Latest Articles

Giving the “Green Light” to Stess Reduction

By Russell Jaffe, MD, PhD

Regular exposure to dichromatic (also called “dichroic”) light is an effective modality for positively influencing the neural pathways between the eyes and the brain in ways that help to reduce the negative impact of chronic stress, and to help the body shift toward greater balance.

How Honest Are Gluten Free Food Claims?

By Beth Donnelly, Contributing Writer

With so many food manufacturers, restaurant chains, and even personal care companies jumping on the GF bandwagon, we need to ask ourselves an important question: Can we trust that GF products are truly “Gluten Free”? In most cases, the answer is "Yes," according to a study by the Food and Drug Administration.

The Caregiver Crisis: Rising Demand, Short Supply Puts Elderly at Risk

By Erik Goldman, Editor in Chief

As the population ages, the need for eldercare is soaring. Yet the number of people willing and able to provide these services is falling short. The impending eldercare gap is one of the biggest public health challenges confronting the nation, an issue that will sooner or later touch just about everyone regardless of race, creed, ethnicity or economic status. But nobody really wants to talk about it.

Dancing to the End of Life: Movement Therapy Transforms Eldercare

By Ali Schechter, R-DMT, LCAT, Contributing Writer

Say the word “dance” and most people think of young, able-bodied people moving freely. It’s not something we typically associate with the end of life. But dance/movement therapy, offers profound physical and cognitive benefits for the eldery, even those with limited mobility.

“Clinically Validated Daily Intake”-- An Antidote to Supplement Fairy-Dusting?

By Janet Gulland, Contributing Writer

The "Clinically Validated Daily Intake" is the minimum daily amount of a dietary supplement ingredient that has been found to produce a positive health effect in human studies. Broad use of CVDIs on supplement labels could go a long way in stopping the practice of "fairy dusting" products with insignificant amounts of popular ingredients. Will the industry embrace the CVDI concept?

Amino Acid Combo Before Hi-Carb Meals? It's a Good Idea!

By Erik Goldman, Editor in Chief

A sparkling water beverage containing a combination of five amino acids plus small amounts of chromium picolinate can reduce postprandial glucose peaks by nearly 30%, making it a potentially valuable new tool for people concerned about their diabetes risk.

Lactobacillus Combo Delays Celiac Onset In At-Risk Children

By Kristen Schepker, Assistant Editor

Lactobacillus Plantarum 660x330Lactobacillus plantarum, one of two probiotic organisms shown to avert the onset of celiac disease in at-risk children. Findings from a new study on celiac disease challenge the prevailing belief that strict gluten avoidance is the only effective approach to managing the condition.

Researchers at Sweden's Lund University showed that certain strains of probiotic bacteria have a suppressive effect on celiac autoimmunity that can delay the onset of the disease in at-risk children.

The investigators found that daily supplementation with a multi-strain lactobacillus probiotic significantly reduced the levels of celiac-related antibodies in kids with genetic predispositions to the disease -- despite their continued consumption of foods containing gluten.

For the estimated three million Americans living with celiac disease (CD), these promising results could shape the future of not only celiac disease treatment, but of prevention as well.

"To our knowledge, this is the first time a probiotic study has been performed on this specific population," said Lund University's Daniel Agardh, MD, PhD, who headed the research team. The data, which they presented in September, at the International Celiac Disease Symposium in New Delhi, India, "show immune-supporting properties of these probiotics as well as a potential preventive effect on the development of CD," he added.  

Agardh's group looked at the effects of two proprietary strains, Lactobacillus plantarum Heal 9 and Lactobacillus paracasei 8700:2, produced by Swedish supplement company Probi AB, on celiac disease autoimmunity. The randomized, double-blind, placebo-controlled trial involved 78 asymptomatic children aged three to seven years, who were deemed to be at increased risk for developing celiac disease owint to the presence of autoimmune markers associated with the disorder.

Much of the research on probiotics in celiac disease focuses on their potential as a therapy to manage existing disease symptoms. The Lund trial is the first to suggest the possibility that probiotics can be used to prevent celiac disease.

All of the kids had two consecutive blood samples that tested positive for tissue transglutaminase autoantibodies (tTGA), taken at least three months apart. They were randomized to take either a probiotic delivering both Lactobacillus strains or a placebo once daily for six months. They did not make any dietary changes, and were encouraged to continuing to eat their usual gluten-containing diets.

Celiac Antibodies Decline

Prior data from both human and animal studies showed that the selected bacterial strains support immune system health and confer "synergistic effects on reducing pro-inflammatory responses in vivo" at doses of 109 CFUs, explained Gun-Britt Fransson, PhD, Vice President Research & Development at Probi. Notably, the present study is the only one as of yet designed to test a larger dose of 1010 CFUs, Fransson added.

The researchers found that over the course of the study, celiac disease-related antibody levels (tTGA-IgA and tTGA-IgG) dropped significantly in children in the probiotic group, but increased significantly in the placebo group.

"The interpretation of this finding is that the probiotics can delay the onset of celiac disease -- and may even prevent from the development of the disease," Fransson proposed. 

Currently, the sole approach known to lessen celiac disease symptoms is a stringent, life-long, gluten-free diet, which, Fransson stated, "seriously affects and complicates everyday life." Therefore, she argued, "giving clinically documented probiotics as a prevention to anyone at risk for developing the disease, which is easy and not too costly, would be highly beneficial." 

Not long ago, scientists first hypothesized that the intestinal microbiota has an influence on celiac disease etiology, leading to the theory that probiotics can serve as a useful adjuvant in the management of gluten intolerance. Today, that theory is gaining traction -- not just within medical research circles, but among key supplement industry players as well.

"We see a growing interest in children’s probiotics," said Probi CEO Peter Nählstedt. The Lund University study, he says, supports the use of probiotics to lower celiac risk, and will, "enable Probi to build a product platform for children."

The Dysbiosis Factor

Several other recent studies further highlight the potential utility of probiotics as a celiac disease therapy.

A 2016 paper in the journal, Digestive Diseases and Sciences, showed that when compared to healthy subjects, patients with celiac disease have reduced levels of beneficial bacteria and elevated amounts of potentially pathogenic microorganisms in their intestinal microbiota.

As a group, celiac sufferers generally exhibit gut dysbiosis, increased intestinal permeability, and immune system disorders. While going gluten-free alleviates gut dysbiosis in some patients, many others will continue to experience symptoms of dysbiosis even after removing grains and other gluten-containing products from their diets. The authors argue that the intestinal microbiota likely plays a significant and independent role in celiac disease pathogenesis (Marasco, G. et al. Dig Dis & Sci. 2016; 61(6): 1461–1472). 

For individuals with celiac disease, certain microorganisms appear to be more efficacious than others in balancing the intestinal flora. There is evidence that species belonging to the genera Lactobacillus and Bifidobacterium in particular convey protective benefits to celiac patients. They exert anti-inflammatory effects as well as "protective properties on epithelial cells from damage caused by gliadin" (Morales, L. et al. Clin Microbiol Rev. 2014; 27(3): 482-489).

In a 2017 literature review of studies exploring probiotics to treat celiac disease, Coqueiro and colleagues note that the "therapeutic effects of probiotics in celiac disease are associated with an improvement in the intestinal microbiota and inflammatory conditions, attenuating the immune response and, generally promoting intestinal health."

Bearing in mind that the amount of scientific data on this subject is fairly limited, the research that does exist shows that using probiotics and enzymes in food production also benefits patients by reducing gluten toxicity, allowing celiac patients to consume foods that would otherwise trigger symptoms. However, the authors stress that probiotics "should be applied as an adjunct in celiac disease treatment." They are not a substitute for a gluten-free diet, which remains essential to effectively treat the condition (Coqueiro, A. et al. Int J Probi & Prebi. 2017; 12(1): 23-32).

Much of the research on probiotics in celiac disease focuses on their potential as a therapy to manage existing disease symptoms. The Lund trial, which has not yet been published, is the first to suggest the possibility that probiotics can be used to prevent celiac disease. Clearly more research is needed, but the initial signals are promising.

Practitioners looking to recommend probiotics to celiac patients should seek out products with documented clinical benefits for human health. "I would look for a probiotic shown to strengthen the intestinal barrier function, strengthen the immune system and reduce the pro-inflammatory response," urged Probi's Fransson.

If current research trends continue, we will likely see the emergence of probiotic supplements designed specifically to prevent celiac disease.


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Is “Keto” the Key to Reversing Diabetes?

By Erik Goldman, Editor in Chief

A wave of recent studies show that in many cases, type 2 diabetes is partly or wholly reversible with high fat, very low carb ketogenic diets. But the process requires careful coaching, and should not be undertaken without good clinical guidance.

Diet Sodas Raise Risk of Stroke & Dementia

By Jill Carnahan, MD, Contributing Writer

Diet sodas are garnering negative attention yet again, and for good reason. A recent report from the ongoing Framingham Heart Study indicates that drinking as little as one can of sugar-free soda per day over long periods can raise the risk of stroke and dementia by a factor of three.

Understanding the Two Forms of CoQ10

By Lauren Hilinski, Contributing Writer

The subject of CoQ10 bioavailability is a cause of contention and confusion for clinicians and patients alike. One of the biggest debates centers around which basic form of CoQ10 is most effective: Ubiquinone or Ubiquinol. Cardiologist Stephen Sinatra sheds some light.

Choline Citrate Improves Magnesium Absorption

By Russell Jaffe, MD, Contributing Writer

Choline, a water-soluble vitamin-like nutrient that is recognized for its role in methylation, liver detoxification, bile production, and neuro-hormonal suppor, is also able to increase the transport of magnesium into cells. 

Restoring Health, Rebuilding Lives: Clinicians Rise to Aid Refugees

By Madiha Saeed, MD, Contributing Writer

Refugee healthcare has become one of the world’s most pressing medical issues. Dozens of international groups provide acute care in the world's most strife-torn regions. But once refugees are out of imminent danger, and find foothold in places of relative safety, a different set of challenges emerge. Clinicians all over the US are working to help recent immigrants restore their health, rebuild their lives, and integrate into new communities.

In Genomics, as in Life, the "80/20 Rule" Applies

By Liz Lipski, PhD, CNS

There’s a lot of hype around genomics these days. From a patient care perspective, it comes down to two basic questions: What types of tests give truly useful information? And, who benefits most from having the testing done? Thought leaders in the field gathered at Maryland University of Integrative Health for a three-day symposium on these issues. 

Fearing "Too Much Information," Clinicians Hesitate on Genomics

By Erik Goldman

Despite all the scientific excitement about genomics—and all the colorful marketing of genetic test systems—holistic physicians have been slow to embrace the personalized medicine revolution. Fear of being deluged with too much useless information is a major reason for the reluctance.

