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Friday, January 27, 2017

CBD and Chiropractic

Emerging from the shadow of its controversial - and sexier - sibling tetrahydrocannabinol (THC), cannabidiol (CBD) is close to being a panacea. Judging from the amount of research conducted in the last 10 years on this phytochemical, and by a wide range of claims concerning its therapeutic benefit, CBD may be a health-care game-changer.

A non-psychoactive supporter of the human endocannabinoid system, CBD appears to be useful in relieving seizures, pain, anxiety, insomnia, depression, and more, and theoretically replacing painkillers, anxiolytics, sleeping pills, antidepressants and other dangerous prescription drugs. CBD has no unwanted side-effects.

In contrast to medical and recreational cannabis products containing THC, CBD oil, an extract of the low-to-no THC industrial hemp plant, is legal for sale and consumption in all states of the U.S. in spite of the December 2016 Drug Enforcement Administration's (DEA) creation of a new "Code Number" for "Marihuana Extract". CBD oil is legal for consumption in all states.

Background

The hemp plant from which CBD is extracted has been used for thousands of years and across a variety of cultures in dozens of applications including paper, clothing, rope, fuel, plastics, and building materials. In 17th century America, farmers were ordered by law to grow hemp. According to an 1850 census there were 8400 hemp plantations in the U.S. In the early 20th century, the Ford Motor Company produced hemp fuel.

But in 1937 Congress put an end to hemp farming by passing the Marijuana Tax Act, spearheaded by Federal Bureau of Narcotics chief Harry Anslinger. The Marihuana Tax Act made it illegal to grow cannabis of any kind including hemp - and for anyone to possess cannabis - without a tax stamp. The catch-22 here is that the government never issued the tax stamps.

A strict alcohol prohibitionist, Anslinger - as the story goes - looked for another prohibition about which to evangelize when alcohol prohibition ended in 1933. Some say that Anslinger chose this new prohibition to justify the continuation of his job at the Federal Bureau of Narcotics. In any case, growing cannabis of any kind, including industrial hemp, in the U.S. became illegal as it still is today. (The 2015 Industrial Hemp Farming Act, a federal bill that would legalize hemp cultivation in the U.S., would change that.)

Ironically, the U.S. is the largest importer and consumer of hemp and hemp products, and it's the only industrialized nation that can't grow it. (The U.S. imports most of its hemp from China.) On top of that irony is another: CBD oil extracted from industrial hemp is legal to sell and consume in all fifty states.

Biochemistry

CBD was discovered in the cannabis plant in 1940 but its structure wasn't described until 1963. When THC was isolated from hashish in 1964 by Yehiel Gaoni and Raphael Mechoulam at Hebrew University, and subsequently identified as the major active component in cannabis, CBD was considered inactive and it faded from view.

Cell receptors in the human body for the cannabinoids were discovered in the 1980's by Raphael Mechoulam. In the 1990's Mechoulam identified cannabinoids made in the human body (called endocannabinoids) one of which he and his associates called "anandamide", from the Sanskrit "ananda" meaning joy or bliss. With the discovery of anandamide, the cannabinoid receptors, and related enzymes, the "endocannabinoid system" (ECS) emerged.

The human body makes the fatty acid endocannabinoids from arachidonic acid and cell-membrane phospholipids. These fat-related molecules, such as anandamide, have cell receptors identified as CB1 and CB2. Anandamide and THC are "ligands" with respect to the endogenous cannabinoid receptors, especially CB1, which is present mostly in the brain and nervous system. ("Ligands" are molecules, inside or outside of the body, that are alike in their ability to bind to the same receptor.) Another important endocannabinoid derived from arachidonic acid is identified simply as 2-AG.

CBD is an exogenous cannabinoid that has a weak affinity for endogenous receptors CB1 and CB2. However, CBD inhibits the enzyme that breaks down the endogenous anandamide, thus increasing the presence of anandamide. Some researchers speculate that its inhibition of this enzyme accounts for some of CBD's effects on the nervous, immune, and other systems.

Some physiological functions of the endocannabinoid system include homeostasis, neuroprotection, memory processing, heart rate and blood pressure regulation, and lung function.

To review, in the human body a very important physiological system of lipid molecules, cell receptors, and enzymes operates to help maintain homeostasis. This system, the endocannabinoid system, responds to lipid chemicals called phytocannabinoids and endogenously-produced cannabinoids such as anandamide and 2-AG. The phytocannabinoids, especially CBD and THC, are produced most abundantly in the cannabis plant. Though legal in some states, at the federal level THC is illegal and still considered a dangerous drug by DEA. However, CBD is legal and the oil can be extracted, sold, and consumed everywhere in the U.S. and is viewed increasingly as a nutritional and therapeutic agent with a wide spectrum of beneficial effects.

Therapeutic effects

A partial list of CBD's pharmacologic characteristics includes anti-inflammatory, anti-convulsant, anti-biotic, anti-fungal, anti-spasmodic, anti-oxidant, anti-psychotic, analgesic, and anxiolytic. CBD has been useful in the treatment of multiple sclerosis, Parkinson's disease, Alzheimer's, Crohn's disease, post-traumatic stress disorder, diabetes, arthritis, and psychiatric disorders ("... cannabidiol may ameliorate psychotic symptoms with a superior side-effect profile compared with established antipsychotics." Leweke, F. Therapeutic Potential of Cannabinoids in Psychosis. doi: dx.doi.org/ 10.1016/j.biopsych.2015.11.018). CBD even can be used in treating acute psychosis induced by THC.

Of the little research that was performed on CBD prior to the 1990's, two studies, one in 1947 and another in 1949, demonstrated CBD's anti-convulsant properties in children, properties comparable to phenobarbitol but without the latter's toxicity. Considering the harmful side-effects of phenobarbitol, which include behavioral and cognitive function issues, it is unfortunate for many families that leads from this research were not followed. Interestingly, a 1924 book by a Dutch neurologist listed Cannabis indica as a drug-adjunct in the treatment of epilepsy. It seems that doctors' fascination with synthetic chemical medicine in the early-to-mid 20th century in the U.S. resulted in the obviation of valuable plant-based medicine and in unnecessary suffering.

As mentioned, endo- and phyto- cannabinoid research has exploded in the last few years. Much of the purpose of this research, however, has been to identify "targets" and "magic bullets" for drug research. There is a compulsion among ECS researchers to isolate the active components of the cannabis plant so that pharmaceutical analogs can be synthesized and marketed for clinical use by doctor prescription. The phrase "ripe for therapeutic exploitation" found in cannabis research articles betrays the modus operandi. ("...the ECS has become one of the main targets for the design of drugs that could act as therapeutic agents in pathological processes." Aizpurua-Olaizola, O et.al. Targeting the endocannabinoid system, dx.doi.org/10.1016/j.drudis.2016.08.005). However, the many and varied regulatory actions of the ECS and the wide effects of the exogenous cannabinoid CBD may frustrate these efforts. There are about 120 molecules identified as cannabinoids, one of which is CBD. And there are cannabinoid receptors everywhere in the body, especially in the nervous and immune system cells, where CBD has effects. CBD also has non-receptor effects. In a sense, these discoveries about the endocannabinoid system and CBD are guiding us to a new, more accurate perception of health and holism.

A recent paper by Ethan B. Russo, M.D., his third in support of his theory of a Clinical Endocannabinoid Deficiency Syndrome (CED), illustrates overlapping relationships between three chronic pain syndromes suffered by many people and whose successful treatment has eluded conventional medical science. These three syndromes - migraine, fibromyalgia, and irritable bowel - have comorbidity and a "commonality of symptomatology", Russo says, that point to a deficiency of endocannabinoids, especially anadamide. Cannabidiol is known to raise anadamide levels ("Cannabidiol inhibits the degradation of anadamide" doi: 10.1038/tp.2012.15).

The identification of a CED was made possible by research into the endocannabinoid system and its cannabinoid ligands. In the conventional manner, we have named three apparently different diseases and have attempted to develop specific drugs to treat these diseases. In the case of CED, however, we see that the three diseases are the same deficiency disease process with symptoms that manifest differently. And we find that, possibly, one plant, that is cannabis, with many synergistic components, is the appropriate treatment. This latter approach is holistic.

