Pain Doctor: No Need to Suffer. Pain Center of Orlando

Cinnamon & Honey

David S. Klein, MD
Pain Center of Orlando, Inc.
225 W. SR 434 Suite #205
Longwood, Florida  32750

407-679-3337
www.suffernomore.com

Cinnamon and Honey

                                 David S. Klein, MD, FACA, FACPM

Okay, you saw this one several weeks ago, but, we are seeing a tremendous number of patients in the office with the flu and/or some miserable respiratory problem lasting up to 2 weeks or more. 

Look this over, and please........... buy some quality honey and cinnamon and give this remedy a try.  

Facts on Honey and Cinnamon: It is found that a mixture of honey and
Cinnamon cures most diseases. Honey is produced in most of the countries of the world. Scientists of today also accept honey as a 'Ram Ban' (very effective) medicine or all kinds of diseases. Honey can be used without any side effects for any kind of diseases.

Today's science says that even though honey is sweet, if taken in the right dosage as a medicine, it does not harm diabetic patients. Weekly World News, a magazine in Canada , in its issue dated 17 January,1995 has given the following list of diseases that can be cured by honey and cinnamon as researched by western scientists:

HEART DISEASES:

Make a paste of honey and cinnamon powder, apply on bread, instead of jelly and jam, and eat it regularly for breakfast. It reduces the cholesterol in the arteries and saves the patient from heart attack. Also those who have already had an attack, if they do this process daily, they are kept miles away from the next attack. Regular use of the above process relieves loss of breath and strengthens the heart beat. In America and Canada, various nursing homes have treated patients successfully and have found that as you age, the arteries and veins lose their flexibility and get clogged; honey and cinnamon revitalize the arteries and veins.

ARTHRITIS:

Arthritis patients may take daily, morning, and night, one cup of hot water With two spoons of honey and one small teaspoon of cinnamon powder. If Taken regularly even chronic arthritis can be cured. In a recent research Conducted at the Copenhagen University, it was found that when the doctors Treated their patients with a mixture of one tablespoon Honey and half Teaspoon Cinnamon powder before breakfast, they found that within a week, Out of the 200 people so treated, practically 73 patients were totally Relieved of pain, and within a month, mostly all the patients who could not Walk or move around because of arthritis started walking without pain.

BLADDER INFECTIONS:

Take two tablespoons of cinnamon powder and one teaspoon of honey in a Glass of lukewarm water and drink it. It destroys the germs in the bladder.

CHOLESTEROL:

Two tablespoons of honey and three teaspoons of Cinnamon Powder mixed in 16 ounces of tea water, given to a cholesterol patient, was found to reduce The level of cholesterol in the blood by 10 percent within two hours. As Mentioned for arthritic patients, if taken three times a day, any chronic Cholesterol is cured. According to information received in the said Journal, pure honey taken with food daily relieves complaints of cholesterol.

COLDS:

Those suffering from common or severe colds should take one tablespoon Lukewarm honey with 1/4 spoon cinnamon powder daily for three days. This Process will cure most chronic cough, cold, and clear the sinuses.

UPSET STOMACH:

Honey taken with cinnamon powder cures stomach ache and also clears Stomach ulcers from the root.

GAS:

According to the studies done in India and Japan , it is revealed that if Honey is taken with cinnamon powder the stomach is relieved of gas.

IMMUNE SYSTEM:

Daily use of honey and cinnamon powder strengthens the immune system and Protects the body from bacteria and viral attacks. Scientists have found That honey has various vitamins and iron in large amounts. Constant use of honey strengthens the white blood corpuscles to fight bacteria and viral Diseases.

INDIGESTION:

Cinnamon powder sprinkled on two tablespoons of honey taken before food Relieves acidity and digests the heaviest of meals.

INFLUENZA:

A scientist in Spain has proved that honey contains a natural ' Ingredient' Which kills the influenza germs and saves the patient from flu.

LONGEVITY:

Tea made with honey and cinnamon powder, when taken regularly, arrests the Ravages of old age. Take four spoons of honey, one spoon of cinnamon powder And three cups of water and boil to make like tea. Drink 1/4 cup, three to Four times a day. It keeps the skin fresh and soft and arrests old age. Life spans also increases and even a 100 year old, starts performing the Chores of a 20-year-old.

