Before about 10 years ago, patients who presented with these symptoms with told that they were depressed and should take a SSRI drug. These patients realized it was not depression, but they were told it was all in their mind. Within the last years the American College of Rheumatology has finally acknowledged this diagnosisand even given it an ICD-9 code.

In my office we see and treat many patients with this fibromyalgia. We usually use an interdisciplinary approach to helping them. We give the patients anti-inflammatory natural supplements as well as change them to  an anti-inflammatory diet. We also give them support for their adrenals and other stress organs, as well as liver support. In addition, the patients will get acupuncture and bodywork. Bodywork is especially important because often these patients have poor posture and "backwards breathing" and need to learn how to stand and walk sit and breathe in a correct way.

Now I am delighted to see a randomized trial of Tai Chi for fibromyalgia being published in the prestigious New England Journal of Medicine. For those of my readers who do not know, Tai Chi is a mind-body practice which began in China as a martial art. It includes meditation along with slow, gentle, graceful movements as well as deep breathing and relaxation. The idea of it is to move the body's life force called "Chi" throughout the body. The beauty of it is that integrates physical psychosocial, emotional, spiritual and behavioral components. It was thought that because of its mind and body attributes that tai chi would be especially well-suited to the treatment of fibromyalgia.
In the study the authors conducted a trial to compare the physical and psychological benefits of tai chi with those of the control intervention that consisted of wellness education and stretching. The study was12 weeks in duration. In all, 66 patients were in the study.

In the study, all patients filled out the  Fibromyalgia Impact Questionnaire (FIQ). They also used a sleep quality Index, as well as a Depression Index. In addition they used a Chronic Pain Self-efficacy Scale test. They also used the Short Form Health survey (SF — 36), which is a general measure or a persons complaints. In addition to be sure any results were long-lasting they also measured all the scales at 24 weeks after the study was completed.

When all the data was evaluated, it showed that the group of fibromyalgia patients who were in the Tai Chi group had very statistically significant improvement compared with the control group. The Tai Chi group consistently did better on all the various measurements that were taken.

Another nice finding is that at 12 weeks, more of the patients in the Tai Chi group had been able to stop the pharmaceutical medication that they were using to treat fibromyalgia. The number was greater but this difference was not statistically significant.

In my opinion this is a seminal study. The data is so strong that the prestigious New England Journal of Medicine approved it and has published it.

This sets a new bellwether for the management of fibromyalgia, and I hope that more and more patients with this condition will begin to practice Tai Chi.

On a personal note, as a long-time practitioner of yoga, I would like to see if similar results could be obtained with yoga classes instead of Tai Chi.

Do you have fibromyalgia? What have you done to help yourself? Have you tried Tai Chi?  Did it help? Do you have family or friends who could benefit from using Tai Chi to help address their fibromyalgia?.

Let me know. I look forward to hearing from you.
 

Reference

Now a new study published in the New England Journal of Medicine has  been published showing the importance of vitamin A and its relationship to lung development in the womb.

In this study, that was led by Wiliam Checkley, M.D., over 1600 children in Nepal were evaluated. Some of the mothers were given vitamin A pills during pregnancy and others were given placebo. An additional set of women was given beta-carotene which is a derivative of vitamin A.
The findings were that the children whose mothers had received vitamin A had significantly better lung function than those whose mothers who were given placebo or beta-carotene during pregnancy. These benefits were even measurable at age 9 in the children.

This study allows us to see the benefit of another nutrient, in this case vitamin A,  and, and it's importance for optimal fetal development.

It is estimated that 190 million preschool age children and 19 million pregnant women have vitamin A deficiency worldwide. This deficiency can cause health problems during the development of the child, including lung issues.

Dr. Wiliam Checkley, the author of this study, was quoted as saying "Early interventions involving vitamin A supplementation in communities where undernutrition is highly prevalent may have long-lasting consequences for lung health". He went on to say     "The magnitude of the effect observed in this study is slightly greater than that associated with preventing exposure to parental smoking in school-aged children."

I certainly urge you to speak with all your friends and relatives about being sure that the pregnant women in their life are taking a prenatal vitamin containing vitamin A.