Magnesium Has Role in Reducing Dementia Risk

By Krystal Krisciunas, Contributing Writer

Recent research suggests that magnesium plays a role in neuroplasticity, and that supplementation with this important mineral could help to prevent Alzheimer’s and other forms of age-related dementia. 

New Bills Urge Wider Federal Coverage of Supplements, Medical Foods

By Kristen Schepker, Assistant Editor

Two new pieces of federal legislation propose to expand access to vital health supports for millions of low-income Americans. If passed, the bills will make crucial medical foods and dietary supplements available to individuals and families who otherwise struggle to afford them.

What the Helminth! Are “Purposeful Parasites” The Next Probiotics?

By Megan Copeland, MS, CNS, Contributing Writer

If the idea of utilizing parasitic worms as therapy makes you squirm, you’re certainly not alone. Sure it sounds strange, but the use of “purposeful parasites” is not as far-fetched as it seems. Researchers like Duke University's William Parker, PhD, believes certain types of helminths can be helpful in treating immunological, gastrointestinal, autoimmune, and even cognitive disorders.

Fed Targets Maker of Addiction Gene Test, Claiming Fraud

By Kristen Schepker, Assistant Editor

Earlier this month, federal agents took action against Proove Biosciences, the maker and marketer of an opioid addiction genetic test, alleging that company is perpetrating healthcare fraud.

On June 7, agents from the US Attorney's office in Southern California arrived at the headquarters of the Irvine-based company, whose Opioid Risk Profile is marketed as a gene-based testFed Raid Proove to determine predispositions to opioid addiction. For the past six years, Proove has promoted the test as a tool to aid physicians in making the best decisions related to patients' pain management. Critics say it's nothing more than a money-making strategy backed by questionable science, charges the company categorically denies.

In what media sources described as a raid, officers from both the FBI and the Department of Health and Human Services (HHS) delivered to Proove a subpoena and executed a search warrant, removing documents from the company's office. Proove issued a press release shortly thereafter, insisting that "there was no 'raid', nor have there been any 'arrests' or 'indictments'" associated with the incident. The company, it said, "will continue to cooperate with any future requests for information from the government."

STAT's Accusations

The federal action, which received some local media coverage but limited national exposure, was covered by STAT News --an independent healthcare and biotech news outlet owned by Boston Globe Media.

STAT's has covered Proove several times, challenging the company's science, its clinical claims, and its marketing practices. In an article posted in late February 2017, STAT writer Charles Piller pointed out that the company was already under scrutiny by the FBI for "possible criminal wrongdoing." Current and former employees cited in Piller's article stated they were questioned by federal agents about "possible kickbacks involving payments to doctors." 

STAT also conducted its own independent analysis of Proove, through which it obtained and published documents illustrating what Piller described as, "largely a ploy to boost Proove Biosciences's revenues."

Among these documents was a copy of a Proove sales brochure indicating that physicians were promised $30 for each person they enrolled in a study of genetic tests intended to guide personalized pain treatment.  STAT claimed that a typical doctor could make $144,000 a year in "research fees" without ever conducting any actual research, raising questions about Proove's  incentive strategies.

An estimated 400 doctors around the US have been using the Proove opioid test, which is based on cheek swab DNA sampling. STAT contends that, "the way the company pays physicians involved in two ongoing Proove trials — both key to the firm's monthly revenues of roughly $2 million — might violate anti-kickback laws."

Piller and other critics also say that the company exercises coercive marketing tactics. Proove has purportedly stationed its employees inside doctors' offices, where they completed tasks including filling out evaluation forms on behalf of the physicians.

There are also questions about the science behind Proove's test--and, for that matter, any gene-based test for addiction risk.

Some addiction and genomics experts interviewed by STAT say Proove's test is inconsistent at best, highly dubious at worst. They point out that it has not been adequately studied in clinical trials--a common problem with newly emerging tests in general. In a December 2016 piece, Piller posited that Proove opportunistically exploits mounting fears about opioid addiction within the medical community.

Unverified Allegations

Then, and now, the company denies any wrongdoing.

Proove's CEO, Brian Meshkin, stands by the accuracy and legitimacy of his company's products. He argues that Piller's "defamatory" coverage of the opioid risk profile inappropriately portrays the company in a negative light and, furthermore, played a direct role in prompting the federal investigations now underway. The STAT publications, Meshkin told HPC, are rife with "many inaccurate claims that have been terribly damaged not only our reputation, but affected our collaborators and customers."

“We are disappointed in the process that allowed these unverified claims to be published and then pique the interest of federal agents,” Meshkin added.

In an official response to Piller's articles, Proove stated that the company "reimburses participating investigators only for the time they spend providing research services. No research or payment is tied to the number of tests ordered, patients referred, or the size or prestige of an institution or medical practice. Investigators are required to submit completed and signed time records, as well as the original source research documents to support an audit of their time records."

Proove reports that the major source of the company's income is third-party reimbursements for laboratory procedures and services.

In a series of official statements, the company responds to STAT's main allegations, arguing that the news site's December 2016 and February 2017 articles, "contained many errors and misstatements about Proove®’s technology, science, business practices, and leadership. Even more disturbing was Mr. Piller’s overall approach and obvious bias. In an age where anyone can post “fake news” online, both pieces contained errors of omission, lacked context and/or perspective in key areas... featured some sources that have no knowledge of our company or our emerging industry, and relied on information – much of it incorrect and/or misleading – provided by disgruntled and discredited former employees."

Meshkin says the company is standing by its methodology, claiming that, "There are five clinical studies demonstrating the high accuracy with which the Proove Opioid Risk® profile performs. These studies were conducted in 126 clinics throughout the United States, which specialize in orthopedics, pain management, psychiatry, primary care and addiction treatment. The accuracy of the test, as measured by the gold-standard of statistical methods, ranged from 76.7% to as high as 96.7%. Three of these studies supporting the algorithm in Proove Opioid Risk® have been accepted for publication in peer-reviewed publications...with 6 additional studies currently under review."

Legal & Regulatory Questions

Proove's leaders are consulting with both in-house and external legal counsel, and "pursuing all possible legal actions to recover damages and protect itself from further harm from these defamatory allegations."

In our Summer edition, Holistic Primary Care reported on Proove's test, and the broader questions of whether genomics can be used clinically to predict addiction risk. At the time of writing, we were unaware of STAT's allegations about coercive marketing and kickbacks.

However, our previous article did underscore the fact that so-called "laboratory-developed tests" like Proove's, fall into a regulatory netherworld with little to no federal oversight. The government defines LDTs as part of a larger class of in vitro diagnostic devices "intended for clinical use and designed, manufactured and used within a single laboratory," but does not require the FDA to oversee the development or marketing of LDTs.

This regulatory loophole allows manufacturers to produce and promote novel tests or devices without extensive clinical testing or premarket approval from the FDA or any other federal body.

Reps. Larry Buchson (R-IL) and Diana DeGette (D-CO), propose to remedy this situation. They recently released a draft of their bipartisan bill entitled the Diagnostic Accuracy and Innovation Act (DINA) that would reclassify LDTs, put them under FDA jurisdiction, and require their premarket approval. 

Given the current climate in Congress, the behind-closed-doors healthcare negotiations, and the generally anti-regulatory views prevailing in the Trump administration, this bill is unlikely to generate much political excitement. But the Buchson-DeGette draft does indicate that the issue of LDTs, and the lack of clear regulations, is on the radar of some legislators.

However it shakes out, the controversy now surrounding Proove serves as a stark reminder of the need for clinicians to be cautious with any rapidly developing medical technology. Dozens, if not hundreds, of genome tests have emerged in the last few years. Many testing companies are marketing at functional, holistic and naturopathic medical conferences, hoping to catch the wave of clinician enthusiasm for personalized medicine.

No doubt, it is challenging to balance the desire to be on the leading edge of innovation care while guarding onesself and one's patients from questionable products and services. It behooves practitioners — and those they treat — to approach technological advancements with a healthy dose of vigilance. The desire to help patients with new tools must be balanced with an equally keen eye for good science. Without substantial changes in federal regulations, the clinical community cannot count on the government to do this for us.

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Gaby's Nutritional Medicine, 2nd Edition, Brims with Clinical Pearls

By Kristen Schepker, Assistant Editor

In today's era of disposable digital media and ephemeral "alternative facts", there's something reassuring about a good old fashioned medical textbook---especially one as thorough and carefully referenced as the new second edition of Dr. Alan Gaby's landmark work, Nutritional Medicine.

Tackling the "Seven Deadly Toxins"

By Kristen Schepker, Assistant Editor

A number of pervasive toxins -- seven, to be exact -- are wreaking daily havoc on health and wellbeing, according to detox expert Deanna Minich, PhD.

"We are living in a sick, toxic world," Minich said at the recent Clinical and Scientific Insights (CASI) conference sponsored by Designs for Health in San Francisco. She discussed her unique holistic approach to detoxification.

Minich, a faculty member of the Institute for Functional Medicine, is a nutrition researcher, clinician, and author of the book Whole Detox.  She holds that effective detoxification programs need to address much more than just diet alone. To successfully clear the body of toxins, it is essential to consider the whole spectrum of toxic elements to which an individual patient is exposed. This includes factors that negatively affect the the mind and spirit.

Deanna MinichThroughout human history and across the globe, we find examples of specific practices aimed at cleansing and purifying the body, but also for clearing the mind and heart. These include salt baths and saunas, fasting regimens, and even more extreme interventions like bloodletting. The point here is that medical traditions in all times and places have understood that people have a need for periodic cleansing activities.

Our present-day infatuation with detox diets and juice cleanses shows that we still share this urge today. And while many who cleanse certainly notice positive physical changes, they often report other less tangible benefits like achieving a clear state of mind or a sense of feeling centered and grounded.

Minich outlined what she defines as the "Seven Deadly Toxins," a constellation of destructive forces that profoundly heighten toxic load. Describing their myriad impacts on human health and wellbeing, she offered practical detox strategies to target each one and support healing throughout all the body's systems.

Food

Like many other detox experts, Minich focuses first on food. Our highly processed modern food supply is rife with agricultural chemicals, industrial byproducts, heavy metals, and other toxins that present serious health risks. To identify and avoid the main sources of food-based toxins, patients must first learn how food is produced, packaged, and distributed.

Each year, the average human consumes around 2,000 pounds of food. Unfortunately, there area fair number of toxins in among the nutrients. 

