                             Sonata
Doxepin                                 Silenor
Benzodiazepines (see below)

Opioid Narcotics

Generic                                   Brand Name(s)
Hydrocodone                           Vicodin, Lortab
Oxycodone                              OxyContin, Percocet
Morphine                               Kadian, Avinza

Benzodiazepines

Generic                                 Brand Name(s)
Alprazolam                              Xanax, Restyl
Clonazepam                            Klonopin, Paxam
Diazepam                                Valium
Lorazepam                            Ativan
Temazepam                             Restoril
Triazolam                           Halcion

Let’s go a little deeper into each of these categories.

NSAIDS

These are nonsteroidal anti-inflammatory drugs. The best known are Advil and Aleve. There are also many prescription NSAIDS. Some are the same medicines as the nonprescription ones (but in higher potencies), and others are different medicines. In terms of dangers, the differences between nonprescription and prescription are only related to the dosage used.

Bleeding Ulcers

Nearly 40% of the American population take ibuprofen or aspirin on a regular basis to help with aches and pains.[1] Each year, 1-2% of those who take NSAIDS have side effects bad enough to warrant hospitalization, mostly related to bleeding ulcers. In 2000, this was 103,000 people with 16,500 of them dying from taking these medicines responsibly.[2]

This does not take into account harm from intentional overdoses, from those who take NSAIDS with incompatible medications, or in cases of the recommended dosages being exceeded.[3]

Stroke

NSAIDs also raise the risk for heart attack, heart failure, and stroke. This risk begins as early as two weeks of starting regular use. The longer you take them and the more you take, the more these risks increase.[4]

Weight Gain

Is it hard to get to your favorite weight? Ibuprofen may be to blame. Studies show it can mimic the effects of diabetes and cause a higher amount of insulin to be released.[5]

Liver Failure

Liver damage with acute liver failure is the most common complication with acetaminophen (Tylenol). These risks are higher for those who use alcohol.[6] One estimate is that of the 2000 Americans who have liver failure each year, 38% of the cases are caused by acetaminophen with 28% of the cases resulting in fatality.[7]

A special concern with acetaminophen is that it is a secondary ingredient in many over-the-counter and prescription medications. This raises the potential for unintentional overdose for those who take it by itself while unknowingly taking it in other products as a secondary ingredient.

Pediatric Dangers

Children may especially be at risk. Those under the age of six have been shown to have non-fatal liver injuries even when taking doses deemed safe.[8]

Opioid Narcotics Fatalities

In 2014 alone, over 47,000 people died from prescribed opioid narcotics. This represents 61% of all drug overdose deaths, both prescription and illicit. This rate has more than tripled since the year 2000.[9]

Despite the facts that opioids are highly addictive and given routinely, they are often not effective against chronic pain.[10]

Safer and More Effective Options for Chronic Pain:

Cognitive behavioral therapy
Targeted amino acid therapy
Mindfulness meditation
Acupuncture
Cryotherapy
Massage therapy
Curcumin alkaloids such as Inflama-Rest
Mind body therapies such as John Sarno’s approaches
Prolotherapy and PRP therapy
Chiropractic and physical therapy

Benzodiazepines

These are medications given for anxiety and sleep. Despite the fact that many people are on these for years, the prescribing labels and practice guidelines recommend them only for short-term use.[11]

The most common brands used are Ativan, Xanax, and Klonopin. The death rate from these medicines has gone up five times in roughly the last decade.