PIMPLES:

Three tablespoons of honey and one teaspoon of cinnamon powder paste. Apply this paste on the pimples before sleeping and wash it next morning with Warm water. If done daily for two weeks, it removes pimples from the root.

SKIN INFECTIONS:

Applying honey and cinnamon powder in equal parts on the affected parts Cures eczema, ringworm and all types of skin infections.

WEIGHT LOSS:

Daily in the morning one half hour before breakfast on an empty stomach And at night before sleeping, drink honey and cinnamon powder boiled in one Cup of water. If taken regularly, it reduces the weight of even the most obese person. Also, drinking this mixture regularly does not allow the fat to accumulate in the body even though the person may eat a high calorie diet.

CANCER:

Recent research in Japan and Australia has revealed that advanced cancer of the stomach and bones have been cured successfully. Patients suffering from these kinds of cancer should daily take one tablespoon of honey with one teaspoon of cinnamon powder for one month three time s a day.

FATIGUE:

Recent studies have shown that the sugar content of honey is more helpful rather than being detrimental to the strength of the body. Senior citizens, who take honey and cinnamon powder in equal parts, are more alert and flexible. Dr. Milton, who has done research, says that a half Tablespoon of honey taken in a glass of water and sprinkled with cinnamon powder, taken daily after brushing and in the afternoon at about 3:00 P.M. When the vitality of the body starts to decrease, increases the vitality of the body within a week.

BAD BREATH:

People of South America , first thing in the morning, gargle with one teaspoon of honey and cinnamon powder mixed in hot water, so their breath stays fresh throughout the day.

HEARING LOSS:

Daily morning and night honey and cinnamon powder, taken in equal parts restore hearing. Remember when we were kids? We had toast with real butter and cinnamon sprinkled on it!

Hypothyroidism- The silent epidemic

Hypothyroidism: The Silent Epidemic

Hypothyroidism can be loosely defined as a medical condition that results from the under-secretion of Thyroid Hormone. The difficulty with this traditional approach to diagnosis of hypothyroidism is that it relies on ‘normal values,’ or reference ranges that are defined by the population itself. It has been estimated that as many as 50 million American suffer from undiagnosed hypothyroidism.

Fact #1: Thyroid hormone is necessary to maintain basal metabolic rate, or the amount of fuel that is consumed to sustain health. The manifestation is that of temperature.

a. When a person is generating too little thyroid hormone, or if the individual has an imbalance that involves thyroid metabolism, body temperatures will fall.

b. These persons may be told that they ‘normally have low temperatures.’

c. This bit of nonsense is causing tremendous problems for society.

d. The result is weight gain, depression and elevations in cholesterol levels.

Fact #2: The traditional approach to the diagnosis of hypothyroidism involves measurement of a hormone released by the pituitary gland, TSH. If the central nervous system senses that there is inadequate thyroid hormone in the blood stream, TSH levels will increase. Increase in TSH should lead to increases in the release of Thyroid Hormone from the Thyroid Gland. As levels of Thyroid Hormone reach adequate levels, TSH release decreases.

Problem #1: Unfortunately, a lot can go wrong between the brain, pituitary gland and the thyroid gland, itself. Inadequate levels of thyroid hormone can persist, and the brain will ‘reset’ to new and lower levels of this hormone. Factors that can cause this include:

1. chronic stress

2. pregnancy

3. trauma

4. chronic disease states.

5. autoimmune conditions

6. fasting or famine conditions.

As TSH levels drop back to normal, the diagnosis of hypothyroidism becomes more difficult, if all the practitioner relies upon is the TSH level. Unfortunately, this is the case more times than not.

Problem #2: Thyroid Hormone does not work alone. It requires adequate levels of estradiol, estrone, progesterone, testosterone, cortisol, insulin, DHEA and a host of other hormones, peptides, fatty acids and humoral elements. If any one of these necessary pieces are missing, out of balance, or in excess, thyroid hormone may not work properly, leading to a state of ‘functional hypothyroidism.’

TSH levels, thyroid hormone levels are ‘normal,’ but the body does not function properly and resembles the hypothyroid condition.

Problem #3: Thyroid Hormone replacement may be inadequate or improper for the patient. That is, not all thyroid replacement works for all patients. There are chemicals in some of the commercially available thyroid preparations that cause all manners of problems. One such substance is ‘Acacia,’ which is a family of shrubs and trees, and portions of this plant are used in some medications to provide form and shape to tablets. Lactose is also used in the most popular of the Thyroid Replacement Hormones. Not only is Lactose an allergic trigger for people with lactose intolerance, but it may actually block the absorption of the thyroid replacement, itself. Signs of lactose intolerance include nausea, cramps, bloating, gas, and diarrhea.

