Inflammatory Breast Cancer—Difficult to Detect and Deadly

By Jan Tucker, MBA
Edited by Martin Palmer, MD, Medical Oncologist

With all the familiar information about what we can do to detect breast cancer early, it’s important to keep these facts in mind: There is more than one type of breast cancer. You don’t have to have a lump to have breast cancer. Mammograms or ultrasounds do not detect all breast cancers.
Inflammatory Breast Cancer (IBC), a rare but aggressive form of breast cancer, accounts for one to five percent of all breast cancer cases in the United States. Since IBC tends to grow in nests or sheets rather than as a solid tumor, it can spread through the breast and remain undiagnosed for some time, even if symptoms are present.
This cancer is called “inflammatory” because it often presents with redness, swelling, and warmth in the breast caused by the cancer cells blocking the lymphatic system just below the surface of the skin.
IBC often occurs in younger women, and more often in African Americans than in Whites. It can occur in men, but usually at an older age than in women. According to the National Cancer Institute (NCI), one or more of the following symptoms are typical:
• Swelling of the breast, usually sudden, sometimes a cup size in a few days
• Itching
• Pink, red, or dark colored area (called erythema), sometimes with texture similar to the skin of an orange (called peau d’orange)
• Ridges and thickened areas of the skin
• Nipple retraction
• Nipple discharge, may or may not be bloody
• Breast is warm to the touch
• Breast pain (from a constant ache to stabbing pains)
• Change in color and texture of the areola
• Swollen lymph nodes under the arm, above the collarbone, or in both places
These symptoms often develop very quickly, over a period of weeks or months. The symptoms can also occur in benign breast disorders, and they are often confused with mastitis, which is a breast infection treated with antibiotics. One symptom of mastitis that is not a symptom of IBC is a fever. If you are being treated for mastitis and your symptoms are still present after a week, you should seek a breast specialist who can further diagnose your problem.
Diagnosis
Breast cancer is diagnosed by pathologic examination of biopsies of suspicious abnormalities such as a breast lump, changes described in the previous section, or characteristic abnormalities identified on a mammography. IBC is a clinical diagnosis supported by the biopsy showing invasion of the lymphatics of the overlying skin of the affected breast.
IBC is classified as either stage IIIB or IV breast cancer, IV being the highest (the higher the stage, the poorer the prognosis). Staging reflects the extent of spread of a cancer, helps guide treatment recommendations, and influences the prognosis. A stage IIIB cancer describes one that has spread from where it started to nearby tissue (to the skin of the breast in IBC) and is known as “locally advanced.” A stage IV breast cancer has spread to other organs beyond the breast and local lymph nodes.
Prognosis
Since IBC is more likely to have metastasized (spread to a site distant from the primary cancer as opposed to local spread) than non-IBC cancers by the time it is diagnosed, the five-year survival rate for IBC patients is between 25 and 50 percent. This is significantly lower than the survival rate for patients with other breast cancers. However, many factors influence the outcome of cancer, and it is important to discuss your particular situation with your doctor if you are diagnosed with IBC.
Treatment
Defining the stage of a cancer helps the doctor determine the best treatment plan as well as the patient’s prognosis or chances for recovery. IBC requires immediate, aggressive chemotherapy treatment prior to surgery.
The most common order of treatment, according to the IBC Cancer Research Foundation is neoadjuvant chemotherapy (prior to surgery), surgery, more chemotherapy, and radiation. These treatments have several purposes: to remove the primary cancer to achieve locoregional control (by surgical resection and post-operative radiotherapy), to treat distant metastases where it is known to exist at diagnosis (i.e., stage IV), and to reduce the risk of recurrence (with systemic treatment such as chemotherapy). While about two-thirds of patients with all types of breast cancer express estrogen receptors (ER) and/or progesterone receptors (PR), making them more likely to respond to blocking these receptors by hormonal treatment such as Tamoxifen, most patients with IBC do not express these receptors on the surface of their cancer cells and thus generally do not benefit from hormonal treatment.
Patients can receive supportive care to help manage the symptoms related to the cancer and the side effects of its treatment. For example, the skin overlying the affected breast can break down because of cancerous erosion through the surface, leaving the patient open to complicating bacterial infection that requires antibiotics as well as careful attention to wound care.
The standard of care for IBC generally involves multi-modality treatment with combined use of chemotherapy, surgery, and radiotherapy, and there are a variety of acceptable choices, particularly for the specific chemotherapy drugs used. Thus the specifics of treatment can vary by doctor, by the institution, by disease stage at presentation, and can also be influenced by where the patient lives (affecting treatment resources locally available), and by their individual medical history (influencing their ability to tolerate side effects of treatment).
Clinical Trials
The National Cancer Institute (NCI), part of the National Institutes of Health of the U.S. Department of Health and Human Services and the Federal Government’s principal agency for cancer research, is sponsoring clinical trials designed to find new treatments and better ways to use current treatments. Speak with your doctor if you are interested in participating in a clinical trial. Information is available by calling 1-800-4CANCER (422-6237) or by visiting http://www.cancer.gov/publications or http://www.cancer.gov/clinicaltrials.
IBC Patients Describe Their Symptoms
IBC is difficult to diagnose yet early detection can be critical to the patient’s chances for survival. Because of this, IBC Research has posted a list of patients’ own words describing their symptoms prior to being diagnosed with IBC. Please see http://www.ibcresearch.org/symptoms/ibc-patients-write for the complete list.
Some brief descriptive words and phrases common in this list are redness; swollen lymph nodes; a lump (often large and growing); change in the size, appearance, or feeling in one breast; hardening of a breast; appearance of a rash, starburst, reddish, bruise-like, or other mark; uncomfortably sensitive breast; constant, intense itching of the breast; a discomfort under the arm. One IBC patient’s doctor told her that often one breast gets larger as you get older.
Several patients described how they rationalized there wasn’t a problem, even though they experienced changes. “I thought I was having a reaction to new [detergent or bra],” or “I was not concerned about this because of [other breast problems I had with similar symptoms],” and “I thought cancerous lumps weren’t painful.”
There are many ways to rationalize or overlook changes we are experiencing. The risk of breast cancer is higher than we may realize: One out of eight women will be diagnosed with breast cancer. According to statistics, one to five women out of every 100 diagnosed will have IBC. The best defense is your awareness of this silent, devastating disease. Do not ignore or rationalize your symptoms. Have them checked immediately.
Please visit the following Web sites, which were also used to research this article: http://www.cancer.gov and http://www.ibcresearch.org.
Dr. Martin Palmer is in oncology practice with Ashwin Kashyap, MD; and Robert Joseph, MD; located at 1240 Westlake Blvd, Suite 117 in Westlake Village. Dr. Palmer may be reached at 805-496-0592.

