Dr. Gerstmar's Thoughts on Health, Happiness, and Well-Being from Aspire Natural Health

“Success in America is definitely defined by how much money you’ve made, not by how happy  you are with your life.”

That’s a quote from a young girl in the trailer for The Race to Nowhere, an interesting and relevant view of what we are doing to our kids in the name of helping them to be more successful.  The trailer is 3 minutes long and worth watching.

“We live in a society today where you have to smart, but you also have to be pretty, but you have to do sports, you have to be involved in arts, and amongst all that you have to find something unique about yourself and you have to know yourself because if you don’t know yourself  before you do all that, you’re going to lose yourself.”

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Desertification, the process by which fertile lands become deserts is a serious and increasing problem in much of the world.  Because of ecologically unfriendly practices, clear-cutting forests, plowing up ground to use as crop fields, over-grazing animals, etc. a growing portion of once fertile land is literally turning into desert.  How to deal with it is a huge issue, and how to turn it back into fertile land once again is an even bigger issue?  How much technology and how much money do we need to spend?

Allan Savory was recently awarded the Buckminster Fuller aware for 2010 for his pioneering work using a simple, low-cost, low-effort technique he calls “holistic management” in which he imitates nature, and has shown that barren land can become fertile land once again.  Traditional management of grazing animals is to keep a modest number of them in an area and keep them moving so that they do not cause too much damage to an area.  Overgrazing, where too many animals are kept on too little land, means the animals eat the majority of the plants growing there allowing the soil to wash away and the land to become barren.  Savory’s technique rests on the recognition that in Africa traditionally massive herds of migrating animals would move over the land.  He found by imitating this, that is by stocking a piece of land very intensively for a very short period of time the large number of animals would churn the ground with their hooves and work their manure into the ground fertilizing it.  Then the animals would move on, giving the remaining plants and the now fertilized ground time to recover.

Very, very cool.  A low tech, low cost way to help recover and restore destroyed ground.  Rather than trying to improve on nature or supplant nature, instead by studying it, understanding it and imitating it we are often able to accomplish far more.  As a Naturopathic doctor, that is always one of my goals, to understand why and how the body is doing what it is doing, and to assist it in returning to health, rather than trying to replace it or force it.  And our results often far exceed what we could do otherwise.

To see the full article, look here:

http://www.fastcompany.com/1655491/plan-to-turn-deserts-green-wins-2010-buckminster-fuller-challenge

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Another piece from Dr. Michael Eades recent blog post (http://www.proteinpower.com/drmike/supplements/sunshine-superman) talking about one of the causes of fibromyalgia, vitamin D deficiency.

“…the huge epidemic of fibromyalgia we are seeing today is in great measure a consequence of vitamin D deficiency.  Without enough vitamin D, bone doesn’t harden as it should.  It grows, but is softer and mushier and less supportive than it should be.  The body continues to make more bone to try to remedy the problem and the bones actually enlarge.  This enlargement presses against the periosteum, the fibrous sheath that surrounds the bone and through which the nerves run.  As the pulpy bony growth presses against the periosteum, it stimulates the nerves in the periosteum and causes the deep bone pain common to sufferers of fibromyalgia.  Doctors who are up to date on their vitamin D knowledge will press the breastbone to try to elicit pain.  And if they do, their patient is probably suffering from a vitamin D deficiency.  If that’s what the blood test shows, then the fibromyalgia can be treated with a course of sunshine and/or vitamin D supplementation.”

A fascinating idea and I’ve definitely seen fibromyalgia patients improve with vitamin D supplementation.  I do not however think this is the only cause of fibromyalgia.  One of the flaws I have with conventional medicine is its insistence on trying to simplify things to one cause-one treatment.  While this works well for a few things like some infectious diseases, my experience has been it works very poorly for complex, chronic diseases.  Of which fibromyalgia is one.  Is all fibromyalgia caused by vitamin D deficiency?  I don’t think so.  Is some?  Yes.  If you have fibromyalgia should one of the very first things you try be Vitamin D?  Absolutely.  Vitamin D is cheap, effective, benefits your health in a vast multitude of ways and is virtually non-toxic.  Have you doctor test your 25-OH D3 levels to establish a baseline and use sensible sun exposure and Vitamin D3 supplements to bring your levels up into the optimal range of 60-80 ng/dL.

