On March 23, I will be giving a seminar on "Surviving
Stress and Thriving in the 21st Century". Given the
circumstances in which we live, I consider this to be the most vital of
The negative effects of stress reach into every
aspect of our lives and health. Stress challenges our ability to
maintain healthy digestive, cardiovascular, reproductive, and immune
systems. It takes away the ability to enjoy restful sleep, makes
emotional balance and relationships difficult, destroys the ability to
concentrate, and makes us more susceptible to illness. And these are the
aspects of stress that are perhaps the least serious. In fact, 9 out
of the top 10 causes of death and disability can be directly or indirectly
attributed to the effects of stress!
Stress causes changes in body chemistry by altering
the balance of hormones in a way that negatively effects your entire body.
It would be ideal to avoid those situations that
cause stress, but that is simply impossible. In fact, even happy events
cause your body to have a stress response!
Each one of us responds to stressful situations in
different ways. Ultimately, how you respond to stress combined with your
body's ability to handle stress at the hormonal/chemical level determines
the effect it will have on your health.
The good news is that there are highly effective
methods of dealing with stress at both the emotional/mental level and at
the neuro-chemical/hormonal level. The even better news is that
implementing these strategies in your life will have benefits that include
not only avoiding the diseases of stress, but will also improve energy
levels, sleep, digestion, love-making, and enjoyment of all of life's
"Surviving Stress and Thriving in the 21st
Century" will be the first in a series of experiential/learning
seminars designed to radically improve the quality of your life. You
This first seminar is open to (and truly needed by)
everyone, whether or not you are currently my patient. It will be
held on March 23, 2002 at the beautiful Ruach Ranch in Topanga
Canyon. This event will start promptly at 2:00pm and continue until
6:00pm. The cost will be $45.00 or $85.00 for couples. Space is very
limited, so if you are interested, contact me as soon as possible by Clicking
Here (go to bottom of page) or by calling 310-293-9475.
- Hour 1 - What are the different types of stress;
how to recognize the effects of stress; what diseases and conditions
are caused by or contributed to by stress; how does stress affect the
- Hour 2 - Nutritional and herbal strategies to
stay healthy and thrive despite stress
- Hour 3 - Physical exercises that can be
performed daily to reduce the effects of stress
- Hour 4 - Using the mind to reduce stress.
How to deeply relax and rejuvenate the body; using sound and
music to help the body/mind/spirit to heal; an experiential sound
healing session featuring Dr. Grossman and Marla Leigh
Please feel free to forward this vital information
with friends and family.
As always, your questions, comments, and suggestions
Medical Morbidity and Mortality:
National Academy of Sciences Institute of Medicine, Nov., 29, 1999
- Medical errors in and out of the hospital total
more than 7 million per year in the US
- Medical errors exceed workplace injuries
- More people die each year from medical errors
than from highway accidents, breast cancer, or AIDS combined.
An interesting quote:
"...44,000 to 98,000 people die each
year because of mistakes by medical professionals. That's probably
an underestimate because there are different kinds of errors we never
learn about because they are never written down & because studies did
not look at areas of care like home care, nursing care, & ambulatory
care centers." Berwick, MD., Institute of Medicine
Anti-Inflammatory Drugs (NSAIDs):
Wolf MM, New Eng J Med
- 103, 000 hospitalizations per year
- 16,500 deaths per year
- Similar to total deaths from AIDs
Death Rate Among Patients Taking NSAIDs for at
Least 2 Months (chronic use):
- 1 in 1,200 - Trammer; Pain
"If deaths from GI toxic effects of NSAIDs
were tabulated separately, these effects would constitute the 15th most
common cause of death in the US." Wolf MM, New Eng J Med
Adverse Drug Reactions: Correct drug given and
taken properly by the patient.
Annual Costs of Drug-Related Morbidity (injury):
- 106,000 deaths per year - Jol. of
the American Medical Assoc. 279:1200-1205, 1998
- $76.6 Billion - Archives of
Internal Medicine 155:1949-1956, 1995 (No doubt it is now in excess of
Hospital Acquired Infections:
- 2 million per year
- 90,000 deaths each year
- $4.5 billion a year in health care costs
Manning A. USA Today March 15, 1998
Young Women who delay childbirth until their thirties are at increased
risk of developing breast cancer, according to a study of 91,000
women. Women whose periods start earlier than average are also at a higher
risk. But having a miscarriage does not increase the risk of developing
Francoise Chavel-Chapelon and colleagues at INSERM, the French National
Institute for Health and Medical Research, tracked the women, aged between
40 and 65, over a ten-year period. Compared with women who gave birth
before the age of 22, those who had their first child in their thirties
were 63 per cent more likely to develop breast cancer before the
menopause, and 35 per cent more likely to develop the disease afterwards.
