Dr. Bray Links

Tuesday, March 29, 2016

Glyphosate: A Root Cause of Chronic Inflammation?

That breadbasket people love to dig into in their favorite restaurants? If the bread is not organic, it is likely soaked in glyphosate.

The weed killer, the active ingredient in RoundUp®, was first patented and introduced by Monsanto in 1974 for agricultural use. Later it was marketed to consumers as a household herbicide. It is sprayed in staggering quantities on most commercially grown staple crops, including wheat, corn, soybean, beet, cotton, canola, and alfalfa.

Since last year, when the World Health Organization classified glyphosate as a “probable human carcinogen,” there has been a lot of media coverage of the potential health risks associated with the use of this herbicide.

Glyphosate as Dessicant

What many people do not know is that since 1992, glyphosate has also been widely used as a “ripening agent” or desiccant on wheat and many other grains. This application stresses or kills the plants, to accelerate drying and speed the ripening of the grain immediately before harvest.

Desiccating wheat with glyphosate is particularly common in years with wet weather and has been increasing in Upper Midwestern states in the US, as well as in areas of Canada and Scotland (where the process began). This pre-harvest application means there’s even more glyphosate residue on the grain by the time it reaches market than there would be if the compound had only been used as an herbicide during the growing process.

In addition to wheat, glyphosate is also used as a dessicant on oats, rye, lentils, peas, flax, potatoes, buckwheat, and millet.

In our lab in Virginia, we have been testing glyphosate levels in common foods. The amount of glyphosate estimated in one slice of ordinary pizza is roughly 10 ppm. That, in addition to the gliadin protein from the gluten in the crust, is enough to degrade human intestinal tight junctions in cell culture almost immediately upon contact.

Safer Than Salt? Not!

According to Anthony Samsel and Stephanie Seneff, gluten intolerance and Celiac disease now affects an estimated five percent of the population of North America and Europe. Symptoms include nausea, diarrhea, skin rashes, macrocytic anemia, and depression.

It is also associated with numerous nutritional deficiencies as well as reproductive issues and increased risk to thyroid disease, kidney failure, and cancer. An amazing graph in their article shows the sharp rise in usage of glyphosate on US wheat in the last decade, in step with the sharp rise in the incidence of Celiac disease (Samsel A, Seneff S. Interdiscip Toxicol. 2013 Dec; 6(4): 159–184).

Samsel and Seneff propose that glyphosate, “is the most important causal factor in this epidemic.”

In 1996, New York’s attorney general sued Monsanto over the company’s use of “false and misleading advertising” about RoundUp. That case ended with Monsanto agreeing to stop calling Roundup “biodegradable,” and to pull ads claiming that Roundup was “safer than table salt,” “practically nontoxic,” and “stayed where you put it.”

Glyphosate was “classified as probably carcinogenic to humans,” according to a recent report from the International Agency for Research on Cancer (IARC), the World Health Organization’s France-based cancer research arm.

The state of California has also moved to classify the herbicide as a probable carcinogen. A growing body of research is documenting the detrimental effect of glyphosate as an endocrine disruptor. The substance also kills beneficial gut bacteria, damages the DNA in human embryonic, placental and umbilical cord cells, and is linked to birth defects and reproductive problems in laboratory animals.

One Pound Per Person

Monsanto introduced glyphosate following the ban on DDT. The company started selling it direct to consumers in the 1980s. Since that time, agricultural and consumer use have both skyrocketed, washing out of our driveways, our lawns, and our croplands and into our water systems.

In 1996, Monsanto debuted the first genetically engineered glyphosate-resistant “RoundUp-Ready” crops -- corn and soybean. Now the whole crop could be sprayed throughout its lifecycle to prevent weeds, and increase crop yield. With each passing year more acres of wheat, corn, soybean, beet, cotton, canola, alfalfa, and other staple crops are sprayed with glyphosate.

Glyphosate is dumped on us at the rate of 300 million pounds per year, almost one pound for every person in the US, according to an article in Newsweek.

Estimates are that 75% of rainwater is contaminated by glyphosate, according to EcoWatch. The US Geological Service reports that more than 88,000 tons of glyphosate were used in the US in 2007, up from 11,000 tons in 1992. Since the advent of “super weeds,” the use of glyphosate has risen significantly.

Since 1974 in the US, over 1.6 billion kilograms of glyphosate active ingredient have been applied, or 19% of estimated global use of glyphosate (8.6 billion kilograms). Two-thirds of the total volume of glyphosate applied in the US from 1974 to 2014 has been sprayed in just the last 10 years (Benbrook C. Trends in glyphosate herbicide use in the United States and globally. Environmental Sciences Europe: Bridging Science and Regulation at the Regional and European Level 2016 28:3)

Globally, glyphosate use has risen almost 15-fold since Roundup-Ready crops were introduced in 1996.

Reuters reported that researchers found residues of glyphosate in an astounding 41 of 69 honey samples, 10 of 28 samples of soy sauce, three of 18 breast milk samples and six of 40 infant formula samples.

Tight Junction Damage

In the intestines, glyphosate is a profound zonulin stimulator. It damages the epithelial tight junction tissue on contact, weakening the barriers that protect us on the inside from the barrage of other environmental toxins to which we are exposed. Injury to the tight junction membrane in the gut can lead to intestinal permeability.

The zonulin production initiated by glyphosate exposure quickly becomes systemic; injury to the tight junction membrane in the brain can result in a breakdown of the blood-brain barrier and a host of neurological symptoms.

With the collapse of the tight junction firewalls, all organ systems go under duress. Just behind that microscopically thin layer of protection of the endothelial cells that separate you from the outside world is the gastrointestinal lymphatic tissue (GALT). The GALT is a layer of immune cells that are vigilantly standing guard to address any breach in your firewall. It is estimated that 60-70% of the immune system, and more than 80% of the antibodies that the immune system produces, originate in the GALT.

The acute inflammatory response becomes chronic inflammation as the system is overwhelmed with toxins from the outside world.

The gliadin protein in gluten also stimulates release of zonulin. I agree with William Davis, MD, author of Wheat Belly, who holds that, “When gliadin triggers zonulin release, intestinal tight junctions are disrupted, and unwanted proteins …gain entry to the bloodstream. Immune-activating lymphocytes, such as T-cells, are then triggered to begin an inflammatory process against various ‘self’ proteins, thus initiating …conditions such as celiac disease, thyroid disease, joint diseases, and asthma.”

Glyphosate enhances the damaging effects of other food-borne chemical residues and environmental toxins. Negative impact on the body is insidious and manifests slowly over time as inflammation damages cellular systems throughout the body (Samsel A, Seneff S. Entropy. 2013: 15(4): 1416-1463)

Glyphosate & GMOs

Genetically-engineered or genetically-modified organisms (GMOs) are live organisms whose genetic components have been artificially manipulated through creating unstable combinations of plant, animal, bacteria, and even viral genes that do not occur in nature, or through traditional crossbreeding methods.

