SaluGenecists Science Blog

At the risk of oversimplification, the functional medicine community has generally taken a very straight-forward stance on antioxidant supplements. Since oxidative damage is central to a number of the degenerative diseases associated with inflammation and aging, liberal use of antioxidant supplements pretty much always has a positive risk benefit ratio.

Of course, a world view that is that basic is going to have a couple of problems. There was a book in the 1980s (can’t find it now, and I don’t remember the title) that painstakingly made the case that disrupting the antioxidant / prooxidant balance in the body could have unforseen consequences. But until recently, nobody could really tell us what they were.

A new study in the Proceedings of the National Academy of Sciences (PNAS) suggests that healthy adults taking 1000 mg of vitamin C and 400 IU of vitamin E have disruptions in the insulin signaling pathway. Specifically, the antioxidants appeared to affect the ability of exercise to decrease insulin resistance - blood sugars only got better with exercise in people not taking the antioxidant supplements.

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A topical comfrey extract outperformed placebo in the treatment of lower back pain, according to a new study published in the British Journal of Sports Medicine.

This finding is probably not very surprising to practitioners of botanical medicine. This herb has traditionally been used as a topical pain reliever, and continues to be in lay botanical practice. Previous studies of the same comfrey gel (Kytta-Salbe, Merck) have shown similar effect versus placebo or topical NSAID in ankle injury and knee pain.

What may be a surprise to botanical prescribers, however, is that the source of funding for this trial is Merck, a company not usually known for interest in CAM practices. Given that they manufacture this topical preparation, perhaps it isn’t surprising to see company support for the trial.

As far as I am aware, this particular extraction is proprietary and may or may not be the same thing as the hot compresses used in traditional applications. The extract does appear to be available in the United States (bless you, Google).

As a topical application, comfrey is not known to be associated with any serious adverse effect. Comfrey should not be taken by mouth, as it contains pyrrizolidine alkaloids, which can cause serious liver toxicity.

Today is the last day of Food Allergy Awareness Week. To celebrate, let’s review the gold standard method for uncovering hidden food allergy and intolerance reactions.

The elimination / rechallenge diet is elegant in its simplicity, if difficult in practice. To get started, we’ll need to track a symptom that we suspect to be related to a dietary trigger. This symptom might be a skin disorder, a nasal allergy, or something more vague like fatigue. The more specific the symptom, the better.

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Iodine deficiency, until recently thought to still be a problem only in developing countries (where it is typically over 50%), is now widespread in the U.S. and Canada.

According to 2001-2002 National Health and Nutrition Survey (NHANES) data, iodine intake has dropped 50% since 1971-1974. Analysis of iodine levels in the breast milk of lactating mothers in Boston found that less than half (only 47%) contained sufficient amounts of iodine to meet infant requirements. The situation is made worse by increasing levels of inhibitors of iodine absorption–perchlorate, nitrate and thiocynate–in our food supply.

Although mostly recognized for its essential role in thyroid hormone production (iodine is a required component of both thyroid hormones, T3 and T4) and normal brain development, iodine is now known to be involved in a wide variety of physiological processes. Only about 30% of the body’s iodine is found in the thyroid itself and in thyroid hormones. The body concentrates the rest in the liver, salivary glands, breasts, lining of the stomach and brain. Iodine deficiency is contributing not only to the increase in sub-clinical hypothyroidism seen in the U.S., but also to fibrocystic breast disease, psychiatric disorders and fibromyalgia. For a comprehensive review of the research relating to why Americans are at risk for iodine deficiency and iodine’s many roles in the body, see Iodine: the next vitamin D?

What can you do? Don’t rely on processed or restaurant food for your iodine. The salt they use is not iodized. Sea salt contains very little iodine. You can buy iodized salt and use a teaspoon daily, but not all iodized salt contains the iodine it says it does on the label. Your best bet: buy dulse granules (a type of seaweed rich in iodine that is dried, powdered and sold in small “salt-shaker” containers) and use as a seasoning instead of salt.

