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A Quarterly Health Update • Spring 1996 • Vol. 1 No. 2

David Perlmutter, MD, FACN

• Quotes
• New Test May Revolutionize Cancer Detection
• FDA Approves Fat Substitute
• Oral Contraceptives Increase Risk of Breast Cancer
• Herb Corner
• Study Adds Support to Health Benefits of Vitamin E
• Volunteers Needed for Study on Alternative Medicine and HIV- AIDS

Quotes

"I am dying with the help of too many physicians." Alexander the Great

"I was Caesarean born. You can't really tell, although whenever I leave the house, I go out through a window." Steven Wright

"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire

"My doctor gave me two weeks to live. I hope they're in August." Ronnie Shakes

New Test May Revolutionize Cancer Detection

The FDA has granted permission to market the Anti-Malignin Antibody in Serum, or AMAS test. This patented blood test will likely revolutionize cancer detection and treatment.

Developed in 1974, by Harvard trained research Neurochemist Samuel Bogoch, M.D. PhD, this test measures the body's production of an antibody produced in response to the presence of Malignin, a chemical marker for a variety of cancers. The idea of a cancer screening test is certainly not new. We are all familiar with the PSA screening test for prostate cancer, and the CEA test for colo-rectal cancer. What is unique about the AMAS test, is its reported ability to detect virtually all types of cancers.

Today, when trying to detect cancer in its early stages, your doctor may perform a physical examination and a variety of laboratory tests including chest x-ray, sigmoidoscopy, CT scans, mammograms, pap tests, prostate biopsies, to name a few. Tomorrow, these tests may be unnecessary unless the AMAS is abnormal.

The AMAS test may prove to be the most sensitive way of determining whether or not a particular cancer treatment program has been curative or not. Research demonstrates that when cancer surgery has been curative, the AMAS value returns to normal. Should any cancer remain, the AMAS test will remain elevated. This will allow oncologists the ability to recommend further cancer treatment only for those patients who need it, and avoid over treating those who do not.

The usefulness of the AMAS test to determine if a cancer has been cured has perhaps been best studied in breast cancer. To date, over 1,000 breast cancer patients have been followed with the AMAS test. Results show convincingly that breast cancer cannot be presumed to be in remission unless the AMAS levels are in the normal range.

In studies of more than 6,000 patients, it has been shown that the AMAS test is accurate 95% of the time and 99% if repeated. This test will have an important impact on the economics of medicine since most physicians will not need to order typical cancer screening tests such as the PSA, CEA, stool blood tests, mammograms, etc. unless the AMAS test is positive. Further, it is quite likely that Life and Disability insurance companies will require the AMAS test before underwriting a new policy.

But the best news of all is that although your doctor has probably not heard of the AMAS test, it is easily available to you. A blood specimen is sent to Dr. Bogoch's Oncolab, Inc., in Boston. The laboratory requires specific medical information as well as a signature from physician and patient. The cost is $125.00 plus $30.00 for handling. The specimen must be frozen and shipped over night to Boston.

To learn more about the AMAS test, call 1-800-9CA-TEST.

FDA APPROVES FAT SUBSTITUTE

Olestra was approved by the FDA on January 24, 1996, as a fat substitute for snack foods. After petitioning the FDA for some 25 years, reformulating the product, and investing close to $200 million dollars, Proctor & Gamble will now be permitted to use Olestra in a variety of snack foods including potato chips, tortilla chips, and crackers. Foods containing Olestra must bear a label stating, "This product contains Olestra. Olestra may cause abdominal cramping and loose stools. Olestra inhibits the absorption of some vitamins and other nutrients. Vitamins A, D, E, and K have been added."