In the US, 88% of the corn crop, 93% of the soybean crop, 90% of sugar beets (accounting for 54% US sugar production), and 94% of cotton are genetically engineered to be able to survive the application of glyphosate. Consequently, they can be sprayed heavily with glyphosate to control weeds and simplify harvest.

What this means is that much of the US food supply is contaminated even prior to harvesting – think of the corn, soy, and their oils, and beet sugar used in processing packaged foods. Additionally, factory-farmed livestock fed corn and soy products concentrate the glyphosate in their flesh, further contaminating the food supply chain.

Alfalfa, is the fourth largest crop in the US, and one that is widely used as feed for dairy cows. The cows concentrate the toxin in their milk, meaning that conventional dairy products have high levels of glyphosate originating from the alfalfa.

The Moms Across America Study

Several years ago, a group of concerned mothers calling themselves Moms Across America, commissioned a study looking to determine levels of glyphosate in breast milk.

Contrary to industry assertions that glyphosate did not bio-accumulate, the MAA study discovered the reality of elevated levels of glyphosate in breast milk. Samples from some women revealed glyphosate in levels of 76 μg/L to 166 μg/L. As reported by The Detox Project, this is 760 to 1,600 times higher than the EU-permitted level in drinking water (although it's lower than the US maximum contaminant level for glyphosate, which is 700 μg/L).

How to Best Avoid Glyphosate

Here are some recommendations I give to my patients for avoiding exposure to glyphosate:

  • Eat as low on the food chain as possible: This is good advice for a number of reasons; avoiding glyphosate is a big one.
  • Obviously, avoid all GMO foods: including processed and packaged foods containing non-organic corn, soybean, and sugar in all their myriad varieties. Organic means non-GMO. There are many non-organic packaged foods now bearing the non-GMO certification.
  • Choose vinegar as a home week killer: Don’t use RoundUp!
  • Animal-derived foods pose complex issues for people trying to avoid environmental toxins. Animals fed and fattened on corn, soybean, and alfalfa feed are basically accumulating and concentrating glyphosate, as well as other toxins including animal antibiotics. This holds true for non-organic dairy products as well, which also concentrate glyphosate in cows’ milk.

Zach Bush, MD, is medical director of a new, integrative medicine practice in Charlottesville, Va. He is also the founder of Biomic Sciences, a nutraceutical company that recently launched Restore, a unique supplement product that can support the repair of the gut wall by reestablishing proper tight-junction function.


Sunday, March 27, 2016

How To Prevent Breast Cancer

  1. Stay thin - fat stores fat-soluble toxins including EDCs and mycotoxins (see Mark Hyman's book "Eat Fat, Get Thin" if you are overweight). Also adipose tissue is high in aromatase which promotes breast cancer.
  2. Avoid alcohol - alcohol upregulates aromatase plus many beer and wine products sold in the US are contaminated with heavy metals, phthalates, and other contaminants (since they are not required to be labeled like other food and drink items)
  3. Get physical activity that involves sweating - sweating helps detoxification, especially heavy metals
  4. Avoid processed sugary foods and sugary drinks - sugar is a fertilizer for cancer cells (or more generally, metabolic inflexibility is a characteristic of cancer cells and can be used to combat cancer)
  5. Eat more vegetables and fruit - a whole-food plant-based diet is high in fiber and antioxidants (fiber is a critical part of detoxification)
  6. Eat more whole grains and legumes such as beans - fiber and phytoestrogens are strongly protective (phytoestrogens act as selective estrogen receptor modulators)
  7. Avoid red meat, processed meat, and dairy products - too many inflammatory compounds and endocrine disruptors
  8. Avoid dangerous personal care products (including creams, makeups, lipsticks, soaps, etc) - check EWG Skin Deep and Breast Cancer Fund
  9. Avoid synthetic progestins in hormones whenever possible.

*Do not support groups (eg. "Mammograms, Martinis, and Manicures" and here) that advertise breast cancer awareness / education events that serve alcohol or distribute endocrine disruptors - that just doesn't make sense. Should we hand out cigarettes at a lung cancer awareness event?*

As always, be cautious of supplements unless you (or your provider) have done an exhaustive review of the research literature and supplement contents (both active and inactive ingredients). You need to be skillful at obtaining and reviewing third-party supplement testing reports to have confidence in a supplement that you put into your body. It is hard to trust what is contained in most over-the-counter non-pharmaceutical-grade supplements.


"Breast cancer is the most common cancer among women in both developed and less-developed countries. Rates of breast cancer are increasing worldwide, with a particular increase in postmenopausal and estrogen receptor-positive cases. The World Cancer Research Fund (WCRF) and American Cancer Society (ACS) cancer prevention guidelines recommend maintaining a healthy weight, undertaking at least 150 minutes of moderate intensity exercise per week, limiting alcohol consumption, and eating a plant-based diet. Observational data link adherence to physical activity and alcohol guidelines throughout life to a reduced risk of developing pre- and postmenopausal breast cancer. Weight control throughout life appears to prevent cases after menopause. Adherence to a healthy dietary pattern does not have specific effects on breast cancer risk but remains important as it reduces the risk for other common diseases, such as cardiovascular disease (CVD), diabetes, and dementia. Emerging data suggest that smoking during adolescence or early adulthood increases later risk of breast cancer. Lifestyle factors appear to modify risk among high-risk women with a family history and those with typical risk of the general population, although their effects among carriers of BRCA mutations are not well defined. Recent expert reports estimate that successful lifestyle changes could prevent 25% to 30% of cases of breast cancer. These reductions will only be achieved if we can implement targeted prevention programs for high-risk women and women in population-based breast screening programs during childhood, adolescence, and early adulthood when the rapidly developing breast is particularly susceptible to carcinogenesis."

2015 - American Society of Clincial Oncology

Other links:



Jessica Bowen: Stage 3 Breast Cancer Survivor

Imagine a world where insurance covered this type of physician supervised care, instead of a 15 minute visit focused on data-entry into a computer every 3 to 6 months:

Bitters ... What Are They?

"Healthy bile flow helps rid the liver of waste products such as oxidized cholesterol and hormonal metabolites, prevents gall stone formation, and provides lubrication of the intestines, easing the passage of stool."



When a bitter substance is recognized by bitter receptors on the tongue, a chain of neural and endocrine events begins, labeled as the “bitter reflex.” Mediated by the release of the gastric hormone gastrin, this reflex results in an overall stimulation of digestive function, which over time strengthens the structure and function of all digestive organs (liver, stomach, gallbladder, pancreas, etc.). Let’s take a more in-depth look at this reflex.