It is very common to hear patients tell the doctor that the thyroid medicine that they are receiving is ‘making me sicker.’ Unfortunately, the practitioner does not often make the effort to figure out why this might be the case.

Problem #4: Certain foods make thyroid conditions worse. Patients with auto-immune disorders may be more sensitive to soy-protein than other persons. Soy contains two chemicals that inhibit an important enzyme that is necessary for thyroid hormone replacement. If a person is already ‘on the edge,’ taking soy protein can make the condition worse. To a lesser extent, peanuts, pinto beans do this, as well.

Recommendations:

1. In order to sort through the diagnosis of thyroid related problems, it is important to determine not only the levels of thyroid hormones and TSH, but it is important to determine the presence of antibodies to the binding protein and converting enzymes.

2. If you suspect that you have hypothyroidism, it is necessary to cease eating anything that contains soy, soy lecithin, peanuts and pinto beans.

3. Replacement of thyroid hormone should be accomplished with products that do not contain lactose, Acacia, and artificial colorations.

4. Thyroid hormone must be taken on an empty stomach.

5. Determination of hormone imbalances that affect thyroid metabolism must be accomplished.

David S. Klein, MD, FACA
Pain Center of Orlando, Inc.
225 W. SR 434 Suite #205
Longwood, Florida  32750      [email protected]

www.suffernomore.com

www.stages-of-life.com

Lake Mary Life Magazine Article 3/1/09

Focus on Pain Center of Orlando
Peter Reilly

Chronic pain is the symptom that your body is out of balance. At the Pain Center of Orlando, Dr. David Klein works to restore hormonal and nutritional balance as well as to relieve pain.

He has helped many headache, hand-, foot- and back-pain sufferers regain their health, taking great satisfaction in curing those who have sought treatment elsewhere and haven’t found relief.

“I want to see the patients who are not satisfied with their care, those who have not found relief elsewhere,” he says from his Longwood office, the walls of which are lined with bookcases and decorated with models of antique cars and motorcycles. “I want the ones who are not getting better. I want to see the patients that no one else can figure out.”

With prior training and experience as an analytical chemist, and with nearly 30 years of clinical experience in medicine, a specialty in anesthesiology and with the subspecialty of pain medicine, Dr. Klein, a Longwood resident, is prepared to diagnose and deal with just about any pain-related disorder. He spent seven years as a Navy physician and five years in the Air Force as a flight surgeon, both on active reserve.

Dr. Klein earned his medical degree from the University of Maryland School of Medicine, surgical internship at University of North Carolina, and residency at Duke University. He has served on the clinical teaching faculties of Ohio State University, the National Naval Medical Center, and Portsmouth Naval Hospital, as well as on many editorial review boards for medical journals.

Certified by five medical boards, the doctor has given countless lectures, invented several medical products, and has been published more than 100 times.

With a resume like that you’d think Dr. Klein would be part of a large assembly-line practice with a big staff of nurses and physician’s assistants, but the decorated Gulf War veteran is a sole practitioner who doesn’t rush through visits or overbook appointments.

“There are no physician assistants or nurses in this office,” he says. “I see every patient, every visit, every time.” In fact, Dr. Klein feels that the only way to correctly diagnose what’s wrong is to spend a lot of time with each patient. Pain medicine is one of the most complicated and detail-oriented specialties in medicine.

“You have to look at the entire person to find the cause of his or her pain, or lack of sleep, or whatever the symptom happens to be,” he says.

His practice attracts patients from all over the country, with some coming from as far away as Europe and China. He has treated everyone from diabetics with nerve pain to colitis sufferers with cramping using his unique approach. In addition to traditional treatments, he finds that many pain sufferers are helped with nutritional supplements and hormone replacement therapy.

“Two-thirds of what I do is actually hormone replacement and nutrition,” says Dr. Klein, who was the reserve flight surgeon to the VIP squadron at Andrews AFB under President Reagan. “When you provide the appropriate nutritional intervention, you may need some prescription medications, but you need far less than are traditionally prescribed to get the job done.”