For more on fibromyalgia I highly recommend you check out Dr. Jacob Tietelbaum’s work.  You can visit his website at: www.endfatigue.com.

He lays out a very comprehensive plan for treating chronic fatigue and fibromyalgia that is holistic in nature: Sleep, Hormones, Infections and Nutrition with each area needing to addressed in order to provide healing.  At its heart Dr. Tietelbaum believes fibromyalgia and chronic fatigue are diseases of inadequate energy production.

Dr. John Lowe at www.drlowe.com believes fibromyalgia and chronic fatigue are fundamentally a disorder of thyroid hormone and has found that a program of healthy diet and lifestyle, moderate scaled exercise, and the monitored intelligent use of thyroid hormone brings great relief to patients.  Since we understand that thyroid hormones control the metabolism of the body and therefore energy production this seems to fit well with Dr. Tietelbaum’s theory of fibromyalgia.

As a Naturopathic doctor my goal is to take the best therapies available and use them.  When a fibromyalgia or chronic fatigue patient comes to see me I use all of these ideas.  We test and replete vitamin D, we test the thyroid and use thyroid hormone if appropriate, we normalize sleep, treat infections and improve nutrition.  I would also add that often we see defects in liver detoxification pathways and often the patient is very toxic, and we need to correct these pathways and help the patient detoxify in order for them to recover their health.  If you have chronic fatigue or fibromyalgia don’t let anyone call your crazy, and don’t let a doctor blow you off.  You can get better.  Find a doctor or other healthcare practitioner who will work with you and use some of these effective non-mainstream therapies to help you recover your health.

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A fascinating discussion posted by Dr. Michael Eades at his blog (http://www.proteinpower.com/drmike/supplements/sunshine-superman)

“Dr. Holick begins his book with a fascinating comparison of a ten-year-old girl growing up somewhere along the equator to a ten-year-old girl growing up in the United States or Europe.  The former will probably never learn how to use a computer, never go to a mall, never learn to drive a car and will probably end up spending most of her life outside tilling the soil as did her parents and grandparents.  She will probably experience periods in her life of poverty and poor nutrition.  By contrast, her US or European counterpart will always have plenty to eat, will learn to shop, order pizza, operate a computer, Game Boy, Wii, and God only knows what other kinds of electronics.  She will have her doting parents slather sunscreen on her to protect her skin from birth until she’s old enough to do it herself.  She will come of age in a different world, filled with the latest in medical technology.

And she will pay for it with her health.

Her equatorial counterpart will be only half as likely to get cancer in her lifetime.  She will have an 80 percent reduction in risk of developing type I diabetes before the age of 30.  And she will live longer.  If she can avoid trauma or an untreated severe medical condition, the girl growing up in the more primitive but sunny circumstances will have an overall 7 percent greater longevity than her US/European counterpart.  She will have stronger bones, lower blood pressure, fewer cavities in her teeth, a greatly reduced risk for heart disease, type II diabetes, obesity, arthritis and most of the other diseases that will plague her more Westernized sisters.

Why the difference?  According to Dr. Holick, the equatorial girl has vastly more exposure to natural sunlight over her lifetime than does the other.”