Imagine you’ve tasted a bitter-tasting substance. Within fifteen to thirty minutes, your appetite is noticeably increased, your digestive juices are flowing, and your intestines begin to contract in anticipation of food.

Starting in your mouth, you’ll notice that your salivary glands have increased their output of enzyme-rich saliva, helping to break down complex starches into smaller and more easily digested oligosaccharides.

In the stomach, the hormone gastrin has stimulated the secretion of hydrochloric acid. The acidity helps break down protein, enhances the bioavailability of many minerals (especially calcium) and destroys any harmful microbes present in your food. It’s interesting to note that more people have levels of gastric acid that are too low rather than the opposite, due to stress or simply aging. Low levels of gastric acid contribute to poor nutrition and increased susceptibility to gastrointestinal infections.

Considered cooling by nature, bitters can reduce hot inflammatory conditions.
Interestingly, low stomach acidity is associated with a variety of allergic and immune-mediated disorders, including asthma; skin disorders such as eczema, psoriasis and rosacea; gallbladder disease and arthritis.

Gastrin also stimulates secretion of pepsin—an enzyme necessary for breaking large protein molecules into smaller parts—and intrinsic factor, necessary for the absorption of vitamin B12.
The smooth muscle of the stomach is also stimulated by the bitter reflex, which increases the rate of gastric emptying, and contracts the esophageal sphincter to prevent the movement of acidic stomach contents upwards into the esophagus. Self-repair mechanisms in the intestinal wall are stimulated, enhancing cell division and growth. While many people with GERD are hesitant to partake of bitters due to the potential increase in stomach acidity, the combined effect of these actions actually can help this condition by ensuring that the stomach contents are moved downward rather than allowed to reflux back up and out of the stomach. Bitters also act to heal any damage done to the gastric mucosa.

Down in the small intestine, the stimulation caused by the bitter taste prompts your liver to increase its production of bile, and your gallbladder to increase bile excretion. Bile is necessary for fat digestion and the absorption of fat-soluble nutrients such as vitamins A, D and E. Healthy bile flow helps rid the liver of waste products such as oxidized cholesterol and hormonal metabolites, prevents gall stone formation, and provides lubrication of the intestines, easing the passage of stool. It should not be surprising that by enhancing movement of waste products out of the liver, bitter herbs have been found to exert a protective effect in liver conditions such as hepatitis and cirrhosis.



  • Chamomile : Matricaria chamomilla. A mild bitter herb used as a sedative and antispasmodic. Its curative properties include relief of both fever and restlessness.
  • Dandelion : Taraxacum. A mild bitter herb used as a blood cleanser and diuretic. Also said to lower cholesterol and blood pressure. Still used in traditional cooking in the Mediterranean and parts of Asia.
  • Goldenseal : Hydrastis canadensis. A strong bitter herb used to stimulate appetite and eliminate infections. In Collections for an Essay Toward a Materia Medica of the United States (1804), Professor Benjamin Smith Barton declared goldenseal a tonic, observing, “The root of the plant is a very powerful bitter.”
  • Horehound : Marrubium vulgare. Dating back to Ancient Egypt, horehound is believed to be one of the original bitter herbs of the Bible. It has been used for colds and respiratory ailments (such as in cough syrup and throat lozenges).
  • Milk Thistle : Silybum marianum. Also known as “sow-thistle,” this herb was likely one of the original bitter herbs. In healing, it’s known as a powerful liver detoxifier, as well as an antidote for Amanita-mushroom poisoning.
  • Peppermint : Mentha piperita. Roman naturalist Pliny the Elder wrote of peppermint, “The very smell of it alone recovers and refreshes the spirit.” The ancient herb is used as a flavor, a fragrance, and medicine. Peppermint oil is used to allay nausea and stomach aches.
  • Rue : Ruta. A strong bitter herb used as an antispasmodic, a sedative, and a mild stomachic. Mentioned in the Bible as “peganon” and in William Shakespeare’s Richard III — “Here is this place/I’ll set a bank of rue, sour herb of grace.”
  • Wormwood : Artemisia absinthium. A perennial plant used as an antiseptic, tonic, diuretic, and stomachic. The herb’s strong bitter taste is still used in wines and spirits, such as vermouth.
  • Yarrow : Achilles millefolium. A flowering plant that produces a mild bitter herb used as an astringent and cold remedy. The entire herb can be used.

Saturday, March 26, 2016

What are the limits for mycotoxins in coffee, wine, chocolate, grain, nuts, spices in the US?

Mycotoxins (ochratoxin, zearalenone, aflatoxin, trichothecenes, fumonisins, patulin, among others) can be allergenic, carcinogenic, and mitochondrial poisons - causing multiple chronic diseases including biotoxin illness and chronic fatigue. Fortunately, most people can detoxify mycotoxins without suffering much noticeable consequence. However, there are many that have difficulty with mycotoxin clearance and detoxification.

The United States currently sets no upper limit on mycotoxins in coffee, wine, chocolate, grain, nuts and spices except for a limited few items. In the US, food and milk (cows that eat contaminated grain make milk with aflatoxin) are regulated for aflatoxin, however the restrictions are some of the weakest in the world and are rarely enforced. Corn is regulated for fumonisins. Apple juice is regulated for patulin. And that's it.

It turns out that most countries require imported U.S. food (and drinks) to be tested and meet their tighter regulations before import is possible. Companies producing foreign coffee, wine, chocolate, grain, nuts and spices love the lack of oversight in the United States, as our country can become their dumping ground for the products not suitable for their own country.

Europe has clear limits on mycotoxins. They limit ochratoxin A in dried fruit, coffee, chocolate, wine, grape juice, beer, liqueurs, spices, baby foods, and cereals. Singapore, Brazil, and nearly 100 countries have tighter regulations than the United States. Even China has tighter regulations than the United States on mycotoxins.

Since ochratoxin is a mitochondrial toxin associated with chronic fatigue syndrome, why are we still allowing this in our food? Some groups are putting out coffee (ochratoxin 2 ppb), wine (ochratoxin 5 ppb), and other foods that are third party tested and meet the strictest international standards for mycotoxins, which I certainly support and applaud.

I don't think that it is coincidence that many of the most common food allergies are also the ones most concerning for mycotoxin contamination. Babies can even be exposed to mycotoxins through their mother's breast milk (when she eats foods with mycotoxins). Babies have more difficulty clearing and detoxifying these mycotoxins they get from their mother, which makes them more sensitive.


