The concept of an infection causing arthritis is not new. In fact, the use of gold injections beginning in the 1940s was based on this compound’s anti-microbial effects. Though highly toxic, and of limited benefit, gold is still being used today. Because of the dramatic relief experienced with the use of cortisone and other anti-inflammatories, the infection theory of arthritis was nearly forgotten.

However, in 1995 a study called the MIRA trial involving over 200 participants was published in the prestigious journal, the Annals of Internal Medicine. This randomized, double-blind, placebo-controlled study showed that patients receiving antibiotics (in this case minocycline), experienced a dramatic reduction in symptoms (pain and swelling) as well as an improved quality of life compared to the placebo group. Additionally, there was a decrease in the use of anti-inflammatories in the treatment group and an increase in the placebo group. Other studies have shown similar results.

Over the years I have had patients report that their arthritis pain diminished while on antibiotics and I’ve had several that went into complete remission.  So why are antibiotics not being utilized more?  One reason is that the FDA has not approved minocycline, or any other antibiotic, for the treatment of arthritis—so it is considered an “off-label” use of the medicine. Also, doctors are understandably reluctant to prescribe antibiotics long term because of potential side effects. However, the drugs typically used to treat rheumatoid arthritis are highly toxic and largely ineffective, and these are prescribed to the tune of billions of dollars a year. To protect their enormous profits, big pharmaceutical companies have done everything possible to discourage any competition.

The antibiotics used to treat rheumatoid arthritis are the same ones used to treat acne in teenagers. These inexpensive drugs, known as tetracylines, do have side effects, but they are typically minor. I recommend pro-biotics to maintain the intestinal flora, and I always recommend high quality vitamin and mineral supplements as insurance against a deficiency. Tetracylines may cause photosensitivity, so extra precautions must be taken to prevent sunburns.

While antibiotics won’t help everyone with arthritis, they sometimes offer enormous relief. You can learn more at www.roadback.org/ or by reading the book, The New Arthritis Breakthrough by Henry Scammell.

-Dr. Angier practices integrative medicine at GET WELL in St. Augustine, Florida.

Allergic reactions—these can occur with any drug, even if you’ve taken it in the past without problems. If you’re lucky it will be just a rash, but more serious reactions can be fatal.

Yeast infections—while most of these are mild, sometimes they can be persistent and can affect the whole body, especially if you have diabetes or a weakened immune system.

Drug interactions—very common and sometimes dangerous, especially if you are on Coumadin (warfarin).

Photosensitivity—certain antibiotics, like sulfa drugs and tetracyclines, can make you sensitive to the sun, and can lead to severe burns.

Tendon injuries—a class of drugs known as fluoroquinolones, which include Cipro, Levaquin and Floxin, can cause tendon rupture (usually the Achilles), which can result in permanent disability.

Drug resistance—many infections have become almost impossible to treat because bacteria have mutated to become resistant to antibiotics.

Diarrhea—very common but can sometimes be avoided with the use of probiotic supplements, yogurt with live cultures, and acidophilus milk.

Some patients develop a severe form of diarrhea caused by a microorganism called Clostridium difficile (C. difficile). This occurs because the antibiotics kill off the good flora that normally keep this bug in check.  The stronger the antibiotic, and the longer you are on it, the more likely you will develop a C. difficile infection.

Drastic measures are sometimes needed to treat this. Recently doctors have begun to use an unconventional approach—fecal transplants. That’s right, they take someone else’s stool (usually a close relative), run it through a blender, and then pump it into your colon using a tube.  As distasteful as this may seem, patients that have months of diarrhea and are suffering from malnutrition are generally quite open to the treatment—especially since it’s 90% effective.

So how do you reduce your risk of these side effects? The best way is to avoid antibiotics when possible. Certainly if you have a serious bacterial infection such as pneumonia or strept throat, you need antibiotics. Bladder infections should also be treated without delay, as they can progress to life-threatening kidney infections. Other important uses of antibiotics include the treatment of peptic ulcers and even some types of arthritis, but if all you have a cough and congestion, ask your doctor if antibiotics are really necessary (they usually aren’t).  If you need the antibiotics, take them as prescribed and finish them. Failure to do so may lead to a second round of antibiotics and an increased risk of adverse effects.

What you really have to worry about is going to the doctor. Radiation exposure from medical tests has become a major concern recently, with the government finally setting new guidelines for reducing this risk.

