Medicine for People!

November 2002

Contents

• Inflammatory Proteins and Heart Disease
• Medical Ethics For Sale
• Multilevel-Marketed Multiple Vitamins
• Letters
•   More about discount prescription drugs
•   More about prevention and treatment of influenza
•   More about ear candles

Inflammatory Proteins and Heart Disease
Not everyone who suffers a stroke or heart attack has a high level of cholesterol. The multiple factors leading to blood vessel disease include not just cholesterol but also free radicals, homocysteine, and the process of inflammation.

Inflammation????
We are all familiar with minor inflammations such as a pimple (a tiny inflamed skin gland) or tendonitis (an inflamed tendon). This kind of localized inflammation is not detectable on a blood test. However, some more serious diseases, such as rheumatoid arthritis, Lyme's disease, certain forms of colitis, and many others, cause a widespread inflammatory response in the body. Many people who feel otherwise well can have a subtle degree of this inflammation. This type of "whole body" inflammation can increase your chances of a heart attack.

The Blood Test
A blood test called C-reactive protein measures whole body inflammation. A recent study in the New England Journal of Medicine found that C-reactive protein is a better predictor of heart disease than is cholesterol. Here is some in depth information.

We have been offering this test to our patients for several years. We hope soon to add it to our standard panel.

Soothing Whole Body Inflammation
If your C-reactive protein is high, we check for hidden sources of inflammation and treat them. In addition, we recommend that you exercise, maintain a normal weight and blood pressure, avoid sugar and refined foods, eat fresh fruit and vegetables, and avoid stress. Surprise!

So, you may ask, what is the use of the test when you already know to do those things? The answer is that knowledge is a great motivator. The test tells you whether you are doing enough of these things or whether you would benefit from doing more. In addition, the test gives you a much more accurate idea of your risk of stroke and heart disease.

Medical Ethics For Sale

We know that the slick color pamphlet we get in the mail is selling something. Would you look at an research study in a respected medical journal with the same jaundiced eye? Well, it is time to start.

Although just ten years ago about 75% of medical research was funded by academic medical centers, today 66% of that reseach is performed by pharmaceutical companies or a "private research firm". Many of these private research firms are owned by advertising agencies. "My, what a strong paw you are putting into the medical research area," said Little Red Riding Hood. "The better to sell you wonderful new drugs, my dear," replied the Big Bad Wolf.

For the whole sorry story, including...

• advertising agencies buying into private research firms so that they can influence the Federal Food and Drug Administration
• manipulation and misrepresentation of research findings to improve profit margins
• medical journal articles written not by the prestigious physician-author who claims credit, but by pharmaceutical-industry-paid ghost-writers
• physicians wined, dined, paid, and often flown to expensive destinations. Then pharmaceutical company pawns use company research to convince them to prescribe that company's drugs. It works, too. Drug sales soar and stock prices go up!

Multilevel-Marketed Multiple Vitamins Versus Fruits and Vegetables
Question: What do you think of USANA or Juice Plus as supplements?

USANA
Some years ago when USANA was marketed heavily here, I looked carefully at their literature. One thing that struck me was a series of illustrations showing a vertical bar for each of many nutrients - The longer the bar, the more of the nutrient in the vitamin tablet. USANA took their own nutrient levels as the "standard" so the graph for USANA showed some twenty bars all nicely lined up perfectly evenly at the "standard amount" height. Comparative illustrations of vitamins from company "A" and company "B" showed bars that were lower for some nutrients higher for others. The bars didn't line up evenly!

Presumably if company "A" had made up the illustrations, their nutrient amounts would be the "standard." They could have printed up similar illustrations showing that their bars lined up evenly but USANA's didn't.

Unfortunately, there is no one supplement formula that is best for everyone. In the office we have a free handout covering amounts of vitamins taken by those who enjoy the best health. Nonetheless, individual needs and priorities vary. It is always best to work with a physician to establish a vitamin and mineral routine.

Juice Plus
Juice Plus contains processed juice of fruits and vegetables. The company publishes a study showing their product improves immune function. However, the manufacturer of the product funded the study. The manufacturer, Natural Alternatives International, even supplied a couple of the researchers. For more about this company, check out this website. I won't vouch for every single fact in this hatchet job, nor I would be surprised to find every word to be true. And I know these kind of shenanigans are not unusual. But I think you need to be aware of what goes on behind the curtain.)