Letter from the Publisher -The Gift

By Ann Alcock, Founder & Publisher, YHC

December is the month that I set aside for my mammograms. I guess it’s because I like the peace of mind knowing that I can start the next year with calm resolve that everything is fine. Last December I had my mammogram done at the Nancy Regan Breast Center in Simi Valley. A week later I received a letter stating that they had to repeat the screening on the left side.

Okay…stay calm. You are healthy and doing all the right things; healthy diet, exercise, self-examination, and annual screenings. Why are they calling me back? I called immediately and they had a cancellation that allowed me to get in quickly.
The outcome?
Fine.
Now I can get on with the New Year and book my other health screenings.

Out of curiosity, I went online to do some research on women’s health screenings; according to the Harvard School of Public Health Web site, there are six reasons for women not getting their annual mammograms: It hurts, fear of the results, complacency, not affordable, the screening is unreliable, and self-examination is sufficient. According to the American Cancer Society Web site, the rate of screenings from 1987 and 2000 showed a dramatic increase, but from 2000 to the present there is a slow decline in the amount of screenings done. Well ladies, this will not do and I’m afraid that I will have to be tough on you! Yes, sometimes it hurts—the last one had me unexpectedly grabbing the rather surprised technician and gasping in her ear. And she said I surprised her! Yikes! Not affordable? Well, it is expensive, but it depends on your health insurance and frankly, it’s less expensive than the alternative. I think that also covers the fear of results; better to know early and take care of it than ignore it. Monthly self-examination is essential, but cannot detect small masses deep in the breast tissue. Modern science continues to improve technologically, but until then, get the mammograms done!

In this issue, we cover the latest information on inflammatory breast cancer, identifying the symptoms of adrenal exhaustion, how your oral health is an indicator of your basic health, the myths and facts behind BOTOX, and a variety of destinations from healing retreats to fun spots for the entire family.

When reading this issue, I hope you will be reminded of the precious gift you have been given—your body. It is a gift, unique in design, to be experienced with purpose. Please treat yourself well and continue to stay empowered about your health.

By the way, thank you to the friendly and efficient staff at the Nancy Regan Breast Center in Simi Valley; I have always been treated with respect and compassion.

Peace, Blessings, Gratitude, and Love,

Ann

Santa Paula: The Jewel of a Committed Community

By Tracy Marcynzsyn

Perched atop a hill like a shepherd overlooking its flock, Santa Paula Hospital (SPH) attests to the strong community spirit living in this little town, located approximately 14 miles northeast of Ventura.
This hilltop gem is the crowning glory in a small town’s quest to have a hospital, and in fact, owes its very existence to the citizens of Santa Paula and the surrounding communities, who worked tirelessly to create and sustain it.
Since its roots in the 1950s when local farmers donated their land, and neighbors pooled their resources to raise funds for the proposed hospital, SPH has been supported and cared for by the residents it serves.
“The community was adamant we had to have a hospital and they made it happen,” remembered fifth generation Santa Paula resident Marsha Rea, who recalls going door to door with her mother in the late 1950s and early ‘60s, raising funds for the hospital.
Their dedicated efforts culminated in the opening of the Santa Paula Memorial Hospital (SPMH) in 1961, “totally built by the community” and having the distinction of being “one of only four hospitals in California built without federal assistance,” explained Dr. Sam Edwards, a Santa Paula native and retired physician who practiced at SPMH in its early days.
“It’s a marvel,” said Dr. Edwards, “There is a community spirit here that just is ‘can do.’”
That attitude of determination proved resilient even in the face of challenges as the fledgling hospital experienced financial troubles. Despite the fight to keep the hospital’s doors open, the weight of debt forced the hospital to close and file Chapter 11 bankruptcy in December of 2003.
Spurred by the need to re-open the hospital, which housed the only emergency room between Ventura and Santa Clarita, community members banded together to find creative solutions to the hospital’s troubles. While its creditors formed a committee and worked with key players, including the hospital’s board members, the Santa Paula City Council, representatives from Ventura County, and from the Ventura County Health Care Agency to solve the crisis, several Santa Paula residents joined Cathy Barringer and her family in tending the hospital rose garden.
“Our family started it 31 years ago in honor of my mother, Catherine Emily Morris,” said Cathy Barringer. “Every Monday at 4 p.m., people just showed up to work on it; we never asked anyone,” she commented, adding her appreciation for the “eclectic group” of volunteers who kept the garden going even during the hospital’s closure.
Finally, after much negotiation, the city of Santa Paula agreed to sell half of the property surrounding the hospital to a housing developer in October, 2004, and the County of Ventura purchased SPMH for $2.75 million in September 2005. The deal settled the hospital debts and resulted in the state-of-the-art, fully refurbished and renovated (to the tune of $4.5 million) SPH, opening its doors to the community as a branch of the Ventura County Medical Center in July 2006.
With 49 beds and 19 private rooms, all with breathtaking views, two full operating rooms, and state-of-the-art radiology, surgery, maternity, and intensive care departments, along with a 24/7 emergency room and a full-functioning laboratory, SPH rivals the services offered at any larger hospital, but is set apart by the personal touch.
“The dedicated staff and smaller size make it a down-home place,” described Dr. Edwards. The staff agrees. “We’re like a family,” said Head OB Nurse Lisa McPheeters. “At lunch in the cafeteria we all sit together and eat and talk, from all different departments.”
And still today, in its refurbished, modernized state, under the wing of the Ventura County Health Care Agency and the Ventura County Medical Center, the hospital’s symbiotic relationship with the local residents continues.
Citizen’s artwork adorns the walls of the hospital, and any proceeds from pieces that sell directly benefit the hospital. Some 23 volunteers still give of their time, working in the gift shop and other departments, and Cathy Barringer et. al. keep maintaining the rose garden, which provides a beautiful place to relax and retreat and also serves as a sort of outdoor chapel for patients and their families.
SPH and its devoted staff provide care for the medical needs of the residents of Santa Paula and the surrounding communities of Ojai, Fillmore, Piru, Saticoy, and Ventura.
Offering big hospital services with individualized attention is a cherished hallmark of the hospital. The newly remodeled and expanded maternity and obstetrics unit is a case in point, featuring a 1-to-1 nurse-to-patient ratio and a relaxed, spa-like atmosphere.
The 2007, $60,000 OB unit renovation almost doubled its size by adding six new private rooms for a total of nine private labor and delivery rooms. Located behind security doors, the spacious, private, comfortable, and clean rooms have large windows framing sweeping mountain and city views. The calm, secure comfort of the maternity ward, coupled with the competent caring and attention of the professional staff make it a place where the women in the community want to give birth.
“We have about 30 births a month here,” said McPheeters. Expectant parents are welcome to attend the monthly tours of the OB unit, which also offers continuing support for parents once their baby is born. The hospital boasts being among a limited number of hospitals in the state designated as “baby-friendly.”
Community members are proud of the full array of services they can access at SPH, including inpatient and outpatient services and full-service departments for diagnostic procedure, treatment, aftercare, and ongoing care, including radiology, surgery, laboratory services, critical care, emergency services, dietetics, and physical therapy. Since it is associated with the UCLA Medical Center, patients also benefit from the latest research and clinical studies. While its small size allows for quick and efficient care and treatment, SPH meets high quality standards for patient safety and procedures and is accredited by the Joint Commission on Accreditation of Healthcare Organizations.
As SPH successfully fulfills its mission “to provide access to health care for citizens of Ventura County, especially those who are underserved,” the community’s commitment to the hospital holds firm.
Hospital-sponsored events like community education classes and its first annual baby fair are well-attended by community members, who know they are truly a part of their little hospital on the hill.
“It really is a jewel,” said Hospital Administrator Kirk Watson. “The support of the hospital in the community is great to see.”
The Santa Paula Hospital is located at 825 N. 10th Street in Santa Paula. To contact the hospital, please call 805-933-8600.