As of 2013, Medicare started to pay for benzodiazepines like Xanax and Ativan. Since then, they have been prescribed an extra 40 million times.[12]

Dementia

These medications may cause premature dementia,[13] leading to impaired short-term memory, confusion, poor word recall, and lack of mental focus. Similarly, they can raise the risk of developing Alzheimer’s disease with as little as 1-2 months of regular use. Each dose after this showed a higher and higher risk of Alzheimer’s.[14]

Addictive

They are also known to be highly addictive and difficult or impossible to stop after months of regular use.[15]

Long-Term Effects

Some of the long-term effects of benzodiazepines are:[16]

Memory loss
Confusion and difficulty thinking clearly
Lethargy and lack of motivation
Fatigue
Headaches
Drowsiness and sleepiness
Difficulty sleeping and disturbing dreams
Nausea
Personality change and changes in emotional responses
Anxiety
Irritability, paranoia and aggression
Depression
Lack of motivation
Weakness
Fatigue
Skin rashes
Weight gain

Sleep Aids

Medicines like Ambien and Lunesta are used by 60 million Americans each year. Large studies have shown they don’t work, as they provide only 14-15 minutes of additional sleep.

Death and Cancer

Several studies have shown these medicines are deadly. As few as 19 doses per year can raise the risk of death by nine-fold in those who are obese and 4.5 times in those who are lean.[17] They have also been shown to raise the risks of many types of cancer.[18,19]

Diphenhydramine (Antihistamine)

Diphenhydramine (Benadryl) is commonly used both as a sleep aid and for allergy symptoms. Histamine can be the chemical trigger of allergy symptoms, yet it is also a brain chemical that causes alertness and mental focus. When it is blocked, many feel groggy and sleepy. Diphenhydramine is the active ingredient in many over-the-counter sleep aids such as Tylenol PM and Advil PM.

Dementia

A large study showed that diphenhydramine can cause dementia. A team of researchers tracked 3500 adults, ages 65 and over, for seven years. During that time, those who used medications like diphenhydramine had a 54% higher risk of developing dementia than those who didn’t use the medicine or who used it for under three months.

Weight Gain

Diphenhydramine has been shown to cause dramatic weight gain and insulin resistance with regular use in both genders. Research has shown men who use it regularly are over 19 pounds heavier than similar men who do not. For women, the difference can be over nine pounds.[20]

Safer and More Effective Options for Anxiety and Insomnia:

Cognitive behavioral therapy
Targeted amino acid therapy
Mindfulness meditation
Theanine
Fish oil
Acupuncture
Kava extracts

If you are in the habit of taking medications for chronic symptoms like pain, insomnia, or anxiety, please reconsider. In most cases they don’t work as well as expected, and they have major risks. There are so many safe and effective options available for you. Not only are natural treatments lower in side effects, but when you identify and treat the cause, your health improves in other ways you may not expect. Think of it as trading in your risks and side effects for side benefits.

