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December 2001

Letter from Dr. Janson
Curry for The Brain and More
Ask Dr. J.
In the Health News
Recipe of the Month: Curried Red Lentils
References

Letter from Dr. Janson
Dear Friends,
In November, Dr. Stephen Straus, the director of the National Center for Complementary and Alternative Medicine (NCCAM) at the NIH, told Congress that “While augmenting one’s natural healing powers may prove beneficial for some illnesses...there is no scientific basis to believe that [alternative medicine] would be of much value in the context of virulent diseases incited by biological weapons.”

Dr. Wayne Jonas, the former director of the Office of Alternative Medicine had reported on a study of homeopathy in mice with the infectious disease tularemia, and he found that the death rate was reduced by 22 percent by the treatment. Straus and Jonas were testifying before the House Government Reform Committee, which has displayed the most serious interest in alternative medicine of any government body (sometimes including even the NCCAM).

While I agree with Dr. Jonas when he says that purveyors of many supposedly alternative remedies (such as colloidal silver), through the Internet and other avenues, had little scientific justification for their remedies for infections, this is not to say that all alternative remedies are useless for these conditions.

Straus said enigmatically that if effective alternative remedies existed, they probably would have been found already. In such a comment, he makes the assumption that all alternative remedies have been in use for centuries, and that there have been no recent discoveries.

Why he should assume this is unclear, as unconventional, or “alternative” does not mean old, such as the recent discovery that the spice turmeric appears to help prevent Alzheimer’s disease. This and other spices have a long history of use, but only recently have some of their benefits been revealed. Reuters Health quoted Straus regarding measles, yellow fever, smallpox, typhus, and HIV as saying, “Had the traditional healing rituals and natural products available to pre-20th-century man been truly effective, our history would have been rather different.”

This is naive and ill-informed. History is different—different from what it might have been had they not had traditional healing methods.

These remedies may well have reduced the incidence and mortality of these diseases, although probably not as much as better hygiene (the alternative remedy of a century ago) and modern plumbing. More importantly, recent discoveries about natural remedies have contributed to our knowledge and treatment of disease, including infectious disease. No healing art is stagnant. We always learn new things. At one time there were medical specialists, pellagrologists, treating the many varied manifestations of pellagra, until it was discovered that this was a simple deficiency disease, treatable (unbelievably to the medical community) with a simple vitamin, niacin. This “alternative” treatment wiped out not only pellagra, but a whole medical specialty.

Curry for The Brain and More
Elderly people in India have a much lower incidence of Alzheimer’s disease than those in the Western world. It is known that high doses of antioxidants, such as vitamin E, as well as supplements of ginkgo biloba can delay the progression of Alzheimer’s dementia. Now research suggests that the reason Alzheimer’s is lower in the Indian population may be the high consumption of curry in food. The rate of Alzheimer’s in India is less than one percent among the population over the age of 65, and this is the lowest in the world.

Curry is a mixture of spices, including turmeric, which is responsible for its yellow-orange color. Turmeric is a root-like rhizome in the ginger family, containing a group of compounds known collectively as curcumin, or curcuminoids. This mixture of phytochemicals has potent anti-inflammatory and antioxidant effects, as well as liver protective benefits.

Substitute for Drugs
Curcumin is a natural substitute for drugs, such as the non-steroidal anti-inflammatory agents (NSAIDS) in managing symptoms of injury, arthritis, and other inflammatory diseases. These drugs include such heavily advertised and prescribed products as Celebrex and Vioxx, and the over-the-counter Advil and Aleve. The former two are known as COX-2 (cyclo-oxygenase) inhibitors, relating to the inflammatory enzyme that they block. The latter two are not as specific, blocking both forms of cyclo-oxygenase.

While these drugs can relieve symptoms, they commonly cause side effects, which are often serious, such as bleeding in the gastrointestinal tract. NSAIDS account for a significant proportion of the more than 100,000 annual deaths from prescription drugs, and recent information links the COX-2 inhibitors to heart deaths and kidney problems. The COX-2 inhibitors were supposed to be safer on the stomach, but an FDA advisory panel has been unwilling to drop the warning about this side effect.

Turmeric, like ginger, reduces inflammation and provides free-radical protection. It is a natural COX-2 inhibitor, but it does not have the side effects of the drugs. Researchers have given daily doses up to 8000 mg without toxicity. In the recent study of Alzheimer’s disease, the researchers injected rats with a substance called amyloid, which accumulates in the brains of Alzheimer’s patients, in order to mimic the disease.

When they fed the rats a diet rich in curcumin, the animals accumulated less beta-amyloid, they retained protein in the synapses (cell junctions), and they performed better on memory tests. They also observed that the animals in the treatment group had less inflammation of the brain and neurological tissues. A previous study in mice, by the same researchers, showed a reduction of two Alzheimer’s markers–the proinflammatory cytokine interleukin-1 beta, and activated microglial cells.

