Drug (Pharmaceutical!) Crime
Pattern of Abuse
Inflammatory Bowel Disease (IBD)
Natural Remedies for IBD
Other Supplements for IBD
Ask Dr. J: Insomnia
In the Health News
Diet and Disease
Recipe of the Month: Cold Cucumber-Yogurt-Dill
I was surprisingly shocked by a recent news article about
the fraud and deception on the part of a large drug company,
AstraZeneca. Surprising because I am quite aware of promotion
schemes that drug companies have been involved in over the
years, and the overwhelming financial power of these companies
to influence medical education and doctors’ prescribing
The criminal actions were this: the drug reps would give
free samples of the prostate cancer drug, Zoladex, to physicians,
and encourage them to bill Medicare for reimbursement when
they administered the drugs. (The prosecutors could never
prove that the company officials were aware of or directing
this practice, but absence of evidence is not the same as
evidence of absence.) The company settled with over $350 million
dollars (a mere drop in the bucket for them), and admission
Although the drug companies are no longer able to directly
pay physicians with free trips and other benefits, they always
seem to find new ways to influence the pocketbooks and capture
the sympathies of doctors when it comes to prescribing their
In addition, the company agreed to settle another charge
without admitting guilt. They were accused of inducing doctors
to buy Zoladex by offering to set and report to Medicare falsely
high prices for the drug. In this way, prescribing doctors
who went along with the scheme could collect higher fees when
billing Medicare. Astonishingly, many doctors defended the
fraudulent practice by saying they needed the money to cover
their incredibly high operational costs for treating cancer.
This is not the first time that drug companies have tampered
with prescribing practices using financial inducements to
doctors. Another prostate drug, Lupron, was similarly promoted
by TAP Pharmaceuticals, and they settled for $875 million.
It makes you wonder whether doctors are prescribing for medical
or financial reasons. Doctors often prescribe through habit,
and drug companies try to influence these habits early on.
Witness the incredible promotion of Nexium to both the public
and to doctors. This “purple pill” is a modified
version of Prilosec, for treatment of acid indigestion, ulcers,
and related digestive disorders. Nexium’s only apparent
advance is that it is newly patented, whereas Prilosec is
now off patent (and much less profitable).
Scientifically validated benefits are good reasons for a
doctor to prescribe a medicine. Financial incentives and fraud
are, or should be, much less convincing.
Inflammation of the bowel usually takes one of two forms–ulcerative
colitis, confined to the large intestine (colon), or Crohn’s
disease, which is usually in the small intestine, but may
extend into the colon, as well. This is a serious medical
condition. Irritable bowel syndrome is also a serious health
problem, although not life threatening or requiring surgery
or drugs, and this condition never causes bloody diarrhea.
The usual symptoms of Crohn’s disease include cramping,
bloating, abdominal pain, fever, and diarrhea, with or without
blood. With time, ulcerations and fissures may form around
the rectum and anus. The symptoms of ulcerative colitis are
almost identical, and both conditions feature inflammation
and ulceration. To make the diagnosis, it is important to
be tested, but the natural treatments for both are quite similar.
It is not known precisely what causes either condition, but
autoimmunity is a component of both diseases and food allergies
are thought to contribute in some cases. Some doctors suggest
that yeast overgrowth in the intestinal tract is another contributing
Conventional treatments include anti-inflammatory drugs, drugs
for diarrhea, and steroids (prednisone) for more intense symptoms.
In many cases, patients go on to have surgery to remove diseased
sections of bowel, and sometimes they have to have a permanent
colostomy or ileostomy with a bag. Some patients are also
treated with immune suppressant drugs.
You may not need any of these treatments with the right diet
and supplement program, plus some exercise and stress management.
However, these approaches also may work well combined with
conventional treatment, reducing the necessary doses of medications.
A diet that is low in land-animal fat (as opposed to fish)
and hydrogenated oils may help reduce the tendency to inflammation.