[1] Kaufman DW, Kelly JP, Rosenberg L, et al, “Recent patterns of medication use in the ambulatory adult population of the United States: The Slone Survey,” JAMA 2002;287:337-344.
[2] Ofman JJ, Maclean CH, Straus WL, et al, “A metaanalysis of severe upper gastrointestinal complications of nonsteroidal anti-inflammatory drugs,” The Journal of Rheumatology, 2002;29(4):804-812.
[3] Singh G, “Gastrointestinal complications of prescription and over-the-counter nonsteroidal anti-inflammatory drugs: A view from the ARAMIS database,” American Journal of Therapeutics, 2000;7:115-121.
[4] Mangoni AA, Woodman RJ, Gilbert AL, Knights KM, “Use of non-steroidal anti-inflammatory drugs and risk of ischemic and hemorrhagic stroke in the Australian veteran community,” Pharmacoepidemiol and Drug Safety, 2010 May;19(5):490-8. doi: 10.1002/pds.1945.
[5] Li J, Zhang N, Ye B, Ju W, Orser B, Fox JE, Wheeler MB, Wang Q, Lu WY, “Non-steroidal anti-inflammatory drugs increase insulin release from beta cells by inhibiting ATP-sensitive potassium channels,” British Journal of Pharmacology, 2007 Jun;151(4):483-93. Epub 2007 Apr 16.
[6] Sinclair J, Jeffery E, Wrighton S, Kostrubsky V, Szakacs J, Wood S, Sinclair P, “Alcohol-mediated increases in acetaminophen hepatotoxicity: role of CYP2E and CYP3A,” Biochemical Pharmacology, 1998 May 15;55(10):1557-65.
[7] Larson AM, Ostapowicz G, Fontana RJ, et al, “Outcome of acetaminophen-induced liver failure in the USA in suicidal vs accidental overdose: Preliminary results of a prospective multi-center trial,” Hepatology 2000;32(4 pt 2):396A.
[8] Heard K, Bui A, Mlynarchek SL, Green JL, Bond GR, Clark RF, Kozer E, Koff RS, Dart RC, “Toxicity from repeated doses of acetaminophen in children: assessment of causality and dose in reported cases,” American Journal of Therapeutics, 2014 May-Jun;21(3):174-83. doi: 10.1097/MJT.0b013e3182459c53.
[9] Mancano MA, “Risk Factors for Androgen Deficiency with Daily Opioid Use; Co-trimoxazole and Sudden Cardiac Death in Patients Receiving ACE Inhibitors; Clindamycin-Induced Myelosuppression; Apixaban-Induced Diffuse Alveolar Hemorrhage; DRESS Syndrome Induced by Allopurinol,” Hospital Pharmacy, 2015 Mar;50(3):189-93. doi: 10.1310/hpj5003-189.
[10] Giron SE, Griffis CA, Burkard JF, “Chronic Pain and Decreased Opioid Efficacy: An Inflammatory Link,” Pain Management Nursing, 2015 Oct;16(5):819-31. doi: 10.1016/j.pmn.2015.04.001. Epub 2015 May 9.
[11] “Short- and Long-Term Use of Benzodiazepines in Patients with Generalized Anxiety Disorder: A Review of Guidelines,” [Internet] Ottawa (ON): Canadian Agency for Drugs and Technologies in Health, 2014 Jul 28
[12] “One Nation, Under Sedation: Medicare Paid for Nearly 40 Million Tranquilizer Prescriptions in 2013,” June 10, 2015, https://www.propublica.org/article/medicare-paid-for-nearly-40-million-tranquilizer-prescriptions-in-2013.
[13] Barbui C, Gastaldon C, Cipriani A, “Benzodiazepines and risk of dementia: true association or reverse causation?” Epidemiology and Psychiatric Sciences, 2013 Dec;22(4):307-8. doi: 10.1017/S2045796013000358. Epub 2013 Jul 3.
[14] Billioti de Gage S, Moride Y, Ducruet T, Kurth T, Verdoux H, Tournier M, Pariente A, Bégaud B, “Benzodiazepine use and risk of Alzheimer's disease: case-control study,” BMJ, 2014 Sep 9;349:g5205. doi: 10.1136/bmj.g5205.
[15] Tan KR, Rudolph U, Lüscher C, “Hooked on benzodiazepines: GABAA receptor subtypes and addiction,” Trends in Neurosciences, 2011 Apr;34(4):188-97. doi: 10.1016/j.tins.2011.01.004. Epub 2011 Feb 25.
[16] “Benzodiazepine Facts,” http://www.druginfo.adf.org.au/drug-facts/benzodiazepines (accessed Jan 2013).
[17] Lan TY, Zeng YF, Tang GJ, Kao HC, Chiu HJ, Lan TH, Ho HF, “The Use of Hypnotics and Mortality - A Population-Based Retrospective Cohort Study,” PLoS One, 2015 Dec 28;10(12):e0145271. doi: 10.1371/journal.pone.0145271. eCollection 2015.
[18] Kripke DF, Langer RD, Kline LE, “Hypnotics' association with mortality or cancer: a matched cohort study,” BMJ Open, 2012 Feb 27;2(1):e000850. doi: 10.1136/bmjopen-2012-000850. Print 2012.
[19] Kripke DF, “Possibility that certain hypnotics might cause cancer in skin,” Journal of Sleep Research, 2008 Sep;17(3):245-50. doi: 10.1111/j.1365-2869.2008.00685.x.
[20] Ratliff J, Barber J, Palmese L, Reutenauer E, Tek C, “Association of prescription H1 antihistamine use with obesity: Results from the National Health and Nutrition Examination Survey,” Obesity (Silver Spring), 2010;18(12):2398-2400. doi:10.1038/oby.2010.176.

