Murray, ND Director of Product Development and Education Natural Factors Nutritional Products, Inc. Eastern Origins of Integrative Medicine and Modern Applications, 2 Ira D. Jones, MD, FABFP Sheila Quinn Leo Galland, MD, FACP, FACN 3. The History of Naturopathic Medicine: The Emergence and Evolution of an American School of Healing, 34 George W. Philosophy of Naturopathic Medicine, 61 Rachelle S. Murray, ND Fantus Test, 121 Dirk Powell, BS, ND Fatty Acid Profiling, 124 Richard S. Alexander Bralley, Ph D Food Allergies, 131 Wendy Hodsdon, ND Genomics, Nutrigenomics, Nutrigenetics, and the Path of Personalized Medicine, 140 T. Changing the diet has myriad effects on health, from reducing inflammation to reversing coronary artery disease. Organ system interventions: These interventions are used more frequently in the acute presentation of illness. With the creation of Bastyr, named after the eminent naturo- pathic physician, Dr. This committee set out to visit and rate each of the 160 medical schools then in operation in the country. 73 Stress Several studies have identified differences between ABO group and possible chemical responses to stress. Palliation is treatment not aimed at curing a patient but at the reduction of symptoms, such as obstruction or pain by reducing the size of the tumor, or a transient extension of life for a brief period without real hope of achieving a cure. The effect of various dietary fibres on tissue concentration and chemical form of mercury after methylmercury exposure in mice. In humans, adenosyl- cobalamin is required in only two reactions: the catabolic isomeri- zation of methylmalonyl coenzyme A (Co A) to succinyl Co A and interconversion of a- and (3-leucine. Subjects with essential hypertension are more sensitive to the inhibition of 11 beta-HSD by liquorice. 27 Infectious Diarrhea Berberine showed significant success in the treatment of acute diarrhea in several clinical studies. However, perhaps more important than simply relieving insomnia was 5-HTP’s ability to improve the quality of sleep. The Commission E evaluates efficacy of herbal medicines on the basis of a doctrine of reasonable certainty, in contrast to the U. Food and Drug Administration’s doctrine of absolute proof. In vitro and in vivo assessment of the antioxidant activity of melatonin and related indole derivatives.

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For example, improving the patient’s sleep bene- ficially influences the immune response, melatonin levels, and T-cell lymphocyte levels and helps decrease oxidative stress. 13 New evidence of the dangers of radiation, synthetic pesticides, and her- bicides, as well as environmental degradation from industrial pollu- tion, were creating a new ethic. Sepsis and cholestasis: basic findings in the sinusoid and bile canaliculus. The homeopathic and eclectic schools of thought met their demise finally due to two significant events: (1) the rapid creation of new medical educational standards between 19, culminating in the publication of the famous “Flexner Report” (1910), and (2) the effective infusion of mil- lions of dollars into selected allopathic medical schools by the newly created capitalistic philanthropic foundations, principally the Carnegie and Rockefeller foundations. The relationship between ABO blood phenotype and total serum cholesterol level was examined in a specific Japanese population. Even in a remission with no detectable disease, it is possible to have millions of tumor cells present, and thus remission is proba- bly a better term than cure, until there is a better way of identify- ing residual tumor cells that may be lying dormant. Aposhian HV, Maiorino RM, Gonzalez- Ramirez D, et al. The amount of cobalamin required in the diet is low, and even people with pernicious anemia can generally absorb sufficient amounts if the coenzyme is supplemented at a high enough dosage. 23 However, although aspirin suppresses fever through its action on prostaglandins, berberine appears to lower fever by increasing the immune system’s handling of fever-producing compounds from microorganisms. CHAPTER 97 Hydrastis canadensis (Goldenseal) and Other Berberine-Containing Botanicals 819 27. Effect of traditional Chinese medicine berberine on type 2 diabetes based on comprehensive metabonomics. The assessment methods used to judge effectiveness included the HDS, self-assessment depres- sion scale (SADS), and physicians assessment (Clinical Global Impres- sion). For example, amentoflavone was shown to bind to benzodiazepine receptors and to act as a modulator of y-aminobutyric acid, which may be a major anxiolytic mech- anism. One claims that the red spots, symbolic of the blood of St.