A 1997 review revealed an increased risk of IBD in people
who consumed higher levels of fat, especially animal fat,
cholesterol, and sucrose. A lower risk was seen in people
who consumed more fluids, fruit, magnesium, and vitamin C.
A Japanese reveiw in 1996 showed similar correlations. In
this study, the risks were increased by total fat (including
conventional vegetable oil), animal fat, animal protein, and
milk protein consumption. While the strongest correlation
with increased risk was with animal protein, the lowest risk
was associated with vegetable protein intake.
For general health, it is wise to include a wide variety of
fresh vegetables and fruits in the diet. Also, you should
not be afraid of fiber. It is more important to avoid junk
and highly processed sugary and fatty fast foods. Also include
whole grains and beans to your diet.
Unlike land-animal fat, flaxseed and fish oil contain fatty
acids that reduce inflammation. Flaxseed (which has not been
studied as much as fish oil) can be taken either as freshly
ground seeds (in juice or smoothies), or as organic oil in
capsules, or as liquid in salads or on cooked vegetables or
potatoes. (Keep it frozen until it is opened, and then in
the refrigerator to slow the oxidation until it is used up.)
Fish oils contain the fatty acids EPA and DHA, and are usually
taken in capsule form, up to 10 to 12 per day to get the effective
dose. Sometimes a lower dose is adequate. These fatty acids
also help with other autoimmune disorders, including rheumatoid
arthritis, lupus, and others.
Vitamn C is depleted by inflammatory disease. Intestinal
mucosal membranes are damaged by free radicals during inflammation
and their vitamin C status declines, so supplements can help
provide protection. I usually recommend at least 4 to 6 gms
daily, although intravenous doses are often helpful as vitamin
C has anti-inflammatory effects.
L-glutamine is an important dietary supplement in any bowel
disorder. This amino acid supports normal immune function
and white blood cell production, recovery from surgery, burns,
and trauma, protection of tissues exposed to radiation, and
improving function in patients undergoing cancer treatment.
Typical glutamine supplements are 4000 to 8000 mg daily,
but some severe inflammatory bowel disease might require even
In animal studies with experimental colitis, curcumin, one
of the spices in curry, helps as an anti-inflammatory and
an antioxidant. These studies from India and Japan suggest
that curcumin, with its high level of safety, should be considered
as part of a comprehensive treatment program for IBD.
Probiotic supplements, or “friendly bacteria”
help to repopulate the intestinal tract with beneficial organisms
(“normal flora”). These supplements include Lactobacillus
acidophilus, and Lactobacillus bifidus (bifidobacteria). They
support immune function, protect against infections, help
treat diarrhea, and control ulcerative colitis.
High-quality probiotics have about 10 billion organisms per
gram. Typical supplement doses are 10 to 40 billion organisms.
I usually recommend a mixture of L. acidophilus and L. bifidus
in equal amounts. These supplements help restore normal organisms
after antibiotic therapy.
Nutritional status tends to be depleted in IBD. Taking a
good multivitamin/mineral is essential to maintain basic health,
immune status, and recovery ability. Common one-per-day supplements
are never adequate in a variety of nutrients, beyond prevention
of serious deficiency diseases. A higher potency supplement,
usually requiring 4 to 6 pills a day is better (One example
is Ultra Vitality, from QCI Nutritionals.)
Q. I have difficulty getting enough sleep
at night. Are there any drug-free treatments for this?
-- HS, Tokyo, Japan, by Email
A. Insomnia is a common health problem.
Lack of adequate sleep leads to depression, fatigue, poor
concentration, and poor physical stamina. Some people can’t
fall asleep, while others are able to fall asleep easily,
but they wake early and cannot go back to sleep.
Psychological problems, stress, poor diet, lack of exercise,
obesity, low back pain and other pain syndromes, smoking,
caffeine, and even food allergies, can all contribute to insomnia.
