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Alexa Fleckenstein M.D.

Blog: On Health. On Writing. On Life. On Everything.

What’s In A Diagnosis?

January 23, 2011
Tags: order, water, food, Movement, antibiotic, ballroom dancing, change jobs, chronic fatigue, diagnosis, divorce, fever - high, headaches - worst of his life, high blood pressure, hypertension, lifestyle, marital counseling, modern-day, pill, sleep, stiff neck, stress, tennis, therapy, tick-borne disease, tularemia, What’s In A Diagnosis?
Sometimes a patient is desperate for a diagnosis: If she has been going from doctor to doctor, and has been told uncountable times that nothing is wrong, it's all in her head - she might be relieved if she finally gets told she has "chronic fatigue." At least, now she can deal with it. Sometimes a diagnosis can save a life: If your belly hurts, and the diagnosis is “appendicitis”, a surgeon will operate on you, and your life is saved in all likelihood. When my son, a few years ago, had high fever, stiff neck and the worst headaches of his life, only the diagnosis of a physician turned the course of the disease around. The physician thought it likely was a tick-borne disease and probably tularemia: With the right antibiotic, my son recovered quickly. Sometimes a diagnosis is just and word: Say, your doctor tells you that you have hypertension - high blood pressure. That doesn’t help you much. It helps the doctor to know what pill to prescribe you – for the rest of your days. Now you are a patient. High blood pressure is a typical modern-day stress disease. Only about five percent of people who are diagnosed with high blood pressure, have an underlying medical condition. The rest – ninety-five percent! – have a wrong lifestyle. But interestingly, the diagnosis doesn’t tell you that there might be a difference – or that something else than a pill might help you. If you have an especially astute doctor, he will tell you that you have “essential hypertension”, “essential” here meaning no real reason he knows of. With other words, the diagnosis is a medical throwing up his arms in the air, declaring nothing can be done. Except for a few pills, of course. You have stress because your boss is unreasonable, or your spouse is the nagging kind, or your gambling debts are threatening to destroy your family life – again, you might not be able to do much. On the other hand, you might be starting thinking about what can be done. Getting more sleep every night? Eating more vegetables? Going into therapy? Returning to school, training for another line of work? Divorcing your spouse, or going to marriage counseling together? Enrolling in a course of ballroom dancing together? Changing jobs? Taking up tennis to get a handle on your stress and work some of the anger off physically? No – you have a diagnosis, and now you get a pill. That’s all. Your doctor didn’t even tell you to drink more water, I bet. You were probably told to go easy on salt. That is nice advice – if you were also told that most processed and restaurant foods contain too much salt, even your breakfast cereals and the “nutritional” bar. And that the salt problem is really big in black people but less of an issue in Caucasian people. Chances are that your doctor also gives you a diagnosis of too high cholesterol – hypercholesterolemia. That’s another pill, right away. Your doctor didn’t tell you that high blood pressure and high cholesterol aren’t two different diseases. They are one bad lifestyle. More often than not they go together. And, oh, now you got diabetes! Your sugars are too high and this new diabetes really needs good management. Your doctor might even give you a new name for the three diseases above: Syndrome X. He will wiggle his head in concern, because having all three makes it really dangerous. One has to be treated extra-extra carefully – with many pills. Some (or all) of those pills have side effects. Liver failure, depression, impotence, muscle