Are You Losing It?

By Candice Lane, M.D.

Are you having difficulty remembering names and appointments, concentrating or keeping track of your glasses and keys? Do you feel you’re not as sharp as you used to be? Do you get crankier than you once did? Have you joked about having a “senior moment” one too many times? Are you distracted and can’t stay on task? Do you fall asleep or are you less able to concentrate during meetings?

Becoming forgetful, moody and even spacey is not a normal sign of aging. The bad news is that the slowdown in brain function that begins in midlife, including memory problems, difficulty focusing, brain fog, irritability, loss of mental agility, and physical coordination, is the beginning of a downward spiral that destroys your brain. The good news is that brain degeneration is not inevitable. You can stop it, reverse it, and recover what you have lost. Your brain has amazing powers of regeneration, but you need to supply your brain with the substances it requires. Your brain needs nutritional substances, appropriate hormones, protection from medications and toxic substances, sufficient sleep and mental and physical exercise.

The first place to start is with your diet. Rid trans fats from your diet! They make for rigid, slow brain cells that age quickly. Trans fats are so prevalent in our food supply that unless the item states “no trans fats,” you can assume that packaged and fast foods contain plenty. Even if you eat a large amount of good fats like fish and olive oil, the trans fats will crowd them out and wind up in your cells. So eliminate all bad fats and increase omega-3 fatty acids, or fish oil.

Omega-3 fatty acids contain DHA, which helps the brain form well-functioning cell membranes. Consume the best fish oil supplements you can buy, or you may be further poisoning your brain with mercury that may not have been adequately removed from cheaper brands. Make sure you’re supplementing the nutrition to your brain since Americans consume bountiful, beautiful foods that are actually almost void of nutrition and tainted by pesticides. For recovery and enhancement the brain needs supplements and free radical protection. The brain uses fish oil, coenzyme Q 10, vitamin E, vitamin C, alpha lipoic acid, n-acetyl cysteine (NAC), acetyl-l-carnitine, phosphatidylserine, vitamin D and B-complex vitamins. Choose foods lower in pesticides like organic vegetables. If that is not possible, then wash fruits and vegetables with an organic wash, vinegar and water or mild soap and water. Stick to food grown in the United States where there is at least some regulation of the amount and types of pesticides being doused on your food, versus fruits and vegetables imported from Mexico and South America.

It is always beneficial to improve nutrition, sleep and exercise, eliminate toxic substances and take appropriate vitamins.

Take stock of the medications, toxins, and additives in your diet. Many medications can cause loss of memory. The list is long, but the most common ones are the cholesterol-lowering, statin drugs like Lipitor and Zocor. Pursuing a healthy pathway to lowering high cholesterol is an even better choice than medication.

Be aware of neurotoxins in your environment like insect sprays and solvents and eliminate them. Few people are aware pools that chronic exposure to high levels of chlorine in outdoor and chlorine gas surrounding indoor pools can be a neurotoxin. This fact has led many people to convert to salt water pools if they spend large amounts of time in the water. The aspartame in sugarless food products also causes memory loss. Did you know that some airlines require their pilots to sign a contract that they will not ingest any aspartame?

Keep your brain active with word or computation games. Learn something new. Practice memorizing number sequences. Physical exercise also improves brain function. Sleep is underrated by our driven society. If you are not getting seven to eight hours of sleep per night, then you are not performing at your mental peak, thus putting your brain at risk. You may not feel tired, but you are not performing at your best cognitive function. Even mild sleep disorders, like getting six hours of sleep per night, show notable declines in reaction time and performance on standard mental functioning tests. Long-term sleep disorders can damage your brain by not allowing neurotransmitters to normalize and brain cells to repair. If you can’t sleep, nutritional, exercise, and hormonal adjustment may help.

Proper hormone balance is essential to brain function. Hormones transmit messages to brain cells and properly modulate their health and function. Stress and fatigue, resulting in increased or decreased amounts of cortisol production, can wreak havoc on your memory and mood. Imbalance and deficiencies of estrogen, progesterone, thyroid hormone, growth hormone, and testosterone have been shown to affect mood, creativity, sociability, irritability, depression, mental activity (mentation), memory, motivation, and cognition. Imbalance of all these hormones can also cause a decline in your general health. Cortisol can be modulated with proper nutrient and hormone replacement. Deficient sex hormones and thyroid hormones can be replaced with bioidentical hormones to achieve optimal function. Neurosteroid replacement including DHEA and pregnenolone has shown a positive additive effect on mental function.

Once the basics of lifestyle, nutrition, and hormones are improved, “smart drugs” or prescription medications can be added to improve cognition. One of the best known is selegilene, which can increase libido, improve memory and enhance attention, cognition, and language abilities. Other medications include hydergine and piracetam.

It is always beneficial to improve nutrition, sleep and exercise, eliminate toxic substances, and take appropriate vitamins. For more advanced supplementation involving specific nutrients, hormones or other pharmaceuticals, it is best to consult a physician who specializes in hormone and vitamin replacement or antiaging. Remember, your brain has amazing powers of regeneration! You can get it back with a little effort if you really want to!

---

Candice Lane, M.D. is board certified and a Diplomate and Fellow of the American Academy for Anti-Aging and Regenerative Medicine, located at 1250 La Venta Drive, Suite 206 in Westlake Village, CA. You can contact her at 805-496-7869.

Regenerative Medicine

By Shannon Anderson

The latest news on regenerative medicine has been a roller coaster of good, bad and not so bad news. The good news is that the whole field is advancing. The innovative therapies of regenerative medicine will soon create a biomedical revolution that, in the coming decades, will help to cure major diseases, increase our physical potential and greatly lengthen the human life span as we know it.

Regenerative medicine research affects almost every family in America. Millions of people worldwide have diseases and conditions that could be improved or cured with regenerative cell therapies.

