How harmful are diagnostic X-rays?

How harmful are diagnostic X-rays?

Jose Mahfoud, ND, MSc

In the age of Google, patients have an extensive availability of information at their fingertips. A great amount of this information can be misleading, when taken out of context. At times, information from by patients can be false and even dangerous. Some patients make decisions based on what they read online, with little or no research to confirm the information.

As a licensed naturopathic physician, I have encountered several patients who have expressed concerns about the dangers of radiation from imaging studies, such as x-rays and CT scans.  These are valid concerns and it is our duty as educators to inform the patient of the reality of the situation, while providing them with a reasonable explanation about the risk/benefit ratio of these diagnostic tools.

X-rays were discovered in 1895 by German physicist Wilhelm Röntgen (Roentgen).  He made his discovery by accident while experimenting with electron beams.  A few years later, Marie Curie and her husband discovered the elements radium and polonium, and used the term “radioactivity” for the first time.

X-rays are a kind of energy called “ionising radiation”, which means that objects become electrically charged when exposed to it.  This includes living tissues.  X-rays can split molecules, creating “free radicals”, and can also damage DNA.  The degree of this damage changes with the intensity of the X-ray beam and the time and frequency of exposure.  DNA damage is one of the key factors in the development of cancer.

Science has come a long way since the discovery of radioactivity, and it is undeniable that the proper use of this powerful kind of energy plays a vital role in science and medicine.  Many diseases would be impossible to diagnose and, many lives would be impossible to save, without the use of X-rays.

As a standard of care, imaging studies play a main role in the diagnosis, management and follow-up.  The benefits of imaging studies may outweigh the risks from radiation, given their indication through proper medical judgement.  For example, in a 70 year-old smoker of 50+ years, the relative risk from a 2-view chest x-ray is minimal, estimated to be 1 in almost 300,000; this is considered to be negligible when compared to the risk of cancer and COPD from a long-standing history of smoking.  The same patient would have an estimated baseline cancer risk of at least 37.5% from age alone, according to some sources.

Of course, the risk increases with time and intensity of exposure.  CT scans and other more specialised forms of diagnostic procedures deliver significantly more radiation but, when indicated, their benefits may very well outweigh the risks.

If you would like to know more about the risks from x-ray exposure, you can find more information on http://www.xrayrisk.com/index.php.  [I am NOT affiliated in any way with this website]

Topical Magnesium Sulfate: its effectiveness in question

Topical Magnesium Sulfate (Epsom Salts baths): its effectiveness in question.

Jose Mahfoud, ND, MSc

MgSO₄ is used in medicine both orally and intravenously, and it certainly has concrete effects through these routes.  Intravenously it is used in the treatment of preeclampsia and as a tocolytic; orally it acts as an osmotic laxative. It is also very popular as a folk remedy for treating musculoskeletal pain, and for removing “toxins” from the body. When challenging the validity of traditional remedies one often encounters resistance from some members of the Alternative Medicine community (both professionals and patients), who sometimes feel very strongly about certain topics, being one of them the topical use of MgSO₄ (Epsom Salts baths) for the relief of musculoskeletal pain and the popular concept of “detox”.

 No adequate studies have been published regarding MgSO₄ and its transdermal delivery.  Most sources that claim Magnesium is systemically absorbed through the skin lack scientific basis and their statements are anecdotal.  One small study is found to be repeatedly referenced by supporters of Magnesium transdermal delivery, some of which also claim that it is best achieved by applying “Magnesium Oil”, which is not truly an oil but a saturated aqueous solution of Magnesium Chloride (MgCl₂), which behaves in a similar manner as Magnesium Sulfate in terms of dissociation.

MgSO4 is a white crystalline substance, highly soluble in water and alcohol but insoluble in oil, with a molecular mass of 120.366 g/mol (1 g/mol is equivalent to 1 Da).  Like other salts, when dissolved in water it dissociates in Mg⁺² and SO₄^-2.  Similarly, Magnesium Chloride dissociates into Mg⁺² and 2Cl.  Dissociation in an aqueous solution occurs when water molecules bind to each of the ions that form the original substance, therefore breaking apart the crystalline form.  If we were to dehydrate this solution, the ions once again form bonds between each other, reconstituting the salt crystal.

Therefore, an aqueous solution of Epsom Salts makes it nearly impossible for Mg^-2 to cross the epidermal layer, due to its necessary bond with water molecules and, as we know, the stratum corneum is largely impervious to water, but highly permeable to oils.  Magnesium sulfate is not liposoluble, hence no transdermal absorption of the compound (nor its ions) occurs.  It lacks two of the three conditions necessary for a drug to be absorbed through the skin.  If any magnesium were in fact absorbed through the skin the amounts would be negligible, with no perceivable effect.