Studies like this one, along with the many studies of the role of vitamin D during pregnancy that I have discussed here,  make me wonder what would the health of the planet be like, if fetuses received an optimal degree of nutrition while in the womb? Given the epidemic of Vitamin D deficiency in pregnancy and combining it with this information on vitamin A makes me wonder if these deficiencies are associated with the asthma epidemic we now see in American children

Let me know your thoughts? Do your friends and family take a prenatal and vitamin A while they were pregnant?

Reference

Recently after an enormous amount of data in the medical literature many prescription prenatal vitamins have start to add an essential fatty acid capsule that is necessary for brain development of the fetus in the uterus.

Integrative medicine doctors have been prescribing this essential fatty acid known as DHA for over 20 years. The information has been in the medical literature but not that literature that is commonly read by obstetricians. More and more studies have shown that DHA during pregnancy and in the first four years of a child's life are necessary to optimize the child's neurological and brain development.

There are other nutrients that the medical literature shows that are essential for pregnancy, and one that has been overlooked by all of the prescription prenatal vitamins that I have seen, is called CHOLINE.

Choline is an essential nutrient and it is usually considered part of the vitamin B complex. It is found in the fat that makes up cell membranes and in certain neurotransmitters. Choline has been found to be essential for the normal functioning of all cells, liver metabolism and the transportation of nutrients throughout the body. Choline can be produced within the body but the amount the body makes is often not sufficient to meet the individuals needs. Therefore choline must be consumed in the diet. Recent research has shown that only 10% or less of older children, men, women, and pregnant women in America are getting sufficient levels of choline on a daily basis.

High amounts of choline is found in foods such as eggs, chicken liver, beef liver, beef steak, cod, broccoli, peanut butter, and milk. I am happy to see that because choline is especially high in egg yokes, the Egg Industry has created a website that talks about choline.

In a pregnant woman choline works with folic acid to help promote brain and memory development in growing fetuses and newborn infants.
Now a new study has been published that shows in mice that a diet low in choline and vitamin B2, during pregnancy influenced the development of the fetus' heart. Specifically the mice that were born to choline deficient mothers had more heart defects, which were specifically ventricular septal defects. The vitamin B2 deficient mothers gave birth to  late embryos and smaller embryos. In addition, vitamin B2 deficiency resulted in decreased thickness of the offsprings' left ventricle in the heart.

The conclusion of the authors of this article were: "Low dietary choline and riboflavin affect embryonic growth and cardiac development in mice. Adequate choline and riboflavin may also play a role in the prevention of these pregnancy complications in women."

Given the increasing preponderance of evidence that choline is essential during pregnancy I have been using a specific prenatal vitamin that is fortified with choline. I believe that choline is the next nutrient that will be found to be essential for all pregnancies. I can only guess how many years it will be until the prescription prenatal vitamins will contain this nutrient. But I am happy to be using one that does contain this nutrient for all my pregnant patients. I like it so much that I have begun to private label it under my name.

Does your prenatal or your family's prenatal's include choline or are you making and sure enough that you are eating enough of the choline containing foods to get enough for the fetus? Let me know if you think I should make my Prenatal vitamin available on my website for the public?

REFERENCE

Other resources and articles:

Egg Nutrition Center

Choline: Critical Role During Fetal Development and Dietary Requirements in Adults

USDA Database for the Choline Content
of Common Foods

The recent study by Kristin AV and others, has recently been published in the medical journal Heart.

In this specific study they looked at congestive heart failure. This is a condition where the heart, due to illness is unable to pump sufficient blood to the rest of the body. It can vary from very mild, to the extreme that a person is unable to walk without oxygen. 4.8 million Americans have this condition. This includes 10% of people over the age of 70.

In this study the authors took 17 patients who were stable with congestive heart failure. All of them were already receiving an optimized medication program for  their heart failure when they entered the study.

The study is all the more impressive because they did use a control group. One group of patients got real acupuncture in the other group received "sham" acupuncture.

After the series of acupuncture treatments, the group that received the real acupuncture significantly increased their ability to walk with less symptoms,. In addition in this group, they found a significant improvement in their "recovery" in regards to their ability to breathe after the exercise.

