In ancient times, diabetes was diagnosed by licking the urine of the patient. If it tasted sweet, a diagnosis of diabetes mellitus (“honeysweet flow”) was made. As a physician, I am glad we have advanced to better tests...
There are basically four different tests to diagnose diabetes (I am talking here mostly of type II):
• Spot blood sugar. Since sugars rise and fall depending what and when you ate, this is a very unreliable test.
• Fasting blood sugar. Does only take a bit of blood, is cheap and fast – but still can vary with what one ate the day before. However, if your fasting numbers are up consistently, you should pay attention!
• Oral Glucose Tolerance Test: a complicated procedure where one drinks an awfully sweet fluid before blood will be drawn in half-hour intervals to ascertain how fast the sugar load is cleared out. It’s complicated, and very time-consuming for the patient. I object of giving a patient a drink 75 to 100 gm of unpalatably sweet glucose solution – which can’t be healthy if there is a disease caused by sugar. My suspicion is that this test is still be used because doctors can bill the most for this.
• Glycosylated hemoglobin, also called A1c: An easy blood test that gives a rough average of your sugars through the last month. I like this one the best because the usual ups and downs of sugar are not interfering with the test, but going into the overall measuring. With frequent episodes of hypoglycemia (too low blood sugars), the test might come back falsely low or normal. In iron-deficiency, A1c are higher than they really are, suggesting diabetes where there might be none. Every time one eats sugar, it “glycosylates” (adding a sugar to the molecule) a protein on the surface of an erythrocytes (red blood cells), and the chemical process is never reversed as long as the blood cell lives. Red blood cells live about three months; blood we draw is always a mixture of very young cells, newly released into the bloodstream from the bone marrow, and older cells, soon to be discarded. Measuring blood glycosylation therefore represents a fair mirroring of recent sugar intake and over time, those numbers can be compared: A lower A1c means you have done something right lately.
In conventional medicine, A1c is called normal if it is below 6.0. A1c is measured in percent of how much of the blood is “sugared”. Starting at 6.1, you have diabetes. That in it itself is rather absurd: A little step upward from 5.9 to 6.0 does not give you diabetes – you had it coming all along. In Natural Medicine, we think that between 5.0 and 6.0, one has “latent” (developing) diabetes. Why that number of 6.0? Because if one would chose 5.0 as the cut-off point, most Americans would have to be diagnosed with the disease.
The Oral Glucose Tolerance Test is more sensitive to detect cases of diabetes – but only if the cut-off point for diabetes is set at 6.0 A1c.
Arbitrarily putting the number to 6.0 does not make a person healthier. In fact, at the date of diabetes diagnosis, I good proportion of patients have already end-organ failure, namely eye problems, kidney failure, neuropathy – to name a few.
Just looking around tells us that many people are overweight and have some of the telltale signs of diabetes: belly fat, scant hairs on arms and legs, rosy cheeks. One sign alone does not make the diagnosis – but several together gives me an idea. But one can be very overweight and never develop diabetes, because in order to get the disease, you have to have the genes AND an unfortunate lifestyle.
Don’t think that genes are an excuse. Because diabetes type II does not strike, if one lives frugally. For instance, after World War II in Europe, basically nobody had it (but people died in droves of tuberculosis then…). Ten years later, with ballooning economies and waistlines, diabetes was back.
But you don’t have to starve yourself, to heal diabetes. You need a mixture of moderate movement (walking, swimming, biking – or dancing; whatever you like) and a diet without sugars, white starches and bad fats.
In diabetes drug studies, diabetes often is called “controlled” if the blood sugar stays within the limits if 7.0 to 10.0 A1c. We can be sure that at those numbers the damage done by high sugars is continuing in the body. I personally favor an approach that does not “manage” the patient’s diabetes, but gets rid of it. And in many cases it can be done, with exercise, better nutrition – and determination on the patient’s side. Read More
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Allopathy, Naturopathy, Homeopathy, Natural Medicine – and Avandia
July 14, 2010
You hear me mumble a lot about Natural Medicine. How does it differ from other kinds of medicine – allopathy, naturopathy, homeopathy? (Allopathy is another name for conventional medicine – the kind that is commonly practiced in the West)?
It is simple to explain: All those systems - except for Natural Medicine - believe in pills: Allopathy in pharmaceutical drugs; naturopathy in vitamins, minerals, hormones – small molecules that are supposedly lacking in your body; homeopathy believes in little sugar pills that don’t do anything at all, but at least keep the patient away from stronger, more detrimental drugs.
Don’t get me wrong: There is nothing inherently wrong with pills. In certain situations, we need them. Only that they are vastly overrated and over-prescribed and can, at times, do more harm than good. Mainly, however: They never address the root cause of the problem.
Let’s look at a patient who walks in with a blood pressure of 200 over 120. Would I want to deny him a pill? Of course, I would start him immediately on some pressure-lowering medications. I might even observe him in the hospital for a day or two if he looks brittle. But then I would work with the patient on his lifestyle – nutrition, water intake, movement, enough sleep, work stress, martial problems, financial debts: anything that might add to his high blood pressure. Not to make him an eternal patient, but to give him a chance at health. I would also make sure that he is not one of the five percent who have a physical reason for high blood pressure, like kidney disease or pheochromocytoma.
But my main goal would be to make the pills unnecessary.