The Natural Resources Defense Council reports that over 80,000 different synthetic man-made chemicals are currently in use in the United States. Those thousands of substances lurk not just in the diet but in countless everyday items, from cosmetics and household cleaners to furniture and even toys. Over 2,000 new substances are added to the chemical index each year, Minich noted.

These numbers capture just the substances that scientists presently know about. They do not include chemicals that researchers have not yet catalogued, or toxic metabolites of known compounds that only appear once those compounds are ingested.

The average human adult human body contains over 7,000 different chemicals, approximately 200 of which are already present in the blood at birth. 

Some food-borne chemicals have direct negative effects on the neurological and endocrine systems, and epidemiological studies show associations between environmental toxins and increasing rates of food intolerance, escalating cancer rates, and rising autoimmunity diagnoses (see Death & Toxins: Tackling the Main Drivers of Chronic Disease).

Some foods are more likely than others to contain toxic chemical residues, and understanding how food is made helps to inform safer, healthier dietary choices. On a more philosophical level, Minish added, failing to recognize where food comes from leads to spiritual fragmentation, separating us from the earth that provides our nourishment.

Understanding the intricate link between human health and the health of the planet is an equally important step in the cleansing process. It is difficult for us to achieve collective wellness without a healthy Earth -- and today, the planet's health status is far from optimal.

"If the planet were a person or a patient, we'd say she is out of balance, toxic, inflamed, and most of all, she's really distressed," Minich said. "Our air, food and water -- our most basic elements of survival -- are now in jeopardy."

To reduce toxic exposure,  Minich recommends eating a colorful diet rich in phytonutrients and whole, unprocessed, organic foods. She also stresses the importance of developing a healthy, constructive emotional relationship with food.

Emotional Baggage

Enjoyment of food comes easier to some personality types than others. A host of negative emotions and conditions can block one's ability to enjoy the simple process of preparing and eating food. For some people, guilt or shame around dietary choices can be major obstacles. In other cases, people may be struggling with serious eating disorders. 

Emotional baggage connected with food is a major health stressor, Minich said, which is why it also appears on her list of deadly toxins.

Whether associated with food or any other element in our lives, unprocessed negative emotions cloud our ability to live as fully and vibrantly as possible. Helping people "detox" requires clinicians to develop a lexicon for talking with patients about emotions, and aiding them in identifing and expressing what they are feeling.

Although it's common to extol the physical benefits detoxing, Minich asserted that, "Detox is a unique interface of medicine and spirituality."

When intentionally addressing both emotional and physical wellbeing, detox is a powerfully cathartic process -- and is not one to be entered lightly. Emotional cleansing can take a long time and require support, Minich counseled. "The longest distance a human travels in the lifetime is 18 inches," she said, defining the short but complex seperation between our heads and our hearts.

Undertaking that lengthy journey with purpose, awareness, and guidance from trained professionals prompts profound detoxifying benefits beyond what can be obtained with dietary changes alone.

Negative Thinking

Similarly to emotional baggage, negative thinking is a toxic health risk. Of the 60-80,000 different thoughts we think in a given day, most of which are reccurring, the majority are also negative, Minich said. All too often, she declared, "we feed ourselves with negative programming."

The scientific literature on negative thought patterns illustrates the health dangers of chronic pessimism: premature aging, inflammation, and stress. Because bad attitudes can deter wellness, it is as important that patients learn to identify and distance themselves from their pessimistic thoughts as it is for them to learn to read food labels.

Minich believes that every thought we think has the capacity to either boost us up or deplete us. It is essential that we ask ourselves which thoughts are draining our vital energy rather than replenishing it.

Sedentism

Minich's fourth deadly toxin is failure to move the body. "We're becoming more toxic because we're sedentary," she argued. Breathing, sweating, and oxygenating the blood through movement are all fundamental pieces of the detox puzzle.

Vigorous rhythmic movement also promotes neuronal plasticity, supports healthy aging, and stimulates a fluid, dynamic emotional flow.

In a study of prostate cancer patients receiving androgen-deprivation therapy (ADT), researchers found that supervised aerobic and resistance exercise not only significantly reduced treatment-related toxicity, but also improved social functioning and mental health (Cormie, P. et al. Brit J Urol Int. 2015; 115(2): 256–266).

For chronic disease patients and healthy individuals alike, moving the body is paramount to the detoxification process. To develop sustainable exercise habits, Minich asks patients what they love to do, crafting movement plans based around activities they find pleasurable. Whatever form exercise takes, if it's not enjoyable, it is not likely to last long.

Not Speaking Truth

When detoxing, honesty is the best policy -- though perhaps the least intuitive of Minich's recommendations for toxin removal.

In the Ayurvedic healing tradition, the mouth represents a source of authenticity, awareness, and personal choice. Like the food we put into our mouths, the words that come out of them hold tremendous power. Speech has its own form of gluttony: some people speak, lie, brag, or swear too much, which not only negatively affects others but also disrupts metabolism, chewing mechanics, and other sensory experiences like smelling and hearing.

Individuals who overspeak often do so because they have difficulty hearing and believing themselves. They benefit from learning to hear and harness their own voice, Minich suggested.

On the other hand, some individuals tend to remain silent when it would better serve them to speak up---a form of self-expression anorexia.

To prevent the buildup of toxic thoughts and emotions, it is helpful to guide quieter patients to learn to express themselves and share their vital truths. For those who struggle to speak out, Minich recommends the use of positive affirmations to develop a strong, loving voice.

Poor Sleep

Poor sleep is the sixth of Minich's deadly toxins. Many toxic substances are eliminated during sleep. At the same time, buildup of toxins can often disrupt sleep or degrade the quality of slee-, creating a negative feed-forward cycle.

Dreams are another important  facet of sleep. According to Minich, dreaming represents a potent form of detoxification, providing us with messages that offer insights into elements in our lives that require attention. But most people only sleep for four or five hours a night, challenging their ability to clearly remember their dreams. Deep, adequate sleep that fuels dreaming and restores the body is crucial for detoxification.

For patients with difficulty sleeping, Minich recommends visualizations and guided imagery to encourage a "best self" view and to achieve a higher quality of rest. She believes that an ability to visualize what we want to manifest in our lives can offer a locus of control, teaching us to "step into the driver's seat of our life, harness our intellect and imagination, well it up, and bring it out."

Lack of Purpose

Lacking purpose is the final toxin on Minich's list. Inability to experience awe and joy in life, or a numbness to the absolute miracle of life will contribute to a sense of disconnection from ourselves and others. In Minich's view, these are all toxic states of mind that over time have serious negative effects on health.

In many traditional healing practices, mediation is a powerful pathway towards finding meaning in one's life. Minich encourages patients to develop meditation or prayer practices that facilitate connection to a greater sense of purpose, fulfillment, and healthful vitality.

Combining science and spirituality, Minich takes a broad scope view toward detoxification. The process involves far more than just juice-fasts or intensive supplement regimens. Deep detoxification requires attention to all the aspects that make us human.

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Probiotics Have Adjunctive Role in Diabetes Care

By Lucy Karanja, PharmD, Contributing Writer

Nearly a decade ago, microbiome researchers began publishing reports suggesting that bacteria in the intestines play a role in glucose metabolism.  Recent studies support that thesis, and provide a basis for use of probiotics as adjunctive treatments for people with type 2 diabetes. 

Sulfate: A Common Nutrient Deficiency You’re Probably Ignoring

By Kristen Schepker, Assistant Editor

"Sulfate deficiency is the most common nutritional deficiency you've never heard of," says MIT Senior Research Scientist Stephanie Seneff, PhD, at the recent Clinical and Scientific Insights (CASI) conference in San Francisco.Seneff

Seneff believes that sulfate deficiency is a major culprit behind most modern chronic diseases and health conditions. But it is one that is largely overlooked.

Sulfate, comprised of the elements sulfur and oxygen is the fourth most abundant anion in our blood. It exists throughout the body in a variety of forms, filling numerous biological functions. A critical component of extracellular matrix proteins, it aids in the detoxification of drugs, food additives, and toxic metals. It also prevents blood from coagulating during transit through capillaries.

Cerebroside sulfate, an integral constituent of the myelin sheaths surrounding neuronal axons in the brain, helps to maintain optimal neurological health.

Like vitamin D--the widely recognized "sunshine vitamin"--sulfate levels depend depend on sun exposure. It is synthesized from sulfide in the skin and red blood cells via a sunlight-dependent chemical reaction.

Seneff described the skin as "a solar powered battery" that captures energy from sunshine to catalyze sulfate synthesis. The enzyme Endothelial Nitric Oxide Synthase (eNOS) "performs the magic" of turning sun energy into sulfate in the skin, she said.

Sunlight & Sulfation

In her research, Seneff identified what she describes as two critical and "mysterious" forms of sulfate: vitamin D3 sulfate and cholesterol sulfate. We simultaneously produce both molecules, which exist in the bloodstream and many other parts of the body, when we're exposed to sunlight.

Vitamin D and cholesterol share a key biochemical connection. Cholesterol, though potentially harmful in large quantities, must be present for the body to make vitamin D. Sunlight acts like a bridge between the two nutrients, as ultraviolet B rays from the sun reach the skin and activate 7-hydrocholesterol, a chemical precursor of vitamin D, converting it to vitamin D3.

While many people get their vitamin D3 from nutritional supplements, Seneff pointed to a significant difference between the type our bodies produce naturally and the kind that comes from a bottle.

In the presence of sunlight, skin cells produce vitamin D3 sulfate, a water-soluble form of the typically fat-soluble vitamin D. The sulfate form can travel freely throughout the bloodstream. But the vitamin D3 found in oral supplements is an unsulfated form  that requires low density lipoprotein (LDL) -- the so-called "bad" cholesterol -- for transport to receptor sites in the body.

It is difficult to obtain the sulfated vitamin D3  from food sources alone, heightening the importance of sun exposure to achieving a healthy vitamin D status (Nair, R. & Maseeh, A. J Pharmacol Pharmacother. 2012; 3(2): 118–126). Sun exposure is really the key.

In addition to vitamin D, many other vitamins, hormones, and neurotransmitters must be sulfated for transport in the blood. Sulfate transport, says Seneff, ranks among the most important bodily functions these various substances perform.

Mysterious Molecules

Cholesterol sulfate is another mystery molecule that Seneff believes deserves more attention from health practitioners. Scientists do not yet fully understand the many biological tasks that cholesterol sulfate carries out. Seneff views this as a problematic oversight, urging that both cholesterol and sulfate are "essential to the wellbeing of all cells."

