November 3, 2003 Research Update

James Bogash, D.C. Mesa, AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com

Metformin on homocysteine, folate and vitamin B12 in type 2 diabetes

This study found that metformin lowered folate and B12 levels with subsequent elevation of homocysteine. This is, of course, of concern. Considering diabetes' strong predilection for CVD, supplementation of B12 and folic acid should be standard with metformin use (heck...even without metformin as well...). Considering that metformin is being used with increasing frequency for polycystic ovaries, this is another condition that supplementation should be included.

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Inhibition of NF-kappaB activation in macrophages increases atherosclerosis in LDL receptor–deficient mice

Here is yet another example of how complex the human body is and how screwing with physiology can lead to unexpected consequences. NF-kappaB is an upstream control substance that turns on many other aspects of the immune system, including TNF-alpha. This study finds that inhibition of NF-kappaB, thus suppressing the immune response, leads to INCREASED atherosclerosis in mice. If this is the case, what might the long term side effects of TNF alpha suppression in rheumatoid arthritis and Crohn's be doing to a patient's blood vessels??

JCI -- Abstracts: Kanters et al. 112 (8): 1176

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Comet assay w/ mouse organs: results w/ 39 currently used food additives

Sucralose in this study showed DNA damage. Now, in total, many other studies have not shown this finding with sucralose. I do bring this study up to demonstrate that we do not yet know enough about this compound for me to recommend it to patients. For now I recommend avoiding it (and most likely this recommendation will stay...) just as with aspartame. The concern is that this sweetener is being used in more and more foods. Recently heard a commercial for "no sugar added" Ovaltine or something like that. Well--the "no sugar added" was a codeword for sucralose (Splenda). Remember that anytime we try to come up with a compound to avoid the lifestyle changes that we know we need to make (olestra, aspartame, "carb blockers"...) the results are usually less than perfect.

Entrez-PubMed

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Herbal medicines put into context

Finally!! An editorial in a major medical journal that brings to light that natural medicine is held to a much higher standard, and that the safety profiles of all natural products put together is incredibly low compared to their pharmaceutical counterparts.

bmj.com Ernst 327 (7420): 881

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Panax ginseng

Once again, American Family Physician provides an objective, complete review of a natural product. Ginseng is considered an adaptagen, meaning that is has the potential to brings things back to normal. In this case, "things" refers to the hypothalamic-pituitary-adrenal axis. Ginseng has shown benefit in modulating our body's response to stress. Too much stress and ginseng slows the enzymes that are overworking to produce cortisol; not enough adrenal activity and ginseng speeds up the enzymes to support healthy adrenal function.

Panax ginseng - October 15, 2003 - American Family Physician

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The effects of fruit juices on drug disposition: a new model for drug interactions

It's interesting to note how many foods interact with the absorption and breakdown of certain drugs. It's always important to note, however, that in all cases the drug is the invader and foreign compound. The food is just doing what Mother Nature intended for it to do--lower the levels and get rid of toxic compounds in the body.

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"Failed back surgery syndrome"

This one obviously hits home. Statistics show that 5-10% of patients undergoing back surgery for disc problems experience no relief. While these odds may seem pretty good, the number of back surgeries done in a year make the total number quite high. Roughly 10% of the population utilizes chiropractic services; it is entirely possible, based only on my personal experiences, that if utilization increased the number of patients going to surgery would drop dramatically. While chiropractic care is not always 100% affected, you can bet that, at the very worst, you will be in the same condition you presented with. You can't say that with surgical procedures.

bmj.com Talbot 327 (7421): 985

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The statin wars: why AstraZeneca must retreat

If you would like a small peek into the complex and powerful realm of pharmaceutical manufacturing and marketing, this editorial should give you a taste. We begin to see how data is manipulated around not for the patient's benefit, but rather for the bottom line of the shareholders.

The Journal : Back Issues

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Dihomo-gamma-linolenic acid inhibits tumour necrosis factor-alpha production by human leucocytes independently of cyclooxygenase activity

I realize this is a long title, but this article demonstrates a potent anti-inflammatory action of DGLA (found in high levels in borage oil) via reduction in TNF-alpha levels. Recall the newest rheumatoid arthritis and Crohn's disease drugs inhibit TNF-alpha action. I have strong concerns with long term use of these new drugs, especially when we are seeing more and more natural approaches that achieve the same ends without indiscriminate shutdown of an essential portion of the immune system that is known to fight off infections and cancer.

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Insulin Resistance, Hyperleptinemia, and Impaired Nitric Oxide Release With In-Stent Restenosis

Many patients have been saved open heart surgery by placing a stent in a blocked artery via a vein in the leg. Unfortunately, these stents have a high likelihood of closing back up in a relatively short period. The medical profession's approach to this has been to use radioactivity and drug eluding stents (DES) in an attempt to halt or slow restenosis. However, many natural approaches have shown good results. These include B12, folic acid and B6 supplements. This article brings to light some other physiological conditions amenable to lifestyle changes that impact stent restensosis.

Circulation -- Abstracts: Piatti et al. 108 (17): 2074

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