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The Definitive Book on B12 Deficiency, Diagnosis and Treatment,
A good friend of ours had a sudden unrelenting pain in her leg which baffled her doctors. After many months of suffering, and many failed treatments and medications, she tried inexpensive vitamin B12 injections which immediately worked, providing complete relief. Occasionally the pain returns and reminds her it's time for another B12 injection. The injections are easy with a small syringe and tiny needle, and the B12 is injected under the skin twice a week. There are many more stories of B12 misdiagnosis in Pacholok's book. Nurse Pacholok first describes her own ordeal with pernicious anemia and B12 deficiency which motivated her to become an expert on the topic. Working within the health care system, she was appalled at the numbers of patients with obvious signs and symptoms of B12 deficiency who were misdiagnosed. Finding the medical system apathetic and unresponsive to her advice about B12 deficiency, Pacholok wrote this book to empower medical consumers and to educate their physicians. Pacholok is on a crusade to change medical practice to routinely screen for B12 deficiency, and her book is one giant step in that direction. Vitamin B12 deficiency is estimated to affect 10%-15% of individuals over the age of 60 years. 40% of elderly hospitalized patients have low or borderline serum B12 levels, and 50% of long term vegetarians have B12 deficiency. B12 absorption depends on many cofactors, so it is possible to take adequate amounts of B12 in the diet, and still have a B12 deficiency. Absorption of B12 requires gastric acid, so anything which reduces gastric acid production such as gastric surgery, atrophic gastritis, or antacid drugs could produce B12 deficiency. The very popular antacid drug Prilosec (omeprazole) has been clearly shown to decrease B12 absorption. Other antacid pills such as Prevacid, Protonix, antac, Nexium, Aciphex, Zantec, Tagamet, Pepcid, Maalox, mylanta, reduce gastric acid, inhibit B12 absorption and may produce B12 deficiency. Drugs such as Metformin and other diabetes drugs can cause B12 deficiency. The anesthetic agent, Nitrous Oxide, or "laughing gas", used in dental or surgical procedures causes B12 deficiency Pernicious anemia is the second most common cause of B12 deficiency. This is an autoimmune disease with loss of Intrinsic Factor, in which antibodies damage the stomach lining interrupting the B12 absorption mechanism. Other people at risk for B12 deficiency include vegetarians, people with eating disorders such as bulemia and anorexia, inflammatory bowel disease with malabsorption (ie. crohn's). Auto-immune diseases such as Hashimoto's thyroiditis may be associated with B12 deficiency(pernicious anemia). Vitamin B12 deficiency can cause unusual neurological symptoms such as tremor, gait disturbance, severe pain, and can mimic MS (multiple sclerosis) or even Parkinson's Syndrome. The physical signs and symptoms can often mimic other diseases and the diagnosis is frequently missed. B12 deficiency damages the myelin sheath around the nerve fibers, this is a soft fatty insulating material which is also damaged in demyelinating diseases such as multiple sclerosis. B12 deficiency can cause mental changes such as irritability, apathy, sleepiness, paranoia, personality changes, depression (including post-partum depression), memory loss, dementia, cognitive dysfunction or deterioration, fuzzy thinking, psychosis, dementia, hallucinations, violent behavior, in children; autistic behavior, developmental delay. B12 deficiency can cause neurological signs and symptoms of abnormal sensations (pain, tingling, and/or numbness of legs, arms trunk or anywhere),diminished sense of touch, pain or temperature (may mimic diabetic neuropathy Charcot foot), loss of position sense, weakness, clumsiness, tremor, any symptoms which may mimic parkinson's or multiple sclerosis, spasticity of muscles, incontinence, paralysis, vision changes, damage to optic nerve (optic neuritis). Atherosclerotic vascular disease is increased by B12 deficiency including; Coronary artery disease, TIAs, CVA, heart attack, heart failure, claudication, all associated with elevated homocysteine levels caused by B12 deficiency. B12 deficiency causes Megaloblastic Anemia (enlarged red blood cells with anemia). In this type of anemia, the red blood cells are fewer in number, yet they are larger in diameter (this large size is called megaloblastic and is measured on the CBC with the mean corpuscular volume, MCV). The anemia can cause fatigue, and weakness. Cervical Dysplasia and increased risk for other dysplasias and cancers are associated with B12 deficiency. B12 supplementation is cancer prevention. Most doctors do