Less than a month ago, a young woman in her mid-twenties called me for “lumps in my armpit”. Now, that can be a thousand different things, not all easy to diagnose, some with dire prognosis. So, I told her I needed to see her.
She came, and the diagnosis needed one look only: Hidradenitis suppurativa. This poorly understood skin disease can’t be confused with any other: The patient has multiple red swellings and scars in the axilla, sometimes at other areas, too. You could describe it as boils in the armpit. They are painful and disfiguring. Conventional medicine describes them as inflamed sweat glands (which is what “hidradenitis” means, and suppurativa means “leaking pus”). They are similar to boils, pilonidal cysts, chronic abscesses, fistulas and different kinds of cysts. They might be exacerbated by hormones, excessive sweating, and overweight. Genetic factors clearly play a role – hidradenitis suppurativa is more common in females, and in people of Mediterranean and African-American descend.
Medicine might not understand the cause of it, but any layperson can see that hidradenitis suppurativa is a highly inflammatory disease. This young, pretty woman was slightly chubby – not badly, indeed. But I advised her to eat more vegetables with olive oil, and leave out all sugars and dairy products, as the most inflammatory foods. She also was bloated and had a family history of gluten problems, so I asked her to leave out gluten, too; at least for a few months. I also recommended anti-inflammatory fish oil and probiotics to help her poor, inflamed bowels to heal.
What happened to the young woman? - Within two weeks, she was dramatically better and had lost some pounds, and all the bloating. I never counsel to lose weight; I recommend a better diet, and the weight loss will follow automatically. She was happy about the result.
Unfortunately, then she went to a party where she indulged in all the wrong foods, including pizza, cheese, and sweets. The boils immediately recurred. I was not worried about the relapse: It only confirmed what she had learned: That what she eats has a beneficial or not so beneficial effect on her digestive system, and her health. – Her choice, really.
I know that at this age, all the young woman wants is to look good and be able to were a sleeveless top, and there is nothing wrong with that. But I will make a prognosis – even if I might not be around to see the result: If this twenty-five year old will be able to stick to her resolutions (at least most of the time), she one day will be vibrant fifty-year old. If not, she will go the way most people go in our society that adores foods that I’d call “non-foods” – and she will experience obesity, diabetes, cancer and the myriad of chronic diseases that seem to pop out of nowhere as we age. – Let’s see which way she chooses … Read More
Blog: On Health. On Writing. On Life. On Everything.
From Mouth to Anus
May 15, 2013
Medicine, for me, is a quest for my healthier self, and healthier patients. I am learning something new every day. In a way, I feel sorry for my patients of so many years ago – now, I think, I could help them so much better.
This also implies that you – the patient – could possibly be a step ahead of your physician, if you are trying to figure out what makes your body feel better and stronger and more awake, and happier. With the Internet, we all have more information at our fingertips, flawed and good information, for sure – but more of the latter. If you ask me.
Take for instance the stomach problems that plagued me when I was younger. Setting out with conventional drugs like H2-receptor blockers (Tagamet, Zantac) and proton-pump inhibitors (Prilosec, Prevacid) years ago, I at least got the problem under control. Then, twenty years the, I found that at the root of my heartburn and stomach aches were allergies: I left out the offending foods – and I dropped all meds, and never looked back.
Forward a bit, and I discovered probiotics – bacteria that are helpful for the intestines. They improved my bowels, and I took them faithfully for many years. I still recommend them to nearly every patient I encounter. Many studies link probiotics to good clinical outcomes, even if we have not yet quite figured out all the intricacies of how they work. One thing is sure: What you eat helps or destroys the microbiome that coexists in your body. A microbiome is the whole entity of bacteria, good or bad, that thrives with you, in you, on you.
Don’t worry – the good guys are winning right now. Otherwise you would be dead. But that the good guys are winning is not guaranteed – it could change any moment. You could crowd out the good guys with sugar, or commercial dairy, or destroy them with a course of antibiotics) or meat from one of those inhumane, antibiotic-resistance breeding feed lots – the list is long how you can hurt your microbiome inside and outside; cosmetics and household cleaners are high on the list. But even if we did everything right in our personal lives, outside forces can destroy your good bacteria – pollutants in water, air and soil.
Not to be an alarmist, but no man is an island, and if we don’t preserve our Mother Earth, we surely can forget about the intricacies of feeding our coworkers - our good bacteria - the right amount of this and that.