Some success has been realized in the "magic bullet/biological target" approach, however. For example, Nabilone, developed by Eli Lilly and Company, is a synthetic THC prescribed for nausea, pain management, fibromyalgia, and multiple sclerosis. Nabilone does have unwanted side effects though. Pharmaceutical extract Sativex, containing about equal amounts of isolated THC and CBD, is prescribed for multiple sclerosis and neuropathic pain and has fewer unwanted side-effects. A CBD pharmaceutical extract called Epidolex currently is the subject of 13 clinical trials in the U.S. alone. These trials are designed to test CBD isolated extract for its effectiveness against epilepsy, seizures, refractory childhood epilepsy, and schizophrenia.

In some research, subjects reported preferring the whole plant to the isolated extract or synthetic form of cannabinoid ("... the antiinflammatory and antinociceptive activities of standardized CBD-enriched plant extracts increased with dose, making whole-plant extracts superior to pure CBD for the treatment of inflammatory conditions." Aizpurua-Olaizola, O et.al. Targeting the endocannabinoid system, dx.doi.org/10.1016/j.drudis.2016.08.005). Because there are 483 compounds unique to the cannabis plant there may exist what Raphael Mechoulam calls the "entourage effect" as a way of explaining the supporting or interacting role played by the plant's less well-known molecules. Viewing the variety of beneficial effects of the cannabinoids from the reductionistic "magic bullet/biological target" perpective, conventional medical scientists describe the action of the whole plant as a "synergistic shotgun". The habitual use by the conventional medical system of the ballistic projectile metaphor is revealing.

Descriptors such as "entourage effect" and "synergistic shotgun" also suggest the inherent holism of application of the cannabis plant in addition to a melding of food, dietary supplement, and medicine concepts. Is a full-spectrum CBD oil extract a medicine, food, or dietary supplement? All of the above?

Still the conventional medical system is behind the curve in developing the phytocannabinoid CBD (see Sanjay Gupta's documentary Weed). As a general use extract, a traditional medicine, or a dietary supplement, companies in Colorado, California, and elsewhere, specializing in botanical extracts, are developing and marketing CBD oil, and a doctor's prescription is not needed to obtain these products. This grass-roots, small private-company approach is likely to appeal to independent chiropractors.

Chiropractic

Research published in 2005 in the Journal of the American Osteopathic Association (JAOA) purports to show that osteopathic manipulation increases the body's production of anandamide. From the abstract of the article (J Am Osteopath Assoc. 2005 Jun, 105(6):283-91), "The authors propose that healing modalities popularly associated with changes in the endorphin system, such as OMT [osteopathic manipulative technique], may actually be mediated by the endocannabinoid system." They found posttreatment anandamide levels had increased by 168% over pretreatment levels. (Subsequent research on this subject was inconclusive.)

A 2008 article published in the JAOA (JAOA Vol. 108. ,No. 10, October 2008) provides a comprehensive review of the ECS, and suggests that it "...may reflect OPP [osteopathic principles and practice] on a molecular level." Citing four tenets observed by the profession that represent principles of patient care, the author shows how the ECS relates to and supports these principles. The ECS's wide ranging homeostatic effects as described resonate with osteopathy's more holistic philosophy, according to the article.

Although the beneficial effects of the chiropractic adjustment in the clinic are well-known, the biochemical mechanisms that underlie it are not. It may be that the effect of the adjustment is mediated by the endocannabinoid system, especially anandamide: both spinal adjustments and the ECS produce a downward modulation by "retrograde neurotransmission" at neural synapses of long-term potentiation in spinal neurons caused by persistent glutamate release. Since stretching, torsion, or compression of a nerve or nerve root, as in subluxation, causes damming of CB1 receptors proximal to the damming effect resulting in persistent glutamate release downstream, the adjustment may precipitate the "retrograde neurotransmission" phenomenon and satisfy the feedback loop for pain relief. Thus in this way we can understand at least the biochemical effects of the adjustment. And we might recommend the use of a CBD herbal extract, orally or topically, for increased pain relief. In addition, researchers have discovered that cerebrospinal fluid contains abundant anandamides and may play a role in the production of the cranial rhythmic impulse, which is known to Sacro-Occipital Technique practitioners.


Another irony, this one comic/tragic, is that the best medicine for the inflammation-based diseases that lately affect so many Americans has been discovered in a plant that has been officially villified, outlawed, and sanctioned as having no value. There are similarities to chiropractic in this irony. Possibly, we are emerging from the harmful effects of a deluding, deceptive perception. In any case, for chiropractors who want to provide patients with whole plant-based nutritional support to potentiate the effects of the adjustment or as support against fibromyalgia and other conditions of imbalance, CBD extract is ideal.

Tuesday, September 20, 2016

Everybody's the Same, and Everybody's Different


Recent stories in the news have sounded an alarm against nutritional supplements. These articles are interpretations of Consumer Reports material that has questioned their safety. The articles imply that nutritional supplements should have approval from the Food and Drug Administration (FDA).

The articles, and original reports, seem to imply that nutritional supplements in general are dangerous. A more careful inspection reveals that the issue is with specific substances in non-nutrient products promoted for easy weight loss, better sex, improved athletic performance, and so on. Consumer Reports articles propose greater FDA oversight and regulation to protect consumers from harmful effects of all dietary supplements.

But, according to its web page fda.gov/food/dietary/supplements, FDA does regulate "both finished dietary supplement products and dietary ingredients." FDA assigns manufacturers of supplements the responsibility for evaluating supplement safety. But if FDA finds a problem it "is responsible for taking action."

These recent articles appear to be a part of a years-long campaign to bring the nutritional supplement industry under the authoritarian control of the FDA and the pharmaceutical industry. But, as many of us know, greater FDA oversight will not make anything safer; and this strategy may result only in the pharmaceutical industry increasing its profits and power. Mercola.com ("Consumer Reports Joins Pharma Campaign Against Dietary Supplements", August 09, 2016) provides a fairly good view of the controversy. Andrew Saul at orthomolecular.org reminds us that there have been "No Deaths From Vitamins. Absolutely None". Orthomolecular's August 12, 2016 "Supplements Are Safe: Who is Lying to You Now?" addresses Consumer Reports' study, also.

FDA scorecard

It's no secret that FDA-approved, doctor-prescribed drugs are a major cause of death in the U.S. each year. Many of these deaths are the result of patients taking drugs as prescribed by the doctor. In 2000 an article appearing in the Journal of the American Medical Association estimated that prescription drugs kill 106,000 people annually. Recently an article in the British Journal of Medicine written by researchers at the Johns Hopkins School of Medicine claims that medical error, including the use of prescription drugs as prescribed, kills 251,000 each year and is the third leading cause of death in the U.S. after cancer and heart disease. In 2010 researcher Robert Wachter wrote that diagnostic errors, which get no attention, contribute to many medical errors. A study published in January 2016 in Anesthesiology found that half of 277 surgeries observed involved medication errors and adverse drug events and that "there is a substantial potential for medication-related harm" in the surgical setting. And we should not forget the overuse and abuse of antibiotics that has induced antibiotic resistance in bacteria, a phenomenon known to FDA, which did nothing about it, since at least 1970.

Also noteworthy in this context is the outbreak in 1989 in the U.S. of a disease called eosinophilia-myalgia syndrome (EMS) that caused over 37 deaths. When it was determined that the amino acid tryptophan was associated with EMS, the FDA in 1991 banned its sale. Closer epidemiological study found that a specific batch from a Japanese company using genetically engineered bacteria to make the tryptophan was responsible for a deadly impurity in the amino acid. The FDA, however, whose expressed policy was to promote biotechnology, attempted - successfully - to obscure the fact that an impurity from genetic engineering was the cause of EMS. Interestingly, in 1991 Michael R. Taylor accepted a newly created post at FDA, "Deputy Commissioner for Policy". He authored the FDA's guidance that appeared in 1992 on genetically engineered food. To accept this FDA position, Taylor left his job as a lawyer and lobbiest for biotech giant Monsanto. In 1996 Taylor left the FDA and returned to work for Monsanto as Vice President for Public Policy.

