Letter from the Publisher (AugSept 2013) Townsend Letter for Doctors & Patients

From the Townsend Letter
August / September 2013

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From the Publisher
by Jonathan Collin, MD

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What Doctors Don't Tell You
My practice involves administering quite a bit of IV therapy, primarily chelation and IV vitamin C. These treatments are time consuming, two to three hours, and boring without reading material. Of course there are a few patients who like to chat and occasionally some great conversations. Most people come prepared with books. In our office, we like to provide a wide variety of magazines for browsing; the most popular reading purveys celebrity schlock – People, US Magazine, and Star. Besides the Townsend Letter (a must for all doctor's waiting rooms), a nice alternative might be What Doctors Don't Tell You (WDDTY).

Lynne McTaggart and Bryan Hubbard, editors, launched the publication in England in 1989. Until this year it was a non-glossy short newsletter/journal focusing on the iatrogenic aspects of medicine – meaning that it examined how and when medicine causes illness and disability instead of curing it. It had a start much like the Townsend Letter. McTaggart and Hubbard wrote and edited the newsletter from their bedroom, mailing out the issue to their readership of 100. The big story in their first newsletter reported on the dangers in the newly released MMR vaccine. Like the two three-part series written by Gary Null, PhD, in the Townsend Letter on the lack of safety in vaccines, the WDDTY article warned of how the British National Health Service initiated the MMR vaccine, covering up the risks. WDDTY was written by two investigative reporters without the sponsorship of an association and without advertising. Over the years, the newsletter evolved into a newsletter/journal with advertising and a growing circulation. In 2012 McTaggart and Hubbard launched the glossy magazine version of WDDTY and they discontinued the newsletter/journal in March 2013. McTaggart's "Viewpoint" editorial in the March issue repeats the concerns that she has had about medical treatments in her first issue of 1989 – that medicine is dangerous, and being hospitalized is putting one's life in harm's way. The WDDTY articles clearly "uncover" the promotional marketing of the pharmaceutical companies – the lack of science in many approved drugs and the failure to disclose data proving life-endangering adverse effects. Given the burgeoning list of adverse effects reported by drug companies and the medical literature, it is frightening to consider that there are even more serious adverse effects that are not reported.

Special WDDTY Report: What the Government Doesn't Tell You About Vaccinations
When I attended a CME lecture at the local community hospital last October, the public health message was clear cut. The only way that the flu vaccine would be effective in the hospital and clinic was for all medical personnel to receive the immunization. It was successful only if the entire "herd" was treated. Medical employees' refusing the vaccine would "endanger" patients and medical workers by incurring the flu and bringing it into the workplace. Patients who were immune-suppressed or hospitalized would be at particular risk from nonimmunized medical employees. Of course, there is no means to ensure that all patients are immunized prior to hospitalization, so the herd effect is largely nullified. I had the "Kafka-like" experience last fall of a medical technician's requesting an excuse so that she did not need to receive a flu shot. Her employment at a local hospital issued a policy that all employees were required to get a flu vaccine; those who failed to receive the vaccination were to be terminated from employment unless they had a medical excuse approved by the medical board. I attempted to write up such an excuse – of course, the approved reason was documentation of a major adverse effect from a previous vaccination. She did not have such a major adverse effect. Still, I wrote up a report indicating that her immune system was fragile and that the risk for such an event after vaccination was serious. Unfortunately I never heard back from the patient to learn whether my excuse was "approved."

