Letter from Dr. Janson
Ask Dr. J.
In the Health News
Recipe of the Month: A Healthy Pizza
I usually spend time researching and defending the scientific
basis for nutrition, dietary supplements, and other alternative
treatments, and noting that conventional medicine is not better
documented than many alternatives. However, science has limits
in human understanding, and devoting so much to it neglects
the rest of the art of medicine. This has to do with the art
of lifewith communication, inspiration, motivation,
Doctors have an obligation and an opportunity to instill
in a patient a positive attitude and a burning desire to get
well and stay well, and give them the knowledge and motivation
to change the habits that often contribute to degenerative
In an Email discussion, a friend pointed out that in addition
to the physical senses of taste, hearing, vision, smell, and
touch, human beings also have non-physical senses that allow
us to live life to the fullest. They are not scientific, and
they are not often considered in the realm of medicine, but
they are essential for a rewarding and fulfilling life. Doctors
are in a special position that allows them to help a patient
cultivate these senses. We must take advantage of our position
to enhance the healing process through these senses that promote
the patients power to enjoy life.
The sense of adventure allows us to step out of our
daily environment and experience the pleasures of different
cultures, new foods, unexpected architecture and scenery,
unusual plants and animals, and different perspectives on
life. It also lets us enjoy new and challenging physical experiences
that are part of our animal nature.
The sense of beauty provides an appreciation of art,
music, crafts, scenery, and human features. It lifts us to
a higher existence. The sense of joy enriches everyday
experiences of relationships, rewarding work, and play, and
allows us to fill ourselves with good feelings.
The sense of wonder leads us to learn new things,
and enjoy both new and old experiences as a child does, with
a feeling of awe and appreciation of the moment. And finally,
a sense of humor keeps everything in perspective, so
we dont take ourselves and our lives too seriously,
and it gives us the healing and restorative power of laughter.
It lets us defuse threatening situations, and learn to cope
with physical and emotional trauma, while being able to laugh
and play together enhances the bonding in human relationships.
Appreciation of these senses takes us out of the realm of
simple existence to live life to its fullest. As one of my
favorite poets, e.e. cummings, says, existings
tricky, but to lives a gift. To be fully alive
means making the most of our gifts. Physicians also benefit
from these senses of joy, beauty, wonder, adventure, and humor,
and when we help our patients enjoy life, we enhance our own
Recent research shows that a high dietary intake of apples,
the trace mineral selenium, and red wine reduces the risk
and severity of asthma, possibly because of antioxidant and
anti-inflammatory effects of the mineral and the flavonoids
found in fruit and red grapes. As people with asthma sometimes
feel powerless to control their symptoms without drugs, this
article and others provide some hope that they may be able
to take charge of their health and control their condition.
Asthma is a condition of the tracheobronchial airways with
spasms restricting air flow in and out of the lungs. The symptoms
are difficulty breathing, cough, and wheezing. It most often
starts early, 50 percent of the time by the age of 10, and
over 80 percent by the age of forty.
Asthma is very common, affecting now about ten percent of
the population, and the incidence is increasing. It may be
triggered by allergies, drug reactions, chemical and toxic
metal exposures, exercise, and stress, as well as by infection.
Asthma is increasing from about one in 20 people 15
years ago to about one in 10 now, perhaps due to air pollution
(ozone, sulfur or nitrogen dioxide), drugs and chemicals such
as aspirin, NSAIDS, and artificial colors, food allergies,
fast foods with hydrogenated oils, sulfites used to prevent
browning of vegetables and dried fruits, and poor nutrition.
Work or leisure exposure to metal salts, wood and vegetable
dusts, farm and garden chemicals, and plastics may play a
Infections also trigger asthma attacks, and sometimes a seemingly
minor respiratory virus may lead to a severe asthma attack.
This might be the result of inflammation leading to increased
sensitivity of the airways to particular triggers.
Exercise, especially in the cold, can precipitate asthma
attacks, and sometimes this is the only trigger when someone
first develops symptoms. This frequently changes much later
into asthma unrelated to exercise. It is also well known that
psychological factors can initiate asthma attacks or help
relieve or prevent them.
When looking at the lungs of asthmatics, pathologists find
extensive secretions plugging the airways, swelling of the
bronchial lining, thickening of the muscles, and collections
of both allergy-related cells called eosinophils and inflammatory
cells in the bronchial walls. The end result of all these
physiologic changes is a marked narrowing of the air passages.
With changes in messenger substances (histamine, leukotrienes,
prostaglandins, and others), and cells related to inflammation,
it appears that asthma is a chronic inflammatory disease.
In addition to recommending environmental controls,
physicians prescribe many drugs for asthma, including bronchodilators,
steroids, and allergy medications. In severe acute asthma,
it is important to take immediate measures, including drug
therapy, but injections of magnesium can be extremely helpful
in stopping such an attack. Other than in emergency situations,
it is best to do whatever you can to avoid drugs while still
Make efforts to reduce exposures to precipitants, such as
airborne allergens, trigger foods, chemicals, and drugs, and
to enhance immune function to reduce infections. Avoid even
second-hand smoke. An air filter (such as Austin Air Systems)
can help to clean up both particulate and chemical contaminants.
Do your best to eliminate house and garden chemicals from
your environment. In most cases, natural alternatives are
A whole, natural, mostly vegetarian diet with few additives
is an essential part of any health program. Avoid sulfites,
not only in commercial salad bars (to prevent foods from turning
brown), but also in wine. Milk is a common food allergen,
as are peanuts, eggs, shellfish and some cereal grains. Hydrogenated
oils interfere with normal fat metabolism and prostaglandin
Supplements are also important in treating asthma. Vitamin
C (2000 to 4000 mg daily) is an antioxidant, anti-inflammatory
nutrient that also reduces allergic symptoms. Although studies
are not consistent, there is a strong suggestion that supplements
might help asthma, especially if exercise induced.