not test for B12, and if they do a test it is the serum B12 which may be unreliable because of the wide normal range. A more accurate test, urinary methyl malonic acid was developed by Eric Norman MD, and is inexpensive and widely available (MMA). The Methyl Malonic Acid MMA is elevated in the urine and serum in patients with B12 deficiency. Pacholok makes the case that everyone presenting for medical care should be routinely screened for B12 deficiency with the MMA, serum B12 and Homocysteine tests. Treatment is Curative: Treatment with inexpensive B12 injections or sublingual tablets is curative. Recent work by Kuzminski showed that daily 2 mg. oral B12 serves as well as monthly 1 mg intramuscular B12 injections. Serum Homocysteine is elevated in B12 deficiency. It is important to discover B12 deficiency early, since nerve damage can be irreversible if not discovered right away. In conclusion, this is the definitive book on B12 deficiency, diagnosis and treatment for the lay reader and for the interested physician. As a result of reading this book, I now routinely test serum B12 and Urinary MMA on ALL patients, and have been surprised to find many symptomatic B12 deficient patients completely missed by the medical system. Needles to say, it is very gratifying to see ill patients completely recover with B12 injections. I applaud the authors on a job well done, bringing B12 deficiency to the attention of the public, and no doubt saving many lives in the process. This book will make a positive impact on the nations's health, and change medical practice for the better. The only thing I would change about the book is to give Sally a name that is easier to pronounce. Jeffrey Dach MD |
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Chapter 5, the Signs and Symptoms of Adrenal Fatigue contains humorous illustrations which communicate very clearly in non-technical language the symptoms of fatigue, lethargy, craving of salty foods, hypoglycemic episodes, decreased libido, stress intolerance, light headed upon standing, depression, loss of memory and cognitive decline, and prolonged recovery time from flu-like illnesses, which characterize adrenal fatigue, the net result of years of chronic stress. In Chapter 7, Wilson explains that adrenal fatigue is not recognized by mainstream medicine because there is no ICD-9 code, and health insurance companies will not pay for diagnosis and treatment without a code. This is perhaps a simplification because the ICD-9 code 255.4 for adrenocortical insufficiency can be used. Wilson goes on to explain that that the only codes and lab tests are for Addison's disease which is complete adrenal failure, so even if testing is done, most people with mild adrenal insufficiency will be told the test results are normal. Thanks to Wilson's efforts to publicize the syndrome, hopefully this is changing. Chapter 8 contains a lengthy questionnaire which will assist the reader in self-diagnosis. I found Chapter 10 on physical signs of adrenal fatigue the most useful, describing findings on physical examination such as the unstable pupil, blood pressure reduction upon standing, and Sergent's white line test. Chapter 11 provides complete coverage of laboratory testing for cortisol levels in saliva, blood, and urine samples, as well as ACTH stimulation. Wilson favors the 4 sample salivary cortisol test as the easiest and most convenient method, with the added advantage that salivary testing can at home without a prescription The largest section of the book, Part Three, deals with treatment and recovery from adrenal fatigue discussing lifestyle, diet, food allergies, replacement hormones, and supplements, and a discussion of cortisol vs. adrenal cortical extracts. Adrenal fatigue is the net result of years of continuous high cortisol output by the adrenals caused by chronic stress from job, family, illness, injury, and poor diet and lifestyle associated with high-tech modern living. After years of chronic stress, the two small triangular supra-renal glands poop out, and we become another casualty of adrenal fatigue, the 21st century epidemic. Since mainstream doctors can't seem to help, either ignoring the syndrome, or prescribing anti-depressants for it, this self-help book may be a life-saver. Thank you, Dr. Wilson. Other books recommended are Safe Uses of Cortisol by McK Jefferies, Hypothyroidism the Unsuspected Illness by Broda Barnes, From Fatigued to Fantastic by Teitelbaum. Jeffrey Dach MD |