"Mycotoxin contamination of cereals and related products used for feed can cause intoxication, especially in farm animals. Therefore, efficient analytical tools for the qualitative and quantitative analysis of toxic fungal metabolites in feed are required. Current methods usually include an extraction step, a clean-up step to reduce or eliminate unwanted co-extracted matrix components and a separation step with suitably specific detection ability. Quantitative methods of analysis for most mycotoxins use immunoaffinity clean-up with high-performance liquid chromatography (HPLC) separation in combination with UV and/or fluorescence detection. Screening of samples contaminated with mycotoxins is frequently performed by thin layer chromatography (TLC), which yields qualitative or semi-quantitative results. Nowadays, enzyme-linked immunosorbent assays (ELISA) are often used for rapid screening. A number of promising methods, such as fluorescence polarization immunoassays, dipsticks, and even newer methods such as biosensors and non-invasive techniques based on infrared spectroscopy, have shown great potential for mycotoxin analysis. Currently, there is a strong trend towards the use of multi-mycotoxin methods for the simultaneous analysis of several of the important Fusarium mycotoxins, which is best achieved by LC-MS/MS (liquid chromatography with tandem mass spectrometry). This review focuses on recent developments in the determination of mycotoxins with a special emphasis on LC-MS/MS and emerging rapid methods."




Friday, March 25, 2016

Getting to a cure for Alzheimer's

For anyone caring for someone with Alzheimer's Disease or even anyone with early cognitive decline, I strongly suggest taking a look into Dr. Bredesen's work on the MEND program. This was recently highlighted at the Cleveland Clinic Functional Medicine Grand Rounds.

"The Cleveland Clinic Center for Functional Medicine and the Institute for Functional Medicine (IFM) have collaborated to produce a special free, live-streamed Grand Rounds featuring Dr. Bredesen speaking on 21st Century Medicine and the Reversal of Cognitive Decline in Alzheimer Disease. 
The research performed by Dale Bredesen, MD, has opened the door to a new therapeutic approach for patients with Alzheimer disease. On March 15 at the Cleveland Clinic, Dr. Bredesen will present his innovative protocol for reversing memory loss— and sustaining this improvement — using a complex, 36-point therapeutic program that involves comprehensive diet changes, brain stimulation, exercise, sleep optimization, specific pharmaceuticals and vitamins, and multiple additional steps that affect brain chemistry."
Dr. Bredesen’s novel insights into the fundamental nature of Alzheimer’s disease recently attracted an investment of $3.5 million toward a $10 million goal for initial clinical trials of these new therapeutics.  This generous support came from the private venture capitalist Douglas Rosenberg, who is helping to fund the Alzheimer’s Drug Discovery Network, centered at the Buck Institute.  The unit is screening drug candidates to find those that can preserve a healthy balance in the signaling pathways that support memory. Dr. Bredesen’s work on nerve cell signaling is also the focus of a collaboration between the Buck Institute and BioMarin Pharmaceuticals, Inc., which is seeking treatments for a rare form of Alzheimer’s disease, early onset Familial Alzheimer’s Disease (eFAD), which may develop in people as young as 30 years of age.


MEND: 25-Step Memory Program

Optimize diet: minimize simple carbohydrates, minimize inflammation.Patients given choice of several low glycemic, low inflammatory, low grain diets.Minimize inflammation, minimize insulin resistance.
Enhance autophagy, ketogenesisFast 12 hr each night, including 3 hr prior to bedtime.Reduce insulin levels, reduce Aβ.
Reduce stressPersonalized—yoga or meditation or music, etc.Reduction of cortisol, CRF, stress axis.
Optimize sleep8 hr sleep per night; melatonin 0.5mg po qhs; Trp 500mg po 3x/wk if awakening. Exclude sleep apnea.
Exercise30-60' per day, 4-6 days/wk
Brain stimulationPosit or related
Homocysteine <7Me-B12, MTHF, P5P; TMG if necessary
Serum B12 >500Me-B12
CRP <1.0; A/G >1.5Anti-inflammatory diet; curcumin; DHA/EPA; optimize hygieneCritical role of inflammation in AD
Fasting insulin <7; HgbA1c <5.5Diet as aboveType II diabetes-AD relationship
Hormone balanceOptimize fT3, fT4, E2, T, progesterone, pregnenolone, cortisol
GI healthRepair if needed; prebiotics and probioticsAvoid inflammation, autoimmunity
Reduction of AβCurcumin, Ashwagandha
Cognitive enhancementBacopa monniera, MgT
25OH-D3 = 50-100ng/mlVitamins D3, K2
Increase NGFH. erinaceus or ALCAR
Provide synaptic structural componentsCiticoline, DHA
Optimize antioxidantsMixed tocopherols and tocotrienols, Se, blueberries, NAC, ascorbate, α-lipoic acid
Optimize Zn:fCu ratioDepends on values obtained
Ensure nocturnal oxygenationExclude or treat sleep apnea
Optimize mitochondrial functionCoQ or ubiquinol, α-lipoic acid, PQQ, NAC, ALCAR, Se, Zn, resveratrol, ascorbate, thiamine
Increase focusPantothenic acidAcetylcholine synthesis requirement
Increase SirT1 functionResveratrol
Exclude heavy metal toxicityEvaluate Hg, Pb, Cd; chelate if indicatedCNS effects of heavy metals
MCT effectsCoconut oil or Axona
Hg, mercury; Pb, lead; Cd, cadmium; MCT, medium chain triglycerides; PQQ, polyquinoline quinone; NAC, N-acetyl cysteine; CoQ, coenzyme Q; ALCAR, acetyl-L-carnitine; DHA, docosahexaenoic acid; MgT, magnesium threonate; fT3, free triiodothyronine; fT4, free thyroxine; E2, estradiol; T, testosterone; Me-B12, methylcobalamin; MTHF, methyltetrahydrofolate; P5P, pyridoxal-5-phosphate; TMG, trimethylglycine; Trp, tryptophan