Red blood cells produce cholesterol sulfate, which collects around the exterior of the cells and creates a negatively charged field around them. This aids their smooth passage through tiny capillaries. In essence, the negative charges prevent the cells from getting stuck to each other or to the capillary walls. Cholesterol sulfate also prevents red blood cells from rupturing, a condition known as hemolysis.

In a paper published in the journal,Theoretical Biology and Medical Modelling, Seneff and her colleagues theorized that sulfur deficiency contributes to the development of atherosclerosis, and the buildup of fats, cholesterol, and other undesirable substances in the artery walls.

Most health experts blame atherosclerosis and CVD on elevated serum LDL, low HDL, and elevated homocysteine. But Seneff and colleagues offer a different theory, one that identifies deficiencies in critical biosulfates--especially cholesterol sulfate--as a prime cause of heart disease.

She suggests that when the body is deficient in sulfates, cardiovascular plaque develops intentionally as an "alternative mechanism" to make and supply more cholesterol and sulfate to the heart. When sulfate levels are low, artery walls cannot function properly, triggering cascades that lead to plaque production and buildup.

Elevated cholesterol is commonly treated with lipid-lowering statin drugs. But Seneff's team says addressing heart disease with medications that lower cholesterol is problematic, because "the cholesterol is desperately needed to maintain blood stability."

"Endothelial cells, macrophages, and platelets collaborate to produce [cholesterol sulfate] from homocysteine and oxidized LDL," she wrote in a 2015 paper. Formation of atherosclerotic plaque is, in her view, the body's elegant way of providing itself with "a well-choreographed program for renewal of cholesterol sulfate"  in conditions where insufficient dietary sulfur and inadequate sun exposure contribute to low cholesterol sulfate levels,(Seneff, S. et al. Theor Biol Med Model. 2015; 12(1): 9). 

Seneff believes there is a link between sulfate deficiency and numerous other health conditions including autism, eczema, asthma, anemia, preeclampsia, premature birth, and digestive disorders (Seneff, S. et al. Entropy. 2012: 14(11): 2265-2290).

If her hypothesis seems like a radical departure from conventional views, that should not be surprising. Seneff is no stranger to scientific controversy.

An electrical engineer and computer scientist by training, she generated considerable consternation from some sectors of the medical world when she jumped the interdisciplinary fences and started publishing research on environmental health issues roughly a decade ago.

Her publications linking incidence of autism with exposure to the herbicide glyphosate, triggered considerable outcry from some toxicologists and medical thought leaders who argued that Seneff was playing loose and fast with epidemiological data and that her claims do not stand up to scrutiny.

For her part, Seneff has not tempered her views on the dangers of glyphosate.

Toxins Disrupt Sulfate Synthesis

Her more recent work on sulfates makes a compelling case for increasing sun exposure, and perhaps increasing dietary sulfate intake. A number of environmental and lifestyle factors make this a challenging goal to achieve.

Countless toxic chemicals in the environment -- and glyphosate is one of them -- can disrupt sulfate synthesis and sulfate transport, leading to sulfate deficiency.

In the last two decades, the use of glyphosate as an agricultural product has skyrocketed in the US and worldwide. Known as the main ingredient in Monsanto's Roundup weedkillers, glyphosate was in the spotlight two years ago when the World Health Organization defined it as a "probable human carcinogen." Last year, the WHO revised its position and downplayed the potential risk. 

But many scientists--and certainly many members of the general public--view it as a pervasive poison in our food system that increases the risk of cancer, autism, heart failure, dementia, and joint pain.

According to Seneff, the herbicide's deleterious impacts on human health can be traced to its effects on sulfate synthesis.

"Glyphosate is a trainwreck for sulfate," she said. It not only disturbs sulfate production, transport, and delivery, but causes loss of sulfate through the kidneys and urine as well. The toxin can also disrupt intestinal bacteria, triggering gut dysbiosis and leaky gut syndrome.

Furthermore, it suppress the activities of members of the cytochrome P450 (CYP) family of enzymes (Samsel, A. & Seneff, S. Entropy. 2013; 15(4): 1416-1463). 

Endothelial nitric oxide synthase (eNOS), which Seneff believes is largely responsible for catalyzing sulfate production in the body, is a CYP enzyme that is highly susceptible to damage from glyphosate and other environmental toxicants including mercury and aluminum (Seneff, S. et al. Entropy. 2012; 14(12): 2492-2530). Arsenic, cadmium, and lead also disrupt CYP enzymes (see Death & Toxins: Confronting the Main Driver of Chronic Disease).

Glyphosate can cause eNOS to malfunction, interrupting production of both sulfate and nitric oxide (NO), leading to excessive haemolysis (anaemia), vascular constriction and hypertension (Samsel, A. & Seneff, S. J Biol Phys Chem. 2016; 16(1): 9–46).

Seneff further argues that the overuse of sunscreen disrupts eNOS as well. In addition to preventing sunlight from catalyzing central chemical processes like vitamin D sulfation, high-SPF sunscreens contain aluminum, which disrupts eNOS. 

Boosting Sulfur Intake

To prevent sulfate deficiency, Seneff recommends avoiding exposure to glyphosate and other toxins that impair sulfate synthesis. Glyphosate testing has revealed residues of the herbicide in many staple foods, primarily sugar, corn, soy and wheat. Replacing conventionally grown produce with organic, non-genetically modified foods significantly lessens the likelihood of unintended toxin consumption.

Eating sulfur-rich foods is another important strategy for boosting sulfate production. Animal protein is a significant source of dietary sulfur. Other sulfur-containing foods include coconut oil, olive oil, organic pastured eggs, legumes, garlic, onions, brussels sprouts, asparagus, kale, broccoli, and wheat germ.

But as with vitamin D, the best way to enhance sulfate synthesis is to get out into the sun.. Easily accessible and entirely free of charge, sunlight is the best and simplest antidote to the problem of sulfate deficiency.

END

The "Wheat Zoomer"--A Game-Changer for Gluten Testing?

By Madiha Saeed, MD, Contributing Writer

A new suite of antigen tests collectively called the Wheat Zoomer is being forwarded as a definitive tool to help clinicians figure out if a patient truly is--or is not--sensitive to gluten and other grain-based proteins. Is the Zoomer all that it's cracked up to be? Experts share their views.

“Why Did We Have to Wait 35 Years?” Raphael Mechoulam on Clinical Cannabis

By Laura Lagano, Contributing Writer

Dr. Raphael Mechoulam is widely recognized as the grandfather of modern cannabis research. In the early 1960s, his team identified and isolated THC. He later discovered the endocannabinoid system in the human nervous system. In this far-ranging interview with Laura Lagano, Dr. Mechoulam--now 86 and still active--shares his thoughts on the strenghts and limits of cannabis medicine, and its implications for clinical practice, research, and public policy.

Soft Drinks Raise Uric Acid...and Gout Risk

By Megan Copeland, MS, CNS, Contributing Writer

Sugar-sweetened beverages—SSB’s as they’re known in public health circles—trigger surges in plasma uric acid levels, typically within 30-60 minutes. While these are temporary, people who drink several soft drinks every day are putting themselves at increased risk for gout.

Endomicroscopy Offers Insight on Leaky Gut Syndrome

By Isaac Eliaz, MD, Contributing Writer

Confocal laser endomicroscopy (CLE) enables direct visualization of cellular and subcellular changes in the intestinal lining of a living patient. This new imaging technique gives the ability to detect subtle inflammatory changes and epithelial gap formations in patients with intolerance to specific food group, providing objective evidence to support the controversial concept of "leaky gut syndrome."

Death and Toxins: Tackling the Main Driver of Chronic Disease

By Erik Goldman, Editor in Chief

If Ben Franklin were alive today, his famous aphorism would likely read, “Nothing can be said to be certain, except death and toxins.” It’s no overstatement to say we are wallowing in new-to-nature toxic chemicals that have considerable power to disrupt our physiology. In his new book, The Toxin Solution, naturopathic pioneer Dr. Joe Pizzorno, outlines the daunting scope of the problem, and offers practical strategies for response.

Cherry-Bombing an Old Foe: Gout

By Sarah Arvelo, MS, Contributing Writer

With gout on the rise in the US and in most of the developed world, many patients are finding sweet relief from a favorite summertime fruit. In one study, daily consumption of cherries reduced the frequency of acute gout attacks by 35%.

Who Cares for the Au Pairs?

By Laura Henderson, Contributing Writer

The saga of Edna Valenzuela, a young Colombian woman who was diagnosed with lymphoma while working as an au pair for a DC-area family, and almost sent back to her home country in the midst of chemotherapy, throws much-needed light on the plight of a very vulnerable population.

What to Do About those "2 AM Wake-Up Calls"

By Jacob Teitelbaum, MD, Contributing Writer

Does it seem like every night at 2–4 AM your internal alarm clock goes off? Or perhaps you have patients who experience this disruptive nightly routine. It is one of the most common problems affecting people with fibromyalgia, and is increasingly common in the general population as well.

But what if it was optional?

Okra: An Unsung Super-Veggie

By Lucy Ruetiman, MS, Contributing Writer

Mention okra to someone you generally get one of two reactions – a passionate declaration of undying love for this humble vegetable, or a repulsed face followed by a dismissive reference to its sliminess. Strong reactions aside, there's no denying that okra is a very healthy vegetable with some interesting medicinal properties.

Probiotics Research Update: Glucose Control, Obesity Prevention & Ulcer Remedy

By Kristen Schepker, Assistant Editor

The recent explosion in human microbiome research and its increasing coverage in the media, has made "probiotics" a household word. While many people understand that beneficial bacteria are a crucial component of digestive health, scientists continue to uncover the myriad ways in which probiotics promote good health far beyond the GI tract.

Following are reviews of some of the latest probiotics studies highlighting the roles that gut flora play in regulating blood sugar levels, influencing obesity, and combating H. pylori infection.

How To Restore Gut Flora After Antibiotics

By Kristen Schepker, Assistant Editor

Antibiotics eradicate pathogenic infections and save lives -- but in doing so, they also disrupt the integrity of the intestinal microbiome. While many physicians recognize the need for restoring a patient's microbial balance following a course of antibiotic therapy, far fewer understand how to do this effectively.

According to Amie Skilton, ND, restoration of gut flora is both art and science. Done well, it can make a world of difference for patients. In some cases, it can even help patients overcome the illnesses for which the antibiotics were initially prescribed.

But it takes more than just recommending an off-the-shelf probiotic and hoping for the best.

The Centers for Disease Control reported last Spring that of the 154 million prescriptions for antibiotics written in doctor’s offices and emergency departments each year, 30 percent are unnecessary. Most of the extraneous prescriptions, the CDC found, were doled out for respiratory conditions caused by viruses like common colds, viral sore throats, bronchitis, and sinus and ear infections, which do not respond to antibiotics. Use of these drugs "put patients at needless risk for allergic reactions or the sometimes deadly diarrhea, Clostridium difficile.”

