Dear Patients and Friends,

We have been blessed over the past several years at the Center for Environmental Medicine with sustained growth with both interesting and challenging patients.  In a greater effort of meeting your health care needs we are expanding our services and availability.  I would like to introduce you to Ami Kapadia, MD who started to work with us at Center for Environmental Medicine this month.  Her training in family medicine has included studying integrative and holistic medicine, including environmental medicine.  Originally from outside of Philadelphia she has been making her way westward over the past few years and is finally settling here in Portland to work here at CEM. 

Her various career experiences have included being on faculty for the Family & Community  Medicine Department at Thomas Jefferson University Hospital, working at inner city clinics, working with Veterans Administration clinics and local urgent care centers here in Oregon.  She also has had the privilege of working with some outstanding integrative medicine practitioners in various settings over the past 7 years.

Dr. Kapadia is excited to be joining Center for Environmental Medicine and looks forward to working with patients who are seeking a more holistic paradigm to address their health.  I believe you will find her passionate about her work in assisting patients get to the root causes of their health problems, and empowering them to make positive changes in their lives.

Her special interests include gastrointestinal/digestive disorders,  detoxification, nutrition, and allergy identification and treatment. Some of the treatment modalities that will be offered include: nutritional therapies, IV therapy, functional medicine laboratory testing,  food & environmental allergy testing and treatment, applied kinesiology testing, and hormone evaluation.

In addition to Dr. Kapadia, we have also partnered with a colon hydrotherapist.  Linda Hallmark, with A Healthy Practice, has been actively participating in Holistic Health since the very early 80′s beginning with Macrobiotics teaching and starting East-West Center in Austin, Texas catering lunch and dinner daily to nearly 225 people.  She began doing colon hydrotherapy approximately 20 years ago.  She uses a Hydrosan closed system, FDA approved, with filtered water and disposable hoses and speculums.  She  is National Board Certified as well  as a member of     I-ACT (International Association for Colon Hydrotherapy).

So, please join us in welcoming Dr. Ami Kapadia and Linda Hallmark to the CEM team.  If someone you know is looking for an integrative physician to work with or someone wishes to add colonics to their program, please pass our contact information along.   We also appreciate your suggestions and feedback on how we can continue to improve the services we offer.

Finally, all the members of CEM extend to you and your family warm wishes for this Holiday Season and a prosperous New Year of increased health and harmony.  We appreciate your continued support and loyalty as well as your own efforts on behalf of your health.

Sincerely,

Chris Hatlestad, MD

The Staff of CEM

Digestive disorders include Irritable Bowel Syndrome,  GERD, and  Inflammatory Bowel Disorder to name a few.  Where do they come from and why? Infection? Food allergy? Stress?  It seems in recent years, the number of people suffering from gastrointestinal disorders continues to increase.  It is estimated that 20% of the U.S. population (or around 60 million individuals) suffer from irritable bowel syndrome, or IBS, and an additional 1.4 million individuals suffer from inflammatory bowel disorder, or IBD. Another estimated 7 million suffer from GERD, or gastroesopageal reflux disease.

Sometimes the cause of digestive disorders can seem elusive.  While there can be genetic links causing predisposition, there are several environmental factors that may also play a role.  In some individuals there seems to be a link with a previous gastroenteritis (prior intestinal infections such as salmonella, e. coli, etc.).  Previous antibiotic use can also be a risk factor for the development of intestinal symptoms.  For others, the cause of symptoms may be related to food allergy, either along with previous intestinal infections, or as a sole cause.  Another related issue seems to be alteration in gut microflora, or a change in the bacteria and other organisms that make up the intestinal ecosystem.  We call this “dysbiosis.”

In Part I of this series, I would like to focus on dysbiosis and how it can be related to intestinal symptoms.  Dysbiosis is defined as a state of altered microbial ecology that causes or contributes to disease/dysfunction.  Organisms of low intrinsic virulence, such as bacteria, yeast and protozoa/parasites, induce disease or dysfunction by altering the nutrition, neuroendocrine and/or immunologic responses of a person.

There are normally around 100 trillion bacterial cells in the human intestinal tract along with a smaller number of yeast colonies (that are kept in check by the bacteria) that are part of our normal flora. These organisms are vitally important to the development and maintenance of a healthy immune system. Some of their “jobs” include: warding off pathogens, decreasing allergic responses, and helping in the excretion of toxins.  A fact you may not know is that 80% of the body’s immune system is located in the lining of the small intestine—allowing alterations in the intestinal ecology of bacteria and yeast (=dysbiosis) to have far-reaching impacts on our overall immune system function. When the natural microbial balance is disrupted, illness can result.

You may be wondering  what causes dysbiosis? Well, there are many factors.  For one, frequent or prolonged antibiotic use can have long-standing effects on the intestinal ecosystem because antibiotics destroy good bacteria as well as the target infection.  This fact is becoming increasingly well-known, as probiotics are becoming more commonly used as a method to replace the good bacteria in the intestinal tract. Unfortunately, sometimes probiotics are not enough, and further evaluation and treatment is necessary when intestinal symptoms start after frequent/prolonged antibiotic use.

