Medical Radiation

Between 1996 and 2010 the number of CT scans performed across the United States tripled (Dr. Smith-Bindman’s study looked at data on patients who had imaging among one million to two million patients a year from 1996 to 2010 in six health maintenance organizations ) This was thought to result from increased improvement and accessibility to the technology as well as avoidance of medical law suits.

As ionizing radiation is cumulative patients need to be warned of this and life-time amounts tracked. The scans can be very useful diagnostically but who is told for example that the angiogram their doctor orders is equivalent to 800 chest x-rays?

 

We know from all the data we have today that 2%-3% of cancers in this country are related to use of medical imaging and ionized radiation.

So, why don’t we tell patients when they have a particular imaging scan exactly how many millisievert (mSv) they’re getting exposed to? A CT angiogram of the heart is 16 mSv; a lot is being done to try to reduce that, but that is equivalent to 800 chest x-rays. How about a typical nuclear scan? A lot of patients who are treated in cardiology get this done every year. At 41 mSv, it’s equivalent to 2000 chest x-rays. But patients aren’t told any of this. And not only that, but we could actually measure exactly how many mSv they got by using the same type of radiation badges that the medical professionals use when they work in a cardiac cath lab or in an x-ray suite. But we don’t do that. This is a serious breach of our responsibility to patients.

We have a very important problem here with this runaway use of radiation procedures but no accountability with respect to patients’ exposure. This has come to a crisis point in children. Children who have a diagnosis of a pediatric malignancy, for example, go through all sorts of radiation imaging, and there have been clear-cut trends that this is increasing. It’s worrisome and, in fact, it could even engender additional problems in children burdened with cancer. We really need to change this.

In a digital world, this information could be collected from birth. Every individual should have their mSv exposure through medical imaging recorded cumulatively throughout their life and added to their electronic health record. Hopefully we’ll see that change come about in the future. This is something that’s a big hole in the current way that we work in medicine.

 

http://www.medscape.com/viewarticle/775659?src=wnl_edit_medp_wir&spon=17

 

Thomas Martin

 

Acupuncture Profession In Crisis

“Your time is limited so don’t waste it living someone else’s life. Don’t be trapped by dogma – which is living with the results of other people’s thinking...”  Steve Jobs

 

I was speaking with a colleague, a fairly recent graduate of a local acupuncture/Oriental Medicine school. She graduated 5 or 6 years ago and told me that she is abandoning her acupuncture career and training for an alternative career. She also told me she knows five other acupuncturist friends from the same class all of whom are looking for work elsewhere.

None of these acupuncturists are surviving on the income from their practices. My colleague, now in her early 40s, stated she has not been able to buy a house and “will never be able to pay off her student loan” because of her career choice. As I will outline below, this is by no means an isolated experience but a widespread phenomenon amongst a majority of acupuncture school graduates. I will show that to make matters worse the very opposite — that acupuncturists are doing well —  is being actively promoted online.

It has long been rumored in the profession that a high percentage of acupuncture graduates fail in their practices in the first few years. Over 50% is a number that has been suggested for many years now.

Unemployment and underemployment among acupuncture program graduates is as alarming as it is under-reported.

It’s surprising that the acupuncture profession as a whole does not collect income data. Chiropractors and massage therapists have Bureau of Labor Statistics data, acupuncturists don’t. The only serious professional attempt to ascertain an approximate income picture are these two papers:

The U.S. Acupuncture Workforce: The Economics of Practice by Steven H. Stumpf, EdD, Clifford R. Carr, EdD, Shauna McCuaig, MAcOM, LAc, Simon J. Shapiro, DO, DAOM, LAc and

Unveiling the United States Acupuncture Workforce, by Steven H. Stumpf, EdD,Mary L. Hardy, MD, D. E. Kendall, OMD, LAc, and Clifford R. Carr, EdD. Both papers are posted in full below with the approval of Dr. Stumpf. Unless otherwise indicated all the italicized quotes are from these papers

Despite the existence of national organizations representing the training programs, licensed members, regulatory boards, and an accreditation body recognized by Department of Education, the acupuncture workforce remains outside the healthcare mainstream (Stumpf et al., 2010). For example, valid longitudinal information describing the acupuncture workforce is simply unavailable in the U.S. A recent review by Stumpf et al. (2010) describes a handful of published studies that provide a minimal depiction of how licensed acupuncturists (LAcs) practice e.g., how many hours they work weekly, their annual earnings, and employment arrangements. As a result, it is nearly impossible for aspiring practitioners to acquire accurate information about practice characteristics and, thereby, forecast their potential to practice successfully.

In the surveys analysed in these papers the majority of acupuncturists are earning a gross income of $20,000 to $50,000 per year. But to emphasize how painfully low these numbers are we need to remember that up to half of this gross income will be taken up with tax, liability insurance, rent, practice expenses, continuing education, health care insurance, loan repayment and so on. That’s a take-home income for the majority of practitioners of close to $10,000 to $25,000 per year.

Three states together—California, New York, and Florida— account for approximately 15,050 or 52.8% of all LAcs in the nation (Zabik, 2009). Approximately 37.7% of the LAcs in these three states earn less than $20,000 per year (Acupuncture Today, September 2010). For these graduates the reality of paying back their student loan debt may be viewed as beyond their reach.

For a health-care profession seeking attention as a serious player in today’s increasingly integrated medicine this is shameful, reflecting poorly on the nation’s acupuncture schools that continue to churn out unsuspecting graduates.

Generally speaking, the respondents to these independent surveys charge fees between $20 and $65 per patient visit; work approximately 30 or fewer hours per week; and generate median gross incomes between $20,000 and $50,000.

