Oct

29

This month in the American Journal of Clinical Nutrition…

“Taylor MK, et al. – Cross-sectional analyses were performed to evaluate the association of dietary glycemic measures with the cerebral amyloid burden and cognitive performance in cognitively normal older adults. The researchers found an association between high-glycemic diet and greater cerebral amyloid burden, which suggested diet as a potential modifiable behavior for cerebral amyloid accumulation and subsequent Alzheimer’s disease risk.“

Amyloid plaguing is the cause of Alzheimer’s disease. In the literature this is now being  referred to as type III diabetes, this article from the American Journal of Clinical Nutrition makes it even clearer why. This is indeed a modifiable behavioral risk factor, as simply reducing  carbohydrate intake markedly reduces this risk. This also reduces risk for diabetes, hypertension, stroke and heart disease, all disorders associated with obesity, which, is also caused by a high glycemic diet. If you have a tendency to overeat carbohydrates, staying full on proteins and (healthy) fats will help.

Mar

11

Various 2012 studies further clarified how excessively sweet, unhealthy foods affect the brain. An animal study out of UCLA found that diets high in fructose can impair cognitive function, which is reversible with omega-3 fatty acid supplementation. High fructose consumption can induce some signs of metabolic syndrome in the brain and can disrupt the signaling of the insulin receptors and reduce the action of insulin in the brain. Other work published in JAMA suggests that fructose consumption modulates the neurophysiologic pathways involved in appetite regulation and encourages overeating. An October 2012 study published in the Journal of Alzheimer’s Disease reported that a diet high in carbohydrates and sugar raises the risk for mild cognitive impairment in the elderly, while a diet high in fat and protein may reduce this risk. Logical yet simple enough, an “optimal balance” of carbohydrates, fat, and protein may help maintain neuronal integrity and optimal cognitive function, particularly in the elderly.

Mounting evidence in 2012 reinforces that high consumption of red meat increases stroke risk. The largest meta-analysis to date looking at the atherogenic effects of red meat found that the risk for total stroke increased by up to 13% for each increase in a single serving of fresh, processed, and total amount of red meat consumed per day. Earlier in the year another study found that processed and unprocessed red meat is associated with a higher risk for stroke, while poultry was associated with a reduced risk. One study found that a diet high in fruits, vegetables, grains, and fish led to a 30% lower depression risk compared with a meat based diet. But, as pointed out last year, meat quality is a factor: Moderate consumption of unprocessed, free-range antibiotic free red meat may actually protect against depression and anxiety. Much of the livestock in the United States is raised on industrial feedlots, which increases saturated fat and decreases very important good fatty acids, whereas pasture-raised animals have a much healthier fatty acid profile.

Information derived from Medscape.

 

Jan

7

A study conducted in Spain reported that consumption of both polyunsaturated fatty acids, (found in nuts, seeds, fish, and leafy green vegetables), and monounsaturated fatty acids, (found in olive oil, avocados, and nuts), decreases the risk for depression over time. However, there were clear dose-response relationships between dietary intake of trans fats and depression risk, whereas other data support an association between trans fats and ischemic stroke risk. Trans fats are found extensively in processed foods, including many commercial chocolates, (hence, check that label when considering dietary intake of chocolate. Also, only the highest levels of dark cocoa contain healthy antioxidants, not milk chocolate). A deficiency in polyunsaturated fatty acids has been linked to attention deficit/hyperactivity disorder in children. Thanks to their high levels of polyunsaturated fatty acids, namely omega-3 fatty acids, fish can help fend off numerous diseases of the brain. A 2010 study correlated fish consumption with a lower risk for psychotic symptoms, and concurrent work suggested that fish oil may help prevent psychosis in high-risk individuals. Although data are conflicting, new research shows that the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid are beneficial in depression and postpartum depression, respectively, and other research suggests that omega-3 deficiency may be a risk factor for suicide. Oily, cold-water fish, such as salmon, herring, and mackerel, have the highest omega-3 levels. Keep in mind that Atlantic fish have elevated levels of mercury and PCB’s compared to Alaskan/Pacific fish, and that farm raised fish contain very little healthy omega 3 fatty acids, due to the confined breeding of farm raised fish.