New Work on Endocrine-Disruptor Cost to Women's Health

Exposure to endocrine-disrupting chemicals (EDCs) is responsible for a substantial proportion of cases of the two most common female reproductive tract disorders, fibroids and endometriosis, at a huge public-health cost, European Union data reveal.
The new analysis demonstrates that EDCs, which are found in pesticides, cosmetics, toys, and food containers, cause reproductive health problems in hundreds of thousands of women a year, at an overall cost approaching €1.4 billion ($1.5 billion).
However, senior author Leonardo Trasande, MD, MPP, associate professor of pediatrics, environmental medicine & population health at NYU Langone Medical Center, New York, warns that this is but a fraction of the overall female reproductive disease burden linked to these chemicals.
"We're hopeful that [these findings] add to the focus on identifying and eliminating chemicals for which the evidence is greatest for their contribution to disease and disability in Europe and the economic benefits of prevention, which have to date not been really considered," Dr Trasande told Medscape Medical News.
He added: "There is active regulatory consideration underway by the European Union to decide the criteria by which to evaluate EDCs and their impact... We believe these are highly informative data that the [European] Commission should take into account in formulating these criteria."
The research was published online March 22 in the Journal of Clinical Endocrinology & Metabolism by Patricia A Hunt, PhD, School of Molecular Biosciences, Washington State University, and colleagues.
Adding to the Evidence Base on Costs of EDCs and Female Disease
The US Endocrine Society issued a recent warning regarding the link between EDCs, diabetes, and obesity, among other conditions, and this new study is part of a wider series of publications that examine the evidence of the contribution of EDCs to disease and disability in the European Union.
As previously reported by Medscape Medical News, EDCs have been shown to contribute to neurobehavioral deficits/diseases and male reproductive disorders, alongside the increased risk of diabetes and obesity. The total annual cost of these conditions in the European Union is estimated to be €157 billion ($175 billion).
"I'm delighted that we were finally able to complete the work by looking at female reproductive conditions," Dr Trasande noted.
To be able to pull together data “from the various strands of evidence,” Dr Hunt and colleagues realized that they would need to take into account the probability of causation, and so they adapted methodology used by the Intergovernmental Panel on Climate Change framework to apply toxicological evidence to disease outcomes.
As it is difficult to link developmental exposure to ovarian function in adult women, the team focused on associating adult exposure with adult outcomes.
Specifically, they examined the outcome–exposure relationship between adult diphenyldichloroethene exposure and the occurrence of fibroids, and between adult phthalate exposure and endometriosis.
Using data from a series of European cohorts, they determined the odds ratio of developing fibroids or endometriosis relative to EDC exposure. They then calculated the direct costs, such as hospital stays, and indirect costs, including lost productivity, associated with the disorders.
The team found that, for both diphenyldichloroethene and phthalate exposure, the strength of epidemiological evidence for an association with fibroids and endometriosis, respectively, was low and the toxicological evidence was also low.
Nevertheless, for both fibroids and endometriosis, it was estimated that between 20% and 39% of cases were because of EDC exposure. This translated into approximately 56,700 women undergoing interventions as a result of fibroids in 2010. For endometriosis, it was determined that there were 145,000 cases among women aged 20 to 44 years because of EDC exposure.
The direct and indirect costs associated with these EDC-related cases was estimated to be €163 million ($182 million) across the EU for fibroids and €1.25 billion ($1.40 billion) for endometriosis.
"Tip of the Iceberg" of Costs of Female Exposure to EDCs
Although the costs associated with EDC-related fibroids and endometriosis are high, the researchers believe that they are just the "tip of the iceberg" in terms of the overall burden of female reproductive problems associated with EDC exposure.
They write: "Although it is highly appropriate to focus on these extremely important uterine tract health deficits, [polycystic ovary syndrome], infertility, and pregnancy complications also affect a considerable number of women, have major cost implications, and are increasingly linked to EDC exposures."
"Thus, it is important to recognize that the cost burdens calculated in this analysis do not represent all, or even most, of the reproductive costs associated with human female exposure."
Dr Trasande noted that exposure to EDCs in the United States is similar to the European Union and the "costs of these EDCs are likely to be equal, if not greater, in the United States."
He noted that the 1976 Toxic Substances Control Act is being actively reconsidered, which, although it does not address EDCs directly, provides a regulatory framework for all new and existing chemicals.
Pointing to a recently published commentary he wrote for JAMA, Dr Trasande said that although "the House and Senate have agreed on different versions of a revised Bill, both versions are rather weak in the 'caffeine content', if you will, and don't go far enough to invest resources in prevention."
This work was supported by The Endocrine Society, John Merck Fund, Broad Reach Foundation, and Oak Foundation. The authors have reported no relevant financial relationships.
J Clin Endocrinol Metab. Published online March 22, 2016. Abstract


Medicare Poised to Fund First Prevention Program, for Diabetes

2013 nutrition update for physicians
The pilot program, developed and administered by the YMCA, helped Medicare enrollees at high risk of developing the disease improve their diets, increase their exercise and lose about 5 percent of their body weight.
Beneficiaries in the program, funded by an $11.8 million grant provided by the health law, attended weekly meetings with a lifestyle coach to develop long-term changes to their diet, discussed ways to get more physical activity and made behavior changes that would help control their weight and decrease their risk of Type 2 diabetes. Participants could also attend monthly follow-up meetings to help keep their new habits in place.
Compared to other beneficiaries also at risk of developing diabetes, Medicare estimated savings of $2,650 for each program enrollee over a 15-month period, more than enough to cover the cost of the program, according to the Department of Health and Human Services.
"Treating this disease isn't just a burden on families, it costs our nation $176 billion in direct medical costs every year," Department of Health and Human Services Secretary Sylvia Burwell said Wednesday.
Burwell said the intervention program could also save lives for people who aren't covered by MedicareSome insurers and employers already offer similar programs to their employees and customers, and others could do so to help the 86 million Americans who have a high risk of developing diabetes, Burwell said.
This is the first preventive service program from the Center for Medicare & Medicaid Innovation that has become eligible for expansion within Medicare. The health law created the center to launch experiments that would change the way doctors and hospitals are paid, building networks between caregivers and training them to intervene before chronic illness gets worse.
According to the Centers for Disease Control and Prevention, one in three adults has prediabetes, a condition determined by blood glucose levels that are higher than normal but not high enough for a diabetes diagnosis. A recent study by researchers at the University of California, Los Angeles, found that nearly half of adults in California have either undiagnosed diabetes or elevated blood sugar levels that can lead to diabetes.
Individuals with prediabetes are at increased risk for developing Type 2 diabetes, a disease that develops in adults in which the body cannot effectively use the hormone insulin to regulate sugar. They are also at higher risk for heart disease and stroke. Many people with prediabetes develop Type 2 diabetes within a decade.
Diabetes is an expensive chronic disease that can be life-threatening. Nonetheless, the concept of prediabetes has been criticized by some medical experts, who dispute how often it advances to diabetes and argue that it is "medicalizing" large populations who may not move on to have those health problems.
Burwell made her announcement Wednesday at the Anthony Bowen YMCA in Washington, D.C., which features rows of treadmills, exercise bikes and weights and a pool. The setting, Burwell said, is a reminder of the lifestyle changes needed to control Type 2 diabetes, which affects about 30 million Americans and causes two deaths every five minutes in America.
Edna Waller, 69, of New Castle, Delaware, said the program helped her lower her glucose levels and cholesterol and drop three dress sizes. What she's learned about diet and exercise has also helped her husband, who is a diabetic, improve his health, Waller said.
An analysis from the Center for Medicare & Medicaid Services' independent Office of the Actuary found that expanding the program would improve the quality of care without limiting Medicare coverage or benefits.
As of March 2015, 6,874 beneficiaries have been recruited to participate in the program and attended at least one session. And of those beneficiaries, 5,696 have attended at least four sessions, according to the CMS actuaries report. Enrollment for the pilot, which began in February 2013, included beneficiaries in Arizona, Delaware, Florida, Indiana, Minnesota, New York, Ohio and Texas.
While the program results "look promising" so far, "the results are very preliminary, and additional results would greatly reduce their uncertainty," the actuaries wrote.
CMS is now evaluating how best to expand the diabetes prevention program in Medicare and may do so through the federal rule-making process, Burwell said. Under the health law HHS can broaden innovations to government programs without seeking permission from Congress.
KHN's coverage of aging and long term care issues is supported in part by a grant from The SCAN Foundation.