Women who remained childless had the highest risk of all. Changes to
breast cells in the third trimester of pregnancy are thought to protect
the breasts from cancer.
The team also found that women who had started menstruating at the age
of 15 had two thirds the risk of developing breast cancer before the
menopause , compared with someone whose periods started at 11. Extremely
complex Previous research on miscarriage had produced conflicting results,
with some studies suggesting it might increase the risk of breast cancer.
But the new study found no evidence of a link. "In the past, the fear
of breast cancer has added to the anxiety already felt by women who have
miscarried. I'm very glad to be able to allay those fears," says
Chavel-Chapelon. Gordon McVie, joint director general of Cancer Research
UK, welcomes the new findings. "The link between reproductive
factors, fluctuation in hormones and women's breast cancer risk is
extremely complex, and previous small-scale studies have often produced
confusing and conflicting results. "Only by looking at very large
numbers of women, as this study has, can we start to build up a picture of
how and why breast cancer develops."
Journal reference: British Journal of Cancer (vol 86)
Comment: The mechanism by which childbirth reduces the
incidence of breast cancer is currently thought to occur by reducing the
total time that breast tissue is exposed to estrogen, which is the same
reason why Hormone Replacement Therapy also increases this risk. It
is important to know that there are safe nutritional and herbal
supplements that also help normalize estrogen levels. Also there are a
great number of lifestyle related risk factors that can be used to further
reduce risks. My feeling is that by doing so, the overall risk of
breast cancer can be reduced dramatically.
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"Use It Or Lose
It?" Study Suggests Mentally Stimulating Activities May Reduce
In recent years, many of us have come to believe
that doing crossword puzzles or playing cards might ward off a decline in
memory or help us maintain “brainpower” as we age. Now, a new study
suggests there might be some truth to the use-it-or-lose-it hypothesis.
The study, by scientists at the Rush Alzheimer’s Disease Center and
Rush-Presbyterian-St. Luke’s Medical Center in Chicago, IL, appearing in
the February 13, 2002, Journal of the American Medical Association, found
that more frequent participation in cognitively stimulating activities is
associated with a reduced risk of Alzheimer’s disease (AD). The research
looked at everyday activities like reading books, newspapers or magazines,
engaging in crosswords or card games, and going to museums among
participants in the Religious Orders Study, an ongoing examination of
aging among older Catholic nuns, priests, and brothers from several groups
across the U.S. On a scale measuring cognitive activity -- with higher
scores indicating more frequent activity -- a one-point increase in
cognitive activity corresponded with a 33 percent reduction in the risk of
The examination of cognitively stimulating activities and risk of AD
was conducted by Robert S. Wilson, Ph.D., and colleagues at the Rush
Alzheimer’s Disease Center, including David A. Bennett, M.D., principal
investigator for the Religious Orders Study, and Denis A. Evans, M.D.,
director of the National Institute on Aging (NIA)-supported Rush Alzheimer’s
Disease Center. The NIA is part of the National Institutes of Health,
Department of Health and Human Services.
The findings are likely to strike a chord among middle-aged and older
people interested in preserving cognitive health. “We are asked
constantly about this use-it-or-lose-it approach to maintaining memory,”
says Elisabeth Koss, Ph.D., Assistant Director of the NIA’s Alzheimer’s
Disease Centers Program. “This study provides important new evidence
that there may be something to the notion of increased cognitive activity
and reduced risk of Alzheimer’s disease. Further research should help
better sort out whether cognitive activities can be prescribed to reduce
risk of AD and why that may be so.”
The study followed over 700 dementia-free participants age 65 and older
for an average of 4.5 years from their initial assessments. At baseline
and then yearly, some 21 cognitive tests were administered to assess
various aspects of memory, language, attention, and spatial ability. At
the initial evaluations, participants also were asked about time typically
spent in seven common activities that significantly involve information
processing – viewing television; listening to the radio; reading
newspapers or magazines; reading books; playing games such as cards,
checkers, crosswords, or other puzzles; and going to museums. The
frequency of participating in each activity was rated on a five-point
scale, with the highest point assigned to participating in an activity
every day or about every day and the lowest point to engaging in an
activity once a year or less.