Stem cells, formed during the earliest stage of human development, can grow into any of the 220 different types of cells in the human body to replace diseased tissues. When a stem cell divides, each new cell can either remain a stem cell or become another type of cell with a specialized function such as a red blood, brain or bone cell. So the reprogramming of adult stem cells has the potential to generate a potentially limitless source of immune-compatible cells for transplantation medicine. The implications for disease treatment with regenerative medicine are significant, giving hope for almost 70 diseases and conditions that have been otherwise considered incurable.

Regenerative medicine also offers hope for millions of people worldwide in need of organ replacement. As desperately as an ailing body needs a healthy organ to replace a faulty one, it often ends up rejecting the replacement part. Decades of research have led to improved drugs to reduce this reaction, but these medicines usually have to be taken for the remainder of a patient’s life and can often lead to a risk of infection and cancer.

When offering examples of the miracle of regenerative medicine, many researchers reference the technique of bone marrow transplant. But medicine has far surpassed even this accomplishment. Currently researchers like Dr. Stephen Badylak at the University of Pittsburgh are developing what are known as biologic scaffolds for regenerative medicine applications. To help spread education about the topic of regenerative medicine, Dr. Badylak talks about the science, the potential and the changes medicine is making.

“Since biologic scaffolds have a potentially universal application, they are not limited to a particular organ or tissue,” Badylak explains. “There are currently biologic scaffolds available for repair or replacement of organs as diverse as the urinary bladder, heart, skin, esophagus and a variety of musculoskeletal tissues.”

As a researcher in the field of regenerative medicine, Badylak and his colleagues at the University of Pittsburgh see plenty of room for future development in the area. These biologic scaffolds can be placed within the body in two ways: in vivo (Latin for within the living, meaning within the body), or seeded with a variety of cell types in vitro (Latin for within the glass, meaning outside the living body). The tissues that are generated in vitro are then implanted into the body.

The answer of “how and why” tissues and cells develop into specialized tissues is the subject of intense investigation. “Right now, scientists believe that local environmental cues play an important role in determining the phenotype (the observable properties determined by genetic and environmental influences) of cells at various locations in the body,” Badylak reports. “Factors like pH, oxygen, tension, mechanical forces and even temperature can affect the lineage differentiation of multipotential cells that participate in the remodeling response.”

In addition, stem cell scientists have recently reprogrammed human skin cells into cells with the same properties of embryonic stem cells. The process involves adding four genes to human skin cells, which reprograms the cells’ chromosomes, allowing them to be converted into other types of tissue. As a result of this discovery, it is now possible to take skin cells from a patient, make them into cardiac muscle cells and then test a potential drug on them. Many deaths occur as a result of unpredicted responses to drugs, and if the cells behave in a volatile way doctors would then know not to administer the drug. This could lead to more personalized medicine between doctors and patients, and since this technique uses neither human embryos nor a cloned mix of human and animal DNA, it eliminates the ethical problems associated with creating and destroying human life in its embryonic stage.

Diabetes patients are another group of people gaining hope from advancements in regenerative medicine science. Human stem cells transformed into nearly normal insulinproducing cells will possibly offer a way to treat diabetes longer term than current medicine permits. The stem cells could keep blood sugar in check when the body’s own insulin-producing cells are dysfunctional.

Researchers today are even exploring advances in therapies for diseases like spinal cord injuries and cancer cells. For other ailments, such as lung diseases like emphysema, scientists are now finding that if they put stem cells into the blood stream the cells will be drawn to any inflammation in the lung to repair damaged tissue. Research has also shown that it is possible to perform repairs on seriously damaged hearts. With so many possibilities waiting at the end of the path of regenerative medicine, patients and doctors alike are filled with a sense of hope for the coming decades.

As our physicians gain more knowledge about regenerative medicine, they may one day be able to replace entire organs. Therapeutic cells and drugs should be able to stimulate the body to regenerate the organ in place and restore its functioning. This brings cardiac medicine a long way from the transplant surgeries available today.

How long will it be before we see cures?

Regenerative medicine research is comprised of a series of small steps, not instant and radical cures. Whereas finding a true cure means doctors have completely routed a disease, regenerative medicine is focusing more on making advances and helping rectify the most debilitating aspects of diseases.

Scientists believe the potential for regenerative medicine is extremely broad and promising. If doctors can come to understand the signals that prompt a regenerative response, these signals may apply to most organs. The ability to regrow a tissue, as opposed to repairing it with scar tissue, is the ultimate goal of regenerative medicine.

Multiple research groups around the world are making advances. The Tissue Engineering and Regenerative Medicine International Society (TERMIS) represents a worldwide organization of investigators interested in this phenomenon. Each group has its own special area of interest and the wide spread contribution of these groups will undoubtedly affect the way medicine is practiced in the future.

If you’re wondering how these changes are going to affect the relationship between you and your doctor, you are not alone. Whatever hurdles regenerative medicine researchers in the U.S. are facing right now, some serious advances are being made. Most major universities have ongoing work with stem cells, and there are also many companies working with regenerative medicine, causing growth and advancement in the field to continue.

Developing new pharmaceuticals and medical treatments, however, is not a quick process. Regenerative medicine may eventually be a very standard technique used in medical research and application. Much more work needs to be done, but this process could pave the way for treatments that use patients’ own cells to make new brain neurons, heart muscle, or any other type of tissue needed.

Sinus Headaches: A Medical Myth with Hidden Diagnosis

By Dr. Lorne S. Label, M.D., M.B.A., F.A.A.N.

Have you ever experienced a sinus headache? You know, the pressure and pain in your face, especially over your cheeks and forehead? Thank goodness for all of those over-the-counter (OTC) pills to help out! Unfortunately, for most individuals, those pains start returning within a few days or sooner. This is the path of those daily OTC headache remedies and allergy pills. Ready for the shocker? Sinus headaches are a myth, a well-accepted myth!

Physicians commonly diagnose face pain or headaches as a sinus problem. According to one government billing study, more than 33 million medical office visits are coded for sinusitis. This contrasts with an average of 11 million office visits for migraine headaches.

So what are sinus headaches? They are really migraines masquerading with face pain.

Remember that a headache is actually a general topic, like fruit or automobile. The question is what kind of fruit are you eating? What kind of automobile are you driving? What kind of headache do you have? In fact, various types of headaches may have different causes and treatments!

The International Headache Society (IHS), an international body of neurologists and headache experts, established in 1988 the diagnostic criteria to standardize headaches worldwide for research and management. In general, the headache categories are separated into primary and secondary (sinister) headaches. The primary category includes migraine (with or without aura), tension-type headache, migrainous headache, cluster headache, chronic daily headache and several other types. Headaches due to the secondary group occur less than one percent of the time. It is beyond the scope of this article to explain each of these various types of headaches in detail. Nevertheless, proper medical evaluations by a neurologist for the correct diagnosis of the headache should never be overlooked.