50% of the licensed acupuncture (LAc) workforce is working less than 30 hr weekly; 50% are earning less than $50,000 on average; and the number of LAcs working independently in practice, either in their own office or sharing one, has increased from approximately 75% to 90%.

It would be reasonable to assume that the situation regarding the financial viability of the acupuncture profession is worse than is outlined in this already dismal picture. Income data gathering of the independent groups within the acupuncture profession referenced in the above papers, most focusing on a treatment style, is likely to contain numerous biases in favor of higher numbers of clients seen and income received for their favored treatment approach.

Self reporting, a significant factor in the surveys reported, is likely influenced by “professional shame” in lacking success, and other psychological factors. Independent data gathering is the only sure path to statistical clarity but such scientific and transparent data seem absent in the profession.

Graduates of the prominent acupuncture training program who completed surveys for this paper averaged $86,979 in student loan debt in 2009. At present, ~65% are enrolled in programs that “kick the can down the road.”

I would submit that most acupuncturists can’t support themselves without either taking a day job, getting health-care insurance and financial support through a spouse, not having children, indefinite student loan debt deferment, living in rental accommodation long-term, relying on financial resources accumulated from prior employment, and many other creative or luck based factors.

Acupuncture schools to this day remain stubbornly entrenched in teaching hopelessly archaic and metaphysically-based programs, indoctrinating students into an anti-modern medicine, or at least separate but equal mindset. “Alternative paradigm” and “Eastern Doctor” are labels often used, though oriental medicine is in fact a diverse mix of different theories and practices, not a relatively unified field — such as is biomedicine. Which, by the way, is the largest , most culturally diverse, globally collaborative medicine in history. The term “Western Medicine” is simply not accurate. Chinese, Korean, Japanese biomedical researchers and doctors are major contributors to modern medicine. Either join this global ongoing scientific revolution or remain in increasing obscurity. It’s hard to see it any other way.

It is important to note that the elaborate theory of energy meridians that acupuncture students must learn has no scientific evidence despite a decades long research effort. (Many acupuncturists/researchers have discussed this fact, Yun-Tao Ma Phd. LAc. for example. See also http://www.ivis.org/proceedings/aaep/2000/220.pdf)

Surprisingly, there is excellent scholarship indicating that the theory of “energy flow” and energy meridians was not the basis of ancient Chinese Medicine, but instead a recently added Western metaphysical concept, with blood flow being the central dynamic feature: http://www.tedpriebe.com/documents/Kendall_SJIM_meridians.pdf

http://tedpriebe.com/documents/Anatomical_Foundations_of_Chinese%20Med.pdf

There are strong sub-beliefs within the profession of certain acupuncture styles working better than others. The evidence of treatment efficacy however does not support this apparent diversity, showing no appreciable difference in outcomes between traditional, neo-traditional, new age contemporary and modern medical acupuncture such as Dry Needling. Fads, charismatic teachers, novelty and reference to ancientness continue to generate new acupuncture styles, in effect creating a kind of surrogate evidence of efficacy.

Acupuncture school graduates enter the workforce set up for isolation in the contemporary medical milieu. Questioning and critical thinking is actively discouraged in acupuncture schools, and graduates are often equipped with a New Age attitude that their success or failure depends on their “energy” to attract success, and not on socioeconomic factors and the inadequacy of their training.

Over 90% have no alternative but to develop private practices in a time when increasingly, standard medical practitioners are finding it unviable to do so. Only 4% of acupuncturists are employed in contemporary medical facilities. The few employment opportunities available within the profession often entail low hourly rates, no benefits such as vacation pay or health-care insurance, or other types of professional support. In such low-paid acupuncture industry situations, clients are usually treated in clinics by groups of acupuncturists, thereby diluting the practitioner/client relationship. Treatment of a particular client is often repeated at length with little or no consistent treatment plan.

Insurance reimbursements to acupuncturists are continually being reduced and client deductibles continue to rise. Medical spending is at its lowest rate in five decades.

There is a very limited job market for acupuncturists, with the only significant employers being acupuncture schools and drug treatment programs . . . Opportunities for acupuncturists to participate in the health care system in the same way other providers do are limited

The future, IMHO

We have a profession whose central defining practice (acupuncture) can be just as effectively utilized in a simple, fairly easily learned way, in a form entirely integrated within modern biomedicine. Oriental medicine is not the primary reason clients seek out an acupuncturist, they just want to get better and have heard that acupuncture might help. If they go often enough they may become suborned into the mindset of energy and meridians, but the original motivation holds; desire for improved health. The question arises, is an independent professional future even realistic for acupuncturists?

The status quo means increasing marginalization and a “99%” type scenario, with a few practitioners doing well and the majority struggling or failing. Income by acupuncturists will decline further as will professional standards. Getting acupuncture may become like having a chair massage. As the above income data becomes more commonly known, acupuncture schools will likely see a fall off in enrollment.

Simple acupuncture techniques like Dry Needling, and Biomedical Acupuncture based on contemporary science and physiology, will be increasingly appropriated by other medical professions. These approaches, sensitive to evidence-based updates, have shown the same outcomes as traditional styles in studies, yet can be taught in a short time to appropriately medically trained individuals.

Many researchers have pointed out that the type of acupuncture doesn’t make a difference in outcomes: To quote Dr. Andrew Vickers, a longstanding acupuncture researcher:

The type of acupuncture didn’t seem to make a difference to the results, said Dr. Vickers. “Some acupuncturists will tell you not to go to such and such a person because that person doesn’t put the needles in the right way, or they don’t use the right theories, or they’re not as well trained, but the particular type of acupuncture you get doesn’t seem to make a large difference.”

http://www.medscape.com/viewarticle/770646

 

A Possible Alternative

The acupuncture profession as we now see it may well become an obscure historical  entity harking back to a proud isolated alternative medicine  mindset of the 1970’s.