inflammation, fatigue, upset stomach, and so on – which will require more pills and more monitoring. None of the pills will buy you real health – glowing, sweaty, happy health as you might experience when you play a round of pick-up Frisbee or swim in the ocean. I am not saying here you should throw away all the pills your doctor gave you. I am just saying you should strive for health, not for diagnoses and an assortment of pills, so that, one by one – and with the supervision of your physician – you might be able to drop the pills. What is the difference between this diagnosis and that diagnosis? My son’s illness had nothing to do with lifestyle, and all to do with a nasty bug. Most diseases like high blood pressure, diabetes, high blood fats, and many cases of depression, arthritis and cancer have a whole lot to do with lifestyle. If you break a bone, only a good cast will help mending it – and good food will speed up the healing process. Once you have a cancer, of course, a bit of lifestyle change is not enough to save your life – you need surgery, radiation, chemotherapy. Once the cancer is diagnosed, eating more fresh vegetables and going for a daily walk in sunlight might help you recover – but better would have been you would have started on a healthy path many years ago. The uncomfortable truth is: Health does not come out of a pill bottle. And a diagnosis is just a name. What you do with your life counts for your health. Read More 
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Standing On One Leg

October 24, 2010
Tags: Movement, balance, brushing teeth, Exercise, exercise – harmful, high blood pressure, hypertension, Kegel exercises, leg, pelvic muscles, standing on one leg, walking, walking on uneven surface, yoga stance
Because I get bored stiff with doing exercise, I am always on the lookout for some easy way out. The Five Tibetans were my favorites for a while, then the yoga ball. But both showed their propensities for inducing harm: The Five Tibetans gave me some lower back pain. The yoga ball made a kink in my neck. Both cases are probably brought on myself, by overdoing it. But I found an exercise that is not harmful (at least not as of now) AND does not even take up any extra time. Unbelievable? Because you do it while you brush your teeth. Easy: Stand on one leg while brushing your teeth. Change legs in the middle. In the beginning, I was very wobbly. But I found focusing on the crease between leg and buttock, improves stability. Over about a quarter of a year, I have been getting quite good: I can lift my leg to a horizontal stance without toppling over. This exercises, of course, your leg muscles. It also tones your pelvic musculature – without being as boring as Kegel exercises. By extrapolation, I would think that it will help lowering high blood pressure – as walking on pebbles or uneven surfaces has been proven to do exactly this. It think it has to do with using muscles, period. And the most important effect: It works on the balance center in your brain. Elderly people are dying often from falls. So we need to maintain as much balance as we can. Especially, if it is just a simple habit added to the twice-daily chore of brushing your teeth!. It turns out that standing on one leg has the same exercise effect as walking for forty-five minutes. Amazing, huh? Read More 
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Gluten-Related Symptoms and Diseases

September 24, 2010