One of the easiest and most impactful things you can do for your health is to get sufficient vitamin D.  Vitamin D supplements are great and I highly recommend them, especially for those of us who do not live in areas where we get a lot of sunlight.  But, just as vitamin and mineral supplements are not a good replacement for a healthy diet, don’t let Vitamin D supplements be an excuse not to get some sunlight.  As with vitamin and mineral supplements, eat a healthy diet and use them to fill in any shortfalls.  So, with summer here, get out in the sun.  The key is NOT to burn.  Sun tan lotion (SPF) prevents the formation of vitamin D as do hats, gloves and long clothing.  Contrary to what you may hear exposing your hands and face to the sun is NOT sufficient, and you SHOULD go out between noon and 2pm.  If you are fair skinned, get as much sun exposure on your skin as you can for a safe period of time (start with 5-15-20-30 minutes as you feel comfortable), than if you want to continue being in the sun put on sunscreen, a hat, etc.  The sun can cause wrinkling over time so if this is a big issue for you, keep your face covered and expose your back to the sun.

Than at the end of summer and the beginning of fall get your vitamin D levels tested (25 OH Vitamin D3) by your doctor and if they are not in the 60-80 ng/dL range, take a Vitamin D3 supplement as appropriate.  Most people need between 2000-5000 units daily, and some people need up to 10,000 units daily.

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There are a large number of things that can cause infertility but one of the biggest we are seeing right now is due to excessive insulin.  High insulin levels cause the ovaries to produce excess testosterone.  While women need testosterone (just as men need estrogen) to feel and function well, normally they need only a tiny amount.  This excessive production by the ovaries in response to high insulin wrecks havoc on a woman’s body.  It begins to masculinize her, with one of the most noticed symptoms being the growth of dark hairs on the upper lip and even the chin.  It also completely throws her menstrual cycle and ovulation out of whack and makes conception very difficult if not impossible.

Conventional treatment for this includes the drug Metformin and the use of IVF (in vitro fertilization) which is a very expensive, involved and time consuming procedure with a very modest track record.

Dr. William Davis, the MD who runs the Heart Scan Blog recently published a short inverview with Dr. Michael Fox a gynecologist who has begun to use a low carbohydrate diet with great success in treating infertility.  High insulin is caused by high blood sugar, and the primary cause of high blood sugar is excess carbohydrates eaten.  Therefore it makes perfect sense that treated with a very low carbohydrate diet would decrease blood sugars and therefore would decrease insulin which would decrease excessive testosterone production which would allow the menstrual cycles to normalize.  Dr. Fox claims around a 90% success rate when both the woman and the man strictly follow a very low carbohydrate diet.

I would add that as a Naturopathic doctor we find the use of adaptogenic herbs complement a low carbohydrate diet by helping to normalize and reset the hypothalamic-pituitary-ovarian access as well as helping to normalize cortisol and stress hormones.  Personally if I were dealing with infertility I would give a very low carbohydrate diet and the use of adaptogenic herbs a thorough try before resulting to IVF.  The experiences of many doctors in the field suggest this approach works very, very well at a fraction of the cost of IVF and is virtually without side effects, other than becoming generally more healthy.

To read the brief interview in full, find it here:

http://heartscanblog.blogspot.com/2010/06/low-carb-gynecologist.html

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The conventional medical community states that gluten intolerance is a fairly rare phenomenon.  My clinical experience and the clinical experience of other alternatively minded doctors in the field suggests that gluten intolerance is far more common.  I find when I ask people to remove gluten from their diet for 30 days, 80-90% of people report mild to significant improvements in their health. 

Gluten intolerance ranges from mild symptoms such as a little gas and bloating, minor aches and pains, and “I feel better not eating gluten than when I do” to autoimmune diseases including Celiac disease at the most extreme end of gluten intolerance.  While Celiac disease is thought to be relatively uncommon data suggests that for every one person diagnosed with Celiac disease, fifty-three people have it and are undiagnosed, meaning Celiac disease is fifty times more common than we believe.

A Minnesota study using frozen blood samples taken from Air Force recruits 50 years ago found that intolerance to gluten is four times more common today than it was in the 1950s.  One of the most common questions I get is, “Why?  My grandparents and my great-grandparents ate lots of wheat and they never seemed to have any problems?”  And to be candid, I don’t know why.  There are lots of theories, but one very interesting theory I’ve been following is that it’s because of the changes we’ve made to wheat itself. 