Writing in the April ll, 1996 issue of the New England Journal of Medicine, Henry Blackburn, M.D., of the University of Minnesota voiced his concerns not only about the safety of Olestra, but also the circumstances by which it gained its FDA approval. Dr. Blackburn was present at the FDA's meetings which evaluated the safety of Olestra and stated "I was concerned at the outset about the presentations by the FDA staff. These presentations were thorough and thoughtful, covering all aspects of the findings, but virtually all the data was from studies carried out by the petitioner, Proctor & Gamble. There were no relevant reports from disinterested investigators, and no independent studies sponsored by the FDA." What Dr. Blackburn reveals is the simple fact that virtually the only data the FDA relied upon for determining the safety of this food additive was information supplied by its manufacturer, Proctor & Gamble!

Further, Dr. Blackburn revealed ... "the one controlled study of the frequency of gastrointestinal symptoms and the nutritional consequences of regular consumption of snacks containing Olestra involve only 194 adults studied for 56 days. The statistical power of this crucial study was inadequate to detect significant short-term effects among the snackers who consumed 8 grams of Olestra per day, which is equivalent to a 1 ounce (28 gram) package of potato chips. An 8-week trial is hardly an adequate test of long-term safety.... the FDA does not have the statutory authority, the staff, or the funding to examine adequately the benefit and safety of food additives generated by the powerful food industry and its sophisticated technology. Moreover, there are now serious political pressures on the FDA, including informal proposals that it become a rubber-stamp certifying body for industry."

That being said, it is obviously no surprise that Olestra has finally won its approval. I am concerned about Olestra. The Standard American Diet (SAD) generally supplies less than adequate amounts of important antioxidant fat soluble vitamins including vitamins A and E. Now we are adding an undigestible chemical to our foods which will actually bind these important vitamins and cause them to be excreted. The amounts of vitamins A, D, E, and K that the FDA requires Proctor & Gamble to add to Olestra containing foods are minuscule.

urther areas of concern include the effect of Olestra on the balance of bacteria in the gut, the effect of Olestra on liver function, the possible teratogenic effect of the added vitamin A in pregnant women, and the effect that Olestra will have on many medications. Unfortunately, once again, the laboratory rats being used to determine the safety of this chemical food additive are the millions of unsuspecting American consumers who very soon will take part in this grand experiment without having been given the opportunity to provide informed consent.

Oral Contraceptives Increase Risk of Breast Cancer

A new study recently published in the British Medical Journal The Lancet reveals a profound increase in incidence of breast cancer in some individuals.

This study, performed in the Netherlands, evaluated the risk of developing breast cancer at various ages and involved 918 women with breast cancer who were diagnosed at between 20-54 years of age.

Over all, the study revealed that using oral contraceptives for 12 or more years was associated with an increased risk of breast cancer of 30%. Beginning the use of oral contraceptives before age 20, and using them for 4 or more years doubled the risk of breast cancer.

Unfortunately, the bulk of literature provided to American women by the cancer establishment contains precious little information on actual breast cancer prevention. Typically, women are told to have frequent mammograms as a way of "preventing breast cancer." Recall, however, that a mammogram in no way prevents breast cancer, it is simply a technique for early detection.

This study demonstrates that oral contraceptives can substantially increase the risk of developing breast cancer. In the United States today, 1 of every 8 women will develop breast cancer, and a third of them will die from this epidemic. These numbers roughly translate into a 747 jumbo jet filled with women crashing and killing all the passengers, every other day!

Here are some of the risk factors for breast cancer that you can change to improve the odds:

Finally, data accumulated over the past decade clearly links exposure to organochlorine type pesticides to increased risk of breast cancer. Unfortunately, we continue to manufacture this group of pesticides and import fruits and vegetables from countries with minimal restriction on their use.

I expressed my concern about the link between these pesticides and breast cancer in the following editorial published in a recent issue of the Journal of the American Medical Association:

Organochlorines, Breast cancer, and GATT

To the Editor: -- Breast cancer, which now affects one in eight American women, must truly be regarded as a modern epidemic. This year 180,000 American women will be diagnosed as having this disease and a third of them will die of it. In the past two decades, breast cancer has claimed the lives of more American women than the total fatalities of the Korean War, the Vietnam War, World War I, and World War II combined.