Dr. Klein believes that many chronic ailments result because people are overweight, but undernourished. Americans take in more than enough calories, but don’t get enough of the right vitamins and minerals. The minerals, in particular, are lacking in what we eat. To deal with this, he offers a line of very specific and focused nutritional products through his practice. “One size does not fit all,” he says.

Lifestyle, age, and genetics can also knock a person’s endocrine system out of whack, causing hormones like testosterone, estrogen, insulin and cortisol to become unbalanced.

“You begin with these common health problems,” he says. “But you can correct them with bio-identical hormone replacement, but it must be done precisely and properly. The safety of my patients is most important. I’m here for one reason, to help them get better. (For more information on this subject, check out Dr. Klein’s column on page 92.)

The Pain Center of Orlando is located at 225 West S.R. 434, Suite 205 in Longwood. For more information or to schedule an appointment, call 407-679-3337 or visit Dr. Klein’s informative website at www.suffernomore.com

Omega 3- Update

Pain Center of Orlando, Inc.

225 W. SR 434 Suite #205

Longwood, Florida  32779

www.suffernomore.com

www.stages-of-life.com

Tel: 407-679-3337

Fax: 407-678-7246

Omega Fatty Acids: The Missing Dietary Link?

Environmental, cultural and practical changes in the industrialized world have resulted in alterations in dietary habits that have had interesting, if not life-threatening implications.  The human physiology has remained relatively unchanged for tens of thousands of years- diet remaining relatively unchanged, but for the periodic and unpredictable famine. Rather suddenly, rapid and remarkable dietary changes occurred.

 Diets rich in fiber, complicated carbohydrates and omega-3 fatty acids were changed to diets poor in fiber, rich in simple carbohydrates and rich in omega-6 fatty acids.  Replacement of simple carbohydrates for the more natural complicated carbohydrates introduces a vulnerability to diabetes, obesity, autoimmune disorders and vascular disease.  Replacement of omega-6 fatty acids for omega-3 fatty acids introduces a vulnerability to inflammatory diseases, vascular diseases and cancer.

The Problem

The human diet influenced human physiology for many thousands of years before the modern age.  Omega-3 and omega-6 fatty acids had been consumed through a combination of vegetable and animal sources resulting in a rather stable ratio between the two classes of oils.  The Western Diet, however, changed, resulting in an increase in the amount of omega-6 fatty acids and a steady decline in the amount of omega-3’s.  As it were, maintenance of the ratio was important for reasons more subtle than simple caloric intake.

Given the fact that the Western Diet has increased omega-6 (pro-inflammatory) fatty acids relative to the omega-3 (anti-inflammatory) fatty acids, the intake of these EFA’s can be adjusted to restore a more normal ratio through the reduction of omega-6’s and the introduction of omega-3 fatty acids. 

Inflammation

Distilled to the essence, the problem is systemic inflammation.  While this may sound a bit simplistic, most elegant problems and elegant solutions are simple in nature. Omega-6 fatty acids metabolize into pro-inflammatory modulators known as prostaglandins and  leukotrienes.  The Omega-3 fatty acids metabolize into anti-inflammatory modulators known as resolvins and protectins. 

Resolvins are compounds metabolized from the  omega-3 fatty acids eicosapentanaeic acid (EPA), and docosahexanoic acid (DHA).   They are produced by through the cyclo-oxygenase  pathway, increased in the presence of  aspirin. Resolvins reduce cellular inflammation by inhibiting the production and transportation of inflammatory cells. Compounds derived from EPA are designated as resolvins of the E series, while those formed from the precursor DHA are denoted as either resolvins or protectins (formerly ‘neuroprotectins’ of the D series.)

Interaction of Omega-3 Fatty Acids and Aspirin

The resolvins and neuroprotectins are distinctive compounds. These lipids are strong anti-inflammatory agents, with immunoregulatory activities at very low concentrations. They are involved in molecular mechanisms that regulate and modulate removal of inflammatory cells and  cell byproducts.  They restore of tissue integrity once the immediate need for an inflammatory response has ended.

Through actions involving resolvins and protectins, aspirin facilitates the resolution of inflammation. At local sites of inflammation, aspirin enhances the conversion of the omega-3 fatty acids EPA and DHA to 18Roxygenated products, resolvins of the E and D series, which are potent anti-inflammatory agents. Low dose aspirin, combined with omega-3 fatty acids is an extremely potent anti-inflammatory combination.