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Any woman hesitant about hormone replacement because of fear of breast cancer should read this book. Joseph McWherter MD, an OB/Gyne doctor in Texas with a large natural hormone practice, wrote this book in response to the Women's Health Initiative Study (WHI) published in JAMA in 2002. The WHI Study was halted early because of increased heart disease and breast cancer. As usual, the newspaper headlines were misleading and got the story wrong, failing to mention the important distinction between the unsafe synthetic hormones used in the WHI study, and the safe natural hormones used by Dr. McWherter and many others. Chapter 2 discusses the causes of breast cancer, namely accumulated DNA damage related to junk food diets, stressful lifestyle, environmental toxins, radiation, hormonal imbalance, and genetic predispositions, etc. Chapter 3, Estrogen Explained, goes over rather detailed and technical information about the three types of human estrogens (E1,E2,E3) and their metabolism. Also clarified are the differences between synthetic estrogen, natural estrogen, xeno-estrogen and phyto-estrogen. Chapter 4 is devoted to explaining the WHI Women's Health Initiative Study, and a discussion of the importance of testing estrogen metabolites, namely the 2/16 hydroxy-estrogen ratio. Increasing this 2/16 ratio by consuming broccoli, or with supplements such as I3C and DIM reduces breast cancer risk. Separate chapters are devoted to exercise, diet, and detoxification, all very detailed and complete. Before studying medicine, Dr. McWherter was a mathematician, and he covers these topics with mathematical precision. The exercise chapter contains actual photos showing how to do each exercise. The diet chapter contains menus and a glycemic index chart. The detoxification chapter includes a questionnaire and 21 day Detox diet. The real crux of the book, of course, is the hormone chapter in which McWherter discusses natural hormones called Bi-Est and Tri-Est topical preparations. McWherter found that blood testing under treatment usually shows an estradiol level in the 20-50 pg/ml range. On page 140, McWherter reveals startling information about the low incidence of breast cancer in his treatment group. There was only one case of breast cancer in 2,300 women over 5 years on his clinic program. This single case is compared to the 60 cases expected based on the WHI placebo arm data. Needless to say, this is an excellent result. Chapter 10, Breast Care Nutrients, covers McWherter's Nutritional supplement program to prevent breast cancer, and the first item mentioned is iodine supplementation. Mc Wherter is familiar with the work of Derry and Brownstein on Iodine as the key to breast cancer prevention, and he gives credit to their work. Other supplements such as I3C, DIM and Calcium-D-glucarate are also mentioned. A final chapter is devoted to breast cancer surveillance and detection with self breast examination, mammography and thermography. Missing from the book is a chapter discussing heart disease. Suffice it to say that the second arm of the WHI using premarin alone actually showed less heart disease in the premarin treated group, and a recent NEJM study showed less coronary calcification on CAT scan in the premarin treated group. These revelations indicate that estrogen is protective, not causative of heart disease. In conclusion, McWherter's book serves as an educational tool for his own clinic patients, and provides a glimpse into his program for every one else. I have found the book a valuable resource, and have adopted the breast cancer prevention protocol for my own clinical practice. McWherter's excellent book sets a very high standard for future authors of natural hormone replacement for women, and the book deserves a prominent place in every medical library. Also recommended is Natural Hormone Balance for Women by Uzzi Reiss MD, Iodine and Breast Cancer Prevention by Derry, and Iodine by Brownstein. Jeffrey Dach MD |
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This is currently one of the best books for women who want to know about natural bio-identical hormones for the menopausal symptoms of night sweats, hot flashes, insomnia, weight gain, and foggy mind. I met Uzzi Reiss at a medical meeting a few years ago, and he mentioned his new book during conversation. After returning from the meeting, I read Suzanne Somers' book in which she mentioned that Uzzi Reiss had been one of her doctors during her long odyssey to find bio-identical hormone replacement. As a gynecologist with a large clinical practice in Los Angeles, Dr. Uzzi Reiss has accumulated a considerable amount of knowledge and experience using natural hormones for women, and Dr. Reiss is one of the few physicians willing to share this knowledge. Reiss's book provides a practical guide for the safe use of natural hormones, and answers the following questions: 1) When to use natural hormones, when to not use them 2) The difference between unsafe patented synthetic hormones, and the safe natural hormones. 