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Dr. Andrew Weil Answers Your Questions

Posted October 14, 2009, 12:33 pm in Health


You asked, and he answered! When we put out the call for your health and wellness concerns, you came back with intriguing, challenging and important questions for the guru of good living, Dr. Andrew Weil. Now he's responding to some of those questions.



1.    My daughter, age 42, has MS. She was dismissed from her banking position, lost her insurance and has run out of disability insurance. Meds are too expensive and she feels they do not help her. Do you know of any alternative therapies that have been used successfully with MS patients? We are at our wit's end.

I’m sorry your daughter finds herself in such difficult circumstances, however multiple sclerosis (MS) is an illness for which an integrative approach can be very successful, in large part because inflammation, stress and lifestyle factors seem to play a central role.

Many factors influence inflammation, among them genetics and toxic environmental exposures, but nutrition plays a significant role, as well. Following a healthy diet can help lessen the persistent inflammation that underlies many chronic illnesses like MS.  Ask your daughter to follow the information on my web site about the anti-inflammatory diet (http://www.drweil.com/drw/u/ART02012/anti-inflammatory-diet). She should focus her food choices around a wide assortment of fruits and vegetables (preferably organic), and healthy fats from cold water fish and extra virgin olive oil, for example. It’s best that she lessens her intake of animal protein, focusing more on plant-based sources such as whole soy foods and beans, and avoids highly processed carbohydrates as much as possible. The spices turmeric and ginger not only add flavor to dishes but also provide anti-inflammatory benefits.



There has clearly been a great deal of stress in your daughter’s life, which in itself can worsen the symptoms of MS. Have her explore healthy means of stress management, especially mind body therapies such as Guided Imagery, breathing exercises, and gentle yoga.

Practitioners of other complete systems of medical care, such as Chinese medicine and ayrdvedic medicine, offer therapies that can be very effective for MS. I recommend that your daughter consider using a fish oil supplement each day (at least 3 grams) and also take supplemental vitamin D3 in a dose of at least 2,000 IU daily.

A number of my patients with MS have expressed interest in using Low Dose Naltrexone (LDN), a therapy that has yet to be definitively studied, but that seems to offer some benefit to people with MS without significant side effects. The typical starting dose is 1.5 mg daily, with the highest dose used I’ve seen being 4 mg / day. LDN therapy requires a prescription from your physician and must be obtained through a compounding pharmacy.

GB Note:
  • Wendy Booker was diagnosed with MS at age 43. But instead of giving up, she pursued new dreams -- including becoming the first woman with MS to conquer the world's seven summits -- and inspires people who are battling the disease.
  • Rain Pryor's famous father Richard was diagnosed with MS and it changed the entire family. See what Rain tells The Growing Bolder Radio Show about the illness and how it re-connected this father and daughter.
  • Men and women all over the world are living life through illness, accomplishing amazing things and leading the way for us all. Need proof? Watch this.


2.    I have osteopenia (just bordering on osteoporosis). It is something that has gotten progressively worse as time goes on. My doctors have prescribed all the usual medications: Fosamax, Boniva, etc., however, I am one of those who has an adverse reaction -- my bones, muscles and joints ache when I use them. I even get this same kind of reaction if I take calcium supplements. As my doctor put it: I am a “skinny white chick” and am predisposed to this because my mother has it also. Even when I was on Fosamax, and calcium, and working out (strength training), stopped smoking over a 5-year period, there was little to no improvement. I have met other women who are in the same situation and we would like to know -- is there ANY alternative means to improve our bone density?

The term “osteopenia” implies the presence of bone that is less dense than normal but does not place a person at an increased risk of fracture. With progressive loss of bone mass, osteoporosis can develop where bones ultimately become brittle and prone to fracture. Doctors often aggressively treat osteopenia with medications in an effort to forestall osteoporosis, but this practice has become controversial.

Physicians frequently assess bone strength by measuring bone mineral density (BMD) via Dual X-ray Absorptiometry, or DXA. Bone mass peaks in our early 20s, and once a woman begins menopause there can be a precipitous decline in bone mass due to the loss of estrogen, increasing the risk for developing brittle bones. As you mentioned, Caucasian women who are tall and thin seem to be at further increased risk for osteoporosis.

Even if you were able to tolerate the medications prescribed for you, there simply aren’t good options to help strengthen and build up bone, and to help prevent fractures. A number of lifestyle and dietary habits, however, can help support bone health.

