Perlmutter Health Center

A Quarterly Health Update • Summer 1996 • Vol. 1 No. 3

David Perlmutter, MD, FACN

Quotes

"You and your family must clearly understand that the great and ultimate healer is always nature itself, and that the drug, the physician, and the patient can do no more than assist nature, by providing the very best conditions for your body to defend and heal itself." -- -Hans Krebs

"The poorest man would not part with health for money, but the richest would gladly part with all their money for health." -- Charles Caleb Cotton

Parkinson's Disease Linked To Liver

Parkinson's disease has, until now, been described as being exclusively a "brain disorder." Indeed, in 1960, researchers first demonstrated that a specific part of the brain called the basal ganglia functioned abnormally in Parkinson's disease. Various medicines were created to supply the brain chemicals missing in Parkinson's patients, and these medications remain the mainstay of treatment. Unfortunately, this approach is entirely symptomatic. This is to say that these medicines, although quite helpful in reducing the symptoms of Parkinson's disease, do nothing for the underlying disease process itself which typically worsens with time.

New and exciting research has recently demonstrated that a majority of patients with Parkinson's disease have a defect in one or more liver enzymes which, when functioning normally, act to detoxify various environmental poisons to which we are exposed. Various epidemiological studies have demonstrated a significant increased incidence of Parkinson's disease in populations having a higher exposure to environmental toxins. In a fascinating report appearing in the Archives of Environmental Health (1990), Goldsmith found an extremely high incidence of Parkinson's disease on three adjacent kibbutzim in the Negev region of Israel whose water was supplied from wells draining a common aquifer.

The incidence of Parkinson's disease was reported to be 500% greater in each of the three kibbutzim than in the remainder of the region. A history of occupational herbicide use has been described as significantly increasing risk of Parkinson's disease by about three fold with data also suggesting a dose response relationship between the duration of cumulative life time exposure to agricultural work and risk of Parkinson's disease. At a recent international symposium on Parkinson's disease, research was presented demonstrating a very high correlation between Parkinson's disease and the use of pesticides. In comparing one farming area southwest of Montreal where pesticides were used in large amounts to areas in the same region with low pesticide use, the incidence of Parkinson's disease was seven times greater in the former.

Why wouldn't everyone with these types of toxic exposure develop Parkinson's disease? The answer may lie in the defective liver detoxifying enzymes described earlier. Thus, most people by virtue of having an adequate liver detoxification system, may not suffer significant ill effects when exposed to various environmental toxic insults. Parkinson's patients on the other hand, because of their defective liver enzyme systems, may actually potentiate relatively low-level neuro toxic chemicals allowing the brain to be damaged and producing Parkinson's disease. Recently, therapeutic techniques have been developed utilizing nutritional approaches in an attempt to enhance the function of the liver detoxification enzymes. In 1992, Dr. Jeffrey Bland described a nutritional intervention program designed to improve the function of these detoxification enzymes. His research demonstrated a significant increase in the liver's ability to detoxify various toxic substances after three weeks on a specific dietary program augmented in certain nutrients known to be helpful for liver function.

It is now possible to identify those patients who would benefit from such a program. New laboratory studies are now available to specifically address the functional activity of the liver. One study, the Detoxification Profile (Great Smokies Diagnostic Laboratory - Asheville, NC) specifically evaluates the detoxification function of the liver. This study is in no way similar to the so called "liver function tests" that are a part of the typical blood studies done by most physicians.

At our Center, those patients found to have defective liver detoxification function are treated utilizing a program based upon the work of Dr. Bland. We utilize a supplement, UltraClear Plus which is a nutritional supplement based upon Dr. Bland's original formula. In addition, we use the herb Milk Thistle in this program since it has been shown to enhance liver detoxification function as well.

Utilizing this program, we have noted significant improvement in our younger Parkinson's disease patients. This approach has allowed us to reduce medication, and in one case completely eliminate all Parkinson's disease drugs. Unfortunately, older Parkinson's disease patients do not seem to respond as well when using this approach.

Another interesting new finding in Parkinson's disease research is the increased level of iron in those unique areas of the brain typically damaged in this disease. As yet it is not known exactly why certain parts of the brain accumulate iron, but it is known that once there, the excessive iron tends to enhance oxidation which leads to brain destruction. In an attempt to reduce this damaging oxidation caused by iron accumulation, Dr. Stanley Fahn treated a group of Parkinson's disease patients with relatively high doses of antioxidants including 3,200 units of vitamin E and 3,000 mg of vitamin C daily. He found that the length of time until pharmaceutical medication became necessary was extended by 2.5 years in those patients taking the antioxidants.

