Dr. Arturo M. Volpe

by Janice Welch

It is closing in on the holiday season and holiday baking is right around the corner. One of the best memories I have of the holidays is helping make and decorate Christmas cookies. This is a tradition that I hope to hand down to my daughter.

She already loves to help me bake. We make all sorts of cookies using healthy ingredients. The problem is, they all end up a very boring brown color. They taste great, but at this time of year I want to add a little pizzazz, a little of the magic that I remember from my own childhood.

If you are committed to avoiding artificial dyes, you’ll find this is not an easy feat. Finding natural colors has become quite a challenge. Spinach powder offers a not-so-pretty Army-green hue. Annatto seed gives a nice orange, but I have yet to be able to disguise the taste (I am still working on it, and will keep you updated).

However, my latest experiment with beet powder resulted in a beautiful reddish-pink that will work well for any stocking or Santa Claus goodies. It is also wonderful for drinks, whether you want pink homemade lemonade or a bright red fruit smoothie.

I had a hard time finding beet powder in local stores, so I ordered mine online at www.suttonsbaytrading.com (it’s in the flavored powders section).

If you want something super-easy, just mix some beet powder into organic spreadable raw honey (the creamy kind, not the liquid kind). The light brown color of the honey mixes with the beet powder to make a burgundy color.

It will also mix well into any white frosting recipe; just break up any lumps in the powder before mixing it in. Start with half a teaspoon and add more, little by little, to get to your desired color. A word of warning though: you will probably never get to a deep red unless you want beet-flavored frosting!

To make frosting a little healthier, try replacing the sugar in your recipe with half the amount of Xylitol plus 5 to 10 drops of liquid stevia extract.

Another nice addition for a very special cookie is sprinkles. Whole Foods carries a brand of sprinkles that, although full of sugar, are naturally colored. In my house, just a few sp rinkles are enough to make all the difference!

Tags: Recipes
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A partial list of signs and symptoms of low thyroid reads a bit like a “who’s who” of adults who come to see me:

Morning fatigue
Sleepiness
Depression
Headaches or migraines
Constipation
Muscle and joint pain
Menstrual disorders
Weight gain
Hair loss
High cholesterol
and so on

In many cases it would seem that just ordering a simple blood test to measure thyroid hormones would solve the riddle, and yet blood tests are often normal – even tests that are sophisticated and expensive!

Some seemingly forward-thinking doctors try to solve the problem by prescribing thyroid medication based on symptoms regardless of test results, but this is probably a bad idea. Excessive thyroid hormones suppress the body’s thyroid function and cause osteoporosis, and people rarely feel better in the long run. A better solution may be found by looking at what happens to thyroid hormones after the thyroid produces them.

The thyroid gland produces mostly T4, an inactive hormone, and much smaller amounts of T3, the active thyroid hormone. As T4 circulates in the blood, it is carried to body tissues where it is gradually converted to T3. For some people, the problem is that their bodies do not convert T4 to T3, not that they don’t produce enough T4.

Since blood tests are just a snapshot, they don’t fully evaluate the conversion of inactive T4 into active T3, a gradual process that occurs throughout the day. Experience has shown that a more sensitive test to evaluate conversion adequacy requires a 24-hour urine collection.

Once it is determined that there is a conversion problem, through testing or a process of elimination, we need to look at factors that could be hindering this conversion. The first of these is a deficiency of the mineral selenium.

I believe that selenium deficiency is widespread, because the soil in which our food is grown is itself depleted of this important mineral, and what little might be in our food is wiped out in refining and processing. Selenium in multivitamins may not be absorbed, considering that minerals compete with one another for absorption and that certain forms of calcium block absorption of other minerals. Further, the form of selenium used for thyroid hormone conversion, selenocysteine, which is found in garlic and broccoli from selenium-rich soil, is rarely included in supplements.

Stress also indirectly suppresses the conversion of T4 to T3 . Stress causes overproduction of the adrenal hormone cortisol, and cortisol blocks the conversion. Therefore, testing adrenal hormone levels makes a lot of sense when there is stress in addition to symptoms of low thyroid. Many herbal extracts, including the Indian herb Ashwagandha can be used to help normalize cortisol levels and can therefore improve thyroid metabolism.

Finally, herbal extracts that support liver function – such as milk thistle – have been found to help thyroid hormone conversion as well, simply because a majority of the T4 our bodies produce is converted to T3 in the liver.