Other Benefits of Curcumin
In addition to its benefits for the brain, the reduction of inflammation not only helps conditions such as arthritis, hepatitis, and acute injuries, but also is likely to reduce heart disease. Numerous studies now support the role of chronic inflammation as a risk factor for hardening of the arteries. Studies have related the level of C-reactive protein, or CRP, an inflammatory marker in the blood, to increased heart disease.

Curcumin reduces the adhesiveness of platelets, lowering the risk of blood clotting in blood vessels compromised by atherosclerosis. Aspirin in low doses is given to inhibit platelet aggregation, but even the low doses have potential side effects, and curcumin, among many other natural products (garlic, essential fatty acids, ginkgo biloba, bilberry, and ginger are examples) lowers platelet activity without side effects.

The antioxidant effects of curcumin may be partly responsible for protection of the brain from Alzheimer’s disease. This effect is also protective against heart disease by reducing cholesterol, raising good HDL, and lowering oxidized LDL cholesterol, which damages cells and arteries.

Curcumin has specific benefits in prevention and treatment of cancer. It causes cell death in eight different melanoma cell types, even cells that are resistant to chemotherapy. It inhibits the growth and causes cell death in breast cancer cells, prostate cancers implanted in mice, and in gastric and colon cancers.

Try to include curry dishes in your meal planning. You will find many books and online sources for recipes, but understand that in India, they eat curry virtually every day, so this would be quite a change from typical diets. However, curcumin is so valuable in both prevention and treatment of so many health problems that it is a good idea to take supplements. Standardized extracts of turmeric, are available, containing 90 percent curcumin. Typical doses of such supplements are 600 to 1200 mg per day, but for acute injuries or serious illnesses, larger doses may be useful.

Consider the benefits of combining curcumin with other protective nutrients, such as vitamin E (400 to 800 IU daily), ginkgo biloba (120 mg), N-acetyl cysteine (NAC, 1000 to 2000 mg), and vitamin C (2000 to 4000 mg). With a complete health program of exercise, whole, natural foods, and relaxation, you should be able to preserve brain function while preventing many chronic diseases and slowing down the aging process.

Ask Dr. J.
Q. My elder brother has had adult diabetes for many years. He still has trouble controlling his blood sugar with medications, and he is developing numbness in his feet. Any suggestions?

A. Diabetes is an increasing problem in the USA, and by 2050 the numbers may increase to 165 percent of current levels, so your brother is not alone. Diet and exercise are most important. I recommend a high fiber diet (vegetables, whole grains, legumes, fruits, nuts, and seeds are all high in fiber, and they have essential fatty acids).

The most important exercise is regular, moderate activity, done at least every day (a gorilla has to exercise every time it wants to eat!). Walking, jogging, cycling, stair or ski machines will all give a good workout. Aerobics and mild weight exercise will help build muscle, and extra muscle metabolizes sugar more efficiently.

Supplements of chromium, usually in high doses of 1000 mcg per day, significantly reduce blood sugar levels, and many patients can come off their medications with this supplement. Your brother should be careful with his medication dose when taking any of these supplements.

Alpha-lipoic acid, a sulfur-containing, high-potency antioxidant, can also help control blood sugar. The numbness in the feet that your brother describes could be the early stages of peripheral neuropathy, a nerve degeneration commonly seen in long-term diabetics. Alpha-lipoic acid also helps to reverse peripheral neuropathy. The usual dose for sugar control is about 300 to 600 mg, and for neuropathy, about 600 to 1200 mg per day.

The heart is also affected by neuropathy, with reduction of the normal variation in heart rate. One study showed that within four months of daily treatment with 800 mg of alpha-lipoic acid, the heart was significantly improved. As an antioxidant, alpha-lipoic acid has advantages: it absorbs easily, crosses the blood-brain barrier, and works both inside and outside of cells for protection of the brain and other neurological tissues.

Alpha-lipoic acid works even better when taken with supplements of gamma linolenic acid (GLA) of 240 mg daily. This is found in capsules of borage oil or evening primrose oil.

I also recommend vitamin B12 for neuropathy, either by injection or taking 1000 to 2500 mcg orally. High doses of oral B12 can substitute for injections. Complement these with B-complex, vitamins C and E, magnesium, and bioflavonoids.

In the Health News
•Antibiotics are far overused, partly due to patient pressure on doctors, even when no antibiotics are indicated. Viral infections are not helped by antibiotics, but in 1600 physician visits, researchers found that about 80 percent of the antibiotic prescriptions were unnecessary for respiratory infections. (Scott JG, et al., J Fam Pract 2001 Oct;50(10):853-8) Patients made requests, modified symptoms, and suggested diagnoses; physicians rationalized their inappropriate treatment. Patients and doctors need education on the dangers of antibiotics overuse, and the alternatives for immune support, such as vitamins C and E, echinacea, astragalus, garlic, and low sugar diets.