Recommendations

        At this time, in our current social environment, it is very, very difficult to dramatically reduce the amount of omega-6 in our diet. To restore the balance of the 3:6 ratio, it is far easier and faster to increase the intake of omega-3’s. 

1.    Distilled (mercury-free) fish oil, 1,000 to 2,000 mg twice daily.

2.    Olive Oil- 1 ounce daily. 

3.    Aspirin 82 to 164 mg per day.

4.    For diabetics- add Alpha Lipoic Acid 250 mg 3 times, daily.

There are many good quality fish oils on the market.  Unfortunately, there are many more poor-quality products available.  Getting high quality does not necessarily take a great deal of expense, but you rarely get quality ‘on the cheap.’

We use (coincidentally) our line of products by ‘Stages of Life, Inc.’  These are pharmaceutical grade, and offer a good value.

1.      Heart & Sole- bottles of 120                       

2.      Alpha Lipoic Acid 250 mg- bottles of 120    

The Olive Oil can be obtained at the grocery store, as can a good quality aspirin (I prefer St Joseph's Baby Aspirin). 

David S. Klein, MD, FACA, FACPM      407-679-3337

www.suffernomore.com

www.stages-of-life.com

www.kinkease.com

Vanadium and Diabetes

Mineral Metabolism:   Vanadium - Insulin receptor activity

This is a very important abstract, below.  While a bit on the technical side, it is interesting to understand that there is well understood science behind the use of certain trace minerals in the treatment of diabetes.

This is partialy explains why the use of 'organic trace minerals' is so important to general health. The balance of vanadium and chromium is delicate, and it is dangerous to simply 'throw' supplements at a patient and expect anything but trouble.

Both vanadium and chromium are necessary for health, but too much is toxic. Chromium should be in the 'polyniccotinate' salt, not the piccolonate form, that is generally available.

Mehdi MZ, Srivastava AK: Organo-vanadium compounds are potent activators of the protein kinase B signaling pathway and protein tyrosine phosphorylation: mechanism of insulinomimesis. Arch Biochem Biophys. 2005 Aug 15;440(2):158-64.

    Organo-vanadium compounds (OVC) have been shown to be more effective than inorganic vanadium compounds in ameliorating glucose homeostasis and insulin resistance in rodent models of diabetes mellitus. However, the precise molecular mechanism of OVC efficiency remains poorly defined. Since inorganic vanadium compounds have been found to activate several key components of the insulin signaling cascade, such as protein kinase B (PKB), the objective of the present study was to investigate if stimulation of PKB and its downstream target glycogen synthase kinase-3 (GSK-3), are responsible for the more potent insulinomimetic effects of OVC. 

NOTE WELL:  In the nutraceutical treatment of diabetes, it is important to recognize that the use of minerals, such as vanadium and chromium can be tricky.  Start slowly, with low dosages of these minerals and increase slowly, or blood sugars can drop too quickly, resulting in dizziness, loss of consciousness and 'insulin shock.' 

One nice side-effect of the use of vanadium & chromium is that insulin levels will down-modulate, resulting in weight loss.

Two products that work well for this are: 

1. 'Diaxinol' which is manufactured by Orthomolecular Products, Inc.
2. 'Diatain' which is manufactured by Progressive Nutrient Solutions, Inc.

David S. Klein, MD

Pain Center of Orlando, Inc.

www.suffernomore.com

---

So you want to keep gaining weight, eh?

The sweetener fructose, sometimes labelled as 'high fructose corn syrup,' is found in many processed foods, soft drinks and confections. 

NOTE WELL:  This is the carbohydrate found in those wonderful fruit drinks that we feed our little children. This may be one of the main issues leading to pediatric obesity.

It has  been found to cause leptin resistance, one of the hormones found to control hunger, thereby linking it directly to weight gain and obesity.

Shapiro A, Mu W, Roncal CA, et al: Fructose-induced leptin resistance exacerbates weight gain in response to subsequent high fat feeding. Am J Physiol Regul Integ Comp Physiol. 2008.

Blended Medical Approach to the Treatment of Diabetic Peripheral Polyneuropathy

 

 

Blended Medical Approach to the Treatment of Diabetic Peripheral Polyneuropathy

Of the many dangerous and unpleasant sequelae of diabetes, the complaint of burning foot pain is probably the most common.  As many as 60 to 70 percent of diabetics have some form of neuropathy, with risk rising with age of the patient and with duration of the illness. Diabetic neuropathy tends to be more prevalent in patients with poor blood sugar control and elevated triglycerides, high cholesterol, elevated blood pressure and obesity.