Other medication related causes of dysbiosis can include use of oral steroids, as well as proton-pump inhibitors or acid-blocking medications.  Other infectious causes of dysbiosis involves parasitic infections. While we generally associate parasites with travel abroad, it is possible to pick up a parasite without leaving the country, just by drinking contaminated water or eating contaminated food (at a restaurant, etc.).   Finally, it has been shown that stress in and of itself, can cause imbalances in intestinal flora.

Fortunately, there are ways to detect and treat some of these hidden causes of dysbiosis.  In many instances, digestive symptoms can be greatly alleviated, if not resolved, with some detective work and the appropriate treatment.

Check back for the next part to this series.

Lebowitz, M and Kapadia, A.,  “Body Restoration: An Owners Manual” ; 2011.

Galland, L., “ The Four Pillars of Healing”,  New York: Random House; 1997.

uptodate.com (topics: IBS, IBD)

http://medinfo.ufl.edu/~gec/coa1/gerdfaq.html

Source: Abstract from Postgraduate Medicine, Volume 121, Issue 1, January 2009, ISSN-0032-5481, e-ISSN-1941-9260

Author : Kent Holtorf, MD,  Holtorf Medical Group, Inc,  Torrance, Ca.

Due to the ongoing debate regarding safety and efficacy of bioidentical hormones (estradiol, estriol, and progesterone), this paper aimed at evaluating evidence comparing the same to commonly used  synthetic hormones and HRT.  Utilizing published papers identified from PubMed/MEDLINE, Google Scholar and Cochrane databases, evidence was collected regarding compared effects for physiologic actions on breast tissue, risks for breast cancer and cardiovascular disease, clinical outcomes and in vitro results.

Reported was patient satisfaction with HRT that contained progesterone compared to synthetic progestin.  Bioidentical hormones have “distinctly different, potentially opposite, physiological effects compared to synthetic counterparts, which have different chemical structures.”   While research indicated increased risk for synthetic progestin, conversely, progesterone consistantly is associated with diminished risk for breast cancer. Four articles were cited for progestin and seven articles for progesterone.   Regarding cardiovascular disease, progestins carry a variety of negative effects which may be avoided with progesterone.  Estriol has some unique physiological characteristics from estrogen counterparts and while it is expected to carry less risk for breast cancer, no randomized controls have been documented.

The effects of progesterone compared with progestins included a 30% reduction in sleep problems, a 50% reduction in anxiety, a 60% reduction in depression, a 30% reduction in somatic symptoms, a 25% reduction in menstral bleeding, a  40% reduction in cognitive difficulties, and a 30% improvement in sexual function resulting in 65% of women who felt HRT combined with progesterone was better than the HRT combined with progestin.

The conclusion of this article, based on thorough review of medical literature is support for the claim that bioidentical hormones  have some effects distinctly different or opposite of their synthetic  counterparts.   More randomized control trials of substantial size and length will be needed to determine these differences.

Dr. Holtorf discloses no conflicts of interest.

Osteoarthritis is the loss of articular cartilage (the cartilage covering bones) which thins and eventually wears out, resulting in a “bone against bone” joint, reduced motion accompanied with pain.  Progression includes concurrent subchondral bony sclerosis (located just below the cartilage) and bony proliferation at the joint margins and growth of osteophytes or bone spurs.

Osteoarthritis affects  the joints exposed to high stress and is therefore considered the result of “wear and tear” rather than a true disease.

The symptoms of osteoarthritis are a gradual onset of perhaps one or a few joints.  Pain ensues that is deep, aching, worse with movement and better with rest and warmth.  Stiffness is identified as worse in the morning upon rising and after periods of rest but improves with movement.  Patients incur sleeping issues related to pain and stiffness.   Cartilage in the joint spaces begins to wear and weakness of the joint when weight bearing is seen.  Chronic conditions have acute flare-ups of pain, swelling, and stiffness.

Many patients find relief with improved diet and addition of supplements.  Suggestions include glucosamine, chondroitin, MSM, vitamin E, calcium, magnesium, vitamin C, essential fatty acids and bosweillia acid, and cetyl myristoleate.

A few weeks ago I was listening to a radio talk show and a gentleman in the car business called in responding to a woman with the same frustration.  He said to use automobile buffing compound and fine steel wool as instructed on the can to successfully clean  shower doors.  I just tried it and I am excited to report it does a great j0b.  After all these years, having suffered with multiple chemical sensitivity in the past, I find this is very low odor and seemingly non-toxic.  Within  30 t0 45 minutes my shower was sparkling clean looking almost new.  It also cleaned the brass and floors as well.

You will need:

Rubbing Compound
Gloves
Fine steel wool
A pale of water
Rags

Instructions are to clean a small area at a time with the steel wool as an applicator.  Do not allow the compound to dry.  Instead, once applied and rubbed for desired amount of time,  wipe it off with a damp cloth.  You will want to rinse out your rags as you go.  Change the steel wool as you need but do not get it wet.

A word of caution;  do not use any other clean in conjunction with the rubbing compound.   Spraying the shower with a bleach or mildew cleaner,  for example,  will result in toxic fumes.