Furthermore heart rate variability which is a sign of the health of the heart increased after the real acupuncture but actually decreased after the "sham" acupuncture

In addition the "general health" score and "body pain" score improved after the real acupuncture.

In a press statement the research group noted that heart failure is recognized to be much more complex than had previously been assumed. Specifically it involves an imbalance in the autonomic nervous system, as well as in various neurotransmitters.

In a press release the authors were quoted as saying "This is precisely where acupuncture may intervene, by bringing these processes back into balance — it influences the autonomic sympathetic nervous system (excitation), boosts the parasympathetic nervous system (relaxation), and also has an anti-inflammatory affect,"

Furthermore, Dr.Arnt Kristen, one of the authors of the study stated "The blood level of a certain messenger, tumor necrosis factor alpha (TNF alpha) actually drops after the real acupuncture treatment. Since TNF alpha leads to a reduction of muscle mass and muscle strength among other things, this would explain the positive effect (of acupuncture) on skeletal muscle function"

I've been using acupuncture in my practice on a regular basis for the last 30 years. I've seen remarkable results in almost every medical condition with acupuncture over and over again. It is wonderful that these types of studies are now coming out that objectively show the benefits of acupuncture for much more than just pain control. This will encourage conventional doctors to begin to be open to the use of acupuncture in congestive heart failure.

Let me know — do you have loved ones who have congestive heart failure? Have they tried acupuncture as an adjunct to their medications? I look forward to hearing from you.

REFERENCE

I was delighted to address the 41 graduating Naturopathic Doctors (ND) as well as their several hundred family members at the Chandler Center for the Arts in Phoenix Arizona.

I worked very hard on my speech, and I am  delighted to say that it was extremely well received. In addition to a standing ovation for my talk, I was welcomed by the graduates as well as their families afterwards with many thanks for the inspiration and encouragement that I gave them.

 The College has made my 20 minute presentation available for everyone to enjoy!  Click  here to view it now.

From the article on the school's website the following summary of my talk was given:

"The graduates were honored to have Dr. Soram Khalsa as their Commencement Speaker. Dr. Khalsa, a well-respected physician, integrates phytotherapeutics, homeopathy, acupuncture and environmental medicine with traditional internal medicine in his private practice. Dr. Khalsa is a member of the Bureau of Naturopathic Medicine Advisory Council for the State of California and serves as Medical Director for the East-West Medical Research Institute. Dr. Khalsa expressed that these men and women could not be graduating at a better, more exciting time."

"You are the leaders of our medical future. Why? Because doctors today all need to be medically multilingual, and that's what you are. I do not refer to holistic, alternative, naturopathic, or integrative medicine as separate divisions of medicine. I regard it as what is best medically for our country.

Only seven percent of graduating medical doctors goes into primary care. In 2020, it is projected that there will be 40,000 too few primary care doctors. This is where NDs are needed.

Three things to remember, however, when it comes to seeing your patients is kindness, compassion, and caring. If you show these three things to them they will enrich your lives and you will love your patients. Be positive and let your presence begin their healing process."

It is my personal belief that Naturopathic (Integrative) Medicine will be growing rapidly in the years ahead and more and more people want a complement of natural modalities and less drugs. Naturopathic medical schools teach all about drugs (pharmacology) as well so their graduates are knowledgeable about both.

I think you'll find my speech both educational and inspiring!

More to come on the School where I teach…..
Let me know what you think!
 

Now biologist Dr. Roger Payne has released new information about the toxicity that he found in almost 1000 whales from all over the world. Dr. Payne set out on his boat in March 2000 from San Diego to document the health of the ocean. He used a small harmless dart gun to collect specimens from almost 1000 whales over 87,000 miles of the ocean.
The samples were sent for analysis and the findings were astonishing. He originally set out to measure persistent organic pollutants (POP's). They found significant amounts of these in the whales.

However, he also looked at heavy metals and what he found was that the whales averaged 2.4 ppm (parts per million) of mercury. He noted that the whales' internal organs would probably have a much higher level than the skin samples they collected. They also found significant levels of cadmium, aluminum, chromium, lead, silver, and titanium in the tissue samples.