Further complicating the picture is the reality that antibiotics aren't only dispersed from doctor's offices; they're also fed liberally to livestock and sprayed extensively on produce, leaving minute but biologically active traces in the foods that humans then consume.

Dose, Timing Determine Impactantibiotics pills

As antibiotics kill off infection-causing microorganisms, they also non-selectively destroy communities of beneficial gut bacteria, weakening the stability of the intestinal microbiome. This wholesale destruction can be massive; experimental data collected from a study using qPCR indicate up to a 10-fold reduction in bacterial isolates immediately after treatment with antibiotics (Panda, S. et al. PLoS One. 2014; 9(4): e95476).

"It's truly a decimating effect," says Dr. Skilton, a naturopathic physician and herbalist at the Elysium Clinic of Natural Medicine, Sydney, NSW, Australia.

In a webinar sponsored by Holistic Primary Care and Bioceuticals, she outlined the myriad impacts of antibiotics on the human microbiome, noting that not all antibiotics are equally destructive to gut bacteria. 

The degree to which these drugs damage intestinal microbiota depends on drug type, treatment duration, and frequency of use, Skilton said. Certain antibiotics, for instance, trigger a greater release of endotoxins and cytokines than others. Higher daily doses are more impactful. Prolonged use of high-dose antibiotics can cause extreme damage to the microbiome that may take years of restorative therapy to reverse, if it can be reversed at all.

And contrary to common belief, intravenous antibiotics can have the same negative impact on gut flora as oral drugs. "For a long time it was thought that IV drugs would bypass the gut and not have the same impact. We now know this is not true."

The timing of antibiotic delivery also makes a difference. Individuals who frequently use antibiotics early in life are more vulnerable to many types of illness as they age. In a paper published earlier this year, researchers demonstrated an association between antibiotic use during infancy and subsequent poor neurocognitive outcomes, suggesting that antibiotic consumption in a patient's first year of life was associated with small but statistically significant differences in cognitive, behavioral, and mood measures during childhood (Slykerman, R. et al. Acta Paediatr. 2017; 106(1): 87–94). 

Others have linked fetal and early childhood antibiotic exposure to the subsequent development of asthma later in life (Örtqvist, A. et al. Brit Med J. 2014; 349. doi: https://doi.org/10.1136/bmj.g6979). Antibiotics have also been associated with obesity and weight gain in children as well adults (Million, M. et al. Clin Microbiol & Infec. 2013; 19(4): 305–313). Researchers attribute these changes to the altered gut microbial composition.

Antibiotics can trigger the release of toxic lipopolysaccharides (LPS), large molecules found in the outer membranes of pathogenic Gram-negative bacteria. Some suggest that antibiotic-induced LPS release may contribute to the development of septic shock in patients treated for severe infections caused by Gram-negative bacteria. Others have demonstrated that LPS triggers an immune response by releasing inflammatory cytokines, a problem that worsens after antibiotic treatment, noted Skilton in her webinar (Wu, T. et al. Toxicol Lett. 2009; 191(2-3): 195-202).

From a pathogen's point of view, production of LPS is a survival strategy. These molecules interact on cell surfaces to form a barrier, preventing the antibiotics and other hydrophobic compounds from entering and allowing Gram-negative bacteria to live even in harsh environments (Zhang, G. et al. Curr Opin Microbiol. 2013; 16(6): 779–785).

How to Restore the Flora

Probiotics are one aspect in a comprehensive strategy to restore gut flora following antibiotics. Given the microbial diversity of a healthy gut ecosystem, Skilton recommends using products that contain many different species of beneficial microbes rather than "monocropping" with one or two single strains.

As a general rule, she advises one month of probiotic treatment for every week that a patient was on antibiotics. Those who have been on prolonged continuous antibiotic regimens, will likewise need long-term restoration. She stressed that for most people,  there are no health risks associated with extended probiotic supplementation.

Patients receiving IV antibiotics should also take commensal probiotics. Some clinicians who are aware of this issue will start the probiotics as early as four hours after a dose of IV antibiotics.

Rebuilding the Glycocalyx

People who have been on long-term or multiple courses of antibiotics typically show a severe erosion of the glycocalyx that normally coats the  intestinal microvilli. This is usually accompanied by a loss of brush borders and a marked reduction in secretory IgA production.

GlycocalyxIn some cases, these changes are caused by the effects of antibiotics themselves. In others, they reflect the impact of the infection for which the antibiotics were prescribed. Either way, the effect is the same: establishment of a microenvironment that is hospitable to opportunistic pathogens like Candida, but increasingly difficult for normal commensal bacteria.

Fungal infections are almost always accompanied by insufficient IgA production, as Candida consumes both glycocalyx and sIgA as fuels. It becomes a vicious cycle: low IgA begets Candida which further depletes IgA. Chronic urinary tract infections, and mucosal infections like thrush are red flags for low sIgA production, Skilton pointed out.

Without a healthy glycocalyx, organisms like Lactobacilli and Bifidobacilli have great difficulty establishing themselves. In this context, supplementation with ordinary probiotics will usually fail.

"Even if you recommend the best probiotics in the world, theres’ no way for them to stick and colonize if the glycocalyx is eroded," Dr. Skilton explained. "You can actually exaggerate the GI symtoms by giving probiotics, if the there's loss of ability to produce glycocalyx."

To restore a healthier microenvironment in these cases, you need to leverage the unique characteristics of Saccharomyces boulardii, an antibiotic-resistant, probiotic yeast originally isolated from lychee fruit in Indochina. Though not a true commensal organism, S. boulardii is a potent inducer of glycocalyx production and IgA secretion. It also stimulates brush border enzymes, and promotes polyamine production, which feeds the intestinal microvilli and can be helpful for healing ulcerative colitis, Crohn’s disease, and irritable bowel syndrome.

S. boulardii is able to work in the context of highly pathogenic antibiotic-resistant bacteria like Clostridium difficile and has actually been used as a preventive therapy against C. difficile–associated diarrhea (Goldstein, E. et al. Clin Infect Dis. 2015; 60 (suppl_2): S148-S158). S. boulardii may reduce some of the toxic effects of enterotoxin A by inhibiting toxin A-receptor binding and preventing the formation of enterotoxin B.

But the most remarkable thing is it's ability to quickly colonize the damaged endothelium and displace pathogenic yeasts while simutaneously creating a healthier microenvironment for commensal bacteria. "S. boulardii actually forces a physical evacuation of the Candida," said Dr. Skilton noting that it is specifically active against 7 out of the 8 most common pathogenic Candida species. The one exception is C. tropicalis.

"Think of the situation like the aftermath of a hurricane hitting a village. The antibiotics are the hurricane. S. boulardii is like the contractor that comes in and repairs the damage to the village. You can then repopulate the village with commensals."

BioCeuticals, an Australian practitioner-only nutraceutical company, recently introduced a product called SB Floractiv, providing 250 mg S. boulardii (also called S. cereviciae) per capsule.

For patients who've been on long-term antibiotics, begin slowly with one capsule (250 mg) per day for 3-4 days, then increase to two per day for another 3-4 days, and then increase in a similar step-wise pattern up to four per day (1000 mg) that should be continued for the remainder of a 4 week period.

S. boulardii is very safe, and the only true contraindication is in patients with true IgE-mediated reactions to yeasts, manifesting as anaphylaxis or Saccharomyceshives. That said, it is important to be aware that in the first few days of taking S. boulardii, some patients may experience a noticeable "bowel flush" as the probiotic yeast displaces the Candida species. Candidal die-off can also make people feel ill. It is best to advise patients of these possibilities beforehand, so they're not surprised if they occur.

According to Dr. Skelton, in 9 out of 10 patients, four weeks of intensive S. boulardii supplementation is siffucient to restore a healthy glycocalyx layer and induce adequate IgA secretion. This then sets the stage for a much more effective round of restoration with a multi-strain probiotic.

Bioceuticals has designed a product specifically for use after antibiotics. Called BioFloractiv 500, it contains 500 billion CFUs, 12 species, and 14 strains of beneficial bacteria. Dr. Skilton recommends a maximum of 14 days, though one week of daily therapy is sufficient for most, according to Skilton.

Patients with irritable bowel syndrome or Crohn’s disease, however, may need longer-term support to rebuild a healthy microbiome after taking antibiotics.

A Comprehensive Approach

Probiotics are just one part of the picture. And if a patient cannot tolerate any type of probiotic, its a red flag that a patient's immune system is not functioning properly.

"You first need to address any aspects of the nervous system, especially sympathetic dominance, that may be affecting the digestive tract," said Dr. Skilton. She has found fish oil, zinc, vitamin A, and colostrum to be of value in many cases. The latter, "is really good for restoring sIgA. Do this for a week or so before even trying probiotics." Slippery Elm and glutamine supplements can also be helpful in some cases.

Plant-based medicnes like oregano oil, tea tree oil, or pau d'arco extract may be helfpul in ridding the GI tract of pathogenic yeast. But Dr. Skilton stressed that these will do nothing to stimulate sIgA production, and chronic yeast infections are almost always associated with low IgA.  These natural yeast-busters should never be used at the same time as S. boulardii; this "friendly" yeast is just as vulnerable to things like oregano and tea tree as the pathogenic yeasts.

A number of probiotic and prebiotic foods can aid the process of gut restoration. Tom O'Bryan, DC, founder of the Gluten Summit and the Certified Gluten Practitioner training program, recommends several foods to eat -- and several to avoid -- when rebuilding the gut after antibiotic treatment.

"When your gut has been compromised, you don’t want to tax your gut," O’Bryan says. "Taxing" foods include wheat, dairy, sugar, unhealthy fats, and fried items. These foods, he notes, "throw gasoline on the fire" of a recovering intestinal system. 

On the other hand, one should eat plenty of foods that promote the growth of healthy commensal organisms. O'Bryan recommends organic stewed apples, cooked until soft and shimmery, as one good option. Cooking apples, he explains, releases pectin -- a soluble fiber that provides fuel for beneficial bacteria.

The pectin present in stewed apples can also help to heal a damaged intestinal lining and seal off the tears in a leaky gut, preventing large food molecules from slipping through.

Similarly, collagen helps to seal a leaky gut. O'Bryan also encourages patients recovering from antibiotic treatment to eat chicken bone broth, a good source of collagen, which also acts as a natural prebiotic, feeding the healthy bacteria in the gut.

