For many years now, I have encouraged my young female patients to go on a program under my guidance, to detoxify environmental chemicals, including phthalates and heavy metals before they conceive. I have now formalized this into what I call a Preconception Pregnancy Preparation Program. Many of my patients have gone through this program to help them have healthy babies.

For a long time now there has been shown to be a link between these environmental chemicals and neurological disorders that are epidemic now in children – autism spectrum disorder and ADHD.

Now a new study has just been published from Harvard University showing that “Women who live in areas with polluted air up to twice as likely to have an autistic child than those living in communities with cleaner air.” They looked at quite a few environmental airborne toxins including Mercury, diesel exhaust, lead, manganese, nickel and methylene chloride. 26 of the 180 pollutants had a significant association between exposure and autism rates.

Quite strikingly for Mercury and diesel, the mothers in the highest exposure group were TWICE as likely to have an autistic child.

Andrea Roberts, M.D. was the lead author of this study. She is quoted as saying “These things (pollutants) are neurotoxins and they can pass from the mother to the fetus while its still developing. And some of these chemicals can cause genetic mutations – the type associated with autism.”

Dr. Roberts said that her next research step would be to take blood samples from pregnant women or from babies to measure these pollutants.

My comment about this research is HOORAY! For years, environmental doctors have been telling their patients to avoid or minimize their environmental chemical exposures while pregnant. Now this article is bringing it to the forefront of everybody’s attention.

My patients, and probably my readers know I am especially concerned about the mercury that is coming from fish consumption into our bodies. This study, finding the highest link between mercury and autism, has overlooked the possible role of fish consumption by the woman during her pregnancy.

I advise all my patients not only clean up the Mercury before they conceive but to eat no fish while they are pregnant. Conventional medicine actually encourages pregnant women to eat low mercury fish so that they get the fish oils for the baby’s brain. This is such an easy problem to solve. All the woman has to do is take one or two fish oil pills a day which contain both EPA and DHA. Many prenatal vitamins now include the DHA that the baby requires for proper neurological development.

Integrative physicians have known the importance of DHA since the late 1990s. It has just been within the last year or two that prescription prenatal vitamins have started to add DHA.

To close this article I want to give a quote from Amy Kalkbrenner, MD, an assistant professor of epidemiology at the University of Wisconsin – Milwaukee. She was not involved in this study but has done an earlier similar study. She stated “It’s the exposures very early in life that we’re concerned about. So by the time they’re diagnosed, it’s too late.”

Please tell your friends who are pregnant to stop eating fish and take the fish oil pills instead. This will minimize their new mercury exposure during pregnancy itself.

More about this in next week’s issue!

References

Environmental Health News

Original Article

Previous Article with Same Findings

In the June 8 issue of the New York Times Opinion section, Paul A. Offit did a great disservice to its millions of readers, when he wrote an article entitled “Don’t Take Your Vitamins.”

He presented medical journal articles, about vitamins and specifically antioxidants, alleging that the studies show that vitamins do not help and indeed might be harmful.

The problem is that the studies he cites have major flaws that have been well documented.  The studies have been criticized for sub-optimal dosages, outdated formulations, and inadequate study duration. Indeed no integrative Dr. would give doses of a single antioxidant without a complement of other antioxidants to go with it.

In fact the Lewin Group estimated a $24 billion savings over five years if a few essential nutritional supplements were used consistently in the elderly. Literature reviews in the Journal of the American Medical Association and the New England Journal of Medicine also support this view.

My readers and patients know of my passion about vitamin D. The economic burden of vitamin D deficiency in the United States alone is estimated at $40 billion-$56 billion per year. It is estimated that if every American took 1000 IU of vitamin D per day that we would reduce the annual cost of cancer treatment by $16-$25 billion a year.

Several of my colleagues who have the time to review and write, have written excellent replies to the editor of the New York Times about this misleading articles . These replies do an excellent job of presenting the  flaws in, and the disservice done, to its readers by, this New  York Times article.

Here is a copy of a letter to the editor of the New York Times from the Institute of Functional Medicine, written for the Institute by both a prominent medical doctor and a very prominent naturopathic doctor.

Here is the letter:

June 12, 2013

To The Editor

Your article “Don’t Take Your Vitamins” (Opinion, June 8) puts readers at real risk by presenting an unbalanced, over- generalized perspective and selective attention to the body of evidence. First, the title gives a directive about the general category of vitamins, when the body of the article only addresses a subset of vitamins: anti-oxidants. Second, the article draws on studies with arguable design flaws (e.g., the Vitamin E used did not contain the full Vitamin E complex), when there are many vitamins and antioxidants whose benefits are supported by current research .Third, genomic science is proving that the best medicine is personalized. Yet the article cites population-based studies, which are known to be inadequate guides to individual care. Most importantly, should people with unique vitamin needs based on age, disease, medication, stress or genetics follow the advice of the article, harmful consequences are likely to develop.