3) Why natural hormones are safe. 4) What route of administration is best, pills, gels, creams, drops, etc. 5) What are your possible responses to each hormone in terms of how you will feel. 6) How to monitor our response and adjust your hormone dosage individually. 7) How to work with your doctor to adjust your hormone dosage for optimal effect avoiding hormone excess symptoms. Regarding hormone testing: Dr. Reiss uses blood testing for baseline hormone levels, however, he says: "The heavy reliance on normal-range readings is nothing less than a tragic, medical addiction" Dr. Reiss's approach: After a routine history and physical exam, baseline blood hormone levels and a pelvic sonogram, treatment is started at a relatively low hormone dosage, adjusting upward as needed. For the adjustment phase, Dr. Reiss empowers his patients with the knowledge to adjust their individual hormone levels. This is done based on symptoms of hormone deficiency or excess, clearly described in detail in his book, which serves as an educational tool for his patients. Separate chapters are devoted to Estrogen, Progesterone and Testosterone with very detailed descriptions of symptoms of hormonal deficiency and hormonal excess. Dr. Reiss does not discuss thyroid, leaving that for other authors. Also, there are only limited comments about adrenal fatigue and the problems associated with low cortisol. A major strength of the book is that Dr. Reiss provides exact hormone dosages and route of administration for his Los Angeles patient population. However, as a matter of practical experience, I have found his starting estrogen dosage somewhat on the high side of the scale for my area of the country, so I would caution the reader about that. Also, Dr. Reiss does not explain why he changed the standard formulation of Tri-Est (10/10/80) to a different unique formulation of Tri-Est gel (0.25E1/ 0.75E2/ 2.75E3). According to most large national compounding pharmacies, the most common formulation is Bi-Est in 0.625 mg to 1.25 mg dosage with (20 E2 / 80 E3) formulation. In any event, these minor flaws are outweighed by the many strengths of the book which empowers women to learn about natural hormone balance. I applaud Dr. Reiss for providing a valuable public service with a book that should be in every woman's library on natural hormone replacement. Jeffrey Dach MD |
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A Remarkable Medicine Has Been Overlooked,
Written with an eloquent flowing style, this book makes the case for Vitamin C as a remarkable medicine that has been overlooked by the medical establishment. Although the crowning achievement of modern medical science is the invention of antibiotics which cures bacterial infections, we have no antibiotics effective for acute viral illness. Dr. Levy says this is incorrect because Vitamin C is a curative "antibiotic" for viral diseases when used properly in high enough dosage by IM or IV route. Dr. Levy's book makes a number of points: 1) Vitamin C is not really a vitamin needed in trace amounts, it is needed in large amounts as a co-factor in oxidation-reduction reactions in the cellular biochemistry. 2) All animals, with the exception of primates, have the enzymes to make their own vitamin C. They do not need to consume Vitamin C in their diet, they make their own. 3) All humans (and primates) lack this final enzyme for the manufacture of vitamin C, and therefore we must consume Vit C in our diet. We have a genetic deficiency in GLO gulano-lactone-oxidase, the final step for the manufacture of vitamin C. 4) Because of this genetic defect, we all have a subclinical Vitamin C deficiency making us more susceptible to infectious diseases. 5) The 60 mg dosage RDA for vitamin C is adequate to prevent scurvy but is insufficient for optimal health. 6) Adequate human "Opti-Doses" of vitamin C based on animal studies is in the range of 3-5 grams per day, and this requirement increases during periods of stress or infection. 7) IV or IM Vitamin C in the appropriate dosage ranges has been clinically proven to cure acute viral diseases such as polio, acute hepatitis, measles, mumps, chickenpox, shingles, viral encephalitis. The most amazing evidence presented in the book is the work of Frederick R Klenner, a doctor in North Carolina who cured 60 of 60 acute polio cases with IM or IV vitamin C and published his findings in Southern Medicine & Surgery, Volume 103, Number 4, April, 1951, pp. 101-107. Klenner wrote more than 20 other publications. Polio vaccine was introduced shortly afterwards, and Klenner's work with Vitamin C was simply ignored. Because of the unconstitutional FDA ruling which prohibits Vitamin C manufacturers from informing the public, very few people are aware of this research showing the incredible