Acupuncture colleges that have the foresight and freedom from current metaphysical dogma could develop primary care programs similar to those of NP’s and PA’s and teach modern biomedical acupuncture and functional medicine based herbology and nutrition. If they did this, high quality students would be attracted and new jobs for graduates would become available within the medical establishment. Current  practices and products could be sifted by the transparent clarity of modern scientific medicine, brought into the 21st century through critical review and evidence.

Such colleges could also teach short acupuncture courses to other medical professions, having some play in what is inevitable anyhow.

These colleges would have an ethical responsibility to link success of their programs to the ability of graduates to pay down their loan debts in a prescribed period of time, thereby linking curriculum to actual job markets and the contemporary medical ethos. This responsibility, it seems, is currently evaded by most acupuncture schools.

The colleague I mentioned at the beginning of the article stated that although she enjoys the work, she would not choose to be an acupuncturist if she had her time all over again. Another colleague who has been in practice 15 years expressed the same sentiment. One wonders how many others among the nation’s practicing acupuncturists would concur?

Misinformation abounds on the web…

“A licensed acupuncturist after one year out of school can expect to make $45,000 a year and up. After five years in practice, one’s income should approach $100,000.

$200,000-300,000 a year is not unrealistic within 10 years in practice.”

From acufinder.com

“The starting salary of individuals in this profession averages $49,844 annually. Salaries after 10 years of practice peak at $133,700 annually.”

From toptenreviews.com

This website actually places ‘acupuncturist’ as a job receiving the highest salary among nine other medical professions.

“Average annual salary for a Licensed Acupuncturist is $51716 based on statistics in the U.S. as of 2013.”

From jobgeeks.com

Note the over-sell, the casual misinformation, the confusion of ‘salary’ with business revenue, and the attractiveness of it all for the unsuspecting applicant prepared to put themselves into major debt. A debt they are likely not to pay off in over 10 years in practice, or even in another career.

Even the Council Of Colleges Of Acupuncture and Oriental Medicine (CCAOM) happily perpetuates this deception. Note the following FAQ from their website –

How much can an AOM practitioner expect to earn?

There are approximately 20,000-25,000 AOM licensees throughout the United States. A recent estimate, which is based on job postings, reports an annual income range between $30,000-$60,000 and notes that gross annual income can be as much as $105,000.

CCAOM must know that there are very few “job postings” for the 20,000 to 25,000 acupuncturists mentioned. What is the hope for honesty and transparency if a major professional organization prefers to present myth over truth.

Occasionally one can find clear criticism of the confusing presentation of income data, deliberate or otherwise, as with this post questioning the Oregon College Of Oriental Medicine’s graduate data by Lisa Rohleder LAc – OCOM Redefines Acupuncture as a Hobby for Girls

That would be “the Sugar Daddy business model”, in which an acupuncturist asserts that  he or she is successful in his or her practice, because in reality he or she doesn’t need to earn a living, since his or her partner/husband/ wife has a real job and supports their household. Plenty of acupuncturists, regardless of gender, claim this kind of success. https://www.pocacoop.com/prick-prod-provoke/post/ocom-re-defines-acupuncture-as-a-hobby-for-girls

 

 A Decision Based On The Facts

Remember the quote above from Steve Stumpf et al. “it is nearly impossible for aspiring practitioners to acquire accurate information about practice characteristics and, thereby, forecast their potential to practice successfully.”

So if you’re thinking of going to acupuncture school here’s how it probably shapes up. Not inevitable, but likely, based on the experience of the majority.

For the first few years after graduation it’s touch and go if you are even able to stay in practice – most likely you will be struggling to set up a private practice outside the support employment offers. If you survive that, statistically speaking you need to have a spouse to support you and to get health-care insurance through. Or you will need another source of income such as another job, an inheritance, savings, something. Frugality is good!

If you gain employment in the industry, such as detox clinics or low cost public health facilities, you will be part-time, without benefits, often treating the same individuals over and over with a vague or no treatment plan. There will be no union watching out for you.

In some measure you will be deferring your $80,000 to $100,000 loan debt, so forget about buying a house and treat your old car well. You will feel the need to learn new acupuncture styles and do business development courses. There are plenty of people ready to bill your credit card for these.

You’ll need to keep up with CEU’s, and pay Liability Insurance. You’ll find yourself with a whole set of beliefs that other medical practitioners don’t seem to care about. You’ll wonder why the Law Of Attraction isn’t working for you…

Or you may be one of the lucky ones – your acupuncture program would have quietly encouraged that feeling all through your training.

But, for sure, you are a good person, sincerely wanting to help others, and life is indeed an adventure of endless learning, not a bank account. Stay flexible, be creative, jettison most of your acupuncture college training, re-discover your own thinking. Learn from your clients: they, your real teachers will be paying you! Change direction if needed. Enjoy making small differences, as in real life; they are the differences that count. Good luck.

 

______________________

Workforce_CHPR_Dr. Stumpf_2010 CHPR374640_Mainstreaming_Stumpf

CHPR374640_Mainstreaming_Stumpf

______________________

May, 2013

Thomas Martin LAc.

http://www.wellnessclarity.com/?p=183

______________________

 The following is a letter from a recent Acupuncture School  graduate who read the above post. The statistics outlined in the post reveal that Michael’s difficult journey, which by no means has yet ended, is shared by a great many. Their plight, in most cases, is not from personal lack of talent or hard work but from deliberate and passive misinformation  disseminated from professional schools and organizations.

Hi Thomas-

Thank you for your blog entry “Acupuncture Profession in Crisis”. 