We should not forget the letter written in 2009 by nine FDA scientists to then President-elect Obama alleging that the agency was "fundamentally broken" and that "there is an atmosphere at FDA in which the honest employee fears the dishonest employee...." The letter further alleged "systemic corruption and wrongdoing that permeates all levels of FDA." The letter said that FDA scientists were "ordered, intimidated, and coerced... to manipulate data in violation of the law" (wsj.com, "FDA Scientsts Ask Obama to Restructure Drug Agency", Jan. 8, 2009). Following on this, in 2012, six FDA whistleblowers filed a lawsuit against FDA for unconstitutionally targeting and monitoring them. The lawsuit alleged that FDA "converted private emails... initiated searches and seizures..." violated their "right to free speech..." and so on.

The FDA/conventional medical/pharmaceutical sector has serious, deep-rooted problems that need to be corrected before it points a finger at the nutritional supplement industry.

Redefining "Expert"

The FDA, however, was not responsible for the Consumer Reports atricles. Consumer Reports chief medical advisor and medical editor, Marvin Lipman, M.D. probably was. He's written articles such as "The dangers of dietary supplements", and recommends that - to be safe - one should research supplements on "trustworthy sites such as ConsumerReports.org." Another expert on the Consumer Reports panel was pediatrician Paul Offit, M.D. who famously called Linus Pauling, Ph.D. a quack for recommending high doses of vitamin C, even as he, Offit, recommends high doses of vaccines for infants. A July 26, 2016 Consumer Reports article claims that "an expert panel of independent doctors and dietary supplement-researchers" created the report, but the panel was stacked with people who oppose even the proper use of nutritional supplements.

In fact, some of the "supplements" Consumer Reports warns against in its report do have potential for harm without contributing benefit. But compared to the number of nutritional supplements produced and marketed responsibly that are beneficial and have little or no unwanted side-effects, the Consumer Reports picks are hardly mentionable.

Quick and Easy

Advertising that promotes a quick and easy fix for our health problems, whether by dietary supplements or prescription drugs, usually is too good to be true. But sometimes we might go for it anyway, maybe because we've been tricked, or because we haven't been responsible for our health and we want to get back what we think we've lost. Marketing is the poblem here: some products that claim to be dietary supplements do contain ingredients that are potentially dangerous for some people. Furthermore, our culture, fragmented and specialized as it is, encourages us to rely on "the doctor" for our health care because we're performing our own specialized tasks and we don't have time to be better informed. This detachment makes us dependent on doctors and questionable "supplements", and makes us externally dependent on the dangerous inefficiency of the diagnosis-drug match game: "I need someone or something 'out there' to be healthy."

An example of how this perception-reversal is maintained is in the concept of diagnosis. A medical diagnosis is the process of using a patient's symptoms, history, and medical tests to identify or name her/his apparent disease. Diagnosis is important to match the disease with a developed drug or medical procedure. (And it's important for insurance companies.) With a diagnosis, "the doctor" can write a prescription that the patient will need to take possibly indefinitely, because "health depends on it".

But diagnoses usually do not address underlying causes. Conventional medical practice deals in symptom-based diagnosis and treatment. It is not equipped to provide support for biochemical, nutritional, or metabolic imbalances - just the idea is met with scorn and acqusations of quackery.

Reputable nutritional supplement companies that produce very high quality products also will promote their products relative to a diagnosis. In some cases, this is useful and effective. However, relying on the diagnosis-nutritional supplement matching game, even when it is successful, obscures the likelihood that the diagnosed disease is merely a manifest symptom of deeper nutritional, metabolic imbalance. In order to compete with the conventional system, nutritional supplement makers must use the same approach.

In fact, there is no reliable way for a doctor to know a patient's nutritional insufficiencies. Hair, blood, urine, saliva, feces, and so on have only a relative value in determining what can be recommended or prescribed to the patient. There is no reliable way, except for one.

Doctor, Diagnosis, Drugs

You're not feeling right - you don't know why - so you go to the doctor's office. The doctor looks you over, arrives at a diagnosis, prescribes medicine, and bills the insurance company.

Usually the medicine is a toxin that interrupts a metabolic pathway or interferes with a normal process in the body. Calcium channel blockers, cholesterol lowering statins, and proton pump inibitors are examples of these toxins. These "medicines" are among the most prescribed in the U.S.

And yet each of these three has a very good "natural alternative" (a phrase that demonstrates the reversed perception: why is the doctor's first choice in re-establishing the patient's health a toxin with harmful side-effects that may extend the patient's poor health?) Health imbalances for which the doctor prescribes potentially dangerous "medicines" may be caused by dietary, nutritional insufficiencies and lifestyle stresses that may be specific to the patient. Instead of first addressing basic nutritional needs to support normal physiological function, the doctor prescribes a substance that further compromises normal function, a substance he prescribes to everyone with the same apparent symptoms, as if the cause of the diagnosed disease is the same from patient to patient.

Calcium channel blockers are usually prescribed for high blood pressure and hypertension. Magnesium is known as the natural calcium channel blocker and calmative. It's also the consensus that a majority of the U.S. population is magnesium deficient. Heart disease is one of the top three causes of death each year in the U.S. Insufficient magnesium is associated with cardiovascular (as well as all-cause) mortality. Magnesium is critical for many important metabolic reactions in the human body.

Your doctor may discover that your cholesterol numbers are higher than the established quantified standard conventionally agreed upon by the experts. And even though this has nothing to do with your original purpose in going to the doctor, he may want to prescribe a statin drug that blocks the body's normal and natural production of cholesterol.

Cholesterol is one of the most important molecules in the body. It is essential in the structure of human cell membranes. Stress and gender hormones and vitamin D are metabolites of cholesterol, and it is necessary in tissue repair and other functions. Except for a small number of people who may be genetically predisposed to maintaining very high blood cholesterol, inhibiting the cholesterol metabolic pathway can produce health problems. The use of niacin, a B-complex vitamin, to moderate cholesterol, as pioneered by psychiatrist Abram Hoffer, M.D., has been the safe "alternative" for many years. Increasing one's daily fiber consumption and improving one's food choices also might be helpful in modulating blood cholesterol that's considered high. Since cholesterol is one of the body's ways of controlling inflammation, eliminating the causes of inflammation (food sensitivities, mental and emotional stress, poor sleep, and so on) will be helpful.

One of the deadliest doctor-prescribed medicines is the proton pump inhibitor. These drugs are designed to reduce acid production in the stomach, which is identified as a cause of "acid reflux disease". But when we understand that, in most cases, acid reflux is the result of too little hydrochloric acid production possibly from too little chloride in the diet, we get a glimpse of the tragic folly that is conventional medicine and drug prescribing in America. Proton pump inhibitor use has been associated with poor magnesium absorption and bone fractures, among other things.

If, on your visit to your doctor, he finds that you have high blood pressure, he may prescribe a calcium channel blocker and tell you to avoid table salt. Table salt is sodium chloride, a main source for the body's chloride dependency. However, it is not the chloride that's contributing to your high blood pressure, it's probably the sodium. And though sodium is necessary for normal health, medical scientists have identified it in certain amounts as causal in high blood pressure, and they tell us to limit our salt intake. Magnesium and potassium supplementation can help normalize blood pressure.

If you've been using table salt that contains an aluminosilicate anti-caking agent, this may represent another layer of complexity to your health. Aluminum is a very good acid neutralizer. Sodium aluminosilicate is approved by FDA as a "generally recognized as safe" food additive. But aluminum is a neurotoxin and continues to be explored in research as a causal factor in the development of Alzheimer's disease. Aluminum has no biological function in the human body. It is toxic.

Once you begin taking proton pump inhibitors the pH of your stomach juice will become even less acidic. Normal stomach pH should be very acidic, roughly 1.5 to 2.5. This low pH is necessary to begin digestion of protein foods and activation of the very important enzyme, pepsin. Without this and other proteolytic enzymes, you will limit absorption of amino acids from the gastrointestinal tract into your body.

If your high cholesterol is the result of chronic, generalized inflammation, a contributing factor may be poor glutathione production. Glutathione is the body's endogenous anti-inflammatory enzyme - possibly the most important in-cell enzyme in the body. The body's cells make glutathione from three amino acids absorbed from the gastrointestinal tract into the liver. Therefore, the proteolytic enzyme action on dietary proteins, with glutathione production in view, is very important.

Glutathione neutralizes reactive oxygen species that are produced in cells as a result of normal energy production. That is, energy production in the body's cells always occurs with free radicals as a by-product. Glutathione, along with other enzymes, neutralizes those free radicals. Without glutathione these free radicals may lead to generalized inflammation, which is a cause of many of our chronic diseases such as cancer and heart disease.