benefits of vitamin C. Missing from the book is the fact that most commercially available Vitamin C products contain a mixture of unbuffered L and R isomers of vitamin C, an inferior product. The buffered 100% L-ascorbate version of Vitamin C is vastly superior. Also missing from the book is a discussion of the Linus Pauling protocol for prevention of heart disease with Vitamin C, proline and lysine. I have had numerous conversations about vitamin C with other doctor friends, and colleagues I have known for 25 years, and invariably any comment about Vitamin C is met with ridicule, laughter, and disbelief. Sadly, that is the current state of the medical establishment. Perhaps Dr. Thomas Levy's book will serve to change this, and one day soon, mainstream medicine will embrace a remarkable medicine that has been overlooked. Jeffrey Dach MD |
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Proposes Iodine as Prevention and Treatment for Breast Cancer,
With ten pages of medical references including the work of B A Eskin and W R Ghent, Dr. Derry discloses the remarkable connection between iodine deficiency, fibrocystic breast disease and breast cancer. Iodine's anti-cancer activity lies in its control of apoptosis, or programmed cell death. Derry presents case studies complete with surgical pathology confirmation showing regression of both fibrocystic breast disease and carcinoma-in-situ breast cancer with iodine treatment. He also presents a case report case of infiltrating breast cancer involving the skin which regressed after prolonged application of topical Lugol's iodine solution. I can report from the experience of my own family members that iodine supplementation causes regression of fibrocystic breast disease. Derry's ideas in the book could be easily revised into an NIH grant proposal to research and confirm the role of iodine. To do so would advance the nation's health and be a great public service. Iodine is safe, inexpensive and readily available without a prescription. A US policy of iodine supplementation matching the Japanese dietary intake of iodine could very well be our best preventive measure against breast cancer. Jeffrey Dach MD |
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This Book Invokes a Renaissance in the Use of Iodine,
This review is from: Iodine: Why You Need It Why You Can't Live Without It (Paperback)
Iodine, Why You Need It and Why You Cant Live Without It by David
Brownstein MD is written for the lay reader, however, all health care
professionals should find the information useful in clinical practice.Brownstein says we are in the "Medical Dark Ages" concerning iodine supplementation, and his book attempts to invoke a Renaissance. David Bronstein MD has a clinical practice in the goiter belt of Michigan, and is involved with an ongoing iodine research project with Guy Abraham MD and George Flechas MD. According to Brownstein, iodine is safe and beneficial, preventing not only goiter, but also preventing the many thyroid cysts, nodules and auto-immune thyroid disease rampant in the population. Iodine is anti-microbial, anti-parasitic, anti-cancer, important for hormone production, reverses fibrocystic breast disease, and shrinks ovarian and thyroid cysts. It may be our most important preventive measure against breast cancer. The book dispels a number of myths about Iodine supplementation. Myth number one: There is no iodine deficiency because of Iodized Salt. The iodine in Iodized salt is not very bio-available, and government surveys show decreasing Iodine levels in the population. Brownstein found that 90% of his patients were iodine deficient based on a 24 urine test for excreted iodine after a 50 mg loading dose. Myth Number two: Too much Iodine above the RDA of 150 mcg is not safe. In reality Iodine supplementation is very safe. The average Japanese diet contains 12 mg per day which is 100 times the RDA in the US. In the event of a nuclear power plant accident, the government gives everyone 50 mg. of Iodine to prevent thyroid cancer. A chapter is devoted to iodine deficiency and fibrocystic breast disease and breast cancer. Brownstein presents case reports of women with fibrocystic disease as well as breast cancer who benefit from iodine supplementation. Another chapter devoted to the thyroid describes patients with Graves' disease and Hashimoto's disease who benefit from iodine supplementation. Iodine tablets are inexpensive and widely available as a nutritional supplement called Iodoral without a prescription. Another book, Breast Cancer and Iodine, by David Derry MD PhD, is also recommended. Jeffrey Dach MD |
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A Sequel to Broda Barnes and a Tribute to Thyroid Medical Pioneers,
Amazon Verified Purchase(What's this?)