During the follow-up period, 111 people in the study developed AD. In
comparing the levels of cognitive activity with diagnosis of AD, the
researchers found that the frequency of activity was related to the risk
of developing AD. For each one point increase in the participants’
scores on the scale of cognitive activities, the risk of developing AD
decreased by 33 percent. On average, compared with someone with the lowest
activity level, the risk of disease was reduced by 47 percent among those
whose frequency of activity was highest.
The researchers also looked at general cognitive decline among the
participants. Over the period of the study, the group of older people
showed modest age-related declines on several types of memory and
information processing tests. There were lower rates of decline, however,
in working memory, perceptual speed, and episodic memory among people who
did more cognitively stimulating activities.
What accounts for the association between cognitively stimulating
activities and reduced risk of cognitive decline and AD is unclear. It may
be, some scientists theorize, that cognitive activities are protective in
some way. Some speculate that repetition might improve the efficiency of
certain cognitive skills and make them less vulnerable to the brain damage
in AD. Or, some kind of compensatory mechanisms might be at work,
strengthening information processing skills to help compensate for
age-related declines in other cognitive areas. The study does not,
however, eliminate the possibility that people who develop AD in future
years may be less prone, years before, to engage in cognitively
stimulating activities. Notes Wilson, “The associations among cognitive
activity, Alzheimer’s disease, and cognitive function are extremely
complex. Additional study, including testing some of these activities as
cognitive interventions, will help to tell us whether such enjoyable and
easy-to-do activities could be employed in some way to reduce the risk of
memory decline and loss.” Because the participants in the study have
agreed to brain donation, the investigators hope to be able to determine
the mechanism underlying the association between cognitive activities and
cognitive decline. More than 900 older Catholic clergy from 40 groups
across the U.S. are participating in the Religious Orders Study. All
participants have agreed to annual memory testing and brain donation at
the time of death. “We are grateful for the remarkable dedication and
altruism of this unique group of people,” says Bennett. “I expect we
will learn a great deal more from them, as we look for insights into how
the brain functions with age.”
The NIA leads the Federal effort to support and conduct research on
aging and on AD. The Rush Alzheimer’s Disease Center is one of 29
NIA-supported Alzheimer’s Disease Centers across the U.S. which conduct
basic, clinical, and social and behavioral research on dementia and AD.
NIA also sponsors the Alzheimer’s Disease Education and Referral (ADEAR)
Center, which provides information on AD research to the public, health
professionals, and the media. ADEAR can be contacted toll free at
1-800-438-4380 weekdays during business hours or by visiting its website,
www.alzheimers.org. Press releases, fact sheets, and other general
information materials on aging and aging research can be viewed at the NIA’s
home website, http://www.nia.nih.gov.
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By Merritt McKinney
NEW YORK (Reuters Health) - High levels of the amino acid homocysteine
may increase the risk of developing Alzheimer's disease (news
sites), researchers report.
In a new study, the risk of Alzheimer's was nearly doubled in people
with high levels of the amino acid.
The study raises the possibility of staving off dementia by consuming
more folic acid and vitamins B6 and B12, which can lower homocysteine
But the study's first author emphasized that the research does not
prove that lowering homocysteine levels will prevent Alzheimer's.
Still, Dr. Sudha Seshadri of Boston University School of Medicine in
Massachusetts told Reuters Health that eating a low-fat, nutrient-rich
diet is always a good idea.
"Our study is observational and cannot be used as a basis for
treatment recommendations," she said. But the results should
encourage future trials to study the effects of vitamin supplements and
lowering homocysteine levels on the development of dementia, she said.
Prior research has shown that elevated levels of homocysteine may
increase the risk of heart disease and stroke. Diet has a major effect on
homocysteine levels. Folic acid and other B vitamins may lower
homocysteine levels by breaking down the amino acid. The benefits of
lowering homocysteine levels have not been proven, however.
The evidence linking homocysteine to dementia and Alzheimer's is mixed.
Some studies have detected elevated homocysteine levels in people with
Alzheimer's, but another study found that homocysteine levels did not
affect the risk of developing dementia.
Now Seshadri and colleagues, under the leadership of Dr. Philip A. Wolf
at Boston University, report that elderly men and women with high levels
of homocysteine seem to have an increased risk of Alzheimer's.
The researchers followed 1,092 people who did not have dementia when
they enrolled in the study between 1976 and 1978. Participants had their
homocysteine levels measured between 1979 and 1982 and again between 1986
After an average of 8 years of follow-up, 111 participants developed
dementia. Alzheimer's was thought to be the cause in 83 cases.