The signs of nutrition deficiency diseases (rickets, scurvy, pellagra, and beri-beri for example) represent the end stage of the disease process that likely has been ongoing for some time in the form of other noticeable, or not-so-noticeable, imbalances. For example, Linus Pauling believed that athersclerosis was a hidden or overlooked sign of scurvy and suggested high-dose ascorbic acid and the amino acid lysine to correct the problem. We want our food to provide us with all of the nutrition materials that we need for good health, and this may be possible for a few of us, but not for all of us. Conventionally trained nutritionists give us information based on the current medical dogma but they resist new, better information. And since everybody's the same and everybody's different it's hard to determne appropriate requirements for essential vitamins and minerals with accuracy for every person. But it can be done.

In addition to harmful dietary aids, over-the-counter drugs, and prescription drugs, there are relatively safe supplements that have a desired effect but do not benefit the highest potential of human function, and do have hidden side-effects. If these supplements are consumed for a specific purpose and they achieve that purpose, then they should be in the category of drugs, not nutritional supplements. Their side-effect may not be as pronounced as that experienced from prescription drugs or hyped weight-loss formulas, but if they take something in exchange for whatever they give they are not nutritional. Fish oil supplements fall into this category. But this is not to say that these should be controlled by the pharmaceutical industry or medical doctors.

Indicator Muscle Testing

The only way to determine if this specific nutritional supplement in this specific dose is beneficial and without side effects for this specific patient is to obtain immediate feedback from the bodymind of the patient. This kind of feedback can be obtained using indicator muscle testing.

Indicator muscle testing is not a muscle test to determine the quantitative strength of a muscle. A young weight lifter's deltoid muscle is much stronger than the deltoid muscle of an elderly, sedentary woman. Both the weightlifter and elderly woman should be able to demonstrate that the muscle works properly, however. That is, the normally healthy muscle contracts and sustains a contraction against a moderate force, and weakens, or demonstrates inhibition, with specific challenges. Once this proper function of an indicator muscle is established, the muscle can be used as an "indicator" for imbalances in the whole bodymind.

This muscle testing is a test of a specific muscle, the right deltoid muscle for example; it's a test of the nerve that supplies motor and sensory function to the muscle; and it's a test of the polarized electrical current in the perineural tissue that surrounds every millimeter of neuron in the body. The muscle will not function properly without its nerve supply, but the motor and sensory neurons in the nerve will not function without the direct current (DC) in the perineural sheath. In fact, the neuron will die without the perineural DC.

The "imbalances" found in the bodymind using indicator muscle testing relate to specific loci on the body that have a specific electromagnetic frequency that resonates with the electromagnetic frequency of a nutrient - a vitamin, mineral, amino acid, or fatty acid. In the electromagnetic body, these imbalance-loci are called "currents of injury", in general. In other words, there is not a place on the body labelled "vitamin C" but there is a place that has a high resonance value with vitamin C. If that place, when specified, causes an indicator muscle to weaken, we say that there is a current of injury there, and that supplying vitamin C will correct that current of injury and help in balancing the body's electrical-energy system.

With the knowledge and practical application of the muscle test as a feedback mechanism that provides the bodymind's reaction to specific nutrients and drugs, our understanding of the use of these substances changes. We begin to have a more basic and comprehensive perception of the human bodymind as electromagnetic and not simply as mechanical or chemical. In fact, our rigid belief that the bodymind is purely mechanical or chemical limits and inhibits the holistic perception of its electromagnetic nature. Indicator muscle testing reinforces the idea that the body is an irreducible whole organism. In this view, we see that all substances taken into the body have an impact on its energy system and, therefore, that all medicine is energy medicine - some contributes to and supports the body's energy, while some compromises the body's energy.



Dr. William Conder
September 2016












Wednesday, June 29, 2016

A Necessary Evil

During the natural birth process (and for the rest of life), sensory receptors in the baby's skin transduce the skin's mechanical distortion into electrical signals that travel up the spinal chord to the thalamus deep inside the brain. Similar sensory receptors found in the ear are sensitive to vibration, which is transduced to sound.

Tactile stimulation and subsequent stimulation of the infant's somatosensory system, as when the infant suckles and the mother holds and caresses it, is the beginning of the development of sensory perception.

During this period, the child becomes accustomed to hearing the quality of its mother's voice. Tactile, acoustic, and vibration communication are basic and critical to the child's development, and to conscious awareness in adulthood.


Normally the child develops hearing and speech functions from this intimate contact with its mother, and with other family members and friends. In the first year of life, the child learns to make sounds to which others respond, beginning its ability to communicate with others in vocal expression. In this way, oral-aural communication in words becomes the basic mode of human communication common to all, facilitating common sense.

We learn to speak, use appropriate words, and make coherent sentences in verbal interaction in the oral/aural environment. But within a couple of years our eyes are presented with the visual coding system that shifts the primary sensory-communication mode from the ear to the eye, confounding common sense.

The alphabet and the ability to read, interpret, and write using its 26 symbols has been imbued with enormous importance though we begin literacy programming before we have fully developed oral communication skills. We call it a "phonetic" alphabet, as compared to an ideographic one, but the speech sounds that are transcribed using this system are limited to 26 meaningless symbols seen with the eyes. The acquisition of literacy skill depends on interpretation of the specific arrangement of letters into a meaningful word. An ideograph directly represents the idea.

The phonetic alphabet usually is credited with being a causal factor in the emergence and evolution of Western civilization, having been initiated in Ancient Greece with Plato and his influence. When the printing press was invented in Europe in the 15th century and the alphabet shifted from script to print, literacy rates exploded destroying Medieval culture and the authority of the Church.

Because literacy programming begins at an early age and is pervasive, we blindly appreciate its benefits and remain ignorant of its side effects. Until the mid 20th century, we believed that literacy made us smart and that illiteracy was a sign of ignorance and stupidity. Literacy gives a sense of objectivity and detachment from experience that is important to scientists and other detectives. In doing so, however, literacy induces in the mind an artificial visual perspective that we tend to impose on all experience, universally.

As we continue to use print literacy, we are used by it: we create structures in the external environment that represent its mechanisms and that reinforce its programming in us. In this way it predetermines perception.

Once we have acquired basic literacy skill, we cannot unlearn it. Presented with words from our learned language, we are compelled to read. Literacy engenders a cognitive bias: it selects for a left-to-right linear arrangements of facts, leads us to believe that complex systems can be understood by breaking them down into smaller parts, and lets us assume that all phenomena can be transcribed and recorded using its letters. Literacy distorts the way we see the world.

Our technologies, including the alphabet and print, are mirrors that keep us hypnotized and anesthetized.

The more conditioned we are by print literacy, the more we believe in its artificial perspective, which has evolved into the so-called "virtual reality". Unfortunately, virtual reality is neither virtuous nor real. In it we are Narcissus.

According to the mythology, Narcissus fell in love with his reflected image but did not know the image was his own. Meanwhile, Echo, whose love is true yet unrequited, beckons from the wood just beyond.

Echo was a nature spirit. The word "echo" comes from a Greek word that means "sound".

But we cannot abandon literacy - it is the trunk of our technology tree and, as we are committed to it by it, it is necessary. Even our electric media are supported by phonetic alphabet literacy.

The popular 1999 movie The Matrix proposed that the world perceived by its inhabitants was an artificially created virtual reality. Interestingly, a matrix in printmaking is the form that holds the imprinting material and, in typesetting, is the mold used to make type. Matrix is from the Latin "mater", which means mother. With the "x" ending, we might identify it as the evil Techno-mother that gives birth to deluding human artifice engendered by the spoken word. And we might distinguish this Techno-mother from every living thing's Mother Nature.


Monday, April 11, 2016

Nature Pushes Back Against A Miracle



"It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them."  Alexander Fleming, discoverer of penicillin, Nobel Prize in Physiology or Medicine; from his 1945 Nobel Lecture.

The overuse, misuse, and abuse of antibiotics in human health care and animal husbandry, and the consequent emergence of antibiotic-resistant bacteria, reveal the ineptness and corruption of the conventional medical establishment in America. Doctors, pharmaceutical-biotech companies, industrial farming operations, and the FDA share responsibility. "There is no longer time for silence and complacency." ("Society's failure to protect a precious resource: antibiotics"; doi: 10.1016/S0140-6736(11)60401-7).