(c) 2015- Integrative Health Care, PC

Would you like to use this article? You may as long as you use the following information along with the article:

Dr. Alan Christianson is an Arizona-based Naturopathic Physician who helps
people overcome adrenal and thyroid disorders and achieve lasting fat loss. He
authored the New York Times' bestselling Adrenal Reset Diet, and The Complete Idiot’s Guide to Thyroid Disease. Dr. Christianson is the founding physician
behind Integrative Health.

Dr. Christianson can be reached at www.MyIntegrativeHealth.com, www.DrChristianson.com and 480-657-0003.

#1 of 20 Types of Fiber

By: Dr. Alan Christianson

All the experts agree - fiber is your ticket to a longer life, a leaner belly, and a better brain. Yet most talk about fiber as if it was one thing. Did you know there are upwards of 20 types of fiber, all with completely different effects?

These last few weeks I’ve been having a blast making the most comprehensive table of fiber types ever made. Here is one preliminary row from it on one of my favorite types, called RS2.

The fiber table is huge and I’m not sure how I’ll use it but I promise you’ll get first access.

Integrative Health’s own Ashley Bug brought us her favorite easy chili recipe to help you get more fiber of several types. Bug is her nickname given to her from the front office team at our clinic. As in cute as a bug. She always does a great job bringing healthy lunches and setting a good example.

You’re also welcome to use extra lean ground turkey. I love adding in mushrooms and a few tsp fresh turmeric if you have some on hand. I buy a tub of it whenever I can and keep it in the freezer. To use it, just take the frozen roots and grate with a micro grater, wasting the peel portion.

Ashley Bug’s Super Easy Chili

Ingredients:

1 lb 95-97% lean ground grass-fed beef
1-2 tbsp macadamia oil
3 (15 oz) cans diced tomatoes with green chiles
3 cups beans of your choice (black, cannellini, kidney, navy)
1 white onion, diced
2 tbsp chili powder
1 pound washed spinach leaves
Handful green onions, chopped for garnish
Handful of cilantro, chopped for garnish

Directions:

In a large stockpot, cook ground beef with macadamia oil over medium-high heat until browned, stirring frequently. Drain excess fat. Add remaining ingredients and stir to combine. Bring to a boil, then reduce heat to medium-low. Cover and simmer for 15 minutes or until the onion is cooked and softened.
Serve warm with garnishes to taste.

[i] Higgins JA. Resistant starch and energy balance: impact on weight loss and maintenance. Crit Rev Food Sci Nutr. 2014;54(9):1158–66. doi: 10.1080/10408398.2011.629352.

Eight Mindsets of Healthy People

By: Dr. Alan Christianson

Have you ever read the Seven Habits of Highly Effective People? I try to get through it at least once per year. In it, the late Steven Covey teaches us that our professional lives are products of how we think more than any other factor.

I would argue that the same is true for our health.

My mentor Dan Sullivan, the founder of Strategic Coach, challenged me to find the common mindsets among my healthiest patients. I thought about those who seemed to have natural health as well as those who had overcome major challenges. It was a powerful exercise. Despite practicing for nearly 20 years, this was a question I had never explored.

After thinking hard about who I would consider to be in this group, I interviewed them and gathered the data which evolved into a list of eight mindsets that I wanted to share with you.

Mindset 1 – You live with purpose

This habit is first on the list for a reason. Purpose matters. People who have a compelling ‘why’ can make do with almost any ‘how.’ What would you say if someone asked you what your purpose was? If you did not have an answer that came to mind, put 'figuring it out' on the top of your to do list.