Even in young children, sinus headaches should rarely be diagnosed. The frontal sinuses do not develop until 7 years of age, and are unlikely to be involved in acute sinusitis until after that age. The sphenoid sinuses do not become clinically significant until ages 3 to 5.

The IHS definition of sinus headache is a headache associated with an acute infection of the sinuses. Furthermore, over the past 20 years of headache research, these groups of headache experts have not established chronic sinusitis as a cause of head or face pain. In fact the mechanisms of these sinus symptoms have been well worked out years ago. It is just that advertisers have done a better job promoting untruths to the doctors and public alike. This is why countless courses of antibiotics and multitudes of sinus headache tablets rarely provide long lasting relief to the headache sufferer. Sinus headaches are an advertising concept that has sold millions of unnecessary over-the-counter analgesics and antihistamines. As a reminder, sinus problems are not the cause for chronic headaches.

Headache sufferers are the main purchasers of 20,000 tons of acetaminophen (Tylenol), acetylsalicylic (Aspirin), ibuprofen (Motrin), and other anti-inflammatory and sinus medications each year. Individuals who lack a proper diagnosis consume many combinations of these ingredients often laced with caffeine. In fact, frequent and excess use of these OTCs are a major cause of daily headaches, let alone all types of other potential problems such as bleeding, ulcers, kidney and liver damage. Shocked? Most of these folks rely on OTC medications because they have never been taught about triggers or received proper migraine-specific treatment.

So when are the sinuses to blame? If one has an infection in a sinus (rhinosinusitis), the major symptoms include a purulent discharge in the nasal cavity, nasal blockage, a dull, aching quality of pain over the involved sinus, and a decrease or loss of smell. With movement or bending over, the localized sinus pain is heightened. The minor symptoms include fever, headache, cough, ear pain or pressure, dental pain, halitosis and fatigue. Radiological examinations would show air-fluid levels or complete opacification (opaqueness) of the sinus or sinuses involved. With proper antibiotic treatment, the infection resolves within seven to 10 days. Of course the headache disappears once the infection resolves.

Patients are amazed to learn that their chronic headaches are not due to sinus problems. They undergo normal sinus x-rays and CT scans and still believe that their sinuses are the culprits. They continue to be misled by physicians, advertisers and their friends. The problem is accentuated by the lack of understanding that migraines can have a variety of headache presentations.

At least 70 percent of the U.S. adult population experiences one or more headaches per month. The prevalence of migraine is fairly constant around the world, with about 12 percent of the general adult population being affected (18 percent in women, 6 percent in men, 4 percent in children). Fortunately, the majority of people do not experience headaches due to the “sinister” type causes like brain tumors, aneurysms, head trauma, bleeding in the brain, systemic or brain infections.

Tension-like headaches are the most common type of headache, followed by migraines without aura, migraines with aura and cluster headaches. An aura is a focal (limited to a small area) neurological phenomenon such a bright scintillating light that precedes the onset or accompanies epileptic seizure or an attack of migraine. Most aura symptoms last between 15 to 60 minutes. Visual phenomena are the most common, though sensory, speech or motor abilities can also be affected. The ratio of migraine without aura to migraine with aura is 4 to 1. More than 25 million Americans experience migraine headaches, and the majority of these migraines occur without any visual change, or other aura manifestations. Some neurologists believe that tension-like headaches are a form of migraines while others feel that they are in a separate category. It all comes down to the particular mechanism of action for these various headaches.

Simply stated, tension-headaches are usually bilateral, steady, non-pulsating pain located in the forehead, temples and back of the head or neck. The headache is commonly described as tight, vise-like pressure. Migraine headaches without aura produce unilateral throbbing pain often aggravated by movement. Migraines commonly are accompanied with nausea or vomiting, photophobia (an abnormal intolerance of or sensitivity to light) and phonophobia (a sensitivity to sounds including one’s own voice). Those having migraine with aura experience these symptoms along with the brief aura. The common misconception is that a headache has to be intense, cause vomiting, flashing lights and overwhelming pain to be labeled a migraine. The severity does not actually define the migraine. Moreover, less than 20 percent of migraineurs have ever experienced visual auras. More than 80 percent of people with migraine headaches are classified as individuals having migraines without aura.

The actual explanation relates to the mechanism of migraine headaches and the anatomy of the sinuses.

Many people experience chronic daily headaches, otherwise known as “analgesic-dependent headaches.” It is these folks who become the habitual users of the OTC drugs. These include Excedrin, Excedrin Migraine Tylenol, Advil, Aleve, Sinutab, Anacin, Motrin, ibuprofen, aspirin, and the many other available varieties. Some chronic daily headaches are related to migraines or tension-like headaches.

So why is there confusion about sinus headaches? In studies evaluating the self-reporting symptoms of headache sufferers, three items are pain, nasal stuffiness and nasal drainage. In 2002, the journal Neurology reported on nearly 3,000 “sinus headache” sufferers who experienced nasal stuffiness or nasal drainage at least 87 percent of the time. When their symptoms were applied to the IHS diagnostic criteria, 98 percent of them fulfilled a migraine type diagnosis and three percent a tensiontype headache diagnosis. In another study, when subjects with self-described “sinus headaches” were treated with oral sumatriptan (brand name Imitrex), 66 percent experienced pain relief and 34 percent were pain free in two hours. These treatment outcomes are similar to patients with known migraines enrolled in similar drug studies.

Upon viewing the nasal passages with a nasal endoscopy during a self reported “sinus headache” of moderate intensity; one can visualize redness, clear discharge and swelling of the nasal turbinates (shell-shaped nasal cavities). However a subcutaneous injection of sumatriptan, a migraine treatment, can resolve these features within one hour.

Migraine sufferers can have many triggers to induce the cascade of chemical events involved with head pain. These include stress, hormonal issues, sleep disturbances, weather changes, lack of food, smells, bright lights, neck pain and others. Weather changes (actually the drop in barometric pressure) for some migraine-sensitive individuals promote an electrical and chemical process of a migraine. This lends to the belief for the existence of “sinus headaches.” The actual explanation relates to the mechanism of migraine headaches and the anatomy of the sinuses. The current pathophysiological model of migraine, the Neurovascular Hypothesis, involves alterations of the trigeminal nerve (the main nerve leaving the brainstem and going to the face and controlling all sensation to the area) and the blood vessels of the cerebral meninges. A “migraine generator” deep in the brainstem is turned on in response to some internal or external stimulation (see triggers). This sets up a programmed cascade of events including the release of various pain chemical mediators with complicated names like substance P, Calcitonin gene-related peptide (CGRP), and nitric oxide, These chemicals (released from nerve cells) cause dilation in certain cerebral blood vessels which release plasma proteins and cause “sterile neurogenic inflammation” thus activating the trigeminovascular system and the trigeminal nerve. The trigeminal nerve winds around certain cerebral blood vessels in the brain. In addition, there are nerve projection relays to pain centers in the higher brain. Since the trigeminal nerve also innervates the sinuses; stimulation causes nasal congestion, pain, and discharge from the sinuses. Migraine treatments that block and dissipate these chemical mediators, and reduce the local sterile (noninfectious) inflammation resolve the headache.