The WDDTY article reported on the internal committee minutes of the MMR vaccine by the UK Joint Committee on Vaccination and Immunization (JCVI). The meetings were held between 1983 and 2010. Dr. Lucija Tomljenovic, a researcher from the University of British Columbia, reviewed the minutes and determined that the committee (JCVI) was grossly negligent in its oversight of the MMR vaccine. The charges leveled by Tomljenovic included that JCVI ignored reports of adverse effects from the MMR vaccine and took no actions to limit the use of the vaccine nor provide public health bulletins to educate medical workers or the public about its dangers. JCVI intentionally reduced the contraindications for MMR vaccine use to increase the population receiving the vaccine. JCVI cooperated with the pharmaceutical companies who "modified" adverse event data associated with vaccine use. JCVI accepted only studies reporting safety and minimal adverse effects; independent researcher reviews were not accepted. JCVI approved the launching of new vaccines without evidence of safety and effectiveness. JCVI took advantage of the public trust in vaccinations to discourage criticism that vaccines posed a risk for long-term brain damage.

A subscription to WDDTY would be a good "read" for the waiting room. To order contact WDDTY;Esco Business Services; Trinity House, Sculpins Lane, Braintree, Essex CM7 4AY, UK. Call + 01371851883. www.wddty.com.

Senate Seeks to Amp Up FDA's Control of Compounded Pharmacies and Prescriptions
In 2012 more than 100 patients died from fungal meningitis that resulted from contaminated compounded corticosteroid injections. While the majority of the steroid injections were "compounded" by the New England Compounding Center (NECC) near Boston, a number of other pharmacies were implicated, including one in Tennessee. Public health authorities and politically based think tanks have been demanding "blood" for the lack of oversight of compounding pharmacies by the FDA and state pharmacy boards. Senators and representatives, primarily Democrats, call the failure of regulation of compounding pharmacies outrageous. They consider many of these pharmacies unscrupulous operators who have unfettered license to produce low-quality products for shameless profit. The New York Times reported that an inspection of the NECC where the injectable steroids were manufactured revealed facilities that were unsuitable for quality injectable manufacturing. Interestingly, another New York Times investigation revealed a number of generic injectable-pharmaceutical manufacturers also having subpar manufacturing facilities. Of course, the bottom line is that these products have a limited profit margin – the profits are minimal compared with blockbuster name-brand products. So the pharmaceutical companies are not interested in investing in pristine manufacturing facilities. That leaves the manufacturing of the injectables to compounding pharmacies. And here is the problem: compounding pharmacies are not supposed to be in the business of manufacturing; they are supposed to be compounding a limited number of injectable products for patient prescription use. The Alice in Wonderland question is, what is a "limited number" of injectables that are compounded – when is that number just compounding and when does it become manufacturing?

In the meantime, the FDA is inspecting compounding pharmacies as though it were investigating pharmaceutical companies. As one would imagine, few compounding pharmacies are set up to the vacuum-sealed hooded-air-control quality standards of a manufacturing facility. Still, most compounding pharmacies maintain good quality controls at site. Nevertheless, the FDA is demanding more. As of the end of May, at least one compounding pharmacy, ApothéCure, operating for more than 20 years, announced that it was closing shop because of the draconian quality requirements that the FDA was obligating.

Mind you, this is what the current FDA oversight is accomplishing in the current regulatory environment for compounding pharmacies. The Senate has introduced a bill, S. 959, that seeks to "amp up" the regulatory and policing powers of the FDA over compounding pharmacies. The thrust of the bill would give the FDA power to outright ban many, if not all, compounded formulations, including injectable, oral, and topical prescriptions. Bioidentical hormone therapies have been deeply criticized for years by Big Pharma and would definitely be a target by the FDA if S. 959 were to become law. Most of the injectables employed in IV chelation, IV vitamin C infusions, and nutrient IVs, as well as other injectables, would be banned. This bill is essentially a death knell for many protocols as used by practitioners of integrative, naturopathic, and alternative medicine. And compounding pharmacies would be put out of business.

Please spread the word and ask everyone to write their representatives to vote against S. 959!