Robert J. Hedaya, MD DFAPA, Clinical Professor of Psychiatry, Georgetown University School of Medicine, Washington, DC; Founder, National Center for Whole Psychiatry,

4701 Willard Avenue

Chevy Chase, Maryland 20815
Joseph Pizzorno, ND, Editor-in-Chief, Integrative Medicine, A Clinician’s Journal

4220 NE 135th St, Seattle, WA 98125.

In addition, an even more comprehensive and thorough critique of the New York Times article was written by my colleague Mark Hyman, M.D., who is the president of the Institute of Functional Medicine. His article is entitled “Why You Should Not Stop Taking Your Vitamins.” I urge you to read it.

You can read it HERE

In addition, HERE and HERE and HERE are more articles critiquing the studies that were referenced by Mr. Offit..

I urge you to discuss this with me or your integrative medicine doctor. I watch patients, with complaints that are not helped at all by conventional drugs, receive benefit every day by taking vitamins and nutraceuticals as part of  an integrative approach to their health care.

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I only had time to write this one article this week. Next week I will be talking about important discoveries about environmental pollution, mercury, and autism.

When I wrote my vitamin D book 4 years ago, I said more detailed studies would be forthcoming showing the relationship of vitamin D deficiency to many health conditions.  One of these was hypertension. I also predicted that these future studies which show a cause-and-effect relationship between low vitamin D and these diseases.

Now a new study from from University College London, after looking at more than 150,000 individuals internationally, has confirmed a CAUSAL association between low levels of vitamin D and hypertension.

With every 10% increase in serum vitamin D concentrations, there was a significant decrease in diastolic blood pressure.

Please note that this study is not proving that low vitamin D is an exclusive cause of hypertension! Rather as Dominic Sica, M.D. of Virginia Commonwealth University said in an interview “What creates hypertension in a person is never something as simple as a low vitamin D level. It’s in the context of body weight, salt and water retention, sodium intake, potassium intake, things of a similar ilk but this is one area now that we have more assuredness that there is a relationship.” He of course was referring to the relationship of vitamin D as a cause for  hypertension.

If you have friends or family who are being treated for hypertension by a cardiologist or primary doctor, please urge them to get a vitamin D blood test and normalize it.

In a new study published in JAMA Internal Medicine, it was found that people who followed a vegetarian diet had a lower risk for death from any cause. In addition, specifically men, also saw benefits for cardiovascular mortality.

All cause mortality was reduced by 12% according to Michael Orlich, M.D. who is the principal investigator in the study.

In men,  cardiovascular mortality was significantly reduced by 29% as was death from coronary artery disease which was also reduced by 29%, in men who followed this diet.

The authors are quoted as saying “Vegetarian dietary patterns have been associated with reductions in risk for several chronic diseases, such as hypertension, metabolic syndrome, diabetes mellitus, and ischemic heart disease, which might be expected to result in lower mortality.”

This was a very large study which was why it was able to be published in JAMA. They looked at over 73,000 participants, whose mean age was 58 and roughly 2/3 of the participants were women.

The follow-up was for almost 6 years and over that time there were over 2000 deaths.

There were no obvious reductions in deaths from cancer according to the researchers.Interestingly, women had no significant reductions in deaths from cardiovascular disease.

The authors stated “The heterogeneous nature of cancer may obscure specific diet – cancer associations in analysis of combined cancer mortality, and lack of significance may reflect insufficient power to detect weaker associations at early follow-up.” This basically means because there are so many different types of cancers, that they would have needed an even larger group of people to find statistically significant connections with all the types of cancer.

Robert Baron MD of the University of California at San Francisco wrote an invited commentary to the article. In it he said, “First and foremost, dietary advice needs to be given to patients based on their own dietary history and preferences, their motivation to change their diet, and their clinical circumstances.”.

I totally agree with this last statement as you cannot force anybody to change their diet. It has to come from within them. I know all my patients and readers will agree with  that.

Source Article

I, and most physicians and scientists are just delighted that the Supreme Court has finally ruled unanimously against a private corporation’s ability to own a gene. Specifically, this landmark ruling centered on patents for just two breast cancer genes, BRCA1 in BRCA2 which were held by a company called Myriad Genetics based in Utah. Although hundreds of mutated forms of these genes have been found, only a few are associated with an increased risk of breast and ovarian cancers. This was most recently brought to the forefront by actress Angelina Jolie who had a double mastectomy because she was positive on this gene testing.

This new decision by the Supreme Court will allow other companies to go into competition with Myriad Genetics, which will not only drive the price of the test down, but also allow innovation and expansion of testing capabilities. Their cost to the patient for this test has been $3000.

Nucleotides are the individual components of a gene. Justice Clarence Thomas in reading the opinion of the court stated “The location and order of the nucleotides existed in nature before Myriad found them.” This one sentence in the court’s opinion, explained why a company cannot own a gene.