Avoiding Sun as Dangerous as Smoking

Questions are raised about the relationship between dermatologist recommendations and sunscreen industry
Nonsmokers who stayed out of the sun had a life expectancy similar to smokers who soaked up the most rays, according to researchers who studied nearly 30,000 Swedish women over 20 years.
This indicates that avoiding the sun "is a risk factor for death of a similar magnitude as smoking," write the authors of the article, published March 21 in the Journal of Internal Medicine. Compared with those with the highest sun exposure, life expectancy for those who avoided sun dropped by 0.6 to 2.1 years.
Pelle Lindqvist, MD, of Karolinska University Hospital in Huddinge, Sweden, and colleagues found that women who seek out the sun were generally at lower risk for cardiovascular disease (CVD) and noncancer/non-CVD diseases such as diabetes, multiple sclerosis, and pulmonary diseases, than those who avoided sun exposure.
And one of the strengths of the study was that results were dose-specific — sunshine benefits went up with amount of exposure.
The researchers acknowledge that longer life expectancy for sunbathers seems paradoxical to the common thinking that sun exposure increases risk for skin cancer.
"We did find an increased risk of...skin cancer. However, the skin cancers that occurred in those exposing themselves to the sun had better prognosis," Dr Lindqvist said.
Some Daily Exposure Important for Health
Given these findings, he told Medscape Medical News, women should not overexpose themselves to sun, but underexposure may be even more dangerous than people think.
"We know in our population, there are three big lifestyle factors [that endanger health]: smoking, being overweight, and inactivity," he said. "Now we know there is a fourth — avoiding sun exposure."
Sweden's restrictive guidance against sun exposure over the past 4 decades may be particularly ill-advised, the study finds, in a country where the maximum UV index is low (< 3) for up to 9 months out of the year.
Use of sunscreen is also widely misunderstood in the country and elsewhere, Dr Lindqvist said.
"If you're using it to be out longer in the sun, you're using it in the wrong manner," he said. However, "If you are stuck on a boat and have to be out, it's probably better to have sunscreen than not to have it."
Women with more pigmentation would be particularly well-served to stop avoiding sunshine, he said, adding that many people in India, for instance, follow guidelines like those in Sweden to avoid sun year round.
And because melanomas are rare among women with darker skin, benefit goes up in those populations when weighing sun exposure's risk against benefits, Dr Lindqvist said.
Age and Smoking Habits
The researchers studied sun exposure as a risk factor for all-cause mortality for 29,518 women with no history of malignancy in a prospective 20-year follow-up of the Melanoma in Southern Sweden cohort.
The women were recruited from 1990 to 1992 when they were 25 to 64 years old. Detailed information was available at baseline on sun-exposure habits and potential confounders such as marital status, education level, smoking, alcohol consumption, and number of births.
When smoking was factored in, even smokers at approximately 60 years of age with the most active sun-exposure habits had a 2-year longer life expectancy during the study period compared with smokers who avoided sun exposure, the researchers note.
The authors do, however, acknowledge some major limitations. Among them, it was impossible to differentiate between active sun-exposure habits and a healthy lifestyle, and they did not have access to exercise data.
Role of Vitamin D Still in Question
The results add to the longstanding debate on the role of vitamin D in health and the amount of it people need, but this study doesn't resolve the question.
"Whether the positive effect of sun exposure demonstrated in this observational study is mediated by vitamin D, another mechanism related to ultraviolet radiation, or by unmeasured bias cannot be determined. Therefore, additional research is warranted," the authors write.
"From Irish studies we know that vitamin D deficiency makes melanomas more malignant," Dr Lindqvist said.
"This is in agreement with our results; melanomas of [those not exposed] to the sun had a worse prognosis."
This study was supported by the Clintec at the Karolinska Institute; ALF (Faculty of Medicine, Lund University, Region Skane); the Swedish Cancer Society; and the Swedish Medical Research Council. Funding was also received from Lund University Hospital; the Gustav V Jubilee Fund; the Gunnar Nilsson Foundation; the Kamprad Foundation; and the European Research Council. The authors declared no relevant financial relationships.
J Intern Med. Published online March 16, 2016. Article


Disease trivialization and name-calling ... a signal for concern?

(from a patient being seen in Cleveland Clinic for problems to chronic mold)

When medical physicians resort to disease trivialization and name-calling, it is very hard to recognize the content for its scientific merit. The below quotes come from "Science-Based Medicine"...


Functional Medicine IV

"Hyman’s principles apply more appropriately to the “functional” conditions we call phantom diseases – chronic fatigue, chemical sensitivities, fibromyalgia, neurasthenia, some irritable bowel, and other depression-generated, somatiform disorders, plus those for which there exist only behavioral definitions: ADD, autism-like syndromes, etc.  Most of these conditions do not respond to specific therapies, but their human hosts tend to seek and respond to off-beat fringe, cultic methods and remedies and infomercials."


"So with this entry I finally see what FM really is – a non-scientific, ineffective, jingoistic, cultic approach to dysfunctional somatiform, non-disease conditions."



Lies, Damned Lies, and ‘Integrative Medicine’

"We’ve previously seen an example offered by ‘integrative’ Mad Man Andrew Weil"


"It takes someone who knows his way around a faculty meeting much better than does ex-hippie Weil, however, to understand that the surest way to usher ‘integrative medicine’ into the curricula of medical schools is to press the delete button whenever the pesky ‘CAM’ term comes up, and to replace it with a few trendy slogans that everyone can agree on."