I had a rough two years after graduating from Tri-State Collge of Acupuncture in 2011. I simply couldn’t make any money in acupuncture (I lost money, actually). With that, my confidence dropped and eventually had such a problem with anxiety and panic attacks that I stopped practicing. I have $140K debt (including personal) and was so optimistic that I would pay the loans back. But working in acupuncture in NYC means community acupuncture, which was half of what I made as a waiter. 

It’s very sad, but I knew that if I didn’t leave, I would be wasting precious time that could be used to find a profession where I could make better money. 

While it makes me angry, to think the school promised so much, I kick myself for not looking further. I don’t want acupuncture to go away, but I think people need to know the facts. 

Thank you again. I hope more people thinking of going into acupuncture will read this entry!

Best-
Michael 

October 2013

Thomas Martin LAc.

 

 

 

 

Health Benefits of Coffee

While caffeine has been  demonized by CAM practitioners for decades an increasing number of studies are supporting tea and coffee consumption in moderated daily quantities (even in some studies what would generally be considered excessive consumption). Coffee which contains numerous flavonoids, chlorogenic acid and the antioxidant caffeine, has been shown to to reduce incidence of several diseases and support healthy brain function.

A study conducted at the University of South Florida and the University of Miami involving 124 people aged 65 to 88 was published 6/5/12 in the Journal Of Alzheimer’s Disease. It showed that those individuals with the highest blood caffeine levels actually avoided conversion of mild memory impairment to Alzheimers disease in the 2 to 4 year period in which the study was conducted.

“These intriguing results suggest that older adults with mild memory impairment who drink moderate levels of coffee — about 3 cups a day — will not convert to Alzheimer’s disease — or at least will experience a substantial delay before converting to Alzheimer’s,” said study lead author Dr. Chuanhai Cao, a neuroscientist at the USF College of Pharmacy and the USF Health Byrd Alzheimer’s Institute. “The results from this study, along with our earlier studies in Alzheimer’s mice, are very consistent in indicating that moderate daily caffeine/coffee intake throughout adulthood should appreciably protect against Alzheimer’s disease later in life.”

 

The following article published by the Life Extension Foundation, an integrative medicine research organization, outlines the numerous health benefits of coffee –

 http://www.lef.org/magazine/mag2012/jan2012_Discovering-Coffees-Unique-Health-Benefits_01.htm 

  • Decaffeinated and caffeinated coffee lowered the risk of kidney stones in women by 9 and 10%, respectively.
  • Caffeinated coffee reduced the incidence of gallstones and gall bladder disease in both men and women.
  • Scientists found that coffee boosted regular weight loss by 8 pounds and promoted body fat metabolism.
  • Sometimes-inconsistent findings have generally linked coffee drinking with reduced all-cause mortality and cardiovascular mortality.
  • For athletes, caffeine reduced muscle pain, increased energy (ergogenic aid), and enhanced endurance.
  • One study found caffeine, taken 2 hours before exercise, prevented exercise-induced asthma.
  • Confirming earlier research, a 2011 study on over 50,000 women found that 4 cups of coffee daily lowered the risk of depression by 20%, compared to coffee abstainers.
  • Antibacterials in coffee were found to inhibit plaque formation and prevent dental decay.
  • Whether caffeinated or decaffeinated, coffee consumption prevents constipation  and – despite the myth that coffee dehydrates the body – contributes to the body’s fluid requirements.
  • Caffeine is believed to boost by 40% the effectiveness of pain relievers against headaches. Caffeine also helps the body absorb headache medications more quickly.

      A large, as-yet-unpublished study presented October 24, 2011, found that men and women with the highest coffee consumption have a 13% and 18% lower risk, respectively, for  basal cell carcinoma (a type of skin cancer).129

      The May 14, 2011, issue of Breast Cancer Research reported that postmenopausal women who consumed 5 cups of coffee daily exhibited a 57% decrease in their risk of developing ER-negative

      A promising study appeared in the June 8, 2011, issue of the Journal of the National Cancer Institute. The research team reported that men who drank over 6 cups of coffee a day had an 18% lower risk of prostate cancer – and a 40% lower risk of aggressive or lethal prostate cancer.

      A 2009 meta-analysis in the Annals of Internal Medicine combined data on over 450,000 people and found that every additional cup per day of caffeinated or decaffeinated coffee lowered the risk of diabetes by 5 to 10%.

     Caffeinated coffee has also been associated with protection against Parkinson’s disease, the second most common neurodegenerative disorder after Alzheimer’s. A study of 29,000 individuals found that one to four cups daily decreased the risk of Parkinson’s by 47% and 5 or more cups decreased the risk by 60%.

     Many epidemiological studies show that the risk of diabetes drops directly according to the amount of coffee consumed. For instance, scientists found that overall risk is reduced by:

  •                1. 13% with one cup a day
  •                2. 47% with 4 cups a day,
  •                3. 67% with 12 cups a day.

It’s noted that most of the benefits outlined are available with decaffeinated coffee as well. Also for many people coffee is the major or only source of  polyphenols in the diet so those consuming a whole foods largely plant-based diet will already likely have significant reduction in incidence of diseases mentioned above. It’s also difficult to deduce which of the 1,000 phytochemicals contained in coffee are responsible for improved health though chlorogenic acid and caffeine may have significant play in neurodegenerative disorders.

 

Thomas Martin LAc.

Chilli Peppers for Heart Health and Pain

Substances found in chilli peppers called capsaicin and capsaicinoids have been shown to relax blood vessels in the heart to increase blood flow, reduce cholesterol and blood pressure.

The team found, for instance, that capsaicin and a close chemical relative boost heart health in two ways. They lower cholesterol levels by reducing accumulation of cholesterol in the body and increasing its breakdown and excretion in the feces. They also block action of a gene that makes arteries contract, restricting the flow of blood to the heart and other organs. The blocking action allows more blood to flow through blood vessels.

