Professional Documents
Culture Documents
VOLUME 3, NO. 8
Asthma
A medical wh e eze
ne of the biggest medical fail - crease may be due to changes in di- death has ever been caused by un-
C O N T E N T S
1
Special Report: Asthma: how drugs
5
What Doctors Read: Cataracts and
7
Books: Inequalities in Health and
often make the problem worse. vitamin C; fluoride and hip fractures. Which? Medicine.
4 6 8
Updates: MMR vaccine withdrawn; Q&A: The new "improved" hepatitis Second Opinion: Harald Gaier.
The trouble with "scientific" tests.
What Doctors Don't Tell You, 4 Wallace Road, London N1 2PG. Editor Lynne McTaggart Editor's PA Jan Green Contributing Editor Fiona Bawdon
Editorial Assistants Dorothy Rothermel, Kerry Johnsonl Designer Clerkenwell Design Group Printed by Premier Press Publisher The Wallace Press
Copyright The Wallace Press No part of this publication may be reproduced without permission.
prevalent causes). names Ventolin ,Ventodisks or Salbu- breath in, and utilize more drug than
The root of the allergy could be a lin), fenoterol (Berotec) and terbu- the usual pressurized aerosol car-
slight malfunction in the immune taline (Bricanyl). tridges. Another possibility is the use
system, having to do with essential If inhaled beta2-agonists don't do the of a spacer, which offers a "space" be-
fatty acids (EFAs). American immu- job or you find you're using them more tween the inhaler and the mouth to al-
nologist and WDDTY panel member than three times a week, the doctor low more time for the propellant
Leo Galland, who has performed a moves up to step two, which includes chemical to evaporate before the drug
good deal of groundbreaking work in anti-inflammatories. Children are reaches you. There are also nebulizers
this field, cites several studies in Su - usually started on a six-to-eight week which produce a spray, slowly releas-
perimmunity for Kids (Bloomsbury trials of sodium cromoglycate (Intal) ing the drug into the bronchial tubes.
£9.99) showing that children with three or four times a day. This drug, If this still doesn't control your
asthma have difficulty converting called a mast cell stabilizer, works by asthma or you have persistent symp-
EFAs into prostaglandins—which reg- preventing the mast cells lining the toms at night despite all the other in-
ulate the function of the immune sys- bronchial tubes from releasing chemi- haled therapies, the BTS suggests
tem. Prostaglandins are controlled by cals causing the bronchial muscles to that you move on to step four, increas-
enzymes; a vital one in converting contract. It is effective in preventing ing the daily dose of inhaled steroids
omega-6 EFAs into an intermediate an attack from starting, but cannot and using an additional bronchodila-
stage from which they go on to become treat an attack once it has begun. tor such as theophylline or amino-
prostaglandins is D-6-D, or what Gal- A similar but more potent drug is phylline on top of the other
land calls the Delta Force. Galland deocromil (Tilade). medication. Theophylline belongs to a
has found that in children and adults Most adults (and children who drug category called the xanthines,
with allergic asthma (as well as haven't been helped by the sodium cro- which includes caffeine. Theophylline
eczema and hay fever) the Delta Force moglycate trial) are placed on inhaled works by relaxing the bronchial mus-
is much less active than normal. "As a steroids, which are supposed to reduce cles and also breaking down a chemi-
result," he writes, "prostaglandin pro- the daily dose and hence the general cal that controls the muscles in the
duction is short-circuited." risks of corticosteroids. These drugs bronchial tubes. Another possibility is
Drug treatment for asthma is include beclomethasone (Becotide) to take oral beta2-agonists, which re-
given largely on a suck-it-and-see and budesonide (Pulmicort). This lease more drug into the body, or a
(or more properly, an inhale-it- anti-inflammatory drug is used con- non-selective adrenoreceptor stimu-
and-see) basis, ending up with the currently with a beta2-agonist inhaled lant like ipratropium bromide, which
patient taking a medicine chest of up to four times a day. affects your heart as well as your
potentially lethal drugs. Recently Step three employs the same bronchial muscles.
the British Thoracic Society published steroids but a more powerful inhaler. If all else fails, you are put on a
new guidelines for following a "step" Dry powder inhalers have cartridges course of oral steroids, in addition to
approach, only graduating on to the which blast the powder when you the other drugs in step four. You
next step in terms of potency of drugs
if the step before hasn't helped. It also
advises that when control is estab-
lished with one step, to consider mov- Asthma treatment
without drugs
ing down to the step below.