A March 25, 2016 New York Times article titled "How To Stop Overprescribing Antibiotics" gets one's attention: do you mean that prescribing doctors continue to over-prescribe antibiotics? Apparently the answer is "Yes". The article promotes the authors' research and suggests that doctors are just as irrational as the rest of us. (Don't let that information get out.) They say their research demonstrates that some very simple measures could be used to reduce the amount of unnecessary prescriptions written by doctors.

The article notes a couple of strategies that haven't worked. Educating doctors and patients about antibiotic use and abuse "has had only a modest effect". Alerts to doctors via electronic health records didn't work because doctors ignored the messages. "And offering doctors financial incentives" to not prescribe antibiotics doesn't work so well either "because the payments are modest relative to a doctor's salary." This last strategy is the most preposterous of all: paying doctors a bonus to do what they're getting paid to do in the first place.

The article mentions a study published in JAMA Internal Medicine that explored the effect of something called "decision fatigue" on the rate of prescribing unnecessary antibiotics. It found that "decision fatigue progressively impairs clinicians' ability to resist ordering inappropriate treatments." In other words, the later in the day you go to the doctor the greater your chance of getting a 'scrip for antibiotics.

The antibiotic penicillin is called the first "miracle drug" for its ability to stop bacterial infections. Its first important use was in World War II to treat soldiers' infected wounds. But it took only 20 or 30 years for the miracle to fade. By 2013 a CDC official had announced the end of the age of antibiotics and the beginning of a nightmare. "Miracle" may have been an overstatement.

A CDC Report, "Antibiotic Resistance Threats In The United States, 2013" estimates that "...more than two million people are sickened every year with antibiotic resistant infections, with at least 23,000 dying as a result". It calls these "minimum estimates". It also lists Candida, a yeast normally found in small amounts in the gastrointestinal tract and whose population increases with the use of antibiotics, as a serious threat due to its growing resistance to the anti-fungal drug fluconazole.

The 2013 CDC Report says that antibiotic-resistant infections "require prolonged and/or costly treatments, extended hospital stays..." and so on, adding "considerable and avoidable costs to the already overburdened U.S. healthcare system." Estimates of cost to the U.S. economy from antibiotic resistance, though hard to calculate, range from "$20 billion in excess direct healthcare costs, with additional costs to society for lost productivity as high as $35 billion a year (2008 dollars)".

The CDC Report says "up to 50% of all the antibiotics prescribed for people are not needed or are not optimally effective as prescribed." Of the subtherapeutic use in food animals to promote growth, the Report says "...it is not necessary, and the practice should be phased out."

Antibiotics pose another problem, however. The proper use of antibiotics has many side effects. A 2012 Time article says that 140,000 people, many of them children, go to a hospital emergency room each year with a bad reaction to appropriately prescribed antibiotics, and 9,000 of these have to be hospitalized. The CDC Report says that 1 out of 5 emergency room visits for adverse drug reactions are for antibiotics and that antibiotics are the most common cause of emergency room visits for children 18 years old and younger. Candida overgrowth, noted above, which represents a change in the human microbiome, is a potentially dangerous side-effect of proper antibiotic use.

The history of the antibiotic resistance debacle, in spite of Fleming's 1945 warning, begins on the farm. In the early 1950's the FDA approved the use of penicillin and a couple other antibiotics in sub-therapeutic doses as "feed additives" after it was discovered that the antibiotics fattened food animals such as chickens, pigs, and cattle. But in 1969 the U.K. "Swann Report on the Use of Antibiotics in Animal Husbandry" said that the rising rate of antibiotic resistant bacteria was due to the subtherapeutic use of antibiotics in animal feed. The FDA wasn't sure, so it put together its own fact finding group, which found that subtherapeutic antibiotics in animal feed was causing the emergence of antibiotic-resistant bacteria. It took FDA until 1973 to threaten to dis-approve the 1950's decision to use antibiotics in food-animal feed - unless "industry" could prove the safety of these feed additives. In 1978, after an abundance of convincing research in the U.S. and elsewhere showing that the subtherapeutic dose of antibiotics in animal feed causes the emergence of antibiotic-resistant bacteria, FDA decided to have a hearing on the issue. However, the U.S House of Representatives Committee on Appropriations ordered FDA to put a hold on its hearings and to do more research. FDA then asked the National Academy of Sciences to do the research. In 1980 the National Academy of Sciences said, in a kind of backward wink-wink statement, that it could not prove that the subtherapeutic use of antibiotics is safe. No worries, in 1980 the House Committee ordered more research. In 1981 the Senate Committee on Appropriations asked for more research so FDA asked a health department in Seattle to do this research. The Seattle researchers found DNA proof of resistance that was transmitted to other bacteria. Enter the pharmaceutical industry, which tried to pressure the FDA into dropping its intention to hold hearings on the issue. FDA resisted. In 1988 the Institutes of Medicine warned that the farming practice potentially was a hazard to human health. Thirteen years pass. In 2001, the American Medical Association comes out against antibiotics in animal feed. Two years later the Institutes of Medicine issues a second, more direct warning. In 2004, FDA considers telling feed manufacturers that subtherapeutic dosing of antibiotics is "high risk". In 2010 FDA prepares a document recommending that industry voluntarily limit the use of antibiotics in animal feed. In 2011, however, FDA withdrew its efforts and did not issue its recommendations. (Partly based on Maryn McKenna's chronology.)

Subtherapeutic doses of antibiotics in animal feed has been used as a "growth promoter" since the 1950's when farmers, and then scientists, discovered that feeding chickens a by-product of antibiotic production made them grow faster, live longer, and lay more eggs. Suddenly the survival of the human race was no longer in question- at least in terms of the world's "dwindling resources". In this way, antibiotics made possible intensive, industrial farming. More farm animals could be crowded into the same space and develop less disease even as they brought higher profits in the marketplace with small doses of antibiotics in their feed.

All of this was going on while doctors were handing out prescriptions for antibiotics to their patients for viral infections, which do not respond to antibiotics. Prescribing antibiotics for acute bronchitis, a viral infection for which antibiotics are useless, has remained at 73% for 30 years in the U.S. according to an October 2013 CNN online article.

In 2009, nine FDA employees wrote a letter to President Obama saying that FDA was "fundamentally broken". In addition, the agency had been accused by three Congressmen of "being too close to industry". Today FDA's home page says "Protecting and Promoting Your Health". They must be looking in the mirror. The FDA website page Consumer Updates features an article titled "Phasing Out Certain Antibiotic Use in Farm Animals". It says that it is "implementing a voluntary plan with industry to phase out the use of certain antibiotics for enhanced food production." Anticipating the question, "Why Voluntary?" the answer provided is that "it's the fastest, most efficient way to make changes." Really? Finally, the page gives an assurance: "Based on our outreach, we have every reason to believe that animal pharmaceutical companies will support us in this effort," says Michael R. Taylor, FDA's Deputy Commissioner for foods and veterinary medicine. This last statement appears to have been dated Dec. 11, 2013.

"We estimate that between 2010 and 2030, the global consumption of antimicrobials will increase by 67%..." according to"Global trends in antimicrobial use in food animals," in PNAS February 2015; doi: 10.1073/pnas.1503141112.

A 2015 FDA report "Antimicrobials sold or distributed for use in food producing animals" says  that the domestic sale and distribution  of approved antimicrobials for food producing animals increased by 17% from 2009 to 2013. Microbiologist and congresswoman Louise Slaughter, in discussing Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues by Dr. Martin Blaser, says that as of April 2015 "80% of antibiotics sold in the U.S. are used on mostly healthy animals on factory farms." She says, "Blaser's work is a stunning dose of reality in an environment flooded with corporate-agenda-fulfilling pseudoscience."

Michael R. Taylor was appointed to the newly created Commissioner position in FDA by the Obama administration. But Taylor has been through the industry-government revolving door so many times his head must be spinning. Taylor is a previous Vice President for Public Policy at Monsanto and a lobbiest for the company. Taylor also worked at the Department of Agriculture.

The obvious question is "Why is a lawyer who was a Monsanto V.P. and lobbiest, the FDA's Deputy Commissioner for foods and veterinary medicine?