Dr. William Davis, the MD who runs the Heart Scan Blog has been conducting experiments using some of the oldest varieties of wheat available.  Davis is himself gluten intolerant and notices measurable improvements in his health when avoiding gluten.   While researching the development of modern wheat he found that in the process there was a mutation to the gluten protein that seems to have made it far more reactive.  So he devised an experiment on himself and a few other of his willing gluten-intolerant patients.  He bought some heirloom wheat (two varieties of which are called emmer and einkorn) and had it baked into bread.  He and his patients ate the bread and monitored their experience.  Unlike modern wheat, they found when they ate the emmer or einkorn wheat they did not have the usual gluten reactions.  They still had the high blood sugars due to the high carbohydrate content of the wheat but not the gluten reactions.  This was a small study involving just a few people but is absolutely fascinating.  We don’t know if they kept eating the emmer or einkorn if they would develop reactions or if these older wheat varieties don’t trigger reactions like modern wheat does.  Could a Celiac patient eat these strains of wheat?  I do not know, and at this point I would not suggest eating either emmer or einkorn.  If you are merely gluten intolerant without any autoimmune component using 100% emmer or einkorn might be okay for an occasional treat but I still would not suggest consuming it on a regular basis.  And to the best of my knowledge there are no readily available sources of emmer or einkorn bread so you would have to bake it yourself.

Still, very interesting, is this one of the reasons for the rise in gluten intolerances, the change in wheat itself?  Let’s hope that we’ll see more and larger studies on this issue in the future, though I’m not holding my breath just yet as the emmer and einkorn farmers don’t have a lot of clout or money to make it happen.

Dr. Davis’ blog posts are worth your time.  Find them here.

Blaming gluten – http://heartscanblog.blogspot.com/2010/05/blame-gluten.html

Wheat & Agribusiness – http://heartscanblog.blogspot.com/2010/05/emmer-einkorn-and-agribusiness.html

In Search of Wheat – http://heartscanblog.blogspot.com/2010/05/in-search-of-wheat.html

Baking Einkorn bread – http://heartscanblog.blogspot.com/2010/06/we-bake-einkorn-bread.html

Einkorn and blood results – http://heartscanblog.blogspot.com/2010/06/in-search-of-wheat-einkorn-and-blood.html

Wheat aftermath – http://heartscanblog.blogspot.com/2010/06/wheat-aftermath.html

Another experience with Einkorn – http://heartscanblog.blogspot.com/2010/06/in-search-of-wheat-another-einkorn.html

Baking Emmer bread – http://heartscanblog.blogspot.com/2010/06/in-search-of-wheat-emmer.html

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Jay Parkinson, a New York based MD, came down with a sinus infection.  Jay is an idealistic doctor who quit has practice to found The Future Well an institute dedicated to finding innovative solutions for healthcare.  Because of this transition he is without health insurance.  So when he came down with a sinus infection he couldn’t treat himself, what did he do?  He went to the doctor.

Read his two part blog entry about his experience and his thoughts. 

Part I – http://blog.jayparkinsonmd.com/post/680444413/today-i-was-a-patient

Part II – http://blog.jayparkinsonmd.com/post/681002266/today-i-was-a-patient-part-two

Of course Jay has an advantage over the average patient, he’s a doctor.  Besides being a terrible patient (doctors consider other doctors the worst patients, because they are always trying to micro-manage their own cases; I’m sure Jay’s not like this) this means he has a full understanding of what is going on.  What’s the worst thing that could happen and what are the odds?  What’s the most likely thing that’s going on?  What are the side effects of treatment?  What are things to watch out for?  For the doctor who was treating Jay, he could be a lot more flexible because the likelihood that Jay would turn around and sue him was minimal.