Immediately following the Supreme Court’s ruling the cost of the BrCa test dropped to $995

See the Articles HERE and HERE

Wheat Belly Lose the Wheat, Lose the Wheat, and Find Your Path Back to Health is a very popular and controversial new book that has recently come out. In the last few months a new blood test for what is now called Non-Celiac Gluten Sensitivity has become available and I am doing this test on many patients at my office.

 In those patients who I find to be gluten sensitive, I’m seeing profound changes in their long-term health, and resolution of health problems that have been resistant to any other treatment from other physicians.

In addition, gluten sensitivity often creates what is popularly called “leaky gut”. This is an increase in the permeability of the lining of the small intestine. This condition is linked with many health problems including fatigue, headaches, gas, bloating, and all autoimmune diseases.

I encourage all of my patients and readers to consider giving up gluten for three months and then reintroducing it, to see if there’s any change in your health. For those in my practice, of course, you can ask me to do the gluten sensitivity and leaky gut blood tests for you when I see you in the office.

You can get the Wheat Belly book here 

or on Kindle here

Or for Busy people the 30 minute-read Summary kindle book here

It is estimated in the years ahead, that over that 50% of people over the age of 80 will have either Alzheimer’s or other type of dementia. Taking preventive measures while you are young and healthy, rather than waiting for a bad diagnosis, is what we should all be doing.

In addition dementia is now affecting more people under than age of 55 than ever before

In my practice, the thing that my patients fear the most at end-of-life is being demented and leaving a burden on their family for their care.

Basically, in his lectures, Dr Perlmutter explained how oxidative stress, which is like internal rusting, specifically in the mitochondria (the energy centers inside the cell), are a huge contributor to the underlying cause of Alzheimer’s disease. More and more medical articles are showing this.

In fact we now know that most chronic disease is linked in a causative way to oxidative stress. The most common example in our lives of oxidative stress is rusting. A major theory for the cause of all chronic disease aging is that we are “rusting” inside.

This is why for so long I have given antioxidants to my patients  and encouraged all my patients to eat fresh fruits and vegetables which are loaded with phytonutrients, which are mother nature’s antioxidants.

Dr. Perlmutter discussed this extensively in his lectures and showed us the biochemical pathways – which I will not bore you with – that lead to shrinking of the volume of a part of the brain called the hippocampus, which is directly linked to Alzheimer’s disease.

Some of the things he recommended to prevent age-related cognitive decline include:

1. Achieving an optimal body weight. In one study, at Kaiser Permanente, it was shown that individuals with high amounts of body fat were at an increased risk of Alzheimer’s disease of 293%, compared to those with low body fat, when followed up 27 years after their initial valuation.

2. Take antioxidants, specifically coenzyme Q 10. He also discussed the new category of antioxidants which I am very excited about which are called Nrf2 activators. Please talk to me about this when you see me in the office, as I am recommending this to ALL of my patients over age 30.

3. Keep your homocysteine low. All of my patients know that I annually measure my patients’ homocysteine level. Elevated homocysteine is associated not only with heart disease but also cancer and now Alzheimer’s disease. Cardiologists are not paying attention to this important risk factor, nor are neurologists. But in one study, a homocysteine level of just 14 was associated with a doubling of the risk for Alzheimer’s disease according to an article published in the New England Journal of Medicine. When you come to the office ask me about your homocysteine level.

4. Countless studies have shown a reduced risk for Alzheimer’s disease in those who exercised aerobically regularly. In fact in one study it was shown that aerobic exercise increases the size of the brain’s most important memory structure as mentioned above, the hippocampus. And now a new article just published in the Journal of Physical Activity and Health has just proven that Yoga improves brain function more than aerobic exercise! This is great news for all of us doing yoga on a daily basis.

We now have, in my office, technologies to measure your degree of oxidative stress and the tools to reduce it. I would be most happy to talk with you about these with your next office visit.

For more information about this I refer you to Dr. Perlmutter’s article for laypeople on the subject at this link.

And you can find his book called Power Up Your Brain here

Or on Kindle here

I want to be sure that all my patients saw the rather controversial article on the cover of the New York Times Magazine last week. It was about breast cancer and the whole conversation about whether mammograms done annually are helpful at all. The author Peggy Orenstein,  is a famous writer who is a breast cancer survivor. She brings out many interesting perspectives from both sides of the breast cancer story.

As you know, epidemiologic studies have shown that if every woman in America had a vitamin D blood level above 52 ng/mL,  we would  reduce the incidence of breast cancer by 50%. Some day when the drug companies are not watching this will appear on the front page of a  newspaper! 

Right now, I cannot get anybody in the breast cancer movement to hear me when I say this.

I believe that the whole thrust for breast cancer research should be on prevention, rather than all the money going to developing new chemotherapy.

I will appreciate your thoughts.

READ THE NEW YORK TIMES ARTICLE HERE