Dec

19

2012 Neurology Game Changers, Which Foods Are Best for the Brain?

Dietary advice is common practice in cardiology and primary care, but recently food and drink have become important considerations for neurologists, too. Diet is inextricably linked to conditions such as heart disease, obesity, and diabetes. However, what we consume also seems to have significant implications for the brain: Unhealthy diets may increase risk for psychiatric and neurologic conditions, such as depression and dementia, whereas healthy diets may be protective. 2012 saw coffee and berries warding off dementia, caffeine supplements improving motor function in Parkinson’s and the Mediterranean diet reducing the odds of developing Parkinson’s. Lycopene-rich tomatoes and the flavanones in citrus fruits were found to protect against ischemic stroke. As for what not to eat, a study published in January in Stroke supported previous work linking red meat consumption with higher stroke risk, while diets high in carbohydrates and sugar reportedly raise the risk for mild cognitive impairment and dementia in the elderly. A 2009 study published in the Archives of General Psychiatry found that people who follow Mediterranean dietary patterns — that is, a diet high in fruits, vegetables, nuts, whole grains, fish, and unsaturated fat, (common in olive oil and other plant oils) — are up to 30% less likely to develop depression than those who typically consume meatier, dairy-heavy fare. The olive oil-inclined also show a lower risk for ischemic stroke and are less likely to develop mild cognitive impairment and Alzheimer disease, particularly when they engage in higher levels of physical activity.

All data derived from Medscape, 2012.

Sep

19

Over the last few years it has become such that you cannot watch one television show without seeing at least a few commercials for drugs.  Not surprisingly, during the part where they list the adverse side affects attributed to the drugs, there is a very attractive young lady smiling and dancing and throwing rose pedals.  Drugs have become more accepted than breakfast in our “better living through chemistry” society.  Well, a recent study published in the archives of internal medicine, depicts a disturbing picture of our societies interpretation of these ads.  Of the thousands of individuals involved in the study, thirty-nine percent mistakenly believed that the FDA approves only “extremely effective” drugs; 25% mistakenly believed that the FDA approves only drugs without serious side effects.   In conclusion this study found that a substantial proportion of the public mistakenly believes that the FDA approves only extremely effective drugs and drugs lacking serious side effects.  This is hard to believe as the side effects are indeed mentioned at the end of each commercial.  It would seem that no one is paying attention for this part.

When I meet with new patients as part of my initial history taking process I ask each patient which drugs they are taking and why. I find that about 20% of my patients on initial consultation do not know why they are taking their drugs, and, many are taking more than six different drugs.   If you are taking prescription medication, you should be aware as to what you are taking and why you are taking it.  Learn the side affects of drugs which you may be taking as well, should you experience any of them. If you are on high blood pressure medication, buy a home blood pressure unit and check your own blood pressure daily.  It is not uncommon for me to meet with a new patient suffering with dizziness only to find out that they are on high blood pressure medication, have lost weight, and are still taking a high dose from before their weight loss and that this is causing there dizziness from low blood pressure.  Drug therapies are still drugs, and they should be used with diligence and with prudence.  Act responsibly and know all of your options before blindly going on drug therapies, as ultimately, you are the one taking the drug.

 

Jun

28

So why is it that one can go to ten different specialists, get no diagnosis or effective treatment , and that same individual can then come to see me and get better in a few days?  Am I just very lucky?  Is it the power of suggestion?  Well, I can tell you, that’s not it.