Step one begins with short-acting in-
haled beta2-agonists for patients who
experience symptoms infrequently or If you are alarmed by medicine's hit-and-miss approach to asthma with dangerous drugs,
with only mild exercise-induced there are many sensible approaches that may lessen or even eliminate your symptoms. As
asthma. These adrenoreceptor stimu- Leo Galland writes: "If an effective allergy-desensitization technique is used and as much en-
lants cause the nervous system to act vironmental control as possible is exercised, drug-free treatment is virtually always possible
on adrenaline receptors throughout in children."
the body. But unless the drugs are Find an experienced clinical ecologist or allergist who can find out what you are allergic to.
highly selective, aiming only to stimu- This may mean going to someone who is familiar with exclusion diets or, in the case of air-
late "beta2" receptors (which relax borne triggers, EPD desensitization methods which will locate your allergies with far more
bronchial muscles and reduce the accuracy than the old prick-test method .
chemicals causing inflammation) they ●Avoid any food or ingested allergens. That particularly includes milk products. Use a cal-
can cause the heart to race and force it cium supplement if you don't add enough calcium from other sources.
to produce larger quantities of blood, ●Add the following supplements to your daily diet: vitamin B6 50-100 mg, linseed (1-2 Tbs
thus raising the blood pressure. In per day) or walnut oil (2 to 4 Tbs) plus evening primrose oil (4-8 capsules); vitamin C (at least
the past, doctors made use of non-se- 500 mg );' zinc (10-20 mg ); vitamin E (at least 600 IUs); and magnesium.
lective adrenoreceptor stimulants like ●Follow a diet low in sugar, animal fat and additives, and high in grains and vegetables.
adrenaline or isoprenaline, which ●Take regular gentle aerobic exercise like swimming or walking, which reduces symptoms.
work on the heart muscles. But other Dr Galland recommends that asthmatic children have the following supplements, which
than for life-and-death emergencies, play a role in assisting or curing asthma:
it's now agreed that drugs like High doses of essential fatty acids. (I Tbs of linseed oil and 1 Tbs of cod-liver oil or 3 g of
adrenaline shouldn't be used since MAX EPA per day). Magnesium: 3mg per pound of body weight per day. Calcium: 600 mg
they can induce a heart attack. per day if dairy products are eliminated. High doses of vitamin C (2 gms a day). B6: at least
The selective beta2-agonists of drugs 200 mg a day. B12: 1 mg twice a day for six weeks.
are sold in the UK as salbutamol, or
albuterol in the States (with brand
A
As some of you may or may anyone I think might help. I've never even virus is 'recommended,' not manda -
not know, Dr Kermani is studied biology at school—but I've got some- tory—tacit acknowledgement that
one of our panel members, thing that no doctor has got: I love my the jab itself is only necessary for the
who has treated many AIDS daughter. The depth of that love will allow newborns of infected mothers. Else -
patients through a combination of no barriers in my search for a cure. —S.A., where in the volume, the AAP admits
conventional and alternative treat - East Grinstead. that the duration of protection and
ments such as autogenic training. Thank you for your heartfelt letter. We the need for booster doses is 'not yet
It's worth remembering that the ar - can sympathize with your enormous fully divined. ' And between 30 and 50
ticle to which you refer mainly con - anger and frustation. The late medical per cent of people vaccinated with
cerned the wisdom of launching a critic Dr Robert Mendelsohn maintained three doses of the vaccine lose de -
nationwide immunization pro - that the many long-term side effects of tectable antibodies within seven
gramme for infants. the live measles vaccine included multiple years. This could mean that you may
We went back to another panel sclerosis, juvenile onset diabetes and need a booster shot every five years
member, immunization expert An - Reye's syndrome. Reye's syndrome can for the rest of your life.
thony Morris, who authored the re - cause the degeneration of organs such as "Again, the AAP admits this with
port on vaccination. Here is what he the pancreas, particularly when aspirin the statement that 'the possible need
had to say. has been used. Mendelsohn once cited a for booster doses after longer inter -
"Most of the work in New Zealand batch of cases of Reye's syndrome in vals than five to seven years will be
was based on vaccines made from hu - Montreal in which five of the children had assessed as additional information
man plasma. However, as recently as been vaccinated within three weeks of becomes available.' Finally the AAP
the early 1990s, Smith Klein and coming down with the illness. In Shot a says that 'in 1-2 per cent of cases the
French was licensed to use the geneti - in the Dark (Avery), Harris Coulter also recommended regime . . . is not effec -
cally engineered vaccine, which is provides ample evidence of the relation - tive.' Therefore, infants should be
grown on yeast cells. However, the ship between pertussis vaccination and tested at nine months or later to see if
earlier plasma-derived vaccine was the failure of children to maintain stable it's taken. This means that 2 out of
never withdrawn, and even those glucose levels. Now that two of the MMR every 100 babies won't be protected by
drug companies which stopped pro - vaccines have been withdrawn, you might the vaccine.