Over the past several decades, EDTA chelation therapy has proven itself as a useful treatment in various forms of vascular disease. It is known that the active chemical in this treatment, EDTA, readily binds excess body iron, and allows it to be excreted. EDTA chelation therapy therefore may play an important role in the treatment of Parkinson's disease since iron accumulation in the brain is so destructive in these patients.

For more information on UltraClear Plus , contact HealthComm International Inc at (800) 648-5883. To learn more about the liver detoxification profile test contact Great Smokies Diagnostic Laboratory at (800) 522-4762.

To locate a qualified chelation practitioner near you, contact The American College of Advancement in Medicine (ACAM) at (800) 532-3688.

Back to top
New Study Finds Fish Oil Helpful in Crohn's Disease

A fascinating report appearing in the June 13, 1996 issue of the New England Journal of Medicine found fish oil preparation to be useful in Crohn's disease. Crohn's disease is a condition characterized by recurrent episodes of inflammation of the intestine. This disease may be serious, and at times patients may require surgery to remove those parts of the intestine most severely inflamed. Typically Crohn's disease is episodic. This means that patients may experience "flare-ups" during which time their disease is active, as well as relatively symptom free periods during which time digestive function is fairly normal.

This recent study looked at 78 patients with Crohn's disease. One group received nine fish oil capsules each day or a placebo. Among the group of patients receiving the fish oil, 28% had relapses during the one year study. In contrast, in the group receiving the placebo, 69% experienced relapses.

It has long been known that foods like fish oil, rich in the omega-3 essential fatty acids, have significant anti-inflammatory activity. The omega-3 essential fatty acids produce a specific type of chemical in the body called prostaglandins, which serve as one of the body's main mediators of inflammation.

The richest natural source of omega-3 essential fatty acids is flaxseed oil. We have long recommended flaxseed oil in a variety of inflammatory conditions including those of the intestine, arthritis, various skin conditions, and even brain inflammatory problems like multiple sclerosis. Our experience reveals that fresh cold pressed flaxseed oil is more effective than fish oil, tastes better, and is less expensive. Many patients taking flaxseed oil have noted improved nail strength, reduced cravings for fatty foods, and improved texture of skin and hair. The typical adult dosage is 1 tablespoon of cold pressed fresh flaxseed oil each day.

To learn more about flaxseed oil, obtain a free subscription to Health Perspectives by calling (800) 200-9931.

Back to top
Study Relates Dementia to High Blood Pressure

A recent study appearing in the journal The Lancet, evaluated the risk of developing dementia at age 85 years in comparison to blood pressure at age 70.

This study of 382 participants found that patients having higher blood pressure at age 70 had a significantly increased risk of developing dementia or Alzheimer's disease at age 85. The authors speculate that elevated blood pressure may ultimately lead to diffuse brain damage since blood pressure elevation is known to cause progressive narrowing of the very small arteries supplying brain tissue.

This study provides very important information in that it demonstrates yet another risk of poorly controlled blood pressure. For years, doctors have been warning patients about the increased risk of heart attack and stroke associated with elevated blood pressures. Now we can add dementia and Alzheimer's disease to the list.

It is important to realize however, that perhaps the most common cause for confusion in the elderly population is pharmaceutical medication. So it is important to realize that while gaining control of high blood pressure is important, drugs might not always be the answer. Life style modifications often times provide adequate reduction of blood pressure, obviating the need for pharmaceutical intervention. The medical literature is full of references citing the usefulness of weight reduction in lowering blood pressure. Blood pressure can be reduced with regular exercise. A minority of patients seem to benefit from restriction of dietary salt. Stress reduction techniques such as meditation, psychotherapy, and hypnosis, all may play a role in a comprehensive non-drug approach to blood pressure lowering.

Unfortunately, despite the usefulness of these techniques, some patients may ultimately require a medication to achieve normal blood pressure readings. Many useful classes of blood pressure medications are available and include calcium-channel blockers, beta-blockers, ACE-inhibitors, and diuretics. Each of these groups has proven useful in treating hypertension. However, certain side effects are commonly associated with each of these groups. For example, the beta-blockers may slow the heart rate and have been associated with elevated levels of cholesterol. Many diuretics can deplete the body of potassium and magnesium - both important trace elements.

Perhaps the most exciting news with respect to blood pressure medication is the recent announcement that a calcium-channel blocker has been developed which takes into consideration the fact that our blood pressure naturally varies during the course of a 24 hour day. If you suffer from hypertension, you may want to discuss this new medication with your doctor.