Health comes down to the health of our gastrointestinal tract. Lately, I have found that probiotics can be applied not just as capsules or caplets, but as probiotic foods. A big group which I just mention in passing are fermented foods – sauerkraut, miso, kimchi, tempeh, and so on. “Fermented” can be taken as another word for “loaded with gut-healthy bacteria”.
I have argued widely against the dangers of dairy – and still do. Ninety-nine-point nine percent of dairy is bad for you because of the highly inflammatory proteins and cancer-breeding hormones (be it naturally occurring, or gene-technologically inserted). But there is a tiny fraction of organic dairy that contains live cultures. Examples are yogurt, kefir, buttermilk and sour cream. But only, if they truly are organic, contain live cultures and have absolutely no additives that turn a good food into a nightmare: sugars, sweeteners, fruit, fruit substitutes, tapioca, carrageenan, and so on. In my mind, to qualify as natural they also have to have their full fat content – nothing skimmed or improved or processed any way other than pasteurizing – and the good bacteria have to be added afterward. Fat is not the culprit in milk and milk products – milk proteins are. Not only are they inflammatory, but also addictive. Now you can even get dairy-free organic yogurts, made for instance from almond milk. Or probiotic powders, ready to be dissolved in warm water. But always read the labels for ingredients!
Good dairy bacteria do not take away dairy’s inflammatory proteins and cancer-causing hormones. Therefore these probiotics should be taken in small amounts – very small amounts, indeed: a sip or a teaspoon full is the serving size here. And you don’t eat or drink them. You swish them around in your mouth as long as you can stand it, or unless you forget about them, and finally swallow them.
Probiotics thus taken increase not only your gut health, but especially your oral health. Studies show that probiotics swished around in the mouth after brushing your teeth reduce caries and gum disease in most cases – and I bet the result would be even better if people would add a healthy, sugar-free diet on top of this.
Using this to fight caries sure beats taking poisonous fluoride. Fluoride made me always uneasy: Studies link fluoride to cancer and neurotoxicity. But other studies clearly showed that it reduced caries – and I had not yet come by a natural method to preserve my teeth. Granted, “primitive” societies usually boast perfect teeth, but I had not quite found out why. Not sure, why, but sugar-free nutrition was probably the main cause. Then again, who of us modern Americans can boast a totally absolutely sugar-free diet – since infancy? Not that I know anyone.
Still, I am a believer in brushing and flossing (and also with good results, I have to say) – and don’t want to get rid of that. But neither fluoride toothpaste appealed to me, nor the brutal cleaning of my teeth at the dentist’s office twice a year. There is nothing natural in putting sharp metal scraping objects in your mouth. Now I am using an organic, neem-based tooth powder most of the time.
With oral swishing probiotics we gently provide a mildly acidic environment in our mouths for a few minutes. That cleans your teeth of plaque and implants healthy bacteria into the lining of your mouth, which then can grow during the next hours, or overnight, and fight bad bacteria. The result is amazing. And natural.
We take for granted that with advancing age we will lose our teeth, and that diseases will creep up on us. Ever been to a nursing home? A certain old-age odor emanates from those old bodies. We think the odor is normal. It is not. If one eats well, nourishes one’s oral cavity and intestines, in their entire length, and not destroys the precious skin bacteria with harsh soaps and cosmetics, we would smell like babies until our final days (and those will come even if we take good care of ourselves, but I bet those final days with be sweeter and easier if you have lived your life well).
Working on the microbiome in my mouth – that has been the newest station on my medical quest. In a way, this quest has been a journey from mouth to anus - and still is. Read More
Ethical Dilemma
June 17, 2012
My neighbors left for Europe vacation. They brought me their fridge’s contents; Several cheeses, Greek yogurt, two kinds of deli, a bread, milk. Which is kind of them. But we don’t eat food like that.
What is a woman to do? Should I throw it out – as is my initial impulse? The daughter delivered the bag of food with words that encouraged me to depose of the things if I didn’t want it – somehow, they knew these are not items I usually put on the table … Or should I hand it to my cleaning ladies who certainly would be happy to get nice things for free?
Only that those things are not “nice”. - Dairy is inflammatory, makes one fat and sets a person up for hay fever, and so much more. The deli is from unhappy cows, and highly processed. The bread we can’t eat because of gluten intolerance.
They are not “free” either. Down the line, because of the addictive nature of milk products, they cause health care costs. Someone will have to pay: The eater with pain and disease; the community for doctor.
Knowing myself, I anticipate that I will give the food to my cleaning ladies – I grew up after World War II in Germany – and wasting food is against my upbringing.
What would you do? Read More