ducing the blood-derived product get a legal opinion as to whether you "This high failure rate has been re -
kept selling it until it was used up. So have a case against the supplier. produced in adults; a study pub -
until very recently, anyone receiving While we applaud your determination, lished in the Journal of Infectious
the vaccine could have received a we would strongly urge you not to take Diseases (April 1992) showed that 10
blood-based vaccine. matters entirely into your own hands with per cent of volunteers vaccinated
"The other issue you raise concerns such a potentially serious condition . We failed to produce antibodies.
the safety and efficacy of the yeast-de - recommend that you work in partnership "There is also the possibility that
rived or 'recombinant' vaccine. You with a doctor with great experience in the hepatitis B vaccine can itself
say that the contents of our article treating diabetics nutritionally.Also, our cause a mutant strain of the virus. In
only applied to this earlier vaccine. issue Vol 3 No 7 on diabetes may be of a study in southern Italy published in
BOOKS
the Lancet (11 August 1990), 44 of the coeliac disease, and even total atrophy
1,590 infants born of HB carriers be - of the gut lining. Title: Which? Medicine
came HB positive, 32 of whom showed "Commonly, patients with giardiasis
evidence of infection and one, serious have a deficiency of the enzyme lac - Author: Rosalind Grant
disease. The study group concluded tase, required to digest cow's milk, and
that the vaccine caused a viral ‘escape’ they may also fail to absorb folic acid ( Consumer's Association ) £12.99
mutation—ie, a slightly different or - and vitamin B12, leading to anaemia.
ganism resistant to the protective ef - "At the moment, diagnosis of giardia -
fects of the vaccine. sis is very difficult, since most labs do This rather expensive paperback aims to
"Finally, there have been reports (the not have the requisite detection skills. give a handy guide to the 80 most com-
Lancet, 25 April 1992) of people misdi - Routine hospital screening of faeces monly prescribed generic drugs and
agnosed as HIV positive after being for the presence of giardiasis misses advice on 1500 prescription and over-
vaccinated with the HB vaccine. " the diagnosis 98 per cent of the time.
In our view, the studies Dr Morris "A newer and probably better
the-counter medicines.
cites demonstrate that no definitive method, described by Bueno and Par - Its basic message is one which WDDTY
statements can be made as to the safety rish in the USA, consists of a superfi - fully endorses. Be an active patient, it
or efficacy of either the old or new HB cial biopsy of rectal mucosa taken by says. Ask your doctor questions and take
vaccine for children. means of a small cotton bud swab nothing for granted, it exhorts.
pressed firmly into the mucosal lining. As well as information on drugs, it sets
"There are various other, less com -
out 20 questions you should ask each
mon parasites, and because of the
deplorable state of diagnostic tech - time you are prescribed a drug.
Q
For the past few years I've niques, doctors like myself consider it However, perhaps inevitably for a book
suffered from a number of a good idea—when parasites are the from the CA, it errs on the side of con-
bowel problems and almost likely culprit of a complaint—to try a servatism. The prevalence of side effects
constant fatigue. I've seen therapeutic trial of treatment to see if is played down, and it barely nods in the
allergy doctors and alterna- it helps. direction of alternative approaches. "Diet
tive practitioners, who have treated "For many of these organisms, the
me for possible allergies, candida al- metronidazoles (Flagyl) are the treat - does not seem to affect the course of
bicans and ME—all to no avail. Any ment of first choice. Therapy may need acne," it baldly states. The section on vi-
suggestions?—B. M., Shropshire. to be kept up for several weeks. Even if tamin supplements is headed pejoratively:
apparently successful, relapses are Money down the drain?
common, probably due to incomplete No doubt the author would point to the
eradication, rather than re-infection. question mark as proof of her impartial-
"A new drug, tinadazole (Fasigyn)
ity, but the same heading could have been
A
Have you looked into the pos - has become available and appears to
sibility that your problems be effective. Nevertheless, it may cause used equally well for many of the more
may be caused by an intesti - short-lived abdominal discomfort and orthodox treatments covered.
