Browse through the alphabetical listing of health conditions in the above drop down menu. Learn more about a specific condition, treatment options based on scientific evidence and how the treatment works.

In using this section, it is important to understand how the research and review articles were selected. No attempt was made to be comprehensive. Rather we sought to provide reliable information from scientific studies on the integrative approaches that have been studied for each health condition and the significant results to date.

Our priorities in selecting articles included the most recent studies or reviews, the largest clinical trials, publication in peer-reviewed journals, and the highest quality studies available on each topic(such as randomized, double blind, controlled clinical trials, systematic reviews).

This section is for information purposes only. The treatment approaches listed are often provided in conjunction with standard medical therapy. No treatment should be initiated, nor any treatment stopped, without first consulting your healthcare practitioner.

We are continually in the process of adding summaries of new research studies for each of the health conditions on the drop down menu. Please check back for new information. Our Research and Guidelines section also offers summaries of research studies on the use of the different therapeutic modalities.

CDC’s Travlers’ Heatlh Website
www.cdc.gov/travel
You can visit it for information when you’re planning a trip abroad. Learn about vaccines, medicine and general travel advice.

Water Saftey Tips: Children Under Age 4 Are At Highest Risk For Drowning
View these articles for tips from the CDC and Safekids.org on keeping children safe in the water. http://tinyurl.com/cvtje3a or http://tinyurl.com/7odqdhz.

Vaccine Storage and Immunity
In order to ensure the immune potency of our vaccines, the Center’s protocol regarding vaccine storage is as follows:

Nursing staff monitors the medication refrigerator/freezer twice daily and the temperature is recorded on a log sheet located on the refrigerator door. (Ref Range should be 36–46 degrees Fahrenheit/ Freezer is 2-8 degrees Celsius)

Monthly inspections are performed and mandatory forms completed and faxed to the Beth Israel Pharmacy

Beth Israel sends a pharmacist to the Center quarterly who inspects refrigerator temperatures, log sheets and expiration dates on all vaccines and medications

Vaccines are ordered a minimum of twice a month with expiration dates reviewed and stock rotated accordingly

FDA Revised simvastatin (Zocor) warning
Visit the FDA website for information on the use of this medication at a dose of 80 mg a day. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm257884.htm

How to Dispose of Unused Medications: Advice from the FDA
Visit the FDA website for their guidelines on proper disposal of prescription medications
www.fda.gov/ForConsumers/ConsumerUpdates/ucm101653.htm

Recall of certain over the counter infant and children’s products
Product Recall information

McNeil Consumer Healthcare in consultation with the U.S. Food and Drug Administration (FDA) is voluntarily recalling all lots that have not yet expired of certain over-the-counter (OTC) children’s and Infants’ liquid products. Some of the products included in the recall may contain a higher concentration of active ingredient than is specified; others may contain inactive ingredients that may not meet internal testing requirements; and others may contain tiny particles. While the potential for serious medical events is remote, the company advises consumers who have purchased these recalled products to discontinue use.
You can visit their website www.mcneilproductrecall.com to learn more information and the specific products being recalled.

Flu information

PREVENTION is always the most important way to reduce the chance of getting sick in the first place. Some important strategies include:

• Wash your hands frequently especially before you eat, after taking public transportation, and especially during symptoms of cold or flu such as coughing or sneezing
• Retire at a reasonable hour and sleep
• If you feel you are coming down with something –REST. Rest strengthens your immune system
• Avoid caffeine and foods that disturb sleep
• Take care to dress according to the weather. Cover your head and neck if it is windy or cold.
• Eat nourishing warm cooked meals several times a day to keep up your strength
• Include 6 helpings of dark leafy greens, yellow-orange red colored vegetables and fruits. These foods provide lots of vitamins useful for enhancing your immune system. We often recommend selecting organic sources if possible.
• Practice stress reduction/ relaxation techniques daily. Here is an example of one you can access from the Internet www.healingchronicpain.org/content/relax/default.asp.
• Avoid direct contact with people who are ill
• If you are sick stay home. You will recuperate faster and it will prevent others from catching your illness

IF YOU DO GET SICK:
Symptoms include fever, cough, sore throat, runny nose, body aches, headaches, chills and fatigue.
Some people have vomiting and diarrhea, and some people with H1N1 have respiratory symptoms without fever.

Stay home, rest and drink fluids. Acetaminophen or ibuprofen can be taken to help relieve symptoms.
See our web site or speak to your provider about botanical, homeopathic and other modalities to prevent and treat colds and flu.
Children under 18 with flu-like symptoms should not be given aspirin due to the risk of Reyes Syndrome.
Children under 4 should not receive over the counter cold remedies without discussing this with your healthcare provider.

If you are not in a high risk group and have mild flu symptoms treatment is not necessary. Most people with flu recover without complications in 3-7 days. If you are in a high risk group or have contact with those who are or have worrisome symptoms such as breathing difficulties, severe vomiting or diarrhea it is important to contact your healthcare provider as soon as possible to discuss management.