This review is from: Hypothyroidism Type 2: The Epidemic (Paperback)
Hypothyroidism, Type Two by Mark Starr MD is a tribute to many of the
great pioneers of thyroid medicine, Broda Barnes MD, Eugene Hertoge, and
Lawrence Sonkin MD. The book is a sequel to the Broda Barnes classic
on low thyroid and a compilation of evidence that modern lab testing is
unreliable for the diagnosis of low thyroid, and the current treatment
equally lacking.Partly to seek treatment for his own musculoskeletal pain, Starr went to New York to study pain medicine with Hans Krauss at Cornell Medical Center. Starr later opened his own pain clinic and quickly realized that the majority of his patients responded to thyroid medication with pain relief. If you have read the Broda Barnes book, Hypothyroidism, the Unsuspected Illness, you will find many of the same ideas explained and elaborated by Mark Starr's tribute to the earlier work. For example, the definition of Type Two Hypothyroidism is defined as cellular resistance to the action of thyroid hormone. While thyroid hormone's main action is to increase the size and number of mitochondria, the mitochondrial DNA is highly susceptible to genetic mutations because of maternal transmission. An unforeseen outcome of the medical victory over infectious diseases with modern antibiotics is the creation of new generations of low thyroid children who in earlier times would have succumbed to childhood infectious diseases. They now survive to adulthood thanks to antibiotics, and according to both Starr and Barnes, later develop heart disease as undiagnosed low thyroid adults. The book contains fascinating reprints of old medical book photos of patients with low thyroid before and after treatment, and adds a valuable chapter on clinical signs and symptoms of low thyroid. Another chapter covers Starr's area of expertise which is musculoskelatal pain syndromes and their relation to the low thyroid condition. Another useful chapter explains in detail why dessicated thyroid is more effective than the synthetic T4 commonly used by the medical system. Unlike the Broda Barnes book which was written at the end of a long medical career, Starr's book appears at the relative beginning of his, and one can only wonder what future additional insights he will share after 30 years of medical practice. Jeffrey Dach MD |
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Excellent Thyroid Book Follows Tradition of Broda Barnes MD,
Amazon Verified Purchase(What's this?)
This review is from: Your Thyroid and How to Keep It Healthy (Paperback)
I recommend to you the book by Barry Durrant Peatfield, "Your Thyroid
and How to Keep It Healthy". Peatfield was a general practitioner in the
British National Health service who came to America and trained at the
Broda Barnes Institute. He returned to England and started a thyroid
private practice. His book summarizes over 25 years of clinical
diagnosing and treating thyroid illness. One section of the book is
devoted to the question, "Why thyroid blood tests can be unreliable".Here is what Dr. Peatfield says: "Anxiety in the medical establishment about rules and dogma has led to a slavish reliance on blood tests, which are often unreliable and can actually produce a false picture of the true situation" "I have sadly come across very few doctors who can accept the fact that a normal, or low TSH, may still occur with a low thyroid." "as a result of this test (TSH), thousands are denied treatment" Peatfield lists several reasons why thyroid blood tests are flawed: 1) They measure hormone levels in the blood. What we really want to know is tissue levels, not blood levels. 2) The blood tests do not measure cellular receptor hormone resistance. 3) The blood tests do not measure conversion block. Some patients cannot convert their inactive T4 to active T3. 4) The thyroid tests do not account for adrenal insufficiency. 5) Paradoxical low TSH may occur with a low thyroid function. These sentiments are shared by the teachings of Broda Barnes MD, and the Broda Barnes Foundation. However, Peatfield's book elaborates beyond the classic teachings of Broda Barnes by including chapters on the adrenal as well as a chapter on iodine supplementation. I found this book excellent, and it belongs in every medical library dealing with thyroid disease. Jeffrey Dach MD |
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A Medical Classic from a Medical Giant which Still Rings True,
Amazon Verified Purchase(What's this?)
