Perlmutter Health Center

A Quarterly Health Update • Spring, 1999 • Vol. 4 No. 2

David Perlmutter, MD, FACN

Quotations

"Drinking when we are not thirsty and making love at any time, madame: that is all there is to distinguish us from the other animals." Pierre-Augustin De Beaumarchais, The Marriage of Figaro

"No man who hath once heartily and wholly laughed can be all together irreclaimably bad." Thomas Carlyle, Sartor Resartus

"One must laugh before one is happy or one may die without ever having laughed at all." La Bruyere, Les Caracteres

"Illness is not something a person has. It is another way of being." Jonathan Miller, The Body In Question

"Nearly all men die of their medicines, and not of their illnesses." Moliere, La Malade imaginaire

"There never was a philosopher that could endure the toothache patiently." Shakespeare, Much Ado About Nothing, Vi

"Everybody likes a kidder, but nobody lends him money." Arthur Miller, Death of A Salesman

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Bug Zappers - A Health Risk?

Now that summer has arrived many of us make plans to participate in various outdoor activities. One area of constant concern is what can be done about the various insects that prove to be such a nuisance at our picnics and other activities. Over the past ten years there has been a large increase in the use of so called "bug zappers". These are very high voltage devices that attract bugs to a light bulb and then incinerate them with high voltage. While at first these devices might seem to be a great idea - killing bugs without pesticides, there may be an important downside. In a recent article appearing in the Journal Lancet, (June 12, 1999), some significant concerns were raised about the use of these devices. Researchers at Kansas State University found that these devices actually release large amounts of insect particles as well as un-killed bacteria and viruses. Entomologist, Alberto Broce and his colleagues found that when bugs were "zapped" particles extended out for a distance of at lest 2 meters containing insect parts as well as viruses and bacteria, representing a significant health concern according to the researchers. It is known that flies, for example, carry several potentially dangerous organisms including staphylococci, enterococci, and Campylobacter jejuni. Dr. Broce is particularly concerned about the use of these devices in enclosed environments. As he stated "under no circumstances should there be insect electrocutors in a sterile environment, in any hospital, or anywhere that handles food because the possibility that pathogens will be spread. Thus, while these devices may seem like an appropriate alternative to dangerous insect sprays, there may be some very important down sides in terms of health risks. Perhaps we should go back to fly paper.

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Book Review

Nutrition and Mental Illness - An Orthomolecular Approach to Balancing Body Chemistry, Carl C. Pfeiffer, PhD., M.D.
ISBN# 0-89281-226-5

It is common practice when reviewing books to seek out the latest "hot off the press" editions. In this issue of the Perlmutter Letter, however, I have chosen to review a book written in 1987 because the information it provides is as vital and timely as it was more than a decade ago. The focus of this book is on an orthomolecular approach to mental illness. The term "orthomolecular" was first used by Nobel Prize winner Linus Pauling. In his description of treating illnesses with nutrients. "Ortho" means correct or appropriate. Thus the term orthomolecular describes a therapeutic approach based upon providing cells, tissues, organs, and the body in general with appropriate nutritional components. Where Nutrition and Mental Illness excels, is not only in providing specific information as to what nutrients are appropriate for specific psychiatric illnesses, but in addition, it describes the negative impact that certain foods may have on psychological and other physical ailments. The book begins with a simple overview of the effects that certain toxic elements in the environment may have specifically, on psychiatric illnesses. Next, Dr. Pfeiffer explores specific psychiatric entities. These include anxiety and phobias which he feels may be significantly influenced by various trace elements, specifically copper, with specific emphasis on how various trace elements affect the level of histamine in the body. Thus, an individual found to be low in histamine is typically "loaded with copper" and may be at risk for canker sores, excessive fat, ringing in the ears, and heavy growth of body hair. Specific nutritional interventions are then described which can bring the body back into balance. Individuals experiencing high histamine levels, are identified by their easy ability to sneeze in bright sunlight, cry, salivate, or feel nauseated easily, may experience psychiatric problems such as suicidal thoughts, abnormal fears, compulsions, or rituals, and have feelings of inner tension and occasional depression. A specific dietary program focused on low protein with high complex carbohydrates is recommended along with a variety of nutrients. Other interesting areas explored in nutritional and mental illness include hypoglycemia, vitamin B6 and zinc, the concept of "brain allergies", and a very fascinating section exploring the relationship between diet, crime, and delinquency. Finally, the book concludes with two sections dealing with the optimum nutrition for mental health, and nutritional programs for specific diseases. This is a very important read for patients and healthcare providers alike. The book may not be easy to find and it may be necessary to contact the publisher, Healing Arts Press, One Park Street, Rochester, Vermont, 05767. Alternatively, the book can be ordered from one of the various online book services.