Dr. Payne said in an interview "The entire ocean life is just loaded with a series of contaminants, most of which have been released by human beings."

He noted that these contaminates can jeopardize seafood, which is a primary source of protein for over 1 billion people in the world.

Dr. Payne further said "You could make a fairly tight argument to say that it is the single greatest health threat that has ever faced the human species. I suspect this will shorten lives, if it turns out that this is what's going on".

Dr. Payne further noted that "When you're working with a synthetic chemical (POPs) which never existed in nature before and you find it in a whale which came from the Arctic or Antarctic, it tells you that it was made by people and it got into the whale."

Chromium which is an industrial pollutant known to cause cancer in humans was found in all but two of the 361 sperm whale samples. Chromium was the toxic chemical that was the focus of the movie "Erin Brockovich".

Dr. Payne pointed out that the consequences of metals could be "horrific for both whale and man".

In my opinion, this report is of major importance for all people. In my own practice of medicine, I routinely check my patients for mercury in their blood. I find many people with blood levels of mercury higher than the government says is safe. This comes from their eating fish. In addition, this mercury accumulates in the organs and tissues of the person and unfortunately it is released from a pregnant mother's tissues during pregnancy into the fetus. I always encourage my female patients to detoxify out the heavy metals in their body before they conceive.

Another thing Dr Payne said was " "I don't see any future for whale species except extinction.This is not on anybody's radar, no government's radar anywhere, and I think it should be."

I do too ! To say nothing of the effects on humans.

Have you had a blood mercury level measured lately? Do you eat fish that are high in mercury? Let me know what you think about all this information and how you will apply it to your life?

ORIGINAL ARTICLE

The following are health impacts that have been linked to low level exposure to BPA in either animals or humans:
-Obesity
-Low sperm count
-Damage to developing eggs
-Miscarriage
-Placental cell death
-Infertility
-Heart disease
-Diabetes
-Changes in brain development
-Predisposition to breast and prostate cancer.

A new report called No Silver Lining — An Investigation into Bisphenol A in Canned foods has recently been released by the National Workgroup for Safe Markets which is a coalition of US public health and environmental health focused NGOs.

This report reviews the data on BPA. It points out that Canada,Denmark and five US states have already restricted the use of BPA in certain children's products like baby bottles and infant formula can linings.

In this report that Workgroup was looking at the amount of BPA that could be consumed from eating canned food and drinks that are commonly available in the United States and Canada. For this study they collected and tested the food and beverage contents of 50 cans that were collected from 19 United States and Ontario, Canada.
The report finds that BPA is a routine contaminant in canned foods. They specifically looked at the potential exposure to BPA from meals that are prepared with canned food and drink that an ordinary American person might consume over the course of the day.

The authors of the report found 20 people from 19 different states and Ontario, Canada. and asked them to donate 50 food and beverage containers from their home cupboards and from local groceries. A wide variety of products was selected including fish, fruits, vegetables, beans, soups, tomato products, sodas and milks, which are commonly eaten foods.

The results of the study showed that BPA was detected in 46 of 50, or 92%, of the canned food samples. They also found that there was no relationship between the age of the product and the amount of BPA in the food.

BPA exposure is especially of concern for pregnant women and babies and children. For that reason the authors looked at how much BPA a typical pregnant woman would ingest in a day from a typical diet. They found that from eating the foods on that diet, a pregnant woman could easily raise her BPA intake to levels that are known to cause health problems in animals.

The authors point out that they were only looking at one source of BPA exposure — canned foods. They point out that other routes of exposure to BPA include air, dust, and water along with common products like polycarbonate water and baby bottles, 5 gallon water coolers, and printer inks, toners and even thermal receipt paper.

The Centers for Disease Control and Prevention found BPA in the urine of 93% of the United States population. In addition, the Environmental Working Group found BPA in umbilical cord blood of newborn babies as I have reported before.

I urge you to download this report and review it for yourself. Please try to minimize your exposure to canned foods and exposure to water bottles and other containers that have BPA. I see many of my patients walking in with plastic bottles now which have stamped right on the plastic "This product contains no BPA". Hopefully soon we will be able to say that about our canned foods as well.