People with the highest level of homocysteine were nearly twice as
likely to develop dementia or Alzheimer's disease as those with the lowest
level, the authors report in the February 14th issue of The New England
Journal of Medicine (news
sites). The association between homocysteine levels and dementia was
still present even after the researchers accounted for various factors
that could have affected the results, including age, sex, blood levels of
vitamins and the presence of an Alzheimer's-linked gene type.
Patients who had consistently high levels of homocysteine in their
blood were most likely to develop dementia, according to the report.
The study provides "convincing evidence" that high
homocysteine levels put the elderly at risk for Alzheimer's disease or
other forms of dementia, according to Dr. Joseph Loscalzo of Boston
University Medical Center.
Since certain B vitamins and other nutrients can reduce homocysteine
levels, Loscalzo notes in an accompanying editorial, "It is
intriguing to contemplate the possibility that consumption of these
vitamins might prevent the development of Alzheimer's disease and other
This approach must be tested in clinical trials first, however, he
In her comments to Reuters Health, Seshadri pointed out that the
National Institute on Aging, which funded the current research, is already
planning a study to see whether high doses of folic acid and vitamins B6
and B12 can prevent or slow the development of Alzheimer's.
SOURCE: The New England Journal of Medicine 2002;346:466-468,476-483.
Comment: This is an important study. However about one
in five people have deficiencies of an enzyme that helps convert folic
acid into a usable form. For these people, high levels of folate,
perhaps five-times the recommended dose would be necessary.
Fortunately, a new form of folate has just been developed that bypasses
this enzymatic step. Please contact me for more information.
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By Merritt McKinney
NEW YORK (Reuters Health) - For anyone who watches television or reads
magazines, where ads for prescription drugs have become commonplace, the
results of a new study will come as no surprise. Since the mid-1990s,
pharmaceutical companies have tripled the amount of money they spend on
advertising prescription drugs directly to consumers, researchers report.
Despite the huge increase, drug companies continue to direct the
overwhelming majority of their advertising spending toward physicians, not
consumers. And most direct-to-consumer advertising is concentrated on a
Still, some physicians and health professionals are concerned that
advertising drugs and medical tests directly to consumers interferes with
the doctor-patient relationship and may raise medical costs by trumpeting
expensive new medications.
Spending on prescription drugs is on the rise and is now the fastest
growing portion of healthcare spending in the US. This increase is due no
doubt in part to a rise in the number of effective medications, but
"there is widespread concern" that part of the increase is due
to advertising of drugs that do not provide better care, Dr. Meredith B.
Rosenthal of Harvard School of Public Health in Boston, Massachusetts, and
colleagues state in a report in the February 14th issue of The New England
Journal of Medicine (news
Though broadcast advertising of prescription drugs has been legal for
years, guidelines released by the Food and Drug Administration (news
sites) (FDA) in 1997 clarified the rules for advertising directly to
consumers. According to these guidelines, drug companies can fulfill their
obligations for informing consumers about prescription drugs by referring
in advertisements to four sources of additional information: their doctor,
a toll-free number, a magazine or newspaper ad and a Web site.
Rosenthal and her colleagues conducted the first study to measure
patterns in direct-to-consumer advertising before and after the FDA
guidelines were released.
From 1996 to 2000, spending on these ads more than tripled, rising from
$791 million to nearly $2.5 billion, the researchers report.
"There has been a dramatic growth in advertising of prescription
drugs," Rosenthal told Reuters Health. Most advertising dollars are
spent on television ads, she said.
"It is important to put this in context, however," Rosenthal
said. She noted that pharmaceutical companies still focus most of their
attention on physicians. In fact, more than 80% of their promotional
budgets target health professionals, she said.
Rosenthal also noted that drug companies market only a small group of
drugs directly to the public. The study found that the top 20 most
advertised drugs--including household names such as Viagra and
Claritin--account for 60% of all direct-to-consumer dollars spent by the
pharmaceutical industry. For the most part, pharmaceutical companies tend
to concentrate their advertising budgets on newer drugs or ones that have
no generic competition, Rosenthal and her colleagues note in the report.
"We can't say for sure what caused the renewed interest in
marketing directly to consumers," according to Rosenthal. The trend
had already started by the time the FDA released the guidelines in 1997.
These guidelines might have been a response to the surge in consumer
advertising, she said.
"The big question, of course, is whether advertising leads to
improvements in health or unnecessary spending and inappropriate
treatment," Rosenthal said.