Patient Table Talk: 'My Cancer Specialist is a Naturopath!'
Not too many years ago, oncologist MDs were telling patients to avoid using herbs or vitamins while receiving cancer treatment because the supplements would interfere with the chemotherapy effectiveness. However, not only does nutritional supplementation enable the chemotherapy to be more effective, but in most cases chemotherapy side effects are minimized. As Dr. Leanna Standish notes in her interview this month, " … every physician knows now that glutamine should be given along with Taxol and platinum-based chemotherapy agents to prevent peripheral neuropathy." It is remarkable progress that nutritional supplements are now being integrated in cancer treatment protocols. The naturopathic profession has developed a specialist category for NDs focusing on cancer care: Fellow of the American Board of Naturopathic Oncology (FABNO). In this issue of the Townsend Letter we have the writing of five FABNO NDs: Leanna Standish, Gurdev Parmar, Veronica Stevens, Stacy Dunn, and Jacob Schor. Now we can refer cancer patients to our preferred FABNO and be sure that an integrative program is being managed in conjunction with chemotherapy and radiation treatment.

Dr. Standish is the medical director of the Bastyr Integrative Oncology Research Center. She is coprincipal investigator in two NIH studies; one is a prospective outcomes study of integrative therapy management in breast cancer, the second study is investigating medicinal mushroom efficacy in cancer treatment. Standish lists the four components of integrative oncology as: (1) naturopathic oncology; (2) Traditional Chinese Medicine and acupuncture; (3) mind-body medicine; and (4) palliative medicine and pain management. Standish has a special interest in South American psychoactive drugs that will alter the mind-body role in cancer progression.

Veronica Stevens, ND, argues that naturopathic oncology is a necessity for every cancer patient. Yes, there can be an herbal interaction with drug therapy that may lead to change in drug metabolism and increased risk of an adverse drug event. Hence, there is a clear-cut need for knowledgeable practitioners capable of designing an integrative herbal/supplement regimen that complements the chemotherapy/radiation program. Stevens explains that understanding the "cancer terrain" requires supporting the immune system, reducing inflammation, supporting hormones, improving digestion, and detoxifying. Stevens recommends Lise Alschuler, ND, FABNO, and Karolyn Gazella's book Five to Thrive for a systematic approach to the cancer terrain.

Stacy Dunn, ND, discusses naturopathic concerns of breast cancer patients receiving adjuvant endocrine therapy. Many breast cancer patients have estrogen and progesterone positive receptors driving the oncology process. Adjuvant endocrine therapies such as tamoxifen are metabolized by differing liver CYP mechanisms. Depending on the CYP genotype polymorphism, tamoxifen metabolism may be compromised, subjecting the patient to greater risk of breast cancer relapse. Herbal support, such as berberine, interferes with CYP2D6 metabolism, contraindicating its use with tamoxifen. Dunn explains the need for employing naturopathic supports with adjuvant endocrine therapy to counter drug adverse effects.

Gurdev Parmar, ND, writes about his experiences using hyperthermia for cancer treatment. Parmar provides total-body hyperthermia employing 6 infrared heating lamps monitoring his patients for hypoglycemia and dehydration. Core temperature is maintained at 38.5 to 40 ºC for 1 to 2 hours. Heating the patient to core temperature takes about 2 to 3 hours, and following the 1.5 hours of core temperature, there is a cooling phase of 1 to 2 hours. Hence, a hyperthermia session lasts for about 5 to 6 hours. Parmar describes his personal experience undergoing a session. At this point he has administered a series of whole-body hyperthermia to nearly 200 patients. He is looking forward to reporting outcomes in the future.

Townsend Letter readers are familiar with Jacob Schor, ND, who writes on naturopathic research. Schor reports on the benefits of administering aspirin in treating breast cancer in four recent major papers. The conclusion: each of the papers shows that aspirin plays an important role in preventing cancer and cancer death in cancer patients. Since aspirin is considered a drug, it is usually not a part of a naturopathic toolbox. However, Schor thinks that we are "doing our patients a disservice by not encouraging more of them to use it."

Jonathan Collin, MD

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