However, even with the matrix as an aid to synthesizing and prioritizing information, it can be very useful to consider the impact of each variable at five different levels. Whole body interventions: Because the human organism is a complex adaptive system, with countless points of access, in- terventions at one level will affect points of activity in other areas as well. In Silent Spring, Carson challenged the prac- tices of agricultural scientists and the government and called for a change in the way humankind viewed the natural world. 1,5 Once the cooperation among the three medical views began, the medical class dominated by the regular school came fully into power. 68 Cholesterol Although several studies on highly select populations have yielded conflicting results, 69,70 the general consensus is that blood group A individuals have a significantly higher basal cholesterol level than those in other blood groups. Remission is complete disappearance of all detectable tumors. The vitamin B 12 complex is split by pancreatic proteases, and the released vita- min B 12 attaches to intrinsic factor and is absorbed in the distal ileum. Berberine produces an antipyretic effect three times as potent as aspirin in a pyretic model in rats. In the study, subjects received either 5-HTP (100 mg) or fluvox- amine (50 mg) three times a day for 6 weeks. illness during therapy with L-5- hydroxytryptophan and carbidopa. The interest in these other com- ponents stems largely from pharmacologic studies with commercially available extracts demonstrating effects and benefits beyond hypericin and pseudohypericin.

Murray, ND Stephen Barrie, ND Immune Function Assessment, 161 Heather Zwickey, Ph D Intestinal Permeability Assessment, 169 Corene Humphreys, BHSc, ND, Dip Med Herb, Dip Hom Laboratory Tests for the Determination of Vitamin Status, 179 Joseph E. There are many interventions that improve organ function. Understanding healing relationships in primary care. Not only did this new college dou- ble the professions capacity to produce new doctors, it also firmly placed the profession on the ground of scientific research and vali- dation. Pizzorno, was a major driving force behind the creation and mission of Bastyr. Bastyr and Pizzorno had significant influence and leader- ship in achieving this focus. Bastyr’s important legacies was to establish a foun- dation and a model for reconciling the perceived conflict between science and the deeply established healing practices and principles of naturopathic medicine. Eighty-two schools received a class “A” rating, led by Harvard, Rush (Chicago), Western Reserve, the University of California and, notably, Johns Hopkins. Resistance exercise as a counter- measure to disuse-induced bone loss. Plasma cortisol levels showed significant ABO variation. Unfortunately, despite a few remarkable successes, for the majority of patients, natural therapies alone were unable to completely control the disease process. The latter reaction is magnesium dependent, and the remaining succinate is fed into the citric acid cycle. 2 result in increased amounts of methylmalonyl Co A and generally an increase in glycine levels. coli (traveler’s diarrhea), Shigella dys- enteriae (shigellosis), Salmonella paratyphi (food poisoning), Kleb- siella species, G. 7 - 8 It appears that berberine is effective in treating the majority of common gastrointestinal infections. Therapeutic effects of berberine in impaired glucose tolerance rats and its influence on insulin secretion. On the SADS, 5-HTP pro- duced a 53.3% drop in SADS values compared with a drop of 47.6% for the fluvoxamine group. In the study 824 SECTION 5 PHARMACOLOGY OF NATURAL MEDICINES TABLE 98-6 5-Hydroxytryptophan (5-HTP) Versus Fluvoxamine in Percentage Changes in the Hamilton Depression Scale (HDS) TABLE 98-7 5-Hydroxytryptophan (5-HTP) Versus Antidepressant Drugs: Comparison of Side Effects DECREASE IN HDS 5-HTP (n = 34) FLUVOXAMINE (n = 29) After 2 wks Mean decrease (%) 23 18.9 75% decrease 10 13 comparing 5-HTP with fluvoxamine, this is how the physicians described the differences among the two groups: Whereas the two treatment groups did not differ significantly in the number of patients sustaining adverse events, the interaction between the degree of severity and the type of medication was highly signifi- cant: fluvoxamine predominantly produced moderate to severe side effects; oxitriptan (5-HTP) produced primarily mild forms of adverse effects. Eosinophilia-myalgia syndrome: coming to grips with a new illness. Whether the herbal product is available by prescription or over the counter is based on its applica- tion and safety of use.

