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March 7, 2002 Research Update |
James Bogash, D.C. Mesa, AZ
info@lifecarechiro.com
www.lifecarechiro.com
Antibiotics increase functional abdominal symptoms
Much evidence, both experimental and anecdotal, point to alterations in the physiology of the GI tract as causative factors in IBS. Impaired digestion, poor diet and abnormal/pathogenic flora are all easily modified factors. Antibiotics greatly alter the balance of the flora in the GI tract, favoring the overgrowth of yeasts. Probiotics should follow EVERY course of antibiotics. I really think that antibiotic resistance is the least of our concerns with antibiotic use--alterations in GI physiology and subsequent systemic alterations are much more common and immediate.
Entrez-PubMed
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Steroid injections, physiotherapy, or a wait-&-see policy for lateral epicondylitis
This article really strikes home because I see alot of elbow and carpal tunnel cases. In general, these conditions are very easy to treat with trigger point therapy. This article compares physiotherapy and cortisone injections. Unfortunately, manual therapies are not included. A note about cortisone injections--cortisone inhibits the ability of cartilage to heal itself, potentially creating a worse condition in the long run. There is even evidence that it is not the substance injected but rather the injection itself that works by injuring the tissue, increasing blood flow through this injury, and creating an inflammatory response. This method is similar to what happens with many advanced soft tissue techniques.The Journal : Back Issues
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Amino Acid-Induced Skeletal Muscle Insulin Resistance
For a long time, the high protein diets were believed to cause weight loss by lowering the insulin response to a meal. However, as more and more research accumulates, we are finding that proteins definately have an impact on insulin response. This article suggests that this impact has a negative impact by increasing insulin resistance. I have been strongly against high protein diets for most patients and the evidence continues to support this type of dietary pattern as harmful in the long run. Diabetes -- Abstracts: Krebs et al. 51 (3): 599
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Antidepressant drug trials exclude most "real" patients
This is an interesting article that dissects clinical trials for antidepressants. The authors find that most clinical trials do not match real life patients, and that, based on the patients in clinical trials, only about 15% of patients currently on antidepressants fit classification from the studies. I see many patients on antidepressants and many have jumped from drug to drug with only moderate results and many side effects. Too often these patients have not tried safer, more effective methods such as exercise and improving their diet. The Journal : Back Issues
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Systemic Activity of Inhaled Steroids in 1-3-Year-Olds w/ Asthma
It should not be any great surprise that inhaled medications make it into the systemic circulation and have side effects distant from the treatment site. Asthma is a condition that I feel is poorly managed and lifestyle changes are rarely recommended to safely affect the course of the disease. Avoiding asthma in the first place involves maintenance of healthy intestinal flora, avoidance of antibiotics taking a rational approach to vaccination. Managing asthma takes these factors into consideration as well as eating a more unprocessed diet. Pediatrics -- Abstracts: Anhøj et al. 109 (3): e40
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Glitazone Therapy Linked to Rapid Weight Gain
The pharmaceutical options for diabetes are becoming more and more grim. Side effects and diminishing effectiveness are all concerns. Sulphonylureas have been found to actual choke off the beta cells of the pancreas via excess amyloid production. This makes prevention of diabetes so much more important by avoiding processed sugars and maintaining a regualr exercise routine. Of course, these factors, along with CLA, alpha lipoic acid, chromium, vanadium and a whole host of other nutrients can also be powerful tools in managing diabetes without side effects.
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Dr. David Matthews, of the Diabetes Research Laboratory at the Radcliffe Infirmary in Oxford, said therapies that increase insulin secretion are generally associated with progressive weight gain of around 4 kilos. However, weight gain was much more likely with some therapies than with others, he told a conference in London organised by the Association for the Study of Obesity. Patients treated less intensively for their glycaemia and those given metformin put on less weight than those on insulin or sulphonylurea. The fastessulphonylurea weight gain, 3 kilos in about 6 months, was seen in patients on glitazone (thiazolidinedione) therapy. Dr. Matthews stressed that of the two evils, hypoglycaemia was worse than weight increase. But he added: "With the advent of thiazolidinediones, where weight increases even faster than with insulin or sulphonylurea, we will need to wait for the outcome of clinical trials before deciding whether these agents are suitable for widespread use or whether we should reserve them for specific indications." European drug regulators had been much more cautious than their American colleagues, recommending that the new drugs be used in combination with metformin rather than alone. "But as to who is right, there is no easy answer." He stressed that dietary intervention on its own was very effective in the early stages of type 2 diabetes. "People fail to realise that it is very important not to just put people on to therapeutic agents from day one." Looking to the future, he said new classes of drugs, such as GLP1 analogues, might have the potential to control glycaemia without weight increase. "Certainly, this seems to be a finding in primate studies."
Pharmacology of Silymarin
Milk thistle is one of those herbs that has strong evidence for its hepatoprotective effects. I have one patient now who was diagnosed with terminal liver disease (of unknown etiology) about 3 years ago by her gastroenterologist. She's been taking milk thistle since and this may be a major reason why her liver is still functioning. Never discount natural medicine's ability to help protect and heal the liver. This is one area where natural medicine stands out because mainstream medicine is typically the group damaging the liver!
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The flavonoid silymarin and one of its structural components, silibinin, are substances with documented hepatoprotective properties. Their mechanisms of action are still poorly understood. However, the data in the literature indicate that silymarin and silibinin act in four different ways: (i) as antioxidants, scavengers and regulators of the intracellular content of glutathione; (ii) as cell membrane stabilisers and permeability regulators that prevent hepatotoxic agents from entering hepatocytes; (iii) as promoters of ribosomal RNAsynthesis, stimulating liver regeneration; and (iv) as inhibitors of the transformation of stellate hepatocytes into myofibroblasts, the process responsible for the deposition of collagen fibres leading to cirrhosis. The key mechanism that ensures hepatoprotection appears to be free radical scavenging. Anti-inflammatory and anticarcinogenic properties have also been documented.Silymarin is able to neutralise the hepatotoxicity of several agents, including Amanita phalloides, ethanol, paracetamol (acetaminophen) and carbon tetrachloride in animal models. The protection against A. phalloides is inversely proportional to the time that has elapsed since administration of the toxin. Silymarin protects against its toxic principle -amanitin by preventing its uptake through hepatocyte membranes and inhibiting the effects of tumour necrosis factor- , which exacerbates lipid peroxidation.Clinical trials have shown that silymarin exerts hepatoprotective effects in acute viral hepatitis, poisoning by A. phalloides, toxic hepatitis produced by psychotropic agents and alcohol-related liver disease, including cirrhosis, at daily doses ranging from 280 to 800mg, equivalent to 400 to 1140mg of standardised extract. Hepatoprotection has been documented by improvement in liver function tests; moreover, treatment with silymarin was associated with an increase in survival in a placebo-controlled clinical trial in alcoholic liver disease.Pharmacokinetic studies have shown that silymarin is absorbed by the oral route and that it distributes into the alimentary tract (liver, stomach, intestine, pancreas). It is mainly excreted as metabolites in the bile, and is subject to enterohepatic circulation. Toxicity is very low, the oral 50% lethal dose being 10 000 mg/kg in rats and the maximum tolerated dose being 300 mg/kg in dogs. Moreover, silymarin is devoid of embryotoxic potential.In conclusion, silymarin is a well tolerated and effective antidote for use in hepatotoxicity produced by a number of toxins, including A. phalloides, ethanol and psychotropic drugs. Numerous experimental studies suggest that it acts as a free radical scavenger, with other liver-specific properties that make it a unique hepatoprotective agent.