This review is from: Hypothyroidism: The Unsuspected Illness (Hardcover)
Hypothyroidism the Unsuspected Illness, by Broda Barnes MD, is a medical
classic and should be required reading for every medical student and
doctor. I have read the book many times. The book contains the
condensed wisdom of a lifetime of research and clinical experience with
the thyroid, and it rings true today as it did in 1976. Thyroid blood
tests come and go, yet human physiology remains the same.Broda Barnes estimated that up to 40% of the population suffers from a low thyroid condition and would benefit from thyroid medication. Of course, Barnes' opinion differed with that of mainstream medicine of his time which relied dogmatically on thyroid blood tests to make the diagnosis of low thyroid. Barnes felt the blood tests were unreliable and instead used the basal temperature, history and physical examination. This medical debate regarding unreliability of thyroid blood testing continues today. Being an astute clinician, Dr. Barnes makes a number of observations about the low thyroid condition. Firstly, low thyroid is associated with a reduced immunity to infectious diseases such as TB. Before the advent of modern antibiotics in the 1940's, most low thyroid children succumbed to infectious diseases before reaching adulthood. Secondly, low thyroid is associated with a peculiar form of skin thickening called myxedema which causes a characteristic appearance of the face, puffiness around the eyes, fullness under the chin, loss of outer eyebrows, and hair thinning or hair loss. A third observation by Dr. Barnes is that low thyroid is associated with menstrual irregularties, miscarriages and infertility. Barnes treated thousands of young women with thyroid which restored cycle regularity and fertility. In his day, the medical system resorted to the drastic measure of hysterectomy for uncontrolled menstrual bleeding. Although today's use of birth control pills to regulate the cycles is admittedly a far better alternative, Barnes found that the simple administration of desiccated thyroid served quite well. Again, Barnes noted that blood testing was usually normal in these cases which respond to thyroid medication. A lengthy chapter is devoted to heart attacks and the low thyroid condition. Based on autopsy data from Graz Austria, Barnes concluded that low thyroid patients who previously would have succumbed to infectious diseases in childhood go on years later to develop heart disease. Barnes also found that thyroid treatment was protective in preventing heart attacks, based on his own clinical experience. Likewise for diabetes, Dr. Barnes found that adding thyroid medication was beneficial at preventing the onset of vascular disease in diabetics. Again, blood tests are usually normal. Dr. Barnes devotes separate chapters in the book to discussion of chronic fatigue, migraine headaches and emotional/behavioral disorders all of which respond to treatment with thyroid medication. The final chapter describes Dr. Barnes work on obesity when he resided over a hospital ward of volunteer obese patients, and monitored everything they ate. He found that the obese patients invariably ate a high carbohydrate diet, and avoided fat. Barnes added fat back into the menu and reduced the refined carbohydrates and found that his obese patients lost 10 pounds a month with no hunger pangs. Missing from the book are discussions of Iodine supplementation and the role of the Adrenal, both of which are covered in later updated versions of Barnes thyroid book by other authors. See Hypothyroidism Type Two by Mark Starr, and Your Thyroid by Barry Durrant Peatfield. Iodine supplementation is covered by both Derry and Brownstein. The Safe Uses of Cortisol by William McK Jefferies is the companion medical classic devoted to the adrenals and cortisol. Jeffrey Dach MD |
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Safe Use of Cortisol is a Unique Medical Classic,
This book contains a condensation of clinical knowledge from the career of a medical giant, and a wealth of knowledge not found anywhere else, and is complete with references to the medical literature, case histories, laboratory studies and dosages. In this slim volume, Safe Use of Cortisol, Dr. McK Jefferies points out an important distinction which is not widely known by mainstream doctors or the public. This is the distinction between the lower and completely safe, physiologic doses of cortisol, and the dangerous higher pharmacologic dosage levels commonly used by mainstream doctors to treat rheumatoid arthritis and other auto-immune diseases. While the lower cortisol doses below 40 mg per day are safe, above this dosage level is increased risk of adrenal suppression, and increased risk of adverse side effects including moon face, osteoporosis with spontaneous fractures, thinning of skin with easy bruising, striae, subcutaneous hemorrhages, fluid retention with edema, and cataracts. Cortisol is widely