Butyrate -- a natural substance made in the intestine -- is another important player in gut bacteria restoration. O'Bryan explains that the cells lining the inside of the gut reproduce rapidly and that butyrate fuels the rebuilding of new cells. Insufficient butyrate production and a slow turnover of intestinal cells make the body more vulnerable to the development of cancer cells, resulting in a higher risk of colon cancer.

An array of prebiotic fruits and vegetables, including foods bananas, sweet potatoes and other tubers help to rebuild the gut microbiome, providing insoluble fiber that feeds good -- but not harmful -- bacteria.

Fermented, unpasteurized vegetables like sauerkraut, kimchi, and fermented beets, are another excellent source of natural probiotics. Every vegetable produces different families of beneficial bacteria during fermentation, O’Bryan notes, encouraging patients to eat one forkful of fermented vegetables twice a day. "The key to health in your gut is the diversity of your microbiome," he argues, pointing out that thousands of different families of bacteria live and interplay in the gut with wide-ranging impacts on our health.

END

What Can Holistic Medicine Expect from GOPcare?

By Erik Goldman, Editor in Chief

How will holistic medicine fare under the Trump administration? It’s a big question with no obvious answer. yet A lot depends on what the new administration does with healthcare at large. And that is still full of unknowns. Some thought leaders applaud the GOP's support for expanding health savings accounts (HSAs). Others see big danger in deregulation.

A Role for N-Acetyl Cysteine in Treating Parkinson's Disease

By Madiha Saeed, MD, Contributing Writer

People with Parkinson’s disease may benefit from supplementation with N-acetyl cysteine (NAC). Researchers at Thomas Jefferson University recently showed that Parkinson’s patients who took NAC daily for three month showed significant improvements of mental and physical abilities, as well as beneficial changes on brain imaging. 

FTC's Crackdown Blows Chilly Wind Down Memory Lane

By Kristen Schepker, Assistant Editor

The Federal Trade Commission's (FTC's) recent crackdown on a popular product marketed for memory improvement has supplement companies thinking twice before making claims that nutrients or herbs can enhance cognitive function. Was the move really about consumer protection or is it evidence of regulatory over-reach?

Gram-negative Bacteria Implicated in Alzheimer’s Pathology

By Kristen Schepker, Assistant Editor

University of California researchers have discovered the presence of marker compounds from Gram-negative bacteria--including Escherichia coli--in brain tissue from people with Alzheimer's disease, providing further support for the notion that there is a microbial component in the etiology of this common form of dementia.

How to "Beet" Hypertension

By By Elizabeth Herbert, Contributing Writer

Drinking roughly one cup of raw beet juice daily can markedly reduce blood pressure, while simultaneously quelling systemic inflammation and improving lipid profiles in people with hypertension.

New Botanical Combo Promotes Fat Loss, Weight Management

By Kristen Schepker, Assistant Editor

A novel botanical combination that includes extracts of Coleus forskohlii, Salacia reticulata, and sesame, can limit the absorption of excess dietary fats, p, according to the results of a study published in the Journal of Functional Foods

Why Probiotics Should Be Part of Pregnancy Care

By Belinda Reynolds, Contributing Writer

In recent years, microbiome researchers have uncovered a wealth of new information about how beneficial microbes promote fertility, pregnancy, and postnatal child health, all of which suggests that probiotics should become a routine part of prenatal healthcare.

The Best of Medicine X 2016

By Erik Goldman, Editor in Chief

The annual Medicine X conference is a great place to learn about potentially transformative new medical technology. Here are a few that captured our attention this year.

Medicinal Mushrooms: Nature's Original "Smart Drugs"

By Isaac Eliaz, MD, Contributing Writer

With a therapeutic legacy spanning millennia and a body of scientific research that continues to expand, medicinal mushrooms have earned a rightful place  as broad-spectrum adjuncts. Think of them as nature’s original “smart drugs.”

Ancient Medicinal Mushroom Improves Renal Function

By Kristen Schepker, Assistant Editor

The Poria fungus--little known in the West but long-used in traditional Asian mediicne--has recently attracted the attention of health researchers and practitioners. Compounds in this unique mushroom have particularly positive effects on the kidney.

STRAIN: A New Tool for Psychosocial Stress Assessment

By Kristen Schepker, Assistant Editor

Chronic stress can wreak havoc on the body, and emerging field of human social genomics is illuminating the mechanisms. A new tool called the Stress and Adversity Inventory (STRAIN) can enhance clinicians' abilities to assess the impact of stress in patients with chronic disease and identify points of leverage for reducing the toll it takes.

The Fed’s Misguided “War on Pain,” And What We Can Do Instead

By Jacob Teitelbaum, MD, Contributing Writer

About a decade ago, with roughly one-quarter of all Americans suffering some form of chronic pain, the US government did what it does best, and declared a “War on Pain.” Doctors responded by doing what they do best: prescribing painkillers. The result? Thousands of preventable deaths due to overdoses and side-effects, a surge of addiction, and even more people in chronic pain. Fortunately, as pain expert Jacob Teitelbaum points out, holistic and integrative medicine offers many safer, more effective options.

Regulatory Actions Signal Storms Ahead for Integrative Medicine

By Erik Goldman, Editor in Chief

Over the last six months, federal agencies have made regulatory moves that could have significant impact on the practice of holistic, functional, and integrative medicine in the coming years. While none represent a direct threat to practice freedom, they set precedents that could greatly limit access to foundational practice tools.

Stop Fighting, Start Restorative Healing: A Functional Approach to SIBO

By By Russell Jaffe, MD, Contributing Writer

The key to helping people dealing with small intestinal bacterial overgrowth (SIBO) is to initiate restorative healing of the affected tissues. We need to shift physiology so that the internal environment no longer favors the overgrowth of hostile bacteria in the small intestine. If we fail to do that, treatments aimed at eradicating the bugs will have little long-term efficacy

Hypermethylation: Are We Overdoing It with Methylation Support?

By Romilly Hodges, MS, CNS, Contributing Writer

Over the last few years, clinicians have become increasingly aware of the importance of methylation as a determinant of health. In general, that's a good thing. But over-methylation, driven by zealous use of supplements like methylated folate and methylcobalamin (vitamin B12), can be as much of a problem as under-methylation.

Strong Fathers, Glass Ceilings & the Neurobiology of Politics

By Erik Goldman, Editor in Chief

Cognitive scientist George Lakoff has spent four decades studying how the human mind makes meaning, and how that factors into politics. He concludes that while people may believe they are “voting their conscience,” for the most part they are voting their “un-conscience.”

Obama in JAMA: Reform Has Achieved Two Main Goals, Says Prez

By Erik Goldman, Editor in Chief

Outgoing President Barack Obama became the first American president to publish an article in a major peer-reviewed medical journal.

And not just any old medical journal, but the Journal of the American Medical Association. In it, he claims that healthcare reform has more or less succeeded in achieving its two main goals: expanding insurance coverage and curbing costs. But other health policy analysts aren't so sure.

Meditation: A Low-Cost, Low-Risk “Blockbuster” Therapy

By Madiha Saeed, MD, Contributing Writer

For many people, the word “meditation” sounds like something that requires a great deal of practice, patience, time, and effort. So people put it off.  But it is really very simple, and the health benefits are profound. If it were a drug, it would be a "blockbuster."

To Prevent Burnout, Get Rid of “Junk” Emotions

By Madiha Saeed, MD, Contributing Writer

Feelings of resentment, anger, and envy are really just “junk” emotions. Like junk food, these junk emotions are  bad for one’s health. In their new book, Psychological Nutrition, psychologists Shoba Sreenivasan and Linda Weinberger explain that many people--including a lot of healthcare professionals-- live in a state of “psychological malnutrition.” As with physical food, changing the emotional diet can make a big difference.

Ph360: Can “Phenomics” Give Clues to Better Health?

By Madiha Saeed, MD, Contributing Writer

ph360 is a new algorithm for determining phenotypes and epigenetic profiles, and then figuring out custom-tailored exercise, and lifestyle plans. “The real key to our health is written in our body’s unique code. And we’ve cracked it," says company founder Matt Riemann. HPC's Dr. Madiha Saeed test-drives the system with her patients and shares her experience. 

Anti-Inflammatory Side-Effects Carry High Price Tag

By Rachael Adams, Contributing Writer

Anti-inflammatory drugs hold the top spot for specialty drug spending in the US, accounting for 23% of all dollars spent on specialty medications. They're also among the most common culprits when it comes to adverse effects, and those end up costing us billions---$2.2 billion to be exact.

Lead Astray: Environmental Toxins Threaten Community Health Nationwide

By Isaac Eliaz, MD, Contributing Writer

The toxic drinking water crisis in Flint, Michigan, recently put the danger of lead contamination in the national spotlight. While the situation in Flint was arguably the most dramatic and egregious example of careless and negligent environmental policy, it is by no means the only one. Not by a long shot. And the fallout is showing up in clinics all over the country.

Labeling Advocates Vow To Fight GMO “DARK” Act

By Erik Goldman, Editor in Chief

Late in July, President Obama signed a nationwide GMO disclosure law that critics say does just the opposite. GMO labeling advocates, as well as the attorney general from Vermont--the only state to fully implement a true GMO labeling requirement--have vowed to fight it.

Probiotics: Benefits Beyond Gut Health

By Kristen Schepker, Assistant Editor

Probiotics are widely touted for their capacity to improve digestive function and strengthen gastrointestinal health. But according to new research, the effects of beneficial bacteria extend far beyond the gut alone.

Is Marijuana a Viable Remedy for Migraines?

By Kristen Schepker, Assistant Editor

In recent years, both an upsurge in medical cannabis research and also changes in the plant’s legal status in many US states have led health practitioners and patients alike to shift their views of cannabis from goofy recreatinal drug to serious medicine. 

New Urine Test Detects Roundup Residue

By Kristen Schepker, Assistant Editor

First marketed as a commercial product in the mid-1970s, glyphosate now has the dubious honor of being the most widely sprayed synthetic herbicide in agricultural history. For years, prevailing scientific consensus was that this weed killer was harmless -- but increasing reports of toxicity associated with glyphosate exposure suggest otherwise. Recently, the Kansas-based Great Plains Laboratory (GPL) introduced a new urine test that allows for more accurate assessment of an individual's glyphosate exposure.

Black, White & Green: Race Has Major Impact on Physician Income

By Erik Goldman

American medicine has a long way to go in terms of racial and gender pay equity. According to a new study published in the British Medical Journal, White male doctors earn nearly 35% more than their Black male counterparts, and that's across all specialties and practice settings. Female doctors earn, on average, 40% less than males, again after adjusting for specialty, practice setting, and patient volumes.