“We concluded that capsaicinoids were beneficial in improving a range of factors related to heart and blood vessel health,” said Chen, a professor of food and nutritional science at the Chinese University of Hong Kong.

http://www.sciencedaily.com/releases/2012/03/120327215605.htm

Also see – http://www.webmd.com/pain-management/tc/capsaicin-topic-overview

Thomas Martin LAc.

More on Yoga Injuries

Pertaining to my Yoga and Transformation post on 1-22-12 http://www.wellnessclarity.com/?p=119 the following article from The New Zealand Herald gives actual statistics from the national accident insurance that all citizens there have largely free access to (ACC).

The article reports that 1000 yoga related injury claims were filed last year. Most claims were for back and neck injuries. To put this in perspective 300,000 claims were made for other sports/exercise injuries.

Also an average of $600 NZ was paid out for each occurrence, indicating that the injuries were likely relatively minor.

The article did indicate injuries are increasing and suggested inexperienced teachers, new ‘fad’ forms of yoga and poor attention to alignment in yoga poses all played a part.

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10786455

Thomas Martin LAc.

The Triage Theory and Supplementing For Healthy Aging

The importance of taking supplements along with a healthy diet, though at the very least a prudent healthy practice, continues to be controversial in mainstream medicine. Widespread deficiencies have been reported especially in the elderly, the poor, obese individuals, pregnant women and those undergoing sustained stress. The genetic need for micronutrients also likely varies greatly among individuals.

Dr. Ames who is emeritus professor of biochemistry and molecular biology at the University of California, developed the Triage Theory of optimal nutrition. The theory shows how over extended periods of time hidden deficiencies in vitamins, minerals and other micronutrients can result in age-related diseases.

When essential nutrients in the diet are limited the body shunts then into functions essential for immediate survival, such as reproduction, so on the surface an individual may appear healthy despite dietary deficiency. As we age however these hidden deficiencies begin to manifest in disease.

There are more or less 40 substances essential for every metabolic pathway in the body – approximately 15 vitamins that are co-enzymes and 15 minerals that are required in enzymes, two essential fatty acids, omega-3 and omega-6, and about eight essential amino acids.

Despite an abundance of macronutrients such as protein, fat and carbohydrates the modern diet is frequently deficient in many of the above micronutrients.

Such Triage Theory deficiencies are especially damaging to mitochondria, components in cells responsible for energy production. This age-related decay not only affects DNA/RNA but weakens cell membranes, reduces oxygen uptake, oxidises fats, increases the formation of cancer promoting metabolites. To this end Dr. Ames’ laboratory is currently working on the use of vitamins, minerals, antioxidants such as lipoic acid and the amino acid acetyl l carnitine to reduce cellular decline and degeneration.

 

From Dr. Ames’ website – http://www.bruceames.org/

Inadequate intakes of vitamins and minerals from food can lead to DNA damage, mitochondrial decay, and other pathologies (7). Intakes below the…RDA, are widespread (e.g. in the U.S.: 56% for magnesium; 12% for zinc; 16% menstruating women for iron; 16% of women for folate) (7).

(Deficiencies) are particularly widespread among the poor, African-Americans, teenagers, the obese, and the elderly (7).

Inadequate intake of folate, B12, or B6 leads to uracil incorporation into DNA and chromosome breaks —a radiation mimic (8, 9).

Inadequate zinc in human cells in culture causes release of oxidants, oxidative damage to DNA, and inactivation of p53 and other zinc enzymes involved in DNA damage repair (10, 11).

Inadequate iron intake inactivates Complex IV in mitochondria, which causes oxidant release, mitochondrial decay, and DNA damage; in the brain complex IV inactivation mimics the neurodegeneration of aging (12, 13).

Biotin inadequacy from food is present in 40% of pregnant women; biotin deficiency in human cells in culture leads to oxidant release, DNA damage, accelerated mitochondrial decay, and premature senescence (14).

Magnesium deficiency in human cells in culture causes mtDNA- protein crosslinks, accelerated telemore shortening, and premature senescence (15).

I suggest evolutionary allocation of scarce micronutrients by enzyme triage is an explanation of why DNA damage is commonly found on micronutrient deficiency (7).

We are developing sensitive assays for measuring DNA damage in human blood (16) so as to determine what level of each micronutrient is optimum for keeping DNA damage to a minimum.

We are exploring the effect of high dose B vitamins in delaying the mitochondrial decay of aging (18)…An optimum intake of micronutrients and metabolites, which varies with age and genetics, should tune up metabolism and markedly increase health at little cost, particularly for the poor, obese, and elderly (7).

 

Also on Dr. Ames‘ research – Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage. – http://www.ncbi.nlm.nih.gov/pubmed/17101959

Optimal micronutrients delay mitochondrial decay and age-associated diseases – http://www.ncbi.nlm.nih.gov/pubmed/20420847  

Are vitamin and mineral deficiencies a major cancer risk? – http://www.ncbi.nlm.nih.gov/pubmed/12209158

 

Harvard School of Public Health recommends a daily multivitamin supplement. http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/multivitamin/index.html

Here’s an example of a high-quality multivitamin supplement (add magnesium and calcium to complete it) – http://www.vitacost.com/Vitacost-Synergy-Basic-Multi-Vitamin

Thomas Martin LAc.