I think the Internet is valuable for patients in that it can educate them.  It gives them access that was formerly only available to doctors.  While this can be scary for many doctors (it imbalances the traditional patriarchal doctor-patient relationship), I for one, think it’s great.  Yes, we all see patients periodically who only want us for our prescription pad, “Hi Dr. Gerstmar, this is what I have, I’ve researched it on the internet.  And this is what I want you to treat me with, here’s all my information, please write me this prescription.”  But for every 1 of those patients 100 have the opportunity to become involved in their health and treatment.  Of course I have an unfair advantage being a Naturopathic doctor, my visits are not mandated to be 15 minutes long, which gives me time to sit down, talk to the person, get to know them and understand what is going on for them.  How scared are they of what’s going on?  What is their financial situation like?  What do they want to do?  And together, just like Jay and his doctor, we often come up with treatment plans that satisfy both of us.

If you can’t collaborate with your doctor, if your doctor doesn’t take your thoughts, input, and opinions seriously, find another doctor.  The most important thing you can do for your health is be actively involved in it, the second most important is having a good partnership with your doctor.

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Maybe, according to research done with mice.  (http://news.discovery.com/human/can-bacteria-make-you-smarter.html)

‘"We found that mice that were fed live M. vaccae navigated the maze twice as fast and with less demonstrated anxiety behaviors as control mice," said Dorothy Matthews in a press release. "Mycobacterium vaccae is a natural soil bacterium which people likely ingest or breath in when they spend time in nature."’

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A recent study reported here (http://health.msn.com/health-topics/alternative-medicine/articlepage.aspx?cp-documentid=100260077) begins to show what we’ve known for a long time,  “…we found that meditators anticipate pain less and find pain less unpleasant, [even though] it’s not clear precisely how meditation changes brain function over time to produce these effects.”

The bad news, “those with upwards of 35 years of meditation under their belt anticipated pain the least.”  Does this mean that only experienced meditators gain benefit?  My experience says no, though the benefits of a regular meditation practice appear to increase over time.

If you or a loved one have chronic pain I would certainly recommend making meditation a piece of your pain control program.

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Some of what conventional medicine does is fantastic.  It’s treatment of trauma and life-threatening conditions is the best in the world.  But much of it is ineffective, costly and harmful.  Critiques of it are not just coming from the “alternative” community anymore but increasingly from within conventional medicine itself.

Dr. John Briffa (a British MD) commented on some recent studies casting doubt on the effectiveness of conventional medicine in a recent blog post (http://www.drbriffa.com/blog/2010/06/10/bmj-piece-reminds-us-just-how-ineffective-much-of-modern-day-medicine-is/).

In a nutshell doctors are overprescribing testing and treatments because:

1.        Sometimes it helps.  If it helps a few people, does nothing for most, and harms a few, we tend to focus on the benefit the test or treatment gave and ignore the money wasted on those who got no benefit, and the harm it caused for some.

a.       This is especially an issue when pricing is hidden.  In the UK medical costs are paid for by the government and so doctors don’t see the costs and patients don’t “pay a bill.”  In the US, those with good health insurance (less and less people these days) also don’t see direct costs.  Because of this, there is no economization, neither doctors nor patients are forced to consider the price tag that goes along with testing or treatment.

2.       “…what most doctors are able to offer falls short of patient expectations.”  Doctors don’t have enough time to spend with patients to discover what the real problem is, so they fall back on extensive and expensive testing.  Treatments don’t work very well, so doctors try to use more, more expensive treatments, and begin treating earlier in the hopes of getting better effects.

Dr. Briffa closes with the quote ‘“We’re now in the ludicrous position that it’s electoral suicide, even in a country on the verge of bankruptcy, for a political leader to make an argument that we’ve been spending too much for too little gain and that, if the budget for health care were cut and doctors did less, most people would be better off.”’

Thought provoking, and we in the “alternative” community need to be as aware of this as our conventional colleagues.

  Dr. Briffa’s has a great blog with a lot of thoughtful and incisive posts.  Check it out.

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