Pizzorno, ND Lactose Malabsorption Testing, 184 Tina Kaczor, ND, FABNO Jeff Baker, ND, DHANP, CCH Metal Toxicity: Assessment of Exposure and Retention, 191 David Quig, Ph D Mineral Status Evaluation, 200 L. For example, bronchodilators improve air exchange, thereby decreasing hypoxia, reducing oxidative stress, and improving metabolic function and oxygenation in a patient with reactive airway disease. Metabolic or cellular interventions: Cellular health can be addressed by insuring the adequacy of macronutrients, essential amino acids, vitamins, and cofactor minerals in the diet (or, if necessary, from supplementation). Kirchfeld and Boyle 3 described his landmark contribution as follows: “Although naturopathic colleges in the early 1900s did include basic sciences training, it was not until Dr. Forty-six schools received a class “B” rating, and thirty-two a class “C” rating. Exposure to the stressor sig- nificantly decreased Tx PA and increased cortisol for the total group of 25 older men. Judiciously com- bining naturopathic therapies with conventional treatments did lead to greater success and significantly improved survival and quality of life. Effect of lipoic acid on biliary excretion of glutathione and metals. Methylcobalamin’s only known biological function in humans is in the remethylation of homocysteine to methionine via the enzyme methionine synthase, also known as 5-methyltetrahydrofolate- homocysteine methyltransferase. Potentiation of hydrocortisone activity in skin by glycyrrhetinic acid. Clinical studies produced results with berberine comparable to standard antibiotics in most cases. For example, in a study of 65 children younger than 5 years of age with acute diarrhea caused by E. Shigella, Salmonella, Klebsiella or Faecalis aerogenes, those given berberine tannate (25 mg/6 h) responded better than those treated with standard antibiotic therapy. Fourteen (38.9%) of the patients receiving 5-HTP reported side effects compared with 18 patients (54.5%) in the fluvoxamine group. Herbal products sold in German pharmacies are reimbursed by insurance if they are prescribed by a physician. The biliverdin-bilirubin antioxidant cycle of cellular protection: missing a wheel?

Rotation Diet: A Diagnostic and Therapeutic Tool, 395 Sally J. Soft Tissue Manipulation: An Overview of Diagnostics and Therapies, 399 Tim Irving, DC, MS, LMT 48. Intestinal Protozoan Infestation and Systemic Illness, 524 Leo Galland, MD, FACP, FACN 58. The Functional Medicine Matrix Model Distilling the data from the expanded history, physical examina- tion, and laboratory findings into a narrative story line that includes antecedents, triggers, and mediators can be challenging. Evidence-based medicine: howto practice and teach EBM. The discovery of effective antibiotics elevated the standard medical profession to dominant and unquestioned stature by a culture that turned to mechanistic science as an unquestioned authority. A combination of baths, herbal teas, and hardening exercises, the system had some vogue in the 1 890’s before flowering into naturopathy. Gastric Acidity Because the prevalence of both pernicious anemia and gastric can- cer is higher in individuals of blood group A and that of duodenal ulcer higher in those of group O, a hypothesis relating blood group effects on acid secretion was inevitable. Performance Indexes Oncologists use a series of performance indexes to indicate the level of a patient’s health. • Enzyme or cofactor deficiency necessary for generation of active folic acid Individuals using supplements or consuming either breakfast cereals or green leafy vegetables have significantly greater plasma folate and lower homocysteine levels than those who do not. Berberine was also shown to activate macrophages, via both enhanced priming and triggering. 23 ' 2 ^ In other words, 5-HTP is most effective as an antidepressant when the amount of serotonin manufactured in the brain is reduced. John’s wort, Klamath weed, hypericum |- GENERAL DESCRIPTION Likely the most well-studied botanical of all time, St.