Back to top
Diet and Cancer: New Support for Vegetarianism

In a recent study reported in The Journal of the American Medical Association (May 1, 1996), researchers at the University of Iowa, College of Medicine, reported a significant increased risk for non-Hodgkin lymphoma (a blood cancer) in older women consuming a "high-meat diet" as well as a "high intake of fat from animal sources." This research evaluated 35,156 women between the ages of 55 and 69 years with no history of cancer. Their diets were carefully reviewed and followed over a seven year period.

In the group with the highest intake of animal protein, the risk for developing non-Hodgkin lymphoma was 144% greater when compared to the group with the lowest intake of animal protein. Consumption of animal fat had a similar effect on risk for this disease. The authors report, "This prospective cohort study reveals an association between higher consumption of animal protein, red meat (especially hamburger), animal fat, saturated fat, and monosaturated fat and the development of non-Hodgkin's lymphoma."

The authors speculate as to the various possible mechanisms that may lead to this increased cancer risk in those subjects eating meat and animal fat. It is known that high intakes of fat and protein have significant effects on the function of the immune system.Typically, this type of diet may cause over stimulation of the immune system which, as several researchers have hypothesized, may lead to a situation of immune system "burn-out." One of the critical functions of the immune system is to provide cancer surveillance. When functioning appropriately, the immune system readily detects cancer cells as being foreign, and mobilizes the troops to eradicate cancer cells. Indeed as the authors of this article state, "Evidence from animal studies suggest that changes in dietary components, particularly animal fat and protein, can effect immune response and the development of lymphomas."

This is certainly another strong argument in favor of reducing your consumption of animal products. As I recently stated in my book, LifeGuide, "Over the past 100 years, dangerous trends have developed in the shifting American diet. Today we consume 280% more poultry, 33% more dairy products, and 50% more beef than at the turn of the century. As a result, our fat and protein consumption has increased significantly, while fiber and carbohydrate consumption have decreased dramatically. The danger is compounded by the reduced nutritional value and increased toxicity of today's animal products. The key dietary recommendation for health and longevity is reducing or eliminating your consumption of animal products."

The literature supporting vegetarianism certainly goes back a long way. The bible states in Genesis I:29, "And God said, Behold, I have given you every herb bearing seed, which is upon the face of all the earth, and every tree in which is the fruit of a tree yielding seed; to you it shall be for meat.'"

To learn more about vegetarian cooking, read Vegetarian Times Cookbook by the editors of Vegetarian Times (MacMillan Publishing Company, NY, NY, 1984). To learn more about the health benefits of a vegetarian diet, read my book LifeGuide, available by calling (239) 649-7400. Other information about vegetarianism can be obtained by calling the North American Vegetarian Society (518) 568-7970.

Back to top
Use of Cancer Drug Should Be Limited

As recently reported in The American Medical Association News, the National Cancer Institute is now recommending that doctors limit the use of the drug Novaldex (Tamoxifen) to a maximum of five years. Novaldex is prescribed to women following breast cancer surgery as a means to reduce the risk of recurrence of cancer.

A recent study, sponsored by The National Cancer Institute, revealed that after five years of taking the drug, further use was unlikely to provide any additional survival benefit. According to Jeff Abrams, M.D. of NCI, "Tamoxifen remains one of our most potent weapons against breast cancer, and these new results should in no way diminish its use, whenever appropriate, in women with early stage breast cancer." While Tamoxifen is clearly useful in reducing the risk of breast cancer recurrence, studies have demonstrated that it does slightly increase the risk of uterine cancer. For this reason, women taking this drug should consult with their gynecologist about appropriate follow-up for early detection of uterine cancer.

Back to top
New Study Shows Doctors Over Using Antibiotics

A recent study appearing in The Journal of the American Medical Association entitled Trends in Antimicrobial Drug Prescribing Among Office-Based Physicians in the United States, brings to our attention the danger of the now widespread overusage of antibiotics by physicians in this country. The study evaluated the prescribing practices of several thousand physicians from 1980 through 1992. The authors draw a direct relationship between the over utilization of antibiotics as well as increasing use of powerful broad spectrum drugs and the emergence of so called drug-resistant organisms, or organisms for which the antibiotics are becoming less effective. The authors state, "Increased use of antimicrobial drugs has coincided with an increase in drug-resistant organisms, which has resulted in the use of more toxic and expensive alternative drugs. Patients infected with drug-resistant organisms are more likely to require hospitalization, have longer hospital stay, and die. Infections with drug-resistant organisms pose major challenges for clinicians, microbiologists, and public health professionals."