Mindset 2 – You see health as essential

There is a saying that a person who has health has a hundred goals yet someone without health has only one. It is impossible to focus on anything else when you have ongoing pain or frustration with your body.

Mindset 3 – You believe you can heal

Do you have a bad set of genes? Are you powerless to change your diet? Does it seem unfair that the foods you like best don’t make you feel good? These beliefs themselves may be more powerful than your genes or your diet. Henry Ford said whether you think you can or think you can’t, either way you’ll be right. Know that every atom in your body is replaced regularly. Most in just a few months. Your mind is so powerful. Never use it to keep yourself trapped in frustrating symptoms.

Mindset 4 – You are flexible

Yoga is great, but I mean mentally flexible. I was at a book signing recently and got to talk to lots of my readers. One asked me how she could get more energy. She knew she was fatigued because her diet was limited to little more than raw vegetables. She explained in detail how she was unwilling to eat any other foods because of all the reasons she had read about how fruit, nuts, legumes, animal protein, and grains were all bad for her. When she was done I did my best to summarize her question: “So you want to do exactly what you’re doing now without changing anything but get completely different results from it?” She and I both had a good laugh and I think the new perspective made her think. If your health is exactly the way you and your doctor want it to be, don’t change a thing. If it is not, being mentally flexible and receptive to change will be necessary for your recovery.

Mindset 5 – You own your habits

Who chooses what goes on your fork? Who decides whether or not you’re working out today? If you don’t feel in charge of your decisions, then let’s change that. Think of it like developing a muscle. Choose one small thing you can control and master it. Start with a solid breakfast. Usually food cravings don’t start until later in the day. Once you get past a month of having a regular, healthy breakfast, think about the next meal to take control of.

Mindset 6 – Your friends are healthy

Are your closest friends health conscious? If not, you’ll have an uphill battle. It is said that we are the product of the five people we spend the most time with. Think about who is already in your circle that you would like to emulate. Maybe even someone you envy or resent for always looking fit. Sometimes those you resent show up in your life to be your best teacher. Mimic their habits or make a bold move and just ask them about how they make it work. People get a rush out of sharing their successes. Give them a chance to shine and give yourself an opportunity to grow and deepen a friendship.

Mindset 7 – You are a team player

Do you have a health care team? How do you feel about them? Do you trust their advice and follow it closely or do you second guess them and do your own research online? Think about this - if an electrician wanted to put a 40 amp circuit breaker in your home’s wiring, would you spend hours on Google trying to figure out if a 20 amp might work better? If you do not feel your team is worthy of your trust, replace them with people who are.

Mindset 8 – You know your vulva from your Volvo

If your nutritionist tells you to eat more greens, it helps if you know he means spinach and kale, not green M&M’s. It is a balancing act, you don’t need to get another degree, but it pays to have a working knowledge of how your body works so you can communicate with your team more easily.

Before you stress about which food to be afraid of this week or how many milligrams of vitamin N you should take, think about your mindset. Once it is right, the details magically fall into place!

How to Beat Food Allergies

By: Dr. Alan Christianson

Food allergies are pretty common and stressful. The question is, are you stuck with them? Shouldn’t you be able to live your life in this world free from fear about what you ingest? The good news is there are ways to reduce food allergies.

Let’s first make a distinction about what types of food allergies can be reduced. Anaphylactic allergies and celiac disease are currently two types of intolerances we can’t overcome. Regarding anaphylactic allergies, we’ve discovered that children who have a larger variety of healthy foods at earlier ages, have fewer anaphylactic reactions. So, encourage your little children or grandchildren to have a wider range of foods, especially peanuts, right around the weaning age. This lowers their risk for reactions later in life. Cultures where children eat the most peanuts earlier in life have the lowest rates of reactions. On the contrary, reactions have increased radically if parents have their children on a more restrictive diet for long periods of time.