Why Antibiotic Use Scares Me

by Joshua Horton

I read a study recently that alarmed me: acute bronchitis is a condition that rarely requires antibiotics, but three quarters of patients presenting with this condition receive a prescription for antibiotics. Even more worrisome, this statistic has not changed in 20 years. To those of us on the cusp of a career in medicine – I am a fourth year medical student – this is terrifying because we are going to have to deal with the consequences. Antibiotic overuse leads to:

  • Increased morbidity and mortality for patients infected with resistant bugs
  • Unnecessary and exorbitant healthcare expenditures
  • The potential to cultivate multi-resistant bacteria that could spread to pandemic proportions

In November, the World Health Organization (WHO) published findings of a large global survey assessing the understanding of antibiotic resistance among subsets of the world population. Twelve countries were surveyed, chosen to encompass varying income levels, populations, and preexisting knowledge of antibiotic resistance (Nigeria, South Africa, Barbados, Mexico, India, Indonesia, Egypt, Sudan, Russian Federation, Serbia, China and Vietnam). Surveys were conducted online or face-to-face and nearly 10,000 (n=9,772) response sets were recorded. The key findings, as listed in the report, were:
  1. 65% of respondents had taken antibiotics within the last six months
  2. Antibiotic use was higher in poorer countries
  3. 72% acknowledge that many infections are becoming resistant to antibiotics
  4. 25% think it’s okay to use antibiotics from a friend or family member
  5. 43% think it’s okay to re-use antibiotics that helped them in the past
  6. 32% say they should stop taking antibiotics when they feel better, rather than finish the course (especially in Sudan, Egypt, and China)
  7. 64% reported that cold and flu should be treated with antibiotics
  8. 57% think there is nothing people like them can do to help prevent resistance
  9. 76% believe “resistance” means that their body is becoming resistant to the drug


I like and encourage debate and healthy skepticism. I think it is through a skeptical eye and open debate (as well as careful observation) that we can come to greater truths. The blog "Science-Based Medicine" provides a weight against being so open-minded that your brain falls out as can be present within the anti-conventional medicine communities. (adapted from Walter Kotschnig November 8, 1939). But as with much information on the internet, it is filled with its own biases and strong emotions to gain an populist edge.


Being a physician is hazardous to your health

Approximately one third of medical school students meet criteria for alcohol abuse or dependence ― double the rate of their age-matched non–med student peers ― with burnout and high educational debt primarily to blame, new research shows.

"This is the first study to explore the relationship between alcohol abuse/dependence and burnout among medical students," senior author Lotte N. Dyrbye, MD, professor of medicine and medical education at the Mayo Clinic College of Medicine, in Rochester, Minnesota, told Medscape Medical News.

"In this national cohort of medical students, a third [of students] met criteria for alcohol abuse/dependence. That is a much higher prevalence than what has been previously reported in similarly aged US college graduates," Dr Dyrbye said.

The findings are from a national survey that the investigators sent to 12,500 medical students in 2012. The study was published online March 1 in Academic Medicine.


Physician suicide is medicine's "dirty little secret," family medicine physician Pamela Wible, MD, says in a TEDMED Talk released on March 23.

In the video, Dr Wible describes losing two boyfriends in medical school to suicide and blames the hazing culture of medical training as well as the "assembly line" practice of medicine for leading physicians to want to kill themselves. Studies have shown that physicians experience depression and commit suicide at a rate higher than in the general population.

Dr Wible, who runs a family medicine practice in Eugene, Oregon, says she unwittingly became a specialist in physician suicide after starting to talk and write about the topic. "Because I'm listening with my heart and soul 24/7, my cell phone has turned into a suicide hotline, and I've received hundreds of letters from suicidal physicians," she says.

Check out Dr Wible's TEDMED Talk and tell us in this article's comments section whether you agree with her statements.


Dr. Pamela Wible, founder of the "ideal medical care" movement

Dr Wible is a family physician born into a family of physicians. She pioneered the first ideal clinic designed entirely by patients. Her ideal clinic model is taught in graduate medical curricula and has been featured on major media outlets.

Wednesday, March 23, 2016

Hypothyroidism requires appropriate balancing of T4 and T3

L-Thyroxine monotherapy for athyreotic rats results in a high T4:T3 ratio at doses sufficient to normalize serum TSH levels (8). Yet, the brain, liver, and skeletal muscle tissues of these l-thyroxine–treated animals continue to exhibit markers of hypothyroidism (9), probably because of the inability of l-thyroxine monotherapy to restore tissue levels of T3 (8). This is probably a direct consequence of lower serum T3 levels and the relatively high T4 concentration in these tissues, which inactivates the type 2 iodothyronine deiodinase (D2). In the hypothalamus, loss of D2 is minimal in the presence of T4, which increases sensitivity to T4 levels and explains TSH normalization, despite relatively lower levels of serum T3. Only combination therapy with l-thyroxine plus l-triiodothyronine normalized all thyroid hormone–dependent measures (9), including serum and tissue T3 levels (8). Whether tissue-specific markers of hypothyroidism are restored with l-thyroxine monotherapy in humans remains to be determined, as does the ability of l-thyroxine plus l-triiodothyronine combination therapy to normalize the serum T4:T3 ratio without adverse events. The development of a novel drug delivery system for l-triiodothyronine would facilitate these studies (5).

In humans, a factor associated with response to combination therapy in a large clinical trial is the Thr92Ala polymorphism in the type 2 deiodinase gene (DIO2), wherein the subpopulation of patients with this genetic alteration had improved well-being and preference for combination therapy (7). This has led investigators to consider whether this polymorphism could confer a defect in the D2 pathway, but normal Thr92AlaD2 enzyme kinetics have been demonstrated (73). Only recently has the Thr92AlaD2 protein been found to have a longer half-life, ectopically localize in the Golgi apparatus, and significantly alter the genetic fingerprint in cultured cells and in the temporal pole of the human brain without evidence of reduced thyroid hormone signaling (74). The significance of these studies transcends the thyroid field—this polymorphism has now been associated with a constellation of diseases, including mental retardation, bipolar disorder, and low IQ (75). If hypothyroid carriers of Thr92AlaD2 benefit from alternate therapeutic strategies in replicate studies, then personalized medicine—based on genotype—may have a role.

Ann Intern Med. 2016 Jan 5;164(1):50-6. doi: 10.7326/M15-1799.

Monday, March 21, 2016

Prayer / meditation / exercise all improve prefrontal cortex & cognitive function

During religious recitation, self-identified religious subjects activated a frontal-parietal circuit, composed of the dorsolateral prefrontal, dorsomedial frontal and medial parietal cortex. Prior studies indicate that these areas play a profound role in sustaining reflexive evaluation of thought.


Meditating before running could change the brain in ways that are more beneficial for mental health than practicing either of those activities alone, according to an interesting study of a new treatment program for people with depression.

As many people know from experience, depression is characterized in part by an inability to stop dwelling on gloomy thoughts and unhappy memories from the past. Researchers suspect that this thinking pattern, known as rumination, may involve two areas of the brain in particular: the prefrontal cortex, a part of the brain that helps to control attention and focus, and the hippocampus, which is critical for learning and memory. In some studies, people with severe depression have been found to have a smaller hippocampus than people who are not depressed.