Antiviral drugs oseltamivir (Tamiflu) or zanamavir (Relenza) are recommended for all high risk groups and for people caring for people at high risk which includes children less than 5 years old (especially those under 2 years) or over 65, pregnant women, people with chronic medical conditions such as asthma, diabetes, chronic heart and lung problems, neuromuscular disorders and immune suppression.

Contact your healthcare provider as soon as possible because treatment is most effective if started within 48 hours.
In most cases a treatment decision can be made based on your history. Rapid in-office testing is not reliable and routine testing takes too long to help in the decision to treat. High risk patients can discuss with their provider about having a prescription on hand to facilitate early treatment if needed.

IF YOU ARE EXPOSED TO THE FLU:
For people who have had close contact with someone with the flu, treatment with antiviral medications should be considered if you are in a high risk group or have close contact with someone in a high risk group.

Exposure is defined as having close physical contact with someone with the flu. Casual contact is not considered a reason to treat.

The infectious period of the flu is 24 hours before symptoms start to 24 hours after fever ends. In some cases (mainly children) people can remain infectious up to 7 days or more after getting sick. Treatment is 70-90% effective in preventing the flu if taken within 48 hours of exposure to susceptible strains. Alternatively, one can wait to see if symptoms develop and treatment can be started at the earliest sign. This decision is best made together with your healthcare provider.

For more information on the flu go to www.cdc.gov/flu or call 1-800-232-4636.

We wish you all a season of health and healing.

Center approach to Vitamin D testing and supplementation

Center practitioners have reviewed the literature and discussed the results regarding our approach to Vitamin D testing and supplementation after the release of the Institute of Medicine report on “Dietary Reference Intakes for Calcium and Vitamin D” released in November, 2010.

Much of the confusion arose around the blood level of Vitamin D that was considered adequate and if testing and supplementation is recommended. The committee set the adequate level at 20 ng/ml and stated that most Americans are at that level and don’t need to do anything to raise their levels. Many vitamin researchers disagree and believe the optimal level to be higher at 32 ng/ml. We know that most of our patients are below 30 ng/ml without supplementation.

Everyone agrees that blood levels of Vitamin D under 20 are associated with poor health outcomes including increased mortality from all causes, increased risk of developing and dying from osteoporosis, diabetes, autoimmune disease, heart disease, depression and several types of cancer. Many studies have demonstrated benefits of higher levels of vitamin D up to 40ng/ml.

Despite the statement that most Americans don’t have to do anything to raise their Vitamin D level, the Institute of Medicine panel increased the recommended daily intake of Vitamin D from food and supplements for everyone above age 1 year from 200 IU to 600 IU and for those over 71 to 800 IU. The IOM expressed concern about high blood levels being associated with increased mortality, specifically with levels above 40 ng/ml but they also determined that these high levels were unlikely to be reached by anyone over 8 yrs old at intakes under 4000 IU day so they raised the upper tolerable limit for Vitamin D from 2000 IU to 4000 IU and even stated in the report that an intake of 10,000 IU day was unlikely to cause harm. The upper tolerable limit for age 0-6 months was set at 1000 IU, 6-12 months 1500 IU, 1-3 years 2500 IU and 4-8 years 3000 IU.

An interesting point about vitamin D is that at higher levels it induces its own destruction. It is easier to increase levels when it is low but as Vitamin D levels go up so does the activity of an enzyme that inactivates it. The result is that for most people it is easier to get their level up to 20 but above that, the rise is more difficult and less predictable. For people who take high doses and suddenly stop, their levels may fall more than people who take none or moderate doses. Also people who get a lot of sun in the summer and don’t supplement in winter may have lower levels in winter than people who don’t get a lot of summer sun.

Most of us agreed that the evidence supports aiming for Vitamin D levels between 30-40 ng/ml and that it is safe to recommend supplementation for infants, children and adults of 1000 — 4000 IU day.

Martin Ehrlich, MD
Medical Director
Continuum Center for Health and Healing

References:

1) Institute of Medicine vitamin D Report Brief, November, 2010.
http://www.iom.edu/~/media/Files/Report%20Files/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/Vitamin%20D%20and%20Calcium%202010%20Report%20Brief.pdf

2) Holick MF. Vitamin D: Evolutionary, Physiological and Health Perspectives. Curr Drug Targets. 1;12(1):4-18, 2011. http://www.ncbi.nlm.nih.gov/pubmed/20795941

3) Vitamin D and Calcium – systematic review – Agency for Healthcare Research and Quality (AHRQ), May, 2010.
http://www.ahrq.gov/clinic/tp/vitadcaltp.htm

4) Leo Galland, MD. New Vitamin D RDA and Vitamin D Deficiency. http://pilladvised.com/2010/12/new-vitamin-d-rda-and-vitamin-d-deficiency