Recent evidence strongly supports the relationship between tissue levels of organochlorines like dichlorodiphenyl-trichloroethane (DDT) and the incidence of breast cancer , with some studies showing as much as a fourfold increase in the relative risk of breast cancer in women with high organochlorine compound concentrations.

Metabolites of DDT have been noted to be 50% to 60% higher in breast cancer patient specimens compared with controls.

The US government, hoping to stimulate the American economy, stands poised to approve the General Agreement on Tariffs and Trade (GATT). To stimulate worldwide agricultural trade, the GATT rules could allow substantially higher levels of pesticide residues on US import produce. Levels of DDT 5000% higher than current US standards will be permitted on imported peaches and bananas with similar deregulation affecting grapes, strawberries, broccoli, and carrots.

While recognizing the importance of national economics, this agreement, which affects safety standards of imported produce, demonstrates that the health of American women is not a primary concern.

"The treatment of breast cancer, once established, is about as effective today as it was 50 years ago. Certainly methods aimed at early detection are useful, but prevention is the name of the game. As China's yellow emperor stated in the 4th century B.C., Prevention is the ultimate principal of wisdom. To cure disease after it has manifest is like digging a well when one already feels thirsty, or forging weapons when the war has already begun."

Herb Corner: Echinacea

Extracts of Echinacea root have been the subject of more than 350 scientific studies world wide. These studies show that Echinacea enhances the function of the immune system by not only increasing the number of immune cells, but also increasing their effectiveness in fighting disease.

From the late 1890's until the mid 1920's, Echinacea was quite popular in this country. With the advent of antibiotics in the 1930's, Echinacea lost its popularity and is now virtually unknown to American doctors while being widely prescribed by our European counterparts.

Perhaps its most common use is in the prevention and treatment of the common cold. It can be obtained from most health food stores and comes in a variety of forms including capsules, tinctures, and extracts. Since Echinacea should produce a numbing sensation when held in the mouth for a few minutes, this is a good way to determine its potency. Taking this time-proven herbal remedy at the onset of a cold is often surprisingly effective. We generally recommend the tincture in a dosage of 1 full dropper in a glass of water 3-4 times a day for a week or two. Some reports have indicated that Echinacea loses its effectiveness when taken on a continual basis for more than 2 weeks at a time, so reserve Echinacea for those circumstances in which you need it most.

Study Adds Support to Health Benefits of Vitamin E

In a new study published in the journal The Lancet, involving over 2,000 patients with proven coronary artery narrowing, vitamin E supplementation reduced the risk of non-fatal heart attack by 47%. Incredibly, these results were obtained after only 1 year of treatment.

The results of this study are not surprising. In a recent report in The New England Journal of Medicine, it was found that the risk of heart attack in women taking vitamin E was reduced by approximately 40%. In fact, the literature supporting the usefulness of vitamin E in reducing atherosclerotic coronary artery disease has been accumulating for the past 2 decades.

Most researchers believe that the beneficial effects of vitamin E with respect to heart disease is a result of its antioxidant properties, preventing cholesterol from undergoing a chemical change which would otherwise allow it to enhance plaque formation.

We recommend daily intake of supplemental vitamin E, 400 IU each day, preferably with the evening meal. Make sure you buy d-alpha tocopherol, not d l -alpha tochopherol, as the latter is a synthetic form less useful to the body.

Voluteers Needed for Study on Alternative Medicine and HIV-AIDS

The first nation wide study of the effectiveness of alternative medicine in HIV/AIDS will be conducted at the Bastyr University. This study is designed to explore alternative treatment methods which may be effective in slowing disease progression and enhancing life span in patients with HIV/AIDS, and it is funded by a 1994 grant from the NIH Office of Alternative Medicine. Participation in the study simply requires completing a questionnaire three times over a one year period, and participants must be HIV positive, at least 18 years of age, currently using alternative therapies, and able to give informed consent. For more information, please contact Candi Wines at 800- 475-0135.