For a drug to have good transdermal delivery, it must be:

1.   of low molecular mass (<500 Da)
2.   highly liposoluble
3.   potent enough [low required daily dose (<2 mg)] [1]

The analgesic (and often spasmolytic) effect attributed to topical MgSO4 is most likely due to the vasodilating and relaxing effects of heat (warm water)or, even perhaps, the placebo effect.  If it were that easy for magnesium to be absorbed transdermally, one can infer that sodium (as NaCl) in sea water would be similarly absorbed (if not more, due to sodium’s smaller mass compared to magnesium) every time we go for a swim.  Such instance would be highly detrimental to one’s health, especially due to sodium’s well known effects on blood pressure.

Magnesium is best obtained orally, mainly from foods like almonds, spinach, cashews, beans, etc., which provide a good (bioavailable) source of the mineral. Nutritional supplements may also be used should they be indicated to treat deficiency, or if dietary intake is deemed insufficient.

---

[1] Transdermal drug delivery: principles and opioid therapy.  Lyn Margetts, FRCA and Richard Sawyer, FRCA FIPP.  http://ceaccp.oxfordjournals.org/content/7/5/171.full Accessed 8-7-2014

El Sueño Dominicano 

Un pueblo alegre, con reputación de hospitalario y lambón; familias que pasean en  el malecón al atardecer, tres suculentas comidas en la mesa y un sistema educativo gratuito de primera... Si tan solo fuera cierto...

¡Si tan solo existiera esa realidad en esta isla decimal; si tan sólo fuera más que cero!

Cero % destinado a la educación de los que ahora crecen con panzas llenas de azúcar y otras baratijas inflamatorias, sucio el cerebro de música popular y personalidades cinceladas por dos comediantes. 

El Sueño Dominicano no es uno a desear.   Podria pensarse pacífico, despreocupado, paradisíaco, y perderse los tweets de protesta de tres gatos en contra de los impuestos. "Tres gatos",  irrelevantes y desorganizados, así ve la monarquía al pueblo. Los usa, abusa, e ignora en la misma medida que se limpia el culo con la constitución, habiéndose cagado sobre los derechos humanos. Trujillo sobrevive en secreto y su evidencia es la censura en la prensa. Al final del año 2012, en esta "Pequeña New York", como le quiso llamar una vez un ladronaso,  nuestra prensa local, vista como quasi patrimonio por alguna generación anterior, publica especiales de venta de telas y la victoria de Obama en primera plana. 

En el Sueño Dominicano la prensa besa culos vestidos de Armani, y llena su panza en la misma mesa servida por algun sonámbulo desnutrido que solo busca alimentar a sus crias raquiticas. 

El verdadero Sueño Dominicano es un profundo sopor, legado del arduo trabajo de un viejo verdugo durante doce años. Es un mundo onírico donde los hombres nacen castrados y sin voz, solo las mujeres hablan, pero los golpes de sus maridos celosos y ebrios ahogan sus gritos. 

El Sueño Dominicano es uno que provoca despertar, pero el murmullo del dembow rapidamente arrulla al pobre durmiente. 

No dan ganas de soñar este sueño, dan ganas de pararse del catre y salir gritando, pero los hombres dominicanos son mudos.  Muchos prefieren acurrucarse con las chinches, perderse las noticias de protesta en su propio patio, y aunarse a la besadera anal de los nobles. 

Se escuchan rumores de que algunos han despertado, o al menos se dieron cuenta de que sueñan, y dicen las malas lenguas que hay una nueva raza de ojos abiertos y cojones intactos... tan intangibles como los dioses, leyendas y parábolas que inspiran el llanto al imaginar que existieran.  

Pero algo hermoso ocurre hoy, y el aroma del café anuncia el alba de un día en el que ya muchos pierden la capacidad de soñar, y empiezan a pensar. 

Despertar del Sueño Dominicano es el paso evolutivo mas importante de nuestra historia, y los que ya no duermen siguen despertando a otros con el ruido de las ollas y palos, o con el escopetazo en el pecho de Willy. 

Nos dicen los entrevistados que en su sueño el presidente era bueno, pero siempre estaba de viaje. Algunos dicen que lo vieron cogiendo al pueblo de pendejo. 

El pueblo en coma, tres gatos descojonados, mujeres de cara inflamada y labios rotos, tributos exhorbitantes y abuso a manos de simios armados; eso resume este día en la isla decimal. 

El Sueño Dominicano terminará cuando la masa roncante se de cuenta de que tiene el poder... Todo el poder de hacer de la Republica Dominicana algo de lo que podamos sentir al menos algo de orgullo una vez mas. 

Lo que MORINGA no puede curar.