Low FODMAP Diet Offers Road to Relief for IBS

By Kristen Schepker

When it comes to treating irritable bowel syndrome (IBS), prevailing wisdom encourages eating more dietary fiber to help manage unpleasant digestive symptoms. But new research indicates that a group of fermentable carbohydrates referred to as FODMAPs -- found in many high-fiber foods -- might actually make IBS symptoms worse.

Losing Ourselves to Diabetes…Then Alzheimer’s

By Erik Goldman

Alzheimer’s affects about 5.4 million Americans, and that number is expected to rise. In part, it’s being driven by the rampant prevalence of diabetes.The epidemiology is clear: people with type 2 diabetes are nearly twice as likely to develop Alzheimer’s as non-diabetics.

Three Safe & Simple Ways to Detox

By Russell Jaffe, MD, Contributing Writer

There are simple steps our patients can take can take that could go a long way in reducing their overall toxic burden. These steps, combined with diligent efforts to limit the uptake of toxins--whether pollutants, pesticides or heavy metals—can and should be a part of anyone’s overall health maintenance and disease prevention strategy.

Should Metformin Come with a B12 “Prescription”?

By Sherryl Van Lare, Contributing Writer

Metformin, a first-line drug treatment for type 2 diabetes, has been prescribed to over 120 million people worldwide.It’s a safe bet that a large proportion of those people are deficient in vitamin B12, thanks to the use of this medication.

Link Between HPV Vaccines & Ovarian Failure Raises Concern

By Jessica Best, Contributing Writer

The vaccine against Human Papillomavirus (HPV) may possibly be associated with ovarian dysfunction and the rare condition of premature ovarian failure (POF), according to a statement released earlier this year by the American College of Pediatricians.

FDA Squelches Home Cancer Tests, Encourages Physician-Guided Liquid Biopsies

By Gina Cushenberry, Contributing Writer

Should consumers have free access to at-home cancer testing kits without physician oversight? Definitely not, according to the Food and Drug Administration. The agency has moved to squelch the marketing of direct-to-consumer cancer tests, at least for the forseeable future. At the same time, FDA has given the green light to the further development of so-called “liquid biopsies” provided they're ordered and interpreted only by physicians.

Wearable Fitness Trackers: They’re Popular, But Are they Accurate?

By Leandro Pucci, Contributing Writer

Wearable fitness trackers are everywhere these days. Consumers are using them to monitor exercise, sleep, and a host of other health-related parameters. Sure, they're popular, but are they reliable? Can we trust the numbers they give us? Leading researchers weigh in on that question.

Antioxidants Attenuate Potential Risks of EMF Exposure

By Isaac Eliaz, MD, Contributing Writer

The dramatic increase in the use of mobile phones, wireless networks, and smart devices around the world in the past decade has fueled concerns about the potential of electromagnetic fields (EMF) to adversely influence human physiology. Fortunately, a wide variety of foods, herbs, and botanicals can provide antioxidant support to attenuate the potential oxidative stress caused by EMFs.

Psoriasis is a Real (Migraine) Headache

By Madiha Saeed, MD, Contributing Writer

People with psoriatic disease — autoimmune conditions characterized by over-expression of proinflammatory cytokines — also had an increased risk for migraine. The connection? Chronic systemic inflammation.

Zika, Climate Change, and the Need for Planetary Stewardship

By William B. Miller, Jr, MD

Zika is all over the news these days, despite the fact that there have not yet been any locally transmitted cases in the US. Some people argue that the threat is overblown. Yet, Zika is rightfully making headlines. Its greater significance extends beyond any current spread.

Will FDA Start Regulating Fitness Trackers?

By Gina Cushenberry, Contributing Writer

Fitness and Health trackers hit the market strongly a few years ago, and they are evolving far faster than the federal regulatory framework for health-related products. Are they "medical devices" or "general wellness products?" FDA's recent draft guidance provides clues to the futurre regulation of these popular products.

Glyphosate: A Root Cause of Chronic Inflammation?

By Zach Bush, MD, Contributing Writer

Glyphosate, the herbicidal compound in Roundup, is dumped on us at the rate of 300 million pounds per year, almost one pound for every person in the US. In the intestines, glyphosate is a profound zonulin stimulator. It damages the epithelial tight junctions on contact, weakening the intestinal barrier function, and fueling chronic inflammation.

"Cleaner" Proteins Scrub Arteries, Reduce Cardiovascular Risk

By Jessica Best, Contributing Writer

Patients at risk of atherosclerosis may have new hope for cleaner arteries thanks to a naturally occurring “scrubber” protein that exists within the body. Alpha-1-microglobin (A1M), referred to as a "circulating wastebasket," scavenges free radicals as well as blood fats that have already been oxidized, potentially opening up a new avenue for reversing atherosclerosis.

Why Probiotics Don’t Always Work

By Zach Bush, MD, Contributing Writer

The optimally healthy human gut should contain between 20,000 and 30,000 species of bacteria. Variety is key. The greater the diversity, the healthier the microbiome. Zealous use of probiotics, while reflecting a positive trend overall, could be causing problems by "monocropping" the GI tract with a relatively small number of species at the expense of ecosystem diversity.

Documenting Hope: New Film Profiles Families That Beat Chronic Disease

By Madiha Saeed, MD, Contributing Writer

Asmorechildrenarediagnosedwith chronicdisorders — 1 in every 2 kids according to some statistical models — an ever-growing number of parents are witnessing the light in their childrens' eyes grow dim with the burden of disease and medication. Butin every darkness, therecan be a light. One organization is giving parents a glimpse of hope and prove that kids with a wide range of chronic conditions can get better with lifestyle and nutritional changes.

Is Allulose the Next Sweet Thing?

By Amy Burkholder, Contributing Writer

Allulose, a naturally-occurring sugar found in small quantities in jackfruit, figs, and raisins, that was recently introduced into the world of food production. Manufacturers say this monosaccharide is absorbed via the small intestine but not metabolized by the body, rendering it essentially calorie-free. But novel no-cal sweeteners have a spotty track record in terms of overall health effects. Is allulose a godsend for the calorie-conscious or just another metabolic trickster?

The Myths & Realities of Precocious Puberty

By Kathleen Jones, MS, Contributing Writer

Early puberty—especially in girls—has become a topic of mainstream conversation, one that has raised significant concern for many parents, and everyone concerned with the issue has a pet theory about what’s to blame.

The downward shift in female pubertal age been well documented epidemiologically, and in recent years it has received considerable media attention.

But is it really a new phenomenon? Probably not. Does it have real health consequences? Very definitely.

Anticholinergic Meds: Bad News For Aging Brains

By Jeannie Hall, Contributing Writer

People who take Benadryl every night to sleep should probably think seriously about an alternative method….if they can remember to do so. A recent report published in JAMA Internal Medicine,  provides convincing evidence that frequent and long-term use of anticholinergic drugs like Benadryl raise the risk of dementia.

Crowdfunded Research Shakes Medicine's Ivory Towers

By Kristen Schepker, Assistant Editor

For most of its history, medical and scientific research has been funded by grants from government institutions, nonprofit foundations, and private companies. But an emerging trend suggests a new potential source of future funding: the internet.

Healthcare’s Balloon-Twisters Blow It on Cost Assessments

By Erik Goldman, Editor in Chief

Like clowns at children's birthday parties, there’s a whole cadre of healthcare policy professionals who ply a statistical version of balloon-twisting

They take claims data sets and twist them into forms that purport to be evidence-based pictures of the medical system. By extension, these statistical balloon-twisters are tweaking the lives of actual practitioners and patients because federal healthcare programs and private insurers use these statistical balloon animals to shape and re-shape healthcare payment systems. 

When the balloon doggie pops--and it turns out the statistics are wrong--the tears start to flow.

State Boards Eye Informed Consent for Telemed Consults

By Kristen Schepker, Assistant Editor

In a landscape of increasingly complex medical procedures and treatments, healthcare practitioners are advised to pay close attention to informed consent regulations in their states--especially those pertaining to remote teleconsultations

Want to Gain Weight? Drink Diet Soda

By Amy Burkholder, MS, Contributing Writer

Contrary to public expectations, consumption of diet sodas might actually be causing weight gain, rather than promoting weight loss. According to a recent study from the University of Texas, we may be able to fool our tastebuds, but we cannot fool our microbiomes.

CoQ10: A Valuable Ally for Male Fertility

By Kelly Kremnizer, Contributing Writer

CoEnzyme Q10 positively impacts all three of the basic semen parameters (morphology, concentration, motility) and seems to have the greatest overall effect on motility. The majority of clinical studies of Q10 in infertile males have indicated positive outcomes on semen parameters and/or pregnancy rates.

Postpartum Depression: When a “Bundle of Joy” Brings Bushels of Despair

By Madiha Saeed, MD, Contributing Writer

For about 1.3 million new mothers, the long-anticipated bundle of joy is also accompanied by a bushel of sadness and woe. Postpartum depression (PPD) is the most common complication of childbirth but unfortunately, only five percent of physicians screen for it. With her new documentary film, Dark Side of the Full Moon, Dr. Shoshana Bennett sheds healing light on the shadow side of the motherhood dream.

X-Ray Selfies and Uber-Docs: A Glimpse of Medicine’s (Near) Future

By Monya De, MD, Contributing Writer

Each year, the Medicine X conference invites tech- and social media-savvy practitioners, patients and business leaders to explore the new frontiers of healthcare technology and the ways in which it is transforming medical practice and the lives of people with chronic disease. Dr. Monya De, HPC's HolisTech correspondent shares the latest from the 2015 MedX gathering. 

For Practice Success, Know Thy Biller!

By Kristen Schepker, Contributing Writer

A good billing service can make the difference between a thriving integrative practice and one that flounders. This is especially true when utilizing "incident-to" billing to obtain reimbursement for services given by non-MD practitioners. Not all billers are the same, and it’s crucial that practitioners align with billers who share their values.

Mercury & Adjuvant-Free, A New Flu Shot Offers Cleaner, Greener Option

By Erik Goldman, Editor in Chief

This flu season, practitioners have a new adjuvant-free option to offer people who’ve been reluctant to take conventional flu shots. The new vaccine, called Flublok, delivers up to three times as much antigenic protein as other flu shots, without additives like thimerosal or aluminum. And, no chicken eggs are involved in its production.

Gluten Sensitivity, Food Allergies & The Gut-Brain Connection

By Kristen Schepker, Assistant Editor

To improve the care of patients struggling with food intolerances and to help them restore their health, clinicians need to understand the gut-brain axis and the ways in which allergen-induced inflammation ripples out through multiple organ systems, including the brain.