Sports Nutrition, 532 Jade Teta, ND, CSCS Keoni Teta, ND, LAc, CSCS 60. Murray, ND SECTION 5 PHARMACOLOGY OF NATURAL MEDICINES, 555 61. Personalized medical care without this expanded investigation falls short. Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB. Science was also fre- quently used as a bludgeon against naturopathic medicine, and the biases inherent in what became the dominant paradigm of scientific reductionism made a culture of scientific progress in the profession challenging. Holbrook pub- lished frequent favorable commentaries on the revised water cure system of Germany’s Kneipp. 59 Additional Physiologic Correlations In addition to the previously described variations in IAP and brush border hydrolase activity, several additional circumstances where ABO polymorphism exerts a significant influence on physi- ology have been reported. Conversely, if the marker rises, the assumption is that the current treatment plan needs modification. [Short-term therapeutic fasting in the treatment of chronic pain and fatigue syndromes — well-being and side effects with and without mineral supplements.] Forsch Komplementarmed Klass Naturheilkd. DHF, dihydrofolate; 5,10-METHF, 5 , 1 0- m et hy I e n etet ra h yd rof o I ate ; 5-MTHF, 5-methyltetrahydrofolate; MTHFR, m et hy len etetra hyd rof o I ate reductase; P5 -P, pyridoxal 5 -phosphate; R5 -P, riboflavin 5 -phosphate; THF, tetrahydrofolate. Clinical trial of deglycyrrhizinised liquorice in gastric ulcer. 15 This improved blood supply may promote optimal activity of the spleen by increasing the release of compounds, such as tuftsin, that potentiate immune function. 5-HTP was most effective in patients with a low 5-HIAA response to 3 days of probenecid. Murray, ND Hypericum perforatum (family: Hypericaceae) Common names: St. Bioavailability and bioefficacy of polyphenols in humans.

It is the process of completing a comprehensive history and physical using the expanded functional medicine heuristic and then charting these findings on the matrix that best directs the choice of laboratory work and successful treatment. 12 The publica- tion of Engel’s “The Need for a New Medical Model” in April 1977 signaled the founding of the field of family medicine based on a holistic philosophy and paralleled a broader social movement in support of alternative health practices and environmental aware- ness. These included the enactment of new licensing laws and the creation of a “respectable” medical educational system. In a separate study, the concentrations of gastrin were measured in the blood of 121 fasting healthy Greek volunteers of both sexes and different ABO blood types, between ages 20 and 70 years. How to prevent and treat cancer with natural medicine. When reading about complete response, partial response, etc., in a journal article, it is important to know exactly what those terms imply. It is thought that the compound GSH may perform this function. These results indicate that berberine may prove to be more effective than BCNU or, at the least, a valuable therapeutic addition in the treatment of difficult brain cancers. 29 5-HTP was compared in the study with the SSRI fluvoxamine (Luvox). Eosinophilia-myalgia syndrome case- associated contaminants in commercially available 5-hydroxytryptophan. Pharmacology of rising oral doses of 5-hydroxytryptophan with carbidopa. The seed is 1 mm long, cylindric, brown, and minutely pitted longitudinally. 1 p CHEMICAL COMPOSITION The major compounds of interest are hypericin (Figure 99-1) and pseudohypericin.

Urinary Organic Acids Profiling for Assessment of Functional Nutrient Deficiencies, Gut Dysbiosis, and Toxicity, 224 J. • Newer, useful technologies such as functional MRIs, single- photon emission computed tomography or positron emission tomographic scans offer more comprehensive assessment of metabolic function within organ systems. In the late 1970s, scholars in family medicine proposed a biopsychosocial model of care in response to a prevailing perception of a growing crisis in standard medicine. In the late 1870s and into the 1880s, the major sects — the orthodox or allopathic school, the homeopaths, and the eclec- tics — began to find more reason to cooperate to obtain common professional goals. Restorative yoga for women with breast cancer: findings from a random- ized pilot study. 67 However, the study had a simple preprandial and postprandial methodology. Detroit, Ml: Gale, a part of Cengage Learning, Inc; 2008. However, just as antibiotic treatments eventually select for resistant strains of bacteria, cytotoxic therapy selects for resistant clones of tumor cells, which over time no longer TABLE 50-2 Comparison of Karnofsky and Eastern Cooperative Oncology Group (ECOG) Scoring KARNOFSKY SCORE DESCRIPTION ECOG SCORE 100 Asymptomatic 0 90 Normal activity, minor disease signs 1 80 Some disease signs with exertion 1 70 Cares for self, unable to do active work 2 60 Requires occasional assistance, in bed 50% of day 3 30 Severely disabled; hospital indicated 4 20 Very ill; requires active supportive traction, bedridden 4 10 Moribund 4 0 Deceased 5 Modified from Murray M, Birdsall T, Pizzorno JE, et al. A newer theory suggests that chemother- apy may kill tumor stromal cells without destroying the tumor stem cells, which can trigger a relapse. To be used in the body, the cyanide molecule must be removed. Topical carbenoxolone sodium in the manage- ment of herpes simplex infection. However, the combination treat- ment of berberine and BCNU exhibited additive effects on killing cancer cells. In 1991, a double-blind study comparing 5-HTP with an SSRI was conducted in Switzerland. Smarius LJ, Jacobs GE, Hoeberechts- Lefrandt DH, et al. The three- bundled stamens are numerous; the ovary is ovoid, 3 to 5 mm long. The plant must be dried immediately to prevent degradation of active principles.