The FDA has issued a public warning to General Mills (who is no more a General than Colonel Sanders was a Colonel or Captain Crunch was a Captain) about advertising claims made on behalf of Cheerios. Even though the company has done research to support their claims, by citing a magnitude of cholesterol-lowering effect in their advertising, General Mills has run afoul of federal regulations.

The Nutrition Labeling and Education Act (NLEA) is the legislation controls industry claims. This important piece of legislation protects consumers against a situation where manufacturers could make egregious and misleading claims about their products. Currently, the NLEA legislation allows about 14 specific claims to be made on behalf of foods.

One of these claims is that soluble fiber containing foods can help reduce cholesterol, which may help in heart disease prevention. The reason that this is an interesting test case is that this is the first case I’m aware of where an approved health claim is denied because of the inclusion of specific study language. As far as I’m concerned, this crosses the line between public protection and intentionally hiding relevant information.

Think about it this way: if my cholesterol is 240, and my goal is 200, wouldn’t knowing the magnitude of expected change be pretty important to me? How is this different than existing DTC drug ads that are allowed to use language about magnitude of effect?

In case you missed it, this week is the FAAN Food Allergy Awareness Week. I’d like to take their lead to pop up a couple of posts related to food allergy as a clinical presentation.

A true food allergy is defined as an immune response against a food protein. This immune response leads to the characteristic cascade seen in allergy - potentially including watery eyes, itchy skin, dry throat, even trouble breathing. The most common allergenic foods include nuts (especially peanuts), dairy, eggs, wheat, soy, and fish (including shellfish). The existence of food allergy, while arguably underdiagnosed in clinical medicine, is not controversial in any way.

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Here is a report of another small study showing that a small percentage of children with autism can recover from the diagnosis with intensive and early behavioral training. Although the report is not specific about the intervention, the therapy is almost certainly an applied behavioral analysis (ABA) type discrete trial program.

There is some controversy in and out of the autism community about whether the behavioral gains seen with these programs are matched by improved CNS function, or are simply imprinting more adaptive behavior patterns. ABA programs are difficult and expensive, so validating that they work at a deep level is quite important. I am looking forward to Dr. Fein’s research being published to see if she addressed this important question.

I have long been disappointed in the CAM world for being more focused on experimental and potentially dangerous biologic therapies for autism to the exclusion of ABA type structured interventions. Hopefully, this will shift as data in favor of ABA continue to mount.

I found this article this morning while researching health care costs by risk factor. I can’t say I agree with it 100% - if the treatments for osteoporosis end up being fairly benign and reasonably effective, screening is fully justified. It does seem to be another evidence point in the case that healthcare policy is driven by industry, rather than the opposite.

Human Chorionic Gonadotropin (hCG) is an agent sometimes prescribed by CAM providers as part of a weight-loss program. It is also commonly prescribed by endocrinologists as part of an infertility treatment.

hCG is an important hormone in regulating the early stages of pregnancy, and is in fact the hormone tested by home pregnancy kits.

But the reason that hCG is newsworthy today is that it can be used as part of an anabolic steroid regimen to undo some of the adverse effects of excess testosterone and support the normal production of testosterone as the steroid regimen is tapered off. Given such a profound effect on as important a hormone as testosterone, the claims that hCG is a safe treatment for obesity really should not be believed.

At $8M lost as part of this suspension, Mr. Ramirez has almost certainly failed the most expensive pregnancy test in history.

A new and as yet unpublished report from an American Geriatrics Society conference revisits the possibility that vitamin E supplements can delay the progression of Alzheimer’s disease. In this five year study, 540 participants with a presumptive diagnosis of Alzhemier’s disease were treated with a cholinesterase inhibitor (a standard pharmacological treatment).

Additionally, participants received either 800-2000 IU of vitamin E, an unspecified anti-inflammatory medication (or group of medications), both, or neither. The news reports are not clear about whether the participants were randomized and if researchers were blinded to which therapies the participants received.

According to the researchers, however, participants receiving vitamin E along with conventional treatment had slower rates of decline than people not receiving vitamin E. Perhaps the most striking finding was that the treatment effect appeared to increase over time, such that the difference between treatment groups was much greater at year five than after the first year.

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