available as inexpensive Cortef from the corner drug store, and is the bio-identical hormone secreted by the adrenal gland. Since it is a natural hormone, it cannot be patented, explaining the lack of funding for research by the pharmaceutical companies. Chapter 4 of the book discusses generally accepted uses of Cortisol, starting with the most logical use which is adrenal insufficiency, also called Addison's disease. However, McK Jefferies also discusses mild adrenal insufficiency, which is not usually recognized by mainstream doctors, and should be. Other uses of low dose cortisol include ovarian dysfunction with infertility, chronic fatigue, allergies and auto-immune diseases. McK Jefferies relies on the Cortrosyn ACTH stimulation test to evaluate adrenal function, as well as urinary cortisol metabolites and serum cortisol tests. He also addresses thyroid function as part of the overall clinical picture; hence the connection with Broda Barnes and the continued advocacy of McK Jefferies' work by the Broda Barnes Institute. I found Chapter 5, Gonadal Dysfunction and Infertility, to be the most fascinating and clinically useful chapter. McK Jefferies used low dose cortisol to successfully treat thousands of young women suffering from irregular menstrual cycles, ovarian dysfunction, hirsutism (facial hair, and acne, both signs of elevated testosterone). Nowadays, teenagers with irregular menstrual bleeding are routinely given birth control pills with synthetic hormones to regulate their cycles. The synthetic hormones in BCPs are associated adverse side effects and do not address the underlying fertility issues. Unknown to the mainstream medical system, the real treatment for irregular menstrual bleeding is found in this medical classic book, namely low dose cortisol and thyroid which successfully normalizes menstrual cycles and restores fertility. Dr. McK Jefferies suggests that the cause of the infertility and irregular periods in these patients is usually excess adrenal production of either androgen (PCOS) or estrogen, and the low dose cortisol serves to suppress this excess hormone production by the adrenals and allow normal ovarian function. Now recognized as the most common genetic disorder in the population, (CYP21A2) non-classical 21-hydroxylase deficiency is associated with menstrual irregularities, hirsutism and acne from elevated testosterone. Rather than low dose cortisol, current practice is to use similar low dose dexamethasone (See the 2006 review in J Clin Endo & Metab Vol. 91, No. 11 4205-4214, by Maria I New). Perhaps non-classical 21-OH should be renamed McJefferies Syndrome to give proper credit to this great clinician. McJefferies stresses that normalization of thyroid function is also required for menstrual regularity and fertility. Broda Barnes agrees with McK Jefferies on the importance of thyroid for normalizing menstrual cycles, and both treat with thyroid medication even though the thyroid blood tests may be completely normal. They have found the blood tests to be unreliable. This is at variance with mainstream medical practice which clings dogmatically to the thyroid blood tests. Most mainstream doctors would refuse to offer thyroid medication unless there is a documented "out of range" lab value. Chapter 9 deals with using low dose cortisol for viral infections such as influenza. Although there was some initial concern that low dose cortisol would reduce immunity in some way, Dr. Mc Jefferies was surprised to find in clinical practice that his patients maintained on low dose cortisol typically reported fewer common colds and other viral illnesses than their family members, suggesting an enhancement of immunity. Another practice he used was to increase the cortisol dosage when patients felt a common cold or viral influenza coming on. He found that this enabled the patient to ward off or recover from the illness more quickly. Of course, he also points out that excess doses of cortisol would have the opposite effect and impair resistance to infection. The final chapters of the book discuss the use of low dose physiologic cortisol for rheumatoid arthritis, allergies, auto-immune disease, chronic fatigue. In addition to the ACTH stimulation tests still in use today, we now have the newer, salivary cortisol testing which I am sure Mc Jefferies would have found useful in his day. What he would have written about the use of salivary cortisol testing ? Unfortunately we will never know. Perhaps a future medical author will build on McK Jefferies work and incorporate salivary testing and other new developments in a future book. I reviewed the third edition which was published in 2004. The first edition was published in 1983. Other books recommended along side this one are, Adrenal Fatigue by James Wilson, Hypothyroidism, the Unsuspected Illness by Broda Barnes, From Fatigued to Fantastic: by Jacob Teitelbaum, Your Thyroid and How to Keep it Healthy by Barry Durrant Peatfield. Jeffrey Dach MD |