In a recent issue of American Medical Association News, an article appeared entitled, Antibiotic-Resistant Bacteria Take Hold in California. This startling report reveals an increasing prevalence of infection with an organism whose technical name is abbreviated VRE. While infection with VRE has claimed a number of lives along the east coast, it has, until recently, been essentially unknown in California. Now several cases have been reported of infection with this organism which is resistant to almost every antibiotic available. According to David Stevens, M.D., Chief of Infection Control at Santa Clara Valley Medical Center, "The reason this organism is so interesting is that we don't have any drugs to treat it. We're going back to the pre-antibiotic era. That's why everybody is getting excited."

So far this year, hospitals in Santa Clara, California have reported 139 cases of VRE infection. The organism spreads through direct contact which explains why VRE infection has been noted to be so prevalent in nursing homes. Efforts are under way to educate health care providers about simply washing their hands with soap as this is an effective means for killing the bacteria.

The American Medical Association News article theorizes that "Over use of antibiotics in the past 50 years has caused some strains of organisms to develop immunity to them." And yet, doctors continue to prescribe antibiotics over the phone for patients with simple viral upper respiratory tract infections, and children with viral otitis (ear infections). Without question, antibiotics are an important tool in the armamentarium against serious bacterial infections. But their overusage is not without consequence. In addition to VRE we are now hearing reports of certain cases of tuberculosis being completely resistant to every antibiotic available. It is also important to realize that in various countries, no prescription is needed to obtain antibiotics. In Mexico for example, powerful broad spectrum antibiotics can be purchased over the counter without patients receiving any direction from a health care provider. Further, a most startling revelation is the fact that approximately 70% of the antibiotics produced in this country are utilized unchecked by the cattle and poultry industries. So it looks as if we may be painting ourselves into a corner. The "golden age" of antibiotics may soon be over.

Back to top
Government Sanctioned For Alternative Medicine

The Access To Medical Treatment Act (Senate Bill 1035/House Bill 2019), if passed, will give freedom to patients to pursue any medical treatment of their choosing, even those not approved by the secretary of Health and Human Services. The bill will allow licensed health care practitioners to pursue non-traditional therapeutic approaches provided the following conditions are met:

For more information on The Access To Medical Treatment Act, call (800) 357-2211.

Back to top
Herb Corner

Feverfew has gained popularity over the past decade in the treatment of migraine headaches. Patients report a significant reduction not only of the intensity, but also the frequency of headaches taking one capsule of Feverfew three times each day. It is also quite useful in the treatment of chronic painful conditions such as arthritis and low back disorders. Most herb textbooks indicate that Feverfew may cause increased uterine muscle tone. For that reason, it should not be taken by women who are pregnant.

To learn more about herbs, read The Healing Herbs by Michael Casselman (Rhodale Press, Emmaus, PA).

Back to top
Book Review

Optimal Wellness by Ralph Golan, M.D.
ISBN:0-345-35874-0, Ballantine Books, NY

So frequently we are asked by patients to provide them the name of a good resource book they can use to gain the knowledge needed to maintain optimal health. Ralph Golan's new book, Optimal Wellness, fulfills that need in every regard. Optimal Wellness is a 500 page bible for 21st century medicine. He hits the bull's-eye with chapters dealing with nutrition and health, finding your optimal diet, dietary hazards and excesses, and explanations of how various symptoms may represent specific nutritional deficiencies. His description of the yeast over-growth syndrome makes this extremely common malady of the late 20th century understandable to the reader.

An extremely intriguing addition is a section on "New Age and Age-Old Approaches" including chapters on fasting, cleansing, and rejuvenation, herbs and their medicinal uses, and energy medicine including a discussion on acupuncture and homeopathy. Perhaps the most useful resource in this text is the section dealing with common ailments, natural remedies and preventive approaches which lists common ailments alphabetically, allowing the reader to readily obtain information about a specific problem.

This is the book that we all need on our book shelf - lay person and health professional alike. Optimal Wellness by Ralph Golan, M.D., ISBN:0-345-35874-0, Ballantine Books, NY.

Back to top

"Knowing the patient is as important as knowing the illness."

Copyright © 2005-2008 Perlmutter Health Center All Rights Reserved.
Perlmutter Health Center - Commons Medical Center
800 Goodlette Road North - Suite 270 - Naples, FL 34102
Tel: (239) 649-7400 - Fax: (239) 649-6370