Panacea: Remedio que buscaban los antiguos alquimistas para curar todas las enfermedades

---------------------------------------------

Hace pocos meses se empieza a escuchar el ruido... un murmullo in crescendo que sonaba muy familiar, como si lo hubiésemos escuchado antes.  Desde cierto punto de vista, no es más que la historia repiténdose de nuevo, ya no con el Noni, sino con la Moringa.

Innumerables personajes afirman con vehemencia las propiedades curativas casi milagrosas de esta antigua planta que tiene su origen en La India, Moringa oleifera (Moringa pterygospermia).  Se le atribuyen propiedades curativas desde Asma hasta Diabetes y Cancer, y con alegaciones como estas, es natural que la gente quiera encontrar una solución mágica para sus problemas de salud.  No podemos culpar al pueblo por querer sanarse, sobre todo si el remedio les quita la dolencia, a la vez que le excusa de la responsabilidad de cuidarse a sí mismos; ¿Quién de nosotros no quisiera tomar una taza de té en la mañana, y no necesitar ya la diálisis, la cirugía o las medicinas recetadas?...  ¿Cuántas personas en el mundo desearían poder comer todo lo que deseen, usar alcohol y otras drogas (legales o no) tan frecuentemente como puedan, sin que esto les haga daño?

Lamentablemente, la Moringa no es ninguna panacea, y es poco probable que por sí sola pueda curar la mitad de lo que se le atribuye.  En cambio, la moringa es una planta con un alto contenido de nutrientes y sustancias que HAN DEMOSTRADO SER EFECTIVOS EN EL TRATAMIENTO DE CIERTAS ENFERMEDADES, en estudios clínicos.

Si bien la Moringa prácticamente carece de toxicidad, y no puede asegurarse que curará el Cáncer, definitivamente sería una buena adicion a la dieta dominicana, ya que contiene un alto contenido de antioxidantes.  En los últimos 20 años ha bajado alarmantemente la calidad de lo que se come en nuestros hogares.  Las comidas procesadas y artificiales, saturadas de azúcar, han invadido nuestras despensas, como una triste imitación de la Dieta Americana Estándar.  El efecto de consumir estos alimentos artificiales y "desvitalizados", es un estres oxidativo mayor, lo que predispone a ciertas enfermedades.  Asimismo, nos beneficiaríamos de consumir alimentos integrales y frescos, usar un buen suplemento multivitaminico, hacer ejercicio, y practicar buena higiene personal, mental y ambiental.

En la República Dominicana, los medios de comunicación han sido en parte responsables por causar una especie de histeria colectiva que ni la moringa ha podido curar; es de hecho su causa.  De ninguna manera debe culparse a la prensa por su servicio a veces imparcial, pero si son responsables de facilitar el que la mala (e incompleta) información se difunda de  manera "viral".  El público en general prefiere no preocuparse mucho, y les es más cómodo que les digan qué hacer...  El resultado de este comportamiento compulsivo masivo son falsas esperanzas y la potencial extinción de la moringa por la cosecha irresponsable e indiscriminada.  Otro posible efecto nocivo de esta novedad, sería la intoxicación con plantas que hayan sido vendidas como Moringa, ya sea que hayan sido adulteradas o se hayan contaminado por error.  Ni hablar del control de calidad, inexistente en este momento.

Existen tambien profesionales de la salud que han emitido advertencias contra el uso indiscriminado de la planta, alegando que puede ocasionar problemas en hígado y riñon.  Esto simplemente carece de funtamento.  De hecho, se sabe que Moringa protege al hígado en caso de envenenamiento con acetaminofén, entre otros.  En la RD, habita en la mente colectiva de nuestros Médicos, que TODAS las plantas medicinales son tóxicas para el hígado, y por tanto deben evitarse a toda costa; y todo esto con una insistencia terrible y ominosa.  Entendemos que las recomendaciones de estos profesionales protegen a muchas personas que por ignorancia o irresponsabilidad, se harían daño al usar ciertos remedios caseros, pero estamos en desacuerdo con hacer de esto una ley.  No se sabe de ningun caso de toxicidad hepática  ni renal a partir de la Moringa, al menos no aparecen en nuestras fuentes de referencia.

En conclusión, la Moringa no es una panacea, ni ninguna otra planta o suplemento tampoco.  Podría usarse Moringa como parte del tratamiento de algunas enfermedades, pero de ningun modo puede llamarsele "la cura".  La planta tiene propiedades antioxidantes, antiinflamatorias y antimicrobianas importantes, y en general podría ser una buena adición al regimen alimenticio de la población general.  Esto no quiere decir que todos deberian usarla.  Se necesitan más estudios de su eficacia, y una actitud más moderada y conservadora respecto a la moringa y otras terapias.  Esperamos que se encuentre pronto la cura para la histeria colectiva que abraza a la República Dominicana, y pensamos que la educación es el remedio que más necesitamos los dominicanos.