Please let me know what you think. Do you check to be sure your bottles do not have BPA? Have you heard any other reports or information about BPA that are worth sharing? I look forward to being in dialogue with you about this.

Click Here for Article

This report points out that in 2009 approximately 1.5 million American men women and children were diagnosed with cancer and 562,000 died from the disease. Approximately 41% of Americans will be diagnosed with cancer at some point in their lives and approximately 21% will die from cancer.

This report was brought about because of the growing body of evidence that links environmental exposures to cancer. The report points out that the" public is becoming increasingly aware of the unacceptable burden of cancer resulting from environmental and occupational exposures they could have been prevented through appropriate national action."

One of the findings of the panel that particularly concerned them was the finding that the true burden of environmentally induced cancer has been "grossly underestimated". They point out that nearly 80,000 chemicals are on the market in United States that are being used by millions of Americans in their daily lives. These chemicals have either been understudied or unregulated. They point out that one such chemical, BPA, is still found in many consumer products and remains unregulated in our country.
The panel also points out that most people are not aware that children are far more vulnerable to environmental toxins than adults. They recommend to the president that efforts should be made to inform the public of such harmful exposures and how to prevent them.

This extensive report looks at exposures to contaminants from many sources including industrial and manufacturing sources, agricultural services, from medical sources, and from exposures related to our modern lifestyle.

The conclusions of the panel offer extensive recommendations. One of the most important ones is in their words "a precautionary, prevention oriented approach should replace current reactionary approaches to environmental contaminants in which human harm must be proven before action is taken to reduce or eliminate exposure." Very few of the chemicals that are in modern use have ever been tested thoroughly before they were released and the committee is advocating that products be tested for their safety before they are allowed to be used on the public.

There are a few wonderful quotes from the report that I would like to give you here:

"Low levels of exposure at a specific point in the development of an organism… Could have really, really significant changes in ways that the classical idea about genetics would not predict." William Chameides Duke Untiversity.

" Our science looks at a substance-by-substance exposure and doesn't take into account the multitude of exposures we experience in daily life. If we did, it might change our risk paradigm. The potential risks associated with extremely low-level exposure may be underestimated or missed entirely."
Heather Logan, Canadian Cancer Society.

"…industry has a lot of data on these chemicals. They just don't have to give it to anybody." Richard Wiles Environmental Working Group.

"We are exposed to many pollutants, many at the same time or in sequences that [cause them to] interact with one another. And yet our policies and most of our research… for the most part [address] one pollutant, one exposure at a time." Winfred  Hamilton, Baylor College of Medicine

… [breast cancer] incidence has stabilized in the U.S., but it's stabilized at one of the highest rates in the world, and as women move from lower risk regions of the world to the U.S., their incidence goes up and continues to rise over a couple of generations. So we know that that's not genes and there's something about industrial society that's playing an important role." Julia Brody, Silent Spring Institute.

I encourage all of my readers for your own sake as well as the sake of your family and children especially to "go green" as much as you possibly can. This applies to everything from the paints you use in your house to the household cleaning products you use, as well as the nail polish and perfume you wear.

 Please let me know if you have questions about what I have written. Leave a message about how you are changing your life "Go Green". Do you know anyone that has developed a cancer that they feel is related to some sort of environmental pollution?
I look forward to being in discussion with you.

You can download the full report here

This 120 page report looks at the current epidemic of childhood obesity. Some of the statistics are overwhelming. Currently one in every three child ages to 19 is overweight or obese. Obesity is estimated to cost 112,000 deaths per year in the United States. One third of all children born in the year 2000 are expected to develop diabetes in their lifetime. In addition, a recent article in the New England Journal of Medicine has pointed out that for the first time the current generation of children may be on a course of having a shorter life span than their parents.

There has been a consistent increase in the growth of childhood obesity from 1971 until about the year 2000, at which time childhood obesity levels off.