It has been my experience that we need to look at more than blood tests to diagnose low thyroid, and treat stubborn cases with more than just a thyroid supplement.

Tags: Osteoporosis, Thyroid issues
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A study of nutritional therapy in children suffering from violent behavior was recently completed at the Pfeiffer Treatment Center (PTC; see their website at www.hriptc.org) near Chicago and was published in the journal Physiology and Behavior (2004 Oct. 15; 82 (5): 835-9).

In this study, more than 200 children were individually evaluated and given nutritional supplement programs based on their specific needs. The evaluation phase included a history and exam, as well as a series of laboratory tests selected on the basis of PTC’s 10-year experience treating psychiatric disorders with nutrition and inspired by the work of the late Carl Pfeiffer, PhD, MD (detailed in his book “Mental and Elemental Nutrients”).

Results were dramatic; upon re-evaluation four and eight months after starting the program, more than 90% of participants had improved, with roughly 60% becoming symptom-free.

As impressive as this study may seem to many, it would be rapidly dismissed and considered “anecdotal” in mainstream medicine because it is an outcome study and not a double-blind study. In outcome studies patients are evaluated before and after treatment, as they are in double-blind studies, but none are given a sugar pill instead of the real treatment and both patients and doctors know what is being done.

The problem is that individualized nutritional therapy simply does not lend itself to analysis by double-blind study. This leads to a vicious cycle where vitamin therapy is considered quackery because there are no “valid” studies, which are not do-able, and the studies that are done are summarily dismissed. As inflexible as this position may appear, it reflects a deeply ingrained bias against natural and nutritional treatments.

In my work, I have long corresponded with the scientists at PTC and use evaluation criteria and nutritional therapies that are very similar to theirs.

Tags: Mental Health
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The average person following the news over the last month or so might have been shocked to find that the popular arthritis drug Vioxx was recalled for causing strokes and heart attacks only a few years after being introduced with great fanfare as the “safe” anti-inflammatory drug.

The truth is that patented drugs are expensive to develop and even more expensive to get through the approval process; yet they remain loose cannons because their safety cannot be truly guaranteed. In many cases, there’s not even a need for them.

For example, in a recent double-blind study, the supplement SAMe was found to be as effective as the drug Celebrex to control arthritis pain (BMC Musculoskelet Disord, 2004 Feb. 26; 5 (1): 6). Celebrex is closely related to Vioxx and, in all likelihood, it is probably only a matter of time before it is shown to cause the same deadly side effects.

In this study, patients were given either 600 mg of SAMe twice a day or 200 mg of the drug Celebrex once daily. After one month, those receiving SAMe reported only marginal improvements in pain, but by the end of the second month the pain was controlled equally well in both groups. Researchers concluded that SAMe has a “slower onset of action but the two treatments are equally efficacious.”

In comparison with Vioxx, SAMe comes with side benefits, not side effects. Other research has shown it to be as effective as antidepressants in fighting depression (for a review of the literature see Curr Psychiatry Rep 2003 Dec; 5 (6): 460-6) and promoting detoxification of environmental chemicals (for example see Minerva Gastroenterol Dietol 1992 Jul-Sep; 38 (3): 145-51).

If you run to the health food store to buy a bottle of SAMe, you will find that it is expensive and realize that taking 1,200 mg of it every day might put a dent in your budget. However, the cost of SAMe is low in relation to Vioxx – especially if we consider the heart disease it caused.

If you can’t afford the SAMe, or simply prefer a holistic approach rather than relying on a single product, arthritis can often be controlled very well through diet change (yes, you’ll have to avoid sugar) and inexpensive supplements like fish oil, enzymes, and herbal extracts that include the common Indian spice tumeric.

My question is: who needed Vioxx in the first place?

Tags: Arthritis
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If you suffer from SAD, the end of daylight savings time is always bad news. SAD is characterized by symptoms of depression that flare up in the winter months when daylight hours decrease. It is far more prevalent up north, but I have seen it even here in Houston.

Since lack of sunlight obviously has something to do with SAD, treatment often involves daily exposure to bright white fluorescent light. However, this approach often doesn’t help and so many doctors just prescribe antidepressants.

An interesting theory is that it is not the lack of sunlight that causes depression, but the resulting vitamin D deficiency. Several studies appear to support this view.

In one study, 37 patients with marginal blood levels of vitamin D were given either 600 or 4,000 IU per day of vitamin D3 for three months, December through February. After this period, all patients reported improved wellbeing, with the higher-dose group faring significantly better (Nutr J 2004 Jul 19; 3 (1): 8).