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Cerebral Palsy and Hyperbaric Oxygen

The term "cerebral palsy" is not a specific diagnosis, but is now generally applied to children who experience some form of brain trauma either at the time of birth or shortly before. Typically, these children manifest some degree of cognitive impairment as well as physical impairment, often with weakness and spasticity of arms and legs. Typically treatment therapies for children with cerebral palsy have been directed at the physical manifestations of the underlying problem. That is, most efforts are geared to increase range of motion, reduce spasticity, and increase strength, along with specific therapies designed to enhance skills of communication and academic performance.

Evidence from around the globe is now accumulating providing strong support for the use of hyperbaric oxygen therapy (HBO) as an approach to the actual underlying problem in children with cerebral palsy - a technique which actually targets the abnormalities of brain function. The use of hyperbaric oxygen therapy in cerebral palsy offers an exciting new therapeutic approach for the treatment of cerebral palsy. In actuality however, hyperbaric oxygen therapy itself is not a new technique. It has been utilized for decades for the treatment of injuries related to underwater diving, and in addition has found great utility in the treatment of poorly healing wounds, burns, various bone disorders, complications of radiation therapy, circulatory problems, carbon monoxide poisoning, multiple sclerosis, head injury, and stroke. Hyperbaric oxygen therapy is approved by the FDA as well as the AMA and acts by enhancing tissue levels of life-giving oxygen. Normally, oxygen is almost exclusively carried by red blood cells. During hyperbaric oxygen therapy, there is a substantial increase in the amount of oxygen carried in all body fluids, including plasma, cerebrospinal fluid, lymph and intracellular fluids. This allows increased oxygen levels in areas of tissue damage or injury. Increasing oxygen levels promotes growth of blood vessels and increases the metabolic activity of previously marginally functioning cells, including brain neurons.

Patients receiving hyperbaric oxygen therapy enter a monoplace (one-person) clear acrylic chamber where they breathe 100% oxygen delivered to the chamber under increased atmospheric pressure. Typically, treatments last one to two hours during which time patients relax, watch television, or sleep, while they are carefully monitored by highly trained technicians. Most chambers are large enough to comfortably treat both an adult and a child. The effectiveness of hyperbaric oxygen therapy in children with cerebral palsy is likely a manifestation of enhanced function of previously damaged neurons. These neurons have been called "idling neurons" in that while they are still alive, they have been damaged to the extent that their function is compromised. The concept of enhancing the function of these idling neurons has been extensively described in stroke patients as we have reported in previous issues of the Perlmutter Letter. Canadian researchers have been vigorously exploring the utility of HBO in cerebral palsy. Dr. Pierre Marois and his team of researchers from McGill University in Montreal have recently studied 25 children with cerebral palsy, aged 4 to 7 years, treated with hyperbaric oxygen therapy on a daily basis for 20 days at McGill University. Another 15 children were treated twice a day for 10 days. Both groups thus received a total of 20 treatment sessions. The results of their post-treatment evaluation were truly remarkable. According to Dr. Marois "…the results are really incredible! 23 of the 25 children have great results. Twenty-three have amelioration with their spasticity and may have amelioration with speech and cognitive function". Further, their published results reveal "the clinical observations do list numerous functional changes, definite improvements, a large amount in the level of arousal/response to communication." From statistical analysis of the objective estimations we confirm these change, more particularly on the level of motor functioning like walking and the quality of sitting position, similarly on the level of spasticity. These results are suprising considering the small number of treatments given (20), and of extreme importance because its (a question of) the first study documenting objectively the prospects of beneficial effects of HBO in the treatment of children suffering from cerebral palsy.

While it is important to recognize that hyperbaric oxygen therapy clearly represents an important tool in the treatment of children with cerebral palsy, it should be viewed as an adjunctive form of therapy to be used in conjunction with other established treatment protocols including physical therapy, occupational therapy, speech therapy, as well as pharmaceutical therapy designed to reduce spasticity. The use of HBO in children with cerebral palsy is now gaining a strong foothold in the United States and there is no doubt that because of its profound effectiveness, its utilization will become much more widespread. Public awareness of the use of hyperbaric oxygen therapy in children with cerebral palsy in North America can be credited in large part to the work done by Mothers United for Moral Support (MUMS). This worldwide organization, founded by Julie Gordon, a mother of a child with cerebral palsy, seeks to unite parents of children with cerebral palsy and other needs and to share information concerning various therapeutic options. They can by contacted at telephone 920-336-5333. E-Mail can be directed to the MUMS National Parent - to - Parent network by contacting MUMs@netnet.net. We are proud to report that the Perlmutter Hyperbaric Center has become a world leader on the use of hyperbaric oxygen therapy in cerebral palsy and other neurological disorders. To receive more information about hyperbaric oxygen therapy in the treatment of cerebral palsy, contact The Perlmutter Hyperbaric Center at 239-434-9699 and visit our web site at perlhealth.com.