nal parasite? Allergy spe - drowsiness. Treatment should be
cialist Keith Mumby has avoided during pregnancy and breast -
done a good deal of work on parasites feeding, and patients under treatment Title: Inequalities in Health
and their treatment. Here is what he should avoid alcohol, which will make
had to say: them ill if taken concurrently with the Author: P Townsend & N Davidson
"It is now accepted by many clinical drug.
ecologists that as many as one in six "Herbal treatment can be strikingly (Penguin) £7.99
people in Britain may be carrying effective, particularly plants from the
around giardia lamblia, a minute, genus Artemesia. These are the worts, Just as the feminists used to say the per-
flagellated protozoan that causes se - such as wormwood (Artemesia ab- sonal is political, this book leaves you in
vere fatigue and bowel disturbance. sinthium) and mugwort (Artemesia no doubt that the state of your personal
Perhaps 10 to 12 per cent carry cryp - vulgaris). Moxa, used in moxybustion
health is political.
tosporidia infestation, a mild enough by acupuncturists, is from this group
infestation in healthy individuals but of plants. It brings together in one edition The
a potentially fatal one for those with "Best known as an antiparasitic is Black Report—which caused a political
compromised immunity, such as AIDS Artemesia annua. It is currently un - storm when it was published in 1980—
victims. der study by the WHO as a possible and an updated edition of The Health Di-
"The majority of patients simply get treatment for chloroquine-resistant vide by Margaret Whitehead.
vague, grumbling symptoms that come malaria. It is available as a bowel Both reports argue convincingly that
and go, never quite adding up to a ‘dis - preparation; usually, 1 gram is taken
ease' or something the doctor would three times a day for 60-90 days. Better governmental policies have a devastating
wish to have fully investigated. Most results may come from combining it effect on the nation's health. If you want
especially occur in the bowel, where with some other herbs. to have a long and healthy life, be sure to
mild symptoms of the ‘irritable bowel' - "Grapefruit-seed extract, known un - be rich, white and living in the South East.
type are quite common. However, sys - der several brand names such as It gives an excellent overview of the fac-
temic symptoms—particularly fatigue, DF/100, Parcan and Citrocida, has a tors which go towards shaping the pat-
lack of energy, muscle weakness, similar range of activity. The two com -
headache, sore throats, enlarged bine very well. If a short-term course of
tern of health care provision—just in case
lymph glands, night sweats and occa - Flagyl is added, this makes up just you thought it was determined by need—
sional fever—can be caused as well. about the best ammunition we've got." and explains how the medical establish-
"Giardia lamblia is an important "If a doctor diagnoses you as having ment conspires to ensure that so-called
cause of traveller's diarrhoea and a parasite and you respond to treat - fringe medicine remains there.
chronic fatigue. Patients with irrita - ment, it is vital to investigate other It also sets out a series of measures
ble bowel or ' food allergy' can often members of your family to prevent
government could take to improve the
date the onset of their symptoms to an cross-infection.
episode of tummy upset on a holiday “In the UK, rectal swabs and the health of its citizens; like uprating child
abroad. Bueno-Parrish method can be done at benefit, making clinics more user friendly,
"Giardiasis can cause severe malab - the London Clinic, 20 Devonshire Pl, and ceasing to conspire in the promotion
sorption, not unlike that caused by London WDN 2DH (tel: 071-723 6581)." of a major killer, by banning all tobacco
advertising.
SUBSCRIPTION FORM
Give a friend the gift of health. Take out a year's subscription to What Doctors Don't Tell You and you still only pay the introductory rate of
£24.95, plus receive a free copy of the Guide to the Side Effects of Drugs, a Filofax insert. Please complete the form below and return with
your cheque or money order (or bank details) to What Doctors Don't Tell You, 4 Wallace Road, London N1 2PG.
Name(Mr/Mrs/Miss/Ms/Dr)
Address
Postcode Telephone
I enclose a cheque for a: ❏ Two-year subscription at the introductory rate of £49.90 ( Company rate £99.90 )
❏ One year subscription at £24.95 ( Company rate £49.95 )
❏ I would like to keep future costs down by paying by standing order at the annual rate of £24.95 ( Company rate £49.95)
Fill in form below and return to WDDTY, not your bank
To the Manager: Bank/Building Society name
Address
Account name
Signed Date
All subscribers outside the UK add £6 for each year's postage and send cheque or money order in British Sterling.