Alcohol consumption can also disturb sleep patterns. Of course,
when people have sleep problems, and can’t stay awake
for their work, they tend to take more caffeine to maintain
their alertness, and this can perpetuate the problem.
Most sedative or anti-anxiety drugs used to treat the problem,
such as Valium, Restoril, Serax, or Ambien, may have side
effects, including fatigue, headaches, dizziness, and nausea.
They also lose effectiveness if taken consistently.
The best approach is to eat a healthy diet. Avoid sugary/fatty
foods foods, caffeine, alcohol, and any known food allergens.
It is also important to address the underlying physical or
psychological problems, and to get more regular exercise.
Supplements may also help with insomnia, without the side
effects of medications. Magnesium is a relaxant, and is commonly
deficient in the diet. I often suggest 200 to 400 mg at bedtime.
The amino acid, 5-hydroxytryptophan (50 to 100 mg) is also
helpful as a precursor to serotonin, which reduces anxiety.
Melatonin, is a hormone from the pineal gland that controls
the body clock, and supplements (3 to 6 mg) often improve
sleep. Valerian (400 to 600 mg of standardized extract) is
as effective as the medications, but without side effects.
Numerous studies still show the advantage of a high-complex-carbohydrate,
mostly-vegetarian diet for health, longevity, and less obesity,
cancer, diabetes, and heart disease mortality.
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Reuters, June 20, 2003 AstraZeneca to Pay
Cancer Drug Fine
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Whether or not you have diabetes, it appears that laughter
reduces the usual rise in blood sugar after meals (poorly
controlled sugar increases risks for heart disease, blindness,
and kidney disease). Laughter has many benefits, improving
immunity, circulation, and mood. (Hayashi
K, et al., Laughter lowered the increase in postprandial blood
glucose. Diabetes Care. 2003 May;26(5):1651-2; reported in
Reuters Health, May 22, 2003.) Watching funny movies
or listening to humorous CD’s are good meal accompaniments.
Stress reduction and positive attitudes really do make people
happy. Buddhists studied in India had brain scans indicating
that they were tranquil and happy (Flanagan
O, The colour of happiness. New Scientist, 2003 May 24;178(2396):44).
This and other studies indicate that mindful meditation is
associated with positive emotions, and can reduce fear and
anger. Meditation appears to be effective not only during
the practice, but also throughout the day. Treating depression
with drugs does not make people happy.
Women in Japan who consumed the most soy isoflavones (genistein)
and miso (fermented soy) had the lowest risk of breast cancer.
Yamamoto S, et al., Soy,isoflavones,
and breast cancer risk in Japan. JNCI, 2003 Jun 18;95(12):906-13.
The highest consumption led to a 50 percent reduction in risk.
Women with the lowest soy intake consumed 250 times more genistein
than Western white women, their breast cancer rates were lower
than in US women. Be careful, though,miso is high in salt.
Dietary soy is particularly protective when consumed during
adolescence. Studies of adults have been inconsistent. An
earlier study showed that soy intake halved the risk of death
from gastric cancer (Nagata C, et
al., ...soy product intake and stomach cancer death. Br J
Cancer 2002 Jul 1;87(1):31-6).
Although I was eager for the warm weather to arrive, now
I want to cook as little as possible (but still enjoy delicious
foods). This recipe is a variation of a Mediterranean staple.
I use English cucumbers, as they are seedless and usually
unwaxed. Shred the cucumbers, and add them to an equal amount
of non-fat plain yogurt, with a little water and fresh lemon
juice to make it a soupy consistency. Add some crushed garlic,
a small amount of flaxseed oil or extra virgin olive oil,
a dash of cumin, ground pepper, and chopped fresh dill. Stir
all this together, and garnish with sliced fresh scallion
greens and crushed walnuts. You can use almost any fresh herb
(oregano or mint are both great). If you prefer, you can substitute
plain soy yogurt for the dairy.