Thus disabling headaches that last for one to three days, occur several times per month and occur with weather triggers, nasal stuffiness, clear drainage, post-nasal drip or tearing eyes, are usually migraines and not “sinus headaches.”

---

Dr. Label is an Associate Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA and operates private practices California Neurological Specialists and Southern California Attention Deficit Disorder Clinic in Thousand Oaks. E-mail the doctor at drlabel@cns-neurology.com.

Blackberry Thumb

By Glenn D. Cohen, M.D.

How many text messages do you send every day? Check your next bill to see. The record in my private practice, held by a 13-year-old boy, is 13,000 texts in one month. That is the equivalent of 433 a day or 27 per hour (assuming you stop to sleep for eight hours). Technology has advanced to a level that may ultimately lead to the elimination of handwriting. Whether you like it or not, text messaging is here to stay and most of us use it daily.

A decade ago, technology was an expensive commodity limited to few people. The first cellular phones were almost the size of shoeboxes. Today everyone is able to complete tasks with their bare hands using devices that previously required a room full of computers and a team of engineers to operate. Technological progress is measured by the ability of a device to do the same job using half the gadget. Unfortunately, the more miniature the device, the more problems our extremities develop. Advances in technology have led to the acceleration of diseases. Hand, wrist and elbow problems used to be problems of arthritics, the elderly, and assembly line workers. Until recently, a teenager with carpal tunnel was cause for concern and meant that a tumor in or on the nerve needed to be ruled out before proceeding with routine splinting and activity modification. Today I routinely treat children and adults with disorders directly related to overuse of the hands, wrists and elbows.

The problem is two-fold. First and foremost, hands are similar to tires on a car. When you drive frequently, quickly and with lots of cargo on board, your tires will wear much faster than the Sunday driver cruising on Pacific Coast Highway in her convertible. Fortunately, unlike tires, our hands have the ability to heal and repair given time and rest. Many problems abate after a short vacation from the keyboards, cell phones, PDA devices and video games but return once the routine is revisited. The second problem is the size of the devices we use. Keyboarding on a computer requires all 10 digits. Laptop keyboards are typically smaller and the size of the keys (and spacing between them) is even smaller. PDAs and cell phones ignore eight of our 10 digits and require primarily thumb motion. The thumbs used to be reserved for the spacebar only, and now they are the sole digits necessary to text using these high-tech tools.

“Blackberry thumb” is the term used to describe an overuse of the thumb when texting. This problem is not new, only the name is. Long before the formation of the American Society for Surgery of the Hand, people suffered from similar disorders. Blackberry thumb is not a made up problem. “Text messenger thumb” has recently become an acceptable diagnosis in New Zealand. The Australian Herald Sun reported that New Zealand (population 4.2 million) has about 4.5 million mobile phones in use and more than 28 million text messages sent every day. The first two reported cases of text messenger thumb were two females, 13 and 20 years old. This “disease” represents a multitude of problems. The one thing all of these patients have in common is overuse (aka repetitive stress) and inflammation. The end result is swollen, painful joints, tendons or nerves. If you have pain, tingling, numbness or triggering (catching or locking of fingers) then you may have a problem. Don’t be too quick to blame it on a computerized device. The device probably accelerated the onset of these problems. Remember the tire analogy; ultimately all tires will wear out no matter how much you drive.

A hand, wrist and elbow surgery specialist should devise the diagnosis and treatment. Physicians with a Certificate of Added Qualifications in Hand Surgery (CAQ) are the leading experts on diagnosis and both nonsurgical and surgical treatment of these maladies. The physician will first and foremost rule out other causes of these problems such as inflammatory diseases, infections, tumors, congenital disorders and trauma. The hand surgeon will then devise a program individually tailored to the patient. Frequently hand therapy, splinting, ultrasounds, electrical stimulation, heat, ice, anti-inflammatory medications (including fish oil, chondroitin, glucosamine, bromelain, and MSM), activity modification and rest are required. Acupuncture may also be an adjunct to traditional Western techniques. Occasionally injections or surgical intervention are required to eradicate the problem permanently.

Ben Franklin once said, “An ounce of prevention is worth a pound of cure.” Preventing overuse in 2008 is not an overwhelming task. Start by minimizing all unnecessary usage of computerized devices, especially miniature gadgets. This is mandatory if you are already experiencing symptoms. When possible, speak on the phone and avoid emailing or texting. Pay attention to how you carry out your activities. Correct posture and ergonomic positioning may help. If you are required to type for your job, find the largest keyboard with the biggest spacing between keys so your hands are not working in a cramped space. It is also beneficial to take occasional breaks to stretch your extremities. Perhaps one day computers will respond to thoughts instead of typed commands. Until that happens, take care of your hands.

---

Dr. Cohen has worked in the field of hand and orthopedic surgery for eight years. His current practice is located in Westlake Village. Contact him at www.handsurgeon.org or 805-370-6877.

Wellness Abounds at New Horizons Naturopathic Clinic

by Shannon Anderson

Many people are visiting alternative and complimentary health care providers today. These doctors engage in some of the most rewarding and beneficial work to be seen in the fight against disease, combining the powers of natural, alternative health care with traditional medicine.

Dr. Clinton Pomroy, doctor of naturopathy at New Horizons Naturopathic Clinic in Calabasas, takes an individualized approach to every patient. When a doctor is able to properly combine the strengths of Western medicine with alternative and nutritional fields, you’ve truly found a recipe for healing.

Pomroy has been in practice for four years and works to enlighten community members about the many benefits of naturopathic treatment. He currently oversees treatments ranging from medical weight management to chronic disease treatment, often working together with a patient’s current family physician to create the best approach for wellness.

“We are advocating the patients’ best interests first and foremost,” Pomroy says. This is good news for many patients suffering from underlying or misdiagnosed causes of health problems. People are often properly diagnosed, but not treated so. Dr. Pomroy works to bridge the gap between conventional and holistic medicine, taking into account aspects of nutrition and lifestyle that perhaps a conventional M.D. alone might not catch.

Twelve years ago, Pomroy launched his holistic health career in Ft. Collins, Colorado. Since then, he has helped treat various patients by integrating acupuncture, homeopathic treatments and other alternative health resources, as well as conventional medicine. New Horizons Naturopathic Clinic offers specific and effective plans for patients that combine the best of both Western and natural medicine.