NSAIDs Implicated in Female Infertility

By Sara McNulty, MS, Contributing Writer

Non-steroidal anti-inflammatory drugs trigger temporary but reversible reductions in female fertility. Women wishing to conceive but having difficulty should avoid taking these ubiquitous medications.

Citicoline Reduces Cocaine Use In Bipolar Patients

By Kristen Schepker, Assistant Editor

Citicoline, a readily available over-the-counter nutritional supplement may help reduce illicit drug dependency in patients with psychiatric illness, according to researchers at the University of Texas Southwestern Medical Center.

Probiotics Quell Fire of Childhood Chronic Disease

By Madiha Saeed, MD, Contributing Writer

One in every two American children has a diagnosed chronic illness and the numbers keep rising. As a result, many parents are searching for ways to prevent and heal these conditions. The answer lies in the microbiome, which affects and alters functions from the immune system to the nervous system, and deeply affects gene expression, inflammation and the likelihood of chronic disease.

When Confronting Lyme, Think Beyond The Spirochete

By Russell Jaffe, MD, Contributing Writer

One of the key features of LD is the broad impairment of the affected individual’s innate immune response. The usual process of phagocytosis and lysosome recycling does not occur properly. Without improved immune defense and repair functions, the remissions obtained with antibiotics alone will seldom be more than fleeting.

Restoring Health Where the Heart Meets the Brain

By Erik Goldman

Cardiovascular disease and neurocognitive problems may be more alike than they are different, says physiologist Scott Minton, PhD. The key to a more holistic and multi-system treatment approach for both types of disorders is to look at physiological mechanisms that modulate cell membrane receptors, channels, and associated signal transduction pathways.

Clinicians Play Catch-Up With the Genome Revolution

By Erik Goldman | Editor in Chief - Vol. 1, No. 2. Summer, 2015

genomics graphicIt's an increasingly common scene, playing out in clinics all over the country: A patient comes in with a worried look and a fat printout from 23andMe. She wonders what all those scary red boxes mean, and whether cancer, Alzheimer's, or some other bad disease is lurking in her genes.

Rethinking the Role of Stress in Stomach Ulcers

By Kristen Schepker | Assistant Editor

New research published recently in Clinical Gastroenterology and Hepatology provides strong evidence that psychological factors need to be brought back into the clinical picture of peptic ulcer disease.

Metabolic Medicine for Monday Morning

By Erik Goldman

Based on more than 3 decades of clinical practice experience, the Metabolic Code is a system for reframing clinical lab information in a way that enables physicians to choose treatment approaches that will have the most impact for each patient.

Probiotic Lozenges Improve Oral Health

By Kristen Schepker, Assistant Editor

The rapid surge of microbiome science in recent years has spurred an equally rapid growth in the number of probiotic supplements, foods, and beverages hitting the consumer market.

Five Keys to a Thriving Integrative Practice

By By Erik Goldman, Editor

Master these five core competencies, and your clinic is much more likely to thrive, regardless of the specific practice model you’ve embraced, says Heal Thy Practice facultymember, Miriam Zacharias.

Want Smarter Kids? Breastfeed!

By By Madiha Saeed, MD, Contributing Writer

Babies who are breast-fed for at least one year grow up to be significantly more intelligent than those breast-fed for less than one month, according to a Brazilian study published in The Lancet Global Health.

Breaking the Mold: How to Get a Grip on Household Mycotoxins

By Jill Carnahan, MD, Contributing Writer

Indoor air pollutants, including mold and mycotoxins, may be contributing to more than 50% of our patient’s illnesses. All too often, though, we clinicians are unaware of it. Fortunately there are effective strategies that can help us help our patients "break the mold" and minimize the negative effects of mycotoxins.

Healthcare IT: What It Can--and Cannot--Do For Your Practice

By Erik Goldman

If the proliferation of new health info technology has your head spinning, don’t worry. You are definitely not alone. Many doctors these days are suffering from "Future Shock." Dr. Paul Abramson, whose San Francisco-based practice is positioned squarely at the crossroads of IT and integrative medicine, offers insight on how to choose IT that will really make a difference in your practice.

Testing Takes Guesswork Out Of Omega-3 Supplementation

By Janet Gulland | Contributing Writer - Vol. 1, No. 2. Summer, 2015

For many practitioners, omega-3 fatty acids are a standard part of patient care, especially when working with people at high risk of heart disease or inflammatory conditions like arthritis or chronic pain.

The Alkaline Way: Ten Tips for Reversing

By Russell Jaffe, MD | PhD Contributing Writer - Vol. 1, No. 2. Summer, 2015

There's a lot of talk these days about following an "alkaline" diet as a way of restoring health and prolonging life. In principle a lot of the core ideas behind this approach make good physiological sense.

AG Action Triggers New Wave Of Supplement Scrutiny

By Erik Goldman | Editor in Chief

SchneidermanNew York Attorney General Eric Schneiderman's crusade against herbal products earlier this year has triggered a number of state and federal moves that could significantly change the way dietary supplements are regulated.

How to Test for Dysbiosis

By Madiha Saeed, MD | Contributing Writer - Vol. 1, No. 2. Summer, 2015

Disturbance of the gut microbiome, also known as dysbiosis, has a major detrimental effect on human health. As microbiome research continues to explode worldwide, we are learning that microbial dysregulation within the gut is an important contributing factor in a wide range of common disorders.

Making Clinical Sense of the Microbiome

By Erik Goldman | Editor in Chief - Vol. 1, No. 2. Summer, 2015

It's "the greatest turnaround in science and medicine in the last 150 years," says Raphael Kellman, MD, of the current microbiome revolution.

Aluminum, Alzheimer's & Autism: Understanding the Connection

By Erik Goldman | Editor in Chief - Vol. 1, No. 2. Summer, 2015

Back in the late 1890s, James Tyler Kent, a forefather of American homeopathy described the nature of someone suffering from aluminum toxicity as follows: "There is confusion of mind, a confusion of ideas and thoughts...The consciousness of his personal identity is confused... he is in a dazed condition of mind... Confusion and obscuration of the intellect."

Ancient Tree Earns New Reputation as Modern Superfood

By Kristen Schepker

For centuries, indigenous African peoples have recognized the vast medicinal and cultural value of the ancient Baobab tree. Widely utilized as a both traditional food crop and a source of medicine, shelter, and clothing, little was known of the prehistoric plant outside its native continent -- until recently.

Surging Vitamin D Deficiency Linked to Pediatric Deaths

By Kristen Schepker

Throughout all developmental stages, adequate vitamin D intake is essential for optimal bone health and immune regulation. The medical community has long known that among infants and children, the consequences of vitamin D deficiency can be dire, ranging from rickets -- characterized by softened, weakened bones -- to unexpected death.

Teen Asthma Strongly Linked To Insulin Resistance

By Madiha Saeed, MD

Data from a recent cross-sectional study shows a strong link between insulin resistance and poor pulmonary function in a large cohort of adolescents. The correlation held for kids with asthma and, alarmingly, also in those without the disease.

NIH Center to Confront Fears Of Herb-Drug Interactions

By Erik Goldman, Editor

“Misplaced fear” about herb-drug interactions is keeping many practitioners from recommending potentially beneficial botanical medicines, said Josephine Briggs, MD, director of the NIH’s National Center for Complementary and Integrative Health (NCCIH).

Resveratrol Improves Insulin Sensitivity

By Andrea Strohecker | Contributing Writer

Resveratrol, a polyphenolic compound found in red wine and widely touted for its antioxidant and cell signaling effects, also improves insulin sensitivity, according to a recent study by researchers at the Albert Einstein College of Medicine, Bronx, NY.

Not Just a Personal Problem, Practitioner Burnout is a Public Health Issue

By Marnie Loomis, ND | Contributing Writer

What can you do if you are feeling burned out?

This is not just a personal question; it's one that has profound implications for patient care. As research reveals more about the negative effects of professional burnout on patient outcomes, medical mistakes, practitioner health, turnover rates and even practitioner suicide, it is increasingly evident that burnout poses a serious risk to patient safety.

How to Bring Intelligence to Antioxidant Supplementation

By Russell Jaffe, MD Contributing Writer

It is a basic fact of physiology that the efficiency of any biochemical pathway is limited by the chemical substrate that is most essential and least available. This is known as Von Liebig's Law of Limiting Substances, and as clinicians we would do well to keep it in mind.

You Don't Have to Be Smarter, Just Give Better Care

By Erik Goldman | Editor in Chief

The key to success in holistic & functional medicine is simply to give better care than the other doctors in your area. Given how utterly dysfunctional mainstream medicine is, these days, it shouldn't be hard, quipped Mark Menolascino, MD, at Holistic Primary Care's 6th annual Heal Thy Practice conference.

Eating Disorders May Signal Autoimmune Conditions

By Lindsey Davis | Contributing Writer

People being treated for eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating appear to be at increased risk for autoimmune disorders including chronic gasteroenterological, ocular, dermatological, connective tissue, neurological, and hematological autoimmune conditions, according to a new study from Helsinki University.

Eating Disorders May Signal Autoimmune Conditions

By Lindsey Davis | Contributing Writer

People being treated for eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating appear to be at increased risk for autoimmune disorders including chronic gasteroenterological, ocular, dermatological, connective tissue, neurological, and hematological autoimmune conditions, according to a new study from Helsinki University.

NY Attorney General Assails Herbal Medicine

By Erik Goldman - Vol. 16, No. 1. Spring , 2015

eric schneiderman smJust weeks after ordering big-box giants Walmart, GNC, Target, and Walgreen's to stop selling some of their "store-brand" herbal supplements, New York Attorney General Eric Schneiderman furthered his assault on herbal products by ordering major manufacturers to turn over data on the authenticity and purity of the products they make.

Calif. Counties Declare a Different "War on Drugs"

By Kristen Schepker, Assistant Editor

Drug overdose is the leading cause of injury-related death among Americans. While a portion of overdose deaths result from recreational drug use, a growing body of research points to prescription drugs--particularly opioids-- as an equally significant culprit.

Got Fractures? Milk Raises Risk

By Kristen Schepker, Assistant Editor

From a young age, Americans are taught that milk is an essential component of a healthy, well-rounded diet. But new research on the long-term health effects of drinking dairy questions some age-old assumptions about milk’s protective benefits.

Mushroom-Derived Compound Shows Promise Against HPV

By Wendy Romig, Contributing Writer

Researchers at  the University of Texas Health Science Center have found that a compound derived from Shiitake mushrooms (Lentinula edodes), can eradicate human papilloma virus (HPV), a leading cause of cervical cancer.