IN SEARCH OF BALANCE

Where can we find balance in our approach to the prevention and treatment of disease? Is it possible to truly be eclectic and take the best of each of a variety of systems of cure?

As an MD who works in a center that specializes in lifestyle change, I tend to meet people who are looking for "alternative therapies." I don't blame them. I try to use medication as little as possible, and only advocate surgery when it is clearly the best option. After all, both operations and drugs can have pretty severe side-effects.

Let's face it, lifestyle therapies can help considerably. Just today, I was forcibly reminded of this again. Jim (not his real name), an octogenarian, and his wife walked into my exam room. Jim was no stranger, about six weeks ago he came to Living Springs' residential lifestyle change program to deal with his "intermittent claudication," a condition caused by blocked arteries to his legs. While at our center he adopted a vegetarian diet--and his wife learned how to cook it. He got on an appropriate exercise program. He was exposed to techniques for stress control, and received further encouragement to continue as a nonsmoker. After one week, they returned home. Jim and his wife continued the lifestyle they adopted at Living Springs.

When I saw him today, Jim was truly encouraged. He had made significant improvement over the last month or so--less leg pain, better ability to walk, more physical endurance. During our program, he had stopped his popular cholesterol and triglyceride lowering drug. Now--without the drug-- his HDL, LDL, and triglycerides were all better than they were on his old lifestyle--with the drug.

Today Jim also remarked that he had been seeing a vascular surgeon for some time who had never suggested these lifestyle options. Does that make that surgeon a bad doctor? No, not in itself. He may well have been an excellent surgeon, but he apparently had no awareness of the power of lifestyle change for Jim's condition.

However, I'm thankful for my surgical and other specialty-trained colleagues. Sometimes medications or operations are simply the best we know for a given situation. We should feel comfortable in using those modalities when they appear to be the best solution.

By the same token, we should feel comfortable using chiropractic when it seems to be the treatment of choice. We should also not hesitate to use the herbal preparations advocated by the naturopath--if research suggests they offer the best hope with the least risk of side effects.

To me the most disturbing trend is to adhere to only one method of prevention and healing and look down at every other system.

I believe the only way we can really be intelligent practitioners, health care consumers, or guardians of our own health is to know both the indications and the contraindications of different types of treatment.

The radio scripts found in this edition of WEJ may seem to be negative but they are dedicated to the purpose of helping us recognize the limitations of some of the healing modalities in today's armamentarium.

SECTION II

Do you feel cheated if you leave the doctors office without a drug prescription? I'm Dr. David DeRose, in a moment we'll look at--"A healthy respect for drug medication" on Wellness Wise.

Many commonly used medications can decrease alertness or impair one's sense of well being. These mental and productivity side effects of drugs are leading some people to think twice before they reflexly buy an over-the-counter drug, or take any medication.

However, affects on productivity are really minor compared to the most serious side effects of medications. Indeed, even normally useful drugs can be life threatening in cases.

Anaphylactic reactions, for example, are cases of severe allergy that can occur with any drug in a susceptible person.

Antibiotics--although they may treat the infection they are intended for--may also lead to the development of serious infections with resistant organisms. A classic case is so called "pseudomembranous colitis"--a potentially life threatening colon problem that can occur from the use of common antibiotics that most consider innocuous.

Medications as common as over-the-counter pain relievers can cause life-threatening bone marrow failure.

To me the message is clear: "all drugs have side effects."

Lets take more of an interest in "lifestyle measures" that in some cases can produce the same desirable effects as drugs -- without the side effects.

For WellnessWise, I'm Dr. David DeRose.

Reference: The Medical Letter, December 29, 1989 (31: 113-118)

DIETARY SUPPLEMENTS & BOTANICALS--PART I: SUPPLEMENTS AND HEALTH

Dietary supplements--what is their place? I'm Dr. David DeRose, "Supplements and Health" in a moment on WellnessWise.

More and more individuals are turning to dietary supplements in an attempt to improve their health. Such supplements include herbs, vitamins, minerals, and amino acids.

As a physician, I recommend dietary supplements for a variety of reasons. However, even if a supplement is natural, it is not necessarily safe or effective.