This very thorough report looks at many aspects of the cause of this epidemic and is full of amazing information. A few of these are
1)    Obese adults in current estimated $1429 more in medical expenses than their normal weight years.
2)    Medical spending on adults that was attributed just to obesity was over $40 billion in 1998. But in 2008 this had increased to an estimated $147 billion.
3)    During childhood excess weight costs an estimated $3 billion per year in direct medical costs.
4)    At least $1.6 billion is spent annually on food advertising directed to children and adolescents.
5)    13% of the daily caloric intake for 12 to 19-year-olds now comes from sugar- sweetened beverages.
6)    On average, children consumed only 64% of the recommended level of fruit and 46% of the recommended level of vegetables in 2003 to 2004.
7)    A mother's preconception weight and weight gain during pregnancy are two of the most important prenatal determinants of childhood obesity. Another way to say this is overweight mothers give birth to overweight children.
8)    Maternal smoking girly pregnancy is associated with a 500% greater risk of obesity at age 5.
9)    Research shows that it is possible that exposure to endocrine disrupting chemicals during pregnancy play a role in the development of childhood obesity. Scientists have coined the term "obesogins" for chemicals that they believe may promote weight gain and obesity.
10)    The Federal Trade Commission (FTC) estimated that in 2006 the food, beverage, and quick serve restaurant companies spent more than $1.6 billion to promote their products to young people.

The statistics in this article go on and on but it is clear that our entire country must change its direction in eating, exercise and focused in order for us to be first the obesity epidemic that we are living with.

The report focuses on five basic things that we can all do together to help this epidemic:
1) Create a healthy start on life for our children, from pregnancy through early childhood;
2) Empower parents and caregivers to make healthy choices for their families;
3) Serve healthier foods in schools;
4) Ensure access to healthy, affordable food;
5) Increase opportunities for physical activity.

I encourage you to read the whole article which can be gotten at this website.
Let me know what you think. Do you talk to your overweight friends about diet and exercise? What do you think can be done to improve this obesity epidemic?

The Government's Food Pyramid

In a new article by Dr Ames and his colleague, Joyce McCann, the authors discuss this new theory. This theory is based on the question "Is micronutrient inadequacy linked to diseases of aging"? Micronutrients include everything from zinc and selenium to vitamin D and vitamin K, all of  which we get in small quantities in our diet.

In this article, they specifically look at vitamin K. What they propose is that when  our body has a limited amount of a given nutrient e.g. vitamin K, it shunts the nutrient to the biochemical processes that are most needed for immediate survival. The theory is that when there is not enough of the nutrient over many years, other biochemical processes that are important, but which do not lead to an acute problem, do not receive a sufficient amount of the nutrient over a long period of time. This insufficiency does not produce immediate problems. But what this theory says is that this long term deficiency of the nutrient neededfor these other essential biochemical processes leads to chronic degenerative diseases, rather than an acute medical problem.

In this article they specifically look at vitamin K. Vitamin K's immediate use is to allow our blood to coagulate. So if you only have a small amount of vitamin K it will be used primarily to allow your blood to coagulate so you do not bleed to death. However what they point out in this study, is that long-term relative deficiency of vitamin K is linked to several age associated conditions. These include bone fragility after menopause, and arterial calcification which is linked to cardiovascular disease. Also in animal models an increased incidence in  cancer has been observed in long term vitamin K deficiency.

This theory is completely compatible with Dr. Robert Heaney's concept of "long latency deficiency diseases" which is discussed extensively in my book on vitamin D. In the case of vitamin D, an immediate deficiency will lead to rickets. However from all the research, it appears that a long term low-level deficiency of vitamin D leads to increased risk for cancer, heart disease, diabetes high blood pressure, osteoporosis etc.

I really like this theory! Whether we call it "triage theory" or "long latency deficiency disease theory," this concept makes enormous sense to me. The profound changes I have seen in my own practice of medicine as well as in my own health, from optimizing vitamin D levels, has shown me that vitamin D in higher levels bestows many additional benefits besides the prevention of rickets. It makes total sense to me that  our current epidemic of chronic diseases and fast food, can be linked to a relative insufficiency of many of the micronutrients that we all will get if we eat a healthy diet.

I have attempted to explain these complex concepts in a way that is understandable for you my readers. Please let me know if you have questions? Please let me know what your thoughts are on these concepts? I look forward to hearing back from you.

REFERENCE