Interestingly, meditation and exercise affect those same portions of the brain, although in varying ways. In brain-scan studies, people who are long-term meditators, for instance, generally display different patterns of brain-cell communication in their prefrontal cortex during cognitive tests than people who don't meditate. Those differences are believed to indicate that the meditators possess a more honed ability to focus and concentrate.


Saturday, March 19, 2016

Toxins as the Primary Cause of Chronic Disease


Did you know ...

  • The average woman absorbs 2 lbs of cosmetics through her skin into her body tissues per year?
  • Over 80,000 chemicals are used in manufacturing of items we either put into our mouth or onto our skin?
  • The EPA estimates 74 billion lbs of chemicals are produced per day in the U.S. alone?
  • 212 chemicals are found in the body of an average U.S. resident?
  • Each time we urinate, our urine contains on average 7 pesticides?
  • Newborn infants have an average of 287 toxic chemicals found in their cord blood (of which 208 are carcinogenic)?
  • More than 80% of herbal supplements from China or India contain harmful levels of heavy metals?

In this video, Dr. Pizzorno discusses the following ...

Arsenic increases the risk of diabetes by 3.6-fold and lung cancer by 5-fold.

Cadmium increases the risk of heart attack by 2-fold, COPD by 2.5-fold, and osteoporosis by 1.4-fold (It is estimated that 20% of osteoporosis is due to cadmium, not nutritional deficiencies).

Lead increases the risk of gout by 3.6-fold, COPD by 2.4-fold.

Organochlorine pesticides increases the risk of diabetes by 9.2-fold and rheumatoid arthritis by 3.5-fold.

Organophosphate pesticides decrease IQ by an average of 7 points and increase the risk for ADHD by 2-fold.

PCBs increase the risk for ADHD by more than 3-fold.

Bisphenol A increases the risk for metabolic syndrome by 1.51-fold and obesity by 2.55-fold

Polybrominated diphenyl ethers increases the risk for diabetes by 3-fold

Phthalates increases the risk for osteoporosis by 14-fold and obesity by 4.3-fold

Polychlorinated biphenyls increases the risk for rheumatoid arthritis by 8.5-fold


Joseph E. Pizzorno Jr., ND, served as Bastyr University's founding president for its first 22 years (1978-2000).

A licensed physician, educator, researcher and expert spokesperson, Dr. Pizzorno is one of the world's leading authorities on science-based natural medicine. Under his pioneering leadership, Bastyr became the first fully accredited, multidisciplinary university of natural medicine and the first school of its kind to receive research funding from the National Institutes of Health (NIH).

Serving the Public

With a commitment to advocating for a wider acceptance of natural medicine, Dr. Pizzorno has held a variety of public posts and served on conventional medical boards, including:

  • Advisory Panel on the Safety and Efficacy of Dietary Supplements for the U.S. Congress in 1993.
  • Ad hoc advisory committee member for the NIH Office of Dietary Supplements in 1996.
  • Seattle/King County Board of Health
  • White House Commission on Complementary and Alternative Medicine Policy (appointed by President Bill Clinton in 2000)
  • Medicare Coverage Advisory Committee (appointed by President George H.W. Bush's administration in 2003).

Works and Writings

Since 2001, Dr. Pizzorno has had his own company, Salugenecists Inc., which develops science-based, artificial intelligence-aided advice systems that provide personalized health promotion and self-care guidance.

Dr. Pizzorno has written and co-authored numerous books and publications, including A Textbook of Natural Medicine, Encyclopedia of Healing Foods, Total Wellness, and Natural Medicine for the Prevention and Treatment of Cancer. He is the founding executive editor of Integrative Medicine: A Clinician's Journal and is on the editorial board of Alternative Medicine magazine and Alternative Therapies magazine, among others.

When he is not writing and editing, serving on boards and running Salugenecists Inc., Dr. Pizzorno travels worldwide, lecturing and promoting science-based natural medicine and collaborative health care.

Awards and Honors

  • 2000: Recognized as one of the four most influential leaders in alternative health care by Alternative Healthcare Management.
  • 2000: Named "Humanitarian of The Year" by the Cancer Treatment Centers of America.
  • 2001: Recognized as one of the leading health educators in the past 30 years by Natural Health magazine.
  • 2002: Awarded "Naturopathic Physician of the Year" by the American Association of Naturopathic Physicians.
  • 2002: Awarded "Founder's Award for Pioneering Complementary and Alternative Medicine" by the National Foundation for Alternative Medicine.
  • 2003: Named "Pioneer in Holistic Medicine" by the American Holistic Medical Association.
  • 2006: Recognized as the most illustrious graduate of the National College of Naturopathic Medicine at its 50th anniversary.


Is your food product contaminated with heavy metals?


Wednesday, March 16, 2016

Are cases of whooping cough an under-vaccination problem?

A New England Journal of Medicine letter was published on February 7, 2013, noting the first appearance in the United States of pertussis strains that are missing pertactin. More recently a paper evaluating the prevalence of these pertactin-deficient strains in the United States was published in Clinical Vaccine Immunology.

Pertactin is one of several components of all pertussis vaccines. It is a protein that helps pertussis bacteria attach to the lining of the airways. There is a new study that found the likelihood of having reported pertussis caused by pertactin-deficient pertussis compared to pertactin-producing pertussis is greater is vaccinated persons. However, current evidence suggests pertussis vaccines continue to prevent disease caused by both pertactin-positive and pertactin-negative pertussis strains since other components of the vaccines provide protection.

CDC is currently conducting studies in the United States to determine whether pertactin deficiency is one of the factors contributing to the increase in the number of reported pertussis cases. CDC will continue to closely monitor the situation and evaluate all available scientific evidence before drawing any conclusions. There is also no suggestion that these new strains are causing more severe cases of pertussis.

Protection from childhood pertussis vaccines still appears to be excellent during the first few years after vaccination, but wears off over time. Outbreaks and epidemics being seen around the country are consistent with what is seen as vaccine protection wears off. It is most likely that the change in pertussis vaccines (from whole cell to acellular in the 1990s) along with better diagnostics and increased reporting are driving the resurgence of pertussis throughout the United States.

Vaccines are the safest and most effective tool we have for preventing pertussis. And we continue to have evidence that pertussis vaccines are working, no longer seeing 200,000 cases per year as we did in the pre-vaccine era.

Note: Antibiotics routinely recommended to treat pertussis remain effective. This new strain is not antibiotic-resistant.


Clin Infect Dis. 2015 Jan 15;60(2):223-7. doi: 10.1093/cid/ciu788. Epub 2014 Oct 9.

Mayo Clin Proc. 2014 Oct;89(10):1378-88. doi: 10.1016/j.mayocp.2014.08.004.

Clin Vaccine Immunol. 2014 Feb;21(2):119-25. doi: 10.1128/CVI.00717-13. Epub 2013 Nov 20