In an older study, 15 patients with SAD were randomly assigned to receive vitamin D or daily light therapy. In this study only the group receiving vitamin D recovered (J Nutr Health Aging 1999; 3 (1): 5-7).

Last January I wrote about the many benefits of vitamin D (click on “Vitamin D” on the topics list of the Newsletters page on my website to view the full article). This vitamin plays important roles in calcium and bone metabolism, immunity, and protection from critical illness. If you suspect you are prone to SAD, that may be one more good reason to have your blood levels of vitamin D tested. The correct test to measure your vitamin D levels is one called “25-hydroxy vitamin D.” It is also important to ignore the lab’s reference ranges because they are based on the average of a vitamin D-deficient population. Instead, a good range is between 35 and 50 ng/ml.

If your levels are low, consider supplementing with vitamin D3, the most natural and safest form of this vitamin. Supplements in the range of 4,000 to 6,000 IU per day are safe for adults and probably necessary to reestablish adequacy if you are deficient. However, if you take high doses, it is important to monitor your blood levels of vitamin D through periodic testing and regular communication with your healthcare professional. Excessively high levels of Vitamin D can have toxic effects that could include kidney stones. Once an adequate level has been established, long-term maintenance intake of 1,000 IU per day has been shown to be safe (Am J Clin Nutr 2001; 73: 288-94).

Tags: Depression, Mental Health, Vitamin D
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The benefits of fish oil have been attributed to two fatty acids that are abbreviated as EPA and DHA. These play many important roles in the body: they contribute to the structural integrity of cell membranes and are converted to substances called eicosanoids that act as hormones, promoting normal communication between cells (including brain cells) and controlling inflammation. When early research showed lower rates of depression and mental illness in people who ate more fish, scientists studied the human brain and found it contains significant amounts of DHA. They concluded that DHA is best for the brain and EPA plays other roles in inflammation and heart health.

However, research failed to confirm this view. When the effects of EPA and DHA were compared in double-blind studies, EPA provided clear benefits whereas DHA did no better or marginally worse than placebo. This was seen in a number of conditions including schizophrenia and bipolar disorder (1). In a study of depressed patients who did not respond to standard medical care, pure EPA at a dose of 1 gram per day was found to be an effective treatment (2). The same dose of EPA was also found to provide some degree of help in borderline personality disorder, a condition that is usually non-responsive to drug therapy (3).

Leading fish oil researchers now believe that DHA only plays a structural role in the brain, whereas EPA contributes to its function (4). There is a critical need for DHA during fetal development and early infancy – the fact that DHA is found in breast milk is clear evidence of this. Past this early period, the need for DHA is limited and too much of it seems to actually have an adverse effect on moods.

Until recently, pure pharmaceutical-grade EPA was only available for research purposes, and all the fish oil on the market contained varying concentrations of both EPA and DHA. Now, the innovative Canadian supplement manufacturer Advanced Orthomolecular Research (AOR; see www.AOR.ca for more information) has introduced a pure EPA supplement called EPA Brite that is also available here in the online store.

(1) Schizophr Res 2001 Apr 30; 49 (3): 243-51, Prostaglandins Leukot Essent Fatty Acids, 2003 Dec; 69 (6): 477-85, Prostaglandins Leukot Essent Fatty Acids, 1999 May-Jun; 60 (5-6): 329-37
(2) Arch Gen Psychiatry, 2002 Oct; 59 (10): 913-9
(3) Am J Psychiatry, 2003 Jan; 160 (1): 167-9
(4) See The Omega 3 Connection, by Andrew Stoll, MD

Tags: Fish Oil, Mental Health
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The mother of one of my patients suggested to Channel 2, the NBC affiliate here in Houston, that they should include me in their multi-part report on autism that ran this month. When they interviewed me, they were very interested in the DAN! (Defeat Autism Now!) approach to treating the condition and the positive results we have seen with many of the children under my care. The report, which ran on the late afternoon newscasts on consecutive days, also included interviews with several of my patient families as well as other healthcare professionals. The series also included useful information about working with insurance companies for better coverage of various therapies. Thanks to Krista Marino, Health Beat reporter, Emily Akin, consumer advocate, and their Channel 2 News team for focusing attention on this important topic.

If you are interested in this subject but missed the series, just ask to see the tape next time you’re in the office.

Tags: Autism
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