Losing pounds while you sleep!

Few things feel better than waking up totally refreshed after a good night sleep.  For good health, it's necessary to get daily, consistent, quality sleep time.  It is known that sleep deprivation and sleep disorders can have a negative impact on your quality of life, affecting both mental and physical health.  Several studies over the past six years have found a strong link between sleep deprivation and weight gain.  The researchers found in those studies that women who slept 5 hours or less per night had a 15% higher risk of becoming obese, and  a 30% higher risk of gaining 30 pounds compared to women who slept 7 hours per night.

Sleep-deprived people may be too tired to exercise, or since they are awake longer, have more chances to eat, making them take in more calories, or simply because of the high anxiety level that sleep deprivation causes; lack of sleep also disrupts the balance of hormones such as cortisol and other ones that control the appetite, so sleep-deprived people may be hungrier than those who get enough sleep.

When asleep the body enters in a "recovery phase", and this time must be long enough and be of good quality so we can wake up refreshed and with that feeling of being full of energy as the day starts.  Naturally, our body follows what is known as "Circadian Rhythm" or "Body Clock", and it is synced with the cycles of light and darkness of our planet.  In other words, nature has designed us to rise and fall with the Sun.  We have thrown off this balance by our modern-day lifestyle, which adds to our stress load everyday by staying up late, and indulging in a disorganized and often excessive, unhealthy diet.

Foods that may interfere with a good nightly rest include stimulants such as coffee and other caffeinated beverages, so avoiding them especially in the later times of the day, can help assure good quality, extended sleep.  

Lately there has been a lot of talk about the glycemic index in your diet, which is a way of measuring how much a certain foods make your blood sugar rise.  By eating a diet rich in carbohydrates and low in protein, fiber and good quality fats, the insulin-cortisol balance is thrown off, causing problems like excessive appetite, high blood sugar, fatigue, inflammation, immune depression and insomnia.

There are many ways to treat sleep disorders ranging from lifestyle changes to less conservative approaches like prescription medication.  Many medications can work for some time, but most of them carry side effects and their benefit wears off as our body becomes dependent on them, needing to increase the dose of these often toxic chemicals.  Luckily, there are natural treatments that have proven safe and effective in treating sleep disorders, especially insomnia; one of these is Melatonin, which is a hormone naturally produced in our brain, that induces sleep as part of the Circadian Rhythm.  Herbs like Valerian, Chamomile, Catnip and Hops can be of tremendous help with anxiety and sleeplessness, taken as a tea, capsules or tincture form.  These herbs are mild, virtually non-toxic, and are often well tolerated by most people.  There is a very slight potential for side effects with these natural alternatives, and that is why I recommend you consult your healthcare provider before taking any of these herbs/supplements.

Acupuncture is another treatment modality that has been shown to help in cases of insomnia, and general stress.  This ancient Chinese healing method works best when combined with a balanced, personalized diet and appropriate herbal medicine.  It is strongly recommended that Acupuncture be administered by a fully trained and licensed professional.

If you have been trying to lose weight and find it difficult, maybe it would be worth looking at your amount and quality of sleep, without getting fixed on the idea that medication is needed in all cases.  Remember that it is NOT normal to wake up unrefreshed or tired in the morning, although it is quite common in today's society.  I encourage you to seek professional opinion if you want help with your weight management and/or sleep health, and I suggest you explore the many options that Naturopathic and Chinese medicine have to offer.

RESVERATROL: not enough in red wine

The previously published research on the anti-aging benefits of this antioxidant, may have been misinterpreted, as new information has come to light.  But don’t be discouraged, for there is still a great deal of potential beneficial effects from this compound!

According to Jay H. Chung, M.D., Ph.D., chief of the Laboratory of Obesity and Aging Research at the NIH's National Heart, Lung, and Blood Institute, the now increasingly popular antioxidant Resveratrol found in certain plants, and also in red wine, may be useful in the treatment of Type 2 Diabetes and Alzheimer’s disease.

The researchers are now beginning to understand how Resveratrol works, after finding that by blocking a chemical called PDE4, Resveratrol triggers a series of reactions in a cell, one of which indirectly activates sirtuin 1, another chemical linked to aging.

Also, it has been recently published that the amount of the hype antioxidant in red wine may not be nearly enough for you to get the results shown in the lab research.  The tests have been done with 1 gram of Resveratrol, an amount found in no less than 60 bottles of red wine!

The consensus is that we still need more information on this promising antioxidant, and that the research that has been done to date comes from in vitro testing, which can be very different from animal or human models.