We’ve been guilty of this in my profession. We had children eat very few foods until much later in their lives, avoiding exposure to dairy, eggs, nuts, and other common allergens until they were much older. Now we know the more exposure children have earlier in life, the less foods they’re severely reactive to later. (There’s also some encouraging data emerging about desensitizing for anaphylactic food reactions, which I’m watching closely.)

If you feel you’re reacting to certain foods, pursue obtaining clarity on exactly what is affecting you. Sometimes you can think a food is affecting you, and it’s really not. We all have symptoms that come and go but aren’t significant. So, it’s easy to misattribute a random symptom to something you just ate. In order to know if the reaction can be attributed to something you ate, it has to affect you the same way each time you eat it.

Some food reactions are delayed or hidden, so how do you discover which foods are the culprits?

Avoidance and Reintroduction Diets

For quite a while, the gold-standard gauge to discover food allergies has been avoidance and reintroduction diets. This is where you eat no food for two weeks, except for something like lamb or rice and a few other simple things. Then, phase foods back into your diet one at a time.

This gauge has been falling out of favor and here’s why: When you restrict your diet, you restrict your digestive capacity. The fewer foods you eat, the fewer foods you can digest. It’s the old “use it or lose it” principle. When you lose your digestive resiliency, you can have reactions to food after an elimination diet that you wouldn’t have had in normal circumstances. We call these reactions “false positives”.

Testing

Testing is good but is different from method to method and lab to lab. There are blood tests, skin tests, and electrodermal tests (where devices measure currents throughout your body).

The blood tests are good but vary widely from lab to lab. I’m not associated with any lab; however, there are two I’ve seen give the same data on the same person on a divided blood sample. They are US Bio Tek and Meridian Valley Labs. They are very good and less expensive than many others. The blood tests can check one hundred foods and rank (from low to high) how reactive you are to them.

The skin tests are reasonable but not great for airborne, dietary, or delayed-reaction allergies.

If you have taken other tests which show you’re reactive to common, healthy foods, like berries, vegetables, or greens, don’t trust them. These allergies are so rare that it doesn’t justify your stress for avoiding these foods and the benefits you’d be missing by doing so.

Once the testing is done, what steps can be taken to overcome the allergies?

Avoidance

Once you have the testing done and discover which foods you’re highly reactive to, the first thing you want to do is avoid these foods for three months. This will allow your immune system to stop making antibodies against them and help repair your intestinal tract.

Improve your flora.

It’s also good to take steps to improve your flora. Stool cultures can show which good bacteria you have, which ones you may have too many of and which ones may be lacking. If you don’t know the exact findings about your flora, I wouldn’t take probiotics. You may have too much of a good bacteria, just as you can likely have too little.

You can always safely consume fermented foods. There are many great ones available. I recommend looking into the fermented food products available from Donna Gates and Summer Bock.

Repair your gut.

There are safe products to raise the resiliency of your intestinal barrier. The two best-studied are glutamine and N-acetyl glucosamine (NAG). It’s very helpful to take these during the food-avoidance stage to repair your gut.

Test again.

After the three months of food avoidance, have yourself rechecked to see what the data shows about the foods you were reacting to. If you see a decrease in your scores, the next phase is reinoculation.

Reinoculation

In the tiniest amounts, add the foods you didn’t tolerate before to your diet. Maybe have only a teaspoon a day for a few months or a tablespoon every few days. Be intentional about adding them back in, as this will gradually allow your body to gain tolerance to them again.

In this phase, you want to expose yourself to a variety of healthy foods in small amounts. Notice the word, “healthy”. I’m not talking about processed food but healthy foods you can find on a farm. The more of these foods you eat, the better your flora and your immune system will be and the more nutrients you’ll have.

Along with avoiding processed foods, dairy is also fine to avoid in general. Of the natural foods, it probably has the least amount of data proving its health benefit. The one exception could be organic, nonfat, unsweetened Greek yogurt, which has both protein and good things from living bacteria.

Recheck.

It’s a good idea to recheck your system about six months after beginning reinoculation to make sure you still see those decreased scores.