Here is why.  Most specialists do what they do very well.  They excel in and have vast studies preparing for their particular area of expertise.  However, most human suffering is not always textbook.  That is to say that when a doctor studies disorders, they do not always match up with what we might see in our offices.  Further, most doctors tend to be trained such that they are examining you with a goal of matching up your symptoms with illnesses that are referenceable in a medical textbook.  Many disorders can be diagnosed in this manner; however, the vast majority of human suffering is not from these “named” diseases.  It is from “shades of grey” symptoms that do not typically match up well with any disorder, yet are real symptoms for the patient.  Since the doctor cannot find any disease that matches your conditions symptoms, you are simply told to “learn to live with it”, or worse, “it’s all in your head.”  Few doctors examine patients cumulatively just trying to get a grasp of what might be realistically happening with that person rather than just trying to find the matching diagnosis code to send to the insurance carrier.  Well when you think about this, you can see how easy it is to have no idea of what may be happening to explain your symptoms.  It is easy to see how all of the individuals with disorders that fall into the “shades of grey” area are just going to be brushed off as being odd or unrealistic problems.

The reason why my office has so much success in this area, is because when I examine patients, I do not have a predisposed opinion of what disease I am trying to rule out.  I look at them for what they are, a human being with symptoms, and I use logic to rationalize what neurophysiology is not working properly, and more importantly, what could be done to fix it.  My office has had great success treating patients with difficult disorders in this regard.  Because of our success, we routinely see patients who come from other states and spend a week with me so that they may get better.

So if you have been told to “learn to live with it”, or have been going from doctor to doctor without answers, you are my best patient.  We always offer a complementary consultation if you prefer one prior to examination as we understand that you may have many questions simply out of years of frustration in dealing with the medical system.

Nov

2

Swine flu has certainly made its way into the media.  Each day, several of my patients ask my opinion as to whether or not the vaccine is a good idea for them and their families.  So here is my opinion.  First, let’s keep things in perspective.  According to the Centers for Disease Control, (CDC), around 15,000 people die in the USA each year from falls.  36,000 people die every year from regular flu.  The World Health Organization, (WHO), reports ~4 million cases of flu world wide each year, from which some 300,000 deaths will occur.  Since most of these deaths occur in third world countries, it doesn’t provoke a media response such as that associated with swine flu here in the USA.

I am not a proponent of flu vaccines.  There is much in the literature to suggest that with respect to flu vaccines, they do not work. Making matters worse, there are known side affects which can be severe.  By now I am sure many reading this article have seen the video going around the internet of the Washington Redskins cheerleader who is alleged to have been crippled with Dystonia following a seasonal flu shot.

Many readers may recall in 1976, the swine flu ordeal from which very few people actually got sick, yet following a vaccination hype, hundreds developed Guillan-Barre’ syndrome, a crippling neurologic degenerative disorder.  Since pharmaceutical companies have virtual immunity from legal actions from vaccine related deaths/disorders, it would appear that the absolute safety of said vaccines would not be as high on the agenda as it ought to be.

Hygiene is of utmost importance during flu season.  If you are sick, stay home, that simple.  Whenever you touch money, one if the biggest carriers of germs, do not touch yourself or food/drink without sanitizing first either with soap/water, or with a alcohol based hand sanitizer.  Immunocompromised individuals should wear a mask in public places.  Keeping ones immune system working effectively in the first place, something that has been largely neglected by the vast majority of our society, is integral, especially during flu season.  Information on healthy eating and on exercise/fitness can be found on my website, and virtually anywhere on the internet.