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Garlic and Breast Cancer

The multiple medicinal uses of garlic have been known for centuries and even under the scrutiny of modern day scientific evaluation, garlic continues to demonstrate its effectiveness in a wide variety of medical conditions including elevated cholesterol, elevated blood pressure, fungal infections, dysentery, gastritis, parasites, and bacterial infections. Recently, some of the finest research institutions in the world have focused on garlic as a potential anti-cancer agent. In a recent publication in Oncology Reports, researchers from Memorial Sloan Kettering Cancer Center and Cornell University Medical College demonstrated a profound inhibitory effect of Aged Garlic Extract (Kyolic Garlic®) on the rate of growth of breast cancer cells in laboratory. In their study entitled Anti-Proliferative Effects of Garlic Constituents in Cultured Human Breast Cancer Cells, the researchers found that two of the components of Aged Garlic Extract (Kyolic garlic®), were profoundly reduced the rate of growth of these breast cancer cells. The study then further explores the specific biochemistry underlying the mechanisms whereby this garlic extract was able to reduce cancer growth. Although the precise mechanisms still remains somewhat elusive. The idea that garlic has significant anti-cancer activity is certainly supported not only by countless other laboratory studies, but also epidemiological data which confirm significant lowering of incidence of both gastric and other digestive tract cancers in parts of the world where there is increased consumption of garlic. Indeed, the very potent anti-cancer effect of garlic has been clearly demonstrated in animal model systems including chemically induced colon cancer, esophageal cancer, and breast cancer. These reports, like so many others that are now appearing in the most highly respected medical research journals, continue to provide support for the recommendation of garlic supplementation in an overall program for health and longevity. Aged Garlic Extract (Kyolic Garlic®) clearly represents the most extensively evaluated commercially prepared garlic supplement in the world. It is the only garlic supplement prescribed at the Perlmutter Health Center. If you would like more information about Kyolic® Garlic or would like to receive copies of the research articles supporting its usefulness, contact Wakunaga of America at 1-800-421-2998.

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No Drugs for Dementia

In our magic-bullet society where physicians and patients alike are programmed to turn to the pharmaceutical industry to cure our ills, it appears that we have come up empty-handed when confronted by dementia. Nevertheless, our medical journals continue to display large compelling advertisements indicating the usefulness of various so-called "Alzheimer's drugs". But, in a recent issue of Archives of Neurology (June 1999), the lack of usefulness of any of these drugs was clearly described by Dr. William Pryse-Phillips. Tacrine (Cognex ®), one of the most promoted dementia drugs in the United States might reduce the "likelihood of nursing-home placement". But, as Dr. Pryse-Phillips reported, "the drug's adverse effects on the liver and high drop-out rate were recurrent problems. While Tacrine is accepted in the United States and in some European countries, evaluation by the Canadian Health Protection Branch lead to its rejection on the grounds that the benefits did not translate into sufficient functional improvement to offset its potential risks (such as effects on the liver), an opinion strengthened by an assessment that concluded that it showed no clear evidence of efficacy or effectiveness". The latest and most highly touted drug for dementia, Donepezil (Aricept ®), while finally providing health practitioners another opportunity to satisfy themselves by prescribing a specific drug for a specific problem, has very little effectiveness whatsoever. As Dr. Pryse-Phillips reported, "Donepezil may improve certain neuro-psychological test scores, but its clinically meaningful benefits in treatment of Alzheimer's disease seem to be minimal". This is a particularly meaningful revelation, especially in light of the potential for adverse reactions to this drug including depression, vomiting, dizziness, and insomnia. In this context, efforts aimed at preventing dementia would certainly seem to take on more importance. In an interesting report appearing in the Lancet, May 8, 1999, from the Department of Neurology and Clinical Chemistry at the University of Heidelberg, researchers revealed that the second most frequent cause of dementia in the elderly population after Alzheimer's disease was so called "vascular dementia" or brain dysfunction as a consequence of disease of the small blood vessels. What was more striking, was the finding of elevation of a particular chemical in the blood of these individuals called homocysteine. Blood homocysteine levels are directly related to intake of the B-Complex group of vitamins, specifically, vitamins B6, and B12, as well as folic acid. The conclusion of the report provided very strong support for the effectiveness of dietary supplementation with the B-complex group of vitamins in terms of reducing risk of dementia. As the author stated "we speculate, therefore, that progression of vascular dementia in patients with identified hyperhomocysteinemia (elevated homocysteine) could be prevented by vitamin supplementation."

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