Diabetic neuropathy is metabolic in nature.  Entrapment or occlusive neuropathy is structural in nature. 

Symptoms

Symptoms of diabetic nerve damage may include:

1. numbness, tingling, or pain in the extremities
2. muscle wasting in the feet or hands; muscle weakness
3. gastrointestinal complaints of indigestion, nausea, or vomiting, diarrhea or constipation
4. blood pressure instability resulting in dizziness or faintness due to a drop in blood pressure after standing or sitting up
5. urinary symptoms including urgency, hesitancy and incontinence
6. erectile dysfunction

Sensory nerves, autonomic and motor nerves can be damaged by poorly controlled diabetes.  The autonomic nerves tend to be the first to be affected, followed by the sensory nerves, and lastly by the motor nerves.  Nerve damage is usually symmetric, beginning in the lower extremities and working toward the trunk. 

Focal neuropathy can appear in specific nerves, most often in the head, torso, or lower extremity. These focal neuropathies may cause:

1. inability to focus the eye, double vision, unilateral eye pain
2. facial paralysis
3. pain in the lower back or pelvis, thigh, chest and  stomach
4. pain on the outside of the shin or inside of the foot

Focal neuropathy is sudden in nature, painful and unpredictable.

Compressive neuropathies are common in diabetics. Carpal tunnel syndrome is very common in diabetics as well as in patients with hypothyroidism. Entrapment of the Medial and Lateral Plantar Nerves occur commonly, as well. 

Co-Morbid Pathological States

Hypothyroidism is common in the general population, but it is even more common in the diabetic patient population. Unrecognized hypothyroidism can result in difficult diabetic control, and hypothyroidism commonly predisposes to focal entrapment neuropathies.  Autoimmune hypothyroidism is more common in diabetics than in the non-diabetic population, and diagnostic blood work must take this possibility into consideration.

Diabetes affects the gastrointestinal tract thereby impairing absorption.  Malabsorption of micronutrients, including zinc, selenium, vanadium, chromium, magnesium and manganese can result in adrenal dysfunction resulting in steroidal hormone imbalance.  Malabsorption of B-complex vitamins, Vitamin K-2 can result in adrenal dysfunction and promote inflammatory conditions. 

Due to the anticipated Malabsorption state, diabetics require far greater doses of these micronutrients than would be expected of the otherwise healthy patient.  Thoughtful supplementation of these micronutrients can improve diabetic blood sugar control, facilitate weight loss, improve vascular flow and reduce pain.

Diagnostic Dilemma

Unfortunately, foot and hand pain is a complaint commonly encountered in the general population.  Often caused by commonly encountered clinical disorders, such as median nerve entrapment and plantar nerve entrapment, and equally often precipitated by clinical conditions such as hypothyroidism, obesity and fluid retention.   In the non-diabetic patient, the diagnostic workup often includes electromyography, sensory nerve conduction velocity testing and somatosensory evoked potential testing (SSEP).  The EMG may demonstrate pathology late in diabetic neuropathy due to the late involvement of motor fibers.  Sensory nerve conduction testing demonstrates nerve pathology earlier. SSEP is useful for evaluation of optic, auditory and certain specific neuropathies.

In the diabetic patient, all too often, the foot pain is dismissed as ‘diabetic neuropathy’ with very incomplete workup.  This is probably the single factor that leads to the inadequacy of treatment and symptom management. Entrapment neuropathy is treated very differently than metabolic neuropathy.

First and foremost, the patient must be properly evaluated for the presence of entrapment neuropathic syndromes as well as musculoskeletal problems that result in referred hand and foot pain.

Treatment

There are many approaches to the treatment of diabetic polyneuropathy.  The need for strict blood glucose control cannot be over-emphasized.  After that, it is necessary to appreciate the nutritional issues that can prevent neural self-repair. 

Mineral Supplementation:  First attention should be placed with mineral supplementation.  Minerals are poorly absorbed unless ingested as organic salts, sometimes referred to as ‘chelates.’  The most common vitamin and mineral preparations use inorganic salts, and these minerals are very poorly absorbed, if at all. Adequate amounts of zinc, selenium, vanadium and chromium are essential.   Additional vanadium and chromium can be introduced after a few weeks or so, which can be expected to result in lower blood sugars.