According to Wikipedia, in 1991 Taylor left a law practice to accept a "newly created post of 'Deputy Commissioner for Policy'" at FDA where he promoted the positions that (1) milk from cows treated with Monsanto's rBGH should not have to be labeled, and (2) the FDA policy statement regarding the acceptance and promotion of genetically engineered foods. Under Taylor's tenure, FDA decided that genetically modified foods are exempt from testing because they're food additives, which are generally recognized as safe (GRAS). However, this was not the consensus among scientists at FDA.

That is, in recent history, two positions have been created at FDA for Michael Taylor.

In the early 1990's another former Monsanto employee, Margaret Miller, was appointed as Deputy Director of New Animal Drugs at FDA. Miller approved a report from Monsanto that attested to the safety of Monsanto's recombinant bovine growth hormone (rBGH). rBGH is given to milk cows to increase production but it also increases the incidence of mastitis, cancer, and other health problems in the cows. No worries. Miller approved an increase by 100 times the legal limit the amount of antibiotics that could be given to the cows. Oh, and the rBGH report she approved while at FDA was written by - herself, Margaret Miller, while she worked in research at Monsanto. ("Question Is Raised on Hormone Maker's Ties to FDA Aides," New York Times, April 1994.)

(While antibiotic resistance was exploding as a public health hazard around the country, at FDA claims were made of the safety and importance of genetically engineered food without their having been tested and against the opinions of agency scientists.)

Antibiotic over-prescribing to humans and subtherapeutic dosing to farm animals have been identified as causal in the emergence of antibiotic-resistant bacteria. However, research has demonstrated that for some antibiotics "extremely low concentrations, similar to concentrations found in natural environments, can select for resistant bacteria." This finding suggests that "antibiotic release into the environment might be a significant contributor to the emergence and maintenance of resistance...." Antibiotic concentrations several hundred times lower than previously determined for bacterial susceptibility will select for and enrich resistant bacteria, according to this research. ("Selection of Resistant Bacteria at Very Low Antibiotic Concentrations", doi: 10.1371/journal.ppat.1002158). In other words, any amount of antibiotics in any environment will tend to induce resistance in the bacteria it is designed to kill, and the emergent, resistant bacteria may be more lethal than the predecessor. Moreover, bacteria with the antibiotic-resistance gene-material have been found in agriculture sectors other than that of food animals. For example, resistant E. coli in spinach may have emerged in cattle eating feed containing a subtherapeutic dose of antibiotics.

A "miracle drug" that has saved many lives also has caused suffering and death. And many who have taken antibiotics prescribed appropriately have developed health issues that until recently have been invisible or mysterious to those who prescribe.

"Antibiotic use is the most common and significant cause of major alterations in normal GIT [gastrointestinal tract] microflora." These alterations "are now believed to be contributing factors to many chronic and degenerative diseases." "...infrequent antibiotic use has much longer lasting effects on the microflora and its metabolic activities than was previously believed." Alteration in gut microflora after antibiotic use increases the risk of infection by pathogens. Recent research has shown that one course of antibiotics alters gut microflora metabolism for 16 months. ("The Causes of Intestinal Dysbiosis: A Review", by Hawrelak and Myers in Alternative Medicine Review, 2004.)

"Dysbiosis" is an intestinal microbial imbalance in which the "good" bacteria no longer control the "bad" bacteria and there is an increase in the yeast population. Antibiotic use is a primary cause of intestinal dysbiosis.

"The human gut contains an immense number of microorganisms, collectively known as the microbiota... The microbiota can be viewed as a metabolic 'organ' exquisitely tuned to our physiology that performs functions that we have not had to evolve on our own... Our findings suggest that the gut microbiota is an important environmental factor that affects energy harvest from the diet and energy storage in the host... Adult humans are composed of an estimated 10 times more resident microbial than human cells.... We speculate that changes in microbial ecology prompted by Western diets, and/or differences in microbial ecology between individuals living in these societies, may function as an 'environmental' factor that affects predisposition toward energy storage and obesity." ("The gut microbiota as an environmental factor that regulates fat storage," November 2004; doi: 10.1073/pnas.0407076101).

Obesity, Type 2 Diabetes, and other health problems have been increasing since the 1980's. By 2014 38% of American adults were obese ("Obesity Rises Despite All Efforts", November 2015, New York Times). Despite a decrease in caloric intake and a general improvement in diet, Americans mysteriously get fatter. Antibiotics are used to fatten chickens, pigs, and cows - it should come as no surprise that they will fatten humans, too.

A 2015 Danish study ("Use of Antibiotics and Risk of Type 2 Diabetes: A Population-Based Case-Control Study", doi: http://dx.doi.org/10.1210/jc.2015-2696) concluded that results "could support the possibility that antibiotics exposure increases type 2 diabetes risk. However, the findings may also represent an increased demand for antibiotics from increased risk of infections in patients with yet-undiagnosed diabetes." A time.com review of this research suggests that children who have had antibiotics experience a change in metabolism due to a change in the composition of their microbiome and consequently develop type 1 diabetes.

A 2015 article in International Journal of Obesity (doi: 10.1038/ijo.2015.218) concluded "...antibiotic use may influence weight gain throughout childhood and not just during the earliest years as has been the primary focus of most prior studies."


In "Antibiotic-induced dysbiosis alters host-bacterial interactions and leads to colonic sensory and motor changes in mice" (doi: 10.4161/19490976.22014.990790) researchers reported that "A 2-week antibiotics treatment induced a colonic dysbiosis..." and "changes in the innate intestinal immune system..." and "...short- and long-term antibiotic treatments seem to generate different states of dysbiosis...."

"Altering the Intestinal Microbiota During a Critical Developmental Window Has Lasting Metabolic Consequences", Cell, August 2014, (doi: 10.1016/j.cell2014.05.052). This study was performed on mice. However, there are implications for humans: "In humans, early-life microbiota disruption, either due to delivery by Caesarian section or antibiotics, is associated with increased risk of overweight status later in childhood...." The researchers, using a mouse model, showed that "subtherapeutic antibiotic treatment delivered at weaning increased adiposity."

"Antibiotic use in early life was associated with the development of childhood asthma, a risk that may be reduced  by avoiding the use of BS [broad-spectrum] cephalosporins." "Increased Risk of Childhood Asthma From Antibiotic Use in Early Life," (Chest, June 2007; doi: 10.1378/chest.06-3008).

"From 1980 through 1992, increasing prescribing... was found for the more expensive, broad-spectrum antimicrobial drugs, such as cephalosporins... The increased use of broader spectrum and more expensive antimicrobial drugs have implications for all patients because of the impact on health care costs and the potential for the emergence of antimicrobial resistance." ("Trends in Antimicrobial Drug Prescribing among office-based physicians in the United States," JAMA, 1995 Feb 11;279(6):434.)

"Exposure to at least one course of antibiotics in the first year of life appears to be a risk factor for the development of childhood asthma." Additional studies are needed to confirm this conclusion, the article says. ("Does Antibiotic Exposure During Infancy Lead to Development of Asthma?" Chest, March 2006; doi: 10.1378/chest.129.3.610).

Subtherapeutic antibiotic treatment "alterations of the microbiome may affect pluripotent cells that can become osteoblasts, adipocytes, or myocytes," ("Antibiotics in early life alter the murine colonic microbiome and adiposity; doi: 10.1038/nature11400).

The abstract of "Dysbiosis of the Gut Microbiota in Disease" (Microbial Ecology in Health and Disease 2015, 26: 26191 - http//dx.doi.org/10.3402/mehd.v26.26191) begins "There is growing evidence that dysbiosis of the gut microbiota is associated with the pathogenesis of both intestinal and extra-intestinal disorders. Intestinal disorders include inflammatory bowel disease, irritable bowel syndrome, and coeliac disease, while extra-intestinal disorders include allergy, asthma, metabolic syndrome, cardiovascular disease, and obesity."

Results  from "Microbiota Modulate Behavioral and Physiological Abnormalities Associated with Neurodevelopmental Disorders" (http://dx.doi.org/10.1016/j.cell.2014.11.024) "support a gut-microbiome-brain connection in a mouse model of ASD [autism spectrum disorder] and identify a potential probiotic therapy for GI and particular behavioral symptoms in human neurodevelopmental disorders."

Reviewing the hundreds of articles detailing the unwanted side-effects of antibiotic use and abuse, one occasionally, unbelievably, comes across the phrase "...but more research is needed...."