 

 

 

Efficient Absorption Mechanism for Plant-source Iron Discovered

The following study outlining a new understanding of plant source iron absorption was reported in Science DailyE. C. Theil, H. Chen, C. Miranda, H. Janser, B. Elsenhans, M. T. Nunez, F. Pizarro, K. Schumann. Absorption of Iron from Ferritin Is Independent of Heme Iron and Ferrous Salts in Women and Rat Intestinal Segments. Journal of Nutrition, 2012; DOI:10.3945/jn.111.145854 – http://www.sciencedaily.com/releases/2012/01/120120003510.htm

 

 “Our study shows that this different mechanism of iron absorption from plant ferritin is more efficient and gives the intestinal cells more control. It can be a new way to help solve global iron deficiency,” says Dr. Theil…

…ferritin iron is absorbed in its protein-coated, iron mineral form by a different, independent mechanism; iron absorbed as ferritin, leaves the intestine more slowly, but may, provide greater safety to the intestines than iron supplements…

In addition to potentially being safer, causing less irritation to the intestines, absorption of iron as ferritin is easier for the intestine. The iron found in meat and non-meat iron supplements enters the intestine from food one iron atom at a time. Each entry step requires the intestinal cells to use up energy. When the intestine takes in a single molecule of ferritin, however, it gets a thousand atoms inside that one ferritin molecule, making iron absorption that much more efficient.

…the results demonstrate that ferritin-rich foods such as legumes can provide a significant source of dietary iron for those in the greatest need of increasing their iron consumption.

Legumes and other plant foods were found to be a good source of highly absorbable ferritin iron which seems to overcome the absorption inefficiency seen in those with iron deficiency. This is significant as it provides an environmentally sustainable supply of dietary iron in plant-based diets low or absent of animal foods. It also suggests that balanced, economically viable plant sources of iron in developing countries are realistically obtainable through agricultural reorganization and dietary planning.

One final point, countering the popular notion that vegetarian diets or diets absent in red meat promote iron deficiency is that the available evidence shows no difference between the incidence of  iron deficiency anemia in vegetarians compared with meat eaters. In other words both groups show a similar incidence.

http://www.adajournal.org/medline/record/ivp_00029165_76_100

http://www.adajournal.org/medline/record/ivp_00029165_70_353

 

Thomas Martin LAc.

 

 

 

 

 

 

 

 

Yoga and Transformation – A Response To The Article – “Yoga Can Wreck Your Body”

An article by William Broad appeared recently in The New York Times, titled How Yoga Can Wreck Your Bodyhttp://www.nytimes.com/2012/01/08/magazine/how-yoga-can-wreck-your-body.html?pagewanted=all

Firstly I support any clear-eyed look at the practice of Hatha yoga, as any activity that proports to be good for health will tend to oversell the benefits and deny possible harms. This is unfortunately how the market works. Also there continues to be a lack of critical thinking when it comes to practices of Eastern origin. There’s an assumption of unquestionable ancient truth and submission to its supposed superior authority.

The teacher-pupil relationship, at times, can be corrupted by a downward dynamic of “the one who knows” to “the many who don’t”. This limits learning to acquisition which in turn corrals awareness which has a natural open-ended, self-reliant, learning-dynamic inbuilt. It also binds the student to the teacher and to a particular style, further retarding true learning.

That said the article is surprisingly poorly written, especially as the writer is supposed to be a highly awarded journalist. There are several extreme anecdotal examples of supposed harm being done by yoga and very little solid data. Ironically the main Yoga teacher cited in the article teaches very aggressively while at the same time stating that “most people shouldn’t do yoga”. Also there is little attempt to separate minor injury from serious injury. Setting up his poorly differentiated claim that yoga leads to serious injuries the author states-

More troubling reports followed. In 1972 a prominent Oxford neurophysiologist, W. Ritchie Russell, published an article in The British Medical Journal arguing that, while rare, some yoga postures threatened to cause strokes even in relatively young, healthy people.

 

I checked this “article” to discover a two paragraph letter to the editor of the British Medical Journal. The stroke syndrome quoted by William Broad is also, in that small note by Dr Russell, attributed to the following activities — being in a dentists chair, at a hairdresser, picking fruit, painting a ceiling, presiding over a meeting. Clearly in some rare instances any type of daily neck extension may be dangerous to health. http://www.bmj.com/highwire/filestream/223144/field_highwire_article_pdf/0/685.2.full.pdf

 

Any arduous exercise regime or activity has the potential to result in injury, is yoga any different? If so where are the comparative data? How many are injured in comparative exercise classes for example.

I do agree with the need for the scientific evaluation of harm in current yoga teaching/practice. The problem here however is that the term yoga covers many and varied styles, with each style interpreted differently by different teachers. There are also fairly aggressive styles that push practitioners away from quiet, slow feedback awareness.

My own experience with yoga — practicing most days in the week since the early ’70s — has shown me that if practiced with clear cognizance to some basic ground rules for beginning, holding and releasing a stretch, yoga is a safe practice. The potential for injury however is ever-present, requiring a “this present moment” watchfulness, independent of length of practice, fitness , etc. Based on this attitude a teacher should be listened to and not listened to — immediate sensitivity is the arbiter of when to listen and when not to heed direction to hold longer or deepen a stretch. Even so, minor muscle strains and soreness do occur from time to time, these can be skillfully folded into the process, stimulating renewed awareness and adaptation.

Slowness, watchfulness, constant feedback reflexivity has long been central to good yoga teaching and practice. Paying attention to the present state of the body despite yesterday’s flexibility, watching for aggressiveness, impatience, tiredness or withdrawal; pausing and sensing are all active protocols for moving into, holding and releasing from postures.

Any sustained physical culturing has similar need for intelligent action and skillful means. Potential for injury increases with the current tendency for large classes, lack of home practice away from class and the sheer popularity of yoga. Short attention span and impatience with the body, frequent patterns of our times, play their part. Seeing a yoga pose in a book and true to our current mentality wanting to do it now or at least in a couple of weeks.