Tags: order, abdominal pain, acanthosis nigricans, Addison’s disease, ADHD, Alcoholism, alkaline phosphatase (bone) elevated, allergic rhinitis, alopecia areata (patchy hair loss), amenorrhea (absence of menstrual period), anemia, anemia – iron deficiency, anemia – refractory, anemia - vitamin B12 deficiency, anti-endomysium antibodies (EMA), anti-gliadin antibodies (AGA), anti-tissue-transglutaminase antibodies (tTG), antiphospholipid syndrome (frequent miscarriages and other problems), anxiety, aortic vasculitis, apathy, aphthous ulcers, appetite – poor, arthritis, arthritis – enteropathic, arthritis - juvenile idiopathic, asthma, ataxia, ataxia - progressive myoclonic, atherosclerosis, Attention Deficit Hyperactive Disorder (ADHD), Autism, learning disorders, autoimmune cholangitis, autoimmune diseases, autoimmune hepatitis, autoimmune thyroid disease, balding – premature, bipolar disorder, Bitot’s spots (foamy patches on whites of eye), bleeding – unexplained, blepharitis, bloating, blurred vision, bone fracture, bone pain, brain atrophy, brain fog, bronchiectasis, cachexia (general wasting), calcium – low, cancer - small cell of the esophagus, cancer (adenocarcinoma) of the small intestine, cancer of the esophagus, cancer of the pharynx, Candida infections – recurrent, cardiomegaly, casein intolerance, cataracts, cerebral perfusion abnormalities, cheilosis (cracked lips and corners of mouth), cholesterol – low, chorea, chronic bullous dermatosis, chronic fatigue syndrome, colitis, common variable immunodeficiency, complications during pregnancy – labor - delivery and post-partum period, congenital anomalies, constipation, copper deficiency, coronary artery disease, cortical calcifying angiomatosis, cow mill “allergy”, cutaneous vasculitis, cutis laxa, cystic fibrosis, dairy intolerance, delusions, Dementia, depression, dermatitis herpetiformis, dermatomyositis, diabetes type I, diabetes type II, diarrhea, disorientation, Down syndrome, dry eyes, duodenal ulcers, dysmenorrhea (painful menstrual periods), dyspareunia (painful sexual intercourse), dysphagia (difficulty swallowing), early menopause, easy bruising, ecchymosis, eczema, edema, Enteropathy Associated T-cell Lymphoma (EATL), epilepsy, erythema nodosum, esophageal motor abnormalities, eyes – dry, eyes – bloodshot, erythema elevatum diutinum, failure to thrive, fatigue, fatty liver, folic acid (folate) deficiency, food allergies - blood-mediated and cell mediated, food cravings, gall bladder – impaired motility, gas, gastric emptying – delayed, gastritis, GERD - Gastro-Esophageal Reflux Disease, glucose abnormalities - too low or too high, gluten, Gluten-Related Symptoms and Diseases, Grave’s Disease, growth retardation, gums – bleeding and swollen, hair loss, hallucination, headache, Heartburn, heart disease, hemochromatosis, hemosiderosis - idiopathic pulmonary, hepatic granulomatous disease, high blood pressure, homocysteine elevated, hyperactivity, hyperkeratosis – follicular, hyperparathyroidism, hypertension, hyperthyroidism, hypocalciuria, hypogonadism, hypoparathyroidism, hyposplenism (atrophy of spleen), Hypothyroidism, hypotonia, ichthyosis – acquired, pulmonary hemosiderosis – idiopathic, IgA deficiency, IgA nephropathy, impotence, inability to concentrate, infertility, insomnia, intrauterine growth retardation, iron deficiency anemia in pregnancy – severe, irritable bowel syndrome, keratoconjunctivitis sicca, keratomalacia, kidney stones, lactose intolerance, lassitude, late menarche (late start of menstrual periods), leaky gut syndrome, liver enzymes elevated, loss of memory, lymphadenopathy, lymphoma - B-cell non-Hodgkin’s, lymphoma - cryptic intestinal T-cell (refractory sprue), lymphoma – non-Hodgkin, macroamylasemia, macrocytosis (red blood cells larger than normal), macrolipasemia, magnesium - low, malabsorption, melanoma, memory loss, migraine, miscarriage, monoarthritis – recurrent, multiple sclerosis (MS) – a possible link, muscle pain and tenderness, muscle spasms and cramps, muscle wasting, muscle weakness, nail problems, nausea, nervousness, neuropathy – peripheral, neutropenia (low white blood cells), nightblindness, nosebleeds – unexplained, obesity, occult blood in stool, ocular myopathy, osteitis fibrosa, osteomalacia, osteomalacic myopathy, osteonecrosis, osteopenia, osteoporosis, pancreatic insufficiency (poor digestion), panic attacks, parathyroid carcinoma, penicilllin V impaired absorption, phosphorus – low, pityriasis rubra pilaris, plasma proteins low, Plummer-Vinson