The problem is: It is so much easier for the doctor to take out her prescription pad – and so much easier for the patient to take some pills for the rest of his life than facing the hard task to turn his life around and make it healthier. We are a culture of pill poppers; we want problems to go away – and fast. We have more important things to do than work on a lifestyle of health and happiness.
And because of that, we are sick.
Granted, there are hereditary diseases, and accidents, and sheer bad luck. But truly: Many health problems are in our own hands. Take diabetes – and the Avandia scandal: Do we really think a little pill can make up for thirty years of bad food choices and no exercise?
I, for one, don’t. Therefore, I opt for Natural Medicine. Read More
Autoimmune Diseases
July 11, 2010
In autoimmune diseases the body’s immune system turns against cells of the own body, slowing destroying them, creating havoc like thyroid problems, allergies, arthritis and muscle weakness, skin afflictions, diabetes type I, neuropathy, autism (at least some forms), fibromyalgia, kidney failure, multiple sclerosis, urticaria, psoriasis, chronic fatigue, bowel troubles – and many more.
Autoimmune diseases are on the rise – more people are suffering from them. Doctors are baffled and, on the whole, helpless. Strong medications like cortisone with myriad side-effects are employed, without getting to the root cause of autoimmune diseases.
Some researchers suspect that our modern diet plays a big role; others blame pollutants in the environment or the fact that we have much less intestinal parasites (compared with cave men) which makes the idle immune system turning against the self. Modern medical drugs (to name just one example - statins - that can cause an autoimmune muscle disease) might contribute.
Of course, I don’t have all the answers either – but these are some ideas that helped patients:
• Make sure you don’t have a gluten intolerance. Test are notoriously unreliable; a better idea is to leave out all gluten (wheat, rye, barley, oats) and see if you improve. Many people feel so much better already after a week off gluten. Others need up to a year.
• Autoimmune diseases hurt the body at different organs. They all have in common an inflammatory effect. To do away with SAD (Standard American Diet) should therefore be the most important step: No sugar, no sweeteners, no white starches, no dairy (which might be the main culprit here!), no bad fats (nothing fried and processed). Instead: vegetables, vegetables, vegetables – and herbs, legumes, a bit meat and fish (but no deli). If you are not willing to cook for yourself and take yourself out of the mainstream food insanity, my hope for your recovery is slim.
• Moderate exercise: For a minimum, go for a walk everyday. Exercise produces anti-inflammatory molecules in your body.
• Bright light: Get some light outdoors. Not to the point of burning (autoimmune patients often have photo-sensitivity and are prone to easy sunburns). But light is important. If you have dark skin, you need more light. – Vitamin D might be what is protecting. I usually don’t give supplements; going outdoors daily and eating cod liver (delicious!) once a month should do the trick.
• Herbs (don’t take them all at once; try one after the other and give it time to work):
---Resveratrol; a strong anti-oxidant. Remember, there is far more resveratrol in the green vine leaves than in red wine – and nearly none in white wine and grape juice.
---Astragalus has shown some benefit. Just know that allergies are frequent in patients with autoimmune diseases. So, if you show signs of intolerance (upset stomach, aching joints, rash, etc.), stop the herb.
---Turmeric (its main ingredient curcumin) has anti-inflammatory properties is.
---Green tea.
---Korean Gamgungtang.
---Padma28, a Tibetan formula. There are some controversies about this. Talk this through with a knowledgeable physician.
---Zyflamend, a blend of several anti-inflammatory herbs. Make sure you don't have an allergy to any of its components.
---Artemisia (vulgaris and annua) both have shown some anti-inflammatory effects.
---Olive leaf extract.
---Cordiceps, a medicinal mushroom. – Eating mushrooms generally has a good effect on the immune system. Just never eat them raw (they could cause cancer): Always cook mushrooms!
---Alfalfa sprouts.
---Gluscosamine, while not an herb in the strict sense, has shown anti-inflammatory promise.
---Bupleurum, a Chinese medicinal plant.
• Be careful with vaccinations. A link between shots and autoimmune disease is suspected by some researchers. That does not mean you should avoid all vaccinations; just stick to the essential ones. Discuss this with your physician – who hopefully has an open ear for alternatives. The link between vaccines and autoimmune disease might come from the suppressing of the normal function of the body, namely fighting viruses off; or might be a function of certain additives in vaccines like mercury, aluminum and squalene.
• Selenium might be missing in your diet (Brazil nuts have the highest amount of selenium, but most nuts have some; seafoods are more moderate sources of selenium). As you might have noticed, I am no friend of supplements: minerals (and vitamins) from a bottle are not the same, and have even been proven to be harmful by recent studies. – With nuts always stay aware that you might develop an allergy at any time.
• Add some good anti-inflammatory fish oil capsules (you should not belch up a fishy taste!) daily.
• Help your intestines with probiotics. The bowels might be at the root of autoimmune diseases: A chronically inflamed bowel (“Leaky Gut Syndrome”) leads to inflammation in other parts of your body.
• One study showed that calorie restriction might decrease inflammation. I would not aim for weight loss per se; eating a fresh diet might lead to weight loss anyway. But a one-day vegetable broth fast per week (see an earlier blog entry here) might be a good idea. – Interestingly, one study showed that fasting during infectious fevers reduced the risk of developing consequent autoimmune disease.
• Don’t try this at home … but nicotine seems to protect from autoimmune disease. So does cannabis (which is still illegal!).
If you want to know which of all the above ideas are most important – probably these: NO DAIRY, NO GLUTEN! Read More