For example, tobacco is a natural plant. Millions worldwide testify by their daily use that it has some desirable chemical effects. Nonetheless, no one can question the growing list of tobacco's adverse health effects.

Similarly opium and cocaine are natural products. They have their medicinal uses--but also considerable abusive potential.

On the other hand, vitamins in appropriate amounts are essential. However, overdosage can cause problems. Even the so-called "water soluble" vitamins can cause problems. For example, chronic excessive use of Vitamin B6 (pyridoxine) can lead to nervous system damage.

Furthermore, some dietary supplements may be relatively safe but simply do not appear to be effective for their intended purpose. Dandelion has both nutritional and medicinal effects. However, one of its alleged therapeutic effects, namely, helping menstrual discomfort, appears to be more hype than fact.

Dietary supplements have a place. But just because they are natural does not make them automatically safe or effective.

For WellnessWise, I'm Dr. David DeRose.

References
(1) re vitamin toxicity: Shils and Young, 7th ed (2) re safety and efficacy or herbs: "The use and safety of common herbs and herbal teas", by Winston Craig, Ph.D., R.D. (3) other ref: FDA Medical Bulletin September 1994

DIETARY SUPPLEMENTS & BOTANICALS--PART II: THE SAFETY OF DIETARY SUPPLEMENTS

Dietary supplements--are they safe? I'm Dr. David DeRose-- a look at that subject in a moment on WellnessWise.

Dietary supplements such as herbs, vitamins, minerals, and amino acids definitely have a place in dealing with some illnesses, risk factors, and symptoms.

However, the safety of such supplements is a subject that often receives little attention. Dr. Winston Craig, addressed this concern with respect to herbs in a recent booklet.

Even herbs that may be safe in moderation can cause problems if used in excess. Here are some highlights:

Alfalfa contains beneficial antioxidants. However, large amounts of alfalfa seeds or sprouts eaten on a daily basis can cause problems including red blood cell breakdown and inflammatory conditions.

Fennel seeds also appear to be safe in moderation and have been used for cold symptoms. However large amounts of fennel _oil_ can cause vomiting, seizures and fluid accumulation in the lungs.

Something may appear to safe in moderation--but may actually cause serious problems in large amounts. Here's the best advice I can give. Before using any preparation--including those mentioned in this broadcast--become intelligent about the supplement. Working with a knowledgeable health professional who knows your health status is often the best option.

For WellnessWise, I'm Dr. David DeRose.

References: same as preceding script.

SECTION II

SCIENCE/HEALTH ABSTRACTS

It has been taught that the use of alcohol in foods was entirely harmless as the alcohol was burned off during the cooking process. A study sponsored by the U.S. Department of Agriculture/Food and Nutrition Service, indicates that as much of 85% of alcohol may remain in food after cooking. (Journal of American Dietetic Association 92(1)486-488, April, 1992)

SECTION IV PARTING WORDS

LETTERS TO THE EDITOR/QUESTIONS AND ANSWERS

We are considering including a few letters to the editor and some questions and answers in upcoming issues. Would this increase or decrease the value of this newsletter to you? Please let us know.

SUBSCRIPTION INFO

We continue to distribute The WellnessWise Electronic Journal free of charge via Internet E-mail to all subscribers. Please address subscription requests and any other correspondence to my preferred address: docderose@aol.com. (Alternate address is 74532.622@compuserve.com.)

SOME WORDS ABOUT OUR SPONSORS

A minimum of twice per quarter we publish a list of sponsors. We appreciate all those who help us to distribute this newsletter free of charge.

Living Springs Lifestyle Center (phone: 1-800-SAY-WELL). Located less than one hour from Manhattan, Living Springs offers residential preventive medicine programs such as weight control, smoking cessation, cholesterol and blood pressure reduction, etc. The facility includes spa services, vegan diet, health lectures, exercise sessions, cooking classes, and more.

WellnessWise Radio Program. (E-mail address: docderose@aol.com). Daily (Monday through Friday) 90 second preventive medicine broadcasts come with a 30 second commercial slot for local or national sponsors. Sponsorship opportunities are available in many US & Canadian locations for this syndicated broadcast. Audio tapes are also available.