Yoga is an excellent activity in which to gain insight into conditioning and imbalances on all levels, physical, emotional and cognitive, as it deeply encourages symmetry and open-ended feedback awareness. There is no end to depth of exploration, to subtlety of discovery.

The art of learning not to go against, not to try to conquer, but to see the presence of things as a deeply integrated whole, even if painful, unpleasant etc  and to work skillfully with them, is the timeless wisdom of yoga.

This timeless wisdom is superbly elucidated in the following link to an article written by Joel Kramer an adept of yoga as a practice for the transformation of conditioning on all levels, titled Yoga As Self-transformation.

 

Yoga involves far more than either having or developing flexibility. Being able to do complicated postures doesn’t necessarily mean you know how to do yoga. The essence of yoga is not attainments, but how awarely you work with your limits — wherever and whatever they may be. The important thing is not how far you get in any given pose, but how you approach the yogic process, which in turn is directly related to how your mind views yoga.

There are different basic frameworks of mind — what I call “headsets” that people bring to yoga. One involves viewing a posture as an end to be achieved, a goal: how far you get in the posture is what counts. Another one views the posture as a tool to explore and open the body. Instead of using the body to “get” the posture, you use the posture to open the body. Whichever framework you’re in greatly influences how you do each posture.

Approaching postures as goals makes you less sensitive to the messages the body is sending. If your mind is primarily on the goal, the gap between where you are and where you want to be can bring tension and hinder movement. You push too hard and fast instead of allowing your body to open at its own pace. Paradoxically, if you’re oriented toward the process instead of the end results, progress and opening come naturally. Postures can be achieved through struggle, but the struggle itself limits both your immediate opening and how far you ultimately move in yoga.

Valuing “progress” is a deep part of our conditioning. It’s natural to enjoy progress, but problems come when your yoga is attached at its core to results, instead of to the daily process of opening and generating energy. This attachment imposes one of the real limits to your yoga.

 

 

 

Here’s the link to the entire article, it’s well worth reading and will change the way you do yoga or inspire you to start. http://www.joeldiana.com/downloads/writings/YogaAsSelfTransformation.pdf

 

Low Serotonin and Depression Link Questioned

An article in New Scientist magazine, July 24th, 2010 by Linda Geddes, reported on the research of Christopher Lowry of the University of Boulder, Colorado.

http://www.newscientist.com/article/mg20727703.300-serotonin-cell-discoveries-mean-rethink-of-depression.html

Though the theory has never been proven, it has generally been thought that depression results from low levels in the brain of the neurotransmitter, serotonin.

The article outlines the central discovery of Lowry’s work that high levels of serotonin in people with depression as well as multiple type of serotonin releasing neurons in the brain is prompting a reassessment of the treatment of depression by simply increasing the neurotransmitter using SSRI antidepressants.

 

Though not mentioned this rethink likely calls into question the use of Tryptophan in complimentary/alternative medicine to boost serotonin in order to treat depression and other disorders presumed to involve low serotonin.

The true picture appears more complex (which seems to be the way it goes in the evolution of medical theory – especially in popular approaches of natural medicine) where multiple types of serotonin neurons are likely to be regulated in independent ways.

Jerry Kennard of Health Central reports Lowry as thinking it

 far more likely that there are subgroups of serotonin neurons that are overactive during depression, rather than under-active as many people have assumed. The piecing together of evidence started over three years ago when researchers at the Baker Heart Institute in Australia discovered up to four times the normal level of serotonin in the brains of people panic disorder. In depressed people not receiving treatment it was two times higher. Another interesting finding was that long-term use of SSRIs in people with depression and panic disorder actually seems to decrease serotonin levels – although it isn’t clear why.

http://www.healthcentral.com/depression/c/4182/116886/depression       

 

In a PLOS Medicine essay,  Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature, Jeffrey Lacasse and Jonathan Leo, cover the demise of the serotonin theory and the failure of the latest anti-depressant drugs to live up the media hype.

In subsequent years, there were numerous attempts to identify reproducible neurochemical alterations in the nervous systems of patients diagnosed with depression. For instance, researchers compared levels of serotonin metabolites in the cerebrospinal fluid of clinically depressed suicidal patients to controls, but the primary literature is mixed and plagued with methodological difficulties such as very small sample sizes and uncontrolled confounding variables…  Attempts were also made to induce depression by depleting serotonin levels, but these experiments reaped no consistent results [9]. Likewise, researchers found that huge increases in brain serotonin, arrived at by administering high-dose L-tryptophan, were ineffective at relieving depression [10].

Contemporary neuroscience research has failed to confirm any serotonergic lesion in any mental disorder, and has in fact provided significant counterevidence to the explanation of a simple neurotransmitter deficiency. Modern neuroscience has instead shown that the brain is vastly complex and poorly understood [11]. While neuroscience is a rapidly advancing field, to propose that researchers can objectively identify a “chemical imbalance” at the molecular level is not compatible with the extant science. In fact, there is no scientifically established ideal “chemical balance” of serotonin, let alone an identifiable pathological imbalance. To equate the impressive recent achievements of neuroscience with support for the serotonin hypothesis is a mistake.

With direct proof of serotonin deficiency in any mental disorder lacking, the claimed efficacy of SSRIs is often cited as indirect support for the serotonin hypothesis. Yet, this ex juvantibus line of reasoning (i.e., reasoning “backwards” to make assumptions about disease causation based on the response of the disease to a treatment) is logically problematic—the fact that aspirin cures headaches does not prove that headaches are due to low levels of aspirin in the brain. Serotonin researchers from the US National Institute of Mental Health Laboratory of Clinical Science clearly state, “[T]he demonstrated efficacy of selective serotonin reuptake inhibitors…cannot be used as primary evidence for serotonergic dysfunction in the pathophysiology of these disorders” [12].