Like an accordion file that compresses and expands upon demand, the amount and kind of data collected will necessarily change in accordance with the patient’s situation and the clinician’s time and ability to piece together the underlying threads of dysfunction. FMRI evidence for right hemisphere involvement in processing unusual semantic relationships. 7,8 This tension split the profession of naturopathic physicians from within after the death of Lust in the late 1940s, at a time when the profession was subject to both signifi- cant external forces and internal leadership challenges. When there is no preparation of the soil by heredity, predisposition or lowered health standard, the individual is amply guarded against the attack. However, preliminary evidence suggests that genes contributing to CHAPTER 43 Nontransfusion Significance of ABO and ABO-Associated Polymorphisms 359 the expression of 2D:4D reside in the vicinity of the gene loci (chromosomal locations: 9q34.2 and lp36. The raw number of a tumor marker is generally less important than the direction of change. This molecule is of central importance, being the precursor of the metabolically active 5-methyl THF, which is involved in homo- cysteine metabolism, and 10-formyltetrahydrofolate (involved in purine synthesis), as well as functioning on its own in the genera- tion of thymine side chains for incorporation into DNA. Treatment of duodenal ulcers with glycyrrhinizin acid-reduced liquorice. The results of the study indicate that berberine interferes with infections due to group A streptococci not only by inhibiting streptococcal growth but also by blocking these organisms to host cells. Because the 5-HIAA could not leave the CSF, it accumu- lated and provided a measure of serotonin manufacture.

Any methodology for constructing a coherent story and an effective therapeutic plan in the context of complex chronic illness must be flexible and adaptive. By the 1930s, a significant tension developed within the profession regarding natu- ropathic practice, as did the development of unified standards and the role of exper- imental, reductionist science as an element of professional development. Tuberculosis is conta- gious, Holbrook acknowledged, but “the degree of vital resistance is the real element of protection. 56 Digit ratio, a marker of assessing the levels of prenatal exposure to androgens, has yielded mixed results 57,58 as a predictor of andro- gen stimulation in individuals with polycystic ovarian syndrome. Table 50-1 lists common tumor markers and diagnoses. This results in the formation of 5,10-methylenetetrahydrofolate (5,10-methylene THF) and gly- cine. Is the true value of botanicals with “antiinfective” actions a multi- factorial effect on all aspects of infections from immune stimula- tion to antimicrobial and antiadherence actions? As a result of this blocking action, the amount of serotonin produced over a 4-day period could be calculated by a repeat spinal tap on day 4.

Yarnell, ND, RH(AHG) Kathy Abascal, BS, JD, RH(AHG) 67. A prime task of the functional practitioner is to help patients iden- tify important triggers for their ailments and develop strategies for eliminating them or diminishing their virulence. Gig Harbor, WA: The Institute for Functional Medicine; 2008. 1 ' 3 By the 1940s, naturopathic medicine had developed a number of 4-year medical schools and had achieved licensure in about one third of the United States, the District of Colum- bia, four Canadian provinces, and a number of other countries. Medical bacteriology was another area of remarkable discovery, bacteriologists having provided, in the short space of the last quarter of the 19th century, an under- standing, at long last, of the nature of infection. The biological mechanisms of cancer-related skeletal muscle wasting: the role of progressive resistance exercise. The ABO locus shows putative linkage with platelet monoamine oxidase activ- ity, 50 reduced levels of which have been noted in group O healthy men. At the same time, up to 30% of men with prostate cancer show normal levels of PSA at the current normal range. Liberation de pesticides organochlores lors de pertes ponderales aigues. Dietary folic acid is a mixture of folates in the form of polyglutamates, which are readily destroyed by cooking. tested in a solid medium, which typically requires a 4 to 10 times greater concentration for the same level of inhibition. Antiinfective Activity Researchers investigated berberine’s ability to inhibit the adher- ence of group A streptococci to host cells on the basis that the therapeutic effect of berberine appeared to be greater than its direct antibiotic effects. 16 Research also showed that combining 5-HTP with clomipramine and other types of antidepressant drugs produced better results than any of the compounds given alone.