To sum up, clearly define which foods are your culprits, based upon reliable data. Avoid these foods. Understand your flora and improve it. Consider taking supplements to heal your gut lining. When you see your reactions lower, start strategically reintroducing the good, healthy foods. After a few months of tolerating small amounts of the foods you initially had reactions to, those foods can take their place in a proper, healthy diet.

Food allergies can diminish. You can have more food options, which provides you with more nutrients and greater peace of mind.

Natural Cure for Headaches

By: Dr. Alan Christianson

Ah, headaches! They come out of nowhere and completely ruin an otherwise good day. Headaches can set you back and cause a lot of frustration. The good news is there are easy steps you can take to prevent them and stop them in their tracks.

Are there different types of headaches?

Yes, there are two types of headaches: structural and chemical.

A structural headache occurs because of your structure—something in your body that is being pulled, inflamed, or irritated. This has to do with your alignment, your muscles, or anything that is too tight or too loose. These headaches typically start with pain in the neck, spread to the back of the head and move out from there.

A chemical headache occurs from spasms of the blood vessels that line the scalp. When those blood vessels constrict, there is pain in the nerves around those vessels. Chemical headaches are more diffused in nature, especially near or around the eyes or along the temples.

What is the best remedy for a structural headache?

The main remedy is to improve your structure. Getting a massage on a regular basis can be a wonderful step. Another simple step is loosening or stretching. If you’re in the same position for a long period of time (at work or otherwise), a good trick is the 20/20/20 rule. Every 20 minutes, get up for 20 seconds and move your head side-to-side 20 times. This goes a long way in reducing tension. Our head is like the weight of a bowling ball. There are a few small structures in the occipital triangle of the neck that bear a large amount of its load. These structures get tight and sore when in the same position for a long period of time.

In most cases of structural headaches, the cause is loose ligaments. This can happen from vehicle accidents when you experience whiplash from the head moving fast. It can also be caused from chronic arthritis. When your ligaments are too loose, your muscles have to tighten to compensate. When the muscles tighten, they pinch nerves, and that hurts. So, the stronger the ligaments are, the less the muscles spasm. To help, you may consider treatments like acupuncture, prolotherapy, and physical therapy.

What can remedy a chemical headache?

With chemical headaches you want to think about things that trigger the spasm. One of the first considerations is what foods you’re eating, as some foods cause inflammation. These food intolerances may be unique to you or could be common for everyone. If you aren’t sure which foods you may be sensitive to, it’s good to pursue finding out. Allergy testing can be a great option to discover which foods are your personal triggers. In the meantime, cut out all the common food allergens: dairy, wheat, eggs, sugar, gluten, soy, and corn products. If you avoid these foods for a while, then you can safely reintroduce a few to see if they are affecting you or not.

Some foods that can affect everyone are sugar, fried foods, and preservatives. In different ways, these foods raise the chemicals of inflammation. They cause your body to respond in such a way that increases the potential for a spasm to occur and lapse into a headache.

Is caffeine causing or helping my headache?

Caffeine deserves a little special attention. It’s a very strong vasodilator, which means it opens those constricted blood vessels. Many of the over-the-counter headache remedies are based on caffeine. In many cases, these are effective in the short-term, but with regular use, they can actually trigger headaches.

If you’re not a caffeine user and have a random headache, an over-the-counter remedy may do a good job of stopping it.

If you’re a regular caffeine user, you may be sensitive to this type of remedy and have more headaches because of it. Many headache treatments, especially those containing caffeine, can cause rebound headaches. This means that in a day or so after taking the medicine, you are more apt to get a headache than you would be otherwise. This is true for ergotamine compounds and the triptan class medications, such as Imitrex, Maxalt, and Zomig. These can be very effective immediately but cause big rebounds. Some older treatments, like butalbital, also have very high rebound rates. I’ve seen many people who take these medicines frequently and have headaches all the time. If they stop the medicine, they get even more headaches initially. So, what is the solution? Detox and come off of them. This process is difficult at first, so if you haven’t tried these medicines already, it’s best not to get hooked on them.