Mar

5

So what is health, and how would you define it? It seems that everyone has a different idea of what they consider it is to “be healthy”. Through the years, I have seen many patients, who consider health to quite simply be the absence of disease. You may even be surprised to learn that many patients consider being able to live with diabetes, hypertension, obesity and other disorders through a delicate balance of drug therapies to be healthy. I think it is safe to suggest that this type of “eyes closed” mindset to taking care of oneself is less than being healthy and certainly less than desirable. Now don’t misunderstand me. I am all for the appropriate management of health conditions. What concerns me however is abandoning healthy habits and adopting poor habits with the assumption that the drug companies will make everything right. This is a tremendous wrong doing in society today and in fact the main reason for the endemic problems of obesity, heart disease, diabetes, cancer, hypertension, etc. that we now have.  There is much information on my Healthy Eating Page regarding, well, healthy eating.  There are also exercises on my Fitness page from beginner to advanced, using a stability ball.  To truly be healthy, is a lifestyle choice with a  balance of healthy diet, exercises and nutrition, and addressing health problems before they take away your health.

Apr

29

Unfortunately, these words are heard by far too many people.  Although this may be true in that the problem really is in your head, (anatomically), one would anticipate that with the myriad of information on brain based disorders available today, that a far more specific diagnosis could be rendered, or, that a referral to a doctor appropriately trained would be offered.  Many of my patients who were told these exact words by their doctors prior to seeing me, are probably reading this article and chuckling, after receiving the needed treatment they so desired and being able to rerun to their normal lives.  You see, if you are being told that your problem is in your head, just learn to live with it, this is a copout for “I can’t find anything wrong with you”.   And not being able find anything wrong with you is not an excuse to put the problem back onto your shoulders by just telling you to learn to live with it. As an example, dizziness is in the top three reasons why one would go to see their doctor.  The primary treatment rendered more often than not is to offer vestibular suppressant medication such as Meclizine, despite the knowledge base, which suggests that this drug not only will not help, but also will actually hinder the natural course of recovery, and, will also cause imbalance associated with disequilibrium. It is often at this point that one is told to just learn to live with it.  Now, it is one thing to be told this, but it is an entirely different thing to actually abide by it.  In this age of providers who specialize in the most detailed areas of medicine and with highly niche practices, it is not difficult to find someone specializing and successfully treating any type of disorder imaginable. To not seek this provider out on your own and follow through with evaluation and treatment is most foolish.  It is most unfortunate when this information is not provided for you by your health care provider, but that does not mean that you should not pursue finding answers on your own.  The Internet is a literal wealth of information and can be used to find just about anything that you are looking for.  Many of my patients find me from our website, (below), performing searches for answers pertaining to vertigo, dizziness, ADD ADHD, brain injury, coma and other brain based disorders.  Most will in retrospect consider this the smartest time they have spent in pursuing treatment options.  Many area physicians refer their difficult cases to me, realizing that I have extensive training in areas that they do not, and that I can help many individuals that they cannot.  It is the ones that don’t know where or when to refer, or take the time to find out that really concern me, as they are the ones saying to just learn to live with it.  So if your doctor should tell you this, what they are really saying is that they have no idea what is wrong with you, what to do for you and that it is up to you if you want to pursue more genuine treatment options on your own, which is exactly what you should do.

Jan

31

Despite the multitude of dramatic success stories associated with chiropractic medicine over the past 200 years, the profession is ridden with myths, wives tails and many unfortunate beliefs, or as it may be, disbeliefs.  I have been running a center, which, very successfully, treats patients with vertigo, dizziness and dystonia for over ten years now.  Because of my success in this area, I have attracted many patients from many states, who come to see me because there is hope.  Many of my patients are referred to me by their doctor, but there are many others who are on the fence because of the assumptions they make based on the myths.  I know this because many of my patients confess after I get them better that they have been reading my articles for some time but assumed inappropriately that I could not help them. The obvious calamity here is the prolonged and needless suffering. Making matters worse is the simple fact that individuals with dizziness have increased risk of fall, and falls are the leading cause of accidental death and non-fatal injuries as reported by the CDC.  Because of this fact, centers such as mine are instituting fall risk screening and fall prevention programs, which are now becoming required by hospital regulatory boards.  Fortuitously, I have been doing this since before these regulations came along; realizing the endemic threat fall risk poses.  So what makes my practice so different?  Well, through education, training and board certification, I chose to limit practice to my specialty to assist other physicians in the diagnosis and treatment of patients suffering from a variety of neurologic conditions.  Typically, I serve in the same consulting manner as a medical neurologist. Patients come in for medical history and examination, they may or may not require specialized testing, which we either perform or prescribe, they get diagnosed, and they get treated according to their diagnosis.  No big surprises here.  The difference is that my therapies and applications do not include drugs or surgery. Our office uses an integrative functional neurologic rehabilitative approach to treatment paradigms. As a result, although many conditions may require drugs or surgery for efficacious treatment, many more do not.  And these would be the individuals best served by me.