B-Complex:  Diabetics can be expected to be relatively deficient in B-12 as well as in Pantothenic acid, B-2, B-6 and inositol.  Generous dosages of a B-complex are an easy and inexpensive intervention. 

Alpha Lipoic Acid (ALA) has been used widely for the treatment of diabetic neuropathy. Dosages of 250 to 500 mg, taken 3 to 4 times daily, ALA can provide pain relief in as little as a few days, but it frequently takes a few weeks or more to reach peak effectiveness. 

ALA may upset the stomach, but the effect is transient and minimal in most cases. It is most effective if co-administered with a high-quality fish oil, 1-2 grams, twice daily.

Lyrica® (pregabalin) is an interesting calcium channel modulator.  While many anti-convulsants demonstrate efficacy in the treatment of DPN, Lyrica® may be unique in the medication armamentarium.  One salutary side-effect of Lyrica® is sleep restoration. Starting with bed time dosages of 50-75 mg, the dosage is increased linearly, by 50-75 mg increments, on a weekly or biweekly basis.  Generally, effective dosages will range between 75 and 300 mg.  Absorption is linear, and side effects are mild, if dose-titration is done slowly and with care.

Summary

The painful symptoms of diabetic neuropathy may be best controlled using a blend of nutritional and traditional medicine.  Diabetic control can be facilitated with the use of a variety of ‘natural medicines,’ only a few of which are presented, above.

When combined with the traditional pharmacological medical approach, clinical improvement is more rapid and patient satisfaction improves.

Only a few, basic suggestions are outlined above.  The molecular basis for the recommendations made above are well founded in the medical and scientific literature. 

David S. Klein, MD, FACA, FACPM

www.suffernomore.com                  www.stages-of-life.com

Nutrition and Diabetes Prevention

I had done a brief article on nutritional intervention and prevention of diabetes. 

It is important to realize that diabetes does not begin when blood sugars start to rise over '100 mg/dl.'  The problem begins, in ernest, when insulin levels climb above 10 microunits/ml.

The ratio of glucose to insulin should be greater than 10:1.  When insulin levels climb above 10, the ratio drops below this benchmark, and the risk of developing diabetes increases.  When the level of insulin exceeds 20, it is far more likely than not that the patient will develope adult onset diabetes.

What is more interesting is that as insulin levels increase, fat deposition increases.  This may be why people get fat some time before they develope frank 'diabetes.' 

The key to this issue is making the cells more sensitive to insulin, thereby reducing serum insulin levels necessary to maintain 'normal' blood sugars.  This can be accomplished with the use of balanced mineral salts, including chromium and vanadium. These minerals are necessary for proper function of the insulin receptor, and mineral deficiencies involving these two cations may be the missing link in the 'mystery' surrounding our obvious epidemic of weight gain.

It is extremely important to note that not all chromium and vanadium cations are effective. This is true of most minerals, including iron, which is non-bioavailable if presented in the wrong type of salt. 

I have more written on this in my article, which is obtainable through the link, below: 

http://www.stages-of-life.com/articledetails.aspx?id=4

David S. Klein, MD, FACA, FACPM

Enlightened approach to diabetic neuropathy

New Diabetic Neuropathy Treatment Options

There has been a good bit of advertisement for a number of 'new products' for the treatment of diabetic neruopathy. Some of these products are very impressive, some, well, not so much.

I have been having some pretty good results using a combination of nutritional intervention with a recently introduced anti-convulsant "Lyrica." 

The trick to using Lyrica is using it principally at bed time, using a dosage sufficient to introduce deep sleep.  Generally, if the patient awakens feeling a little groggy, the dosage is close to being enough.  Introducing a good night's rest is important for general health, but in the treatment of diabetic neuropathy it is a major blessing. Starting dosage is 50-75 mg at bed time, although the higher dosage seems to work better.  Increase to 150 mg and then 225 mg on 2-3 week intervals.

In addition to the Lyrica, and equally important, is the use of alpha lipoic acid (ALA).  The dosage to introduce is 250 mg three times daily.   After a few weeks, the dosage can be doubled, if the symptoms have not gotten significantly better (which they usually do.) 

The combination is quite effective, about 80% of the time.

David S. Klein, MD, FACA, FACPM