Syndrome, PMS, pneumococcal septicemia, pneumonia – recurrent, polyglandular syndrome, polymyositis, potassium - low, premenstrual syndrome, primary biliary cirrhosis, primary sclerosing cholangitis, progressive multifocal leukoencephalopathy, prolactinemia, prothrombin time prolonged, prothrombinemia, prurigo nodularis, psoriasis, psoriatic arthritis, puberty – delayed, purpura – idiopathic thrombocytopenic, rhabdomyolysis – hypokalemic, rheumatoid arthritis, rickets, sarcoidosis, Schizophrenic Spectrum Disorders, scleroderma, seborrhea, short stature, Sjögren’s syndrome, skin rash – itchy, small intestinal bacterial overgrowth, smell - loss of, sperm abnormalities, spina bifida, sprue – refractory (see: gluten), steatorrhea (pale, malodorous, floating, hard-to-flush stools), stomach ulcer, stroke – premature, sugar intolerance, swelling, Systemic Lupus Erythematosus (SLE), taste - loss of, tetany, thrombocytopenic purpura – idiopathic, thyroid disease - juvenile autoimmune, tongue – red and/or burning, tremors, tuberculosis - increased susceptibility to, Turner’s syndrome, urinary tract infections – recurrent, urticaria - chronic hives, uveitis, vaginitis, vasculitis, vasculitis of the CNS (Central Nervous System), vitiligo, volvulus (twisted intestines), vomiting, weight gain – unexplained, weight loss – unexplained, xerophthalmia (dry eyes), zinc – low
Nearly one in one hundred people have gluten intolerance (gluten enteropathy, sprue, celiac sprue). In only fifty percent of them does the disease show with gastro-intestinal symptoms - the rest has non-intestinal symptoms. Be aware that many of these symptoms can also have other causes - this list does not replace a doctor who sees you! • Abdominal pain • Acanthosis nigricans • Addison’s disease • Alcoholism • Alkaline phosphatase (bone) elevated • Allergic rhinitis • Alopecia areata (patchy hair loss) • Amenorrhea (absence of menstrual period) • Anemia • Anemia – iron deficiency • Anemia - refractory • Anemia - vitamin B12 deficiency • Anti-endomysium antibodies (EMA) • Anti-gliadin antibodies (AGA) • Anti-tissue-transglutaminase antibodies (tTG) • Antiphospholipid syndrome (frequent miscarriages and other problems) • Anxiety • Aortic vasculitis • Apathy • Aphthous ulcers (mouth sores) • Appetite – poor • Arthritis • Arthritis – enteropathic • Arthritis - juvenile idiopathic • Asthma • Ataxia • Ataxia, progressive myoclonic • Atherosclerosis • Attention Deficit Hyperactive Disorder (ADHD) • Autism, learning disorders • Autoimmune cholangitis • Autoimmune diseases • Autoimmune hepatitis • Autoimmune thyroid disease • Balding – premature • Bipolar disorder • Bitot’s spots (foamy patches on whites of eye) • Bleeding – unexplained • Blepharitis • Bloating • Blurred vision • Bone fracture • Bone pain • Brain atrophy • Brain fog • Bronchiectasis • Cachexia (general wasting) • Calcium – low • Cancer - small cell of the esophagus • Cancer (adenocarcinoma) of the small intestine • Cancer of the esophagus • Cancer of the pharynx • Candida infections – recurrent • Cardiomegaly • Casein intolerance (cow mill “allergy”) • Cataracts • Cerebral perfusion abnormalities • Cheilosis (cracked lips and corners of mouth) • Cholesterol - low • Chorea • Chronic bullous dermatosis • Chronic fatigue syndrome • Colitis • Common variable immunodeficiency • Complications during pregnancy, labor, delivery and post-partum period • Congenital anomalies • Constipation • Copper deficiency • Coronary artery disease • Cortical calcifying angiomatosis • Cow mill “allergy” • Cutaneous vasculitis • Cutis laxa • Cystic fibrosis • Dairy intolerance • Delusions • Dementia • Depression • Dermatitis herpetiformis • Dermatomyositis • Diabetes Type I • Diabetes Type II • Diarrhea • Disorientation • Down syndrome • Dry eyes • Duodenal ulcers • Dysmenorrhea (painful menstrual periods) • Dyspareunia (painful sexual intercourse) • Dysphagia (difficulty swallowing) • Early menopause • Easy bruising • Ecchymosis • Eczema • Edema • Enteropathy Associated T-cell Lymphoma (EATL) • Epilepsy • Erythema nodosum • Esophageal motor abnormalities • Eyes – dry • Eyes - bloodshot • Erythema elevatum diutinum • Failure to thrive • Fatigue • Fatty liver • Folic acid (folate) deficiency • Food allergies - blood-mediated and cell mediated • Food cravings • Gall bladder – impaired motility • Gas • Gastric emptying – delayed • Gastritis • GERD - Gastro-Esophageal Reflux Disease • Glucose abnormalities - too low or too high • Grave’s Disease • Growth retardation • Gums – bleeding and swollen • Hair loss • Hallucination • Headache • Heartburn • Heart disease • Hemochromatosis • Hemosiderosis - idiopathic pulmonary • Hepatic granulomatous disease • High blood pressure • Homocysteine elevated • Hyperactivity • Hyperkeratosis - follicular • Hyperparathyroidism • Hypertension • Hyperthyroidism • Hypocalciuria • Hypogonadism • Hypoparathyroidism • Hyposplenism (atrophy of spleen) • Hypothyroidism • Hypotonia • Ichthyosis - acquired • Pulmonary hemosiderosis - idiopathic • IgA deficiency • IgA nephropathy • Impotence • Inability to concentrate • Infertility (in both sexes) • Insomnia • Intrauterine growth retardation • Iron deficiency anemia in pregnancy - severe • Irritable bowel syndrome • Keratoconjunctivitis sicca • Keratomalacia • Kidney stones • Lactose intolerance • Lassitude • Late menarche (late start of menstrual periods) • Leaky gut syndrome • Liver enzymes elevated • Loss of memory • Lymphadenopathy • Lymphoma - B-cell non-Hodgkin’s • Lymphoma - cryptic intestinal T-cell (refractory sprue) • Lymphoma – non-Hodgkin • Macroamylasemia • Macrocytosis (red blood cells larger than normal) • Macrolipasemia • Magnesium low • Malabsorption • Melanoma • Memory loss • Migraine • Miscarriage • Monoarthritis – recurrent • Mouth sores • Multiple sclerosis (MS) – a possible link • Muscle pain and tenderness • Muscle spasms and cramps • Muscle wasting • Muscle weakness • Nail problems • Nausea • Nervousness • Neuropathy - peripheral • Neutropenia (low white blood cells) • Nightblindness • Nosebleeds – unexplained • Obesity • Occult blood in stool • Ocular myopathy • Osteitis fibrosa • Osteomalacia • Osteomalacic myopathy • Osteonecrosis • Osteopenia • Osteoporosis • Pancreatic insufficiency (poor digestion) • Panic attacks • Parathyroid carcinoma • Penicilllin V impaired absorption • Phosphorus - low • Pityriasis rubra pilaris • Plasma proteins low • Plummer-Vinson Syndrome • PMS (premenstrual syndrome) • Pneumococcal septicemia • Pneumonia – recurrent • Polyglandular syndrome • Polymyositis • Potassium - low • Primary biliary cirrhosis • Primary sclerosing cholangitis • Progressive multifocal leukoencephalopathy • Prolactinemia • Prothrombin Time prolonged • Prothrombinemia • Prurigo nodularis • Psoriasis • Psoriatic arthritis • Puberty - delayed • Purpura – idiopathic thrombocytopenic • Rhabdomyolysis - hypokalemic • Rheumatoid arthritis • Rickets • Sarcoidosis • Schizophrenic Spectrum Disorders • Scleroderma • Seborrhea • Short stature • Sjögren’s syndrome • Skin rash – itchy • Small intestinal bacterial overgrowth • Smell - loss of • Sperm abnormalities • Spina bifida • Sprue - refractory • Steatorrhea (pale, malodorous, floating, hard-to-flush stools) • Stomach ulcer • Stroke – premature • Sugar intolerance • Swelling • Systemic Lupus Erythematosus (SLE) • Taste - loss of • Tetany • Thrombocytopenic purpura – idiopathic • Thyroid disease - juvenile autoimmune • Tongue – red and/or burning • Tremors • Tuberculosis - increased susceptibility to • Turner’s syndrome • Urinary tract infections - recurrent • Urticaria - chronic hives • Uveitis • Vaginitis • Vasculitis • Vasculitis of the CNS (Central Nervous System) • Vitiligo • Volvulus (twisted intestines) • Vomiting • Weight gain – unexplained • Weight loss – unexplained • Xerophthalmia (dry eyes) • Zinc - low I will add to this list as I come across new links –keep checking! Read More 
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