If you have regular headaches and use caffeine every day, give yourself a two-week holiday from it. See if your headaches become less frequent. If they do, you have one more tool in managing the headaches. If they don’t, you can go back to using caffeine. I recommend you try this at least once since caffeine has been a common cause of headaches.

Are over-the-counter, anti-inflammatory medications safe?

Aspirins, acetaminophen, and ibuprofen sometimes work to bring headache relief but have their drawbacks. Acetaminophen is a little different, but all the others thin the intestinal lining. This leads to greater food sensitivities. The healthier your intestinal lining is, the fewer food reactions you’ll have.

Another drawback with these medications is kidney damage. I’ve seen many healthy people, taking recommended doses for long periods of time, who have severely damaged their kidneys. According to experts, there are more than 30,000 emergency room diagnoses per year of dangerous stomach bleeding due to over-the-counter, anti-inflammatory drugs. So, it’s better to avoid them.

Are there any safe remedies?

Yes! There are several safe options for bringing relief.

Hot and Cold Remedy

Because headaches are caused by constricted blood, moving the blood will bring relief. You can adjust blood flow by simply using hot and cold simultaneously. Think about it: When you bump yourself and put ice on the hurt area, you feel better. This is because you’re moving blood away from the hurt area and closing those blood vessels. With a headache, the trick is to move blood out of the constricted vessels.

Here is how you do it: Take cold packs (bags of frozen veggies work well for this), and put them where it hurts. As you’re doing this, place your feet in a bucket of warm, but tolerable, water (about 100-105 degrees). By doing these two things simultaneously, you are routing the blood out of the stuck vessels and towards the opposite end of your body. You’re pulling that pressure downward. It’s a very dramatic way to stop a headache in a matter of moments! It’s also helpful to do this in a dark, quiet place while taking a few deep breaths.

Magnesium to the rescue!

Another great treatment is magnesium. Magnesium relaxes muscle tissues. This relaxes the smooth muscles that make the vessels cramp in the first place.

Magnesium comes in several forms. Although the pills work well for those who are deficient, they won’t bring immediate relief to a headache. What brings immediate relief is a magnesium bath. Thoroughly mix a two-pound carton of Epson salts in your tub, and soak in it.

Magnesium oil can also bring relief when rubbed on your neck or wherever you’re feeling the tension. (The oil is actually a very saturated, hypertonic solution.)

Magnesium IV’s are very powerful, as well. Many natural clinics offer them as a treatment for an acute headache.

Curcumin

This is one of my favorite natural ingredients. Curcumin is extracted from turmeric and works like an anti-inflammatory without hurting your stomach. It’s actually helpful for the stomach. You can use it in high amounts to relieve pain without any drawbacks. The better forms of curcumin have carrier compounds that help them absorb effectively. These are mostly phosphatidylcholine-based carriers. Those who are avoiding soy are cautious about phosphatidylcholine, but it isn’t necessary. The negative parts of soy are isoflavones, lignans, and some of the other protein compounds. The phosphatidylcholine from soy is harmless and has no drawbacks like soy does otherwise.

Ginger and Boswellia

Both ginger and Boswellia naturally lower inflammation and help break the cycle of chronic pain.

Part of the problem with a headache is not only are the blood vessels tight, but the blood is also thick. When your blood is thicker and clotting easily, it’s more apt to get jammed up and create that cycle of pain. Ginger not only lowers inflammation, but also thins the blood, causing less platelet aggravation.

Boswellia is a tree resin with strong aromatic properties. You’ve heard of the gifts to the baby Jesus of gold, frankincense, and myrrh. Frankincense is Boswellia, and research shows it reduces inflammation.

By using these easy, safe tricks, managing your diet by keeping away from inflammatory foods, and having some great rescue options, you can have fewer headaches or be completely headache-free!