As a naturopathic doctor, Pomroy says that he has seen his share of chronically suffering patients—from the simplest cases to the most aggressive and frightening ones. Unfortunately, the treatment of cancer has recently become extremely segregated and non-inclusive. Cancer patients wishing to supplement their treatment modalities with natural methods are oftenhard-pressed to find a doctor qualified in both Western and naturopathic medicine. Western medical methods often treat cancer using one standard approach: identify, label and attack.

Alternative fields of medicine aim to create treatment modalities for cancer and other ailments with nutritional alternative medicine. At New Horizons, a more natural approach is taken to reduce a patient’s most troubling symptoms. Although natural medicine is generally much less risky than Western medicine, particular combinations of both types can potentially be hazardous. Dr. Pomroy tailors specific strategies for his patients, helping them naturally reduce or eliminate some of the most adverse symptoms.

Problems with a person’s health can also stem from lifestyle issues like poor diet and lack of exercise, and cannot be treated merely with a quick fix. The strengths of integrative medicine are apparent, and have been for decades since the inception of naturopathic medicine.

Dr. Pomroy’s main concern when treating patients is relieving them from their pain, illnesses and stress that cause them much anxiety. Even for chronic sufferers, he insists that there is much good that can be done through supportive therapy. For patients who are on a different level and need unique, interpersonal care, New Horizons Naturopathic Clinic offers an integrative, more natural way of life.

---

New Horizons Naturopathic Clinic is located at 23945 Calabasas Road, Suite 101 in Calabasas, CA. For more information call 818-224-2404.

Ayurveda: Neuroscience Disorders

By Aditya Sharma, Ph.D., Clinical Ayurvedic Specialist

Ayurveda is India’s traditional, natural system of medicine that has been practiced for more than 5,000 years. Ayurveda is a Sanskrit word meaning “science of life,” or “science of longevity.” Ayur means “life or longevity” and Veda means “science or knowledge.” Ayurveda provides an integrated approach to preventing and treating illness through lifestyle interventions and natural therapies. Ayurveda is based on the view that the elements, forces and principles that comprise nature (and hold it together so that it functions) are also found in human beings.

There are five elements called ether, air, fire, water, and earth. Doshas are defined as vata (air and ether), pitta (fire and water), or kapha (water and earth). Psychologically, vata governs the feelings and emotions such as freshness, nervousness, fear, anxiety, pain, tremors, and spasms. Pitta arouses anger, hate and jealousy. Kapha is responsible for the emotions of attachment, greed, and longstanding envy but is also expressed in tendencies toward calmness, forgiveness, and love.

In Ayurveda, nervous system disorders are linked to mental disorder since the mind and nerves are directly connected by a system. The mind (or consciousness) and the body (or physical mass) not only influence each other, they are each other. Together, they form the “mind-body.” The universal consciousness is an intelligent, aware ocean of energy that gives rise to the physical world we perceive through our five senses. Ayurvedic philosophy and practices link us to every aspect of ourselves and remind us that we are in union with every aspect of nature, one another and the entire universe.

In the Charaka Samhita, an ancient Indian Ayurvedic text on internal medicine written by Charaka, and believed to be the oldest of the three ancient treatises of Ayurveda, Charaka describes eight essential psychological factors that are negatively affected in various ways in all psychiatric disorders. The psychopathological condition is a function of these factors, which are manas (mind), buddhi (intuitive intelligence), smriti (memory), sajna jnana (orientation and responsiveness), bhakti (devotion), shila (habits), cheshta (psychomotor activity), and achara (conduct).

Nervous system disorders include minor problems such as insomnia, headache, anger, insanity, addictions, anxiety, depression, tremors, and major malfunctions like epilepsy or paralysis. Degenerative nervous system diseases such as multiple sclerosis, Parkinson’s disease and Alzheimer’s disease are other types of nervous system disorders that have unpleasant side effects and are difficult to treat with Western medicines.

Nervous system diseases develop either by blockage of nerve impulses or through nerve tissue damage. Energy flow can be blocked by accumulation of any of the three doshas or by ama (toxins), or undigested food mass. Emotional or psychological blockage also causes nervous diseases. Nerve tissue damage can be caused by malnutrition, poor digestion and hyperactivity, or blockage of nerve energy over a period of time. Other disease producing factors include lack of emotional nourishment or mental groundings, and excessive meditational practices.

Herbs to treat nervous system disorders are skullcap, Ashwagandha, Guggul, turmeric, Hops, passionflower, chamomile, and Bhrangaraj. Gotu kola is important for clearing the nervous system and relieving inflammation. Holy Basil (Tulsi) cleanses and clears the brain and nerves.

According to Ayurveda, signs of balanced mental health include good memory, ingesting the right food at the right time, maintaining awareness of one’s responsibilities, maintaining cleanliness and hygiene, and exhibiting enthusiasm, cleverness, braveness and perseverance. Other signs are maintaining cheerfulness and fearlessness regardless of one’s situation, exhibiting sharp intellectual function and self-sufficiency, following a good value system, and having the ability to proceed steadfastly against all odds.

In order to maintain mental health, Ayurveda prescribes the Ayurvedic daily routine, beginning with Abhyanga (oil massage) to remove toxins and stimulate the flow of natural intelligence in the body. Transcendental meditation is an essential component of the routine to dissolve deep-rooted stress and promote harmony, creativity and clarity of mind through bliss consciousness. A proper diet in line with the Ayurvedic body type is also important. Ayurveda believes that an imbalanced digestive system is the root cause of most disease since stress plays a key role in health. A healthy digestive system is the single most important long-term determinant of your health and well-being. Digestion is a key element of health. Yoga relaxes and calms the nervous system and detoxifies and energizes the body.

---

Note: This information is for educational purposes only and is not intended to replace medical care or advice. Before making changes to your diet, lifestyle or exercise program, please consult an Ayurvedic practitioner or physician.

Aditya Sharma, Ph.D. is a Clinical Ayurvedic Specialist at Geeta Ayurvedic Healing Center, Inc., P.O. Box 1653, Simi Valley, CA 93062. Call 805-584-9025 or send questions and comments to aditya2@pacbell.net. For more information about Ayurveda and Rishi products, visit www.rishiherb.com.

The Gist of Genetic Testing

By Dr. Sharon Norling, MD, MBA

How can a person with normal cholesterol who lives a healthy lifestyle suffer a heart attack at age 40? What makes some people more sensitive to allergens? Why are some individuals more prone to adverse drug reactions? Each individual person has a predetermined susceptibility to disease based on single nucleotide polymorphisms (SNPs). SNPs (pronounced “snips”) are DNA sequence variations that occur when a single nucleotide (A, T, C or G) in the genome sequence is altered.