In children and adults, 100 to 200 mg of vitamin B6 can markedly
reduce asthma symptoms. Serum markers of B6 activity tend
to be low in asthmatics. The flavonoid quercetin (800 to 1200
mg daily) reduces allergies by stabilizing the cells that
release histamine. It also inhibits the action of lipoxygenase,
an inflammatory enzyme involved with prostaglandin metabolism.
Anti-inflammatory herbs, such as curcumin (1000 to 2000 mg)
and ginger (250 to 1000 mg) help control the chronic inflammation
and bronchospasm seen with asthma.
Several studies with ginkgo extracts show benefits for asthmatic
patients. Ginkgo interferes with the effects of platelet activating
factor, known to promote inflammation. Patients challenged
with allergens after taking ginkgo extract had much less bronchoconstriction
than controls. The usual dose is 120 to 240 mg daily.
Essential fatty acids are prostaglandin precursors. Prostaglandins
derived from gamma-linolenic acid (GLA, 240 mg from borage
or primrose oil) and flaxseed or fish oil have anti-inflammatory
effects, help reduce allergic symptoms, and they relax bronchial
muscles. Although there are few specific clinical studies
on asthma, I have found these oils helpful in practice.
Magnesium is a smooth muscle relaxant, and helps to relieve
bronchospasm when taken by mouth, as well as when administered
intravenously for acute asthma attacks. The usual oral dose
is about 400 to 1000 mg daily.
N-acetyl cysteine (NAC, 1000 to 2000 mg) helps to loosen
bronchial secretions, and makes it easier to clear the
airways. It is usually administered as an inhalant, however,
the oral dose is just as effective but without side effects.
In many cases, these nutrients and lifestyle changes with
stress management, combined with immune support and environmental
controls have helped patients reduce or eliminate their asthma
medications, and live a healthier life.
Q. Im in serious need of an herbal solution for hot
flashes! They are strong, frequent, day & night! Good
rest at night is difficult. M.C., New Mexico
A. Menopausal hot flashes, or vasomotor flushing, are the
result of complex hormonal changes at the time of menopause
or after surgery that removes the ovaries. They can be quite
uncomfortable, and even though they normally go away within
a few years after menopause, or can be suppressed with hormonal
therapy, sometimes a good nutrition program and dietary supplements
can make a big difference in controlling them.
I recommend supplements of soy isoflavones, 500 mg daily,
standardized at 40 percent isoflavones. These have natural
weak estrogenic effects, and have been shown to control hot
flashes up to 50 percent. Bioflavonoids (2000 mg) are plant
pigments that were shown to reduce hot flashes almost 40 years
Black cohosh (standardized, 40 to 120 mg) is probably the
most commonly known herb that is used for menopausal symptoms.
A number of double-blind studies support its use. Another
herb that might help is dong quai (Angelica sinensis, standardized,
200 to 600 mg).
Other helpful supplements: vitamin E (800 to 1200 IU), shown
decades ago to be helpful, although recent studies show only
a small effect (perhaps because they did not give it for long
enough); gamma linolenic acid ( GLA, 240 mg).
I would not discount using natural hormones, such as progesterone
and estrogens modified from soybeans to mimic the same hormones
found in humans. These can be quite helpful, and are not the
same as synthetic progesterone analogs or horse estrogens
that are commonly prescribed.
I am intrigued by an article that came out in July extolling
the virtues of coenzyme Q10 (Tran MT, et al., Role of coenzyme
Q10 in chronic heart failure, angina, and hypertension. Pharmacotherapy
2001 Jul;21(7):797-806). The authors say that coQ10 helps
with congestive heart failure, angina, and hypertension based
on an extensive search of the past 25 years of research. They
point out that coQ10 supplements improve ejection fraction
(heart muscle function), cardiac output, and exercise tolerance,
meaning that every measure of heart function is helped. They
note that it is safe and well tolerated. Then, incredibly,
their conclusion says that CoQ10 should not be recommended
as monotherapy or first-line therapy in any disease state.
WHY NOT? Maybe because this article comes from a school of
A new study shows that saw palmetto significantly helps
urinary symptoms in benign prostate enlargement (Gerber GS,
et al., Urology 2001 Dec;58(6):960-963). In the study of 85
men, quality of life also tended to improve, but
it did not reach statistical significanceperhaps because
of inadequate dosing or too few subjects. In previous studies,
saw palmetto was superior to the drug finasteride (Proscar).
Another study shows that eating legumes is associated
with a significant reduction in heart disease (Bazzano LA,
et al., Legume Consumption and...Coronary Heart Disease... Arch
Intern Med 2001;161:2573-2578). The study of nearly 10,000
people for 19 years showed a 22 percent reduction in coronary
disease in those eating beans at least 4 times a week, and
a reduction in vascular disease overall. Legumes include kidney,
black, navy, pinto, lima, and azuki beans, and others, and
I buy a wholewheat crust or make a simple one using
my VitaMix. Lightly sauté chopped onions, broccoli,
and mushrooms with olive oil. Spread a layer of refried beans
(homemade or canned, organic ones) on the crust. Add a layer
of tomato sauce or salsa, spread the vegetables on top, and
then a layer of fresh tomatoes. Sprinkle with oregano, basil,
and fresh ground pepper to taste and a thin layer of grated
romano sheep-milk cheese. Put in a preheated oven at 425 degrees,
and cook until the crust is crisp and turning brown at the
edges. You have your tomato lycopene, broccoli phytochemicals,
whole grain nutrients with fiber, and beans, all of which
prevent heart disease, cancer, and prostate problems, and
preserve your vision, in one traditional, tasty, and easy
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