If you check out the Juice Plus website, you'll see a comparison between two JuicePlus "Orchard Blend" capsules and 8 ounces of fruit juice. Their tables show that, in comparison to the orange juice, their capsules contain twice the vitamin C and 33% more vitamin B. In comparison to eight ounces of mixed fresh vegetable juices, Juice Plus capsules contain about 4% more beta carotene/vitamin A, 33% more folic acid, but only about 80% of the calcium.

However, if you are looking for a good source of supplemental vitamins A, B, C, folic acid, and so forth, you'll need to look somewhere else. Friends, these are not real tremendous amounts. Given that there is solid evidence that larger amounts of these antioxidant and other vitamins can reduce the risk of Alzheimer's, heart disease, and cancer, I do not think anyone can make a reasonable case that these relatively small amounts in Juice Plus can substitute for an adequate multiple vitamin-mineral.

Nor do these products substitute for fresh fruit and vegetables. What is in fresh fruits and vegetables is life. Why do we eat only living things, and not rocks and silicon chips? Because only life has the ability to organize itself, to turn something as disorganized as soil and sunshine into something quite organized such as a flower, a fruit, or a seed. This is why we eat living things such as fruit, vegetables, and other animals, to take the orderliness and life from them. One of the selling points of JuicePlus and similar products is that it contains some indefinable something that is in the fresh fruit and vegetables. When we dry and process living things, they lose some of their order and their life, and they are not as nourishing.

So, if you want higher doses of vitamin E, take a concentrated form of vitamin E. But you MUST, if you want to remain healthy, focus your diet on fresh fruits and veggies as well as quality dairy, meat, fish, etc.

One final word: if you take the above supplements, don't feel bad. They do you SOME good. If you take them and they make you feel better, then trust your feeling and continue to take them. We are all different; don't let me interfere with what works for you! OK?

We get mail

Discount Prescription Drugs
Dear Doc:
In regard to your article last month about internet pharmacies, I recently purchased "Avapro" from halfoffmeds.com. 90 day supply cost $89 compared to $150 locally. The tablet itself looks the same as the one I got locally and the bottle does have a "Distributed by Bristol-Meyers, Squibb" label, of course it is from Montreal. I believe the package was shipped from Edmonton, Alberta. Shipping was $10, which would cover your whole order if you ordered more than one item.

I will probably continue ordering from them if I don't find anything cheaper.

Dear Helpful Reader:
Thanks for sharing your experience.

Prevention and Treatment of Influenza
Dear Doc:
I just wanted to mention Tamiflu to you. It is a new drug that actually kills the influenza virus and has been shown to greatly shorten the duration of flu if given early in the infection. I believe it has also been approved for prevention (like in a nursing home situation). We have an internist friend who swears by it, and he has a large population of older folks. Of course it is specific for influenza, and I think Jim uses an in-office diagnostic test for influenza. It might be good for households to have on hand, (as we do).

Dear Thoughtful Reader:

Tamiflu (and its cousin Relenza) are effective against influenza A and the less common and less virulent influenza type B.

We have not been recommending Tamiflu or Relenza because they are expensive! An article in the American Journal of Medicine (2002 Sep;113(4):300-7) compared the different antiviral drugs for cost and effectiveness. Here are some quotes:

"Amantadine costs $9.06 per illness day avoided or $11.60 per quality-adjusted day gained. Compared with amantadine, zanamivir (Relenza) costs $198 per illness day avoided or $185 per quality-adjusted day gained, whereas oseltamivir (Tamiflu) costs $252 per illness day avoided or $235 per quality-adjusted day gained."

Amantadine and rimantadine are no longer effective for influenza, most strains of the virus now being resistant.

Most "flu-like" illnesses are caused by viruses other than influenza A or B.

Ear Candles
Dear Doc:
A mad scientist at heart, I did the experiment of burning the ear candles without an ear under them. You should see the wax that thing pulled out of thin air!

Golleeee, who'd a thunk the air needed such a cleaning!

HA HA.

Dear Mad Scientist:
Maybe you found the solution to pollution!

Medicine for People! is published by Douwe Rienstra, MD at Port Townsend, Washington. Edited by Carolyn Latteier.

Subscribe | Previous issues | Contact Dr. Rienstra | More information