Genome variations are differences in the sequence of DNA from one person to the next. Just as you can look at two individuals and see that they are different, you could do the same by looking at the genomes of two people with the right chemicals and laboratory equipment. Although more than 99 percent of human DNA sequences are the same across the population, variations in DNA sequence can have a major impact on how humans respond to disease, and environmental insults such as bacteria, viruses, toxins, chemicals, drugs and other therapies. The 0.1 percent is what has important implications for our health. Genomic instability can be avoided by receiving adequate nutrients, which are significantly above the Recommended Dietary Allowance (RDA).

We are now beginning to understand that DNA is not only responsible for the transfer of traits from parents to off-spring, but it also plays a dynamic, active role in their daily lives. When we exercise, genes in our muscles are suddenly awakened and make proteins that permit us to more effectively metabolize energy sources. When we are hungry, genes in our body are turned on that impact insulin levels. Certain food substances have been identified that turn genes on or off. Retinoic acid, zinc and other food substances are known to bind DNA.

SNPs are individual genetic variations in the genetic code associated with almost all diseases. SNPs alone do not cause disease rather they influence a person’s susceptibility to specific environmental factors that increase disease risk (including infections and chemical, physical and nutritional behavior triggers). SNPs lead to the unique responses of individuals that differentiate how they look and function, their predisposed immunity and how they will respond to therapy.

For the first time, physicians now have an assessment tool for determining individual susceptibility to potential disease. Specialty labs offer a unique line of predictive genomic diagnostic profiles for cardiovascular, detoxification, immune function, estrogen metabolism, neurological bone metabolism and inflammation. Testing for SNPs are relevant, prevalent and measurable. Most importantly, the effects of SNPs are modifiable. This means that the SNP can be modified by environmental and lifestyle factors such as nutrition, diet and toxic exposure.

These tests can help identify genetically based sensitivity to drugs, allergens and toxic chemicals. They can uncover genetic factors that trigger resistance to standard treatments. Have you ever asked yourself, “Why didn’t this work for me?” Physicians can now also understand hidden genetic factors affecting the severity of symptoms.

Customized treatments can:

1. Provide more precise, proactive health screening
2. Identify inherited risks within families
3. Gain deeper clinical insight into chronic, multi-factorial conditions

At no time in history has there been a more acute focus on health. Clearly there is a correlation between food, diet and disease. Nutritional genomics is a science studying the relationship between the human genome (all of the DNA a person possesses), nutrition and health. Diseases like obesity, cancer, diabetes and cardiovascular disease are polygenic diseases that arise from the dysfunction in a cascade of genes, not from a single mutated gene.

A number of genetic variations have been shown to increase susceptibility to dietrelated diseases. These include variants associated with Type 2 diabetes mellitus, obesity, cardiovascular diseases, some autoimmune diseases and cancers. According to internationally renowned nutrition researcher Dr. Jeffery Bland, everyone’s gene expression is determined by nutrition.

The food we eat is composed of complex mixtures of chemicals, many of which are biologically active. Vitamins, minerals and fatty acids act as dietary signals that manipulate our highly organized, tightly regulated DNA. Nutrigenomics seeks to understand if and how foods and plant extracts can affect the expression of genes in well-known disease pathways. Advances in nutrigenomics studies are the result of completion of the human genome project and new gene technologies. The ultimate goal of nutrigenetics is to provide personalized nutritional recommendations for individuals.

Hyperlipidemia is usually associated with atherosclerosis and coronary heart disease. Therapy includes lifestyle changes as alterations in the patient’s diet, physical activity and treatment with pharmaceuticals. However, individuals respond differently to the treatment. This is attributed to genetic variations within the population. Genetic variations in genes encoding for apolipoproteins, some enzymes and hormones can alter individual sensitivity to developing cardiovascular diseases. Some of these variants are susceptible to dietary intervention.

Are you plagued by a chronic condition that resists medical treatment? Testing can reveal whether you have genetic variations that make you more vulnerable to the harmful effects of toxins. They can also tell if you are less likely to respond well to certain drugs or nutrients.

Do you have a family history of a condition like heart disease or osteoporosis? When conditions “run in the family,” they often have a genetic component. Testing can show what specific genetic factors could pose a potential problem for you. For example, are your cholesterol levels more sensitive to a fatty diet than other people? Is your blood more likely to clot during long periods of inactivity? Do your bones properly use the nutrients they need? Is your blood pressure apt to be highly influenced by your salt intake? Once you have this information, you can develop a focused plan to “break the pattern”—and better prevent your family risks from turning into realities.

Do you take a very active role in optimizing your health? These tests can help you and your physician design a preventive program that works best for your body’s unique needs and health risks. The information can help you take aim at your most important targets years before symptoms even develop. Knowing your genetic “strong” and “weak” points allows you to devise a targeted, personal approach that increases your chances of remaining fit and active as you grow older.

Based on your genetic test results, your physician can work with you to develop a customized treatment plan. But the support doesn’t stop there. Testing is also available to monitor whether your personal healthcare strategy is having a positive impact on your genetic risks. These “functional assessments” give your physician a concrete way to evaluate how your body is responding to treatment. They also ensure that powerful environmental factors (hormones and nutrients) are in a state of optimal balance that minimizes your genetic health risks.

Seeing the results of your genetic test is like seeing the cards you’ve been dealt by nature. Once you know the cards, you can develop the most effective strategy to play out your hand. That means working with your healthcare provider to carefully develop a diet, lifestyle and supplement program that matches the unique health risks for your body. Genetic testing is a personal decision. Consult with your physician about your personal health history as well as your family history to determine if this option will give you important information for your health.

Current Tests Can:

1. Evaluate genetic variations (SNPs) that modulate blood pressure regulation, lipid balance, nutrient metabolism, inflammation, and oxidative stress
2. Evaluate SNPs associated with increased risk of impaired detoxification capacity especially when exposed to environmental toxins. It also identifies individuals potentially susceptible to adverse drug reactions
3. Evaluate genetic variations (SNPs) that modulate estrogen metabolism, coagulation, cardiovascular disease, and osteoporosis
4. Evaluate SNPs that modulate immune and inflammatory activity. These variations can reveal potential defects in immune system defense and stimulate mechanisms leading to chronic, overactive inflammatory responses
5. Evaluate SNPs that modulate methylation, glutathione conjugation, and oxidative protection relating to brain function
6. Evaluate SNPs that modulate the risk of osteoporosis and inflammation, including mechanisms affecting calcium and vitamin D3 metabolism.

---

Dr. Sharon Norling is the only physician in the U.S. to be nationally board certified in integrative medicine, medical acupuncture, functional medicine and OB/GYN. Her practice combines her extensive medical knowledge with the most recent advances in mind/body medicine. Her office is located at 32123 Lindero Canyon Road, Suite 210 in Westlake Village. Please call 818-707-WELL (9355).