My colleague at the Arizona Center for Integrative Medicine, Victoria Maizes, M.D., speaks widely on the topic of osteoporosis management and favors an integrative approach that emphasizes dietary measures, appropriate exercise and prudent supplementation. One of the most important things you can do is not smoke, and I applaud you for having quit.



Your diet should include plenty of fruits and vegetables, and only a moderate amount of protein. Data suggest that high protein intakes may contribute to calcium movement out of bone, and plant-based sources may be preferable. For example, soy isoflavones contained in fermented whole soy foods like miso and tempeh can help maintain bone strength. Drinking a lot of coffee (> 4 cups per day) contributes to bone loss, whereas consumption of green tea strengthen bone.  

Vitamin D from prudent sun exposure (15 minutes a day) and supplementation (based on results of your blood test for vitamin D, or taken in a dose of at least 2,000 IU daily) can help with calcium deposition in bone as well as contribute to muscle strength, thereby helping to prevent falls. Calcium supplementation is often recommended and may be of benefit, but I prefer to encourage regular ingestion of high-calcium content foods such as leafy greens (which provide another helpful nutrient in vitamin K) and hard cheeses.  

I hope you have continued to exercise, because weight-bearing exercise is important. Even if you can’t regularly get to the gym   simply walking briskly for 4 hours a week can help limit progression of osteoporosis in the lower extremities. The practice of Tai Chi supports fitness of both body and mind, helps enhance balance and lessen falls, and is also a great stress management tool.

GB Note:
  • Think you don't have the time to work out? Maybe you think you're too far out of shape. Heather Quillen is proof that it's never too late to change your life for the better:



3.    I have a dear friend (only 50 yrs old) that is severely in need of hip replacement, confirmed by x-ray -- are there any reasonably priced, non-prescription pain relievers that would take the edge off? He’s very hard-headed, and won’t have anything done until he can get Medicaid or other help, as he has no insurance and can’t work. The arthritis also bothers his knees and hands, but he has great upper body strength.

It sounds as if your friend has degenerative joint disease, otherwise known as osteoarthritis (OA), where the cartilaginous lining of the joint breaks down after long years of use. It’s possible that surgery is the best option if the degenerative process has progressed to a point where limited mobility and pain are significantly impacting his quality of life. Short of surgery, however, there are a number of ways to help relieve discomfort and enhance unrestricted joint movement.

Of utmost importance is maintaining a healthy weight for height. Being overweight places additional strain on hip and knee joints, which can lead to further cartilage breakdown, bone rubbing against bone, and pain. Thus, diet and exercise have important roles to play.

Since osteoarthritis has an inflammatory component, following an anti-inflammatory diet (http://www.drweil.com/drw/u/ART02012/anti-inflammatory-diet) can be very helpful. Omega-3 fatty acids, whether from consuming cold water fish or from supplements, can help quell the fire of inflammation, and the spices turmeric and ginger have natural anti-inflammatory effects, not to mention making food taste better.

Although your friend may be in pain, he will likely be able to engage in water exercises. Even water walking, especially with hands in the water, provides aerobic exercise against resistance with the added benefit of buoyancy that lessens the impact on hips. Appropriate exercise can strengthen the muscles around affected joints and so support overall joint health, as well as contribute to desired weight loss.

One supplement you’ve likely heard of is glucosamine sulfate, which has been studied for its ability to help slow down the degenerative joint process, and actually build some of the cartilage back up. Many practitioners recommend glucosamine in combination with chondroitin, another compound that looks promising in the treatment of OA. Some experts recommend avoiding supplementing with chondroitin in men who have been diagnosed with prostate cancer, which make make the disease process worse.

The pain of OA can be significant, and while non-steroidal anti-inflammatory agents (NSAIDs) have been the mainstay of  conventional medical management, they also come with the potential for some significant side effects. Acupuncture has been shown effective in relieving the discomfort of OA affecting large joints like the knees, and mind body therapies, specifically mindfulness meditation, guided imagery and hypnosis, can also be effective in relieving painful conditions.

Dr. Andrew Weil has a new book called "Why Our Health Matters," available in stores now!



Want more health advice?
--Dr. Weil's Web Site (with FAQs!)
--GB's Health Channel
--Suzy Cohen: America's Most Trusted Pharmacist

 

© 2006-2014. Growing Bolder Media Group. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Comments


  • spaceman.jpg
    db
    Posted 8:05am October 16th, 2009

    We are big fans of Dr Weil. His advice is easy to undersand, integrating traditional with non-traditional preventative health solutions.

    He is a great asset as we all continue to Grow Bolder..Thanks GB





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