In January 2016 at the World Economic Forum in Switzerland 80 pharmaceutical and biotechnology companies complained that they've phased out their antibiotics research efforts because there wasn't any money in it. In a "Declaration" presented at the Forum these companies acknowledge that combating antibiotic resistance "is a top priority for global policy and public health." But because the value to society is not reflected in the costs for developing the drugs, the companies "call on governments to commit to allocating the funds needed to create a sustainable and predictable market for these technologies...." In other words, the wealthiest and most ethically challenged companies in the world want governments to subsidize their research and development of new antibiotic drugs and to "mitigate financial risk". Before following this recommendation, governments first might calculate in monetary terms the responsibility that these companies share in the overuse of antibiotics and the emergence of resistant bacteria. Where was their social consciousness in the 1980's when they tried to pressure FDA into dropping proposed hearings on the safety of antibiotics in animal feed and later when its sales reps pushed doctors to prescribe the expensive broad spectrum cephalosporins?

It's the end of the "miracle" and the "antibiotic age", and it's the end of "The War On Bugs" and the perception that permits such metaphors. The "bugs" have won because their natural adaptive response is more powerful than the human intellect.







Friday, April 10, 2015

Pretty Smiles


We have to be careful when we make decisions for others, or when we criticize others for making decisions with which we don't agree.

For example, putting fluoride in a water supply from which everyone in a community drinks - when other options are available, when controversy exists about its safety, when some people simply do not want the chemical added to their water - may be unhealthy, imprudent, and unethical.

Concern is reasonable in a community whose members have a variety of health issues, some known and some not known, that the fluoridation of its water supply may not have a net benefit. Yet there seems to be pressure to convince communities to add fluoride to its water supply. Dentists and doctors, citing scientific research, have written how important water fluoridation is for dental health. Special interests, present but invisible, use “Science” in an attempt to coerce public opinion and overwhelm common sense without addressing the complexities.

If the fluoridation issue was only about healthy teeth and pretty smiles, there is compelling scientific evidence to contradict the scientific evidence that shows the safety, efficiency, and necessity of adding fluoride to drinking water. This alone might cause concern in the minds of those who would be drinking the water. But it's not about healthy teeth and pretty smiles as much as it is about people making decisions for themselves and their families.

Authoritative fluoride promotion expresses concern for the welfare of the community: “We know what's best for you,” is implied. Other assurances are issued from some levels of government but even the federal government cannot make fluoridation of local water supplies mandatory. It appears that the intention is to control public policy.

Fluoride, usually in the form of hydrofluorosilicic acid (HFSA), a cheap waste product of phosphate fertilizer production, is added to water supplies to reduce the incidence of dental caries - cavities - in people who drink the water. It has been done in various places in the United States since 1945 when sodium fluoride, a pharmaceutical grade chemical, was used. By most accounts it appears to be effective at reducing the incidence of cavities.By 2008, over 195,000,000 Americans were drinking fluoridated water.

The Environmental Protection Agency (EPA) approved of the use of HFSA in place of sodium fluoride for water fluoridation in 1980 without prior animal or human studies. It based its decision on HFSA's low cost and the “longstanding problem” it perceived as air and water contamination from fertilizer manufacturing. In some expert opinions this “two birds with one stone” solution amounted to a “double whammy” on human health.

Hydrofluorosilicic acid, the fluoride compound used in over 90% of American communities that employ fluoridation, contains about 30 parts per million of arsenic and may be responsible for leaching lead into water from pipe fittings. HFSA is a good lead solvent and was associated with elevated children's blood lead levels in Washington, D.C. in the 2001-2004 period. The EPA's maximum water contaminant level for arsenic is 10 parts per billion and for lead, 15 parts per billion. Arsenic is a known human carcinogen and lead profoundly harms children's neurological development. A 1992 research project in northern Mexico proposed an interaction between fluoride and arsenic with the possibility that fluoride is partly to blame for signs and symptoms that usually are attributed to arsenic alone, since they often occur together and both harmfully affect enzyme activity in metabolic energy production pathways.

Sodium fluoride, which is found in many commercially available toothpastes, contains virtually no arsenic and no heavy metals. According to the EPA, sodium fluoride is not appropriate for water fluoridation.

As pointed-out in an April 2013 petition to the EPA, 99% of the water treated with HFSA flushes toilets, washes clothes, bathes bodies, and waters lawns and as such is an inefficient way to apply fluoride to human teeth where it has its effect. It may be more a profitable way that the fluorochemical industry has of disposing of a hazardous waste than it is an efficient dental treatment.

According to a 2010 report, the global fluorochemical market was expected to exceed 2.6 million tons by 2015. In 2006, at a considerably lower production rate, the fluorochemical market was valued at $16 billion with water fluoridation accounting for about 5%, or roughly $750 million.

The U.S. is the largest consumer of fluorochemicals in the world. Fluorochemicals are used in refrigerants, electronics, water repellants, and aluminum smelting. Teflon and Scotchguard are made using fluorchemicals. Fluorides are used also in the manufacture of drugs including statins, antidepressants, and antibiotics. Dupont, 3-M, and Merck are among the biggest participants in the fluorochemical economy. The American Chemical Society (ACS), headquartered in Washington, D.C., owner of a Title 36 Congressional Charter, is a powerful lobbying group representing Dupont, 3-M, Merck, Dow, Exxon, and Procter and Gamble, among many others. In 2015 a former Dupont executive became the CEO of the ACS. A goal of the ACS, of course, is to establish public policy supportive of its industry.

In the 1970's, with the U.S. Public Health Service (USPHS), Procter and Gamble sponsored a study of fluoride's carcinogenicity but did not find a statistically significant relationship between fluoride and cancer.

The Safe Drinking Water Act, the federal law that ensures quality drinking water in the U.S.,  prohibits the EPA “...from requiring the addition of any substance to drinking water for preventive health care purposes...” according to the 2013 petition. Adding fluoride, either in the hazardous waste form or the pharmaceutical grade form, is considered a local matter.

According to the FDA, “Fluoride, when used in the diagnosis, cure, mitigation, treatment or prevention of disease in man or animal is a drug that is subject to Food and Drug Administration (FDA) regulation.” But HFSA has not been evaluated or approved by the FDA - no new drug applications to study HFSA for ingestion have ever been received by FDA.

In 2006 the National Academies of Science suggested that EPA update its recommendations on fluoride exposure based on what appeared to be an increase in the incidence of dental and bone fluorosis over the previous decades. In 2010 the Department of Health and Human Services (HHS) reviewed “the best available information” on the incidence of cavities, the incidence of fluorosis, exposure of adults and children to various sources of fluoride, and data from the EPA, resulting in a downward revision of the EPA's recommended standard of 0.7 to 1.2 milligrams per liter to 0.7 milligrams per liter, the value at the low end of the range. Note that the recommended revision was downward from an acceptable range to the concentration at the low end of the range of EPA's previous standard. It's not known if EPA has implemented the revision.

Dental fluorosis, considered a developmental defect, is caused by ingesting fluoride while teeth are developing. Fluorosis starts to occur at fluoride concentrations in water at 1 part per million, according to The Chemistry of Mature Enamel. It is characterized by white lacy markings on teeth in its mild form to pitting and mottling with brown discoloration of the enamel in more severe cases. The greatest risk is to children up to 8 years of age, but in the period 1999-2004 the incidence of fluorosis in 12 to 15 year olds was 41%. The CDC has blamed the increase in incidence of fluorosis on the availability of fluoride-containing toothpastes and other dental treatments, and the consumption of food prepared with fluoride-containing water. By the 1990's, 90% of commercial toothpastes contained fluoride. Some antibiotics contribute to fluorosis at lower levels of fluoride ingestion.

Dental caries is a bacterial infection of teeth in which acids from bacteria dissolve the tooth's enamel, resulting in pain, tooth loss, and possibly systemic infection. These bacteria live in the plaque that forms around teeth and sticks to tooth enamel. The more sugar that enters the environment of the mouth, the happier and more active the bacteria become.