•People with mildly increased blood pressure that is not considered abnormal, frequently go on to develop significant hypertension within four years. (Ramachandran et al., Lancet November 17, 2001; 358: 1682-86) People with optimal BP of under 120/80 had only one-third the risk of developing hypertension as those in the range of 120-129/80-84. This means that it is important to maintain optimal BP through a high-fiber, mostly-vegetarian diet with garlic and onions, exercise, stress management, and supplements, such as vitamins C and E, omega-3 oils, and magnesium. For already elevated BP, add supplements of coenzyme Q10, garlic, arginine, and taurine.

Diet and Disease
•Obese people who have had a heart attack have a higher risk of recurrence than people of normal weight. This finding was not explained by diabetes, cholesterol, hypertension, exercise, smoking, age, sex, or heart failure. (Rea TD, et al., Am J Cardiol 2001 Sep 1;88(5):467-72.) Other factors that the authors suggested might play a role: inflammation, increase in thrombosis factors, or nervous system activity.

Recipe of the Month: Curried Red Lentils
Sauté onions, garlic, celery and carrots in a small amount of olive oil, then add curry powder to taste (hot or mild curries are available). I add extra cumin, which is a component of curry blends (in addition to coriander, cardamom, anise, turmeric, cinnamon, fenugreek, and hot peppers). Fold in one cup of red lentils, mix well, and add 2 cups of water (with extra water you can make this a soup, called mulligatawny in India). Simmer to infuse the flavors until the lentils are cooked. Add extra chopped chard, spinach, or mustard greens at the end, and after turning off the heat fold in some chopped cilantro. Serve this with brown rice or whole wheat flat bread (chapati), and a salad.

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References

Editorial
Alternative medicine doesn’t hold cure for bioterror agents,
lawmakers hear. Reuters Health, November 14, 2001.

Curry for The Brain and More
Curry spice may slow Alzheimer’s disease. Reuters Health
November 15, 2001.

Lim GP, et al., The Curry Spice Curcumin Reduces ...Amyloid
Pathology in...Alzheimer Transgenic Mouse. J Neurosci 2001
Nov 1;21(21):8370-7.

Satoskar RR, et al., Evaluation of anti-inflammatory property
of curcumin... in patients with postoperative inflammation.
Int J Clin Pharmacol Ther Toxicol 1986 Dec;24(12):651-4.

Cheng AL, et al., Phase I clinical trial of curcumin, a chemo-
preventive agent... Anticancer Res 2001 Jul-Aug;21(4B):2895-900.

Bush JA, et al., Curcumin Induces Apoptosis in Human Melanoma
Cells through a Fas Receptor/Caspase-8 Pathway Independent
of p53. Exp Cell Res 2001 Dec 10;271(2):305-14.

Kim MS, et al., Inhibition of invasion and induction of
apoptosis by curcumin in H-ras-transformed MCF10A human breast
epithelial cells. Arch Pharm Res 2001 Aug;24(4):349-54.

Dorai T, et al., Therapeutic potential of curcumin in human
prostate cancer... Prostate 2001 Jun 1;47(4):293-303.

Moragoda L, et al., Curcumin induced modulation of cell cycle
and apoptosis in gastric and colon cancer cells.
Anticancer Res 2001 Mar-Apr;21(2A):873-8.

Soni KB, Kuttan R, Effect of oral curcumin administration on
serum peroxides and cholesterol levels in human volunteers.
Indian J Physiol Pharmacol 1992 Oct;36(4):273-5.

Diabetes and Peripheral Neuropathy
Jacob S, et al., Oral administration of...lipoic acid modulates
insulin sensitivity...Free Radic Biol Med 1999
Aug;27(3-4):309-14.

Ziegler D, Gries FA, Alpha-lipoic acid in the treatment of
diabetic peripheral and cardiac autonomic neuropathy.
Diabetes 1997 Sep;46 Suppl 2:S62-6.

Packer L, et al., Neuroprotection by the metabolic antioxidant
alpha-lipoic acid. Free Radic Biol Med 1997;22(1-2):359-78.

 


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CONSULTATIONS:

From September to June, I see patients in New Smyrna Beach, Florida.
Call 386-409-7747, or send an email to to make arrangements.

In summer, I have a variable schedule, and I see patients in offices at the
Rothfeld Center for Integrative Medicine in Waltham, Massachusetts. For appointments, send an email to make arrangements, or call: 386-409-7747.

I primarily do phone consultations, as well as email and instant messaging consults.


Information herein is not medical advice or direction. All material in this newsletter is provided for information only. Its contents should not be used to provide medical advice on individual problems. Consult a health care professional for medical or health advice.

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