Doctors have become more reliant on X-rays, CT scans and other radiological imaging studies to make a diagnosis. In particular, the use of CT scans has risen dramatically. This is due in part because they are readily available and they provide a lot of information quickly.

Unfortunately CT scans are ordered too often and sometimes for the wrong reasons—the most common being concern about lawsuits. Also, many doctors don’t recognize the risk associated with these tests. A recent study in the journal Radiology revealed that only 50% of radiologists and 9% of emergency room doctors were aware that CT scans were associated with an increased risk of cancer.

So how unsafe are these tests? The FDA and the National Academy of Sciences start estimating cancer risk at only 10 mSv (millisieverts). To put this in perspective, an abdominal CT is 8 mSv and approximately 2% of the population receives 20 mSv or more per year—which is certainly reason for concern. Studies show that 100 mSv of radiation will almost always result in cancer.

Ways to reduce your radiation risk:

• Try to limit x-rays, in particular CT scans, especially if you’re under forty, because the younger you are, the more vulnerable you are to radiation.
• Ask your doctor about other options. It may be that an MRI or ultrasound could be done in place of a CT. It might also be that you don’t absolutely need an x-ray (for example, sprained ankles don’t always need to be x-rayed).
• When you have x-rays, insist on the use of lead aprons and shields to protect areas that are more sensitive to radiation, such as the thyroid gland and reproductive organs.
• Keep track of the “high dose” radiology exams you have. In particular, CT scans but also barium studies, heart catheterizations and nuclear studies (nuclear studies include bone scans, thyroid scans and the radioisotope scans given in association with stress tests).
• There is no question that mammograms save lives, but you might consider reducing the frequency of mammograms and having thermograms more often.

Despite the government’s forty year “war on cancer”, many types of cancer have actually increased, including childhood leukemias, breast cancer, and thyroid cancer. At least some of these cases can be prevented by reducing the radiation exposure from medical tests.

The Mediflow water pillow (also known as the Chiroflow water pillow) is simply a pillow with a water-filled base that you can adjust by putting in more or less water. The base is insulated and there is a layer of polyester between you and the water bladder. Once you get it adjusted right (and that may take a few nights), you should be able to get your head lined up with the rest of your spine.

In most cases this results in a better night’s sleep and less neck pain. A clinical study done at the Johns Hopkins School of Medicine in 1997 showed that this pillow was significantly better than the cervical roll pillows that many people use. I have provided hundreds of my patients with these pillows and found that they are almost always helpful. In fact, in a way they were bad for business because after buying the Mediflow pillow, these patients often didn’t need to see me anymore!

In cases where people didn’t respond well, I found they had usually put too much water in the pillow. The manufacturer recommends that you start with 3 liters which is way too much for most people. It’s always better to start with less (1.5-2 liters) and increase it gradually. I also recommend that you first try out the pillow during a short nap so that you’re not trying to adjust the amount of water at eleven o’clock at night. Keep your old pillow beside the bed in case you need to switch back to it in the middle of the night. In time, you should be able to find the perfect thickness for you and then leave it alone!  It may be that you’ll want to change the water every few months, but measure what you took out to save going through the adjustment process again.

As with most types of chronic pain, there is rarely one intervention that will fix you, but if you improve your nighttime posture with the right pillow it should significantly reduce your neck pain. These pillows are available at GET WELL in St. Augustine, FL and are also available at Amazon for around $55, and that’s a lot cheaper than repeat visits to the doctor or chiropractor.

GET WELL is an integrative practice where natural alternatives are often utilized in addition to more traditional medical approaches. “While we provide primary care services, we focus on helping our patients achieve optimum health through exercise, nutrition and stress management,” says Angier.

Dr. Angier is board-certified in family practice and has over 20 years of clinical experience. He also has a degree in nutrition and is a graduate of the WellCoaches® program. He is certified in chelation therapy through the American College for the Advancement of Medicine.

The practice accepts Medicare and offers $78 office visits for those without insurance or who have high deductibles. Appointments can be scheduled on-line by visiting www.GetWellFL.com or calling 904-217-7030.