According to the Centers for Disease Control and Prevention (CDC), “Fluoride's predominant effect is... topical and depends on fluoride being in the right amount in the right place at the right time.” This statement seems to recommend the use of fluoride-containing toothpaste when brushing teeth after eating, but CDC still recommends water fluoridation calling it “one of the ten great public health achievements of the 20th century”. Though we often hear that fluoride “prevents” cavities, experts insist that fluoride technically doesn't prevent cavities – it promotes re-mineralization of enamel that's been dissolved by bacterial acids. Thus, fluoride's beneficial effect is observed when it's applied topically as opposed to systemically by ingestion.

Cavities are no small problem. The World Health Organization recognizes dental caries as a major health concern related to diabetes, cardiovascular disease, cancer, and lung disease by risk factors that are considered “modifiable”. An odd thing about the incidence of cavities is that it is very low in poor, non-industrialized countries but in developed, industrialized countries it is high especially in poor, socioeconomically disadvantaged areas. Risk factors for dental caries include - in addition to low income - high sugar consumption, smoking and other tobacco use, and low (acidic) salivary pH. They're “modifiable” because we can choose to eat less sugar or stop smoking cigarettes, for example. Usually cavities are a sign of poor health in general not an isolated health problem.

A 1999 Polish study found that a variety of factors influence a child's risk for caries, including genetics, and that prevention should be individualized to match the risk. The study found that high caries-risk children benefitted most from chewing fluoride gum.

Chewing gum sweetened with xylitol has benefits to oral health including reduction of plaque formation and gum-tissue inflammation, and in increasing re-mineralization of tooth enamel.  American Dental Association (ADA) research questions xylitol's benefits, however, quoting the study's author as saying “The best evidence for preventing tooth decay is still brushing with fluoride toothpaste and eating less sugar.”

Fluoride isn't safe - it's relatively safe and relatively toxic. It is not an essential nutrient in the human diet. The pharmaceutical compound sodium fluoride is a drug regulated by the FDA and requires a doctor's prescription (except in toothpaste or mouthwash). Ingested either from the water supply or in a pill as prescribed, fluoride interferes with magnesium absorption. It's generally acknowledged that many people are magnesium deficient, even that magnesium deficiency is endemic in the U.S. According to the U.S. Department of Agriculture, 57% of the U.S. population does not meet the U.S. RDA for dietary intake of magnesium. The more magnesium deficient one is the greater is one's absorption of fluoride. Taking magnesium supplements may reduce fluoride absorption. Fluoride also inhibits iodine absorption and, because of the chemical similarity between the two, the former competes with the latter in the sensitive metabolism of the thyroid gland and its hormones. Because of the way in which it can interfere with thyroid metabolism, fluoride is considered a “hormone disruptor”. Fluoride is excreted from the body by the kidneys. If one has kidney problems, one must filter fluoride from the water before drinking it. Fluoride accumulates in bone and soft tissues. Fluoride has an affinity for aluminum, which is abundant in the environment and in prepared food, and which has been implicated as a causal factor in the development of Alzheimer's disease.

Chronic ingestion of fluoride at 4 parts per million or more can cause serious neurological and musculoskeletal health problems, and at lower concentrations it has other unwanted and unanticipated effects. In research to explore the effect of fluoride ingestion on postmenopausal women, it was found consistently that fluoride increased bone mass but also increased the incidence of bone fracture. Research performed by a former researcher from the National Cancer Institute (NCI) demonstrated an increased risk of cancer in those ingesting fluoridated water, research that was contested by the NCI and the U.S. Public Health Service (USPHS) in a famous court case in the 1970's.

It doesn't seem reasonable to assume that fluoride does not have harmful effects on the human body along a continuum of concentrations before side effects manifest, especially if the body's ability to detoxify it is compromised in some way. It may be that we don't recognize yet some health problems as fluoride-related.

Fluoride occurs naturally in many water supplies in the U.S. In some areas, for example in the Southwest, naturally occurring fluoride is present in water at high concentrations and must be reduced for drinking. In Rifle, Colorado, where artificial water fluoridation is an issue, the naturally occurring fluoride content of public water is 0.33 milligrams per liter, which is about half of the most recent recommendation of 0.70 milligrams per liter made by the U.S. Department of Health and Human Services.

Researchers have discovered that living at a relatively high altitude improves enamel production in the same way that fluoride does and that its effects may be additive to fluoride's. This observation was made on dental patients at an elevation of 4300 feet above sea level. Rifle's elevation is 5350 feet above sea level.

Some European countries have rejected fluoridation of public drinking water on the principle that doing so amounts to the indiscriminate medication of a population. Under the terms of the 1999 European Biomedical Convention, “Fluoridation as a practice is clearly unethical.” The Convention established “the individual's right to informed consent on any personal intervention”.

Informed consent” is a voluntary agreement between a patient and her or his doctor for participation in a research project, or for a diagnostic or therapeutic procedure, the patient having been informed thoroughly of the purpose, methods, benefits, and risks. “The patient must be put in a position, through the use of terms he or she can understand, to weigh up the necessity or usefulness of the aim and methods of the intervention against its risks and the discomfort or pain it will cause.” In some opinions, in the case of water fluoridation informed consent does not occur and fluoridation, therefore, is medical malpractice.

A classic paper in support of water fluoridation titled the Newburgh-Kingston Caries-Fluorine Study: Final Report, published in the Journal of the American Dental Association in 1956, announced that water fluoridation presented no risk to human health, and that those who opposed it were “... chiefly food faddists, cultists, chiropractors, misguided and misinformed persons who are ignorant of the scientific facts on the ingestion of water fluorides, and, strange as it may seem, even among a few uninformed physicians and dentists.” According to Graham and Morin, in a paper published in the Journal of Land Use and Environmental Law in 1999, this sentiment “...set the tone of ADA and USPHS activists and others promoting this practice in the face of growing opposition from eminent scientists and physicians... there has always been learned and respectable opposition to artificial fluoridation of public water supplies, and all attempts to deny it can only be characterized as irresponsible.” Graham and Morin say further that “...the lowest rates of tooth decay in children occur in areas where the fluoride level is about 0.2-0.4 ppm, which is the normal level in most parts of the world.” And finally, “...trial judges over the past twenty years have repeatedly found, after hearing experts, that fluoridation is injurious to public health”.

World renowned cancer research scientist Dean Burk, head of cytochemistry at NCI, testified before congress in 1976:

The scientific and medical status of artificial fluoridation of public water supplies has now advanced to the stage of the possibility of socially imposed mass murder on an unexpectedly large scale involving tens of thousands of cancer deaths of Americans annually.

In response the USPHS criticized Burk's methods and the NCI, for whom he'd worked for 30 years, attacked his epidemiological work. Eventually, NCI convinced Congress that there was no association between fluoridation and cancer.

(Dean Burk earned his first Ph.D at the age of 20, co-discovered biotin, taught biochemistry at the medical school at Cornell University, and co-authored research with Nobel laureate Otto Warburg, with whom he was a close friend. Burk had a remarkable professional career.)

Other important lawsuits against mandatory fluoridation have been decided in favor of plaintifs who sought injunctions against the procedure. Three notable cases, in Pittsburg, Alton (Illinois), and Houston, in the '70's and '80's all found that research demonstrated that fluoridation was associated with an increased risk of cancer and that the proposed benefit was not worth the risk. The finding of the Judge in the Houston case was unequivocal:

...the artificial fluoridation of public water supplies, such as is contemplated by [Houston] City Ordinance No.80-2530 may cause or contribute to the cause of cancer, genetic damage, intolerant reactions, and chronic toxicity, including dental mottling, in man; that the said artificial fluoridation may aggravate malnutrition and existing illnesses in man; and that the value of said artificial fluoridation is in some doubt as to the reduction of tooth decay in man.

Subsequently, the Texas Court of Appeals found that injecting fluoride into the city's water was harmful. But these decisions (and judges' rulings in Pittsburgh and Alton) were not enough to prevent the state from exercising what is called “police power” to proceed with fluoridation. Police power is the legal authority of states to act in the interest of the “health, safety, morals, and general welfare of the public”. It gives the states the power to force people to do what it thinks is best for them and to overturn a judge's decision.

Having learned their lesson in court, “pro-fluoridation activists” from the ADA and the USPHS decided on a different tactic for future defenses of its program: avoid court and the decisions of a judge who probably would not know enough about science to make the "right" decision.

Graham and Morin believe that, eventually, the practice of artificially fluoridating water supplies will be discontinued. Meanwhile it is important to maintain the legal history of the issue because, as they say, "time is the solvent of truth".