July 17, 2000 Research Update

Nutrient deficiency allows viral infection

Not that this is rocket science...a person with poor nutritional status is more likely to suffer effects of a viral infection. Do we really need a vaccine for the flu?? How about taking better care of ourselves? AJCN -- Abstracts: Beck 71 (6): 1676S

Prebiotics and probiotics: are they functional foods?

AJCN -- Abstracts: Roberfroid 71 (6): 1682S

Kidney Damage From Aristolochic Acid in Dietary Supplements

I always recommend consulting a physician knowledgable in natural medicine before taking any herbal products. Don't trust the commissioned employee at the big chain stores with only a few hours of training with your health.

The US Food and Drug Administration (FDA) has sent letters to healthcare professionals and industry officials warning them of the possibility that certain botanical products, including some dietary supplements, contain aristolochic acid and may cause kidney toxicity. "Aristolochic acids," the FDA said, "are potent carcinogens and nephrotoxins that are present, primarily, in plants of the family Aristolochiaceae." These types of plants are used in traditional Chinese medicines and may be found in some dietary supplements.

St. John's Wort Induces Drug-Clearing Enzyme

Normally, this is a good thing!! Anything that helps the liver get rid of toxins should be considered beneficial. The concerns here is that is will affect the body's breakdown of many pharmaceutical drugs. What this article states is that St John's Wort helps the body get rid of toxins...which is exactly how the body treats many drugs.

Clin Pharmacol Ther 2000;67:451-457 St. John's Wort appears to be an inducer of CYP3A4, a metabolic enzyme involved in most clinically significant drug-drug interactions. Since CYP3A4 isozyme is responsible for the metabolism of more than 73 medications, when patients take St. John's Wort there may be reductions in therapeutic efficacy in many types of medications, "including oral contraceptives, certain antiretrovirals, antiepileptics, calcium channel blockers, cyclosporine, fentanyl, and select chemotherapeutics, antibiotics, and antifungals."

Osteopathic Manipulation vs. Standard Care for Subacute Pain

Of course, this article mentions osteopathic manipulation, but since chiropractics deliver 90% of the manipulations in the US with only 10% of the adverse side effects, who would you rather go to?? The basis of this article is that manipulation is just as effective as medications. The article does not go into the long list of potentially very harmful side effects of the meds...

Twelve weeks of osteopathic manipulation and twelve weeks of standard medical care resulted in the same degree of clinical improvement among patients with subacute back pain, according to a randomized trial by Gunnar B.J. Andersson, MD, PhD, et al. Although patients in both treatment groups made similar recoveries in the new study, Andersson et al. found an advantage for osteopathic treatment. The osteopathic treatment group used significantly less medication (e.g. NSAIDs and muscle relaxants) and physical therapy. "Given the known and potentially serious adverse effects and costs of nonsteroidal anti-inflammatory drug therapy, the achievement of equal outcomes in regard to pain relief, function, and satisfaction, with less use of medication and physical therapy, suggests an important benefit of osteopathic manipulative treatment," according to Andersson et al. "This type of treatment deserves careful examination through a formal cost-benefit analysis."

Maine Study Challenges Major Assumptions About Spine Care

Very interesting article. The success of spinal surgery is higher in the areas of the country with the lowest rates of surgery. And, based on the facts that the rates of surgery vary widely accross the country, and yet patient presentations do not, are many patients getting unneccessary and unsuccessful surgeries??

The Back Letter 14(12):133,140, 1999 When two surgeons in Boston and Paris perform disc surgery on similar patients using similar techniques, will the results be similar? What about two surgeons in Boston and New York? Or two surgeons in Maine? The answer may be surprising. One of the most provocative spine studies of 1999 didn't get a lot of headlines. It didn't offer new diagnostic technology or promise miracle cures. Yet the study challenges central assumptions about spine care and recommends major changes in the way specialists conduct their practices. The study found that patients in areas of Maine with higher surgery rates had inferior outcomes to patients in areas with lower surgery rates. The reason? It appeared that surgeons in the areas with lower surgical rates had more stringent selection criteria for spine surgery. Yet the surgeons in these areas did not appear to have any inkling that they were practicing their specialty differently. "Before presentation of the results of the current study, surgeons in each of the three areas [of Maine] believed that they operated on patients with similar indications and that they produced similar outcomes," according to Robert B. Keller et al.