Pierre Angier, DO
GET WELL
1100 S. Ponce de Leon Blvd
St. Augustine FL 32084
www.GetWellFL.com
904-217-7030

• Get plenty of rest, drink plenty of water and eat healthy foods, including plenty of garlic. Garlic is a well-known immune booster. If you don’t like to eat it, or you’re concerned about bad breath, you can always take Kyolic®, which is available in pharmacies and health food stores.
• Minimize, or learn to better manage your stress. Stress has been shown to greatly increase your chances of getting sick. In fact, I usually ask patients why they think they got sick, and more often than not they tell me thy think it’s from stress.
• Take a good multi-vitamin. Even the AMA recommends this now, but the benefits of a good supplement have been known for years. One of my favorite studies is out of Canada, where they gave older patients a multi-vitamin or placebo. The group that took the vitamins got colds and flu only half as often as the placebo group. And, when they did get sick, they got better in half the time. This is a no-brainer. Take a good multi-vitamin.

Other food supplements that have also been shown to improve immune function include Vitamin C, Vitamin E and Omega 3 fatty acids.

One of the most significant advances in medicine was the discovery of interferon in the 1950’s. This compound is made naturally by the body to fight infection, but it has also been successfully used intravenously to treat severe viral infections such as hepatitis, as well as other serious conditions.

In Europe they have been using interferon tablets and nasal sprays to treat the flu, and there are studies to show it is effective. In this country we don’t yet have this available, but we have something that may be just as good—it’s called Nutriferon® and it was developed by Dr.Yasuhiko Kojima, the scientist who discovered interferon over 40 years ago. The product, made by Shaklee, uses four natural compounds to increase the body’s natural production of interferon. I’ve used it for years with great results. In fact, I won’t even get on a plane without first doping up on Vitamin C and Nutriferon®.

If you get a cold or the flu, you might consider elderberry root. This has been used for centuries to treat colds and flu, and there are many good studies that show it works. I recommend that you take elderberry extract (Sambucol®) as this is what most of the studies have used.

If you get sick with a high fever, cough and marked fatigue, you need to stay away from people so you don’t spread this around. Drink lots of fluids to avoid dehydration and if you have trouble breathing or have other serious symptoms, get yourself to a doctor.

Dr. Pierre Angier is an osteopathic physician who practices integrative medicine at GET WELL in Saint Augustine, Florida.  To learn more visit www.GetWellFL.com or call (904) 217-7030.

The primary source of B12 is red meat and some seafood. There are also small amounts in yogurt, cheese and eggs. Therefore, it is the strict vegans who are at greatest risk for a deficiency. Having said that, I’ve treated several patients that developed signs of B12 deficiency after 5 years of just avoiding red meat.   A study done on long-term vegetarians (Seventh Day Adventist ministers) showed that 73% had low B12 levels.

So what are the signs of a B12 deficiency? Because every cell in the body utilizes this vitamin, a variety of problems can occur. Patients can develop a serious blood disorder called pernicious anemia.  There can also be a variety of neurological symptoms including numbness and tingling, cognitive disorders, and mood changes. In fact, B12 deficiency is a common cause of dementia and is frequently overlooked.

For vegetarians, the solution is simple. Take a B-complex supplement. I recommend taking all the B vitamins together because they work synergistically. There is also the possibility of masking other B vitamin deficiencies if you take only B12.

The other group that develops B12 deficiencies are people that have trouble with absorption.  To be absorbed, B12 must bind with intrinsic factor—a  protein produced by the parietal cells of the stomach.  These cells are sometimes absent or diminished due to autoimmune disease, stomach surgery (including gastric bypass), and atrophy of the stomach lining—which is common in the elderly.  Acid is also needed for absorption, and many older patients don’t make a lot of acid. Drugs that stop acid production, such as Zantac and Prilosec, can further contribute to the problem.

If you’re in a high-risk group for B12 deficiency, or you have some of the symptoms, you should have your B12 level checked. If you are low or even low normal, a follow-up test called methylmalonic acid (MMA) should be done. This can be done on the blood or the urine, but the urine test is more accurate. If the MMA is high, you have a B12 deficiency.

Again, if you’re just not eating enough, a supplement by mouth is probably all you need. Those who have trouble absorbing B12 need to take injections, although some of my patients have done well using the sublingual (under the tongue) supplements. Either way, you need to be followed by your doctor to make sure this problem is resolved.

Dr. Angier is an osteopathic physician who practices integrative medicine at GET WELL in Saint Augustine, Florida.  To learn more visit www.GetWellFL.com or call (904) 217-7030.