Nov

4

Many patients that we see have seemingly bizarre symptoms that they have been living with for long periods of time, resultant to changes in the way their brain is functioning.  These neurologic findings are sometimes attributable to post-concussive syndromes, following an accident or other head injury, and sometimes not and are caused by other environmental factors.  The symptoms that occur often include imbalance or dizziness, tremor, headache, wincing of one or both eyes, tearing, fear of light, (photophobia), intolerance to sounds, (hyperacusis), reduced or deteriorating handwriting, (micrographia/dysgraphia), cognitive loss, personality/behavioral change, and on and on.  If these neurologic symptoms are as a result of a structural abnormality, they are usually caught long before the patient is referred to my office.  However, when there is no underlying demonstrable change, i.e. on MRI, this points to a neurophysiologic problem.  Neurophysiologic problems are such that they cannot be seen on imaging studies.  It would be like taking a picture of your car to try and figure out why the motor won’t start.  These types of problems can only be observed on clinical examination of a patient and by utilizing other non-imaging type examinations such as the neurodiagnostic equipment found in my office.  The good news is that if no structural lesions are involved, there is often a good chance of complete recovery once the diagnostic dilemma is uncovered and appropriate functional neurologic rehabilitation is utilized.  The patients that we see with these types of problems refer to my office misdiagnosed, or undiagnosed.  Often they are on drugs that they have no idea why they are taking, and which are not only not helpful, but oftentimes harmful.  (Whenever you are prescribed a drug, you should ask why).  They have seen several doctors and have had batteries of tests.  We particularly enjoy working with these types of patients, as when they get better the joy is heartfelt by all.

Sep

7

Mild cognitive impairment, (MCI), is a condition in which a person has problems with memory, language, recall and other simple activities of daily living which are severe enough to be noticeable to other people.  Often times those affected are frustrated by inabilities to perform otherwise simple things that perhaps a child could easily perform.  Research has shown that individuals with MCI have an increased risk of developing Alzheimer’s disease over the next few years, especially when their main problem is memory although not everyone diagnosed with MCI goes on to develop Alzheimer’s.  Although Parkinson’s is a movement disorder, areas involved in the disease are also the areas involved in MCI.  It is therefore not uncommon for patients suffering with MCI to exhibit balance loss, dysequilibrium and thus increased risk for fall.  Because of the overlap of these disorders, when they are recognized early, they can oftentimes be successfully managed with appropriate rehabilitation.  My office has had tremendous success in managing patients with these disorders and the earlier treatment is sought, the better typically the outcome.  End stage disorders invariably involve drug therapy and or live-in care due to overwhelming disability and incapacitation.  Typically at the onset of these disorders, the use of a cane to assist with walking becomes necessary.  This eventually progresses to a walker.  Although this is good for stability, it causes the brain to work even less, thus eventually requiring advancement to a wheel chair.  Due to the lack of gravitational influence from no longer weight bearing upright, this leads to even more rapid deterioration and incapacitation.  Because of the severity of progression associated with these disorders, if you or a loved one seem to fit the general description of MCI, we urge you to consider coming in to see us for a consultation.  We never charge for this service, and, you can also have a free balance test using state of the art computerized dynamic posturography on the same visit.