Reasoning backwards, from SSRI efficacy to presumed serotonin deficiency, is thus highly contested. The validity of this reasoning becomes even more unlikely when one considers recent studies that even call into question the very efficacy of the SSRIs. Irving Kirsch and colleagues, using the Freedom of Information Act, gained access to all clinical trials of antidepressants submitted to the Food and Drug Administration (FDA) by the pharmaceutical companies for medication approval. When the published and unpublished trials were pooled, the placebo duplicated about 80% of the antidepressant response [13]; 57% of these pharmaceutical company–funded trials failed to show a statistically significant difference between antidepressant and inert placebo [14]. A recent Cochrane review suggests that these results are inflated as compared to trials that use an active placebo [15]. This modest efficacy and extremely high rate of placebo response are not seen in the treatment of well-studied imbalances such as insulin deficiency, and casts doubt on the serotonin hypothesis.

Also problematic for the serotonin hypothesis is the growing body of research comparing SSRIs to interventions that do not target serotonin specifically. For instance, a Cochrane systematic review found no major difference in efficacy between SSRIs and tricyclic antidepressants [16]. In addition, in randomized controlled trials, buproprion [17] and reboxetine [18] were just as effective as the SSRIs in the treatment of depression, yet neither affects serotonin to any significant degree. St. John’s Wort [19] and placebo [20] have outperformed SSRIs in recent randomized controlled trials. Exercise was found to be as effective as the SSRI sertraline in a randomized controlled trial [21].

 http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0020392

Thomas Martin LAc.

 

Effectiveness of Depression Drugs Questioned

The discussion and links in this post are not meant to discourage anyone from listening to their healthcare provider or from taking medical drugs where deemed necessary. It does however serve to show how complex the mind/body is, how being informed and how conscientiousness and self-reliance are important no matter what treatment approach is followed

As to the much lauded effect of the best-selling antidepressant drugs turning out to be very little more than the depression alleviating effect of an inert placebo pill see Sharon Begley’s excellent expose from Newsweek

 …let me show you the studies on PubMed. It seems I am not alone in having moral qualms about blowing the whistle on antidepressants. That first analysis, in 1998, examined 38 manufacturer-sponsored studies involving just over 3,000 depressed patients. The authors, psychology researchers Irving Kirsch and Guy Sapirstein of the University of Connecticut, saw—as everyone else had—that patients did improve, often substantially, on SSRIs, tricyclics, and even MAO inhibitors, a class of antidepressants that dates from the 1950s. This improvement, demonstrated in scores of clinical trials, is the basis for the ubiquitous claim that antidepressants work. But when Kirsch compared the improvement in patients taking the drugs with the improvement in those taking dummy pills—clinical trials typically compare an experimental drug with a placebo—he saw that the difference was minuscule. Patients on a placebo improved about 75 percent as much as those on drugs. Put another way, three quarters of the benefit from antidepressants seems to be a placebo effect. “We wondered, what’s going on?” recalls Kirsch, who is now at the University of Hull in England. “These are supposed to be wonder drugs and have huge effects.”

The study’s impact? The number of Americans taking antidepressants doubled in a decade, from 13.3 million in 1996 to 27 million in 2005.

http://www.thedailybeast.com/newsweek/2010/01/28/the-depressing-news-about-antidepressants.html

For more on this subject see my post here – http://www.wellnessclarity.com/?p=89

 

See also Harriet Fraad’s article in The Guardian

So-called miracle drugs like Prozac are taken by 11% of the population – and Prozac is only one of the 30 available antidepressants on the market. …

Anti-psychotics drugs alone net the pharmaceutical industry at least $14.6bn dollars a year. Psycho-pharmaceuticals are the most profitable sector of the industry, which makes it one of the most profitable business sectors in the world. Americans are less than 5% of the world’s population, yet they consume 66% of the world’s psychological medications.

Do these psycho pharmaceuticals work to restore mental health? Actually, the evidence is overwhelming that they fail. Antidepressants, the most popular psycho-pharmaceuticals, work no better than placebos. They work 25% of the time and stop working when the user stops taking them. In addition, they may actually harm patients in the long run. They disrupt brain neurotransmitters and may usurp the brain’s organic soothing functions.

http://www.guardian.co.uk/commentisfree/cifamerica/2011/mar/15/psychology-healthcare

Until quite recently there used to be a fairly clear demarcation between reactive sadness and major depression that is sustained and apparently without cause – a distinction going back as far as the ancient Greeks. In past years however this distinction has been confused and normal sadness that most people experience from time to time has been increasingly medicalized into a treatable disorder and actively marketed as such.

Here Gordon Parker in the British Medical Journal, discusses this increasing medicalization of sadness.

http://www.bmj.com/content/335/7615/328.full

Also on the over-diagnosis of depression from the Guardian

http://www.guardian.co.uk/lifeandstyle/2007/aug/17/world.health

 

Andrew Weil’s Integrative approach to improving Mood

See Andrew Weil’s (who has experienced bouts of depression life-long) book Spontaneous Happiness on the wholistic approach to emotional wellbeing. Weil also recommends acupuncture, exercise and meditation for this mood condition.

http://www.amazon.com/Spontaneous-Happiness-Andrew-Weil/dp/0316129445/ref=sr_1_1?s=books&ie=UTF8&qid=1326240423&sr=1-1

Exercise Improves Depression

The following study demonstrated exercise to be  equal to Zoloft in improving depression in older adults at 4 months of intervention.

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Search&doptcmdl=Citation&defaultField=Title%20Word&term=Blumenthal%5Bauthor%5D%20AND%20Effects%20of%20exercise%20training%20on%20older%20patients%20with%20major%20depression.

 

Thomas Martin LAc