Unfortunately, according to the Harvard researcher, there is no solid
evidence "on the appropriateness of prescribing that results from
consumers requesting an advertised drug."
"For now, the jury is still out on the public health effects of
direct-to-consumer advertising of prescription drugs," she said.
Direct-to-consumer medical advertising is not limited to pharmaceutical
industry, however, researchers point out in a second report in the same
"Increasingly, entrepreneurs, including physicians, are offering
to the general public high-technology screening tests that are not covered
by most health insurance plans," according to Drs. Thomas H. Lee and
Troyen A. Brennan at Harvard Medical School (news
Two commonly advertised tests are electron-beam computed tomography
(CT) to screen for undetected coronary artery disease and low-dose spiral
CT to screen for lung cancer and other malignancies.
For people thinking about paying to have one of these screens, Lee told
Reuters Health, "This is not a good way to spend your money."
These tests are perfectly legal, but their benefits for detecting these
diseases in low-risk people who have no symptoms have not been proven, Lee
and Brennan note in their report.
When and if these tests prove valuable, health insurance plans will
start to cover them, Lee said.
"In the meantime, there is a pretty good chance that an abnormal
test will be needlessly frightening to you and a negative test will be
giving false reassurance," Lee said.
The Harvard researcher noted that doctors do not know what to do with
the information these tests provide. This uncertainty is normal, he said,
and will be resolved within a few years.
"In the meantime, there is no reason to throw away your money to
enrich entrepreneurs," according to Lee.
What is even more troubling than the unconfirmed accuracy of these
tests is that patients must undergo invasive diagnostic procedures to
confirm the results, according to Dr. Jeffrey M. Drazen, the
editor-in-chief of the journal. These tests have high false-positive
rates, so the results have to be confirmed.
"I am sure that there will be anecdotes about people who believe
that their lives were saved by the early discovery of such lesions,"
Drazen notes in an editorial.
"But these stories will be counterbalanced by untold stories about
those who suffer from the inevitable complications of diagnostic
procedures that are required in order to prove that an incidentally
discovered lesion was benign," he writes.
Despite claims by the pharmaceutical industry that direct-to-consumer
advertising is educational, the public is often misinformed about these
ads, according to Dr. Sidney M. Wolfe, of the Public Citizen Health
Research Group in Washington, DC.
He points out in an accompanying editorial that one study found that
"a substantial proportion" of people mistakenly believe that the
FDA reviews all ads before they are released and allows "only the
safest and most effective drugs" to be promoted directly to the
Though a ban on direct-to-consumer advertising would be
unconstitutional, Wolfe urges the FDA to increase its control over such
ads. He points out that FDA actions to enforce advertising rules have
decreased as direct-to-consumer pharmaceutical advertising has mushroomed.
"The education of patients--or physicians--is too important to be
left to the pharmaceutical industry," whose primary aim is to promote
drugs, according to Wolfe.
"Public Health Service agencies such as the National Institutes of
sites) and the FDA, along with medical educators in schools and
residency programs, must move much more forcefully to replace tainted drug
company 'education' with scientifically based, useful information that
will stimulate better conversations between doctors and patients and lead
to true empowerment," he concludes.
But a representative of the drug industry asserts in another editorial
that direct-to-consumer advertising can enhance the physician-patient
Alan F. Holmer, of the Pharmaceutical Research and Manufacturers of
America in Washington, DC, a drug industry trade group, notes that drug
ads may prompt patients to talk with a doctor about a previously
undiscussed medical condition.
"Direct-to-consumer advertising does not replace the
physician-patient relationship," according to Holmer. "Its
purpose is rather to encourage an informed discussion between patient and
Although advertising can inform the public, it is important for
patients to remember that it is "simply advertising," according
to Drazen, the journal editor.
"It should not be confused with medical advice given in the best
interest of the patient by a learned intermediary," he concludes.
One of Rosenthal's co-authors has served as a consultant for several
SOURCE: The New England Journal of Medicine 2002;346:498-505,524-531.
Comment: I find direct to consumer advertising of drugs to be
deplorable. I also find it deplorable that physicians receive much
of there information directly from drug company representative, are given
perks for prescribing certain drugs, and will generally disdain any form
of nutritional or other natural treatments that can help people avoid
these powerful and often dangerous substances. Please, please,
please, read the fine print on these advertisements. Please be educated in
their possible dangers and side effects. Over 100,000 people die
each year from the side effects of properly prescribed and properly dosed
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